How to follow the specific carbohydrate diet

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So you’re ready to start the Specific Carbohydrate Diet (SCD)! You’ve prepared yourself, you’ve picked your date and now you’re ready to go with the intro diet.

How to follow the specific carbohydrate diet

The intro diet is one of my most frequently asked questions from those starting the Specific Carbohydrate Diet. Most people want to know how long to follow it and if it needs to be followed exactly.

When you’re getting started I can’t stress more that you still need to be following the instructions of your doctor if you’re still working with them. At the time I started I wasn’t on any medications, I was trying to prevent recurrence of Crohn’s symptoms. However, I have known of people who decided on their own to stop medication. This can be dangerous.Even if you sometimes feel at odds with your doctor, you do need continue to work with them. Changing your diet is a way to help yourself, but it’s not a substitute for medical treatment while you’re still having active symptoms.

I’ll address some common questions below:

I’ve started the Intro Diet. When will I feel better?

According to Breaking the Vicious Cycle* most people will follow the diet for about five days (pg 51). This will vary depending on your symptoms. If your symptoms are severe you’ll want to do the intro for the five days to give your body time to adjust and heal. If you’re not feeling better at all after five days it’s time to assess your symptoms. A few years ago one of my readers wrote to me asking the very question above. They had been on the intro diet for about two weeks and were still feeling pretty sick. They had bloating, and heartburn. They also felt like they had to go to the bathroom all of the time, but they weren’t actually able to relieve themselves.

This alarmed me. I told them it would be a good idea to visit their doctor because it sounded like they might have an intestinal blockage. These were the exact symptoms I had before I was admitted to the hospital with a full blockage. My blockage was caused by scar tissue, which wouldn’t be helped by changing diet. A couple of weeks later they wrote b back to let me know they did indeed have a partial blockage and had been admitted to the hospital. Luckily the hospital was able to treat the blockage without surgery and they were now on the road to recovery and ready to start the diet again.

I don’t say any of this to scare anyone, but just to remind that assessing and accepting your symptoms is important. If you’re feeling so bad that you can’t eat, work, or get out of bed it’s always a good idea to get checked out.

Do I really need the yogurt and do I really have to make my own?

Yes! Yogurt is a very important part of SCD. There is a whole section on yogurt in Breaking the Vicious Cycle. In my edition it comes after the recipe section, starting on page 131. This section outlines the importance of yogurt and provides instructions for making your own.

In a nutshell, yogurt provides good bacteria that helps heal your gut. We make our own so we can allow it to cook for at least 24 hours in the yogurt maker, which allows the lactose to be cooked out of it. You won’t be able to substitute Greek yogurt or any commercially made lactose-free yogurt and get the same result.

What do I eat on the intro diet?

The short answer is not much. This is something to prepare yourself for. When you start the diet it will be restrictive and the intro is the most restrictive of all. If you’re not feeling well you might not mind too much, but if you’re not feeling too bad, or when you start feeling better, you’ll have to be prepared. As time goes on you’ll discover tons of SCD-friendly foods you can try.

In the intro you’ll need to keep it really plain:

Yogurt, chicken broth, plain broiled meat, cooked carrots, and gelatin made with fruit juice.

I know, it’s not much! But you’re trying to get yourself to feeling better and to a whole new way of eating!

You’ll also see dry curd cottage cheese (DCCC) in the intro diet, which leads me to the next question.

I can’t find dry curd cottage cheese, do I need it?

Unlike the SCD yogurt, DCCC is not quite as essential. In fact I hardly ever buy it. Granted, you might want it because it’s something else you can have, but you can have success on the diet without it. It is hard to find and kind of expensive so don’t worry if you don’t end of including it.

I much prefer to strain my yogurt so it’s extra thick. Personally, I don’t really care for the “cheesecake” recipe that is in the book and a part of the intro diet, however that doesn’t mean you shouldn’t give it a try. Everyone has different tastes!

When you’re ready, start the intro and study the Specific Carbohydrate Diet chapter in Breaking the Vicious Cycle that goes over permitted (and not permitted) foods. I’ll be talking about this in my next post!

