When the Whole30 Isn’t Enough

December 18, 2020 | Post by Sam Presicci

When the Whole30 Isn’t Enough

I’m a BIG fan of the Whole30. So much so that I was one of the first Whole30 Certified Coaches when the program launched in 2017. I consider it an excellent tool to figure out what works for you and help you feel your absolute best.

But as with any tool, it’s not perfect for every job. Have you completed a Whole30 as prescribed, only to find yourself with persistent GI issues like bloating, gas, diarrhea, and pain? How about fatigue, headaches, or anxiety? The truth is that the impact of less than optimal GI health is vast, touching parts of our body we’d never think (like our skin!). If you’ve completed a Whole30 and are still having issues, it might be time to dive deeper.

But where to begin? I know firsthand how overwhelming GI issues can be, since I suffered from them myself for most of my childhood and early adult life. Since gut health is really foundational to our overall health, it can feel like an out of balance gut impacts a lot of other facets of your health too. I’m going to walk you through a few things that may help. I like to call these avenues detective work, since they’re all about digging down to see what might really be going on.

Potential Detective Work

A Low FODMAP diet

FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols. Quite the mouthful, isn’t it? These are all carbohydrates (aka sugars!) that are not well absorbed or digested, so they go through the digestive tract without getting broken down.

The Low FODMAP diet is well-researched for conditions like IBS, and involves eliminating fermentable carbohydrates like apples, coconut flour, and onions. It’s important to note that FODMAPs are often healthy foods (like lots of fruits & veggies). These foods are not inherently problematic, and in fact many serve as great prebiotic food sources. In this case, it’s not really the carbohydrates that are the problem, but rather the fact that the carbohydrates feed an overgrowth of microbes in the small intestine.

The general practice is to remove high FODMAP foods for 30-60 days, then reintroduce them one by one (much like Whole30) to figure out your specific triggers. For more information on the Low FODMAP approach, head here.

Specific Carbohydrate Diet (SCD)

SCD is an elimination diet commonly used for those with Irritable Bowel Disease (IBD) or autoimmune diseases. It focuses on removing certain carbohydrates. The general premise is that certain carbohydrates help feed and encourage an overgrowth of “bad” bacteria in the small intestine, especially if you have IBD. As the bacteria overgrow, they ferment and produce byproducts that may promote inflammation or lead to other symptoms, like decreased absorption of nutrients from food. Unlike the Low FODMAP diet, SCD allows monosaccharides as a carb source, but still focuses on removing oligosaccharides, disaccharides, and polyols. There’s definitely some overlap between the two diets.

But don’t think this is common practice. I presented a case study in grad school (about 6 years ago, so not that long ago!) where I presented trialing SCD for a patient with IBD, and I was lambasted by my professor because she didn’t think it was a research-based option. Keep in mind that I was recommended the patient trial SCD before getting her colon removed. I think we get too far removed from common sense sometimes. Why not try a much less extreme option before undergoing invasive surgery? All of that is to say that SCD is still not the norm when it comes to treatment for IBD, but it’s a viable option that is well-researched.

To learn more about SCD, you can head here.

The Autoimmune Protocol (AIP)

This paleo-focused elimination diet is restrictive, but ideal to reduce inflammation and improve symptoms from autoimmune diseases. Think of it as paleo +, since it goes beyond the typical paleo framework to remove things like eggs, certain spices, nightshade vegetables, and nuts. Much like Low FODMAP, this is not necessarily intended as a forever diet. After 30-60 days (or symptom improvement, whichever comes first), you slowly reintroduce foods one by one to figure out what works for you.

Unlike SCD and Low FODMAP, AIP pretty naturally fits into the Whole30 framework. Both SCD and Low FODMAP do allow in some grains, added sugars, and more, so you have to modify them to work for your Whole30.

The Paleo Mom has some fantastic AIP resources. To check out her site, head here.

Functional Medicine Testing

There are functional medicine gut tests that can help you get to the root of your issues too. I often prefer to test, not guess, meaning I’d rather dig deeper initially rather than trying a longer term diet intervention that may or may not work. Depending on your symptoms, your provider may recommend getting tested for SIBO using a breath test, or running a comprehensive stool test.

A comprehensive stool test will tell you a wide range of things, including:

  • any infections
  • pathogens
  • parasites
  • H Pylori
  • The balance of normal & opportunistic bacteria
  • fungal or yeast overgrowths
  • intestinal health & inflammatory markers

Having this specific information can be vital in coming up with a customized treatment plan. Especially if you’ve had issues for a while despite trying lots of different things, there might be an overgrowth or some dysbiosis that you’re not targeting appropriately.

For instance, let’s say you suffer from bloating. The cause of bloating may be vast – not enough stomach acid, SIBO, dysbiosis, a parasite or pathogen, and more. It will help quite a bit to complete a Whole30, or better yet a Low FODMAP Whole30, but what if your symptoms still haven’t fully resolved? The GI map helps your provider to see whether certain antimicrobials or other interventions might be helpful in addition to diet & lifestyle changes.

I know this is a LOT of info, and it’s barely scratching the surface. This is part of the reason I created my Go With Your Gut program. To get actionable advice around gut health into your hands so that you can improve your overall health. I even offer an option with a GI Map stool testing add on, along with a 1:1 consult. If you have questions for me, ask them below!

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