Fast Tract Diet Q&A

Acid Reflux – Fats or Carbs?

Question:

I suffer from acid reflux and am confused by conflicting information regarding what food causes reflux. I read that “foods high in fat slow stomach emptying, increasing upward pressure on the lower esophageal sphincter and increasing the chances that food and acid will reflux upwards.” This goes against your theory of acid reflux, doesn’t it?

Answer:

This idea has been around for some time, but I truly believe that carbohydrates are the real culprit based on the evidence I present in the Fast Tract Digestion Heartburn book. In the book I list over 100 scientific journal references including a report by Penagini R., which states “It is concluded that, in the light of present evidence, there is no sound rationale for clinicians recommending that patients with GORD (European for GERD) follow a low-fat diet.” and this paper by Pehl, et.al states that there is no difference observed in reflux between a high and low fat meal if calories are the same. Additional evidence and studies are presented in my four-part article on acid reflux. 

Am I Getting Enough Carbohydrates?

Question:

I started the Fast Tract Diet for my LPR. Dairy and nuts in my diet tends to upset my stomatch even though I use enzymes. I work out 6x a week and am concerned that my carbohydrate intake is too low. Am I getting enough carbohydrates?

Answer:

Chewing well may help with nuts, and you can always cut back a bit on the amount as they do contain fiber. Also, limiting diary may help in the near term, and low lactose dairy with lactase may be added back gradually at a later date.

While there are essential amino acids (which make up protein) and essential fatty acids (which make up fat), there is no actual dietary requirement for carbohydrates. So I wouldn’t worry about getting enough carbohydrates. But adding more fat calories is important when cutting back on carbohydrates. There is also a metabolic adjustment period as your body begins preferentially burning fats in place of lost carbs. I recommend giving it a week or two making sure to increase fats, especially saturated fats.

Are Elemental Diet Drinks Gut Friendly?

Question:

I was not able to figure out how to calculate FP for “Unsweetened Vanilla Elemental Drink”. Can you help me with this?

Answer:

I took a look at the nutrition facts and ingredients. Though this product does not have a measured glycemic index (GI), the carbohydrate sources are 54 grams of cassava root (Tapioca) Maltodextrin (GI 100), and 7 grams of sugar which I assume is sucrose (updated GI 62).

I used the FP calculator  to calculate each component which yields a final FP of 3 per serving. This is low in symptom potential. While this product is low in FP, some of the other Absorb Plus elemental drink mixes contain significant amounts of fructose and hence the FP values will be much higher.

Update May 24, 2016: @Katrina Crocker contacted me concerning a  typo in the ingredients for the Unsweetened Vanilla Elemental Drink. There is actually no fructose added to the unsweetened version, so I updated my calculation for this product. Also, I had used a GI of 81 for tapioca for calculating the FP of the maltodextrin in this product, but since this product actually used pure maltrodextrin from tapioca, the GI for maltodextrin is assumed to be the same as glucose – 100.

Should I take apple cider vinegar for my GERD?

Question:

I have had GERD for 3 years and last year I was diagnosed with Fructose Malabsorption. I have taken apple cider vinegar (ACV) 30 minutes before every meal to facilitate acid production in my stomach, but I found that some insist that ACV should not be taken for fructose malabsorption because it has fructose in it. However, in the Fast Tract Diet app, ACV has 0 FP. Would you recommend drinking ACV?

Answer:

ACV contains very tiny amounts of fructose (well under 1/10 of a gram in a tablespoon). Other carbohydrates are also negligible. Therefore, ACV is assigned an FP value of zero.

Does the Fast Tract Diet cure SIBO?

Question:

If I do indeed suffer from small intestinal bacterial overgrowth (SIBO) for a non physical cause, can I expect that following the Fast Tract Diet may “cure” me of this condition? Or will it always recur whenever I do not adhere to the diet?

Answer: 

Great question. As I discuss in the Fast Tract Digestion Heartburn and Fast Tract Digestion IBS books, there are many possible causes of SIBO. If you can identify and address the underlying cause, there is good reason to believe you will be able to “cure” SIBO or at least become less susceptible to flares or blooms of SIBO. An example is someone who is lactose intolerant. Once they take lactase enzyme with lactose-containing foods or avoid lactose, the problem is solved. SIBO (post infectious IBS) from having a gastrointestinal infection, tends to improve or resolve months to even years after the event.

In many cases however, SIBO reflects a new normal – decreased ability to process fermentable carbohydrates and increased sensitivity to fermentable carbohydrates. The best course of action in my view is to treat this by limiting these in your diet. In most cases diligence will pay off with decreased sensitivity, but you will likely always need to keep fermentable carbohydrates in check as well as incorporate pro-digesiton strategies outlined in the books into your routine. For individualied help including a root cause analysis, you can reach out to us here.