Have any more questions about the intro diet? Feel free to leave a comment or send me a message!

*All references to Breaking the Vicious Cycle refer to the 7th edition published in 1999.

This post may contain affiliate links.

How to follow the specific carbohydrate diet

Whether you’re new to the SCD Diet, or you’re an old time pro looking for fresh options to try, this 30-day SCD Diet meal plan is for you! While the intro phase of the SCD Diet is very restrictive, and it takes time to re-introduce foods into your diet and evaluate how they make you feel, there is a light at the end of the tunnel. And it’s a pretty delicious one!

There are TONS of yummy SCD legal breakfast, lunch, and dinner recipes you can try, and we’ve curated 90 of our favorites below. From delicious breakfast cookies, pancakes, and waffles, to oven baked chicken nuggets and a delicious shaved Brussels sprouts Caesar salad, to family-friendly cauliflower pizza and pulled pork short ribs, we hope you love this SCD Diet meal plan as much as we do!

What Is the SCD Diet?

The Specific Carbohydrate Diet was developed by Elaine Gottschall – whose own daughter was diagnosed with severe ulcerative colitis at the age of 4 – and has helped people all over the world manage the symptoms of Crohn’s disease, ulcerative colitis, IBS, celiac, diverticulitis, autism, cystic fibrosis, and other ailments rooted in the digestive tract.

The SCD Diet allows specific foods based on their chemical structure. It limits the use of complex carbohydrates (disaccharides and polysaccharides) and focuses primarily on monosaccharides. Foods that are not properly digested, such as grains, sugars, starches, and processed foods, are banned on the SCD Diet as they cause bacterial and yeast overgrowth, irritation of the small intestine, and challenges with food absorption. The SCD Diet is designed to restore gut flora and stop the vicious cycle of bacteria and yeast overgrowth by eliminating the foods they feed on, thereby allowing the intestinal tract to repair and heal.

You can find an extensive list of the foods that are and are not allowed on the SCD Diet HERE, and I urge you to read Elaine’s book, Breaking the Vicious Cycle, in its entirety as she does such a great job of describing the role diet plays in the treatment of the disorders listed above.

We’ve written an entire post about the SCD Diet, including tips for beginners, strategies to stay motivated, and some of the things my husband and I learned through trial and error, which you can read HERE.

Oh! And if you’re looking for more recipes, there are heaps of great SCD-friendly cookbooks you can purchase. Cooking for the Specific Carbohydrate Diet by Erica Kerwien and Recipes for the Specific Carbohydrate Diet by Raman Prasad are two of our favorites!

30-Day SCD Diet Meal Plan for Beginners

When you first start the SCD Diet, it can be extremely overwhelming, and it can also feel pretty restrictive and limiting. It’s a big adjustment, but if you suffer from Crohn’s disease, ulcerative colitis, IBS, celiac, diverticulitis, autism, cystic fibrosis, and other ailments rooted in the digestive tract, it can completely transform your life. Thankfully, there are tons of people who have graciously shared their experiences and recipes online, and I took great pleasure in curating 30-days worth of yummy SCD approved recipes for this post!

These recipes are designed for people who have already completed the introductory diet, have their symptoms under control, and have successfully re-introduced multiple foods back into their diet. While many of these recipes only include a few ingredients, do not attempt any of them until you have introduced each ingredient back into your diet and know that you can tolerate them.

SCD Diet Breakfast Recipes

SCD Diet Lunch Recipes

SCD Diet Dinner Recipes

I hope you find several recipes in this SCD Diet Meal Plan that appeal to your appetite, and that they help you find joy in food again!

This post contains affiliate links.

If you enjoyed the recipes in this 30-Day SCD Diet Meal Plan, please share this post on Pinterest!

How to follow the specific carbohydrate diet

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Specific Carbohydrate Diet

Are their any scientific or medical studies on the SCD for IBD people? Has anyone here personally tried the SCD for IBD? Did it help any IBD symptoms? Can anyone explain the scientific discrepancies in the SCD diet such as OK to eat honey, but not maple syrup? Or Tabasco sauce is ok, but not natural hot sauce of any other brand? Many people claim to been helped or cured of IBD through the SCD, so that is why I bring this topic to discussion.

