SIBO Diet Success Strategies (Interview with Debbie Steinbock)

SIBO Diet Success Strategies (Interview with Debbie Steinbock)

Debbie’s resources mentioned:

Video Transcript

Introduction and Basic Nutrition

Josh (0:11)

Cool, so, hey everyone. Super excited to be joined today by Debbie Steinbock and Debbie specializes in nutrition and diet and holistic nutrition and little bit about Debbie before we kind of get rolling into this interview, so she dealt with a chronic illness, digestive illness, herself when she was younger and that’s kind of how she came to this path of helping other people with diet and nutrition relating to digestive disorders and a lot of the conditions. So basically here’s her little bio. After years of being told she had an incurable chronic health condition, she turned to her diet to help her understand her disease, restore her body and regain control of her health. Her own life experience motivated her to become a nutrition counselor and natural foods cooking instructor and she now educates and inspires others, like I was saying. So, Debbie’s just passionate about working with individuals with challenging and chronic health conditions and just because she’s navigated that road and kind of been down this process of you know getting to the point where you can’t eat a lot of foods and you’re really struggling to incorporate things in your diet and you know things are causing your body to react. Like what do you do? And Debbie has personal experience going down that route and now she helps other people in her clinical practice in Colorado. Debbie received a bachelors of arts degree with honors in psychology from Emory University in Atlanta, Georgia and she earned certifications as a holistic health counselor at the Institute for integrative nutrition in New York City. She’s also accredited by the American Association of Drug-less Practitioners, that’s pretty cool being a drug-less practitioner, I gotta say. So, first of all, Debbie, anything else you wanna let people know about you, where’s your practice?

Debbie (2:20)

So, I started my practice back in 2000 in Manhattan, after I graduated nutrition school, and then I moved in 2001 to Boulder Colorado and I’ve been here in practice for going on 18 years now.

Josh (2:40)

Awesome, awesome. Cool, so let’s kinda just dive right into this diet and nutrition topic. It just can be so confusing and so frustrating for a lot of people, so it’s just gonna be good to hear from you in how you help patients and what your approach is. So, basically I just kinda want to start out with just the basics of nutrition for maybe people who have normal digestive systems and then we’ll get into when your guts really having issues and it’s compromised and you’re in a disease state, how do you go from there. But I think it’s important to educate people on the basics of nutrition and what kind of foods you should be eating and just a little bit of that before we get into the digestive system.

Debbie (3:30)

Sure. I’d love to, and do you want me to share with your audience kinda how I got into nutrition? Because we kind of touched on that a little.

Josh (3:40)

Yeah. Yeah, definitely, share with us.

Debbie (3:45)

So, basically when I was eighteen years old, actually the summer before I went off to college, I was diagnosed with Crohn’s disease and you know at eighteen I didn’t know a whole lot about anything, and they just gave me drugs so I was convinced that I would just take a pill and everything would be good. What happened to me was actually totally the opposite and so I spent pretty much the first two years of college taking lots of different medication and really struggling with my digestive system still. And I always tell people that for better or for worse, back then in 1995 or 96 there was really not a whole lot of medications available for Crohn’s and I had gone through and exhausted all of them, and at that point they actually enrolled me in medical trials to see if new medications would work for me. And so what I always tell people is that getting into nutrition was really my last ditch effort to try to like save my digestion because nothing was working for me and I didn’t have any holistic background, my family didn’t think that way, and so I got into nutrition about my junior year of college, really on my own. I still remember going to the bookstore because there was no internet at the time and there was one book on Crohn’s disease. It was Elaine Gottschall, Breaking the Vicious Cycle, which is now the Specific Carbohydrate Diet, which is how people know that. So, I did that diet for a full year and even though it didn’t cure me, what it did do was it opened my eyes to realize, hey, what I’m putting in my diet may have an effect on this condition that I’m dealing with and so that was really like the door that opened for me, in looking into nutrition and figuring out how diet and the foods that I’m eating might possibly affect my digestive system. So, as I started to see improvements there, I actually took a little career change whereas I had been in college and believed I was going to be a therapist and graduate and go get my Ph.D. Instead what I did was I found my nutrition program, and decided to you know do that for a year, put my Ph.D. off and here we are eighteen or nineteen years later and as they say, the rest is history.

