Knowing what to eat when treating SIBO can be daunting and confusing and finding the ‘right’ diet for you can take time. In today’s episode of The Healthy Gut podcast, Rebecca Coomes is joined by nutritionist Kristy Regan to talk all about what foods we should, and shouldn’t, be eating while treating SIBO.
In Episode 11 of The Healthy Gut Podcast, we discuss:
✓ Understanding the different diets for SIBO and how you can find one that works for you
✓ Managing multiple food intolerances – how you can start experimenting with food when you react to everything
✓ Kristy’s big no-nos when it comes to food
✓ Easy strategies for when you feel completely overwhelmed by food
✓ The link between IBDs and SIBO
✓ Whether to starve or feed the SIBO bacteria
✓ How to eat when you have multiple, sometimes contradictory, conditions
Kristy Regan, of Vital Food Therapeutics, combines nutritional therapies, lifestyle education and counselling to assist her clients in achieving optimal health and well-being. Having personal experience with a debilitating illness she appreciates how nutrition and wellness therapies support us in healing.
While obtaining her Master’s of Science in Nutrition, Kristy completed a year-long internship with Dr. Sanberg-Lewis, a co-founder of the SIBO center. Kristy is currently working with Dr. Siebecker, the other co-founder of the SIBO Center, to format Dr. Siebecker’s newest version of the SIBO Specific Food Guide.
Kristy is available for nutrition and wellness appointments via Skype or in-person in the Portland area at 8 Hearts Health & Wellness & Rose Cabinet Medicine. www.vitalfoodtherapeutics.com
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Rebecca Coomes is an author, entrepreneur, passionate foodie and intrepid traveller. She transformed her health after a lifetime of chronic illness, and today guides others on their own path to wellness. She is the founder of The Healthy Gut, a platform where people can learn about gut health and how it is important for a healthy mind and body and coaches people on how to live well with SIBO. Rebecca is the author of the world’s first cookbooks for people treating Small Intestinal Bacterial Overgrowth (SIBO) and the host of the SIBO cooking show and The Healthy Gut podcast.
REBECCA: Today’s guest, Kristy Regan of Vital food therapeutics combines nutritional therapies, lifestyle education and counseling to assist her clients in achieving health and wellbeing. Having personal experience with a debilitating illness, she appreciates how nutrition and wellness therapies support us in healing. While obtaining her masters of Science in Nutrition Kristy completed a year internship with Dr. Samberg Lewis, a co-founder of the SIBO center. Kristy is currently working with Dr. Siebecker, the other co-founder of the SIBO center to format Dr. Siebecker’s newest version of the SIBO specific food guide. Kristy it is so wonderful to have you one the Healthy Gut podcast with me today.
KRISTY: thank you. Thank you for having me.
REBECCA: My pleasure and we actually got to meet in Portland when I headed over to the States for the SIBO symposium and I met you even before the symposium started at this wonderful pop-up SIBO dinner and that was so much fun. And I got to taste some of your gorgeous food too.
[1:14] KRISTY: it was so great to have you there. It was such a pleasure that you were able to make it on kind of last minute notice.
[1:22] REBECCA: yeah it was great. Here I was flying into the States I knew nobody and I was coming to Portland, a town that I have never been to before and then suddenly there is this dinner and I am going to it and it was just gorgeous. I met such lovely people there and it was such a fun night and a balmy summer’s evening and here I was coming straight from Australia from the depths of winter. It was just a gorgeous hospitality. So I had a wonderful time.
[1:51] KRISTY: great yeah. It was a really great night. I feel like people with SIBO should have more of that where they can go out and eat with friends and be in a comfortable environment where they felt safe with what they are eating.
[2:05] REBECCA: Exactly. That was the great thing with it. I knew that I could eat freely off the menu because everything was SIBO friendly and everyone there had a common interest. We either had SIBO or people were interested in supporting people with SIBO. So it was a glorious night. So hopefully there’s more pop-up dinners around the world for people with SIBO just like that one because it was so fun.
Now, I’ve got you on the show today because one of the biggest topics for anyone treating SIBO is around their food and nutrition and that scenario that you specialize in, so I would love to talk about how you came to be in the position that you are in today where you are working with people around their food and their nutrition to help them get well again.
[2:56] KRISTY: so I decided to do a career change and go back to school and while I was taking some of my medical prerequisites I was diagnosed with SIBO back in 2012. And I ended up going to school in Portland and I met Dr. Samberg Lewis. He was actually my doctor and helped guide me through SIBO along with a team of wonderful people and as I got my masters in nutrition it just made sense for me to focus on helping people with SIBO because I had been through it and I knew how isolating it and frustrating it was. So I created an internship with Dr. Samberg Lewis while I was getting my masters and I was lucky enough to be able to learn a lot from him and I continued to learn a lot from local doctors. Portland is a little about SIBO town if you will. So that really helps me learn a lot to offer my clients.
[4:10] REBECCA: It’s such a fascinating little sort of hotspot for digestive health Portland and there are some incredible physicians and practitioners in Portland who are all working towards trying to help people live a better life with SIBO. So I would love to live there.
[4:34] KRISTY: The only thing I don’t like is the weather. But the people and the food are great.
REBECCA: Exactly. So talk to me about your SIBO journey. Do you still have SIBO or have you been able to get rid of it?