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Welcome to Connect @mountainoceangirl.
You ask great questions about the specifics of SCD. I’m tagging @mbengst @jwatch @bearylynn who have written about trying the Specific Carbohydrate Diet in the past and will hopefully return to share their experiences.

In the meantime, I found this video with Mayo’s Dr. Jeanne Tung, M.D., where she discusses a study, published in the journal Nutrition, where pediatric gastroenterologists at Seattle Children’s Hospital looked back at their patients who had tried the specific carbohydrate diet. http://ibdblog.mayoclinic.org/discussion/specific-carbohydrate-diet-for-pediatric-ibd/

@Pookith85 @missie @bmaske @sherw have any of you tried the Specific Carbohydrate Diet?

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SCD diet (specific carbohydrate, http://www.breakingtheviciouscycle.info/home) is helping tremendously.

Still constipated. Dr said could be possible nerve damage? Maybe bad bacteria dying off causing it?

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Thanks for sharing @clemlaa! I moved your message to this discussion about SCD. Did you find the transition to the new diet hard? I bet @mountainoceangirl would like to hear any experience or advice you can share.

@johnbishop, @meemer, @mieke, @michellecrcrn, @ambrose and @uneeq1 – you have all made major diet changes to manage your digestive health issues. Have any of you tried Specific Carbohydrate Diet (SCD)?

Also regarding constipation, you have to read @cahnny‘s experience with the “squatty potty”. She’s had some luck alleviating her constipation using this. Furthermore, she’s a hilarious writer. You can read about her experience here, https://connect.mayoclinic.org/discussion/ibs-222fde/?pg=1#post-233925.

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Thanks for posting this Nate…I enjoyed the link for the “squatty potty” link. May have to buy one as it reminds me that when I used to go backpacking in a land and time far, far away, we would dig a hole and squat to do our business. Then bury it…:-). I had never heard of the SCD diet so did a quick search and found lots of info on it – http://www.breakingtheviciouscycle.info/. It is interesting and I would definitely look into it if I had gut issues (other than it just being too big!). I started the basic Wahls Protocol diet about 2 months ago – no gluten, no sugar, no dairy, no processed foods, etc. just because I was inspired by Dr Terry Wahls story and her research into nutrition and causes for MS and autoimmune diseases. I was looking to see if it would have any impact on my SFPN or PMR. She has some great TED talks on YouTube…just have to search her name. I do have some of the “not allowed” stuff but I really try to limit the amount and frequency. I’ve lost about 20 lbs but have about 15 more to go before I will be happy.

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After reading Jane Gottachall’s book and website and following diet strictly, I realize error of my ways. All those starches (even ‘healthy’ ones) sweet potatoes, rice, quinoa were beyond my ability to digest and the undigested starches were feeding the bad bacteria and yeast. Geez all those food journal entries when I would go down after eating linked to the complex carbohydrates my gut was not able to eat. Makes sense since they require more steps to break down as opposed to simple foods that digest easy in one step. JAne is brilliant. Her life dedicated to studying the science behind digestive disease is awe-inspiring. Worth a read is her book. Changed my life

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After reading Jane Gottachall’s book and website and following diet strictly, I realize error of my ways. All those starches (even ‘healthy’ ones) sweet potatoes, rice, quinoa were beyond my ability to digest and the undigested starches were feeding the bad bacteria and yeast. Geez all those food journal entries when I would go down after eating linked to the complex carbohydrates my gut was not able to eat. Makes sense since they require more steps to break down as opposed to simple foods that digest easy in one step. JAne is brilliant. Her life dedicated to studying the science behind digestive disease is awe-inspiring. Worth a read is her book. Changed my life

Priyanka Chugh, MD, is a board-certified gastroenterologist in practice with Trinity Health of New England in Waterbury, Connecticut.