Diet for a Sensitive Stomach

Josh (6:32)

Yeah, it’s so interesting how kind of you know the life path unfolds cause I never expected that I’d be doing this either, so it’s very interesting and you know, kind of like you talked about in your story a lot of times people have a similar situation where they get sick and then start investigating other things and even like you were talking about, like you went towards kind of the conventional, medical route and tried all the drugs and all the different things that they recommended but you still weren’t getting better, right?

Debbie (7:10)

Exactly, exactly.

Josh (7:12)

I know that probably a lot of people who are listening to this or in the audience probably have been through a similar type of situation and you know it’s frustrating, but there is hope because there are other things you can do like you talked about what kind of sparked your interest into you know, diet to heal to help you heal as well as other alternative medicine practices so really cool. So I guess to start with just by doing this specific carbohydrate diet like what did that really teach you what did that open your eyes to as far as what you should be eating, diet, nutrition, especially with you know a sensitive stomach?

Debbie (8:02)

Yeah so what first showed me is you know even in college I’m just like what is a whole food? Like what is an unprocessed, unadulterated food? It’s not like I grew up on a “bad” diet, I grew up in New York so of course there’s a lot of pizza and Chinese food and Italian food and all of that stuff, but being on that diet really made me look at foods differently and you know realize how much to some degree of processed food I had and chemicalized foods even that I did have you know throughout my diet for most of my childhood.

Josh (8:45)

Yeah, definitely so that’s cool to kind of see that first insight and you know would you say that the main thing that you’ve kind of learned overall is eating whole foods it’s kind of one most important pillar in diet, right? Whichever type of diet you choose. There’s a lot of different diets, right? Like there’s the FODMAP diet, the SCD diet there is you know, low fermentation diet, there are all these different diets. But I think the core component of a lot of these healthy diets, especially for digestive disorders, is eating real food, eating whole foods.

Debbie (9:29)

That’s exactly it, yeah. So you know going back to the other question that you say this is kind of like what’s the basis of nutrition, and I say this, you know, 15 times a week in my office but you know if we start with like a whole foods approach, what does that mean? So that means that we eat lots of vegetables so green leafy vegetables, non starchy vegetables, and look at it to the subtle nuances of how that changes depending on the suggested concern you’re dealing with but, you know, good quality vegetables the second thing is we want fruits you know we want to eat a moderate amount of fruit that is in season. You wanna have protein sources and we want to have protein from, you know, animal or vegetable proteins and then you get to carbohydrates and with carbohydrates that would mean that we have like the whole grains in their whole form, so things like brown rice or quinoa or buckwheat or you know, whatever that might look like as well as the vegetable starches. So things like your sweet potato, your butternut squash or rutabaga, your turnips, your beets, you know etc. Then good fats and oils and adequate hydration. And that’s kind of the basis of all these diets.  But then what we have to do is we have to individualize that for each person based upon whatever health conditions they might be dealing with. Anyway, so, for example, you know the population of your listeners so people that are dealing with SIBO or IBS, you know they might have to choose a diet lower in fermentable starches you know they might not do as well with things like cruciferous vegetables. My clients that have inflammatory bowel disease, you know my mantra in my office is that from whatever the categories I listed they choose from they have to do things that are like softer warmer mushier like not a lot of raw foods but leaning more toward like soups and stews and crock-pot meals and things like that so really individualizing it based on you know what your what your digestive health needs.

Josh (11:40)

Definitely, definitely, so yeah great kind of segue. I just want to talk more about let’s say someone comes in with pretty severe digestive issues maybe they’re you know in the IBS SIBO category like a lot of my audience you know they have a compromised gut, they’re reacting to a lot of things, so how do you, what’s kind of your process, how do you start there?