[4:50] KRISTY: I think I am part of the 2/3 cases where there are some long term issues. So I am the harder case but I have really high hydrogen gas around 150 and had a ton of anxiety and physical symptoms and that is definitely in my rearview mirror but I still have some residual pieces that I work with.
[5:25] REBECCA: And it is such a common story whereby people are left with dealing with sort of a longer term if you will chronic illness. It just doesn’t seem to be for most people a quick fix when you start treating SIBO
[5:44] KRISTY: Right and I mean I think part of our knowledge is still just in the beginning phase. I mean it’s though this has been around in some form or other for many many years like Dr. Siebecker talks about I think the focus of it of not just saying, “Oh you have IBS symptoms and go home and don’t stress out so much.” You know it’s no longer that. Now we are looking at longer term, people getting better but I still feel like it’s in its infancy.
[6:20] REBECCA: So do I and I am sure in 5 years, 10 years, 20 years, we will look back at this period and think, “Oh we just knew nothing because our science would have evolved and our research would have evolved.” And we really are kind of working with what we can right now. And one of those things that we can work with and that I know that people feel that they can have some control of is their food and their nutrition. It is so important in the treatment of SIBO. And I just like to talk a little bit about your own journey. How did you manage your food and nutrition with your SIBO and how much of an impact did that have on sort of progressing you through your condition?
[7:06] KRISTY: Well I started out on the advice of my first doctor in Northern California. I started out on the specific carbohydrate diet and it’s not actually meant for SIBO. It wasn’t created for SIBO. So it did help me in some ways but in some ways it didn’t address my needs at all and I think I was still reacting to a lot of high FODMAP foods that aren’t taken out on the specific carbohydrate diet. So once I moved to Portland and started seeing Dr. Samberg Lewis, I transferred over to Dr. Siebecker’s SIBO specific diet and that definitely helped my symptoms but I also you know having been on a strict diet for so long and also being someone who really loves going food, it was really challenging for me to cut so many things out and still figure out how to have beautiful food and eat with friends and feel comfortable going out. And so that is an area that I really love help people with as much as possible because it is a hard place to be.
[8:29] REBECCA: it is and food should be joyous and wonderful and it can become such stressful anxiety filled thing that we have to do every day. And I think you are experiencing your own experience with being limited with food, loving food, I think must be so good for the clients that you work with. Who are the types of people that you see?
[8:56] KRISTY: I mostly see SIBO clients. I have a little couple other clients but mostly SIBO folks and that are referred by doctors in my area. But I also see people over Skype across the country or earth. So it’s mostly people who are looking for help, widening their diets or trying to figure out what they are reacting to in their diet, people that are looking for new recipes, or maybe don’t even like cooking but need to figure out how they can have food around and nourish themselves and take care of themselves and I think a lot of people that feel overwhelmed with all the changes and want someone to know what is going on with them and on their side to really kind of help them through the process.
[10:01] REBECCA: this condition can feel so isolating I think especially if you are the only person that you know that has digestive problems or SIBO and when you look around and everyone else around you seems to be fine and they are eating burgers and fries and food that we just can’t touch normally and they don’t seem to have a problem and that can feel really unfair.
[10:28] KRISTY: yeah and I think there are… maybe a lot of other people do have problems but they you know haven’t really kind of faced up to them yet. You know there is a pretty high percentage of people that have IBS symptoms and then a lot of those people have SIBO but it’s not named as SIBO yet and it’s really hard to be the one on a more restrictive diet and get questioned from other people or be told things like “Oh if I can’t have a croissant I would just die.”
Yeah, I agree but it’s also I think the flipside of that and I think you have said this is your kind of introduced to this other way of eating that can really help you feel better and start managing your symptoms more and put you in a better place with your blood sugar possibly. I mean there’s all these kind of friends’ benefits. I mean no one would ask to have SIBO. No one would ask to have a vast change to their diet and yet there possible are some good things that come out of it.
[11:47] REBECCA: yeah definitely. I look at my own journey and think, wow two years ago when I was at the lowest I had ever been and I was desperately seeking answers as to why I felt sick. I wanted to know what it was but I don’t know that I necessarily wanted all of the changes that were about to unfold in my life. But now when I look back with the great thing called hindsight I realized it was the best thing possible for me. It just didn’t feel like it at the time. I am so much healthier now.
And other things like you says is interesting that you raised, other things have happened that I just didn’t really think too much about previously and it was about my blood sugar. So I used to get terrible crashes and I‘d get the hangry – the hunger plus angry when I haven’t eaten. I couldn’t go for long periods without food because I would just get really shaky. I would literally go from one minute bang I am absolutely fine to the next minute like feeling like I needed to fall over because I just have a dramatic drop I n my blood sugar. And then as soon as I took out the carbohydrate and sugar rich foods and I moved to a completely natural way of eating all of that stopped. And I had thought, “Ok there is a connection with my food here. But I hadn’t really dove too deeply into it. And then other things like headaches, joint pain… I used to have some strange symptoms, skins rashes. None of that occurs anymore.
So there’s great positives from changing my diet as hard as it has been.
[13:33] KRISTY: yeah, I mean it’s really wonderful to hear people have a transformation like that when things that were kind of once normal at some point like, “Oh I just have joint pain all the time. I just have these rashes and it’s like…” well it’s also possible not to have them and that normal can be shifted to a healthier place. And often it does take time.