The Specific Carbohydrate Diet was originally designed as a treatment for celiac disease but was then expanded to treat a variety of other disorders. Although not necessarily intended as a treatment for IBS, its focus on gut bacteria lends itself to the question as to whether the diet might be an option for people who have IBS. This overview of the diet can help you to make an informed decision as to whether it presents a viable option for you.

How to follow the specific carbohydrate diet

Overview

The Specific Carbohydrate Diet was originally designed by Drs. Sydney and Merrill Haas based on their clinical work with patients who were diagnosed with celiac disease. The diet involves the restriction of specific types of sugars and starches. The diet garnered increased attention with the publication of Breaking the Vicious Cycle: Intestinal Health Through Diet by Elaine Gottschall, B.A., M.Sc. In her book, Gottschall states that the diet can benefit people with the following health problems:

  • Crohn’s disease
  • Ulcerative colitis
  • Diverticulitis
  • Celiac disease
  • Cystic fibrosis
  • Chronic diarrhea

Gottschall also discusses the benefits of the Specific Carbohydrate Diet for children who have autism, noting that intestinal difficulties are frequently associated with an autism diagnosis. In her book, she presents anecdotal evidence that children who are placed on the diet show improvement in their behavioral symptoms; such improvement is noted even before their digestive symptoms improve.

The theory behind the diet is that the restriction of specific carbohydrates resolves the intestinal dysbiosis that is thought to be the underlying cause of these health conditions. According to Gottschall, it is thought that toxins released by the fermentation of these carbohydrates damage the cells lining the intestines. It is also thought that eliminating these carbohydrates over time reduces the population of troublesome intestinal microbes.

The Diet

The Specific Carbohydrate Diet involves strict restriction of many common foods, while still offering a balanced, nutritious daily diet. It is recommended that the diet be followed strictly for one month and should only be continued if symptom improvement is noted after the first month. Gottschall claims that many disorders can be “cured” if the diet is followed strictly for one year. She notes that the diet should be continued for approximately one year after symptoms resolve.

The Book

Breaking the Vicious Cycle outlines the theory behind the diet, discusses its application to various health disorders and provides lists of foods that are “allowed” and “not permitted” on the diet. Half of the book is dedicated to a variety of recipes. Although the book might serve to help someone to follow the diet, you might find it to be quite disorganized, with a disturbing lack of solid research to back up Gottschall’s claims. Although she provides some limited research regarding the relationship between gut bacteria and health problems, she does not provide research regarding the effectiveness of the diet itself. Instead, she offers dramatic anecdotes from parents and others as to how the diet has changed their lives.

Does the Diet Have Research Support?

Considering the enthusiasm of proponents of the diet, we found it astonishing how few studies, if any, have been conducted as to its effectiveness. We were not able to find a single study on the use of the diet for IBS.

A Word From Verywell

It is hard to completely disregard anecdotal reports, but it is also hard to endorse a diet without any controlled research studies. Drs. Haas were pioneers in recognizing the contribution of gut dysbiosis to various health problems, as well as noting the effect of diet on the health of the gut flora. Unfortunately, the fact that their theories were based on their clinical experience rather than well-designed research studies may be behind the lack of acceptance of the diet by traditional medical practitioners.

It was interesting to me the overlap of the theory behind the Specific Carbohydrate Diet and that of the low-FODMAP diet. The sharp contrast is that the low-FODMAP diet is based solidly on research in terms of how FODMAP carbohydrates exacerbate symptoms in people who have IBS. If you are considering taking a nutritional approach to addressing your IBS symptoms, your better choice may well be the low-FODMAP diet.

How to follow the specific carbohydrate diet

Inflammatory bowel disease (IBD) is a term for two conditions, Crohn’s disease and ulcerative colitis. Both are characterized by chronic inflammation of the gastrointestinal (GI) tract and treatment options include:

  • Pharmacotherapy
  • Surgical removal of diseased areas of the GI tract
  • Elimination diets to improve symptom management and induce or maintain remission, such as the Specific Carbohydrate Diet

The Specific Carbohydrate Diet (SCD) allows carbohydrate foods consisting of monosaccharides only and excludes disaccharides and most polysaccharides, such as linear or branch-chained multiple sugars or starches. This diet is based on the theory that disaccharides and polysaccharides pass undigested into the colon, which results in bacterial and yeast overgrowth, overproduction of mucus, and this may cause intestinal injury.

