Understanding What to Eat with Auto-Brewery Syndrome: A Nutritional Guide

October 16, 2025 •

4 min read

Case reports have shown that individuals with auto-brewery syndrome often report a high-sugar, high-carbohydrate diet, which fuels the production of ethanol within their own digestive system. Managing this rare and challenging condition requires a targeted nutritional approach focused on what to eat with auto-brewery syndrome to starve the fermenting microbes and restore balance.

Quick Summary

A crucial step in managing auto-brewery syndrome involves adopting a strict low-carbohydrate, sugar-free diet. The goal is to eliminate the primary food source for the yeasts and bacteria causing endogenous fermentation. Dietary modifications should include increased protein and high-fiber foods to support gut health and prevent relapse.

Key Points

Low-Carbohydrate is Key: A low-carb, sugar-free diet is the most effective nutritional strategy for starving the fermenting yeast and bacteria that cause ABS.
Focus on Protein and Fats: Fill your plate with lean proteins (like chicken and fish) and healthy fats (like avocado and coconut oil) to maintain energy without fueling fermentation.
Avoid Refined Sugars and Starches: Steer clear of processed foods, white flour products, fruit juices, and sugary snacks, as these are potent fuel sources for the gut microbes.
Mind Your Fiber Intake: Incorporate high-fiber, low-glycemic vegetables like broccoli and leafy greens, but approach more complex carbohydrates cautiously, as individual tolerance varies.
Seek Professional Medical Guidance: Work with a healthcare team, including a dietitian, to create a personalized plan and consider antifungal medication to rebalance your gut microbiome.
Consider Probiotics Carefully: While some probiotics can help, they are not a universal solution and should be introduced under medical supervision, especially for individuals with SIBO.

What is Auto-Brewery Syndrome?

Auto-brewery syndrome (ABS), also known as gut fermentation syndrome, is a medical condition in which fermenting organisms like yeast or bacteria produce ethanol endogenously within the gastrointestinal tract. In affected individuals, the ingestion of carbohydrates can lead to the production of alcohol, causing symptoms of intoxication such as dizziness, slurred speech, confusion, and chronic fatigue, even without consuming alcoholic beverages. While a definitive diagnosis requires a glucose challenge test under medical supervision, dietary changes are a cornerstone of treatment to limit the fuel available for fermentation.

The Role of Diet in Auto-Brewery Syndrome

The core principle of a dietary plan for ABS is to drastically reduce or eliminate the intake of carbohydrates and sugars, which are the primary food source for the fermenting microorganisms. By limiting these substrates, the overgrowth of yeasts like Candida and Saccharomyces or bacteria like Klebsiella pneumoniae can be brought under control. A low-carbohydrate or ketogenic diet is often recommended as the initial therapeutic approach.

Foods to Include in an ABS Diet

A successful ABS diet focuses on nutrient-dense foods that do not ferment easily. Prioritizing lean proteins, healthy fats, and low-glycemic vegetables helps maintain energy levels and support gut health without triggering alcohol production.

Lean Proteins

Eggs: A versatile and complete source of protein.
Lean meats: Chicken, turkey, and other poultry.
Fish: Rich in omega-3 fatty acids, an excellent dietary staple.
Nuts and seeds: Almonds, walnuts, chia seeds, and pumpkin seeds provide protein and fiber.
Legumes: Lentils and certain beans can be included, but should be monitored for individual tolerance, as they contain some carbohydrates.

Healthy Fats

Avocado: High in healthy monounsaturated fats and fiber.
Coconut oil: Contains monolaurin, an antimicrobial compound that can help combat yeast overgrowth.
Olive oil: A staple of anti-inflammatory diets.

Low-Carb Vegetables

Leafy greens: Spinach, kale, and lettuce are virtually carbohydrate-free.
Cruciferous vegetables: Broccoli, cauliflower, and Brussels sprouts are low in carbs and high in fiber.
Other non-starchy vegetables: Bell peppers, cucumbers, zucchini, and asparagus are safe choices.

High-Fiber Foods

Incorporating high-fiber foods, especially complex carbohydrates like whole grains, can help some individuals by supporting beneficial gut bacteria. However, this should be done with caution and with professional guidance, as some complex carbs may still fuel fermentation in sensitive individuals. Examples include brown rice, oats, and quinoa.

Foods to Avoid with Auto-Brewery Syndrome

Eliminating fermentable carbohydrates is critical to managing ABS. These are the main culprits that provide fuel for the gut microorganisms.