[14:02] REBECCA: Yeah exactly. I used to say, “I’m just one of those people that just has to eat every 2 to 3 hours.” and for some people that is their case. For me, no it was just that the fuel I was putting on my body wasn’t sustaining me long enough and now if I want to I can go for several hours without food and I don’t get any of those awful symptoms anymore. I just feel like I haven’t eaten for a while so it’s a nice change. It’s nice for my friends and family as well. They don’t have to deal with hangry Rebecca.
[14:34] REBECCA: I would love to talk around the different types of diet protocols that there are that people follow when it comes to SIBO and this is such a topic of confusion and debate and I would love to go through what each diet type is and then why someone would use it?
[14:50] KRISTY: So we’ve got things like the SIBO specific diet, the specific carbohydrate diet, the low FODMAPs, autoimmune protocol, there’s Dr. Nirala Jacobi’s SIBO biphasic diet which is used here in Australia which is what I use to great success. Can you talk me through around what are those different types and when and why would you use them?
[15:15] REBECCA: Sure, except you can probably talk better about Dr. Nirala’s than I can.
REBECCA: I can.
KRISTY: I know that you are an expert on that which is great. So low FODMAP, FODMAP is fermentable oligosaccharide, disaccharide, monosaccharide and poliols. So these are foods that can ferment and be eaten by the bacteria which is normally, it’s normally good part of a bodily process and totally normal to eat these foods. These aren’t bad foods but when you have SIBO, then you have an overgrowth in the wrong place. It’s a location issue. So you often react to FODMAP foods. I like the Monash University list because they do so much research and they have the app that is updated all the time. so I think that is great and then the specific carbohydrate diet and that’s what I mentioned before that I started on, that’s… a lot of people with different digestive issues use that diet and the thing I will personally don’t like about SCD or the specific carbohydrate diet is the fanatical compliance piece. And I really recommend my clients that you test foods and that some people will do well with certain foods and some people will be ok with different foods and it’s good to test and build up. And it’s going to start with the general structure but it’s really meant to be a tool. At least for those people with SIBO because they can’t tolerate different things.
But SCD tends to look at polysaccharides and exclude those. And then the SIBO specific diet puts SCD and low FODMAP together and that is Dr. Siebecker’s diet and additionally in her next version that she is going to put out, it has also included a lot of her clinical experience and so that I think is fantastic since she sees so many patients and is able to impart that information to people.
And a lot of the people I see are on the SIBO specific diet or some form of that. And just again it is more restrictive for this SCD and low FODMAP together. So it’s more restrictive but it can also be kind of a better starting place and it’s just meant to be a guide. So you know it has like the far left green column which is foods that tend to cause less symptoms in people but the columns further to the right, those could still be tested. But there are things that might cause some symptoms on people. And then the autoimmune protocol diet is helpful for people that have autoimmune issues, diseases like celiac. And that can be combined with a SIBO specific diet. And that’s where it can be helpful but then you know people can, it can also feel more restrictive so that’s where testing again is really important.
And then diets can be further structured when someone is vegetarian or they have histamine issues or what have you. I think that the diets are good places to start and not a good place to end. It’s not meant to be and ending point. It’s just meant to be a starting point and a tool.
[19:38] REBECCA: And how do you… what is your advice to someone that’s listening to this podcast who is trying to work out which is the best diet for them? What would you say to them in terms of starting somewhere?
[19:53] KRISTY: Well if they know some foods that they already know they don’t tolerate, that might give them some clues as far as if those are high FODMAP foods or not. That kind of thing. Depending if somebody is kind of in a flare where they are having a lot of symptoms like a lot of diarrhea, a lot of constipation. That type of thing. It is nice to do like a three day intro diet where you are really trying to calm the system and this is like very general. So with my clients, I talk to them very specifically knowing their medical history but in general, most people do better with meat. So starting an introduction diet with meat, with polysaccharide free bone broth. If they do well with bone broth in general and then maybe like A vegetable like carrots that they know they do well with. And sticking with that for 1 to 3 days until the system has calmed a little bit and then adding food in.
[21:18] REBECCA: and how should people add food in? This is something I hear form a lot of people who are down to about 5 foods and they are feeling pretty miserable. How do you work with your clients on how to get them to stop broadening the foods that they can tolerate and can eat?
[21:35] KRISTY: I mean it’s very challenging and when people are starting to cut out more foods in their diet, I really recommend that first they try to kind of fight that as much as possible. And some people will have some symptoms and having a symptom like great it’s not comfortable but you kind of have to manage your symptoms with your nutrition. So you don’t want to get to a point of being underweight or just having a couple of foods that you can eat because then you might even become sensitive to just hose foods. So you really want to focus on keeping your diet as wide as possible and you know and managing your symptoms but knowing that if you have SIBO you may still have symptoms.
So if you are already to a place of only having a few items in your diet, part of it depends on you know if you are underweight or not. For people that are underweight, I generally recommend trying like a quarter cup of rice and not…. Just cooked rice so it’s not cooked in refrigerated and then introduced again because you don’t want it to be a resistant starch. So fresh cooked white rice about a fourth cup to test that because for your carb intake. Or peeled white cooked potato and those are two that are actually not on the diets but they tend to be higher glycemic so they don’t stick around and ferment and I generally recommend eating them with the healthy fats. So that’s pea, or butter or coconut oil or olive oil depending on what people tolerate.
