Over the last decade, the incidence of inflammatory bowel diseases (IBD) has increased worldwide ( 1 ).

Symptoms are often painful and include diarrhea, bleeding ulcers and anemia.

Elimination diets, such as the Specific Carbohydrate Diet™ (SCD), have gained traction as potential treatments for IBD and other inflammatory and autoimmune disorders.

While the SCD was introduced in the 1920s by gastroenterologist Sidney Haas, it was expanded and popularized in the 1980s with Elaine Gottschall’s book “Breaking the Vicious Cycle.”

This article explores the SCD, the science behind it and its effectiveness.

The SCD is an elimination diet that emphasizes the removal of certain types of carbohydrate-containing foods based on their chemical structure.

The governing theory behind the SCD is that complex carbs encourage an overgrowth of unhealthy bacteria in your small intestine if you have IBD.

As these bacteria grow, they produce byproducts that promote inflammation and eventually lead to reduced absorption of nutrients in your digestive tract.

The SCD claims to inhibit the growth of such bacteria and restore digestive function by eliminating all carbohydrate food sources that have two or more linked sugar molecules (di-, oligo- and polysaccharides).

Though many carbs are prohibited, the SCD does permit carb sources that have single, unbound sugar molecules — or monosaccharides — as your digestive tract absorbs them more easily.

The SCD is an elimination diet that restricts certain types of carbs in an effort to treat various autoimmune and inflammatory bowel diseases.

As the name implies, the SCD restricts specific carbs based primarily on their chemical structure.

The diet labels any food or food additive “illegal” that contains two or more chemically linked sugar molecules. The SCD guidebook, “Breaking the Vicious Cycle,” collectively refers to these foods as complex carbs.

In scientific terms, any food with disaccharides, oligosaccharides or polysaccharides will appear on the list of illegal foods.

As you can imagine, the list of banned foods is extensive. Here are a few of the main groups of illegal foods:

• Potatoes
• Grains and pseudograins, including rice, wheat, corn, quinoa, millet, etc.
• Processed meats and meats with additives
• Dairy, except some cheese, butter and homemade yogurt that has been fermented for at least 24 hours
• Most legumes, though certain dried beans and lentils are permitted after soaking
• Most processed sugar, artificial sweeteners and sugar alcohols
• Processed foods

The general structure of the SCD is very rigid and intended to be followed exactly as outlined in the guidebook — with little to no room for flexibility.

While some people may reintroduce certain illegal foods after symptoms subside, this will vary depending on an individual’s response to the diet.

The SCD restricts any food with two or more linked sugar molecules, such as dairy products, starchy vegetables, table sugar, grains and most legumes. These foods are referred to as “illegal” and are strictly prohibited.

The foods approved by the SCD are collectively referred to as “legal.”

Most of the foods on this list are unprocessed, whole foods that don’t offer many complex carbs.

The main sources of approved or “legal” carbs in the SCD come from the monosaccharides glucose, fructose and galactose.

These are some of the SCD’s legal foods:

• Fruits: Most unprocessed, fresh or frozen fruits and juices. Canned fruits may be allowed as long as they don’t have added sugar or starch.
• Vegetables: Most vegetables, except for potatoes, yams, plantains and some other high-starch vegetables.
• Meat: Most fresh meats, as long as they don’t contain any fillers or additives.
• Eggs
• Some dairy: Homemade yogurt fermented for at least 24 hours and some natural cheeses.
• Certain legumes: Some dried legumes, as long as they’re soaked and prepared according to the directions outlined in the guidebook.
• Nuts and nut butters: Most nuts, as long as they’re free from added starch or sugar.
• Herbs and spices: Most dried or fresh herbs and spices. Spice blends are typically discouraged as many of them harbor “illegal” additives.

As it can be difficult to determine which foods are legal, the SCD guidebook recommends eating only the explicitly legal foods to avoid inadvertently ingesting something illegal.

Most unprocessed fruits, vegetables, nuts and meats are permitted on the SCD — with a few exceptions. Some legumes and dairy products are permitted as long as they’re prepared appropriately, as outlined in the guidebook.

The SCD was originally designed as a therapy for people with IBD, an umbrella term which includes ulcerative colitis, celiac disease and Crohn’s disease.

