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Fast Tract Diet Q&A - Acid Reflux: Fats or Carbs?

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

The most likely reason that fat has been blamed for acid reflux in my view is the connection between fatty foods and carbs. We think of french fries and other deep fried foods including fried chicken or fish as “fatty”, but they also contain lots of carbohydrate i.e., french fries are made from potatoes and fried chicken and fish are coated in wheat or corn-based flour.

Also, in terms of delayed stomach emptying, this recent study and others indicate that high fat diets actually accelerate gastric emptying. In this study, they showed that mouth-to-cecum transit time (MCTT) actually decreased with high fat meals. In other words, food is moving more quickly to the end of the small intestine with more fat. This should help prevent bacterial overgrowth in the small intestine and reduce, not increase acid reflux

Fast Tract Diet Q&A for SIBO - FP for Parsnips

FP on Parsnips

Question:

After three years of searching for an answer, it only took a day for my symptoms to improve on the Fast Tract Diet. A quick question regarding the app vs. the book for FP. Why would 80g of parsnips in the app be 9 FP but only 3 according to the book? If in doubt should there be more like this, should I follow the book or the app for other food items as well

Answer:

Great observation. While developing the expanded database of foods for the mobile app, I realized that the GI (glycemic index) for parsnips published on the University of Sidney website was 52 (http://www.glycemicindex.com/foodSearch.php).

This is significantly lower than the GI of 97 published in their original database and included in the book “The New Glucose Revolution”, which the FP calculation was based on in the Fast Tract Digestion books.
In other words, the FP value in the books is based on that older GI. I have reached out the U. Sidney concerning this discrepancy but have not received a response. Maybe if more people ask, they will provide an answer. The bottom line is this: until I resolve this issue, it makes sense to use the most conservative GI, which translates into a higher FP for parsnips.

Fast Tract Diet Q&A for SIBO - Am I Getting Enough Carbohydrates?

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.

Fast Tract Diet App for Gut Health

Raw vs. Cooked Veggies in the Fast Tract Diet App

Question:

Why do some vegetables in the Fast Tract Diet App show cooked vs raw for FP but for all? For example, 1 cup of spinach raw is 1FP, but 1 cup of spinach cooked is 5 FP. And mushrooms are only listed as raw.

Answer:

The answer lies in portion size. For example, 1 cup of cooked spinach contains much more spinach than 1 cup of spinach raw. This is due to water loss from cooking.

When you measure out raw veggies, the FP will either be the same or slightly lower when you cook it. It will never be higher. But when you measure a veggie that has been cooked recognize that you often will be getting more veggies and less water and air – its more concentrated.

That is why I included some examples of cooked veggies. When in doubt, measure the veggies out raw and use the corresponding FP whether or not you cook them.

Fast Tract Diet Q&A - Not All Elemental Drinks Are Gut Friendly

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.

Fast Tract Diet Q&A for SIBO - Should I take apple cider vinegar for my GERD?

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.

If it helps you, there is little harm as long as you take a sip of water after to clear the esophagus. Also, most people with GERD have normal amounts of stomach acid (read “Does low stomach acid cause GERD?” in this article), so it might not be needed.

You can have your stomach acid tested via the Heidelberg capsule test or an equivalent endoscopic procedure. Lastly, many people are fructose intolerant but also have other intolerances (fiber, resistant starch, sugar alcohol and lactose). I recommend limiting all these carbohydrate types with the Fast Tract Diet until symptoms are gone. Then try adding one type of carbohydrate at a time to see how your body reacts.

Fast Tract Diet Q&A for SIBO

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.

Fast Tract Diet Q&A for SIBO - Rapidol Express

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.

Fast Tract Diet Q&A for SIBO - Are Too Many Veggies Not Good For SIBO?

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.

It’s important to remember that it only takes 30 grams (just over one ounce) of undigested carbohydrates for your gut bacteria to produce 10 liters of gas. Also, FP can build up due to slowly fermenting hard-to-digest carbohydrates from previous meals.

