The Specific Carbohydrate Diet (SCD) is a nutritional regimen, created by Dr. Sidney V. Haas and popularized by biochemist and author Elaine Gottschall, which restricts the use of complex carbohydrates (disaccharides and polysaccharides) and eliminates refined sugar, all grains and starch from the diet.[1] It is promoted as a way of reducing the symptoms of irritable bowel syndrome (IBS), Crohn's disease, ulcerative colitis, coeliac disease and autism. Gottschall believed that, due to damage to the microvili in the body, these microvili lack the ability to break down specific types of carbohydrates (i.e., disaccharides and polysaccharides), resulting in dysbiosis, the overgrowth of harmful bacterial flora. In a 1924 study, Haas reported, "In cases which the diet can be controlled for a sufficient long time, recovery ensues in every instance and without nutritional relapse."[2]
In 1922, Kleinschmidt wrote a scientific paper about the efficacy of Dr Haas's diet, stating, "The prognosis in celiac disease has undergone a complete change during the last few years. The discouraging results of the previous methods of treatment have entirely disappeared since we have followed the diet of the American, Haas."[3] In 1928, Von den Steinen reported on a study which validated the efficacy of Dr Haas' diet and verified its results.[4] Haas also wrote a 1955 case report on 191 patients treated with the diet.[5]
Following the death of Dr Haas in 1964, there have been no controlled studies published of the SCD related to IBD.[6] One trial of the SCD effects on IBD is ongoing at the Rush University Medical Center.[7], and a two-patient case study was reported in 2004.[8]
Several books written by doctors and dietitians since 1998 mention or recommend this diet for specific conditions.[9][10][11][12]
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The rationale of the diet, as described in Gottschall's Breaking the Vicious Cycle, is as follows:
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 autoimmune diseases can be lessened. The goal is to rid the body of complex saccharides so the gut will be able to heal itself and enable further healing to occur.
The method of the diet is to keep the bacterial flora well balanced and to allow the gut to digest all of the food it is given, thereby starving out the harmful bacteria.
Certain foods, such as commercial syrups and sugars, starchy vegetables, and dairy products are not allowed while on the diet. Other foods, such as fruits, greens, animal protein, and nuts, are allowed.
The Crohn's and Colitis Foundation of America published "The Specific Carbohydrate Diet: Does It Work?",[13] in which several doctors say that there have been no clinical trials to prove or disprove efficacy, so no conclusions can yet be drawn about the diet. Edward V. Loftus, Jr., M.D., Associate Professor of Medicine and member of the Division of Gastroenterology and Hepatology at the Mayo Clinic in Rochester, MN, said, "We're not ruling out the possibility that it works, but you need more than a few successes to establish proof. In the absence of that, it's hard to recommend this or any diet." He also said, "In my experience, for every patient I see who tried the diet and it worked, there are three to four others who tried it and it didn't work." Dr. Athos Bousvaros, Associate Director of the IBD Center at Children's Hospital in Boston, thinks the diet, while difficult to follow, is probably safe, and recommends that "if you do decide to put your child on the diet, do it under the guidance of an experienced nutritionist."
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