Diet for Leaky Gut

by Sue Kira, Naturopath & Clinical Nutritionist

Introduction to leaky gut

Fixing a leaky gut

Step 1: See a qualified practitioner for diagnosis and advice 

Step 2: Commence Intermittent Fasting

Step 3: The Clearing Phase (the SIBO/Low Histamine Diet)

• Histamine intolerance and leaky gut
• SIBO and Leaky Gut

Step 4: The Healing and Sealing Phase

Step 5: The Rebuilding and Re-seeding Phase

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Case Study: Did she have Autism or Leaky Gut?

Introduction to leaky gut (intestinal permeability)

Our digestive tract serves as a protective barrier between our blood stream and the food we eat. At the same time, it absorbs fully digested fats, proteins, and carbohydrates from the gut into our blood stream.

These macro-nutrients are absorbed into the blood via ‘tight junctions’ which are very small, tight joins between the cells in the gut lining which butt up against each other.

But when the digestive tract gets affected by infections, inflammation, antibiotic use, chronic stress, environmental toxins or processed food, then the gut lining gets weak, those ‘tight joints’ start to separate, and the gut becomes more permeable or in other words ‘leaky’ (hence the term ‘Leaky Gut’ or ‘intestinal permeability’).

With a weak or leaky gut lining, larger undigested food particles enter the blood stream. The immune system gets confused by these undigested food particles floating around and starts to launch immune responses against certain foods, creating food sensitivities. If left unchecked, additional immune responses can occur which can result in various diseases and disorders.

By healing your leaky gut, you can help prevent a myriad of health conditions, including auto-immune diseases.

Common symptoms & disorders associated with ‘Leaky Gut’

• Allergies
• Anxiety
• Arthritis
• Asthma
• Autism
• Autoimmune disease
• Cancer treatments
• Celiac Disease
• Chronic fatigue syndrome
• Constipation
• Crohn’s disease
• Cystic Fibrosis
• Depression
• Diarrhoea
• Eczema
• Ear Infections (recurring)
• Environmental illness
• Food sensitivities/allergies
• Gas/bloating/wind
• Hives
• Hyperactivity
• Indigestion
• Irritable Bowel Syndrome
• Learning and behaviour problems
• Malabsorption/malnutrition
• Multiple Chemical Sensitivities (MCS)
• Parasites
• Poor immune function
• Psoriasis
• Skin rashes
• Ulcerative colitis

Fixing a leaky gut

The most important thing to help your gut heal and seal is first remove what is damaging your gut and creating inflammation.

The process to heal leaky gut takes time, the length of which will depend on the severity of your symptoms, related health conditions, and your dedication to following a step-by-step therapeutic dietary program.

Some clients take three to six months to heal leaky gut, whereas for severe cases it may take up to two years…and that’s provided the dietary protocols are faithfully followed.

The step-by-step therapeutic dietary program is the most important aspect to heal leaky gut. While supplements are certainly beneficial, some clients cannot afford them or may react to supplements. Supplements without dietary intervention will not be enough to heal, whereas the recommended leaky gut diet program alone has delivered excellent results. Optimally, diet along with a specific nutrient/herbal supplementation regime delivers the fastest results.

The consequences for your health and vitality can be considerable for you to enjoy a better quality of life.

These are the various steps to heal Leaky Gut with the details to follow. But depending on circumstances, each step may not have to be followed.

Step 1: See a qualified practitioner for diagnosis and advice.

Step 2: Commence an Intermittent Fast

Step 3: The Clearing Phase (SIBO or Low Histamine Diet)

Step 4: The Healing and Sealing Phase (Diet for Leaky Gut – Level 1)

Step 5: The Rebuilding and Re-seeding Phase (Diet for Leaky Gut – Level 2)

Step 1: See a qualified practitioner for diagnosis and advice

If you feel you have symptoms or sensitivities associated with Leaky Gut Syndrome (see above) that are getting worse then it is imperative to seek advice from a professional health care practitioner regarding some of the causes and concurrent imbalances such as possible infections, bacterial overgrowth, and food intolerances. There are various tests your practitioner can arrange.

Your practitioner can also provide good nutritional, probiotic and gut healing support, guide you through the diets, and monitor your progress.

Important: Before you commence this diet, ask your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.

Note: During the early stages of the diet, you may experience symptoms such as fatigue, headaches, or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.

The best and most efficient way to heal a leaky gut/intestinal permeability is to follow a four-step dietary progression (which follows) by eliminating foods considered detrimental and including foods that support your body to give it the best chance to heal naturally and regain balance and vitality. That’s why it is so important to exclude antagonistic foods and drinks such as gluten, dairy, additives, and sugar – apart from the specific recommended foods within each stage.

Step 2: Commence Intermittent Fasting

Intermittent fasting is an excellent and sustainable way of eating, irrespective if you are perfectly healthy or otherwise.

