Sports Performance and SIBO: what is the connection?
Carlos Soler, INDYA sports nutritionist, explains this medical condition, its causes, treatment and how an athlete with SIBO can minimise effects on performance.
Let us begin!
What Is SIBO and How Is It Treated?
SIBO stands for small intestinal bacterial overgrowth, or excess bacteria in the small intestine.
It involves excessive microbial growth in this organ, disrupting intestinal microbiota and producing symptoms.
How is SIBO treated?
Treatment involves several stages.
Initially, antibiotics and sometimes herbal compounds reduce bacterial overgrowth. A low-FODMAP diet may relieve symptoms during treatment. Foods containing FODMAPs are temporarily removed, then gradually restored using reintroduction protocols for fermentable-carbohydrate foods.
A second stage may involve strain-specific probiotics to support intestinal mucus and barrier function, the microbiota and digestion.
Treatment must be prescribed and monitored by healthcare professionals caring for the person with SIBO.
What Can Cause SIBO?
Several factors increase SIBO risk.
The condition gastroenteritis can impair natural intestinal clearance, sometimes producing excess unwanted bacteria associated with SIBO.
Certain autoimmune conditions, including type I diabetes and hypothyroidism, are associated with SIBO. Some medical treatments adversely affect intestinal flora and may increase risk.
SIBO’s Effects on the Body
Understanding SIBO helps explain its unpleasant effects.
Possible effects include:
- Excess gas and bloating from carbohydrate fermentation.
- Fat-soluble vitamin malabsorption following bile acid deconjugation, also causing fat malabsorption.
- Fewer available micronutrients because bacteria consume them.
- Poor absorption, especially of carbohydrates, through changes in intestinal villi.
- Reduced short-chain fatty acid production, important for microbiota balance.
- The state of intestinal and systemic inflammation may contribute to irritable bowel syndrome.
- Increased intestinal permeability.
How Does SIBO Affect Athletes?
The symptoms of SIBO include abdominal pain, bloating, diarrhoea, flatulence and distension, potentially impairing training and competition.
Additionally, SIBO involves macro- and micronutrient malabsorption, potentially compromising nutrition. Good nutritional status supports injury prevention and recovery.
What If SIBO Is Untreated?
Without SIBO treatment, symptoms persist, causing discomfort and frustration and disrupting daily life.
An Athlete’s Diet with SIBO
Symptom management often uses a low-FODMAP diet.
This temporarily excludes foods high in fermentable short-chain carbohydrates: oligosaccharides, disaccharides, monosaccharides and polyols.
The group athletes maintaining high-volume or intense training should prioritise foods rich in carbohydrate such as rice, oats, maize, quinoa, potatoes, sweet potatoes and cassava to replenish glycogen and prepare for subsequent sessions.
Choosing fruit and vegetable types and portions can be difficult. Professional planning assesses individual tolerance in SIBO.
The FODMAP approach has 3 phases. The first is most restrictive. The second gradually reintroduces foods under controlled conditions. The third phase is personalisation after FODMAP reintroduction.
Which Foods Are Restricted?
Foods commonly restricted with SIBO include:
- Wheat, rye, whole grains, onions and garlic for fructooligosaccharides.
- Pulses for galactooligosaccharides.
- Dairy containing lactose.
- Honey and syrups, plus some fruit and vegetables containing fructose.
- Some nuts such as almonds, pistachios, hazelnuts and cashews.
- Foods containing polyols such as sorbitol, xylitol, maltitol and mannitol, including many light or sugar-free products.
Our Advice
The condition SIBO is complex and can substantially affect life. Consult a medical professional for treatment, then a nutritionist familiar with it to design a nutrition plan meeting needs within individual tolerance.
As an athlete with SIBO, our team can plan daily nutrition to support wellbeing and sporting performance. Explore our subscription options and contact us with questions.
