Part 4: Food reintroduction after the Elemental Diet

In the third part of my Elemental Diet blog series, I talked about how to come off the Elemental Diet and the things you need to consider before reintroducing foods. 

Now, we will dive deeper into the food reintroduction phase and discuss what you can eat before going back to your normal diet.

What you should eat during the food reintroduction phase

Reintroducing foods after 14-21 days of not eating anything can be challenging. This is a healing process so you need to carefully plan the foods you’re going to eat. 

Treat your gut like a newborn's stomach post-Elemental Diet. We don’t feed our babies with hard solid foods when we first feed them, right? Instead we give them puréed, mashed, simple foods and we start with one ingredient at a time. 

You will also do the same thing when reintroducing food after the treatment. Start by consuming soft, puréed foods that are very easy to digest. 

To help you get started on your food reintroduction journey, here are some foods you can prepare after coming off the Elemental Diet.

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Day 1

Start with something simple like chicken or vegetable broth on the first day of the food reintroduction stage. This broth should be clear and does not contain any chicken or vegetables, as these should be removed prior to serving. This allows you to get the nutritional benefits without the challenge of having to digest these whole foods. 

Although you’re only eating broth, make sure to chew each mouthful to help stimulate your digestion. You may also need to consume this along with your Elemental Diet shakes as they will provide the calories your body needs. It’s also recommended that you take digestive enzymes and a prokinetic with each meal, and another prokinetic before bedtime to fire up your digestion. 

Think of it like a fire that has died down to a few embers. We need to build your digestion back up to a roaring fire, and this will take time and support.

Recipe to try: Chicken broth is one of the easiest recipes you can make during day 1. Make sure you don’t include chicken frames and bones in your stock as these contain cartilage which turns into carbohydrates that can be problematic when first coming off the elemental diet. 

Days 2-7

Slowly incorporate small amounts of well-cooked and puréed vegetables into your diet. Start with the vegetables you know you’re okay with and try one vegetable at a time. When you’re ready, you can then add some puréed chicken to your broth. 

On Day 2, you might like to add puréed carrot to your chicken broth. Once you know you can tolerate that vegetable well, you can move on to another vegetable such as puréed zucchini. When you feel ready, add some of the chicken meat from when you made your broth. Make sure to chew each mouthful extremely well as the introduction of protein can be harder on your digestive system.

Many people like to start with chicken but you can reintroduce any meat, poultry or fish you like. Choose from organic pasture-fed meats and poultry, and sustainable wild-caught fish and seafood. Other SIBOers also like to start with SIBO-friendly vegetables such as those listed on the SIBO Bi Phasic Diet or Low FODMAP Diet. 

Once you have successfully introduced these vegetables back into your diet, you can start experimenting with the higher FODMAP vegetables to see how you do with them. 

The traffic light system in the Monash University Low FODMAP app is really helpful. You could start out eating the ‘green’ vegetables, then move to the ‘amber’ vegetables before finally experimenting with the ‘red’ vegetables in the coming weeks.

Recipe to try: This roasted tomato and basil soup is a comforting classic that you will surely enjoy. I personally love this recipe because it’s delicious, gluten-free, SIBO friendly and so delicious after only consuming the elemental diet for 14 or 21 days!

Week 2

You can now eat chunkier soups, stews and slow-cooked food during this week. But don’t forget, your gut is still adjusting so you still need to eat easy-to-digest foods. You can also try adding a bit of well-cooked rice to your soup if you like, or you could make congee which is easily digested by many SIBOers. Continue expanding on your proteins and vegetables this week.

Recipe to try: My hearty beef stew recipe is easy to prepare and bursting with flavour. When doing this, you can save portions in the freezer for easy meals in the future. Just heat it up and you’re good to go. 

Week 3

Continue eating foods indicated from week 2. You might like to try adding eggs to your dishes. Start with egg yolk first as this is easier to digest than egg white and monitor for symptoms. If you feel okay, you can then add the whole egg to your dishes. 