Sorbitol (a sugar alcohol) in Rapidol Express 

Question:

I’m forced to take a reflux suppressant called Rapidol for my very bad reflux and LPR. But it contains sorbitol, a sugar alcohol which can cause fermentation. I can’t limit the medication until the reflux eases, but the medication itself could be causing more reflux. Any advice?

Answer:

I believe you are referring to Rapidol Express which contains the following active ingredients:

– Phycodol™, an Extract from Brown Algae (coats the stomach)
– Sodium Bicarbonate (antacid)
– Calcium Carbonate (antacid)

This product is certainly better than H2 blockers and PPIs, but as you pointed out, Rapidol Express contains sorbitol. It is a fermentable sugar alcohol and might be alright if you don’t take a lot.

Gaviscon Advanced also contains a raft forming ingredient, alginate and is a better choice in my view.

Once the diet fully kicks in, you shouldn’t need any medicine before long. For your full recovery:

1. Stick with your appropriate FP goal daily
2. Put gut friendly practices into action
3. Identify and address any possible underlying causes

The Fast Tract Diet App is great for #1 and 2, and our consultation program can help you with all 3.

Are too many veggies not good for SIBO?

Question:

I’ve been on the Fast Tract Diet for almost 3 months and completely off my meds during the time. But it seems like I’m taking a step backward each time I eat too many veggies even though all veggies combined are no more than 10 Fermentation Potential (FP). Any though?

Answer:

I can understand your concern with not being able to eat more veggies at this moment, but it’s great to see the progress you have made – off meds and able to control your symptoms most of the time.

Which Fibers Don’t Ferment (Gut Friendly)?

Question:

Are there any fibers that don’t ferment? Which would you say are necessities if I were to isolate those in my diet and exclude the rest?

Answer:

All forms of dietary fiber are potentially fermentable, but the least fermentable is cellulose. Cellulose fiber is long chains of glucose molecules chemically bonded together. But the type of chemical bonding between the glucose molecules makes cellulose a tough fiber.

Don’t High GI Foods Feed Bad Bacteria in Large Intestine?

Question:

I finished the Fast Tract Digestion book, great book. I like the theory behind it. I am wondering though if the foods with a high Glycemic Index (GI) would be feeding other bad organisms that may be present in the large intestine ?

Answer:

The answer is no as high GI carbohydrate-containing foods are easier to digest. Once they are fully digested, the single sugars from high GI carbohydrates are rapidly transported out of the intestine into the blood stream. This is also the reason that you should not overdue high GI carbohydrates (high blood sugar levels).

Low GI carbohydrates are broken down slowly and the sugars are more likely to feed potentially symptom-causing blooms of intestinal bacteria.

How Can I Convert Grams & Ounces to Common Household Measures for Foods in the FP Tables?

Question:

I appreciate the pre-calculated 16 FP food tables in the Fast Tract Digestion books that shows symptom potential in foods. But, they are in ounces and grams and need to be converted to ordinary household measures in order to know how much food we’re dealing with (teaspoon, tablespoon, cup, etc.) It requires buying a scale or visiting the grocery store and taking down all the label numbers for each product in which you’re interested. Is there an easier way to implement the diet?

Is Gellan Gum in Almond Milk Safe for SIBO?

Question:

I use the Trader Joe’s almond milk, but just noticed that it contains gellan gum and zanthan gum, both of which are not allowed on the Sibo diet. What is your view?

Answer:

Both gellan gum and zanthan gum are complex polysaccharides (chains of sugar molecules) that are produced by non-pathogenic bacteria. Since both are fermentable by gut bacteria, they are capable of producing GI symptoms if consumed in large amounts. The fermentation potential (3 grams for one cup) is quite low for unsweetened almond milk.

Is the Fast Tract Diet Effective for Gastritis?

Question:

I have been diagnoses with both gastritis and acid reflux. Is the Fast Tract Diet effective for gastritis just as it would be for most other GI conditions?

Answer:

Gastritis which means inflammation of the stomach is distinct from acid reflux and SIBO. And gastritis has many causes.

Are Gluten Free Flours Easy to Digest? 

Question:

After rice flour made from jasmine rice, how would other gluten free flours rank as far as their symptom potential (i.e. Fermentation Potential, FP)? Any idea about the FP of tapioca flour, potato starch, sprouted oat flour and sprouted corn flour?