Debbie (12:07)

So sometimes these things people are reacting to can generally give you a clue as to what’s going on, I’m meaning that, you know, if somebody’s really reacting to the higher FODMAP foods, you know, I might at that point decide to do a test for them to see if in fact they do have small intestinal bacterial overgrowth. So and sometimes they just have no clue like everything is just kind of bothering their system and so at that point you want to just help them to find a diet that keeps their symptoms controlled as best as possible pretty short term right that’s not a long-term solution and then seeing if you could do some testing whether that’s some SIBO testing or stool testing to see if that indicates, you know, what might be going on for the individual and if there’s SIBO, then definitely doing a protocol to eradicate SIBO if there’s you know not SIBO but there’s a lot of large bowel dysbiosis or fungal overgrowth again in the protocol that addresses using diet at that time like I said to really just minimize symptoms while they’re going through treatment and then what happens for people most of the time is once they get through treatment and then you put in things to heal the lining of the digestive tract and to put in, you know, good probiotics to rebuild back their digestive flora. Then what happens is they can kind of incrementally increase the variety of foods that they are able to tolerate and do well with.

Josh (13:52)

And I’ve actually seen that personally like when I was kind of more in a severe state and really having a lot of really bad issues, you know I was reacting to a lot of different things and I couldn’t eat a lot of foods but you know as I got a little bit better gradually I was slowly able to eat like you know wider variety of foods and like go out to restaurants and you know eat a burger do all those things, right? And it’s like, it takes time and it’s a gradual process, right, but I think that basically at the beginning it’s best to kind of get the person on a diet where it kind of controls their symptoms and then you’re also focusing on what other other issues that you can treat are and then you know eventually getting to that stage where you know they can maybe incorporate some more diversity, is that kind of correct?

Debbie (14:48)

That’s absolutely correct.

Understanding SIBO Symptoms

Josh (14:51)

Okay so do you have any, when you’re starting someone on maybe they’re more in a severe state do you recommend like a specific type of diet or is it more just like kind of  an elimination type phase where they monitor what they’re reacting to?

Debbie (15:12)

So what I found in you know the almost 20 years that I’ve been practicing probably about 12 years ago I myself went on a gluten and dairy free diet and that helped me so much so that I started recommending that to my clients and, you know, had people who just had such great success with that and I now understand that those two proteins are really difficult to digest proteins and so if you have a more challenged digestive system the thing that’s going to go first is the ability to digest the hardest to digest proteins so I generally start by pulling people off of gluten and dairy so that we can just stop the strain on their digestive system and really just give their body more of the energy resources to use for other things. So you know at that point once they are off of gluten and dairy then people might know other foods that they suspect or feel that they’re reacting to like eggs or corn or sometimes I just have to point out like one of the more common things that I hear my practice is somebody saying to me something along the lines of I have no clue what to eat I made x for dinner on Sunday night and I ate it I felt completely fine I felt fine all day on Monday I ate leftovers on Monday night and I felt horrible how can that be when I ate the same food you know and that like said those are the clues that like if the food reaction is not repeatable then to me it goes back to there’s generally something that’s off in the state of the digestive system that needs to be looked at and of course there are other factors outside of that too like was Monday more stressful then Sunday you know?

Josh (17:14)

It’s such a good point just because I agree and it’s like you know diet for sure is a fundamental component of  healing your gut through time but I think it’s like you said you have to be careful and not to take it to the extreme where you know because in that example that you talked about you know it could be stress it could be dysbiosis and it may not just be the specific foods right so it’s important to have a healthy whole food diet but I think it’s also important to realize that you know stick to the big things that are causing issues right like you said dairy gluten what I’ve found personally and talking a lot of people is that you know the main ones that I see a lot are like dairy like you said gluten and then like some of the more tougher to digest fibrous vegetables like broccoli cauliflower a lot of onions a lot of garlic stuff like that so what I think just not going overboard to because you see a lot of times that people will try and measure every symptom right and try and look at what they ate and trying to quit in sometimes that’s not healthy to do that constantly so.

Debbie (18:42)

Exactly and next one I see in my practice is that if somebody’s following a diet and you know restricting certain foods and it’s working for them and they’re getting symptom relief from that the next but what I really caution people against is just taking more and more foods out of your diet to the point that you know they think that the only way that they can feel well is with a total of five foods you know in a day all times and and that I really cautious people against because you know that really leads to nutrient deficiencies and then clearly there’s like a root of something that hasn’t been discovered yet because you know we shouldn’t have to eat only five foods total you know to be able to feel and function okay.