These diseases can hamper your ability to digest and absorb nutrients from food. Thus, the SCD aims to heal intestinal tissue in order to restore its functions.

The SCD’s promoters claim that some people are less adept at digesting foods — such as grains, legumes, refined sugar and high-starch food additives — that result from settled agricultural practices and the modern food industry.

Supporters assert that continued ingestion of these carbs leads to an overgrowth of unhealthy bacteria in your gut which promotes inflammation, eventually diminishing your ability to digest.

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

To this day, the SCD is primarily used to treat intestinal disorders — but with varied success.

One of the major criticisms of this diet is its lack of concrete scientific evidence.

The bulk of the available data is weak and limited to very small studies or anecdotal evidence, which isn’t enough to definitively state whether or not the SCD works (2).

Ultimately, more research is needed to determine whether the SCD is truly an effective treatment for IBD.

Though the SCD is often promoted for people with IBD, there are very few studies that support its effectiveness.

Affiliation

• 1 *Department of Pediatrics, Division of Gastroenterology, Seattle Children’s Hospital and University of Washington †Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA.

• PMID: 28825603
• PMCID: PMC5653423
• DOI: 10.1097/MPG.0000000000001613

Free PMC article

• Search in PubMed
• Search in NLM Catalog
• Add to Search

Authors

Affiliation

• 1 *Department of Pediatrics, Division of Gastroenterology, Seattle Children’s Hospital and University of Washington †Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA.

• PMID: 28825603
• PMCID: PMC5653423
• DOI: 10.1097/MPG.0000000000001613

Abstract

Introduction: The specific carbohydrate diet (SCD) is an exclusion diet used as a therapy in inflammatory bowel disease. The aim of this study was to evaluate the nutritional adequacy of the SCD.

Methods: Prospective dietary data for 12 weeks were analyzed for pediatric patients on the SCD. Intake of 20 key nutrients was compared to dietary recommended intake levels and nutrient intake data from similarly aged children from The National Health and Nutrition Examination Survey National Youth Fitness Survey in 2012.

Results: Nine patients enrolled, with 8 patients completing the study. Six of 8 individuals completing the study had gained weight, 1 individual had weight loss, and 1 had no change in weight. Energy intake was significantly greater than 100% of the recommended daily allowance (RDA)/adequate intake for 64% of daily intakes completed for this study. The majority of participants’ daily intakes met or exceeded the RDA for vitamins B2, B3, B5, B6, B7, B12, C, A, and E. One hundred percent of participants’ intakes were below the RDA for vitamin D. Seventy-five percent of daily intakes were less than the RDA for calcium. The upper limit was met or exceeded for magnesium in 42% of daily intakes. Average vitamin A intake was significantly greater than the upper limit (P = 0.01).

Conclusions: Nutrient intake of pediatric inflammatory bowel disease patients on the SCD was adequate when compared with a healthy peer reference population, but adequacy was variable when compared with the dietary recommended intakes. Close monitoring with a multidisciplinary team for patients using the SCD as an alternative or adjunct therapy is recommend to ensure positive outcomes for overall patient health.

Trial registration: ClinicalTrials.gov NCT02213835.

Conflict of interest statement

Conflicts of Interest: None of the authors have a conflict of interest in regards to this article except for David Suskind who has written/published Nutrition in Immune Balance (NIMBAL).

Overcome Carbohydrate Addiction with a Detox

Get Started on a Low Carb Diet

Introduce Carbs After Doing a Keto Diet

Make Low Carb Dieting Simple and Easy

Go on a Carb Free Diet

Get More Fiber on a Low Carb Diet

Follow the Specific Carbohydrate Diet

Choose Low Carb Breakfast Options

Related Topics

• Home
• Health
• Nutrition and Food Health
• Lifestyle Diets

• Home
• About wikiHow
• Experts
• Jobs
• Contact Us
• Site Map
• Terms of Use
• Privacy Policy
• Do Not Sell My Info
• Not Selling Info
• Contribute

Lose weight & save time with intermittent fasting

We noticed you’re using an ad blocker.

We know ads can be annoying, but they’re what allow us to make all of wikiHow available for free. Please help us continue to provide you with our trusted how-to guides and videos for free by whitelisting wikiHow on your ad blocker. If you really can’t stand to see another ad again, then please consider supporting our work with a contribution to wikiHow.