Intermittent fasting is more about changing when you eat, rather than not eating. It can be an amazing tool for healing the gut. Intermittent fasting has been reported to have many benefits, including losing excess weight, balancing hormones, healing a ‘leaky gut’ and even muscle building.

If your Leaky Gut symptoms are mild it is quite possible that intermittent fasting alone will be enough to heal the gut. But if your symptoms are more severe, then intermittent fasting is still a wonderful adjunct to run concurrently with the complete dietary program…and you may find it beneficial to continue after you have healed.

The idea of an intermittent fast is to give your body the time and space it needs to heal, without continually adding food. When you eat your body uses up more energy for digestion, which instead could be re-directed to aid the healing process.

There are various types of intermittent fasts, but to heal leaky gut, an easy fast is the daily type where you have a 16-18hr window of fasting between your night-time meal and break-fast the next day.

For example, you could eat your evening meal at 6pm, your next meal at 10am, and then eat freely until 6pm…and repeat the cycle, which gives you a 16-hour fasting period. You choose the times to suit your lifestyle.

A 16-18hr fasting time allows your intestinal tract to heal because it is very hard for a gut to heal that is constantly digesting food. The process of digestion itself is an inflammatory activity, even without considering the type of food you are eating.

If you are hungry outside of these times, the ‘go to’ is clear bone broth or water, as our bodies are often thirsty rather than hungry.

You are still encouraged to eat the same calories/kilojoules in the 6-8hr window so your body doesn’t feel that you are starving it, and you will also get enough of the nutrients your body needs. The reason why it is better to avoid the early breakfast and eat later in the day (if possible) is because the morning is when the body naturally goes into detoxification and elimination mode, expelling waste matter through bowel movements.

Intermittent fasting still requires you eat healthy foods to reduce inflammation rather than pro-inflammatory foods. That way your body will naturally produce the hormones needed to maintain good health.

I recommend you include intermittent fasting to help regain your health and vitality. Discuss intermittent fasting with your practitioner before starting, as this style of eating doesn’t suit everyone.

Step 3: The Clearing Phase (SIBO or Low Histamine Diet)

It is very common for people with leaky gut to have SIBO (small intestine bacterial overgrowth), high histamine levels, and intolerance to histamines. This means SIBO and/or excessive histamine levels must be reduced before moving onto Step 4: The Healing and Sealing Phase.

But if you are fortunate not to have both conditions, you can move directly onto Step 4.

The SIBO Diet is similar to the Low Histamine Diet. In most cases I recommend my clients follow the SIBO Diet as it is not necessary to follow both, which could be confusing.

However, there are variations depending on the symptoms. For example, if symptoms tend to be more respiratory based, I’d recommend the Low Histamine Diet; if more gut based, I’d suggest the SIBO diet. There are other variations, depending on symptoms, client history and test results.

Following is an overview of both the Low Histamine Diet and the SIBO Diet, including recommended foods and foods to avoid. Your practitioner can advise which is more suitable for you in Step 3: The Clearing Phase.

Histamine intolerance and leaky gut

Many symptoms of histamine intolerance are similar to ‘leaky gut’, which is an important reason to avoid high histamine foods, until at least some of the symptoms improve.

Histamine is a neurotransmitter (chemical). Its job is to communicate important messages from your body to your brain, increase stomach acid to help you break down food, and assist the immune system to fight invading pathogens. Your body needs just the right amount of histamine to do its jobs, not too much and not too little.

An imbalance of bacteria in the intestines (known as dysbiosis) means there are more ‘bad bugs’ than ‘good bugs’, or maybe good bugs in the wrong place, such as bacteria from the large intestine being in the small intestine instead.

These ‘bugs’ are the bacteria and parasites that secrete histamine, which creates inflammation and irritation. In this inflamed state, the gut may be unable to create enough enzymes needed to deal with the extra histamines.

Dysbiosis not only directly increases histamine levels by secreting histamine but dysbiosis also indirectly increases histamine via damage to the gut lining which decreases the enzyme Diamine Oxidase (DAO) – an enzyme that breaks down histamine.

This can create a cyclic effect of inflammation – the gut creates more histamine and higher histamine creates more inflammation. This is why we reduce the added histamines from food, particularly in the early phases of the Leaky Gut Diet, to allow the gut to settle the inflammation and also to clear the SIBO.

After a few weeks or so (determined by your practitioner, based on symptoms) we introduce gut healing foods using pre and pro-biotic foods that are higher in natural histamines. These are beneficial to balance the healing needed to restore the bacterial balance.

Symptoms of a histamine intolerance or overload of histamine in the bod

• Rash or itching (anywhere)
• Heartburn or acid reflux
• Headache or migraine (not related to neck strain)
• Gas, bloating, cramping and diarrhea or constipation
• Dry or swollen lips
• Muscle tremors or twitching
• Anxiety or panic attack
• Insomnia (especially where you wake between 2-4am
• Low blood pressure, irregular or racing heartbeat
• Asthma, acne, eczema or psoriasis

Histamine is naturally high in some foods, but lower in others. However, ‘time’ can increase histamine levels. For example, left over foods have more histamine compared to fresh foods.