Answer:

Tapioca flour and potato starch both have relatively low FPs. ¼ cup of Tapioca flour has 4 FP points and the same amount of potato starch has 2 FP points.

Is SIBO Autoimmune Disease?

Question:

What do you think about Pimentel’s theory that SIBO is actually autoimmune disease?

Answer:

This is fascinating research. They seem to be on to something for a subset of people with IBS – who previously experienced food poisoning (gastroenteritis) caused by certain bacterial pathogens that produce a toxin called cytolethal distending toxin B (cdt B). Antibodies to this toxin cross-react with other human proteins including a protein called vinulinwhich is involved in normal gut motility.

Gut Microbes Feed or Impede?

Question:

Experts in this area (Sonnenburg – The Good Gut & Huffnagle – Probiotic Revolution, for example) tend to strongly emphasize the importance of high fiber, high resistant starch diets to maintain a healthy microbiota within the colon. Obviously they are not taking into account SIBO, but given the Fast Tract Diet is designed to deprive SIBO causing bacteria in the small intestine of their required fuel (fermentable carbohydrates), would this approach not also deprive the bacteria in the colon of the same fuel and lead to an unhealthy / unbalanced colonic microbiome?

Why Does The Fast Tract Diet Include Processed Foods?

Question:

I am a health conscious individual and was surprised to see that the food tables in the Fast Tract Digestion books include some processed foods. Although the Fast Tract Diet worked like magic, I am curious as to why you recommend processed foods.

Answer:

Let me be clear, I am not recommending that people eat processed foods. The food tables in the Fast Tract Digestion books and in the Fast Tract Diet mobile app on Android and iTunes list a large variety of whole foods including vegetables, fruits, starches, meat, seafood, etc. I personally practice a lower carbohydrate / not-so-strict paleo whole foods type diet based on controlling Fermentation Potential (FP), which includes seasonal vegetables from my own organic garden.

High GI Carbohydrates and Low FP Foods

Question:

I hear that low Glycemic Index (GI) foods are healthier because they do not raise blood sugar, but low symptom potential (i.e. fermentation potential – FP) foods in the Fast Tract Digestion books are high in GI. How do I reconcile the conflict in applying the Fast Tract Diet?

Answer:

I recognize that too many carbohydrates, particularly high GI carbohydrates can contribute to increases in blood sugar levels which can present problems for people with diabetes, other insulin-related or metabolic issues. But the best way to combat these issues is controlling the actual levels of dietary carbohydrate. This is by far superior to the low GI approach.

Would Simethicone Reduce Gas? 

Question:

Thanks for this great book! Would using simethicone be beneficial to reduce gas from SIBO?

Answer:

While the safety and side effect profile for simethicone appears to be fairly benign, this product does not reduce intestinal gas which is produced by intestinal bacteria. But if it breaks up some gas bubbles and works to help you with symptoms, I don’t see a huge downside.

A Ten Year Old with SIBO

Question:

Can the Fast Tract Diet be used with a child aged 10 who has symptoms of SIBO?

Answer:

Of course, it’s always a good idea to discuss your child’s diet with your pediatrician. But since the Fast Tract Diet consists of healthy fats, carbohydrates and proteins from a variety of plant and animal sources, it should be absolutely fine for your 10 year old child.

Supplements 

Question:

Would you recommend people stay on any supplements they are currently taking when they start the Fast Tract Diet? I’m of two minds. Part of me thinks it might be tough to determine what’s actually helping, the diet or the supplements (or the combo!). But I’ll take whatever help I can get for symptom reduction.

Answer:

This is a great question but one that’s not black and white. In general, taking fewer supplements is best as many supplements have not been adequately studied for their safety and effectiveness.

As you mentioned, multiple interventions make it more difficult to figure out what’s helping or not. Also some supplements may actually impede progress or carry health risks. For instance, some probiotics can make bloating worse. People with adequate amounts of stomach acid could have worsening symptoms taking betaine HCl. Taking too much iron in the absence of a clear deficiency can cause serious side effects, even death.

On the other hand some supplements are helpful and don’t have much of a down side. For instance, lactase enzyme is safe and effective for treating dietary lactose intolerance.The same can be said for amylase enzyme to improve starch digestion. Basic vitamin and mineral supplementation is also a good idea with SIBO-related conditions as vitamin and mineral malabsorption is common in these cases.

Here are three things to consider when thinking about supplements:

1. Identifying the underlying cause of your symptoms is the best way to determine how diet can help and if supplementation is needed.

2. If there a clear need, choose a supplement that is safe and effective, and also backed by science.

3. Ensure that the supplement does not simply mask problem or cause additional side effects.

Soy Protein Isolate Powders and Tempeh

Question:

I am a vegetarian looking for a low symptom potential (FP) protein source. Where would soy protein powder and tempeh be placed on the FP scale?