The SCD was introduced in the 1920s by gastroenterologist, Sidney Haas. It was then expanded and popularized in the 1980s with Elaine Gottschall’s definitive SCD guide in the book, Breaking the Vicious Cycle: Intestinal Health Through Diet.

There is an increasing body of evidence that shows the SCD is a viable option for maintaining remission in adult and pediatric Crohn’s disease and ulcerative colitis. The SCD may help improve symptoms, decrease inflammation and may lead to increased biodiversity of the microbiome. Some research found a change in the microbiome of patients with IBD who followed the SCD, including reversal of some of the dysbiosis reported in patients with IBD.

The SCD allows almost all fruits and vegetables containing more amylose (a linear-chain polysaccharide) than amylopectin (a branch-chained polysaccharide), nuts, nut-derived flours, dry-curd cottage cheese, meats, eggs, butter, and oils.

It excludes sucrose, maltose, isomaltose, lactose, grain-derived flours, and all true and pseudograins, potatoes, okra, corn, fluid milk, soy, cheeses containing high amounts of lactose, as well as most food additives and preservatives. The SCD isn’t necessarily a low-carbohydrate diet, but it’s extremely specific about the types of carbohydrates that are permitted.

How to follow the specific carbohydrate dietSource: Diet to the Rescue: Cessation of Pharmacotherapy After Initiation of Exclusive Enteral Nutrition (EEN) Followed by Strict and Liberalized Specific Carbohydrate Diet (SCD) in Crohn’s Disease

The diet is supplemented by homemade yogurt fermented for 24 hours to free it of lactose, a disaccharide not allowed in the SCD. Recommended cultures include Lactobacillus bulgaricus, Lactobacillus acidophilus, and Streptococcus thermophilus. You can find a homemade coconut yogurt recipe here.

How to follow the specific carbohydrate diet

Tip: Use That Clean Life’s Specific Carbohydrate filter to find SCD recipes and our Specific Carbohydrate Diet Programs for full done-for-you meal plans with grocery lists, recipes, prep guides, and supporting evidence.

How to follow the specific carbohydrate diet

The SCD can be modified based on the client’s unique response to foods. Prior to starting a client on the SCD, the nutrition professional should educate both the client and their family on the diet and the work that it entails. The diet is implemented in three steps:

1. Diet Introduction

Once the client begins the SCD, they should follow up with their healthcare provider in one to two weeks. These first visits with the healthcare professional are to ensure that individuals are maintaining their weight or at least have minimal weight loss, their symptoms are under control, their laboratory studies are within an acceptable range, and it is an opportunity for clients to ask about specifics in regard to the diet.

2. Maintenance

If the client goes into remission, then they can proceed to the diet foundation and maintenance step with reduced follow-up. The efficacy of the SCD should be judged at the earliest in one month. There should be an assessment of symptoms using appropriate symptom scores and also markers of inflammation including CRP, fecal calprotectin, and possibly colonoscopy if clinically appropriate. If there are no improvements in symptoms and/or inflammation, it may be reasonable to discontinue the SCD and consider other therapeutic options available.

3. Food Reintroduction

This step involves reintroducing foods that were previously eliminated. Data suggests that an attempt to liberalize the diet should occur preferably after the disease is well controlled and is in the inactive phase. This step does not necessarily need to happen and has no set time frame. Clients may or may not want to reintroduce foods. This step can be important for clients who struggle with maintaining the strict SCD. The most important aspect of this step is to reintroduce foods slowly and one at a time, closely monitor symptoms and laboratory studies, as well as fecal calprotectin levels to ensure that inflammation is not rebounding.

How to follow the specific carbohydrate diet

The diet should be closely monitored by a nutrition professional to assess for potential deficiencies. Nutritional deficiencies that can possibly occur with the SCD including folate, thiamine, vitamin B6, D, C, A, calcium and potassium deficiencies.

