4

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Fodmaps versus specific carbohydrate, hey aren't people just kinda guessing all this stuff?

Answered on August 19, 2014
Created June 21, 2012 at 8:00 AM

Okay, so i have had digestive issues. I found starches, lactose and sugar seemed to be a problem. So I looked into fodmap, specific carbohydrate, and paleo (hey, here I am). But the more I think about all these limitations, and the ideas, the more a confusing jumble of ideas it seems.

Bacteria can eat anything resembling a sugar (apparently they can also eat protein if need be, just not nealry as effeciently as sugar type foods). So fodmap has it sort of half covered, as far as the short chain simple ones go.

But then it completely ignores polysaccharides, the long chain carbs, like starch, and cellulose. Which equally break down into sugar. And which one has to admit, are much harder to digest, than some of the simple sugars.

And fodmap seems totally nebulous. Nobody is sure what contains what. Coconut used to be though to contain sorbitol, but aparrent the level is actually low. It may also contain fructans, but that also feeds alot of good bacteria, and tomatoes contain fructans, but they are usually on the "good" list. These nutrients are so obscure, that not enough solid nutrional data exists to even quantify what level most of them occur in various foods.

And bacteria can also efficiently eat soluble fibres (less so insoluble).

Then you have specific carbohydrate/maps, which instead of limiting all short chain sugars, limits some, and the hard to digest long chain ones...

Now, if one where to limit all of these foods, one would be left with very little left to eat, apart from meat. There would be a very very low level of carbs generally. (which is part of the point, but could cause health issues too).

It might be hard to get proper nutrition on both diets combined. Neither of them account for soluble fibre either. None of them suggest you use digestive enzymes to break the food down faster. Few of them have any gut healing protocol, like bone broth, or glutamine.

One is left with the feeling, that they are picking these ideas out of a hat. Now I definately benefit from having no added sugar, using low sugar fruits like berries, and having no high starch carbs. But then its somewhat of a balancing act to get that minimal level of carbs in that we need optimally. I have taken some advice from both diets, but I am also aware that if I followed all of there advise, id be eating next to nothing, it would be unhealthy, and much of it is really arbitrary.

And for weird reasons, some foods bother some people and not others (probably different speicies of bacteria, with different food differences). The only semi-universal uber sugar would seem to be lactose.

The specific carb diet lists glucose as bad because its a sugar. But its the most easily digestable sugar there is, it never makes it past the first two feet of your intestine, so its never going to feed any bacterial problems.

The whole thing seems like throwing grenades in the general vicinity of the enemy in the hopes one might hit.

So my question is - what in these two diets actually makes rational sense in terms of not feeding bacteria?

Monosaccharides? disaccharides? oligosaccharides? polysaccharides? polyols? Fructans?

Is it going to vary completely by bacterial species?

Whats going to be the worst out of these?

what doesn't make sense?

(they all seem to insist on un-sugar related things, like dont eat bacon because its got nitrates, or dont take stevia because its a steroid......seriously, your being a food nazi enough already, let us make those calls)

What advice in them is bad?

Severe carb restriction on some of these diets seems to be somewhat problematic, especially for atheletes. Not eating short chain sugars, and then allowing starches seems absurd to me.

Then theres the whole problem of hey, we need a few carbs here and there, what ones should we be eating? (I figure the ones that digest the fastest, like glucose does, which ever ones those are out of the list above...not sure)

Please give your thoughts on these "bacteria based" diets! (ive given some of mine).

The entire area is very confusing, often conflicting/contradicting, not evidence based at all, and probably in some ways unhealthy, so help us digestive impaired make sense of this mess!

Thanks :)

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 30, 2013
at 05:24 PM

To your point, the founding book on SCD is called "Breaking the Vicious Cycle". SCD allows brush border cells to heal but the author suggests for some they might never heal. In other words, for these people the diet must be maintained indefinitely. I had horrible IBS for several years before gradually moving to an SCD diet. After one year I am able to add some starches fairly safely. But one has to go slow and be very careful not to regress.

Fd70d71f4f8195c3a098eda4fc817d4f

(8014)

on June 21, 2012
at 01:54 PM

I agree that it is *so* confusing, and often times *does* seem like people are pulling things out of you-know-where. Just wanted to say that in terms of gut healing protocols, the GAPS diet *does* address this, in addition to avoiding certain carbohydrate foods. (GAPS is huge on bone broth, glutamine, and probiotics.)

Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on June 21, 2012
at 08:48 AM

It appears, in addition to glucose, fructose is effeciently absorbed provided it is not over a certain amount (there is a rate limitation). The presence of glucose, and certain amino acids increases fructose absorbtion. Sucrose decreases it. So small amounts of glucose/fructose balanced fruit, or fructose fruit with added glucose may actually be a good carb source for those with bacterial issues?

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4 Answers

3
22fd82abf435768244f8d074430cd1e6

(590)

on June 21, 2012
at 09:12 AM

I think FODMAPS should be taken as a reference for "possible problematic foods". One should experiment and see which ones he tolerates well.