Josh (19:30)

Yeah, definitely. So I mean just from your experience of what you’ve seen like do you find that when people are down to like let’s say they’re eating five foods and like they’re really just having issues like it’s probably is it in a lot of cases probably that there’s other stuff going on right it’s not just the diet?

Debbie (19:52)

Exactly, yeah it’s not it’s not just the diet and oftentimes it’s not just the digestive problems and what I mean by that is that if someone’s digestion is generally that compromised the times that I’ve seen that there’s generally something going on. Either elsewhere in their body or in their life that just has their nervous system or their immune system on some sort of a red alert. You know what I’ve learned I’ve had two big health issues in my life the first one as I shared was with Crohn’s disease and the second time after my daughter was born – I developed Hashimoto’s Thyroiditis and I used this as an example all the time so I had such great success with my Crohn’s with changing my diet and taking nutritional supplements that as I said that became my career and my focus well. Fast forward you know after 20-something years or 15 years of very good health I come down with another autoimmune disease so my focus becomes like “okay, what do I need to do to change my diet more, I’m already on a whole foods diet maybe I need to go paleo, you know, what supplements do I need to take” and really like follow that same mindset that had healed me the first time only to have no success healing the second time it was like taking my diet from being 90 percent great to 95 percent great didn’t really give me the results and what I realized at that time that the Hashimoto’s that I got was really just a bigger picture or symptom of my life in general and the stress that I was under and the way that I internalized that stress and you know how that was affecting my adrenals, my thyroid all that stuff and so long story short you know sometimes the thing that actually heals what you’re dealing with is actually outside of diet and nutrition.

When to Try Something Else

Josh (21:50)

Yeah, definitely, so this brings up a really good question that I have is like you know let’s say you try someone on a diet that’s like maybe the SCD or you know avoiding gluten and dairy for a certain length of time and you know let’s say you give them that and you’re thinking that maybe diet is one of the issues that’s really need some work within this patient and then like how long let’s say they’re on that diet for a certain length of time how long until you say okay the diets in place they’re still not getting better this has to be something else like how long do you go there?

Debbie (22:30)

Yeah, it’s a great question and I would say generally in my practice I always start with making dietary changes and sometimes in as little as 3 to 6 weeks someone might see some really big changes that tell us “ok, we’re really moving in the right direction” and if that just continues and we just continue with that and of course that depends on when the person comes in how processed or chemicalized their their diet is. We didn’t even get into things like caffeine, alcohol and sugar you know besides gluten and dairy free. You have somebody that subsisting on coffee for their entire morning and then you know lots of processed food and sugar foods and beverages you know I can have a pretty good idea that when we take those I call those extreme foods when we take those extreme foods out of their diet we are gonna allow their body and their gut microbiome and all that to come back much more into balance however if somebody comes in to me and they’re on a super clean diet and they really haven’t seen the results but they’d like to you know at that point you might you know go in and do some testing fairly early on you know because they’re frustrated they’ve been committed to this for sometimes over a year and you want to see if you can help them get answers at that point.

Eating What Works for You

Josh (23:59)

Definitely that’s cool. So then a couple other points you brought up that are just good to talk about, what is your take on coffee? Like, let’s say someone in my audience, people who maybe have a chronic digestive disorder, what is your advice on coffee?

Debbie (24:23)

So you know what you asked before about an elimination diet, it’s in some ways you know avoiding gluten and dairy and the extreme foods, that’s kind of my version of doing an elimination diet, really just eating good quality whole foods in the forms that are easy for your body to digest, which as I said that might mean more cooked foods for some people you know or if someone tends towards constipation they really need the roughage. It might mean more raw foods and more nuts and seeds for another person and once you kind of figure out what works for you, then what I always tell my clients is it’s not like I am against coffee or alcohol. What I want is that find what works for them so then you put that food back into your body and let your body tell you how it works for you. I have clients that will sit in my office like begging and pleading like please don’t take away whatever and I’m like I’m not gonna take away anything, you decide what works for you, what you’re willing to do and then reintroduce it and see if your body’s able to maintain it’s good functioning at that point. If it does fantastic you have your answer if it doesn’t that’s fantastic because you know it doesn’t work for you.

