Specific Carbohydrate Diet
What Is the Specific Carbohydrate Diet?
The Specific Carbohydrate Diet (SCD) is a diet where certain carbohydrates are restricted and others are allowed based on the chemical structure of these foods and because they are difficult to digest for some people. The idea is that the incomplete breakdown of these feeds harmful bacteria in our intestines causing them to overgrow and potentially cause pain, bloating, gas, inflammation, diarrhea, and constipation. Removal of these carbohydrates can help restore beneficial gut bacteria balance.
The carbohydrates that are allowed have a monosaccharide (or “one sugar”) structure so they are easily absorbed in the intestines. Monosaccharides are glucose, fructose, and galactose.
Complex carbohydrates (with a disaccharide (“two sugars”) structure or polysaccharides (“many sugars”) are not allowed because they are difficult to digest and the incomplete breakdown of these feeds the harmful bacteria in our intestines causing them to overgrow, produce harmful byproducts and cause pain, bloating, gas, inflammation, diarrhea, constipation, etc. Over time, the beneficial bacteria proliferate, while the harmful bacteria are starved and die off, and ultimately gut balance is restored.
The SCD was created by Dr. Sidney Haas and popularized by Elaine Gottschall in her book “Breaking the Vicious Cycle”. Dr . Haas recommended adherence to the diet for 12-18 months for “complete cure”.
The GAPS Diet is similar in that it is based on SCD but there are a few key differences.
The GAPS diet differs in that more probiotic-rich and cultured foods are included to help recolonize the gut with beneficial bacteria and counteract the bad bacteria.
The GAPS diet contains more detoxification principles, utilizes more supplements, and also has more phases and is more intensive than the SCD diet.
Indications This Diet Might Be a Good Fit:
Someone with gastrointestinal issues may want to follow this diet because it was this population that the diet was designed to help. Those with inflammatory bowel diseases (IBD) like Crohn's disease and ulcerative colitis, celiac disease, diverticulitis, cystic fibrosis, and chronic diarrhea would benefit most from this diet.
Those with yeast overgrowth, undiagnosed gastrointestinal symptoms, and/or gut dysbiosis.
Those with the above symptoms that require more flexibility than the GAPS Diet allow
Those with the above GI symptoms and mitochondrial disorder, that require a diet that is less restrictive on carbohydrates
Recommended Foods
Unprocessed fresh or frozen meats or seafood without additives including beef, pork, lamb, goat, wild game, poultry, fish (including canned tuna packed in water), and shellfish
Eggs
Fruits:
Freshly squeezed fruit juices
Fresh, raw or cooked, frozen or dried fruits with no added sugar
Vegetables:
Most fresh, frozen, raw or cooked vegetables and string beans
Fresh pressed vegetable juices
Grains & Legumes:
Nuts, Seeds, & Their Oils
Ghee, pastured-cow or grass-fed butter
Dry curd cottage cheese and homemade yogurt made with SCD guidelines
Hard cheese aged over 90 days like cheddar
Other:
Plant-based milks like almond, coconut
Fermented foods like sauerkraut, kimchi and pickles
Honey as a sweetener
All individual herbs and spices as long as there are no additives
Most vinegar except balsamic
Foods to Avoid
Proteins:
Canned and most processed meats including chicken nuggets, cold cuts, hot dogs, bacon, sausage and smoked meats
Fruits:
Canned or dried fruit processed with additional sugar or additives
Vegetables:
Starchy vegetables like white potatoes, sweet potatoes, rutabagas, parsnips, and turnips
Canned vegetables with added ingredients
Grains & Legumes:
All grains including corn, wheat, barley, quinoa, oats, and rice, and any foods made with these grains include bread, pasta, cereal, crackers, and baked goods
Pinto beans, garbanzo beans, canned beans, all forms of soy
Nuts, Seeds & Their Oils:
Dairy:
Soft cheese including ricotta, goat cheese, feta, cream cheese and mozzarella
Commercial yogurts
Milk from animals or milk and cream-based products
Kefir or margarine
Sweeteners:
Sugar, molasses, agave, date, coconut or palm sugar, maple syrup, sucrose, high-fructose corn syrup or any processed sugar
Other:
Commercial condiments and dressings
Lifestyle Changes
Small and gradual changes with diets like this are preferable, especially with children who may be picky eaters or have limited diets. Changing over the diet slowly takes more time but is often more feasible and practical.