Answer:

Most soy protein isolate powders have low total carbohydrate and fiber counts, similar to whey protein isolates. The FP value is very low depending on the brand.

But, tempeh has a moderate FP, 13-14 for a single serving (113 g). I would lower the standard serving size for tempeh until your symptoms are improved.

Is Lactose Free Milk OK?

Question:

Thanks to the Fast Tract Diet! I am feeling much better just in a couple of days. Now that I am not drinking regular milk, I would like to find a substitute. I think lactose free milk is OK, isn’t?

Answer:

A cup of lactose free milk has a symptom potential (FP) of 5, so not too bad. The reason the FP value is not zero is because while lactose-free, it contains some fermentable oligosaccharide sugars.

Erythritol (SIBO Safe Sweetener)

Question:

Erythritol is a seemingly safe sugar alcohol based on new information and I have seen a few different brands. The Swerve brand has oligosaccharides in the ingredients. Is this to be avoided? The Now brand lists only erythritol crystals… Would this be a better choice?

Answer:

I looked up the nutrition facts for Swerve. Though they mention that the product contains oligosaccharides, they don’t list the actual amount. If they did, you would count oligosaccharide content as dietary fiber in the FP calculation. I would avoid this product. The Now brand of pure erythritol is a better choice. You can also get erythritol blended with stevia.

For other SIBO safe sweeteners, refer to the Fast Tract Digestion books.

Jasmine Rice and Digestion

Question:

I tried Jasmine rice the other day, but it came out completely undigested. I am confused because Jasmine rice should be one of the legal foods in the Fast Tract Diet. Why was I not able to absorb/digest it? Do I need to supplement with amylase enzyme?

Answer:

Jasmine rice is the easiest starch to digest, so I share your concern. Here are some possible reasons that could lead to poor digestion of even easy-to-digest starches:

Millet and Symptom Potential (FP)

Question: 

I see millet is not mentioned in the Fast Tract Digestion books. While thought of as a grain, it is actually a seed. It is deemed one of the world’s healthiest foods and I like to include it from time to time, although I’m enjoying the jasmine rice. So I’m wondering about its symptom potential (i.e. Fermentation Potential – FP).

Answer:

Great question. When prepared as porridge, 1/4 cup of raw hulled millet has an FP of 12 grams. However when millet flour is used to make flat bread, the FP is 1 gram per slice.

Fermentation Potential (FP) for Herbs

Question: 

Are the fibers/carbs in powdered herbs anything to be concerned about in terms of fermentation potential? Not concerned so much for basil or other green culinary herbs, but more those made from roots or fruits, i.e. a teaspoon of, say, powdered cinnamon, or ginger, turmeric, curry powder or paprika?

Answer:

I have been recently studying the FP of herbs, so this question is timely.

Do Fermented Foods Produce Gas?

Question:

I heard that fermented foods are good for digestion because they have less fermentable carbohydrates, but could already fermented food be re-fermented: therefore, producing gas in my intestines?

Answer:

Fermented foods are already fermented, though not quite to completion before you eat them. Unsweetened fermented foods (i.e. dill pickles, plain yogurt, etc.) in particular are much lower in fermentable carbs.

However, there are still some carbs in fermented foods. Plain yogurt still contains 4-6 grams of Fermentation Potential (FP) per cup depending on the brand. FP as you may know is symptom potential of foods you eat.

So yes, they could produce some gas, but not as much as the pre-fermented foods such as the milk used to make yogurt or the cucumbers used to make pickles. For more information on symptom potential of foods in FP points, refer to the Fast Tract Digestion book(s).

Does the Fast Tract Diet help with Bloating?

Question: 

I have terrible bloating. Can the Fast Tract Diet help? If so, how?

Click here to learn more.

Food allergies and SIBO / IBS 

Question: 

Do you think food allergy testing is important for SIBO/IBS?

Click here to learn more.

Agave and Fermentation Potential 

Question:

Is Organic Blue Agave sweetener acceptable?

Answer:

Great question. Agave nectar, also referred to as agave syrup is a high fructose sweetener. One teaspoon of agave (7 grams) contains 5.3 grams total carbohydrates, most of which is fructose. Agave’s Fermentation Potential (FP) is 5 points (grams). This FP value is high as its easy to consume more than one teaspoon of any sweetener.

Recall that gut bacteria can make 10 liters of gas from 30 grams of unabsorbed carbohydrate. That means that each teaspoon of agave (5 grams of unabsorbed sugar) can give rise to 1.6 liters of hydrogen gas. So I recommend caution with this sweetener.