The specific carbohydrate diet (SCD) is a diet originally created to manage celiac disease; it limits the use of complex carbohydrates (disaccharides and polysaccharides). Monosaccharides are allowed, and various foods including fish, aged cheese and honey are included. Prohibited foods include cereal grains, potatoes and lactose-containing dairy products. It is a gluten-free diet since no grains are permitted.

Origin

In 1924, Sidney V. Haas (1870–1964) described the first SCD for the treatment of children with celiac disease; this was known as the banana diet. Haas described a trial with 10 children; all 8 children treated with bananas went into remission, and the two control children died. The banana SCD was the cornerstone of celiac therapy for decades until bread shortages in the Netherlands caused by World War II caused children with celiac disease to improve, which led to the isolation of wheat proteins, not starches, as the cause of celiac disease. Before the banana SCD, one out of four children with celiac died. After more research, he described the SCD as a treatment for celiac disease and inflammatory bowel disease (IBD) in his 1951 medical textbook The Management of Celiac Disease; Haas never accepted the finding that wheat gluten was the damaging part of wheat; he insisted it was starch and called the discovery about a gluten a “disservice.”

The diet was later re-popularized by biochemist Elaine Gottschall, the mother of one of Hass’s patients, in her 1996 book Breaking the Vicious Cycle. 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.

Biased Unconfirmed Claims

The claims that the SCD is beneficial for children with autism are based on the supposition they have too much harmful bacteria in their gut. While case studies have shown SCD can be beneficial, there is need for further research to study the effects of SCD on autism. Parents adopting the SCD for their children are at risk of experiencing guilt when their expectations of improvement are dashed.The SCD is one of many unevidenced treatments offered for children with special needs that have the characteristic signs of being pseudoscientific.

A 2013 review on SCD and other exclusion diets concluded: “However, we lack large prospective controlled trials to provide the dietary recommendations patients’ desire. Taken together, studies of exclusive enteral nutrition, exclusion diets, and semi-vegetarian diets suggest that minimizing exposure of the intestinal lumen to selected food items may prolong the remission state of patients with inflammatory bowel disease. Even less evidence exists for the efficacy of the SCD, FODMAP, or Paleo diet. ” It also said that the diet risks imposition of an undue financial burden and potentially causes malnutrition.

As of 2017 there was preliminary evidence that the SCD may help relieve the symptoms of adults with inflammatory bowel disease.

The Gut and Psychology Syndrome Diet (GAPS Diet) is an even more restrictive variant of the SCD, devised by a Russian neurologist. The diet is promoted with claims it can treat a wide variety of conditions including autism, schizophrenia and epilepsy. Like the SCD, claims of the diet’s usefulness for children with autism are supported by anecdote rather than published studies. Harriet Hall has described the GAPS diet “a mishmash of half-truths, pseudoscience, imagination, and untested claims”, and Quackwatch includes the GAPS Diet in its Index of questionable treatments.

• facebook
• twitter
• linkedin

Jay Yepuri, MD, MS, is a board-certified gastroenterologist and a practicing partner at Digestive Health Associates of Texas (DHAT).

BSIP / UIG / Getty Images

• Nutrition
• Diagnosis
• Living With
• Support & Coping
• Crohn’s Disease
• Ulcerative Colitis
• Related Conditions
• Surgery
• Treatment

View All

The Specific Carbohydrate Diet (SCD) is an eating plan described in the book The Management of Celiac Disease, by Doctors Sydney Valentine Haas and Merrill P. Haas. Dr. Sydney Haas, a pediatrician, took an interest in the diet of his patients who were diagnosed with celiac disease. He noted certain carbohydrates were better tolerated by these patients than others and went on to develop the SCD as a treatment for celiac disease. A diet free of gluten is currently the treatment for celiac disease.

Elaine Gottschall, desperate for a treatment for her daughter who had treatment-unresponsive ulcerative colitis, was put in touch with Dr. Haas. Gottschall started her daughter on the SCD and the girl’s symptoms improved. Gottschall, a biochemist, and cell biologist were then inspired to research the diet more deeply. She went on to write Breaking The Vicious Cycle: Intestinal Health Through Diet, which details the specifics of the SCD.