So to really put that fat and carb combination in there for weight gain as needed and to introduce things one at a time, and it really depends on the person and kind of what kind of state they are in as far as how many things can be introduced and how quickly.
[24:12] REBECCA: and how long generally, and this is very general and every person is so unique but how long generally does it take to introduce one new food. Should it take you a few days or a week? Like what kind of timeframe are we looking?
[24:27] KRISTY: I think with people with SIBO, I generally say test the food and then wait 2 days. And some people will say longer but I feel like a lot of people with SIBO are in a sensitive enough state that they see a reaction pretty quickly. Either they have a reaction like you know they feel noxious, they have bowel grumbling, that kind of thing. And so it is pretty immediate or they can see a change in like the next day in their bowel movements or even that same day.
[25:09] REBECCA: do you need to sort of test and retest to make sure that food is ok or do you just eat it once and then if everything has been ok you can reintroduce it?
[25:21] KRISTY: I think if you eat it once and you get a symptom then you know to take it out and then if you do ok then I recommend trying a little bit more. And sticking within your diet that you are on as far as the amount so like for instance butternut squash, it’s a 1/4 cup for the SIBO specific diet or low FODMAPS also I believe. So I would test less than that to start and then go up to a 1/4 cup max. And so kind of adding until you get up to the amount that is right for you.
[26:06] REBECCA: Yeah and I think that’s really good advice that you just kind of keep testing. I know with myself, I tested foods throughout my journey and there were some foods that in the early days I could not tolerate. Pumpkin was one of them or squash. I just couldn’t eat it without having quite a strong reaction. But then at the 6th month mark, I was fine. I was absolutely fine. So do you work with your clients around testing food and then retesting it later on to see if they can tolerate it later down the track?
[26:42] KRISTY: Definitely. I think that is so important because as we start healing different things going to… we are going to react different to them and I think it’s really important to not say like, “Oh I can never have pumpkin again!” because it’s just not true. Whether it’s a food sensitivity issue because those will change if you have leaky gut or if it’s an issue maybe the first you had pumpkin you also had butternut squash the night before and so it’s just too much squashed together. That kind of thing and that is also why I tell people to keep a food diary. Not forever but for a little while at least hopefully in the beginning. That can be really helpful for people too.
[27:34] REBECCA: it can. Definitely. And one thing that I just want to touch on is around the symptoms and I am wondering if all symptoms are created equal. We are hyper aware of our symptoms when we have SIBO. We are so focused inward. How do we feel? Am I going to the toilet? Am I bloating? Am I in pain? And I am wondering if we become hyper aware to the body’s response to a new food and whether it necessarily is a negative reaction or it’s just it’s a reaction because it’s a new food. Do you work with your clients around identifying ok well that’s just normal that is something that your body didn’t really like? Like what is the spectrum of symptoms that we should be thinking about when it comes to reintroduction of food?
[28:22] KRISTY: that is a great point because yes…the answer is yes. So I think it is kind of important to kind of ascertain you know what kind of symptoms is normal versus something that is definitely bothering you. And then other piece to that is anxiety and fear which anyone who has SIBO is on these one of these diets. It’s really easy to kind of gain some disorder to eating patterns and it’s something that I mean I think we’d all have to be aware of that we are on this restrictive diet and yet we also have to find ways to eat present, to have really positive food experiences and keep our diets wider so that we don’t kind of get stuck into this place of fear and anxiety all the time around food.
[29:26] REBECCA: I hear from people all the time around disordered eating and people that have potentially suffered from eating disorders in the past then they get diagnosed with SIBO and there’s a lot of fear and anxiety that going back into restricted eating is going to trigger their eating disorder and I myself suffered from bulimia when I was younger and I remember at that time that my SIBO diet started that I thought, “Oh this could be a trigger. I might have to be really mindful of how I cope mentally with this diet because this could be slippery slope for me.” I had to be very conscious and it didn’t become one and I think because I was conscious of it potentially doing that it didn’t. But I looked for signs within myself that I didn’t want to go there again.
[30:25] KRISTY: yeah. It’s such a big deal. I mean especially having it already in your life. I mean I applaud you for the mindfulness because I think that is a huge part of having SIBO or any illness. Whether it’s around eating or just around being ill is the ability to be present in our lives and find gratitude even when things are hard and finding ways to be present continually.
[31:02] REBECCA: Definitely. And that’s one of the 5 key pillars to health that I realized I had to deal with when I was getting well and there’s that whole piece on mindset and also awareness that you need to be really monitoring how you are thinking and feeling and also just to have presence.
The flipsides of starting you SIBO diet is when you’ve got your all clear and I know I suffered from quite a bit of anxiety and I know I am not along with this. ,when I could start to open my diet up, I felt security and safety within my very limited foods and when my naturopath said to me, “ Rebecca its time for us to start reintroducing other foods, testing them, broadening your diet, your bacteria…. Your numbers are down. Let’s get you back to eating as normally as we can.” it did take me some time to get my head around that. How do you work with your client around that phase of their treatment?