For alternative low FP sweeteners, refer to the Fast Tract Digestion books.

Inulin and Fermentation Potential 

Question:

What’s the status of inulin in the Fermentation Potential (FP) universe. I drink a lot of hot chicory beverage (Le roux). I wonder if it’s contributing to my SIBO distress.

Answer:

Inulin is a type of dietary fiber that many plants use (as an alternative to starch) to store energy in their roots or rhizomes (underground plant stems). Inulin is composed of chains or polymers of fructose and is not digestible by humans.
Inulin is considered a prebiotic potentially feeding healthy gut bacteria such as bifidobacteria and lactobacillus.

SIBO Diets

Question:

I am off of the elemental diet and reintroducing foods. I am trying to combine aspects of Specific Carbohydrate Diet, low FODMAP and Fast Tract Diet, but each diet is contradictory to each other. What would you suggest?

Answer:

Trying one specific diet at a time is the best way to go. Combining multiple approaches at the same time results in fewer food choices and potentially nutritional and caloric deficiencies.

If one diet doesn’t work after an adequate amount of time, stop and try another diet. At least with symptomatic GI conditions, you have a gauge to measure the success or lack of success on any diet or other approach.

While implementing the Fast Tract Diet, we can help you identify and address a variety of underlying causes and individual issues such as food intolerances, persistent symptoms, weight loss or weight gain through our consultation program.

For more information on the differences among 3 dietary approaches, refer to SIBO Diets and Digestive Health.

SIBO and Fecal Transplant

Question:

I have small intestinal bacterial overgrowth (SIBO) and would like to get rid of it once for all. Do you think that fecal microbiota transplantation (FMT) could be a cure for SIBO?

Click here to learn more.

Bone Broth and Fermentation Potential

Question:

Is bone broth ok on the Fast Tract Diet? I do this mainly for my bone issues and it’s supposed to be very good for digestive issues.

Answer:

Absolutely. Bone broth is a gut-healthy delight. I will add bone broth to the soup section of the Fermentation Potential (FP) food table in the next book printing.

Fruits and Fermentation Potential 

Question:

I am a fruitaholic. I have a banana smoothie every morning, and usually snack between meals with fruit and use it as my night time treat mixed with yogurt. How do I best implement the Fast Tract Diet?

Answer:

While there are several low Fermentation Potential (FP) fruits, many fruits are higher in FP mostly due to fructose and fiber content, though bananas (especially if not fully ripe) also contain resistant starch.

SIBO and Leaky Gut

Question:

Can small intestinal bacterial overgrowth (SIBO) cause leaky gut? If so, will the Fast Tract Diet help correct it?

Answer:

SIBO is most definitely linked to leaky gut, and the connection goes a long way to explain why SIBO is linked to many autoimmune conditions…Read more

Acid Reflux, LPR and Prescription Drugs

Question:

I am wondering why so many doctors are quick to prescribe proton pump inhibitors and H2 blockers, often both together for acid reflux and LPR. I’m worried about possible side effects from these medicines, especially if I need to be on them for a long time.

Answer:

This is one of the subjects that I am really passionate about, so my answer went beyond the usual scope of the Fast Tract Diet Q&A. Click here to read more.

Glycemic Index, Starch and Fat

Question:

I had a small serving of mashed potatoes as part of my dinner and experienced discomfort later on in the evening. The meal as a whole had a Fermentation Potential (FP) around 9 grams (chicken, small portion of zucchini, and mashed potatoes) which was within the Fast Tract Diet guidelines.

Since foods in combination have a different glycemic index (GI) than the individual foods taken separately (https://1.usa.gov/1Ez29Im), I am wondering how this affects the FP of the meal as a whole.

Candida Overgrowth

Question:

I have successfully reduced SIBO to negligible levels, in part due to the Fast Tract diet. Thank you! The doctor indicates that candida is the chief problem now. Is the Fast Tract diet helpful for candida as well? I know candida is more yeast based and a different creature.

Answer: 

SIBO has received a lot of press in recent years given its strong connection to IBS and so many other digestive (GI) and health conditions. But small intestinal fungal overgrowth (SIFO) can also result in GI symptoms as highlighted in this recent review.[1]

A variety of fungi including Candida albicans are natural members of our gut microbiota. For the most part, we never know they’re there. But unlike most fungi, C. albicans can overgrow under the certain conditions and even assume an invasive hyphal form that can cause tissue damage. [2] Read more

SIBO and Weight Loss

Question:

My main concern with SIBO right now is weight loss. How can I follow the Fast Tract Diet and gain some weight? I eat larger portions of the suggested menu.