Helpful Resources
Websites
Breaking the Vicious Cycle - The Specific Carbohydrate Diet Official Website
Following the Specific Carbohydrate Diet (SCD) | NiMBAL IBD Diet Planning
Diets for Autism Spectrum Disorder: Learning from IBD and IBS Treatments
Books
Recipe blogs
Recommended Supplements
Supplements should be kept to a minimum, but due to malabsorption issues, they may be necessary in the beginning. Once healing has progressed, the aim should be to minimize supplements. Supplements must be SCD compliant.
DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.
Specific Carbohydrate Diet in the Research
Adult Inflammatory Bowel Disease (IBD)
SCD can be an effective tool in the management of some IBD cases, specifically with colonic and ileocolonic CD. [1]
SCD helps improve symptoms, decrease inflammation and may increase microbiome biodiversity. The SCD should be a treatment option for IBD patients. [2]
The SCD is utilized by many patients as a therapy for IBD and many patients perceive clinical benefit from use of the SCD. [3]
The SCD was an effective therapy for IBD in this patient with IBD and PSC. The dominant intestinal bacterial species may be related to diet effectiveness. [4]
Pediatric Inflammatory Bowel Disease (IBD)
Many studies show increased prevalence of GI symptoms in ASD patients, especially constipation, diarrhea, and associated cognitive and behavioral deficits in certain groups of individuals. [5]
Clinical and mucosal improvements were seen in children with CD, who used SCD for 12 and 52 weeks. [6]
SCD helps control inflammation and supports stable growth parameters among those with pediatric CD. [7]
SCD may improve clinical and laboratory parameters for pediatric patients with non-structuring, non-penetrating CD and UC. [8]
Nutritional interventions including EEN (exclusive enteral nutrition), SCD, and nutritional supplements show promise in the treatment of pediatric IBD. [9]
SCD and other low complex carbohydrate diets are therapeutic options for pediatric Crohn disease. [10]
Gut Microbiome, ASD and IBD
Children with ASD were more likely to meet criteria for Crohn's disease (CD) and Ulcerative colitis (UC) compared to controls, which confirms the association of ASD with IBD. [11]
There is increased prevalence of IBD in patients with ASD than their respective controls and nationally reported rates for pediatric IBD. [12]
Abnormal gut microbiota is associated with IBD, ASD and mood disorders. Microbiome-mediated therapies may be safe and effective treatment for ASD. [13]
Increasing evidence for the reciprocal interaction network among microbiome, gut and brain. [14]
In a mouse model, certain bacteria may increase the risk of neurodevelopmental disorders in the offspring of pregnant mothers undergoing immune system activation. [15]
Carbohydrate Enzymes
Autism and SCD
The Bottom Line
It is clear from the research that the Specific Carbohydrate Diet is well known and well utilized in the treatment of Inflammatory Bowel Disease (IBD). An abnormal gut microbiome is associated with ASD and this population is at greater risk for IBD. Those with gastrointestinal issues or IBD would do well to give this diet a try. The SCD seeks to rectify dysbiosis, which impacts not only the gut but the brain, and this may be a reason for its effectiveness.
Scale 1-5 Stars ★(1 Star Being Worst, 5 stars Being the Best)
We rate the quality and quantity of the Research supporting the efficacy of the diet in improving symptoms as well as the Ease of Adherence, taking into account the cost, resources available, time required, social acclimation to the diet including options available in restaurants and grocery stores which assist in convenience and adherence
Ease of Adherence ★★★
This diet is one of the more difficult diets to follow. There are quite a few resources available and it is becoming more well known.
Research ★★★★
There is research to support the use of this diet in those with inflammatory bowel disease. Many people with autism suffer from gastrointestinal issues and that may be why this diet has been effective.
Grade: B
Disclaimer: The information provided in the Autism Nutrition Library is intended for educational purposes only and should not be interpreted as medical nutrition therapy, nutrition counseling, diagnosis, prognosis, health care treatment, instruction, advice, or any other individualized medical service. Always let your physician know about any of your health concerns, and check with your doctor or dietitian before making any diet, medication, exercise, or lifestyle changes.
