There’s no shortage of anti-Candida, Candida cleanse or anti-yeast diet listings and information online offering ways to prevent or treat yeast infections. Many of those same diets also claim to relieve a wide range of symptoms related to gut health.
Candida is a type of yeast that typically lives inside the body in places like the mouth, throat, gut and genitals. There are hundreds of species of Candida yeasts. The most common is Candida albicans.
Their presence is normal and isn’t a problem alone. The Centers for Disease Control and Prevention notes that about 20% of women normally have Candida in the vagina without having any symptoms. But when Candida grows out of control, it can cause infections. The most common type of yeast infection are vaginal yeast infections. It’s estimated that 3 in 4 women have at least one yeast infection in their lifetime.
Candida vs. Yeast Infection
Because yeast infections are so common, numerous anti-Candida diets have bloomed in response. The most popular is the Candida diet, which subscribes to the notion that sugar feeds so-called Candida overgrowth, usually in the gut, leading to a range of problems that extend beyond one’s intestines. These problems — which are described as “symptoms of Candida” — range from yeast infections to digestive issues, sinus infections, food allergies, mild depression and joint pain.
Lisa Richards, a certified nutrition coach and creator of the Candida diet, is a proponent of the belief that Candida in the gut can cause such wide ranging symptoms.
In describing the diet online, she states: “By improving your gut health and restoring the balance of the bacteria and yeast that live inside your body, you can get relief from Candida symptoms like bloating, indigestion, yeast infections, fatigue, nausea, diarrhea and gas.”
Richards further wrote in an email: “The Candida diet is a low-sugar, anti-inflammatory diet designed to reduce the colonization of Candida in the gut and lower the incidence of yeast infections and other symptoms.” It’s also a gluten-free diet.
Candida Diet Foods
The diet includes:
— Non-starchy vegetables, such as zucchini and broccoli.
— Some low-sugar fruits like berries (while avoiding fruits like bananas, grapes and mangoes).
— Gluten-free grains like quinoa (avoiding wheat, barley, rye and spelt).
— Lean proteins. Eggs and the white meat of chicken and turkey are preferred choices, though some red meat, like well-cooked beef, is allowed.
— Only some dairy products like ghee and butter fit in the diet; no cheese or milk.
— Fermented foods, which contain probiotics — like yogurt (that doesn’t have a lot of sugar) and kefir — are two other sources of dairy that get the green light.
In addition, followers of the diet are encouraged to avoid alcohol and minimize caffeine consumption.
Despite healthy elements of the Candida diet like reducing sugar intake, some independent experts question the diet’s claim that it can reduce yeast infections. They also question the wide range of symptoms attributed to Candida overgrowth. What’s more, clinicians and dietitians worry that its restrictive nature could be worse for gut health, compared with eating a wider variety of foods, and may therefore undermine one’s overall health.
The most recent gut microbiome research links diverse, plant-based diets to diverse gut microbiota that are associated with robust gut health and metabolic and cardiovascular health. In parallel, research that shows diets that restrict categories of plant-based foods, including grains, legumes and certain fruits and vegetables, seem to have an adverse effect on the health of the gut microbiome by essentially ‘starving’ the good bacteria.
It’s also not clear whether dietary changes of any kind can prevent or treat yeast infections in most women. “In women who are diabetic, where the glucose is out of control, it does increase their risk of having yeast infections, and there dietary changes may make a difference,” says Dr. Paul Nyirjesy, a gynecology specialist with the Vulvovaginal Health Center at Thomas Jefferson University in Philadelphia. Nyirjesy has been a consultant on the CDC’s guidelines on sexually transmitted diseases treatment since 2005 and wrote the American College of Obstetricians and Gynecologists’ most recent guidelines on vaginitis.
While dietary changes may help with the management of diabetes, Nyirjesy says that doesn’t translate to individuals whose blood sugar is in a normal, healthy range. “For most women with yeast infections (who don’t have diabetes) there’s no evidence that dietary changes make a bit of a difference,” he says.
[See: Foods That Cause Bloating.]
Lack of Scientific Evidence
In the 1980s, a study of 100 women found that cutting down on artificial and real sugar led to a decrease in the incidence and severity of yeast infections. However, Njirjesy questions the study’s methods and results. In addition, he notes that there’s been a lack of supportive research in the decades since, which he sees as undercutting those findings.
For her part, Richards contends that reducing sugar intake can also help control candida growth in the gut. “There is evidence that Candida colonization in the gut forms a ‘reservoir’ that allows patients to be repeatedly re-infected with vaginal yeast infections,” she says, citing 2001 research published in the journal Clinical Infectious Diseases.
However, according to gut microbiome researchers, there are no established “normal” reference ranges for Candida in the gut, so the idea of overgrowth is a subjective one.
Heidi Silver, a registered dietitian nutritionist and a research associate professor of medicine at Vanderbilt University Medical Center in Nashville, also describes a lack of research that directly tests or supports the Candida diet, despite decades of people following it. While there’s much emerging data on the wide-ranging importance of gut health, experts like Silver say there’s a dearth of studies to support that an anti-Candida diet specifically is what’s needed to bolster gut health, reduce yeast infections or address a range of other symptoms.