As with all of these recommendations, adjusting for each individual’s unique needs is important and often necessary. Following the SCD with guidance from a nutrition professional could optimally nourish a patient with IBD.

IBD is a complex medical condition and the SCD intervention may improve symptoms in some people, however there is no guarantee that it will work for everyone. Clients require proper meal planning and preparation to make it easier to follow the diet. Other dietary strategies proposed for managing symptoms of IBD include the Low Fodmap Diet, Anti-Inflammatory Diet for IBD (IBD-AID), gluten-free, lactose-free, Mediterranean or Paleo diets.

How to follow the specific carbohydrate diet

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How to follow the specific carbohydrate diet

Registered Dietitian providing the tools to build an evidence-based practice.

The Specific Carbohydrate Diet (SCD)

By Carol Frilegh

SCD is proving to be an effective dietary intervention for autism and is receiving recognition from DAN! doctors. Dr. Sidney Baker, co-founder of DAN! and the author of numerous books, has said “SCD is the best treatment that I have found so far for many children on the Autism Spectrum.”

What is The Specific Carbohydrate Diet (SCD)?

The Specific Carbohydrate Diet was developed from the work of Dr. Sydney V. Haas, a pioneer in Celiac Management by the late Elaine Gottschall, B.A., M. Sc. She was a biologist and scientist who successfully healed her daughter from Ulcerative Colitis using SCD.

How Does It Work?

Research indicates starches and certain sugars feed microbes, such as bacteria, yeast and fungi. These harmful microbes in the intestinal tract can cause GI problems, autism and other illnesses. SCD eliminates these microbes by starving them while continuing to nourish the body. As the body heals the gut/brain connection is repaired.

How Is It Different From GFCF?

You can remain GFCF on SCD. SCD is gluten free, but does not allow starch and sugar. SCD includes dairy that is virtually lactose free and contains denatured casein. However, dairy foods are not mandatory on SCD. Pam Ferro, of The Gottschall Autism Center and Hopewell Clinic, says the first three months for ASD children should be dairy free. The majority of ASD children begin SCD without dairy and many successfully integrate dairy back into their diet after some healing occurs.

How Successful Is SDC?

Anecdotal reports indicate a success rate of about 80-85%. With guidance this rate increases. Pam Ferro, R.N. of The Gottschall Center reports an amazing success rate with the children she has been treating. Parents and teachers of autistic children on SCD report a change in their attitude, increases in skills and responsiveness. In some of these cases it occurs only a few weeks after beginning the diet. Many children recover with SCD. As one mother has said, “When you see them emerge, the true child, with a loving personality, like an iridescent butterfly breaking out of its cocoon, well, that’s why we all persevere.”

What Kind Of Food Is Required?

SCD uses healthy nutritious meat, fish, poultry, fruits, vegetables, cheeses, honey, nuts and milk that is incubated into yogurt to remove the lactose and denature the casein. These natural foods are used to create kid-friendly recipes such as ketchup, crackers, cookies etc.

What Do I Need To Get Started?

The information to get started on SCD can be found in the book:

“Breaking the Vicious Cycle, Intestinal Health through Diet” by Elaine Gottschall.

Online information is available at:

Support

  • To receive help with SCD you can join the SCD children’s list “Pecanbread.” The Pecanbread Yahoo group provides help, encouragement and motivation from Veterans of SCD and from other families doing the SCD.
  • Individual help can be obtained from SCD Counselors

Common Questions from Parents about SCD

  • My child is a picky eater, can I still do SCD?Picky eating may be a sign of starch addiction which many children lose after they do SCD.
  • My child is allergic to nuts, eggs and dairy.SCD can be implemented despite these restrictions. As the SCD heals the gut, many allergies and sensitivities go away.
  • My child does not have any GI symptoms. Can he/she still benefit from SCD?SCD is a balanced, healthy, nutritional diet and generally beneficial to overall health. Many parents of ASD children find that despite having no obvious GI symptoms SCD helps their children behaviorally.