[32:05] KRISTY: Well I think that is a very normal place to be because it’s like you know you never want to go back to feeling the way that you felt before. And yet like your doctor said… I mean your body needs a variety of foods so it is really important to expand your diet and so depending on someone’s sensitivities, I recommend testing specific types of FODMAPS. So there are foods that have specifically like only sorbitol in it as a high FODMAP or only Mannitol in it as a high FODMAP.
So for people that are more sensitive, I recommend testing specifically that way and then you can see kind of what group of foods you know you do better with. And to add those… And so that should help from a psychological perspective of… like I know I do ok with fructose, I am going to go ahead and test this group of foods and add them in as I do well with them and with that feels a little bit safer and your broadening your diet.
[33:21] REBECCA: I think that is fantastic advice and it definitely to me it doesn’t seem so overwhelming when you can be more narrow in your approach of the foods that you reintroduce.
KRISTY: Yeah exactly.
REBECCA: I was just going to say, we’ve talked about those that are underweight but as with SIBO there’s both sides of the coin. There’s also those people like myself who struggle to lose weight who have gained quite significant weight in some instances with this condition, how do you work with them to help bring the excess weight down when they feel like all they are doing is gaining?
[34:03] KRISTY: It’s interesting like I kind of dealt with both sides of that coin myself when my hydrogen was at its highest. I lost a lot of weight and I have never been unnaturally thin person. And it’s scary to lose that much weight and then on the other side, when your motility is slower and you are working with that piece, it’s frustrating when you are not eating that much and you know or the food you are eating is very healthy and it’s still isn’t working the way you want. I mean I think it’s important for everyone to be on a prokinetic and I think most doctors know that now that they are prescribing a prokinetic after someone has gone through the rounds of antibiotics or the treatment and are SIBO free. And also you know I think it’s scientifically proven that high carb, high fat diet tends to be the one that helps people gain the most weight. And so when you go lower carb and higher fat then that can help… unhealthy fats I mean, and that can help people lose weight but I think it needs to be done very judiciously and with exercise and with a prokinetic and really seeing what works for that person.
And you know there’s different options for different people but I think it should be done very consciously and very healthy because you also have to understand that you are still healing and you really want that to be your priority.
[36:07] REBECCA: definitely. And we can get so caught up in wanting to attain the perfect figure, the perfect weight, and I had to really sort of change my thinking and this has all occurred through my SIBO journey. Rather than worrying about what the scales were saying to me, I looked at it that my body was still not working optimally because it was still carrying weight. It was still saying, “Hey I am not coping. My mechanisms, my processes still aren’t working properly.” and so I shifted my mindset of, “Ok I am still not… I haven’t achieved my health goals yet. So keep working Rebecca.”
[36:55] KRISTY: Great. Yeah. And I mean weight gain and inflammation are very closely linked. So I think that is an important piece to also look at as far as foods we are eating. Do we still have SIBO? Is there a different autoimmune piece or what is it because like you mentioned before, it’s often kind of a web and you have to pull it apart a bit and for many people it takes some time.
[37:28] REBECCA: it does. And I look at my own journey and SIBO really has been the tip of the iceberg. I already knew I had endometriosis but when I was diagnosed with SIBO then not long after that I was diagnosed with hemochromatosis where my system thinks I don’t have enough iron and it stores too much. Although very interestingly since getting rid of my SIBO, my iron saturation has gone back to normal which is fascinating because it just shows how interconnected other conditions are with the help of our gut. And now I am looking at, “Am I having some issues with insulin?” so I know that i feel so much better now that I am on a lower carbohydrate almost no sugar other than a bit of fruit diet. And I am starting to see some weight come off slowly. But it is frustrating. And either end of the spectrum either underweight or overweight, it’s frustrating especially when you are not eating a lot and you feel that people are judging you because you loo a certain way and it’s not your fault necessarily. It’s not because you are actively trying to do that. It’s just that your system is saying, “I am really not coping right now.”
[38:47] KRISTY: Right. And I mean it’s hard. I mean people will say the craziest things to you. But I think that is where it is important to have a community of support whether that is a group of friends or people that have SIBO and even your padre or doctor, nutritionist, whoever it is, it is important to have kind of a variety of support systems.
[39:20] REBECCA: it is and finding people that can and are willing to go on a journey with you is important, I look at my naturopath and she and I are doing this together. So she is very much on my team and part of my team and I have a personal trainer that I work with and a psychologist that I work with. And I see them as my support team. But my naturopath and I are sort of on this journey were we are looking for what is going wrong in my body to prevent it from allowing the fat cells to be released to shift fat because we have done some body composition testing and we can see that I am carrying a reasonable amount of excess fat on my system. It’s not just I am naturally heavy on the scales. So it’s great because I know that she is thinking about it. She is researching. She is looking into possible conditions that are causing this and we are constantly moving forward and trying to find a solution which is great because I had her support and I didn’t have the support of medical practitioners for a long time. So it is really nice to finally have someone that I know believes me.
[40:38] KRISTY: I think that is huge and I mean what you said about you know kind of looking at the different pieces. I mean I always want practitioners who are very very curious you know. That really… I am like, “Why is that happening?” and they don’t need to know necessarily at the beginning. They need to want to know and want to explore it and really be on your side. I feel like someone who is interested and your story and your condition and curios that that’s…. it’s just so important whether it’s a doctor that knows a ton about SIBO or someone who knows something about SIBO but very tenured doctor and confident for a long time. Like you said too, you have a team of people and I think it’s important to find that when one has kind of multiple conditions or a bigger picture.