You may also have a threshold level of histamine in foods that is ok, but when combined with a bacterial imbalance and a glass of red wine or piece of chocolate, which are naturally high in histamine – then whammo, you get one of the above symptoms.

You don’t have to have conditions like hay-fever or allergies to have a histamine problem, but you may have what is called histamine intolerance.

Anybody can have histamine intolerance, but you are at higher risk if you eat a ‘GAPS’ style diet, or a low-carb/high protein diet, or enjoy gourmet foods, or consume fermented foods, because histamine is found primarily in aged, fermented, cured, cultured and smoked foods.

The best way to avoid histamines is to shun foods high in histamine, choose fresh foods whenever possible, look for the ‘packed on’ date of the meat or fish being sold. ‘FAS’ (frozen-at-sea) may be your best bet.

Grass-fed and pastured meats are not necessarily better choices from a histamine perspective – it depends on how far it travelled and how long it took to get to your store. Most beef ‘hangs’ for at least two weeks before it is chopped up, packed, wrapped and shipped to the butcher, even if it comes from a local family farm that pasture raised their animals. Therefore, most beef is aged to some extent.

Once histamine develops in a food, there is no getting rid of it, not even with high heat. And if bacteria or yeast are still present in the food then histamine levels will continue to rise.

Even though the foods in a traditional leaky gut healing diet are soothing and gut restorative, for some people these healing foods (bone broth, pre and probiotics and fermented foods) can actually make them feel worse. This can be due to the extra histamines found in these foods along with histamine intolerance. Also, as mentioned earlier, if you have an overgrowth of  bacteria in your gut or parasites, these critters will secrete histamine too.

When progressing onto the last phase of the Leaky Gut Diet (Rebuilding and Re-seeding) be aware if you get any return or exacerbation of symptoms when you introduce the foods like bone broth, fermented foods and probiotic foods. Check with your practitioner if you are unsure about any symptoms.

There is no such thing as a totally ‘histamine-free diet’, but the best way to reduce your levels is to eat low histamine foods and avoid high histamine foods.

Low histamine level foods (acceptable):

• Fresh meat, fish and chicken (cooled, frozen or fresh) and egg yolks
• Fresh fruits: except those listed below as high histamine
• Fresh vegetables: except tomatoes and other nightshade veggies
• Grains: only rice, buckwheat and quinoa (freshly cooked)
• Milk substitutes: coconut milk, rice milk (NOT nut milks)
• Most oils are fine but check for rancidity
• Most leafy herbs are fine
• Herbal teas: but not black or green tea or coffee as these are fermented

High histamine level foods (to avoid):

• All alcohol and any other fermented, pickled or canned foods/drinks
• Cheese, especially matured cheeses
• Smoked meat products – salami, ham, sausages
• Shellfish, tinned fish and fish that’s not very fresh, or fresh frozen
• Beans and pulses – chickpeas, soy beans, peanuts, cashews (not so bad if sprouted)
• All nuts and nut milks but especially walnuts (can be ok for some people in small amounts especially if soaked)
• Chocolates and other cocoa based products (raw cacao nibs without sugar can be ok in small amounts for some people, but all cacao beans are fermented)
• Black teas and coffee because they are fermented
• Citrus fruits plus kiwifruit, pineapple, plums, papaya, strawberries & tomatoes
• Wheat and foods containing yeast as they are a catalyst for histamine generation
• Vinegar and foods with vinegar such as mustard, mayo
• All fermented foods are high in histamine but can be tolerated once the ‘leaky gut’ has had a degree of healing. However initially avoid bone broth, kefir, kombucha, any fermented foods, yoghurts etc.
• Ready-made packet meals
• Salty snacks, sweets with preservatives and artificial colourings & additives – benzoate, sulphites, nitrites, glutamates and food dyes

Some find that a Low FODMAPs Diet also helps to settle down histamine reactions to foods too. Talk to your practitioner about which diet best suits you to support the healing of ‘Leaky Gut’.

Just for your interest – the Low FODMAPs and SIBO diets (following) are very similar to each other, both reducing fermentable foods that might otherwise lead to bacterial fermentation, immune activation, release of inflammatory cytokines, gas production, reduced gut motility, permeability (leaky gut), GI symptoms and even cognitive and emotional changes.

SIBO and Leaky Gut

The health of our gut is the foundation of the health of our entire body.

The gut is not just an organ that we push food in and waste comes out the other end. In fact, our intestines have an amazing number of jobs to do. It certainly breaks down and digests our food so that we can get the nutrients needed to stay healthy…‘but wait there’s more’. Our intestines host innumerable amounts of bacteria both good and bad.

It’s all about the type of bacteria in our small intestines.