Sugary Foods and Simple Carbohydrates

Refined sugars: Glucose, fructose, and dextrose found in candy, desserts, and sodas.
High-fructose corn syrup: A potent fermentation fuel.
Fruit juice: Concentrated sugar, often stripped of fiber.
Refined grains: White bread, pasta, white rice, and pastries.

Fermented Foods

Fermented foods like kombucha, kefir, and sauerkraut may provide additional fermenting microorganisms and should be avoided, especially in the initial stages of treatment.

Starches

Starchy vegetables like potatoes and corn should be limited, as they can be easily converted to sugar.

Dairy

Dairy products, especially those high in lactose, should be approached with caution or avoided, as lactose is a sugar that can be fermented.

Nutritional Comparison: A Low-Carb vs. High-Carb Diet


Feature	Low-Carb ABS Diet	High-Carb Standard Diet
Primary Fuel Source	Proteins and healthy fats	Carbohydrates (sugars and starches)
Carb Intake	Very restricted, focusing on fiber	High, often including refined carbs and sugars
Gut Microbe Impact	Starves fermenting organisms like yeast	Provides abundant fuel for fermenting microbes
Symptom Management	Aims to eliminate endogenous alcohol production	Exacerbates intoxication symptoms
Key Food Groups	Lean proteins, low-carb vegetables, healthy fats	Refined grains, sugary snacks, starchy foods

Lifestyle Adjustments and Long-Term Management

Successful long-term management of ABS often requires more than just dietary changes. It is crucial to address the root causes of the microbial imbalance.

The Importance of Probiotics

While some fermented foods are off-limits, certain multi-strain probiotics may be beneficial. They help repopulate the gut with healthy bacteria, potentially outcompeting the fermenting organisms. However, this should be discussed with a healthcare professional, as some individuals with Small Intestinal Bacterial Overgrowth (SIBO) may react poorly to probiotics.

Medical and Professional Guidance

Working with an interprofessional team, including a gastroenterologist and a registered dietitian or nutritionist, is highly recommended. They can help customize a diet plan and monitor your progress. The use of antifungal medications may also be necessary to reset the gut flora before dietary therapy can take full effect.

Hydration and Meal Timing

Drinking plenty of water can help flush out toxins. Eating smaller, more frequent meals rather than large, carbohydrate-heavy ones can also help control fermentation.

Addressing Underlying Conditions

ABS is often linked with other conditions such as Crohn's disease, diabetes, or SIBO. Treating these underlying issues is a critical step in achieving long-term relief from ABS symptoms.

Conclusion: A Path to Recovery

Living with auto-brewery syndrome is a significant challenge, but a disciplined nutritional plan offers a powerful tool for regaining control. By understanding what to eat with auto-brewery syndrome—namely, focusing on a low-carbohydrate, sugar-free diet rich in proteins and healthy fats—individuals can effectively starve the overgrowing microbes responsible for endogenous alcohol production. This dietary strategy, when combined with professional medical guidance, antifungal treatment, and careful reintroduction of complex carbohydrates, can significantly reduce symptoms and improve quality of life. The journey requires patience and consistency, but the ability to reclaim your health is well worth the effort.

For more in-depth medical information on the diagnosis and treatment of Auto-Brewery Syndrome, consult the resource provided by the National Institutes of Health.

Frequently Asked Questions

You should completely avoid all simple and refined carbohydrates, including refined sugars, white bread, pastries, fruit juice, and high-fructose corn syrup, as they provide an immediate food source for fermenting microorganisms.

Not all carbohydrates are equally harmful. While simple carbohydrates and sugars should be eliminated, complex carbohydrates, particularly those high in fiber, can sometimes be tolerated in small amounts under medical supervision. However, the initial phase of treatment often requires a strict low-carb diet.

Some multi-strain probiotics can potentially help restore balance to the gut microbiome. However, their use should be discussed with a healthcare provider, as they may not be suitable for everyone, particularly those with conditions like SIBO.

Antifungal medications are often prescribed by doctors to reduce the overgrowth of yeast in the gut. This treatment, combined with a strict low-carb diet, helps to reset the gut flora and is a critical part of the initial therapy.

No, fruit juice should be avoided. It is a concentrated source of simple sugars, like fructose, which are easily fermented by gut microbes and can significantly worsen symptoms.

The duration of the dietary restrictions varies depending on the individual and the severity of their condition. An initial period of strict adherence is usually followed by a gradual and careful reintroduction of certain foods under medical guidance.

Yes, relapses are possible, especially if the underlying cause is not fully addressed or if the individual returns to a high-carbohydrate diet. Long-term management involves continued dietary awareness and addressing related health conditions.