The information provided in the Autism Nutrition Library is intended for educational purposes only and should not be interpreted as medical nutrition therapy, nutrition counseling, diagnosis, prognosis, health care treatment, instruction, advice, or any other individualized medical service. Always let your physician know about any of your health concerns, and check with your doctor or dietitian before making any diet, medication, exercise, or lifestyle changes.
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[1] Kakodkar S, Farooqui AJ, Mikolaitis SL, Mutlu EA. The Specific Carbohydrate Diet for Inflammatory Bowel Disease: A Case Series. J Acad Nutr Diet. 2015;115(8):1226-32.
[2] Kakodkar S, Mutlu EA. Diet as a Therapeutic Option for Adult Inflammatory Bowel Disease. Gastroenterol Clin North Am. 2017;46(4):745-67.
[3] Suskind DL, Wahbeh G, Cohen SA, et al. Patients Perceive Clinical Benefit with the Specific Carbohydrate Diet for Inflammatory Bowel Disease. Dig Dis Sci. 2016;61(11):3255-60.
[4] Dubrovsky A, Kitts CL. Effect of the Specific Carbohydrate Diet on the Microbiome of a Primary Sclerosing Cholangitis and Ulcerative Colitis Patient. Cureus. 2018;10(2):e2177.
[5] Lefter R, Ciobica A, Timofte D, Stanciu C, Trifan A. A Descriptive Review on the Prevalence of Gastrointestinal Disturbances and Their Multiple Associations in Autism Spectrum Disorder. Medicina (Kaunas). 2019;56(1):E11.
[6] Cohen SA, Gold BD, Oliva S, et al. Clinical and mucosal improvement with specific carbohydrate diet in pediatric Crohn disease. J Pediatr Gastroenterol Nutr. 2014;59(4):516-21.
[7] Burgis JC, Nguyen K, Park KT, Cox K. Response to strict and liberalized specific carbohydrate diet in pediatric Crohn's disease. World J Gastroenterol. 2016;22(6):2111-7.
[8] Obih C, Wahbeh G, Lee D, et al. Specific carbohydrate diet for pediatric inflammatory bowel disease in clinical practice within an academic IBD center. Nutrition. 2016;32(4):418-25.
[9] Kaenkumchorn T, Kesavan A. Dietary Management of Pediatric Inflammatory Bowel Disease. J Med Food. 2019;22(11):1092-9.
[10] Suskind D. Nutritional Therapy in Pediatric Crohn Disease: The Specific Carbohydrate Diet. scdrecipe.com. http://www.scdrecipe.com/scd-uploads/studies/2014-suskind-christie.pdf. Published 2014. Accessed November 1, 2020.
[11] Lee M, Krishnamurthy J, Susi A, et al. Association of Autism Spectrum Disorders and Inflammatory Bowel Disease. J Autism Dev Disord. 2018;48(5):1523-9.
[12] Doshi-Velez F, Avillach P, Palmer N, et al. Prevalence of Inflammatory Bowel Disease Among Patients with Autism Spectrum Disorders. Inflamm Bowel Dis. 2015;21(10):2281-8.
[13] Li Q, Han Y, Dy ABC, Hagerman RJ. The Gut Microbiota and Autism Spectrum Disorders. Front Cell Neurosci. 2017;11:120.
[14] Yang Y, Tian J, Yang B. Targeting gut microbiome: A novel and potential therapy for autism. Life Sci. 2018;194:111-9.
[15] Kim S, Kim H, Yim YS, et al. Maternal gut bacteria promote neurodevelopmental abnormalities in mouse offspring. Nature. 2017;549(7673):528-32.
[16] Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C, Tildon JT. Gastrointestinal abnormalities in children with autistic disorder. J Pediatr. 1999;135(5):559-63.
[17] Williams BL, Hornig M, Buie T, et al. Impaired carbohydrate digestion and transport and mucosal dysbiosis in the intestines of children with autism and gastrointestinal disturbances. PLoS One. 2011;6(9):e24585.
[18] Barnhill K, Devlin M, Moreno HT, et al. Brief Report: Implementation of a Specific Carbohydrate Diet for a Child with Autism Spectrum Disorder and Fragile X Syndrome. J Autism Dev Disord. 2020;50(5):1800-8.
[19] Adams J. Parent ratings of behavioral effects of biomedical interventions. Autism.org. https://www.autism.org/wp-content/uploads/2018/12/ParentRatings2009.pdf. Published 2009. Accessed November 1, 2020.