Apparently we have more bacterial DNA in our body than human DNA in our body. Most of these bacteria work in harmony with our cells. The cells and the bacteria work together symbiotically to create many necessary changes needed to run ‘your machine’. There’s a type of ‘pay off’ system, whereby the bacteria, in the process of breaking down food (along with digestive enzymes etc) to get what they need to survive, give us what we need to survive and thrive. In other words, we look after each other.

We see this type of symbiotic relationship in the plant and animal kingdom when something is unwell or weak, and then another animal, plant or insect will kill and break it down so that the cycle continues with birth, death and recycling. Now we really don’t want something in our body breaking us down, so it’s imperative that we maintain a healthy body.

Digestion starts when we chew food which then travels to the stomach. The chewing action stimulates the release of hydrochloric acid into the stomach which continues to break down the food.

After about three hours (depending on the type of food), the mixture passes into the small intestine which should be an alkaline environment that is aerobic (with oxygen). Then later, the mixture moves into the large intestine, an acidic anaerobic environment (without oxygen), where the bacteria fully break down any scraps.

The acid in the stomach is supposed to be very acidic and if not acidic enough, then it won’t break down the food properly before it is passed down to the small intestine where alkaline pancreatic acids are secreted.

And in reverse, should the bacteria in the large intestine get into the small intestine, they change the environment in the small intestine to one that is acidic and anaerobic. As a result, the large intestine bacteria kill off the friendly bacteria in the small intestine that need oxygen and an alkaline environment to thrive.

This environment makes the small intestine acidic and putrid with the right conditions for the acidic bacteria to grow and breed in the small intestine, hence Small Intestine Bacterial Overgrowth (SIBO).

As the acidic large intestine bacteria erodes or chews down the microvilli of the small intestine, this really upsets the apple cart as then we then can’t absorb our nutrients properly. If you don’t get the nutrients that would normally be absorbed from normal healthy digestion then you are likely to be deficient in vitamins, minerals and amino acids needed to balance hormones, neurotransmitters, build muscles, repair tissues and cells and give you the energy you need.

In this environment, food rots (ferments) rather than digests in our bodies, giving off poisonous noxious smelling gasses (farts) such as methane and/or hydrogen causing bloating, wind, cramping, diarrhoea, burping, constipation and many more symptoms.

It is also thought this gas can cause ‘leaky gut syndrome’, where the cell wall of the gut becomes permeable (leaky) which allows food particles into the blood stream instead of broken down nutrients and molecules. In turn, this creates an immune response because the immune system sees these particles as foreign, leading to food intolerance or even allergy if it continues. It is postulated in some cases to contribute to the creation of auto-immune diseases.

This is why a fully functioning digestive system is so important for us, where the payoff is the removal of waste without it rotting inside us and poisoning our body. The payoff for the bacteria is their survival.

What causes SIBO?

SIBO can be triggered in different ways, including the overconsumption of simple carbs and sugar, poor digestion from low stomach acid, candida overgrowth, an ileocecal valve problem, stress, underactive thyroid, the pill, antibiotic use, constipation, parasitic infections, bacterial overgrowth and various other causes.

Foods containing fermentable fibre, starch, lactose and fructose can create and/or aggravate SIBO, so part of the solution is to avoid these fermentable foods and allow the intestines to repair before consuming them again.

Given the right conditions the gut is very capable of repairing itself, but usually additional support with herbal antimicrobials, antibiotics (or both) is needed to kill off some of the bad bacteria, fungi and parasites. Be sure to get advice from your health care provider. There are stool tests and breath tests readily available to determine the level of SIBO, how bad it is and the type (Hydrogen, Methane or sulphur dominant).

Symptoms of SIBO

• Bloating
• Cramping
• Wind/flatulence or burping
• Constipation &/or diarrhoea
• Food sensitivities
• Skin rashes and other skin conditions
• Recurrent iron and/or B12 deficiency
• Recurrent headaches
• Restless legs syndrome
• Inability to lose weight or maintain weight in some cases

About the SIBO Diet

Normally the first stage to heal a leaky gut, apart from Step 2: Intermittent Fasting, is to go onto the SIBO Diet (Step3) to clear bacterial imbalance and any parasites.

You will need assistance from your integrative/functional doctor or health practitioner as you may require herbs or antibiotics to support this process.

The SIBO diet is in two parts, the first part (Phase 1) is to clear bacterial imbalance and any parasites. It is rather limiting in the foods allowed and can be tough to stick to, depending on what you are used to eating. Some of my clients have said it is the hardest thing they have ever done but so worth it.

It is important to follow SIBO Phase 1 for around six weeks or at least until your symptoms have settled. If you still have symptoms after six weeks you need to speak with your practitioner about further testing.

Then under the guidance of your practitioner you go onto Phase 2 foods (which allow more flexibility) for around six weeks. Be careful with sweeteners and feel when your body tells you that a food doesn’t suit you or causes bloating or any other symptoms.

