What Can People with Auto-Brewery Syndrome Eat?

October 19, 2025 •

4 min read

According to the National Institutes of Health, a low-carbohydrate, sugar-restricted diet is an essential component of managing auto-brewery syndrome. For those with this rare condition, certain yeasts in the gut produce ethanol when they ferment carbohydrates and sugars, leading to symptoms of intoxication without consuming alcohol. The right dietary strategy is crucial for restoring gut balance and minimizing symptoms.

Quick Summary

The cornerstone of managing auto-brewery syndrome is a high-protein, low-carbohydrate diet to reduce fermentable substrates in the gut. Individuals should eliminate sugars and refined carbs, including white bread, pasta, and sugary drinks, while focusing on nutrient-dense, fiber-rich whole foods. The diet's goal is to minimize ethanol production and restore a healthy gut microbiome balance.

Key Points

Low-Carbohydrate Diet: The cornerstone of managing auto-brewery syndrome is a low-carbohydrate and sugar-free diet to reduce the fuel available for fermenting microbes.
Avoid Refined Carbs and Sugars: Eliminate simple sugars and refined carbohydrates like white bread, pasta, sugary drinks, and fruit juice, which are primary triggers for ethanol production.
Focus on Protein and Healthy Fats: Increase intake of lean proteins, healthy fats, and non-starchy vegetables to maintain energy and support overall health without causing fermentation.
Consider Probiotics with Caution: Certain probiotic supplements may help restore gut balance, but they should be used under medical supervision, as some fermented foods can worsen symptoms.
Gradual Reintroduction of Carbs: After initial treatment, complex, high-fiber carbohydrates may be slowly reintroduced while monitoring for symptoms, but a low-carb diet is typically maintained long-term.
Seek Professional Medical Advice: Always consult a healthcare provider and a dietitian for a personalized diet plan tailored to your specific needs, as underlying conditions and individual triggers can vary.

The Importance of a Low-Carbohydrate, Sugar-Free Diet

For individuals with auto-brewery syndrome (ABS), the gut microbiome contains an overgrowth of fermenting yeasts or bacteria, such as Saccharomyces cerevisiae. These microorganisms feed on dietary carbohydrates and convert them into ethanol, causing unintended intoxication. The primary nutritional strategy for managing ABS is to deprive these organisms of their food source by drastically reducing or eliminating sugars and digestible carbohydrates.

Initially, many healthcare providers recommend a very strict, temporary diet that is completely free of carbohydrates to allow the gut to reset. After this initial phase, a long-term, low-carbohydrate diet is necessary to prevent relapse. This dietary approach starves the fermenting microbes, helping to re-establish a healthy balance of gut flora. In some cases, this dietary modification alone can be enough to resolve symptoms, though many patients also require antifungal medication. Consulting with a nutritionist or dietitian specializing in gut health is highly recommended to tailor a safe and effective plan.

Foods to Embrace for Better Gut Health

Focusing on high-protein, high-fiber, and low-glycemic foods is key to managing ABS long-term. This diet provides necessary nutrients without triggering the fermentation process.

High-quality proteins: Lean meats, fish, eggs, poultry, and certain protein-rich plants like lentils and pumpkin seeds are excellent choices. Protein helps maintain satiety and provides energy without affecting blood sugar levels.
Non-starchy vegetables: Leafy greens such as spinach, kale, and lettuce, along with broccoli, cauliflower, bell peppers, and cucumbers, are low in carbohydrates but high in fiber and nutrients.
Healthy fats: Avocados, olive oil, and nuts are good sources of healthy fats that can be consumed in moderation.
Complex carbohydrates (in moderation): After the initial strict carbohydrate-free period, some individuals may be able to slowly reintroduce small amounts of complex, high-fiber carbs. Examples include brown rice, quinoa, and whole-grain oats. Monitoring symptoms closely during this phase is essential.
Water: Staying well-hydrated is crucial for flushing out toxins and supporting overall health.
Probiotics and Prebiotics: Certain probiotic strains, like Lactobacillus and Bifidobacterium, can help rebalance the gut microbiome. Prebiotic foods, which feed beneficial bacteria, can also be introduced gradually under medical guidance.