As you progress initially by keeping your FP points low, you will almost certainly improve your tolerance levels. But it takes time for some people. Keeping an eye out for hidden hard-to-digest carbohydrates and following the pro-digestion behavioral practices outlined in the Fast Tract Digestion book(s) will help.

The new Fast Tract Diet mobile app should also help, which has greatly increased the number of low FP food choices. The app will have the FP points for over 800 different foods, drinks, condiments, supplements, etc.

Fast Tract Diet Q&A for SIBO - Which Fibers Don't Ferment (Gut Friendly)?

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.

Cellulose is found in fruits, legumes, whole grains, and green vegetables. For most people, cellulose is a low risk fiber. The trouble is that many foods that contain cellulose also contain many other types of fiber, some of which are much more fermentable and more likely to invoke symptoms.

My advice is to consume low Fermentation Potential, FP vegetables, fruits and even some starches in moderation while limiting other higher FP choices.

Refer to the Fast Tract Digestion book(s) or soon to be released Fast Tract Diet app for help in choosing low FP foods.

Fast Tract Diet Q&A for SIBO - Don't High GI Foods Feed Bad Bacteria in Large Intestine?

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.

In cases where SIBO is extensive or extends to the early part of the small intestine, high GI carbohydrates could actually become part of the problem and a lower overall carbohydrate diet would be recommended in the short term, which allows your body to clear out the SIBO.

Both high and low GI carbohydrates are capable of feeding bad as well as good bacteria. It depends more on the metabolic capabilities of each type of bacteria. This really means whether they possess the enzymes to break down the various types of carbohydrate or not. But low GI carbohydrates are more available since they are not digested and absorbed as efficiently.

Fast Tract Diet Q&A for SIBO - How Can I Convert Grams & Ounces to Common Household Measures for Foods in the FP Tables?

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?

Answer:

Thanks for the question.

Common household measures are available in the Fast Tract Diet mobile app for Android and iPhone/iPad. The mobile app complements the books including 800 foods / drinks (more than doubling the number of foods in the FP food tables) in common household measures and grams. The app will also have a meal and symptom tracker, FP calculator, shopping list, etc. You can calculate FP on your specific brand of foods and drinks on the fly.

The dashboard gives you a trend of your FP vs. symptom on a graph by week and month, so that you can monitor your progress. Best of all, the app will feature voice recognition.

Fast Tract Diet Q&A for SIBO - Is Gellan Gum in Almond Milk Safe for SIBO?

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.

I’m not aware of any human safety issues with either gum, but in a rat study (not sure of the amount used, but likely much higher than product concentrations), the gellan gum groups exhibited a stickyness property that caused the intestinal microvilli to stick together. If this were to happen in people, you might imagine that your digestion would be much less efficient, potentially resulting in malabsorption and SIBO.

This may not be relevant with concentrations used in almond milk, but it’s hard to tell without comparing the quantity used in products with that used in the rat study and possibly conducting additional testing in humans. For making solutions more viscous, approximately 0.1 to 0.5 % is used. If you go over 1%, you typically create a gel.

If you consume almond milk regularly, perhaps you can make your own almond milk without any additives.

Gellan Rat study and Gellan tox review in humans 

Fast Tract Diet Q&A - Is the Fast Tract Diet Effective for Gastritis?

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.

H. pylori is the most common cause, but over use of NSAIDs, alcohol abuse or an autoimmune condition called autoimmune metaplastic atrophic gastitis (AMAG) can also be involved. Gastritis may be acute or chronic. It can affect different areas of the stomach (cardia, body and antrum) and may be erosive or non-erosive in nature.

Successful treatment will depend on learning more about your specific condition and identifying and addressing the underlying cause(s). If you need help, consider our consultation program.

The Fast Tract Diet specifically targets SIBO and related conditions. Controlling bacterial overgrowth will reduce the amount of bile, bacteria and digestive enzymes being refluxed into the stomach and beyond. That may reduce irritation and improve gastritis in some cases, but this is speculative. I can’t guarantee the diet will resolve gastritis without taking the steps outlined above.