Be vigilant of any returning symptoms and mindful of any constipation or diarrhoea, as both can re-ignite SIBO. You will also, under the care of your health provider, need some good strength multi-strain probiotics prescribed – and not just any old ones from the shops as many contain strains that may make matters worse for you. Commonly acidophilus types are not suitable at this stage.

If Phase 2 SIBO foods re-ignite the SIBO symptoms again, you can always go back to Phase 1 foods for a while longer. Usually this means that you need more anti-microbials, but if your body has become sensitive to antimicrobials or antibiotics, then the diet will continue to play a big role in your recovery.

Weight loss and the SIBO diets

Some of my clients have lost a lot of weight, particularly with the Phase 1 SIBO diet. For some this is a blessing, but for the slimmer ones, not so welcome.

If the weight loss becomes a problem for you, include more fats and oils to help keep the calories up. Every gram of carbohydrate (vegies included) has 4 calories and every gram of fat has 9 calories, so you can see that fat is a much more calorie dense food. If you want to increase your calories, try eating coconut oil, or the skin and fat from organic roasted chicken, or by not straining the fat when making bone broths. Your weight will adjust as you bring in more foods in the Phase 2 SIBO diet and beyond.

SIBO Phase 1 Foods

The Phase 1 diet includes an unlimited quantity (but don’t go overboard) of fresh:

• Meat
• Fish
• Poultry
• Eggs
• Bok Choy
• Carrots
• Kale
• Lettuce
• Olives (in olive oil or brine but not vinegar)
• Capsicum/bell peppers
• Radish
• Rocket
• Sunflower sprouts
• Lemons
• Limes
• Unlimited amounts of water, herbal teas or Rooibos tea in warm/hot water

Plus: only one of the following per meal if desired*

• Fresh Beetroot/Beets, 2 slices (not in vinegar) can be shredded (cooked or raw)
• Broccoli – ½ cup
• Celery – 1 stick
• Fennel bulb – ½ cup
• Green beans – 10 beans
• Peas – ¼ cup
• Snow peas – 5 pods
• Zucchini – ¾ cup
• Pumpkin – ¼ cup
• Almonds – 10
• Macadamias – 20
• Pumpkin seeds – 1Tbs
• Sunflower seeds – 2Tbs
• Pecans – 10
• Hazelnuts – 10

You can also mix up things and have less of one item and add a portion of another e.g. 5 green beans plus 5 chopped almonds sprinkled on top of the other vegetables

* Two extras per meal for vegans (see also notes below)

Plus some:

• Fats and oils: olive, coconut, grape seed oils; coconut cream – ¼ cup max per day
• Salt and pepper; all fresh and dried herbs and spices (additive free) – but not the blends as they often have additives.

Vegan and Vegetarian options with the SIBO Phase 1 Diet

If you are vegan or vegetarian it is certainly a lot harder to follow a SIBO diet because of the limited foods available. It is much more restrictive than the meat eater’s option as legumes and pulses are temporarily off the list which really restricts the food choices. But generally, vegans and vegetarians respond quicker to the diet and can often transit to the Phase 2 diet faster and then have more variety of foods to choose from.

Vegetarians have the option of using eggs as their main protein source along with the vegetables, nuts and seeds.

Vegans need to have plenty of the allowed vegetables and two lots from the Additional Foods section. For example, plenty of bok choy, carrots, kale, lettuce, olives, capsicum/bell peppers, radish, rocket, sunflower sprouts plus ½ cup fennel plus 10 macadamia nuts and 1 tablespoon of sunflower seeds.

Or as another example, bok choy, carrots, kale, lettuce, olives (in olive oil not vinegar), capsicum/bell peppers, radish, rocket, sunflower sprouts plus 5 macadamias, 1 tablespoon of sunflower seeds and 1 tablespoon of pumpkin seeds. You can mix and match to get your protein and variety.

If your symptoms don’t improve or get worse during the Phase 1 treatment, then you may have histamine sensitivity. Some bacteria actually secrete histamine, and if this is the case you will need to include a low histamine diet with the SIBO Phase 1 diet to reduce the inflammation that this extra histamine causes. Any added histamine from food can further drive inflammation and make it hard for your body to heal. Speak with your practitioner before changing or adding diets. With elevated histamine you may need additional antimicrobials and specific enzyme treatment.

SIBO Phase 2 Foods

Phase 2 brings much more variety to your meals and is a welcome change from the Phase 1 diet.

If you have been on the SIBO – Phase 1 diet, then in Phase 2 you can slowly introduce more of the foods you love, but be aware that if any symptoms return, then go back to Phase 1 and after a couple of weeks, reconsider what foods you gradually reintroduce. Speak to your practitioner about any symptoms you are unsure of or if any new symptoms arise.

The foods in phase 2 are either the same as phase 1 but you can now have a greater quantity of them, or there may be new foods (and old favourites) that you may wish to introduce now.