What’s For Dinner (And Breakfast, Lunch and Snacks)?

Understand more about the SCD Diet from creator Elaine Gottschall and this amazing video (produced by Stan Kurtz)

Note from TACA friends:

Many families who tried the Gluten and Casein free (GFCF) diet with little to no benefit need to consider the SCD Diet and allergen free diet prior to “ditching diets altogether.” Often, taking the “diet” one step further can be the key to success for many children on the spectrum. That one step depends on the unique issues to the child.

Many TACA families have gone SCD after the GFCF Diet only to be amazed and happy to find that the SCD Diet helped their child immensely – while the GFCF Diet did not. It is also important to note BED (Body Ecology Diet) and Low Oxylate Diets are also valuable tools to for families to consider. Each diet has a benefit that needs to be fully evaluated before families “DITCH THE DIET” as an effective treatment and should be discussed with the child’s doctor in defining direction and next steps in a treatment protocol.

Antedoctal information regarding diets, feedback from families, and a progression of treatments unique to an individuals needs should be shared with all families on the spectrum. Not every solution works for every child. SCD and other diets in our community offer strong benefits out there and should be considered as a valuable tool for treating issues.

How to follow the specific carbohydrate diet

Inflammatory bowel disease (IBD) is a term for two conditions, Crohn’s disease and ulcerative colitis. Both are characterized by chronic inflammation of the gastrointestinal (GI) tract and treatment options include:

  • Pharmacotherapy
  • Surgical removal of diseased areas of the GI tract
  • Elimination diets to improve symptom management and induce or maintain remission, such as the Specific Carbohydrate Diet

The Specific Carbohydrate Diet (SCD) allows carbohydrate foods consisting of monosaccharides only and excludes disaccharides and most polysaccharides, such as linear or branch-chained multiple sugars or starches. This diet is based on the theory that disaccharides and polysaccharides pass undigested into the colon, which results in bacterial and yeast overgrowth, overproduction of mucus, and this may cause intestinal injury.

The SCD was introduced in the 1920s by gastroenterologist, Sidney Haas. It was then expanded and popularized in the 1980s with Elaine Gottschall’s definitive SCD guide in the book, Breaking the Vicious Cycle: Intestinal Health Through Diet.

There is an increasing body of evidence that shows the SCD is a viable option for maintaining remission in adult and pediatric Crohn’s disease and ulcerative colitis. The SCD may help improve symptoms, decrease inflammation and may lead to increased biodiversity of the microbiome. Some research found a change in the microbiome of patients with IBD who followed the SCD, including reversal of some of the dysbiosis reported in patients with IBD.

The SCD allows almost all fruits and vegetables containing more amylose (a linear-chain polysaccharide) than amylopectin (a branch-chained polysaccharide), nuts, nut-derived flours, dry-curd cottage cheese, meats, eggs, butter, and oils.

It excludes sucrose, maltose, isomaltose, lactose, grain-derived flours, and all true and pseudograins, potatoes, okra, corn, fluid milk, soy, cheeses containing high amounts of lactose, as well as most food additives and preservatives. The SCD isn’t necessarily a low-carbohydrate diet, but it’s extremely specific about the types of carbohydrates that are permitted.

How to follow the specific carbohydrate dietSource: Diet to the Rescue: Cessation of Pharmacotherapy After Initiation of Exclusive Enteral Nutrition (EEN) Followed by Strict and Liberalized Specific Carbohydrate Diet (SCD) in Crohn’s Disease

The diet is supplemented by homemade yogurt fermented for 24 hours to free it of lactose, a disaccharide not allowed in the SCD. Recommended cultures include Lactobacillus bulgaricus, Lactobacillus acidophilus, and Streptococcus thermophilus. You can find a homemade coconut yogurt recipe here.

How to follow the specific carbohydrate diet

Tip: Use That Clean Life’s Specific Carbohydrate filter to find SCD recipes and our Specific Carbohydrate Diet Programs for full done-for-you meal plans with grocery lists, recipes, prep guides, and supporting evidence.