Fast Tract Diet Q&A for SIBO - Gluten Free Flours and Their Symptom Potential

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.

Sprouted grains are reportedly easier to digest and should therefore have higher GI values and lower FP values. Unfortunately, I don’t have the specific FP for the sprouted oat and corn flour because there are no GI values available as far as I can tell.

One product that was tested for GI is sprouted 3 grain bread by Stonemill. The GI was measured as 55 giving an FP value of 7 for one slice, which is not terribly impressive and leading me to question the “easier to digest” claim. But someone on the Fast Tract Diet FB page indicated that these sprouted grain breads also contain un-sprouted flour which makes my conclusion questionable.

The bottom line is this. We need more research into the digestibility of sprouted grain products to make a final conclusion and determine accurate FP values for these grains.

One assumption you could make is that sprouted oat and corn flour should not be any worse than the corresponding non-sprouted grains.

– ¼ cup of oat flour consumed as porridge = 7 FP
– ¼ cup of corn starch = 4 FP
– ¼ cup of whole grain corn meal = 9 FP

Stay tuned for the Fast Tract Diet mobile app for Android and iOS coming out this fall. The app includes over 30 flours and grains out of 800 foods and drinks.

Fast Tract Diet Q&A for SIBO - Is SIBO Autoimmune Disease?

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.

But there are many other IBS sufferers whose condition was brought about by other means including a variety of other motility disorders, digestive enzyme deficiencies (cystic fibrosis as the extreme example), antibiotic use, lactose or fructose intolerance or simply consuming more fermentable carbs than one’s body can process, particularly as we age. Each of these cases (and others) can lead to SIBO or general dysbiosis and IBS, GERD, leaky gut and other SIBO-related conditions.

Fast Tract Diet Q&A for SIBO - Gut Microbes Feed or impede?

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?

Answer:

Good question and one I have thought about quite a bit. A simple answer is no and here is my answer in two parts.

The first part has to do with changes over the years in our microbiota. With rampant use of antibiotics and preservatives along with more cooked and processed foods, there is no doubt the diversity of our gut microbes has been reduced. This change could make it more difficult to process huge amounts of fermentable and complex carbohydrates as we may have once been able.

The second part has to do with how we count fermentable carbohydrates. The strict definition focuses on dietary fiber in its various forms. But I think the definition should be expanded to include all carbohydrates that routinely escape digestion / absorption and are available for fermentation. Thus I created the FP formula to measure this.

The number of fermentable carbohydrates is also higher for people with various carbohydrate intolerances (i.e. lactose, fructose intolerance, etc.) You can add fiber and resistant starch intolerance as well. In addition to fiber, other foods containing fructose, sucrose, lactose, resistant starch and sugar alcohols have many of the attributes of dietary fiber.

When you look at things in this way, we are not starving our gut microbes but more likely overfeeding them. The typical Western diet contains well over 100 grams of fermentable carbohydrates per day when you measure them using the Fermentation Potential (FP) calculation as explained in the Fast Tract Digestion books. The Fast Tract Diet recommends limiting FP under 45 grams a day. This is much higher than the 12 grams of dietary fiber per day cited by Sonnenburg and others. Over feeding our gut microbes can result in blooms of bacterial growth, SIBO and dysbiosis, but a less diverse microbe population overall.

Fast Tract Diet Q&A for SIBO - Gut Friendly flours

Gut Friendly Flours 

Question:

I am severely allergic to tree nuts. I was wondering what I could substitute for the Almond Flour in a few of dessert recipes in the Fast Tract Diet?

Answer:

A good alternative to an almond flour crust is using a mix of tapioca flour and rice flour. Here’s a good recipe I use, though I replace the sugar with a non-sugar sweetener such as erythritol, dextrose or stevia for example.

Fast Tract Diet Q&A for SIBO - Why Does The Fast Tract Diet Include Processed Foods?

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.

Please remember that the Fast Tract Diet is a flexible point system adaptable to a variety of dietary preferences and you are empowered to make your own food and drink choices as long as they are within the FP guidelines for relief from SIBO and related symptoms.