Josh (25:44)

Yeah, definitely. That’s such a good point because as you know everyone’s body is so individualized and, for example, for me I know that if I have too much caffeine it’s not gonna be good for myself because my body gets too ramped up and you know it just causes problems but if I have a little bit when I’m feeling good it’s fine so it’s just kind of like listening to your gut and monitoring how you’re feeling. Really being in tune with your body.

Debbie (26:16)

Exactly and our biggest resistance is actually around not wanting it to be that way meaning that we have such an attachment to the coffee or alcohol or whatever it might be that we don’t want to hear from our body that it actually isn’t working for us.

Josh (26:34)

Yeah, yeah definitely. And you know it could be the case that maybe a couple glasses of wine or you know a little bit of caffeine is okay for some people and it just depends, right?

Debbie (26:48)

Exactly, in general I find that if my clients can follow what I call either 80/20 principle or a 90/10 principle based on you know the severity of the person and their symptoms where 80 to 90 percent of their foods are healthy and whole and unrefined then they have that wiggle room of that 10 to 20 percent of whatever it is that they love. Like for me, it’s chocolate, I love chocolate and I never want to live without chocolate.

Josh (27:18)

Yeah, yeah, who doesn’t love chocolate? I love it.

Debbie (27:20)

Yeah, but I wanted my chocolate and my life in a way that it doesn’t cause me any distress. So for some people, their chocolate is their coffee or their alcohol so it’s just about finding that amount that you can have those foods in your life and the forms you can have that in so that you feel good most of the time.

Josh (27:36)

Yeah, definitely and do you think that having, like you said, the 80/20 or the 90/10 principle like having that 10 or 20 percent, do you find that that’s really helpful? Because I found personally that when I go super crazy about diet and when I was in the super restrictive mode it was almost like putting way more stress on my body in general and when I allowed myself to kind of like just eat something, you know, normal like let’s say a burger or something like chocolate it actually kind of let me relax a little bit. I thought it was good for me at least.

Debbie (28:16)

That’s one of the biggest principles in my practice with people is that there’s no absence of a lack of resources in 2018 where people can find all the foods that they shouldn’t be eating anymore and what I always tell people is that all of that needs to be weighed against the stress of doing a diet that’s that restrictive so if somebody is following some sort of diet where you know they have no histamines, no oxalates, and no gluten, no dairy, no alcohol, no caffeine, then that you get into a situation where they cannot socialize at all every work function becomes stressful, nobody in that family is eating the same foods as they’re eating, so they’re like a short-order chef who’s making multiple meals and that in and of itself it’s like a big degree of stress for the individual. So you know that always needs to be weighed upon how much benefit is going to be derived from what they’re doing and so there’s some people who you just tell to take dairy out of their diet and that creates stress for them so I’m not saying you just take a free pass if it stresses you out. I’m saying that you know you need to get support around it to make these changes to your health for sure but when we get to these like multiple levels of restriction I think what that does it just puts our body into this stress state you know this fear this you know fight-or-flight state and we know that all healing needs to happen when our bodies in our parasympathetic nervous system, I mean it’s literally called your rest and digest nervous system so if you’re constantly in stress and fight-or-flight you’re not helping your digestion at all.

Josh (30:13)

Yeah and I feel like that’s, from my experience too, almost just as important as diet sometimes is you know getting to that point where you’re not freaking out or just constantly worrying about everything and it’s it’s hard sometimes because I’ve been there and you know when you’re having trouble and having severe symptoms and stuff and you can’t eat a lot of food, it is tough. But I think just adding a little bit gradually and having a little more diverse of a diet is helpful just so that, you know, you can maybe go out with friends and do those things because social interaction is so important too if you can get out and be with people.

Debbie (31:01)

Exactly, exactly.

Staying Consistent and Having Faith

Josh (31:05)

Yeah, yeah so I guess my last question here is, any parting advice, anything you’ve seen as far as people with IBS or SIBO, as far as diet and nutrition. I mean, what should they know? Like what have you seen in people who are able to maintain good results consistently? I think that’s one of the biggest challenges is a lot of people go on these diets, right, like whether it’s a low FODMAP, SCD or eliminating certain foods and you know they’ll do it for a month and then they’ll kind of get out of it and get back off track. So, what are you seeing in the people that are consistent over time?