An unlimited quantity (but don’t go overboard) of fresh:

• Meat
• Fish
• Poultry
• Eggs
• Bok Choy
• Carrots
• Kale
• Lettuce
• Olives (in olive oil or brine but not vinegar)
• Capsicum/bell peppers
• Radish
• Rocket
• Sunflower sprouts
• Lemons
• Limes
• Unlimited amounts of water, herbal teas or Rooibos tea in warm/hot water

Additional Foods: only one of the following per meal if desired
Note: just have one of these foods below per meal in addition to your core diet above. You will slowly be able to introduce more of these as you progress, provided you don’t have any recurring symptoms. Be guided by your health practitioner.

• Fresh Beetroot/Beets, 2 slices (not in vinegar) can be shredded (cooked or raw)
• Broccoli – ½ cup
• Celery – 1 stick
• Fennel bulb – ½ cup
• Green beans – 10 beans
• Peas – ¼ cup
• Snow peas – 5 pods
• Zucchini – 1 cup
• Pumpkin – ½ cup
• Almonds – 10
• Macadamias – 20
• Pumpkin seeds – 1Tbs
• Sunflower seeds – 2Tbs
• Pecans – 10
• Hazelnuts – 10
• Spring onion – one shoot
• Parsnip – 1 small one
• Asparagus – 3 spears
• Brussels sprouts – ½ cup
• Leek – ½
• Spinach – 5 leaves/150g
• Banana – ½
• Berries (all varieties) – ½ cup
• Kiwifruit – 1 piece
• Rockmelon, honeydew, paw paw, papaya, pineapple – ¼ cup
• Passionfruit – 1 piece
• Rhubarb – 1 stalk
• Avocado – ¼
• Cherries – 3
• Grapes – 10
• Lychee – 5
• Pomegranate – ½ small or ¼ cup of seeds
• White Rice: Basmati or Jasmine – ½ cup per serve
• Organic Honey (clear)– no more than 2 tbsp per day (preferably none)
• Unsweetened Almond Milk – 1cup
• Hazelnuts – 20
• Pecans – 40
• Walnuts – 100g
• Apple cider vinegar (only this type of vinegar) 1tsp per day
• Sugarless Mayonnaise, Tabasco, Wasabi, Mustard (without garlic at this stage)

You can also mix up things and have less of one item and add a portion of another e.g. 5 grapes plus 20 pecans

Plus some:

• Fats and oils: olive, coconut, grape seed, pumpkin seed, sesame oils; infused oils e.g. garlic, basil, chilli; coconut cream – ¼ cup max per day
• Salt and pepper; all fresh and dried herbs and spices – but not the blends as they often have additives – if additive free then that’s fine

After you have completed Phase 2 of the SIBO Diet (the time will depend on symptoms – check with your practitioner) then it is time to move onto the Healing and Sealing phase.

Step 4: The Healing and Sealing Phase (Diet for Leaky Gut – Level 1)

This healing and sealing phase allows any remaining inflammation to settle, the leaky gut to seal and heal, and for the joins between the cells lining the intestine to become ‘tight junctions’ again.

The SIBO 2 and Leaky Gut 1 diets are very similar – the main difference is more diversity of food choices in Leaky Gut 1. If the SIBO diet was done completion (diligently) and depending on your symptoms and possibly re-testing for leaky gut to confirm sealing, you may only need to be on this phase for two or three weeks. Generally, six weeks is sufficient (but longer for severe cases of Leaky Gut).

The Leaky Gut Level 1 diet is low histamine and avoids grains, legumes, most nuts (except coconut), egg-whites, processed foods, foods with nitrates, sugar and nightshade foods.

It includes foods that are anti-inflammatory and gut healing such as fresh soups, steamed vegetables, healthy fats, wild-caught fish, pasture fed meat, certain low reactive vegetables, fresh low reactive fruits, and lots of other yummy foods to bring your body back to harmony.

Once completed then it’s time to move onto Step 5, the Rebuilding and Re-seeding Phase (Diet for Leaky Gut – Level 2).

Step 5: The Rebuilding and Re-seeding Phase (Diet for Leaky Gut – Level 2)

The final step is the rebuilding and re-seeding Phase (Diet for Leaky Gut – Level 2). This diet focuses on the gut restorative foods, slowly reintroducing fermented foods, probiotic rich foods, bone broths, soups, steamed vegetables, healthy fats (like egg yolks, salmon, avocados and coconut oil) and other foods to complete the healing and rejuvenation cycle of gut restoration and to bring balance back to the good bacteria in your digestive system.

One of the most powerful gut healing agents is bone broth which is packed with anti-inflammatory, amino rich, gelatine and collagen to help heal and seal your leaky gut. Many suggest the use of bones from chicken, turkey, duck, beef, lamb, pork, or fish.

I get my bones from an organic butcher to be certain there are no contaminants stored in the bones. Variety in flavour comes from using different vegetables, herbs and spices mixed with the broth. If you have FODMAP sensitivity you can omit onions in your brews that can cause more wind. (green bits from spring onions/scallions work well as a substitute).