The Fast Tract Diet works on a similar principle as the Weight Watcher program, except that you monitor your FP points instead of calories.

There are two main reasons that some processed foods are included in the tables:

1. To show that some of them have high symptom potential and you should avoid or limit them.
2. They are commonly available in the market place and some people choose to consume them for convenience so we want these folks to have access to the FP points for those foods.

Fast Tract Diet Q&A for SIBO - High GI Carbohydrates and Low FP Foods

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.

Low FP foods include both high carbohydrate

high GI foods as well as low carbohydrate foods. Using this combination of low FP foods allows one to address SIBO, IBS, GERD, LPR, etc. while controlling blood sugar at the same time.

The Fast Tract Diet described in the books recommends approximately 75 grams of carbohydrates per day. It is a lower carbohydrate diet compared to the 300 grams in the Standard American Diet. Depending on your individual tolerance for carbohydrates you can adjust the levels of carbohydrate in the Fast Tract Diet. Obviously, people with diabetes, metabolic disorders, etc. should adopt a lower carb diet.

Fast Tract Diet Q&A for SIBO - Would Simethicone Reduce Gas?

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.

My preference is to first employ dietary and behavioral strategies outlined in the Fast Tract Digestion books to control symptoms and improve gut health.

A Ten Year Old with SIBOFast Tract Diet Q&A for SIBO - A 10 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.

It will also help reinforce good decision making on snack and junk foods as many are high in FP points and should be limited.

Fast Tract Diet Q&A for SIBO - Suppliments

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.

Fast Tract Diet Q&A for SIBO - Soy Protein Isolate Powders and TempehSoy 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.

Fast Tract Diet Q&A for SIBO - Is Lactose Free Milk OK?

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.

There are other milk alternatives including rice, almond, coconut, and soy, etc. that are also low FP. Just make sure to choose unsweetened.

Fast Tract Diet Q&A for SIBO - Erythritol (Safe Sweetener)

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.

Fast Tract Diet Q&A for SIBO - Jasmine Rice and Digestion

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:

  1. Damage from small intestinal bacterial overgrowth, SIBO – as we have discussed in previous Q&As, people with SIBO often digest foods less efficiently than healthy people because of damage to the villi or microvilli digestive structures in the small intestine, as well as the enzymes on the microvilli.
  2. Deficiency in amylase enzyme needed to digest starch – the number of human amylase gene copies vary quite a bit from person to person. Your suggestion to try an amylase supplement makes sense.
  3. The rice not being prepared correctly – confirm that you ate freshly cooked Jasmine rice. If it was cooked, cooled and reheated, it could resist digestion/absorption due to an increase in resistant starch. 
  4. Consuming more rice than one’s body is capable of digesting – if this was the case, reduce the serving size to ½ cup prepared rice.

I suggest you hold off on Jasmine rice until your symptoms improve. But, if you want to try again, make sure that you eat freshly made rice, chew well and eat slowly. This gives your amylase better access to the starch molecules and more time to act before food makes it to the acidic stomach destroying the amylase.

Fast Tract Diet Q&A for SIBO - Coconut Yogurt and Symptom Potential (FP)

Coconut Yogurt and Symptom Potential (FP)

Question:

I am wondering if coconut yogurt has the same symptom potential (FP) as coconut milk. Being Paleo, coconut yogurt is a godsend.

Answer:

For one container (170 g) of Coconut Grove Plain Coconut Milk Yogurt, the FP is 8. Not too bad. This compares to the same serving size of regular plain milk-based yogurt which has an FP value of 6.

Fast Tract Diet for SIBO Q&A - Millet and Symptom Potential (FP)

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.

Fast Tract Diet Q&A - Fermentation Potential (FP) for Herbs

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.

Herbs range from 0 grams to 5 grams per tablespoon. Fresh herbs such as parsley, bay leaves and basil are on the low end (0-1), turmeric (2 g) in the middle with ground ginger (3 g), Paprika (3 g), curry powder (4 g), and ground cinnamon (5 g) on the higher end. A teaspoon has 1/3 the FP values listed above.

