Over the last decade, the incidence of inflammatory bowel diseases(IBD) has increased worldwide [1]. Symptoms are often painful and can include diarrhea, bleeding ulcers and anemia.

The Specific Carbohydrate Diet (SCD) is a very restrictive, unconventional diet plan that severely limits carbohydrates. By eliminating most carbohydrates (primarily grains, starches, dairy, and sugars) and allowing only specific carbohydrates that require minimal digestion, we can reduce inflammation and make eating enjoyable for people with gastrointestinal (GI) disorders.

History of SCD:

In 1924, Sidney V. Haas described the first SCD for the treatment of children with coeliac disease; this was the banana diet [2][3]. The banana SCD was the cornerstone of coeliac therapy for decades until bread shortages in the Netherlands caused by World War II resulted in children with coeliac disease to improve, which led to the isolation of wheat proteins, not starches, as the cause of coeliac disease [4]. We should all be avoiding gluten.

The SCD became popular again in 1996 when biochemist Elaine Gottschall published a book Breaking the Vicious Circle. Gottschall's daughter was reported to been cured of ulcerative colitis in two years by SCD. Gottschall described the theory of how restricting diet might reduce gut inflammation associated with various medical conditions. Gottschall asserted that the diet could "cure" a number of medical conditions without providing data. Gottschall advocated using SCD to treat Crohn's disease, ulcerative colitis, diverticulitis, cystic fibrosis, chronic diarrhea, and autism.

Who might benefit from SCD?

Gut bacteria are sensitive to what you eat, but it is a very complicated phenomenon and whether or not the SCD is anti-inflammatory and beneficial remains unknown,” says Joel Mason, MD, associate professor of medicine, nutrition, and gastroenterology at Tufts University in Boston. It appears to work for some people and not others.

People who have been diagnosed with:

  • Inflammatory bowel disease (IBD)

  • Irritable bowel syndrome (IBS)

  • Coeliac disease

  • Crohns’ disease

  • Cystic fibrosis

  • Chronic diarrhea

  • Indigestion, flatulence and bloating

  • Candidiasis and intestinal dysbiosis

  • Leaky gut wall

  • Learning and behavioural disorders

These digestive issues can hamper our ability to digest and absorb nutrients from food. Thus, the SCD aims to heal intestinal tissue in order to restore its functions. A healthcare practitioner may advise SCD as a temporary diet or a long term treatment strategy depending on the lifestyle and symptoms of the client.

If you have severe gut issues like SIBO or IBS, SCD is one possible solution that can work for some people. Others may benefit from a low FODMAP Diet [4], or the GAPS Diet [5]. Many people have used these diets with great success for gut health and autoimmune disease.

High Performers:

Low carbohydrate diets DO NOT SUPPORT high-intensity training (HIT) and those who have digestive issues should scale back on HIT until they fix their plumbing. How can anyone perform if the fuel lines are broken?

What is the science behind SCD?

In theory, the benefits of the SCD occur at the cellular level to control bacteria. The premise is that unrefined carbohydrates alter bacteria in the gut. As these bacteria populations grow, they produce byproducts that promote inflammation and eventually lead to reduced absorption of nutrients in your digestive tract. By removing complex carbohydrates we can change the metabolism of the bacteria that live in the gut and reduces inflammation.

Strict adherence to the SCD is supposed to eventually starve these bacteria by depriving them of food, allowing your gut tissue to heal.

Those with gut issues can sometimes have trouble making certain digestive enzymes to break down complex sugars and starches, which provide more food for bacteria to feed upon. Complex carbohydrates often take longer to digest and breakdown in the gut, subsequently they can be fermented by harmful intestinal bacteria and lead to bloating, gas, cramping, diarrhea and a feeling of nauseousness.

You might be surprised to learn that not all carbohydrates are equal. There are many different type of carbohydrates and when your gut is healthy it's a good idea to include a variety of them in your diet. When your gut is not healthy, it can be helpful to remove some types for a short period of time. Another reason why, if it fits your macros is not enough.

Complex carbohydrates come in form of:

  • Disaccharides (two simple sugars joined together) - common examples include the milk sugar lactose (glucose + galactose), cane sugar or table sugar sucrose (glucose + fructose), maltose (glucose + glucose), and lactulose (galactose + fructose).

  • Oligosaccharides (usually between three to ten simple sugars joined together) - common examples include fructooligosaccharides (FOS), galactooligosaccharides (GOS), mannooligosaccharides (MOS), they are only partially digested by humans before they are available as a source of food for intestinal bacteria.

  • Polysaccharides (many simple sugars joined together) - most common examples include starch, glycogen, Cellulose, and Chitin.

Simple sugars (carbohydrates), known as monosaccharide include glucose (dextrose), fructose, galactose, ribose, and xylose, can be absorbed directly into the bloodstream. They are absorbed quickly and easily and can be broken-down with lower levels of digestive enzymes when compared to complex sugar molecules (complex carbohydrates). This makes simple sugars easier to digest and less likely to ferment and feed bad bacteria in the gut that can cause symptoms associated with digestive and behavioural disorders.

What food are allowed?

SCD prohibited foods include cereal grains, potatoes and lactose-containing dairy products. It is also a gluten-free diet but all other non-gluten containing grains are not permitted either.

Maintaining your calorie intake is critical, as cutting back on calories and eating a low carbohydrate diet can cause problems with the immune system, sleep quality, and the bodies natural ability to heal. When lowering the intake of carbohydrate foods we must increase protein and fats to compensate.

A downloadable list of SCD approved foods can be found on our downloads page.

Some argue that SCD is a low nutrient diet, but if we're eating organic meats (especially organ meats like liver), we will have no issues with b-vitamins, vitamin-D, and minerals. The idea that grains are high in b-vitamins and iron is flawed.

If you’re feeling bloated and a little overwhelemed with where to start, you may find it useful to work with a health caoch.

Resources:

COOKBOOKS:

  • Eat Well Feel Well

  • Recipes for the Specific Carbohydrate Diet by Raman Prasad

  • Two Steps Forward One Step Back by Tucker Sweeney

  • Lucy’s Specific Carbohydrate Diet Cookbook by Lucy Rosset

  • SCD Lifestyle Surviving to Thriving on SCDLifestyle.com

  • Against all Grain by Danielle Walker

SCD WEBSITES:

REFERENCES:

  1. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies, Prof Siew C Ng, PhD, et al, 2017

  2. Diet and inflammatory bowel disease: review of patient-targeted recommendations. Hou JK, et al, 2014

  3. Dr. Sidney Valentine Haas Dies

  4. A Brief History of Celiac Disease, 2007

  5. Starting the FODMAP Diet

  6. GAPS Diet - Natural Digestive Healing

As always, this information is not designed to diagnose, treat, prevent or cure any condition and is for information purposes only – please discuss any information in this post with your health care professional before making any changes to your current lifestyle.

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