Comparison of ABS-Friendly vs. Problematic Foods


Food Category	ABS-Friendly Options (Consume)	Problematic Foods (Avoid)
Carbohydrates	Brown rice, quinoa, whole-grain oats, lentils (in moderation after initial phase)	White bread, pasta, white rice, flour, crackers, potato chips, corn, corn syrup
Sugars	Natural alternatives like stevia	Refined sugars (glucose, fructose, dextrose), corn syrup, honey, maple syrup
Beverages	Water, herbal tea, unsweetened coffee (black)	Fruit juice, soda, energy drinks, kombucha, alcohol
Dairy	Unsweetened Greek yogurt (some can tolerate, some can't), hard cheeses	Milk, creamy dairy products (many individuals report issues)
Proteins	Lean meats, fish, eggs, poultry	Processed meats with added sugar or fillers
Fruits & Vegetables	Non-starchy vegetables, limited amounts of whole fruits (monitor tolerance)	Starchy vegetables like potatoes, corn, and fruit juice
Fermented Foods	Probiotic supplements (certain strains)	Fermented foods like kimchi, sauerkraut, kefir, and yogurt (may worsen symptoms)

Lifestyle Adjustments Beyond Diet

While diet is the cornerstone of managing auto-brewery syndrome, a holistic approach is most effective. Managing stress, getting enough sleep, and engaging in regular exercise all support a healthy digestive system and can aid in managing symptoms. Additionally, patients with ABS should be cautious with antibiotic use, as it can disrupt the gut microbiome and cause a relapse.

Some individuals with severe or chronic ABS may require more advanced treatments. In rare, resistant cases, fecal microbiota transplantation (FMT) may be considered to restore a healthy bacterial balance in the gut, but more research is needed.

Seeking Professional Guidance

For anyone diagnosed with auto-brewery syndrome, working closely with a healthcare team is essential. This often includes a gastroenterologist, a dietitian, and other specialists. They can provide a personalized plan that includes diet modifications, monitoring, and, if necessary, antifungal medications. The reintroduction of carbohydrates should be a gradual, monitored process to avoid symptom recurrence.

Conclusion

For individuals asking what can people with auto-brewery syndrome eat, the answer lies in a carefully managed, low-carbohydrate diet that starves the fermenting microbes in the gut. By eliminating simple sugars and refined carbs and focusing on high-quality proteins, healthy fats, and low-starch vegetables, patients can significantly reduce or eliminate symptoms. Combining dietary changes with professional medical guidance, lifestyle adjustments, and potentially probiotics can provide a comprehensive strategy for managing this challenging condition. A proactive and disciplined approach to nutrition is the most powerful tool for regaining control over one's health with auto-brewery syndrome.

For further information on this condition, you can refer to the NCBI Bookshelf for Auto-Brewery Syndrome.

Frequently Asked Questions

The primary dietary goal is to limit the amount of fermentable carbohydrates and sugars, which act as fuel for the yeast overgrowth in the gut, thereby reducing endogenous alcohol production.

People with ABS should avoid simple and refined carbohydrates, including white bread, pasta, white rice, processed snacks, and sugary drinks like soda and fruit juice.

Yes, some natural sugar alternatives like the herbal sweetener stevia are generally considered safe because they are not fermented by the yeasts in the gut.

Non-starchy vegetables are typically safe and encouraged. The intake of fruits should be monitored carefully due to their sugar content; limited amounts of whole fruits may be tolerated, but fruit juices should be avoided.

Protein is very important as it provides a stable source of energy without causing fermentation. A diet high in protein can help patients feel fuller and more satisfied while minimizing carbohydrate intake.

Probiotics, particularly multi-strain supplements containing beneficial bacteria like Lactobacillus and Bifidobacterium, can help restore a healthy gut microbiome. However, some fermented foods should be avoided, and professional guidance is recommended.

A strict carbohydrate-free diet may be necessary during the initial treatment phase. Long-term management often involves a transition to a low-carbohydrate diet, with the gradual reintroduction of complex carbs under medical supervision.

Professional guidance from a gastroenterologist and a registered dietitian is crucial for a personalized treatment plan. They can help identify specific trigger foods and create a safe, sustainable dietary strategy.