Fast Tract Diet Q&A - Do Fermented foods produce gas?

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).

Fast Tract Diet Q&A - Does the Fast Tract Diet help with bloating?

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.

Fast Tract Diet Q&A - Food allergies and SIBO / IBS

Food allergies and SIBO / IBS 

Question: 

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

Click here to learn more.

 

 

Fast Tract Diet Q&A - Agave and Fermentation Potential

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.

Cup of tea with chicory, isolated on white

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.

But this prebiotic property can also feed less desirable gas-producing bacteria resulting in gastrointestinal symptoms such as gas, bloating, cramps, etc. While some people can consume greater than 10 grams on inulin without side effects, many people will experience symptoms at much lower levels (http://jn.nutrition.org/content/129/7/1412S.full).

According the the FP calculation used to measure hard-to-digest fermentable carbohydrates on the Fast Tract Diet, each gram of inulin equals one gram of fermentation potential.

Most chicory-containing drinks contain 1 to 3 grams of total carbs, but the exact amount of inulin is not generally listed. I recommend counting the total carb count from the nutrition label as dietary fiber in the FP calculation to be on the safe side. Personally, I have experienced acid reflux from consuming these drinks and avoid them.

Fast Tract Diet Q&A - SIBO Diets

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.

Hands in medical gloves holding different empty plastic containe

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.

Fast Tract Diet Q&A - Bone Broth and Fermentation PotentialBone 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.

Depending upon the recipe, the FP of bone broth is either zero or really low. ENJOY!

Fast Tract Diet Q&A - Fruits and Fermentation Potential

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.

Most people will need to limit fructose, fiber and starch-containing fruits to stay within the FP limits.

But not everyone is fructose intolerant. If you are one of those people (you can be tested), you may be able to tolerate more fruits. Also limiting does NOT mean eliminating. You can still have a few slices of ripe banana in your smoothie instead of the whole thing.

Fast Tract Diet Q&A - SIBO and Leaky Gut

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

Fast Tract Diet Q&A - Acid Reflux, LPR and Prescription Drugs

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.

Fast Tract Diet Q&A - Glycemic Index, Starch and Fat

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 (http://1.usa.gov/1Ez29Im), I am wondering how this affects the FP of the meal as a whole.

Answer:

I agree that mixed meals, especially when fat is involved, will affect the glycemic index (GI) of the whole meal. Still, you’re still better off choosing low FP foods if your goal is to keep FP low.

Also, here’s a little known fact. The GI lowering effect observed when starch and fat are cooked together involves “starch:lipid complex” formation. The complexes are harder to digest.

But these complexes are formed between amylose starch and fat. So high amylopectin starches, such as red potatoes or jasmine rice that are low in FP will be less subject to this effect.

Here are three suggestions:

1. Choose starches with the highest amylopectin to amylose ratio (lowest FP, refer to FTD Tables).
2. If you’re still concerned, consume a little less potatoes, make them fresh, eat slowly and chew well.
3. This suggestion is less appealing, but consume potatoes in isolation because most potatoes have some amylose in them.

Fast Tract Diet Q&A - Candida Overgrowth

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

Fast Tract Diet Q&A - SIBO and Weight Loss

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.

Fast Tract Diet Q&A - Ankylosing Spondilitis, Klebsiella pneumoniae and Fiber

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?

Answer:

I agree, limiting starch, particularly amylose starch is a good strategy, but you should limit fiber as well. K. pneumonia can also degrade pectin, rafinose, stachyose, fructose oligosaccharide and other soy oligosaccharides. Here’s an old study.

Also, even if K. pneumonia could not use other forms of fiber, the breakdown of complex carbs is a collaborative activity where a wide variety of organisms – Clostridia, Bacteriodes, Klebsiella, Bifidobacteria, etc. work together to break apart these complex carbs and jointly use the partial or complete breakdown products.