Click here to learn more.

Ankylosing Spondilitis,  Klebsiella pneumoniae and Fiber

Question:

I have been applying the principles of SIBO diet to my auto Immune Ankylosing Spondilitis (AS). I have dramatic results with NO starch, no dairy (without lactase), including going off all meds, reducing stiffness and pain most of the time.

When I have a relapse, I need to avoid ALL fiber (no vegies, no fruit, just protein foods and a very low fiber homemade strained juice). Somewhere I read that Klebsiella pneumoniae does not feed/grow on veggie fiber, however I have a hard time believing that. Can you shed some light on this?

SIBO Negative Reflux and IBS

Question:

I have reflux and IBS and take PPIs. I did a hydrogen breath test, but the result for SIBO was negative. You talk about SIBO being the cause of reflux and IBS. Does the Fast Tract Diet work for SIBO negative reflux and IBS?

Answer:

That’s a great question. SIBO, as you might imagine is always in a state of flux. Your body’s control mechanisms (stomach acid, efficient digestion of food, bile, immunity, motility, etc) are always working to keep intestinal bacteria in check, especially in the small intestine. But bacteria from the large intestine are often trying to work their way back into the small intestine where more nutrients are available.

I believe you can test negative yet still have periodic bouts or blooms of SIBO.

Other possible contributors to false negative results are:

1. Eliminating fiber and high residue foods from your diet well before the test. By doing this, you are actually beginning an intervention diet that helps control SIBO. I would like to see this practice adjusted to only limiting fiber the night before the test.

2. Using glucose instead of lactulose in the test. Glucose is absorbed very quickly and may not detect SIBO in some cases, but lactulose is not digested at all so can detect SIBO throughout the length of the small intestine.

My advice is to give the Fast Tract Diet a try. There is good reason to believe it will work for you.

Probiotics and Fermented Foods

Question:

I am taking Lactobacillus Plantarum probiotic supplement. Is this a good idea when having SIBO or would you recommend other strains of beneficial bacteria?

Answer:

According to one recent placebo-controlled study, L plantarum was associated with improvements in pain, bloating and feeling of complete evacuation.

Keep in mind, this study enrolled more vegetarian men and the same results might not be realized in Westerners on different diets. But the paper references some other studies that also show some benefits (see discussion section), although one smaller crossover study showed no benefit.

All in all, there is enough here in my view to give this probiotic a try. This probiotic is well tolerated. Another more natural way to get L. plantarum along with other lactobacilli is consuming kimchi, sauerkraut and other lacto-fermented veggies.

Quinoa and Fermentation Potential 

Question:

I am a vegetarian with SIBO. I did not see quinoa listed in the Fast Tract Digestion (FTD) IBS book. Can you tell me the Fermentation Potential (FP) for quinoa?

Answer:

We will continued to add more foods in the FTD books when we update them. But, here is the quick answer. ¼ cup of dry quinoa (43 grams) has 14 FP points based on glycemic index of 35.

Klebsiella and Red Potatoes

Question:

In the Fast Tract Diet, red potatoes are considered low in symptom potential. But, they would fuel an overgrowth of Klebsiella, wouldn’t they?

Answer:

If the gut becomes leaky, Klebsiella pneumonia can stimulate antibodies that cross react with types I, III, and IV of collagen and HLA-B27 antigen through molecular mimicry in people susceptible to ankylosing spodylitis and rheumatoid arthritis. In these cases, limiting the growth of K. pneumonia is a good idea.

5 Hard-to-Digest Carbohydrates and SIBO

Question:

The Fast Tract Diet limits 5 hard-to-digest carbohydrates. Can some people tolerate some of these better than others or do we all need to avoid all five types?

Answer:

Yes, some people can tolerate some of these carbs better than others. Northern Europeans rarely experience lactose intolerance. They have evolved in this regard. Their lactase genes are stuck in the on position. Approximately 80% of the rest of the world remains lactose intolerant.

Also fructose intolerance, though prevalent, it is not a problem for everyone.
There is also variability in people’s ability to digest starch based on amylase gene (needed for starch-digesting amylase enzyme) copy number. People with more copies of this gene can digest starch better than someone with few copies.

Lastly fiber digestion depends on each person’s complement of fiber fermenting gut microbes.

Given all that, my strategy is to limit all five carb types using the Fermentation Potential (FP) point system to control SIBO and symptoms. When symptoms are under control, people can add each carb type back in a controlled manner, thus determining their specific intolerance profile.

Digestive enzymes including amylase, lactase and xylanase offer an additional tool to improve carbohydrate digestion.

