Tips and Tricks for success on the SIBO Diet (2024)

The SIBO Diet is a great way to reduce symptom severity if you're dealing with SIBO - the Bi-Phasic Diet is the one I usually use with clients as it's more effective than the low FODMAP diet, although it was formulated based on that and the Specific Carbohydrate Diet.

My experience using this diet with clients means I have learnt a lot about how to make it a success and less difficult than it needs to be. I want to share that wisdom with you to make the experience more successful and less stressful.

This article is designed as a supplement to the handouts from The SIBO Doctor explaining the Bi-Phasic Diet. There are various versions of the Bi-Phasic Diet, including
the original Bi-Phasic diet, a low histamine version, a vegetarian version and a low sulphur version.

General Advice

• Always leave a 4-5 hour gap between eating and eat proper meals rather than snacks where possible. This may mean you need to have larger portion sizes than you are used to. Remember it’s an adjustment process.
• However, an occasional snack is OK rather than going hungry because the stress of being overly hungry isn’t conducive to healing. You may also need to pack snacks if travelling. Please see below for some snack ideas.
• Some people may feel better eating 4 smaller-sized meals rather than 3 larger meals
• To enhance digestion, you can practice a simple breathing technique before meals called
  4-7-8 breathing. It stimulates the parasympathetic nervous system, also known as the “rest and digest” system because it helps us do both of those things. Many people with chronic digestive issues are stuck in the sympathetic, “fight or flight” state which inhibits digestion by moving blood flow away from digestion and to the muscles (in anticipation of needing to flee).
• The diet isn't something that should be followed for an extended length of time, just like the low FODMAP diet. This is because it can negatively affect the microbiome and cause psychological stress. If you can stick to the diet strictly during treatment, we can then start systematically re-introducing categories of foods so that your diet becomes less restrictive.
• “Progress not perfection” is a mantra to keep in mind - aiming to be absolutely “perfect” with the diet will create a lot of pressure and internalised stress. You won’t set yourself back if you occasionally eat something not on the list of foods. Be kind to yourself.

Choosing and Cooking Specific Foods

• In terms of protein, avoiding a shift to hydrogen sulfide gas production while on the diet is important so ensure to eat plenty of lower sulphur proteins such as seafood, fish, dark chicken meat, dark turkey meat and tofu. Don’t just rely on eggs and red meat.
• Cooked vegetables, served warm or hot will always digest better than cold ones. Even a quick braise of greens is helpful.
• Certain types of rice are typically better tolerated than others - basically, a reverse of the usual nutrition advice is the key. It’s very counterintuitive but it works. Basmati and brown rice are the least well tolerated because of their low GI - they take longer to digest, meaning more time for the bacteria to ferment the starches and cause symptoms. Sticky rice, sushi rice, jasmine rice and black rice are ideal. This is related to the type of starch contained in these different types of rice. Quicker digesting types of rice are higher in amylopectin rather than amylose - amylopectin digests much faster.
• If eating quinoa, soak it, agitate with a wooden spoon for a few minutes and then rinse thoroughly. Don’t leave it to soak. This reduces the amount of saponins in the quinoa which can cause digestive upset in some people.
• Finding a suitable milk can be difficult, so I have a resource on how to choose IBS and SIBO-friendly milk

Mindset and Practical Tips

• Remember the diet is not forever - it's easy to get tunnel vision and forget the bigger picture
• Remember you are giving your body a gift and nourishing it in a way that will assist your current health challenges
• Ensure you have recipe resources (eg. Phoebe Lapine’s book, Rebecca Coombe’s books)
• Meal plan on the weekend so you don’t end up too hungry during the week
• Schedule regular meal prep time 2-3 times a week so you always have food ready to go
• Batch/freezer cooking is your friend - make extra serves of a meal and freeze leftovers
• Multicookers/pressure cookers and slow cookers are really helpful for making dishes more hands-off
• Keep meals simple for the most part, you can also make them more interesting with herbs and spices
• Meal delivery services that have keto and dairy-free meals tend to have the most suitable options for the SIBO diet - just remember to check the type of rice and the onion and garlic content if you are sensitive to those
• Eat plenty of potassium foods allowed on the diet - beetroot, beet greens, kiwi fruit, banana, Jap pumpkin/kabocha squash (in the amounts allowed on the diet)
• Eating out can be tricky - you may want to eat a meal before going out, take some snacks or choose a simply cooked protein such as steak, salmon or roast chicken and have some steamed veggies on the side

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Snack ideas

Thanks to the SIBO Doctor herself, Nirala Jacobi, for these snack ideas:

• Carrots or celery with almond or other nut butter (not peanut)
• Hard-boiled eggs
• Unsweetened beef jerky (also avoid any with soy or palm oil)
• Make your own trail-mix from oil-free nuts, seeds and shredded coconut
• Warm cup of bone broth
• Oil-free plantain crisps
• Tuna or salmon salad (made with sugar-free mayonnaise)
• Kale crisps
• Smoothie
• Carrot chips
• Homemade coconut yoghurt

Struggling with the diet?

If you’re still struggling, a non-diet approach is the Nerva hypnotherapy app from Monash which has been shown to be just as effective as the low FODMAP diet. It is a 6 week program for less than the cost of 1 hypnotherapy session. For people who want to go down this route, I do suggest still avoiding your big dietary triggers - for many it’s onion and garlic - but avoiding a strict diet if you can (as this is the whole point of the hypnotherapy app). I have started recommending this more and more for people who find the diet side of things challenging, if there has been a history of disordered eating or if someone has a very short list of foods they can tolerate.

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