Over the last year I have been experimenting with several diets to help deal with SIBO – the Specific Carbohydrate Diet (SCD), the Low FODMAP diet, the Paleo diet and the Paleo Autoimmune Protocol (AIP).   I have also recently been working on the SIBO Food Guide app and I got to do a lot of research into all of these crazy diets. The app gives the legal/illegal status for each of these diets along with FODMAP ranking of foods with serving sizes where appropriate.  The app should be available by the end of the month.

The main thing all these diets have in common is that they are about the opposite of my old vegan/vegetarian and part-time pescatarian diets, they are all low-carb and high animal protein diets.   Since finding out I was gluten and casein intolerant early in the year I had to give up my old diet of mostly rice, beans and veggies and move to a no grain, no dairy, no bean diet.  This is the cornerstone of Paleo and AIP, eat only foods that were available before agriculture.  SCD and low FODMAP do allow dairy and some legumes but with my SIBO being what it is that wasn’t really possible.

I started out on SCD in January and made the mistake of jumping right into the middle of it instead of really doing the Intro and working my way up through the stages properly.   This changed in March when I began working with Dr. Christine Bowen, ND and she got me back to basics on SCD.  SCD was designed for Inflammatory Bowel Disease, IBD, and not really for SIBO so a lot of the “standard” SCD foods actually messed me up big-time.  This included applesauce, pear sauce, SCD almond milk yogurt and a few veggies usually recommended in Phase 1 like butternut squash.  These were bad because they end were actually highly fermentable foods which contraindicated them for SIBO.  Obviously SCD alone was not going to do it for me.

Enter the SIBO Specific Food Guide.  This “diet” was developed by Dr. Allison Siebecker, ND of the SIBO Center and combines SCD and the Low FODMAP diet, the idea being to cut out or limit the most fermentable foods in SCD.   FODMAPs give most people with SIBO trouble.  FODMAP stands for Fermentable Oligo-, Di-, Mono-saccharides, and Polyols.   This includes most short-chain carbohydrates, fructose,  fructans, disaccharides, galactans and polyols.   Unfortunately this cuts out a lot of foods including very common ingredients like onions and garlic and limits a lot of vegetables to small amounts.    I found that if I stuck to the green column of low FODMAP foods I could greatly reduce my symptoms and over time I was able to start eating some foods in the yellow or orange columns as long as I paid attention to the amounts and didn’t inadvertently mix several foods with the same FODMAP type in a single meal.

In the summer when I began having some weird autoimmune symptoms on top of the SIBO symptoms I had to take another look at my diet and find out what the triggers were that caused inflammation and symptoms.   This led me to look closer at the AIP diet which is probably the least inflammatory diet out there.   To move to AIP I gave up nightshades, eggs and nuts but added in coconut products which I could finally handle again.   Nightshades obviously gave me symptoms, if I eat them more than 1 day in a row I start feeling it.   Eggs are the hard one for me and I still need to get this tested again to see where I really fall on an allergy, I was borderline when tested in January.   Nuts were OK to give up since I could add in coconut, it is a better source of fat with no phytic acid to deal with.   I do  have to stick to a low FODMAP version of AIP though which limits an already limited diet quite a bit but it is currently working for me but luckily most AIP cookbooks have low FODMAP substitutions.

There are other diets that are used for SIBO too which I haven’t even bothered with because they just seem less healthy than the SIBO diet or low FODMAP AIP.  The Cedar Sinai Diet and the FastTract Diet both allow white rice, white bread, white potatoes, table sugar and other foods that I wouldn’t really want to eat even if I could.   The idea behind these is to eat foods that are digested as high up in the GI tract as possible which makes sense but to me they look like a good way to have a carb crash a few hours after you eat.

I actually eat pretty darn well and probably the cleanest food around.  The bulk of my food even comes from the Snoqualmie Valley.  We have done CSA with Sol to Seed and Jubilee both this year plus buy locally from Oxbow and other small organic farms in the valley along with growing some of our own vegetables.  Proteins include grass-fed beef from Jubilee Biodynamic Farm,  grass-fed lamb, pastured poultry from Bright Ide Acres, pastured pork from a friend’s small farm, Great Lakes grass-fed gelatin, some wild game supplied by a friend, wild salmon, wild sardines, wild halibut and trout/steelhead that I supply.  For fats I eat a lot of Ancient Organics ghee (my only dairy and technically not AIP), Tropical Traditions coconut and palm oil,  plus some avocado and olive oil.   I am trying to limit my fruit but can eat strawberries, tangerines, bananas, oranges, lemons and limes.  My vegetable list has grown from nothing but pureed carrots to carrots, green beans (a semi-suspect ingredient for AIP), kale, chard, collard greens, summer squash, winter squash, celery root, parsnips, fennel, radishes, olives, scallions and avocados.  I even had a bit of sweet potato recently that seemed to be OK.  I make my own coconut milk from shredded coconut, getting Tropical Traditions when I can since they seem to be the best quality.