SIBO diet is a combination the SCD diets and low FODMAPs. This restrictive diet may help relieve more symptoms in some people. Read this post to learn more about SIBO diet and all the food categories.
How to Choose the Best SIBO Diet—Keto, AIP, Low FODMAP & Beyond
Let food be thy medicine…especially when it comes to your SIBO diet. Here’s an overview of the best diets for treating SIBO—Keto, AIP, low FODMAP included—and a 3-step approach for choosing the best SIBO diet for your individual needs.
SIBO, or small intestinal bacterial overgrowth, is a condition, affecting the small intestine, wherein bacteria that normally grow in other parts of the gut start growing in the small intestine.
The SIBO Symptoms
Common symptoms include:
- bloating after meals
- loose stools
- food intolerances
- nutrient deficiencies (like anemia, brittle nails and hair, pale skin, cold hands or feet).
However, it’s important to be aware that SIBO can also manifest as many non-gut-related symptoms (such as skin conditions, high cholesterol markers, poor immune function, allergies (seasonal), blood sugar or hormone imbalances, and a slow metabolism).
Because of this, SIBO often goes under the radar in traditional healthcare settings.
SIBO is currently diagnosed through both:
- An analysis of your signs and symptoms
- At-home breath testing
Currently, an at home lactulose or glucose breath test is the gold standard. Although its not perfect and some cases SIBO may still be missed, this test is the best measure for assessing whether or not you have abnormal amounts of hydrogen or methane gas in your body (related to abnormal growth of gut bacteria).
Stool testing, organic acids urine testing (OATS) and inflammatory blood markers are also helpful test tools that may contribute to your clinical picture. Under the guidance of a trained functional medicine provider or other knowledgable practitioner, you can better determine whether or not you have the condition.
5 Essentials for SIBO Treatment
So what to do if you’ve been diagnosed with SIBO?!
Successful SIBO treatment involves a five-pronged approach including:
1. Proper Diagnosis & Testing
Breath testing and/or working with a skilled clinician experienced in assessing and diagnosing SIBO.
2. Lifestyle Factors
Addressing stress and lifestyle factors to promote SIBO healing, such as getting enough sleep and proper exercise—not too much, but not too little.
3. Appropriate Supplementation & Anti-microbial Treatment
Beyond probiotics and pre-biotics, a supplement protocol and/or prescribed SIBO medication by your doctor that helps decrease the overgrowth of bacteria is essential. (Fun fact: studies show that herbal anti-microbial treatment can be just as effective, if not more, than prescription medications) (1).
4. Nutrient-Dense, SIBO-Reduction Diet
Foods that help decrease your SIBO symptoms, and support gut healing.
5. Re-testing & Reestablishing a Healthy Gut Flora
After SIBO is eradicated, a “plan of attack” to both re-assess if your treatment worked, and gameplan for adding back in a balance of healthy gut bacteria.
While there is NO one-size-fits-all treatment protocol for kicking SIBO to the curb, these 5 essentials are “non-negotiables” for kicking SIBO to the curb.
The best part?
SIBO healing and the remission of your symptoms is greatly within your own control!
In fact, there is no question that one of the greatest influences in your SIBO healing is what you are feeding your gut bugs (i.e. your SIBO diet). (In other words: You cannot supplement your way out of a poor diet).
Thus, a nutrition plan that works for your body’s unique needs is ESSENTIAL to not only feeling good, but helping your total SIBO protocol work for you.
SIBO Diet Recommendations
The 4 most popular dietary recommendations for treating SIBO are:
- The “Low Fermentation Diet”
- The Low FODMAP Diet
- Specific Carbohydrate Diet
- Elemental Diet
Generally, the Low-FODMAP, Low Fermentation and/or Specific Carbohydrate Diets have helped many people over the years improve their symptoms. Then you have the Elemental Diet—more of a “last resort” 2-week diet, consisting of drinking an elemental formula. Elemental formulas are pre-digested, easily absorbed forms of nutrients to help starve gut bacteria.
All four of these SIBO diets are very similar, however, in that they restrict carbohydrates—specifically“fermentable fibers” and sugars that your gut bacteria LOVE to feast on (i.e. carbohydrates).
While certain foods may be “allowed” on one program, but not the other, generally the top foods to eliminate include:
SIBO Diet Foods to Eliminate
- Grains (breads, pastas, rice)
- Starches (potato, sweet potato, yucca, taro)
- Beans, Soy & Peas
- Industrial Seed Oils (sunflower, grapeseed, cottonseed, soybean, canola)
- Dairy (cheese, milk)
- Sugar & Sweeteners (agave, honey, corn syrup, sweeteners)
- Cruciferous Veggies (cabbage, cauliflower, broccoli, brussels sprouts)
- Many fruits (apples, cherries, pears, bananas, watermelon, plums, nectarines, mangos, peach, pears)
- For some: Avocado, Coconut
The result? SIBO symptom relief from gut upset that typically happens when you eat a sweet potato, Brussels sprouts or quinoa—at least in the short term.