Limiting overall carbs, particularly the hard-to-digest carbs (i.e. implementing the Fast Tract Diet) is the best way to reduce inflammation, leaky gut and overgrowth of gut bacteria including non desirable organisms such as K. pneumoniae.

Fast Tract Diet Q&A - SIBO Negative Reflux and IBS

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.

Fast Tract Diet Q&A about Probiotics and Fermented Foods

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.

Fast Tract Diet Q&A about Quinoa and Fermentation Potential

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.

Note that the glycemic index was determined on cooked, cooled and microwave reheated quinoa. Freshly cooked quinoa would likely have a higher GI and hence, lower FP. But the bottom line is consume quinoa with a good degree of caution. If you do have some, make it fresh, limit the quantity to 1/2 cup, eat slowly and chew well. If you have symptoms, switch to a lower FP starch.

Fast Tract Diet Q&A - KLEBSIELLA and Red Potatoes

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.

How to best accomplish this is the question. Avoiding all starch (and other carbs) is certainly the best dietary option. I have communicated with AS expert Dr. Alan Ebringer in UK extensively on this topic.

But the idea behind the Fast Tract Diet is that easier to digest amylopectin starch has a better chance of being fully digested and absorbed compared to amylose starch.

For that reason, low FP starches (with high glycemic indexes and higher amylopectin / amylose ratios) are preferred if you want to consume some starch in your diet. And red potatoes are more waxy, higher GI and lower amylose than other varieties. Of course, any starch that is malabsorbed can feed this bacterium.

One strategy is to omit all potatoes early on and then reintroduce low Fermentation Potential potatoes like red potatoes gradually being sure to follow the pro-digestion strategies discussed in the Fast Tract Digestion books.

Fast Tract Diet Q&A about 5 Hard-to-Digest Carbohydrates and SIBO

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.

Fast Tract Diet Q&A about SIBO, Elemental Diet and Fast Tract Diet

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.

Elemental diet products also contains predigested protein (free amino acids), and small amounts of fat in the form of easy-to-digest medium chain triglycerides. Lastly, the products contain essential minerals and vitamins.

But I would not recommend staying on the diet for more than two or three weeks as a whole foods diet is the healthiest in meeting our (complex) nutritional needs.

I recommend transitioning to the Fast Tract Diet after a couple of weeks. Keep in mind that full recovery depends on identifying and addressing any additional underlying factors that contributed to SIBO in the first place. The Fast Tract Digestion books and our consultation program can help with this process.

Fast Tract Diet Q&A about Red Potatoes and Symptom Potential

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.

I recommend trying the ones you have access to. Make sure you cook them well (baked is best), consume them fresh. Eat slowly, chew well, limit serving size and don’t consume leftovers.

Fast Tract Diet Q&A about Flatulence, Cause and Dietary Solution

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.

This could also be a sign of an imbalance in your gut microbiota or simply consuming too many complex carbohydrates.

The Fast Tract Diet should address this issue effectively because it is specifically focused on reducing excessive fermentation and the gas that goes along with it.

Fast Tract Diet Q&A about Inulin and Inulin Containing Suppliments

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.

As you know, I recommend limiting the fermentable carbs for people with IBS, GERD or other SIBO-related conditions. This supplement is no exception.

Though inulin, like lactulose may have mild laxative effects, the side effects (bloating, gas, belching, flatulence, reflux, cramps, etc.) are not worth the benefit.

I was looking at the supplements on the Gutsense page and notice that some (Ageless GI Recovery for instance) contain inulin, but the amount is very tiny – only 250 mg or 1/4 of a gram. This amount is very unlikely to cause any significant unwanted GI reactions.

If you are following the Fast Tract Diet and your daily FP points were 35 grams, taking this supplement twice a day would increase your FP points to 35.5 grams. No biggie.

Fast Tract Diet Q&A about “Fermentable Carbs” vs. “Fermented” Foods

“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.

 

Fast Tract Diet Q&A about Fermented Foods and Digestive Health

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.

Fast Tract Diet Q&A about Rice milk and Fermentation Potential (FP)

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.

