Specific Carbohydrate Diet

The Specific Carbohydrate Diet is a nutritional regimen used to treat a variety of chronic and auto-immune disorders including Crohn's Disease, Celiac Sprue, Ulcerative Colitis, Diverticulitis, Celiac Disease, Autism and Cystic Fibrosis. Commonly compared to the Atkins Diet and other low-carbohydrate approaches, the SCD eliminates all starches, processed sugars, and complex carbohydrates. Popularized by Elaine Gottschall's book Breaking the Vicious Cycle, the diet is specifically designed to alleviate signs and symptoms of many of these chronic conditions. However, Gottschall makes it clear that if one is thinking about following the diet, one must do so with what she calls "fanatical adherence," meaning that it should be followed to the letter for best results.

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The diet

The diet was originally developed by Dr. Sydney Hass, and is based on the same guidelines Gottschall's daughter followed decades ago in her bout with Ulcerative Colitis. The rationale of the diet described in Breaking the Vicious Cycle is as follows:

1. When the body receives complex carbohydrates (disaccharides or polysaccharides) these substances must be broken down before they can be absorbed.
2. In the body of a person who is not able to break these substances down efficiently, an influx of undigested material causes harmful bacteria to flourish.
3. Bacterial overgrowth is accordingly followed by a significant increase in the waste and other irritants they produce.
4. Irritation in the lining of the digestive tract results in the overproduction of mucus and injury to the digestive tract, which in turn causes malabsorption and makes it even more difficult to maintain proper digestion.

The purpose of the diet is to break the ongoing cycle caused by an overpopulation of harmful bacteria in the gut. When the body is able to absorb the proper nutrients from simple sugars and other carbohydrates that are easy to digest, the inflammation and other complications caused by many auto-immune diseases can be lessened. The goal is to rid the body of complex saccharides so that the gut will be able to heal itself and enable further healing to occur.

The method of the diet is to keep the intestinal flora well balanced and to allow the gut to digest all of the food it is given, thereby starving out the harmful bacteria.

Main necessities and substitutions

1. Nut Flour: Nut flour is the only known substitution for the conventional flour made from grains. Grain flours contain starches which must be broken down when they enter the body. Other flours such as tapioca still contain starch, though they do not contain gluten.
2. Honey: Honey is always used when a sweetener is needed, as the bees have already broken the sugar down into its simplest form. Other forms of sweeteners, such as high fructose corn syrup are processed and therefore contain more complex sugars that must be broken down by the body. Stevia is normally a good and beneficial sweetener as it contains no sugars and doesn't present the side effects that most artificial sweeteners do, but it has unknown and possibly negative effects to those on the SCD and must be avoided if possible. Saccharin is allowed.
3. Milk Products:
   • Yogurt: Commercial yogurt is not allowed on the diet as commercially-produced yogurts usually contain large amounts of the sugar lactose. However, with the purchase of a yogurt maker, lactose-free yogurt can be made from plain yogurt and milk by fermenting it for 24 hours. The fermentation process breaks the lactose down.
   • Cheese: Certain types of cheese are not allowed on the diet, usually because they contain too much lactose (mozzarella, ricotta) or because they are not true fermented cheeses (American). Also, many cheeses are infused with starch-containing enzymes that are added after the fermentation stage, making them unsuitable for use on the diet. Many cheeses are allowed however, including cheddar, colby jack, muenster, provolone, Swiss, and brie, among others.

"Legal" vs. "Illegal"?

These terms are used to identify whether or not a person who is following the diet is able to eat the food. In no way does it mean the legal enforcement of certain things; however, it could figuratively be considered as such. It puts foods in a better perspective and subconsciously makes the "inedible" foods less desirable.

Support

The diet is supported through patient testimonials and a handful of websites containing recipes, listserv communications, and other helpful information. The book "Colitis & Me: A Story of Recovery" by Raman Prasad provides one of the most extensive journals of a patient who found relief from his symptoms that he attributes to the benefits of the SCD.

The Crohn's and Colitis Foundation of America does not support the diet due to lack of studies proving its effectiveness. Without the backing of a large pharmaceutical company or other large enterprise, however, there is no suitable foundation for a study of the diet since its success could never yield a money-making product or service. In a recent article on their website, the CCFA claims that "decreasing poorly digestible carbohydrates may decrease symptoms of gas, bloating, cramps, and diarrhea in patients with IBD, but that is not the same thing as decreasing the inflammation, or affecting the disease process."^[1]

It is important to note that there is no current cure to any of the above diseases, nor does the Specific Carbohydrate Diet claim to be a cure, but rather, an effective treatment.

Similarities to other diets

The Specific Carbohydrate Diet removes many of the same foods prohibited on a Gluten-free, casein-free diet. It's therefore possible that the SCD patient improvements may to some extent result from removing food that cause allergies or intolerance from the diet, thereby reducing inflammation, rather than the bacterial-based mechanism SCD is theorized to work by. The fact that both diets have advocates who suggest it's effective for treating autism is an additional similarity.

The diet recommended by the David Klein, Ph. D. book "Self Healing Colitis & Crohn's"^[2] focuses on reducing bowel irritation and toxins by a limited diet derived exclusively from vegan whole foods. It is similar to the SCD in that both diets remove grains, milk, and sweeteners, but in addition it prohibits meats and eggs. The Klein diet can almost be considered a stricter version of the SCD, but there are some small differences in allowed foods such that it's not a perfect subset.

Further reading

• Gottschall, Elaine (1994). Breaking the Vicious Cycle: Intestinal Health Through Diet, Revised edition, Kirkton Press. ISBN 0-9692768-1-8. 
• www.breakingtheviciouscycle.info - Official Breaking the Vicious Cycle Website
• www.scdrecipe.com - Recipes for the SCD diet
• www.pecanbread.com - SCD diet used for autism
• www.scdiet.org - Original SCD website
• www.breakingtheviciouscycle.org - T's Breaking the Vicious Cycle Website

References

1. ^ CCFA.org Specific Carbohydrate Diet
2. ^ Natural Colitis & Crohn's Diet Cure