“This was a very popular fad diet as far back as 35 years ago. So it’s been around for quite a while,” Silver says. “It’s not a new concept.” But despite all the time that’s passed, “there really isn’t a scientific evidence base to make any conclusions about the anti-Candida diet.”
Silver adds, “Truthfully if you really want to improve your gut health, you really wouldn’t want to restrict the variety of nutrients in your diet, and the variety of nutrients comes from eating a variety of foods.”
While clinicians like Dr. Edwin McDonald concede that cutting back on certain foods may reduce bloating or help address gastrointestinal upset, they’re quick to point out that doesn’t mean wholesale dietary changes are in order. “Within GI, the gastrointestinal literature, I have not seen any official studies that have demonstrated the benefit of this anti-Candida diet,” says McDonald, a gastroenterologist and assistant professor of medicine at the University of Chicago. McDonald is also the associate director of adult clinical nutrition at UChicago Medicine and a trained chef.
One primary issue, he points out, is that there’s not even a test, at present, to determine if a patient has candida overgrowth in the gut. “I don’t want to say that there’s nothing to this. I’m just going to say that so far it is not well understood,” McDonald says. And yet, he adds, “On the internet, if you just Google Candida overgrowth, you would think that this is a pandemic.”
Treatment for Yeast Infections
McDonald says he’s had plenty of patients come in who’ve searched online for answers to GI symptoms who are convinced it’s due to Candida overgrowth. For those patients, “I definitely have diagnosed them with lactose intolerance, with small intestinal bacterial overgrowth, with sucrose intolerance or fructose intolerance,” he says. “But these are all conditions that we have diagnostic studies to help suggest that these are possibilities that may be the underlying reason why people are having symptoms. And we also have treatment for that.” Small intestinal bacterial overgrowth, also known as SIBO, is a condition with symptoms that include bloating and GI distress.
He and other clinicians worry, practically speaking, that a fixation on Candida may miss the actual cause of symptoms like bloating, such as an intolerance to lactose (the sugar in dairy) or otherwise obscure any number of underlying conditions, from irritable bowel syndrome to cancer. “The causes of bloating can be wide-ranging, but include ovarian cancer,” Nyirjesy adds.
Experts roundly emphasize that before making any major dietary changes in an attempt to deal with problems such as a potential yeast infection, persistent bloating or diarrhea or any other concerning symptoms, it’s important to seek medical attention to ensure a proper diagnosis.
For women who have vaginal yeast infections, antifungal medications are still the mainstay of treatment. Probiotics are also often recommended — both oral and vaginal. While some clinicians say those may help, especially in combination with medication, Nyirjesy contends there isn’t sufficient evidence to support using probiotics for treating yeast infection.
Our Gut Microbiome
Generally speaking, experts say including fermented foods like yogurt in one’s diet could bolster gut health. But above all, dietitians generally stress eating a wide range of nutritious foods — fruits and vegetables and healthy sources of fiber, where most Americans fall short — is key to proper gut health and better overall health.
Cutting down on excess sugar and processed foods is also advised. While research is still ongoing to better understand how diet impacts gut health, what’s clear is that we thrive when we host a diverse and plentiful collection of microorganisms in our gut. The trillions of bugs in our gut are collectively known as our gut microbiome.
By contrast, McDonald says he sees a lot of patients who, after going on a restrictive diet, suffer from malnutrition. “When you restrict foods, you’re restricting nutrients,” Silver adds. “I can’t know if I’m not working with you directly, have you now increased your intake of other foods that provide those nutrients?”
Similarly, dietitians generally recommend that if people suspect they have a gluten intolerance — where consuming the protein found in grains like wheat and barley could do damage to the body — they should undergo an evaluation before making sweeping dietary changes. This should be done to hone in on whether issues such as celiac disease or a non-celiac gluten sensitivity is to blame, although it can take time to make that determination.
“It is usually very difficult to identify food intolerances,” Richards contends. “The Candida diet eliminates many foods that can cause gut inflammation, like added sugars, additives in processed foods and gluten.” She adds that “most people start the Candida diet because they suffer from repeated yeast infections or they suspect that antibiotics or a poor diet may have disrupted their gut flora.”
Besides asserting that the diet is good for one’s gut — and the microorganisms in it — Richards also pushes back against the concern that it’s unnecessarily restrictive. “The Candida diet is a healthy diet that, if followed correctly, should not result in any nutritional deficiencies,” she says.
But even for patients who may see some symptom relief after going on the diet, clinicians like McDonald and Nyirjesy reiterate that it’s important that symptoms are evaluated to ensure a proper diagnosis and treatment. That way, the therapy — including dietary changes, if recommended — can be targeted accordingly. That means not relying solely on self-diagnosis or self-treatment for yeast infection or other symptoms — and getting a second opinion if necessary.
Nyirjesy says many patients get desperate because they have these ongoing symptoms that keep coming back. “And the reason that they’re not getting better,” he says, “is they’re not being diagnosed properly, either on their own or sometimes by their provider.”
More from U.S. News
Candida Cleanse Diet: Does This Work — and Is It Safe? originally appeared on usnews.com
Update 06/07/21: This story was originally published at an earlier date and has been updated with new information.