[41:45] REBECCA: Definitely. I really love what you just said there having someone that is curious and I think that is the real take home message that if you are seeing a practitioner and they are not curious and they don’t want to know, they are probably not the right practitioner for you. My naturopath doesn’t know everything about everything but she is curious in what is happening in my body and she wants to find the solutions and if she is not the right person for me, I have great confidence that she would say, “I think you should go and see this person because he’s got expertise in this area.” But she is so curious and constantly learning and it’s great to be under her care.
I would just like to back track slightly and just talk about we covered off the types of different diets you can use when it comes to treating SIBO. Is there one diet protocol that you think is the best when it comes to treating SIBO?
[42:42] KRISTY: Well, I think it depends on someone’s individual health picture. A lot of people that I see are on the SIBO specific diet because it combines SCD and low FODMAPs. So it tends to cut out a lot of things that tend to bother many people. I mean that said again, I really believe in tailoring the diet to the specific person. And I mean I might start with the SIBO specific diet but if someone has an autoimmune issue or what have you specifically have histamine intolerance, something like that, then we just continue to tailor it.
[43:33] REBECCA: and I think that it’s very human nature of us to want something that we can just rinse and repeat that we can follow and just follow it to the letter. But I think a real take away message here is that we do need to play private investigator really into our own bodies and what our bodies can tolerate and find the foods that work for us and use those diet protocols as a guide rather than as black and white.
[44:08] KRISTY: Yes, I’d be very critical of any person or thing that said, “This is the exact right diet for you.” Because I don’t think there is one exact right diet for anybody that no matter the illness it is person specific. Some people do really well with meat. Some people do well without meat as long as they are getting protein. I mean it’s such a hard place to be because we really so much want an answer. So it’s so hard to hear like, “Mmmm you have to test.” But the beautiful thing about is that kind of like side benefit after we get out of the worst of it is that we become our own advocates and become experts on ourselves and when the anxiety lessens and we don’t feel like we have to be hyper vigilant all the time. But still we know ourselves. I mean that can be just a wonderful skill to have. I mean I know for myself I kind of came from a background of wanting to be a little bit divorced from some of the symptoms I was having like, “Oh that is not really a big deal.” And then getting to a point where I learned more and more about myself and started to have an inner authority of what felt right to me and I feel like a skill that really permeates my life of being able to know myself and stand up for myself and pick people in my life who will support me.
[45:53] REBECCA: wonderful. That’s so good to hear you and it is definitely I think part of the journey and I feel very similar to that. What are your thoughts on feeding versus starving the bacteria when you are on active treatment? There is so much discussion and debate amongst people that are treating SIBO who have SIBO around this issue. How do you approach it?
[46:17] KRISTY: I say to feed judiciously. To not make yourself sick with symptoms. I think that is really important. You don’t want to go into a flare. But I believe it can possibly be helpful to feed the bacteria a bit while you are in treatment. So to me that means if you are sensitive to gluten you don’t go out any pizza. You want to take care of yourself still… so it might be having an avocado if you normally wouldn’t have avocado. That type of thing where it is still healthy and you are not having mass amounts but you are introducing some things that you have been avoiding.
[47:12] REBECCA: yeah interesting. And I think the key there is don’t go out and go crazy on highly processed foods because they are not good for anybody and I do suspect that some people think that it is license to do that. To go crazy. They go like, “Well my doctor said fed the bacteria. So I am going out and I am eating a full pizza pie on my own.”
[47:38] KRISTY: Right and unfortunately that probably will have consequences.
REBECCA: Definitely. Do you have any sort of no nos when it comes to food?
KRISTY: Well, one is don’t overly restrict which we have talked about already. So that is a big one to make sure that we are testing foods. And the other one to start out slowly when you are starting a diet. So I feel like it’s normal if I ate a muffin for breakfast every morning before I started the diet. Maybe I would still want a couple of muffins every morning but if they are now made with nuts which are harder to digest and I am eating a lot of those, it might be a hard way to start out on a diet.
So I think it’s good to start out with keeping in mind the amounts listed on a diet and seeing how you deal with those and not going overboard with the sweeteners and the nuts. For some people if you have leaky gut, then it’s good to peel and cook your vegetables and fruits well. Puree them if needed. It’s basically like you really want to help yourself out in the beginning to make sure that your food is as digestible as possible.
[49:18] REBECCA: What’s your advice for people who have commenced the SIBO treatment and now they are having to work out, “Oh my gosh, how do I eat out?” or, “How do I go to a friend’s house for dinner?” How do you help your clients with that side of life?”
[49:38] KRISTY: I think that’s very important to not lose socialization with our friends and family. So it’s great to have a couple local restaurants. They are probably a little bit higher end but they are not fast food where you either know there is something on the menu that is within the perimeters of your diet and is safe for you or you call ahead and talk to the chef or someone else there. And specifically tell them what you can eat and you tell them when you are coming in so they can expect you and have something ready for you. And it’s been my personal experiences that most places really want to help you and accommodate you and you just want to make sure to call not during a dinner service. You want to call early in the afternoon so the shop has time to talk to you. You know a couple of days before when possible. You don’t want to put yourself in the situation were you are trying to get information from a waiter who has a bunch of tables and is already overworked and might just not understand your personal situation. And as far as going to someone’s house for dinner I think it’s always nice to, if it’s a party, to eat a bit before so that you’re not in starvation mode or feeling desperate that you have to eat something that you wouldn’t normally eat that you know might cause some symptoms.