SIBO, Elemental Diet and Fast Tract Diet

Question:

I have SIBO. My dietitian advised me to do the Elemental Diet, but I can not find good information on it. What is your view on the diet compared to the Fast Tract Diet?

Answer:

The elemental diet has been shown to be quite effective (80-85 percent cure rate) for people with SIBO because the only carbohydrate in elemental diet products is glucose which is easy to absorb and less likely to fuel SIBO.

Red Potatoes and Symptom Potential 

Question: 

Re. the Desiree and Pontiac potatoes, they are red potatoes that are low in Fermentation Potential (FP) / symptom potential, but when I got to a store, none of the red potatoes are labeled. Are any red OK?

Answer:

While I can’t guarantee that all red potatoes will have the exact same FP, red potatoes are considered “waxy” meaning they have less amylose (hard to digest) and more amylopectin (easier to digest) starch.

Flatulence, Cause and Dietary Solution

Question: 

I have had horrible flatulence for over two years. What could be the cause and how to fix it?

Answer:

Intestinal gas is produced by gut bacteria that ferment complex dietary carbohydrates and / or sugar alcohols as well as sulfur-containing amino acids from protein.

Inulin and Inulin Containing Supplements

Question: 

Regarding the inulin in the products on gutsense.org, I am wondering if it is okay or must all people with reflux avoid all inulin.

Answer:

Great question. Inulin, a prebiotic dietary fiber from plants such as chicory root, is not digested or absorbed. But it is fermented by gut bacteria.

“Fermentable Carbs” vs. “Fermented” Foods

Question:

What are the differences between fermentable carbohydrates vs. fermented foods? I am a bit confused.

Click here to learn more.

Fermented foods and its benefits for digestive health

Question:

I have been hearing that fermented foods are good for digestion. Can you explain why?

Answer:

Fermented foods include yogurt, kefir, cheese, pickles, sauerkraut and other vegetables. The bacteria that drive the fermentation process are mostly lactic acid bacteria, though other types of bacteria can be used, for instance Bacillus subtilis for natto from soy beans and even molds, for instance for tempeh from soybeans.

Since fermented foods have already been fermented in the pickle or sauerkraut jar or yogurt culture etc., they are lower in carbohydrates and higher in short chain fatty acids (SCFAs), mostly lactic acid.

Here are some potential benefits from consuming fermented foods:

1.  Fermented foods are low Fermentation Potential (FP). They have few remaining fermentable carbs so you can expect fewer symptoms such as bloating, cramps, altered bowel habits, reflux, etc.

2.  Fermented foods contain lactic acid, butyrate and other SCFAs which are healthy fats our body can utilize for energy.

3.  Fermented foods still contain many nutrients including vitamins – early American settlers depended on fermented foods to survive the winters.

4.  SCFAs are acidic which is beneficial for our small intestine. Lactic acid is a natural preservative that bacteria in our small intestine also produce which helps ward off bad bacteria. Note: Acidic SCFAs also helps to extend the shelf life of fermented foods.

5. Fermented foods include some of the same species of bacteria that live in our intestines, especially small intestines. These bacteria can fortify our existing healthy small intestinal microbiota and help compete with bad or pathogenic bacteria.

6. Fermented diary helps with lactose intolerance because the bacteria produce the enzyme lactase.

Rice Mike and Fermentation Potential

Question:

I can’t eat soy, how about rice milk? Is it gut friendly?

Answer:

Rice milk is a gut friendly choice having relatively few Fermentation Potential (FP) points. I would suggest unsweetened because it is easier to digest compared to the varieties with sugar added. You can add your choice of low FP sweetener if needed.

Here are the Fermentation Potential (FP) points based on the FP calculation:

• Rice Dream Unsweetened Rice Milk (per cup):
  FP: 1
• Rice Dream Original Rice milk (per cup):
  FP: 2
• Australia’s own natural rice milk (per cup):
  FP: 3
• Vitasoy rice milk (per cup):
  FP: 5

Thanks to all our readers for the continued questions and feedback, we continue to add more foods and beverages to be included in new editions of Fast Tract Diet books and a new Fast Tract Diet Implementation Guide due out this summer as well as a Fast Tract Diet mobile app due out this fall.

Cooked vs. raw veggies

Question:

Is there a big difference in Fermentation Potential points (i.e. symptom potential) between cooked vs. raw vegetables?

Answer:

I don’t think it matters that much for lower carbohydrate veggies. For example cooked vs. raw carrots, the difference is only a couple of Fermentation Potential (FP) points as listed in the books, which indicates symptom potential.