Week 3 is the time to start bringing harder to digest foods into your diet. This could mean moving away from soups and stews and eating a plate of cooked food. For instance, you could have some grilled chicken breast, steamed vegetables and cooked rice for a meal. 

If you feel ready, you could start to incorporate SIBO-friendly fruits. Many SIBOers do better eating cooked fruits initially before graduating to raw fruits as the cooking helps to break down the fruit, therefore, making it easier for us to digest. 

Recipe to try: My SIBO-friendly version of the Japanese ramen has a flavorful broth that you’ll love. It’s a great way of incorporating eggs back into your diet, while also having rice (in the rice noodles), vegetables and protein

Week 4

You can start reintroducing some harder to digest foods like nuts in week 4. But make sure to take it slowly and do the following 3-step process before eating whole nuts. 

  • Step 1: Baby food - Start by making nut milk with the pulp strained. Your body gets the experience of nuts without the hard to digest nut bits.
  • Step 2: Soft food - Prepare nut milk with the ground nuts left in. You can also soak nuts and add them to your soups.
  • Step 3: Hard food - Start eating whole nuts. You might like to start with roasted nuts before moving to raw nuts.

Recipe to try: If you want to create your own version of nut milk, my almond milk recipe is perfect for you. It’s gluten-free, easy to prepare and tastes so much better than the store-bought versions.

Weeks 5 & 6

Challenge yourself by eating harder foods such as raw vegetables and seeds during this period. You can now add some ingredients like onion and garlic that will help your body get ready to eat out.

Recipe to try: This smoked salmon salad is one of the easiest SIBO recipes I ever made. You can make it in under 15 minutes with simple ingredients like arugula, spinach, zucchini and smoked salmon.

Key tips for food reintroduction

  • Chew, chew, chew! The more you chew, the more you tell your brain to switch the gut on and process your food.
  • Eat low-fibre and easy-to-digest foods. You might like to start on one of the SIBO diets initially before expanding your food options.
  • Go slowly. Add one new food at a time so you can test and measure your body's responses to these foods. 
  • If you have a reaction to a specific food, come back to it. Your body might not be ready for that food today, but it doesn’t mean it won’t be able to tolerate it again in the future. 
  • Don’t rush the process. Be patient and take as much time as you need to reintroduce foods.
  • It is totally normal to have some digestive symptoms when reintroducing foods. Just be mindful of how strong they are. We’re looking for symptoms that are 1 to 5 out of 10. If your symptoms are stronger than this, that could be an indication that your body is not ready for that food. You might have an intolerance or allergy to it or that you need to consume a smaller quantity of that food next time. It can feel like you need to play private investigator at times, but trust your intuition with foods and remember that this is a slow process.
  • Take digestive enzymes and a prokinetic to help support the Migrating Motor Complex (MMC).

Use this time as an amazing opportunity to connect with your body. Write down your daily experiences using my Food and Mood Diary so you can refer back to them and see how far you have come.

If you want to know more about my food reintroduction experience, you can watch my YouTube vlog series here.  If you would like to learn more about the Elemental Diet and other SIBO treatment options, check out my Live Well With SIBO: 5 Week Challenge (On Demand) program.

This article is Part 4 of a five-part series on the Elemental Diet. Read the first, second and third articles if you haven’t seen them yet. Stay tuned for the next one as we will talk about why you should or shouldn’t do the Elemental Diet. 

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16 thoughts on “Part 4: Food reintroduction after the Elemental Diet”

  1. Thank you for sharing your wisdom with us!! I have been diagnosed with hashimotos and borderline insulin resistance. I read a book about addressing the root cause and starting with the pure elemental diet is what was suggested. I’m on day 10 of alternating a blend of pure 21 amino acids by joMar labs in unsweetened cranberry juice, and herbal tea with coconut oil. I’m not feeling so great, and I do not want to take another sip of coconut oil. i feel like a failure but i think I’m going to keep taking the amino acids and switch out the coconut oil for bone broth for the last 4 days and then start trasitioning to the elmination diet. Do you think that’s okay?