Debbie (31:50)

Yeah, that’s a great question. I would say the biggest factor that I see that makes people be consistent and makes people be successful over time is sticking to something long enough to actually get the results from it. Which involves a lot of patience and health is a long road to recovery for some people and you’ve been there, I’ve been there you know it’s longer than most of us would like it to be and what I often see in my practice is the people that are most successful, they find a plan that feels right for them and they stick with it for you know a long enough time to really see the results where I see people get messed up a lot is that the minute they have a symptom come back in, they start to change course and they think they’re on the wrong path and they go down a totally different approach and then nothing’s really given you know the length of time that it takes to really allow the body to heal and the truth is the road to recovery, actually I have a picture in my office that I pull out no less than five times a week and it basically shows a road to recovery with a little guy at the bottom who’s kind of crashed out and then he’s jumping up at the top over here you know 100% well and the chart shows progress back, progress pitfalls, progress plateaus, and it’s this really like up-and-down thing to go from here to here and so it’s you know the journey back to health is really one of ultimate trust that you’re in the right hands with a good practitioner trusting that your body has resources to heal and trusting that when you have those setbacks and those pitfalls and those plateaus that you could still be on the road to recovery.

Josh (33:50)

Yeah, it’s awesome and just consistent gradual process, right, and just kind of I guess faith in the plan and kind of small healthy changes implemented over a long period of time. Would you say that’s it?

Debbie (34:12)

Exactly I would say that one thing that I would add to that is to really use a holistic approach and what that means to me is what we talked about already, that it’s not stick with the plan and the plan is only diet or the plan is only supplements or the plan is only an elemental diet. It’s really being willing to take a step back and ask ourselves like how does our lifestyle work for us how does all the travel that we do how does the relationship we’re in you know all of those factors that influence how our body feels and functions you know beyond the food that we put in our mouth are such an integral part of our healing. Sometimes we come into it like I said very narrow minded where we’re willing to change one thing but all of these other things are off limits and the most successful people and where I have had most success my own health is when I’m really willing to just look at the whole picture of everything and, you know, address all those areas that my body is telling me need to be looked at.

Josh (35:21)

Awesome. So if anyone maybe wants to reach out or work with you, I guess couple things, do you take Skype consults or phone consults?

Debbie (35:34)

I do, yeah. I work with clients all over the country, all over the world. In fact, I have some clients right now in India and I do phone sessions with people. My practice is located in Boulder, Colorado and it’s called mindful nutrition. Yeah I work with people here outside my office as well as just from all around the world.

Josh (36:00)

Right, awesome. So if someone wants to find you online can they search mindful nutrition is it

Debbie (36:10)

Yeah, mindful nutrition or mindful family medicine because I have a joint practice with my husband who’s mindful pediatrics so our website any of them will catch you there. Mindful nutrition or mindful family medicine.

Josh (36:18)

Awesome, so thanks so much Debbie for joining me and just chatting a little bit about diet and kind of sharing some of your knowledge and wisdom on this topic, appreciate it.

Debbie (36:34)

My pleasure, it’s been great to connect with you.

For more information on the basic diets used to help with SIBO and IBS see the SIBO Diet Post.

SIBO Diet Success Strategies Interview Summary

  • Debbie was diagnosed with Crohn’s disease when she was younger and healed herself through whole food nutrition and lifestyle changes.
  • In Debbie’s opinion, a whole foods diet is the best diet for everyone, and for people with sensitive stomachs, it’s a matter of figuring out what works for them.
  • The goal is to increase food variety over time.
  • Sometimes the stress of a restrictive diet is worse than actually eating the food that you’re avoiding.
  • Sometimes the symptoms don’t directly relate to the food one is eating, rather just the digestion itself.
  • It often takes about three to six weeks to notice a change in symptoms based on a dietary change.
  • Every person has a different tolerance of foods.
  • Sometimes people have such a strong attachment to a certain food, which makes it hard to give it up, even when their body clearly tells them it’s not working.
  • Debbie finds that her clients do well with an 80/20 diet, meaning 80% of their diet is whole foods, with 20% wiggle room for things they love.
  • Being consistent with diet and trusting the process is key.
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