I generally agree with you that it sounds a bit like a "out of a hat" trick, but a lot in nutrition and intolerances is.

Also the same food will not always be tolerated in the same way, which makes things harder to figure out.

Me, I have histamine intolerance (at least that's what it seems like).. but also some FODMAPS food can be problematic, especially when my histamine level is high.

1
276a5e631b62f8e0793987c0496364bb

(1644)

on June 21, 2012
at 12:35 PM

My understanding is that FODMAPs focuses on not eating anything (at first) that could be fermented by your gut flora, whereas SCD focuses on not eating those things which you can't break down and absorb before they get to your colon. I'll admit to not having read a significant amount about them, though. Most of my info comes from talking with my girlfriend (who has a LOT of digestive issues).

What I do believe is an accurate opinion, though, is that we currently understand very little about our gut flora. FODMAPs, SCD, etc. are all great starting points in your very personalized journey to healing.

Side note: I would disagree with your statement that it would be hard to eat a nutritious diet if it's mostly meat-based. Take a look at Peggy (The Primal Parent), for example.

0
F1c64c97fa4e6795b7d7c21b3e1c8cb0

on June 30, 2013
at 12:03 PM

A person may have gut-dysbiosis for many reasons. They can broadly be classified into two categories: 1. Structural problems

  • Abnormal structure created due to intestinal surgery (blind loop etc.) Pancreas removed Small intestine diverticula etc.

2. Functional problems - Acholorhydria - may be temporary or permanent - Pacreatitis - acute or chronic (lack of digestive enzymes may result in gut-dybiosis)

Once you have gut dysbiosis, the toxins produced by excess bacteria will damage the "Brush-border" cells of intestine. These cells produce Lactase, Maltase and other disaccharidases required for digestion. Once brush-border cells are damaged, the food (specially carbohydrates) won't be digested and will further support bacterial overgrowth which will further damage the brush-border cells. This is a vicious-cycle and I think this is why gut-dysbiosis is almost always chronic. In my opinion the level of recovery and the time to recover will depend on the cause of gut-dysbiosis and how long a person has been affected by it.

Role of diet: Even if you've eliminated the cause of gut-dybiosis, without breaking the vicious cycle you can't get rid of it. The main challenge in recovering from it is to avoid recurrence. To get rid of it, you should have proper gut-flora and completely healed brush-border cells. Re-balancing gut flora can be done quickly by medications and supplements/probiotics but repairing brush-border cells takes time and proper diet. This is where SCD/GAPS/low FODMAP come into picture. If you search for the term "villi recovery time" (Brush-border cells repair time) you'll find its somewhere between 6 months to 2 years. Hence, one has to be on an easily digestible diet for a long time before one can recover completely assuming all the other things are already in place (no issues due to structural problems, proper supply of everything such as stomach acid, digestive enzymes and co-enzymes). About what to eat and what not to eat when following a diet, I think it is subjective. In my personal opinion low FODMAP diet/protocol is for those with mild cases of SIBO and were diagnosed early. I still don't support having rice/potato when healing because their complex structure won't be broken down by brush-border cells. I think Pecanbread phases(http://pecanbread.com/p/how/stages.html) of SCD diet look pretty reasonable to me. The more our gut lining is healed the more variety of foods we can eat. SCD diet will work only if followed in phases. I know people who suffered from IBS for 25 years, came to SCD and now have been on SCD for a decade and living a happy-healthy life. You can join the yahoo group BTVC-SCD(http://health.groups.yahoo.com/group/BTVC-SCD/messages) and ask around.

75d65450b6ff0be7b969fb321f1200ac

(2506)

on June 30, 2013
at 05:24 PM

To your point, the founding book on SCD is called "Breaking the Vicious Cycle". SCD allows brush border cells to heal but the author suggests for some they might never heal. In other words, for these people the diet must be maintained indefinitely. I had horrible IBS for several years before gradually moving to an SCD diet. After one year I am able to add some starches fairly safely. But one has to go slow and be very careful not to regress.

0
A8fd841dd0af9f5881a6d00155342d22

on March 12, 2013
at 09:58 PM

I've been on the SCD for two years, with some success but no cure. I'm about to try FODMAP. You are mistaken when you say SCD eliminates sugar just because it's a sugar. Elaine's thesis is that monosaccharides are absorbed sooner than disaccharides, which are absorbed sooner than starches. She draws the line at monosaccharides (honey, fruit, etc.) because she wants to maximize the carbs getting into your blood while minimizing the carbs available to the bacteria in your lower gut (not just the colon). I have eaten PLENTY of carbs on the SCD, but mostly in the form of honey and apples.

It's strange how similar the theses are between SCD and FODMAP yet how different the food lists! On SCD, honey is nearly required; on FODMAP, it's forbidden. Both are about absorption, but FODMAP adds this fermentation idea. I think you are correct that much of this is trial-and-error. Hopefully the µ-biome project will sort some of it out.

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