And I think it is also helpful to bring something with you. And that’s nice from the perspective of bringing something for the host or hostess if they are open to that. And also it’s something that you know that you can eat that you can put on your plate. And not feel different, not have to answer questions from people of you know, “Why are you eating? Etcetera. Unless that is something that you want to talk about and that’s great too. And maybe even bringing your own drink like a lemonade something made with homemade honey simple syrup and lime and water. Just so you can have a drink in your hand and feel comfortable if that is something that makes you feel more at home.
[52:13] REBECCA: Yeah and I applied all of those strategies when I was going through my journey and it really worked and I’ve got to say I did eat a reasonable amount. I wasn’t eating out as much as I probably normally would have. But there was only one café out of all the places that I went to that refused to make any modifications and that was fun. I just never went back there. And I went to the places that I knew were really happy to accommodate me, who were really interested in my condition, wanted to know more about it and were really eager and happy to tailor their menu so that I could eat something because at the end of the day I was a willing and happy paying customer. So they want my service.
What about when you are traveling a lot? So there are people that contact me and say on the road for work a lot and say, “Help how do I do this?: What do you say to people who eat on the go that normally would have potentially grabbed some takeaway food as their meal option on the road?
[53:25] KRISTY: yes, that definitely becomes more challenging for most people when possible to bring homemade snacks with you. Like I used to travel in an airplane with my 24 hour yogurt because I knew that it was something that I did well with. So, I mean I took it through airports and sometimes it went through very easily. Sometimes it got wended but it just made it a little bit easier for me and get me a little more peace of mind to have something with me. So anything you can take is great. And then I think it kind of goes back to being very specific when you go to a restaurant even if you are just showing up there. “Can I have meat without a marinade? No spices except for salt and pepper? Vegetables with butter.” That kind of thing.
So I mean it’s challenging but I think it’s possible.
[54:29] REBECCA: it is. And something that I applied my little technique with, I would say just so that people took me seriously. I would say, I have an allergy and these are the foods I can eat. So I would say so I can have protein, any kind of protein as long as it is just cooked simply with just olive oil. And I could tolerate butter so I could say you cook it in butter or olive oil. That’s fine. No garlic, no onions, and then I would say just a salad because I could eat raw vegetables. So I would say Salad with no dressing, maybe just a slice of lemon and some olive oil that I can make a dressing with or some plain steamed veggies.
And yeah you know sometimes I felt a little bit annoyed that i felt I was eating quite plain food. But it meant that I could still go out have social situations with my friends, have a nice time, my friends realized what I was doing. They were all very supportive of that. And I got to have fun. I still felt like I had a life. That is really important.
[55:37] KRISTY: That’s funny because I used to say also that I had an allergy because restaurants I feel like you know especially when you are traveling and it’s not a restaurant you go to all the time. I think that that’s a respond to that better than… you know they don’t really understand what an intolerance or they think, “Oh that person just is on some kind of fad diet.” So I think putting across this seriousness of it can be very helpful.
[56:04] REBECCA: Exactly. And at the end of the day our health is really important and we owe it to ourselves to take it seriously. So on occasion restaurant, I would say no onion, no garlic, and my food would come out and it would be slathered in onion. The salad would be full of onion slices.
Now I could have just gone, “Oh well I’ll deal with it.” but then I realized, the only person that is hurting is myself and the only person that is prolonging my journey to health is myself. So I would say I am sorry but I did say that I have an onion allergy and I can’t eat that. Can you please provide me with a new salad without onion?
So yes it can hard especially if you are not that kind of person who naturally speaks up or would speak out in a situation like that. But I just always thought, “Ok I just want to get well and what do I need to do to do it and I am going to make sure that I eat the right food for myself at this point in time. And so sometimes you have to have what might be a little bit embarrassing or difficult conversation but I found that it was worth it in the end because I could then go home and I would not have a flare and could have experienced a nice night out for instance.
[57:26] KRISTY: right I definitely agree. It’s not worth it. And you know it doesn’t always feel great but when you are feeling well and you are helping yourself in the healing process, I mean long term. That is what it’s about.
[57:41] REBECCA: So one thing that you do is around nutrition counseling and I am just really interested to learn more about even that terminology. Like what is nutritional counseling?
KRISTY: that is a great question. I mean it can mean a lot of different things to different people. I mean I work with my clients on what they want. So I mean I would say recipe modification and what have you is not necessarily nutritional counseling but it falls under a bigger umbrella. And a lot of people start out with wanting is wanting help on knowing what they should eat and what they shouldn’t eat and how to modify recipes and meal plan. That kind of thing. But then I also think that part of nutritional counseling is how to be present when we are eating, making sure that we are not only stopping to eat but we are chewing our food and really tasting our food. The texture of it, smelling our food and dealing with the anxiety around eating and not knowing what to eat. I mean you know a lot of people with SIBO have heightened levels of anxiety that just come along with having SIBO. And the addition of also having to be on a diet. If you don’t have anxiety before then you certainly have anxiety for that.