But, it does matter for starchy vegetables such as peas, corn, plantains, grains, most root vegetables, and tubers. These have to be cooked really well to aid digestion.

If you do notice that certain raw veggies give you problems, I recommend either switching to cooked veggies, or reducing serving size.

Constipation, SIBO and Methane

Question:

I suffer from chronic constipation and recently tested positive for methane by breath test. What does methane have to do with constipation and do you think the Fast Tract Diet will help?

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GERD, H. pylori and Low Stomach Acid

Question:

Since I was diagnosed with GERD, I started reading a lot about it. What is your view on H. pylori & Low Stomach Acid being the cause?

Answer:

This is an interesting question. I also wondered about this myself and dug into it.

Splenda and SIBO

Question:

I don’t like Splenda because it’s not natural and I have SIBO. This study suggests a negative effect on gut bacteria. What is your view?

Answer:

I totally respect your view. The Fast Tract Digestion books also suggest several natural alternatives to sugar including stevia for instance.

The most important thing for SIBO is to limit fermentable carbohydrates in your diet which include sucrose (i.e. sugar which contains fructose) and fructose (i.e. fruit sugar) itself.

As for the study, I view these results with a pretty big grain of salt for the following reasons:

             1.   The study was paid for by the sugar industry (who doesn’t like competition)
             2.   It was done in rats (is it relevant in humans?)
             3.   It has conflicting data (lack of a dose response)

Also, the study was discredited by an expert panel of scientists which concluded that “The study conclusions are not consistent with published literature and not supported by the data presented.”

At the end of the day, science is the judge. I continue to monitor studies on Splenda and other sweeteners and will post on these as they are published.

Jasmine rice and Fermentation Potential

Question:

There are two kinds of Jasmine rice, brown and white. Which one would you recommend?

Answer:

I recommend white jasmine rice because the Fermentation Potential (FP) points are very low.

About brown jasmine rice, the FP is unknown because glycemic index data is not available as far as I know, which makes difficult to derive its FP points.

But, because brown rice is less processed in general, fibrous carbohydrates (bran and germ layers) will impede digestion over white jasmine rice.

FP Calculator and Glycemic Index

Question: 

I want to use the free online FP calculator, but can not find Glycemic Index (GI) for the food I am interested in. What would you suggest?

Answer:

Here are a couple of websites where you can look up GI values: Mendosa.com and The University of Sydney website.

Though GI values exist for approximately 3000 different foods, many are culturally specific. Unfortunately, a GI value is not available for every single food in the market place.

The reasons being:

1. There are so many foods to test.
2. The test is expensive as it requires extensive testing on 10 people.
3. Testing of some lower carbohydrate foods is difficult because the test subjects must ingest a serving size with 50 grams net carbs.

If you can’t find a GI value, I recommend plugging in an average GI value of 50 for an estimate of the FP. For lower carb foods, the GI doesn’t actually matter that much and higher carb foods generally have been tested for GI.

The Fast Tract Digestion books list the Fermentation Potential (FP) or symptom potential for over 350 common foods including 60 vegetables. The books also give daily allowances of FP as part of a complete dietary solution. The Fast Tract Diet mobile app is another great resource, which has greatly increased the number of low FP food choices and included meal planning, point and symptoms tracking, voice recognition to look up foods on the fly and a built in FP calculator

IBS and Gut Microbiota

Question:

The Fast Tract Diet seems to starve all types (good & bad) of gut bacteria for my IBS. The ultimate goal to re-balance the microbiota is to use fermented foods and sometimes even antibiotics and antifungals, isn’t it?

Answer: 

The diet does not “starve” gut bacteria. The diet limits (not eliminates) hard-to-digest fermentable carbs that feed gut bacteria. Gut bacteria are also fed by fermentable animal-based foods as well as fermentable mucus carbohydrate side chains that our own body produces.

People with IBS have been shown to have less diverse gut bacteria with an overabundance of gas-producing carb-loving firmucutes bacteria. In other words, too many fermentable carbs can actually decrease the diversity of your gut microbiota.

Another way to dramatically disrupt the microbiota is taking antibiotics which do not discriminate between healthy and unhealthy gut bacteria. Seems we have quite different views on this subject.

This diet strikes at the underlying imbalance not just the symptoms. The Fast Tract Digestion IBS book also dedicates an important chapter to evaluation and correction of other potential underlying contributing causes.

I believe the single most important underlying cause of IBS in most people is the modern Western diet.

SIBO and Resistant Starch 

Question:

Can you comment on resistant starch? I have been on the Paleo diet and I learned that resistant starch should be helping small intestinal bacterial overgrowth (SIBO).

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