Fast Tract Diet Q&A about Raw vs. Cooked VeggiesCooked 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 bookswhich 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 - Fast Tract DietConstipation, 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?

Click here to learn more.

Fast Tract Diet Q&A about GERD, H. pylori and Low Stomach AcidGERD, 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.

H. pylori and low stomach acid are not a common cause of acid reflux, but may contribute to something called atypical non-acid reflux in some people. This article has the details.

Fast Tract Diet Q&A about Splenda and SIBOSplenda 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.

JasmFast Tract Diet Q&A about Jasmine Rice and Fermentation Potentialine 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.

Fast Tract Diet Q&A about FP Calculator and Glycemic IndexFP 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.

Fast Tract Diet Q&A about IBS and Gut MicrobiotaIBS 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.

Fast Tract Diet Q&A about SIBO and Resistant StarchSIBO 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).

Click here to learn more.

Fast Tract Diet Q&A about HoneyHoney 

Question:

How come honey which is high in fructose is allowed on the Fast Tract Diet (FTD)?

Answer:

The FTD actually recommends limiting fructose-containing foods including sucrose, honey and maple syrup. But technically no food is illegal.

It’s all about counting the Fermentation Potential (FP) grams for the serving sizes of any food and making sure the overall FP points are within the limits for individual meals and overall daily totals.

For example, if you have one teaspoon of honey in your tea, you will add relatively a small amount of FP. Not too bad, but it can add up if you use too much.

Fast Tract Diet Q&A about SIBO Diets and Half and HalfSIBO Diets and Half and Half 

Question: Most diets for SIBO say don’t eat milk products. If I take half and half in tea with a lactase pill, am I going to be OK?

Answer: Yes, you should be fine. But milk and milk products also contain several oligosaccharides that behave as dietary fiber, which can be problematic in higher quantities. Therefore even lactose-free products still have fermentation potential (FP).

But since only a small amount of half and half is needed for tea, the FP value would be fairly low, particularly if you take a lactase pill.

Fast Tract Diet Q&A about Psyllium Husk and IBS / SIBOPsyllium Husk and IBS / SIBO

Question:

What is your opinion on taking psyllium husk for my IBS / SIBO?

Answer:

Above what you get from green stalked and leafy vegetables, I don’t think fiber is needed. In many people, fiber supplements make symptoms worse.

Also, some fiber supplements contain lots of sugar which is half fructose. Symptomatic fructose intolerance is very common.

Lastly the FDA has warned of choking and intestinal blockage risks associated with fiber supplements. I don’t recommend these supplements, but if you try them, experiment with small amounts and drink lots of water.

Fast Tract Diet Q&A about GERD and Hiatal HerniaGERD with Hiatal Hernia

Question:

Does the Fast Tract Diet work for GERD with hiatal hernia?

Answer:

Having a hiatal hernia is a bit like wearing tight clothes or being pregnant. Because the hernia is essentially the top part of your stomach being pinched above the diaphragm.

There is often extra intragastric pressure (pressure in your stomach) that can trigger reflux. The Fast Tract Diet (FTD) is designed to reduce this intragastric pressure at the source, gas produced by overgrowing bacteria in your intestines which is fed mostly by unabsorbed carbohydrates.

There is every reason to believe that the FTD will help even in the presence of the hernia, but you might have to be extra diligent reducing FP points even more and following the proabsorption behaviors in the Fast Tract Digestion Heartburn book.

Fast Tract Diet Q&A about Pregnancy and GERDPregnancy and GERD

Question:

I am 9 weeks pregnant and having a terrible time with GERD. Is the Fast Tract Diet safe?

Answer:

The Fast Tract Diet (FTD) is based on whole healthy foods and is fine for pregnancy. I am aware that gestational diabetes can arise half way into pregnancy sometimes. But, that is not an issue with FTD as the daily carbohydrate count of its meal plans is approximately 75 grams per day.

Fast Tract Diet Q&A about GERD and Asthma

GERD and Asthma

Question:

The Fast Tract Diet helped my GERD and asthmatic symptoms. Why does the diet work for asthma?