In working with that, with food in general, like what do you do when you feel overwhelmed? How do you come back to present?
[59:37] KRISTY: so it really I specific to the person but you know I find that kind of food is the entry point with a lot of my clients and then hopefully we are also working on their wellness of how to go through the process and the journey of healing.
[1:00:04] REBECCA: and if there is a takeaway that you could give people listening to the podcast today on how to calm when it comes to eating and I think that’s… for me I had to really work on that. How do you teach people to just calm down before they sit down and have a meal?
[1:00:22] KRISTY: I recommend that people go more into a grounded state and start out thinking about, “Oki am going to try to have an anxiety free meal because I know what I am eating is supporting me. I am eating in a nice environment with my friends or family.” And starting with that piece and then also grounding through the body. So really, you know I feel like when we have anxiety, our energy goes upward and we kind of have all those random thoughts and we are going a mile a minute then it’s just going to be okay. What symptoms am I going to have? That kind of thing. But when we come back and feel our feet on the ground and feel the connection to the earth and the support from the earth and feel our bottom and the chair and really kind of do a body scan of – How do I feel right now? What kind of quality does my breath have? Can I follow a complete breath and not do anything about it? Just feel the quality of it.
When we start to ground through the body, we start to become more present and gosh just as far as calming our nervous system that can help in helping out motility and our digestion. It can have such big implications.
[1:01:55] REBECCA: And I am assuming that when you are talking about grounding you possibly advise not to be eating on the go? Like what is your take on eating on the go, eating around?
KRISTY: I think in our society it is hard to not be rash sometimes especially when you have kind of… If you are cooking for yourself and you aren’t lucky enough to have a personal chef, cooking can kind of be an added part time or full time job. So I don’t want to pretend that people are ever going to be rushed but I like to recommend that as much as possible that there are some mindfulness even if you are eating in the car. I think that that is possible that we can still come back to our groundedness and come back to ourselves and say, “Ok I am going to eat this thing in the car and I am going to do my best to be present with it and notice my chewing and notice the taste and how those linger and the textures of my food and if it’s really chewed enough before I swallow it.” those types of things. And I feel like it’s important to also to not have too much blame when those things don’t happen. But to have more natural curiosity about ourselves like, “oh I just ate the whole thing of that and I didn’t really notice. Like where was I? what was i doing?”
How can I tune in next time a little bit? Or maybe I was able to stay present for a part of that but then I zoned out and started thinking about such and such. So the curiosity and kind of kindness to ourselves is really important.
[1:03:55] REBECCA: I think that is a great advice and it is making me smile as I am listening to you talking about that because that is such a journey that i went on and still am on. I was always a speed eater like I could have won a war. I could eat a meal and I didn’t meant to eat fast. I just love the flavor so much it just went in quickly. And I realized I was about becoming present and mindful that when I ate really quickly I didn’t feel so good and had also always eaten at my desk in front of a computer. So I’d have like my plate of food in front of me. I would be typing. I would probably be on a call as well. So I would be literally doing three or four things at the one time as well as trying to scoff down my lunch or my dinner or my breakfast. Pretty much every meal is in front of a computer.
And then I made a conscious decision that as much as possible I would get up and eat my food away from my computer in a completely different room. And I would turn off all my electrical devices. So I wouldn’t have the TV on where possible where I would not have my phone or my iPad with me. I would literally just sit down and concentrate on eating and concentrate on slowing down on my chewing. And I started doing something whereby I would put a mouthful of food into my mouth and then I would put my cutlery down and my hands in my lap and sit and chew and I had to be really conscious about slowing down the speed which I ate. But now that’s second nature to me and it’s really interesting for me now. I have a day were I am busy and we all have those days when we would run off our feet and I do have to eat on the go. I really could feel the difference and that used to be my normal. So it’s really interesting how my normal has shifted. And now what was my normal feels abnormal and it doesn’t make me feel so good.
[1:05:54] KRISTY: right. And I think even when we are rushed to be able to say to ourselves like, “Can I afford three minutes? Can I even just sit over here without the media for thee minutes and to give yourself that whether it’s 3 minutes or 20 minutes or an hour” But you know yeah to start cultivating things over time and you have the things that come to our awareness are like, “Oh when I take a big bite of something, I can’t really taste it as well because I’m just struggling to control it.” I mean there are so many little pieces that you know are so interesting.
REBECCA: they are definitely. And there are so much more to our nutrition than just eating on the zone. I think those tips that you have given are great and they are so useful for our listeners today. I just would love to say a big thank you for coming on the show and talking all things food and nutrition especially when it comes to SIBO because it is such an important part of our journey and something that we all can have some control which can be a positive and a negative when we are dealing with a condition like SIBO.
Now if people would like to find you, how can they connect with you?
[1:07:25] KRISTY: My website is vitalfoodtherapeutics.com. I’ll say that one more time because it’s kind of long I apologize. So vitalfoodtherapeutics.com.
REBECCA: And I’ve got that linked in the show notes below so if you want to connect with Kristy then you can just click that link and head straight to her website. It has been a joy to have you on the healthy gut podcast today with me Kristy and I think what you have talked about is so interesting and I am sure it will help a lot of our listeners.
KRISTY: Thank you Rebecca. It has been my pleasure to be on.