The Problem with SIBO Diet Recommendations
The research is still out as to whether these diets help people improve in the long term—particularly once you’ve started a SIBO treatment protocol (supplements or medication).
While all 3 SIBO diets are safe and can be helpful for gut issues like eliminating bloating, gas and IBS, a problem many people run into with these approaches is HOW and WHEN to reintroduce eliminated foods (if at all)—often discovering that their SIBO symptoms soon return when carbohydrates are allowed back in to the diet.
“Will I ever be able to eat broccoli (or rice, or sweet potatoes, or apples) again?!” They cry.
Unfortunately, long-term prebiotic fiber (carb) and FODMAP restriction can also backfire—since it not only decreases unhealthy bacteria, but healthy gut bacteria too.
So what should you do?!
Mix and match!
Here are 6 novel (no-long-term-restrictive) SIBO diet approaches for healing your gut (and SIBO) for good— taking the most effective strategies from various gut-healing diets, and forming them together—all in one.
The ultimate goal? Least restrictive diet as possible—all within the context of nutrient-dense foods of course (with the occasional Friday night pizza night if you must).
6 Non-Restrictive SIBO Diet Approaches
1. Start with Establishing a Real Food Base
Simply put: Eat real food—as close to its natural state as possible. If it didn’t grow on the land, roam the earth, or swim in the sea, it’s not real food. Real food includes:
- Meats, poultry and fish.
- Healthy fats.
- Veggies & Fruits
- Minimal starch
- No added sugar
- Lots of clean, filtered water
- Supporting local, responsible producers and organic as much as possible
2. Phase 1: Short-Term Low Carb Diet (14-30 Days)
Once you realize what “real food” is, you’re now ready to attack your SIBO diet in phases—starting with a lower carb or lower FODMAP reset.One consideration many people find short-term effectiveness from as a “therapeutic diet” is the ketogenic diet—a popular low carb (or “very low carb”) approach to eating that includes plenty of nutrient-dense healthy fats (ghee, coconut oil, coconut butter, olive oil, avocado, raw nuts/seeds), moderate amounts of organic protein, and 20-grams of “net carbs” or less per day.
Many people with SIBO symptoms, find that a short-term break from many of the gut-bacteria-feeding foods (i.e. carbs and sugars found in carbs) can be a great relief from their SIBO symptoms while they get their personal SIBO treatment protocol (supplement supports and lifestyle factors) in place.
Call it “keto,” “low carb,” or yes, “low FODMAP” or “specific carbohydrate diet.”
The bottom line here is to confirm that for a short term (2-4 weeks), going “low carb” can be effective.The key for the effectiveness of these “low carb” approaches however is to ensure you are eating ENOUGH.
A common roadblock SIBO sufferers run into is unwanted weight loss, low energy and frail health due to the malabsorption of nutrients and IBS symptoms. Hence, reason why a keto approach may be more effective for curbing SIBO symptoms (in lieu of just going “low FODMAP” or “low carb) is that the emphasis on healthy fats can help boost energy stores (given your gallbladder and liver are healthy and able to digest these fats in the first place). Check out the sample SIBO kickstart meal plan below for a sample day on a “short term” lower-carb phase.
3. Phase 2: Eat 1-2 Prebiotics Per Day
After your “short-term” reset, and once your full SIBO treatment protocol (i.e. supplement or medication digestive support) is underway, it’s crucial to also feed healthy gut bacteria—to make sure the good guys stick around while you kill off the overgrown “bad guys” Enter: prebiotics—fibers found in certain carbohydrates that “feed” beneficial gut bacteria.
Prebiotic foods include:
- Green-tipped bananas and plantains
- Cooked & cooled sweet potatoes/potatoes
- Cooked & cooled long-grain white rice, parboiled
- Cabbage (sauerkraut)
- Dandelion Greens
- Onions & Garlic
- Coconut/Coconut Flour
- Raw Manuka Honey
- Apple Cider Vinegar
- Soluble Fibers (cooked carrots, butternut squash, acorn squash, delicata squash, beets)
- Supplements (like Sunfiber or Glucomannan).
- Aim to incorporate 1-2 prebiotic based foods into your diet, as tolerated after your short-term low carb reset.
4. Inflammatory Considerations
Beyond just FODMAP and carbohydrate foods, consideration of other “gut inflammatory” foods that may contribute to your personal symptoms may be warranted—particularly these suspects:
- Dairy (cheese, yogurt, milk, etc.)