At least a cup a day of bone broth is important and three to four cups, if you can manage it, is even better. You can buy bone broth ready-made as a liquid, a concentrate paste or even a powder, but it can be expensive, and you also don’t have control over what goes into the broth (e.g. onion). Talk to your practitioner about how much you should drink depending on how bad your leaky gut is.

If your symptoms feel worse from bone broth, you may have a histamine intolerance and the Diet for Low Histamine may be needed for a while. Speak with your practitioner before switching diets.

High histamine foods that are not gut healing are not included in this diet, but you can add these gradually after your healing program is complete and you and your practitioner are satisfied that you are safe to eat foods on the high histamine list. Take care by introducing any histamine food gradually to avoid relapsing into previous symptoms.

Next, ensure you are eating plenty of anti-inflammatory foods and foods that help to heal the gut. Anti-inflammatory foods are those that are rich in Omega 3 fatty acids from wild-caught fish and pasture fed animals. Barn raised and grain fed animals are higher in pro-inflammatory fats and will not help your condition. If you can afford organic, then better still.

Certain vegetables can also help to settle inflammation, such as spray free or organic dark green leafy vegetables, the cruciferous family of vegetables like broccoli, kale, Brussels sprouts, cabbage, cauliflower, and the colourful veggies like carrots, beets/beetroot, pumpkin/winter squash.

But if you also have or still have some SIBO and get bloated, take care with cruciferous veggies as they may aggravate the situation initially until your gut has begun to heal and seal.

Berries and papaya are about the only low sugar fruits that are suitable for leaky gut and they also provide bonus antioxidants, vitamins and minerals for your diet (and something sweet).

If you have SIBO symptoms, then you will need to stay off fermented foods for at least 6-12 weeks as part of the Leaky Gut Diet protocol.

But when your symptoms have settled, then fermented foods can be a great way to introduce some good bacteria to re-establish the gut lining. Start with some coconut yoghurt as this is very soothing for your tummy. Later when things feel further settled try a small amount of the fermented foods like sauerkraut. For more info click onto the Diet for SIBO.

It is important for healing that you get adequate vitamin D from either the sun (20 mins ‘sensible’ sun exposure per day), eating liver 2-3 times a week, or from a supplement.

Gut Inflammation link to anxiety & depression

Many people suffer from the debilitating effects of anxiety and depression and studies have shown a link between these symptoms and inflammation in the gut and leaky gut.

Interestingly, the incidence of anxiety and depression is increasing, while the incidence of poor gut health also increases. A coincidence?

After consulting with more than 15,000 clients, I estimate that at least 85% of them (and that’s being conservative) had gut issues that adversely affected their health.

Why is poor gut health on the increase? Reasons include poor diet, denatured food, less time spent in the kitchen, fast food, the overuse of antibiotics…and more.

Other key factors are stress and elevated cortisol, low cortisol or cortisol resistance. Cortisol resistance is where the body doesn’t recognise or is resistant to the message from cortisol that there is a stress response in the body. Kind of like ‘the boy who cried wolf’ syndrome.

Cortisol is our body’s way to deal with stress and inflammation but if either are prolonged then we can create ‘resistance’ and therefore the cortisol no longer reduces inflammation even if cortisol levels are high. The result of this is a prolonged inflammatory state.

Inflammation signals the release of white blood cells called Monocytes into the blood, which turn on proinflammatory genes that lead to the release of inflammatory cytokines.

Once triggered, the inflammatory cytokines talk to the central nervous system, via the Vagus nerve, which connects the gut and the brain, activating microglia in the brain, releasing an enzyme called IDO (indoleamine 2, 3-dioxygenase) which stimulates production of biomolecules that can result in symptoms of anxiety, restlessness, agitation or even panic attacks.

We often relate the cause of anxiety and depression to a brain biochemistry fault, when the cause could indeed be coming from the gut being inflamed, leaky or dysbiotic (wrong balance of bacteria).

Consider this: if medication for anxiety or depression is working, then the cause may well be a brain biochemistry imbalance; but if medication is not working effectively, the cause could be related to gut issues. It’s worth checking.

There are many ways to check if you have gut inflammation. In clinic, I use Live Blood screening to view the various types of blood cells and other factors visible. I also use external tests, particularly the gut microbiome testing that looks at things like leaky gut, digestion markers, bacteria levels (good and bad), viruses, parasites and fungi like Candida species. Another good test I often use is Organic Acid testing. For more on tests, view here.

The right tests provide valuable information which may uncover underlying causes of anxiety, depression, restlessness and generally feeling out of sorts.