How to follow the specific carbohydrate diet

The SCD can be modified based on the client’s unique response to foods. Prior to starting a client on the SCD, the nutrition professional should educate both the client and their family on the diet and the work that it entails. The diet is implemented in three steps:

1. Diet Introduction

Once the client begins the SCD, they should follow up with their healthcare provider in one to two weeks. These first visits with the healthcare professional are to ensure that individuals are maintaining their weight or at least have minimal weight loss, their symptoms are under control, their laboratory studies are within an acceptable range, and it is an opportunity for clients to ask about specifics in regard to the diet.

2. Maintenance

If the client goes into remission, then they can proceed to the diet foundation and maintenance step with reduced follow-up. The efficacy of the SCD should be judged at the earliest in one month. There should be an assessment of symptoms using appropriate symptom scores and also markers of inflammation including CRP, fecal calprotectin, and possibly colonoscopy if clinically appropriate. If there are no improvements in symptoms and/or inflammation, it may be reasonable to discontinue the SCD and consider other therapeutic options available.

3. Food Reintroduction

This step involves reintroducing foods that were previously eliminated. Data suggests that an attempt to liberalize the diet should occur preferably after the disease is well controlled and is in the inactive phase. This step does not necessarily need to happen and has no set time frame. Clients may or may not want to reintroduce foods. This step can be important for clients who struggle with maintaining the strict SCD. The most important aspect of this step is to reintroduce foods slowly and one at a time, closely monitor symptoms and laboratory studies, as well as fecal calprotectin levels to ensure that inflammation is not rebounding.

How to follow the specific carbohydrate diet

The diet should be closely monitored by a nutrition professional to assess for potential deficiencies. Nutritional deficiencies that can possibly occur with the SCD including folate, thiamine, vitamin B6, D, C, A, calcium and potassium deficiencies.

As with all of these recommendations, adjusting for each individual’s unique needs is important and often necessary. Following the SCD with guidance from a nutrition professional could optimally nourish a patient with IBD.

IBD is a complex medical condition and the SCD intervention may improve symptoms in some people, however there is no guarantee that it will work for everyone. Clients require proper meal planning and preparation to make it easier to follow the diet. Other dietary strategies proposed for managing symptoms of IBD include the Low Fodmap Diet, Anti-Inflammatory Diet for IBD (IBD-AID), gluten-free, lactose-free, Mediterranean or Paleo diets.

How to follow the specific carbohydrate diet

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How to follow the specific carbohydrate diet

Registered Dietitian providing the tools to build an evidence-based practice.

What is SCD?

SCD stands for Specific Carbohydrate Diet. This is a nutritionally balanced diet focused on removing grains, most dairy products and sugars. [Ref]

Created to help people address certain medical conditions, the diet has become an important part of nutritional therapy. IBS Clinics are leading experts on the specific carbohyrate diet in the UK.

At its core, the diet recognises that certain types of carbohydrate need minimal digestive processes. They are readily absorbed and will not cause any microbial overgrowth in the intestine. The simpler the structure of the carbohydrate, the more easily the body digests and absorbs it. But not everyone can fully digest all types of carbohydrates. Indeed, complex carbohydrates are difficult.

The problem of undigested carbohydrates

When we have undigested carbohydrates in our gut, we over-feed bad bacteria and yeast in our intestinal tract. This triggers a nasty cycle of excess toxins, acids, and gasses in our guts, causing irritation and inflammatory bowel disease.

Following focus as a dietary intervention to counter celiac disease, the SCD has also been effective in healing inflammatory bowel disease (IBD). We use the diet for treating Crohn’s disease, ulcerative colitis, celiac disease, diverticulitis, cystic fibrosis and chronic diarrhoea. Also, some specialists use it for treating SIBO.

At IBS Clinics we operate a phased programme for the SCD. The introductory phase features easy to digest, natural foods. This allows for tailoring of the diet to each patient’s individual conditions. With a phased approach we effectively lower the bar on commitment, with the result that our SCD success rates are consistently high.
Let’s discuss whether this diet could be helpful for you.