- Instant Coffee
- Nightshades (spices like chili and paprika, bellpepper, tomato sauce, tomatoes, eggplant)
If any of these are regular additions in your diet and your symptoms or SIBO is still present—particularly at the end of your SIBO treatment protocol, a short term 30-day AIP (autoimmune protocol) may help further support gut healing. This is especially true for individuals with “leaky gut.” In other words: There is more to SIBO eating than just “low FODMAP” foods, and broccoli may not be as big of a culprit as you’ve been made to believe.
5. Don’t Forget the Digestive Support!
Once you’ve established a real-food diet, with moderate carbohydrate introduction (prebiotic), and potentially the short-term elimination of any inflammatory foods you may suspect (like almonds, yogurt or hummus), adding in some “gut loving” support is the extra 1-2 punch to take your SIBO treatment to the next level.
If you’re working with a skilled practitioner, that individual should be able to help create and guide you through a custom SIBO protocol—established specifically for you—with pharmaceutical-grade, high-quality formulas that can support not only gut health, but the elimination of overgrown gut bacteria.Here are a few top general recommendations:
- Antimicrobial Support: Dysbiocide + FC Cidal from Biotics
- Biofilm Disruptor: Interfase Plus
- Soil-Based Probiotic
- Prebiotic (Partially Hydrolyzed Guar Gum)
General Digestive Support
Liver/Gallbladder Support (for digesting healthy fats)
- Beta TCP by Biotics
- Beta Plus (if no gallbladder)
Follow your practitioner’s instructions as to how long to be on your personal SIBO protocol. Treatment length will depend on the severity of your SIBO, typically ranging 30-90 days. During your SIBO protocol, it is imperative you stick as closely to real food as possible—particularly limiting the Western diet influences of wheat, conventional dairy, sugar/sweeteners, industrial seed oils, corn and soy.
However, as noted earlier, sticking to a strict low carb or low FODMAP diet is not advised for the longevity of your SIBO diet plan—given your symptoms are not severe when you do eat a little bit of prebiotic fiber or grass-fed, fermented yogurt.
There is NO one-size-fits-all approach to the ideal SIBO diet, but as your treatment plan ensues during Phase 2, the “least restrictive as possible” approach tends to work best for people’s sanity and relationship with the healing process.To “reintroduce” foods that you may have eliminated during your Phase 1 or “Anti-inflammatory” food considerations, reintroduce foods 1 food at a time in this fashion:
Day 1 Re-introduction: Eat a small portion of the food alone (2-3 bites).
Day 2 Re-introduction: Eat a little bit more of a portion/a serving of the food, alone.
And, Day 3 Re-introduction: Add the food in alongside a meal or appropriate pairing foods.
If symptoms are noted during reintroduction, it may mean your body is not ready yet for it, or it is simply an inflammatory food for you.
SIBO Diet Sample Meal Plans
Phase 1: Low Carb SIBO Diet (7-21 Days)
- 16 oz. Warm Lemon Water
- Apple Cider Vinegar shot
- Turkey Sausage (4-6 oz.)
- 1/2 Avocado
- Sauteed Greens & Bell Peppers in Coconut oil
- Mixed Greens
- Chicken Breast
- 2 Tbsp. Paleo Cesar Dressing
- Pastured Strip of Bacon or Turkey Bacon (bits)
- Mixed Veggies: Roasted Carrots, Cucumbers, Cherry Tomatoes
- Baked Wild Salmon
- Rainbow Chard sautéed in Ghee
- Roasted Yellow & Zucchini Squash, drizzled in avocado oil
- Handful Macadamia Nuts
Phase 2: Real-Food, Nutrient Dense, Anti-Inflammatory SIBO Diet (30-90 Days, during supplement protocol)
- 16 oz. Warm Lemon Water
- Apple Cider Vinegar shot
Lite Coconut Milk (watered down for smoother consistency)
Beef Isolate Protein Powder
- 1 Tbsp. Sun-butter
- Coconut Flakes
- Greens or Greens Powder https://amzn.to/2NGjE5R
- Chicken Salad with Avocado Mayo
- Pickled Cucumbers
- Roasted Carrot “Fries”
- Ground Bison “Tacos” (Turmeric, Oregano, Sea Salt, Garlic, Onion Seasoning)
- Roasted Summer Squash
- Collard Green Wrap
- 1 Cup Bone Broth
- Eating Evolved 100% Dark Chocolate Square
Customize Your SIBO Healing
Want your own custom SIBO diet plan and supplement protocol? Contact Dr. Lauryn to get started to feeling really good. Inside and out.
1. Chedid, V., Dhalla, S., Clarke, J. O., Roland, B. C., Dunbar, K. B., Koh, J., … Mullin, G. E. (2014). Herbal Therapy Is Equivalent to Rifaximin for the Treatment of Small Intestinal Bacterial Overgrowth. Global Advances in Health and Medicine, 3(3), 16–24. http://doi.org/10.7453/gahmj.2014.019; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/