If you would like to book an in-clinic, skype or phone consultation which may help to unravel the root causes, please click here

Case study: Healing leaky gut and depression naturally

Client name and identifying information changed

When Ronald first came to me he was suffering badly from chronic depression. He had already been on numerous different anti-depressants and even tried electro-convulsive shock therapy (ECT). He had almost given up and at times felt suicidal, but he had much to live for with a loving wife and two small children. His wife initially visited me for her own stress support, and then on her advice, he made an appointment.

He couldn’t remember when it all started or even how, but it seemed to just sneak up on him and gradually get worse to the point where he could no longer work or look after himself. He seemed at a loss.

I said that because he hadn’t responded well to drug treatment, then there must be something else going on that had been previously missed, so I organised a variety of tests. Fortunately, his wife brought along lots of results that had already been screened by his doctors which helped to rule out many possibilities.

I tested him for pyrrole disorder (common in mental health symptoms) but that was all clear. I checked his gut function and it was a mess. He had leaky gut, food allergies and intolerances, no good bacteria at all and a few different types of bad bacteria. Luckily, nothing too harmful but it still undermined his health and gut.

The gut is responsible for about 80% of our serotonin (the happy & relaxing neurotransmitter) so it was obvious that he couldn’t get the right balance of neurotransmitters because of the condition of his gut.

The first thing to do was to remove all offending foods that came up on Ronald’s intolerance test including gluten, dairy, eggs, yeast, most nuts and chocolate (which he constantly ate to try and feel better). I also advised him of the foods that would help to heal and seal his gut.

Fortunately, he had a dedicated wife who could prepare all that he needed. He loved the bone broths and as she said, “he can’t seem to get enough of it, drinking up to 2 litres of the stuff a day”. His body was calling for it.

We also implemented a protocol of herbs to kill off the bad bugs along with some probiotics to re-inoculate the ‘good guys’ as he couldn’t use other fermented foods for a while due to the SIBO (bacterial overgrowth).

Even though he felt much better within a week, it gradually took six months for him to come back to feeling strong enough to go back to work, which he wanted to do. He couldn’t even contemplate working when he first came in.

After twelve months on the diet plus some supplements to speed things up, he was back to his normal chirpy self. I barely recognised him when he came in with his daughter for an infection a few years later. He just looked so vibrant, healthy and happy.

Case Study: Did she have Autism or Leaky Gut?

Client names and identifying information changed

Samantha was born by C-section after a long, difficult labour turned a bit nasty. Her mum, Casey really wanted a natural birth as she felt this would be the best start for Samantha, but this was not an option due to complications.

To make matters worse, little Samantha had trouble sucking and had to go onto the bottle after only a few days. Samantha seemed to thrive well and that appeared to be the end of the story, until Samantha was about 2yrs old and started to behave ‘differently’.

Casey said it was after Samantha had a vaccine injection, but it’s hard to say what may have happened, except that her little girl was just ‘different’. Doctors didn’t know what was going on and Casey was passed off as being a ‘worrier’. By the time Samantha was four she was rude, belligerent, cried frequently, held her tummy a lot and fought with her brother at any given moment.

Samantha started pre-school and the child-carer suggested that she get tested for autism because her behaviour was uncontrollable most of the time, with very little engagement with other children, except to hit them.

When Casey brought Samantha to my clinic, no tests had been done at that stage. So I observed Samantha and she seemed to be in pain, although this had not been mentioned by either mum or Sam. I asked Samantha where it hurt and she looked at me blankly as if she didn’t know what that meant.

Casey said that Sam never complained about pain, but maybe she didn’t know what it was and just used her actions to express herself. Even though Samantha was four she didn’t talk much, which worried Casey.

We ran some tests including a comprehensive digestive stool analysis to look at her good and bad bacteria levels. We also looked at her mineral and metal levels.

The results were quite mind blowing for such a small person. It appeared that Samantha had developed celiac disease, even though there was no family history.

Her gut was very inflamed which meant she would not have been absorbing any nutrients.

Her bacteria levels showed high bad bacteria and hardly any good bacteria. Her heavy metal screen showed high copper and very low zinc, magnesium, potassium and calcium. Her poor little body simply couldn’t absorb any good minerals from her diet.

The first thing to address was diet and Samantha was taken off all gluten foods and all foods with any possible cross-reactivity. She was fed lots of foods rich in vital minerals to support her body and to help to heal her ‘leaky gut’.

We could not get her to take any supplements, although we did manage to sneak in some probiotic powders into coconut milk for her, which she loved. Generally, she seemed happy to comply with the diet (although some creative bartering was needed for full compliance).

Six weeks later she was a new girl. Her behaviour was significantly better, she was more settled, listened to those around her and expressed herself much more. She held her attention on me when we spoke and when I asked her about her tummy pains, and pointed to her tummy at the same time, she smiled and shook her head.

Samantha did need speech pathology support, but I saw her a few years later and she had grown up so well and was happy to see me and show me a picture she had drawn for me as a present. You wouldn’t know she was the same little girl that I first met and she certainly didn’t have any sign of autism at all.

Autism or Leaky Gut? It’s worth exploring.

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