    1. Hi Emily
      Without knowing your health history it’s difficult to comment on what the best course of action is for you. I do hope you are being supervised by a practitioner or doctor while doing this?
      Kind regards

  2. This is very helpful thank you so much for sharing this guidance! I was wondering about reintroducing gluten though, as I did not see anything about this here.

    1. Hi Lina
      If you choose to bring gluten back into your diet, I would do this in weeks 5 or 6 (or later).
      Kind regards

  3. When I am starting out with pureed veggies, am I able to add something to them to make them tasty? I’m thinking spices, maybe a little olive oil, etc. Plain pureed veggies sounds kind of meh and I’m dying to eat something that actually tastes good!

    1. Hi Jill
      You will be amazed by how delicious plain veggies taste after only drinking the ED for 2-3 weeks! If you would like to add something to your veg to make them a little tastier, eg olive oil or simple dried spices, please feel free to do so.

  4. you don’t say anything about fruit on the first week of reintroducing food. Is there a reason to not eat fruit?

    1. Hi Steve
      Great question. Fruit can be challenging for many people who have had SIBO. It’s often easier to start with simple vegetables and well cooked meat. If someone is ready to bring fruit back in, eating cooked and pureed fruit can be a good first step as it’s easier to digest.

  5. Hi Rebecca, thank you for these blogs, they are very helpful.
    I am in the last 5 days of the diet, Hurray!! Lucky me; I didn’t have to suffer as much as you did. I am not hungry as long as I sip enough of the diet. Only the sweetness of the drink bores me, brrr..
    Long ago I fasted for about 5 days. I have a little old book on fasting. It recommended to start with 5 days eating less before fasting and to reintroduce slowly, just like you do. Only, the first day you ate some cooked apple. That seems to work wonders on starting your motor.
    The only thing is, it is high Fodmap, so I can’t try it now. But maybe someone else?

  6. Hi, thanks so much for this post i appreciate the detailed information you have provided!

    I have never made a bone broth before and would be buying 1 from amazon would this be the equivalent as making your own? I have listed the 1 i’m looking at buying as the ingredients aren’t containing anything irritating. Would this specific bone broth brand be ok to use? I have listed the ingredients below and linked the product below also if you could get back to me and let me know i would highly appreciate it as i have just gone and started the elemental diet as of today and i’m new to all of this! Thanks!

    Grass-fed, pasture-raised Australian and New Zealand beef leg bone extract (90%), evaporated sea salt.

    1. If you aren’t able to make your own broth, finding the best quality commercially made broth is a good next option. Bones and salt as the ingredients are fine.

  7. Hi Rebecca,

    I’m healing from SIBO and am facing constipation . My practitioner says this is normal but I am not having any bowel movements for days! Any advice?

  8. You are so right about the overstressing leading to poor digestion! I am way overthinking it, as I do everything. Thank you so much for the great info!

  9. Hi Rebecca! Thank you so much for all this wonderful info- I am in the middle of my 2 week elemental diet gut reset and I realized I have so much prep to do for transitioning out. I am excited to try the broth recipe. How much broth did you end up consuming on day 1? How much pureed veggie did you start out with day 2? I know it will vary per person depending on how your system reacts, but I have no idea where to start and I am stressing over how much to eat because I need a lot of calories, but am scared to overdo it. Thank you!

    1. Hi Brianna
      I had a few cups worth of broth in the first day and maybe half a carrot which I then pureed.
      Please don’t stress about reintroducing food – stress does not help you digest your food! If you go into the food reintroduction phase with the mindset that it’s all one big experiment and that you will have some wins and some failures, when something doesn’t agree with you, it won’t feel so bad psychologically.

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