Click here to learn more.

 

Fast Tract Diet Q&A about Fermentation Potential (FP) and FP Calculator Fermentation Potential (FP) and FP Calculator

Question:

What is Fermentation Potential (FP) in the Fast Tract Diet and how does it work?

Answer:

FP is a mathematical formula that measures the symptom potential of foods. High FP foods are more likely to drive small intestinal bacterial overgrowth (SIBO) and other SIBO related conditions including acid reflux, gastroesophageal reflux disease (GERD), laryngopharyngeal Reflux Disease (LPR) and irritable bowel syndrome (IBS).

The Fast Tract Diet is based on the idea that certain carbohydrates are difficult digest because of their molecular structures in food chemistry. Difficult-to-digest carbs are more subject to malabsorption (a failure to be fully absorbed from the gastrointestinal tract). And they tend to persist in the small intestine, which potentially feeds blooms of SIBO.

Unless you are a nutritionist, it’s hard to know what types of carbohydrates are in each food and how much. The Fast Tract Diet solved this problem with FP. Give the free online FP calculator a try to see how it works

Fast Tract Diet Q&A about Specific Carbohydrate DietSpecific Carbohydrate Diet

Question:

In the book, Breaking the vicious cycle, apple and banana are listed as legal foods. What is your view?

Answer:

Breaking the Vicious Cycle (Specific Carbohydrate Diet, SCD) is a groundbreaking book that helped bring to light the connection between diet and gut microbes in digestive health.

That being said, the SCD does not limit fructose or fiber consumption, but the Fast Tract Diet (FTD) does. Both apples and bananas have high Fermentation Potentials (FP) because of fructose in both fruits, and also resistant starch (up to 37%) in the case of bananas. Therefore, they have significant symptom potential.

You can still consume apples and bananas on FTD, but adjust the amount. For instance, start with one quarter of an apple or 1/3 of a ripened banana once your symptoms are under control. For more info. on the difference between SCD and FTD, refer to my blog article on SIBO Diets

Fast Tract Diet Q&A about Calories

Calories 

Question:

I feel hungry being on the Fast Tract Diet. What do you suggest?

Answer:

The diet reduces fermentable carbohydrates: therefore, you need to replace calories with low fermentation potential (FP) foods, proteins and fats.

Fats are not the enemy if you are concerned. These are a couple of readings for your reference.

Study: Doubling Saturated Fat in Diet Does not Increase Saturated Fat in Blood

Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis

Fast Tract Diet Q&A about Fiber Fiber 

Question:

I am a little concerned about the lack of fiber for long term in the Fast Tract Diet, especially for my constipation. Thoughts?

Answer:

There is much more fermentable material (both from plants and animals) in our diet than we realize.

30-45 grams of fermentable carbs (FP points) per day is plenty to keep our microbes happy but not enough to make those of us with lower tolerance ill.

Unfortunately, the many health claims on dietary fiber are not supported by current research. And the dark side for digestive health is real.

As for constipation, a recent study reported that stopping or reducing dietary fiber intake actually reduced constipation.

Fast Tract Diet Q&A about FODMAPs vs. Fast Tract DietFODMAPs vs. Fast Tract Diet

Question:

I want to try the Fast Tract Diet, but I have grown so confused dealing with all of the conflicting food advice. FODMAPs suggests avoiding onions, garlic, artichokes, asparagus, avocado, beets, broccoli, green beans, mushrooms yogurt etc.

Answer:

The FODMAP diet is an elimination diet. But, the Fast Tract Diet uses a quantitative approach based on Fermentation Potential (FP). For this reason, reasonable sized servings of vegetables that contain small amounts of FODMAPs are still acceptable as long as you keep your overall FP levels in line with recommendations.

For example, a few small cloves of garlic do contain a FODMAP (fructose oligosaccharide) but only a couple of grams which is also reflected in the FP value. So by following the low FP approach, you are also controlling FODMAP levels, but in a quantitative manner as opposed to just eliminating any food with even a trace of FODMAPs.