Specific Carbohydrate Diet (SCD) — Diets
Therapeutic diet restricting complex carbohydrates and disaccharides for inflammatory bowel disease and GI disorders.
Overview
The Specific Carbohydrate Diet (SCD) was developed by Sidney Haas and popularized by Elaine Gottschall. It restricts disaccharides and polysaccharides (grains, starch, lactose, sucrose) while allowing monosaccharides (glucose, fructose, galactose). The theory is that undigested complex carbohydrates feed pathogenic gut bacteria, perpetuating intestinal inflammation. Clinical studies in pediatric and adult IBD show clinical remission rates of 50-70% and mucosal healing in some patients. The PRODUCE trial (2024) at Seattle Children's Hospital provided the first RCT evidence for SCD in pediatric Crohn's disease, showing non-inferiority to Mediterranean diet for clinical remission.
Indications
- Inflammatory bowel disease (Crohn's, ulcerative colitis)
- Celiac disease (as adjunct to gluten-free diet)
- Chronic diarrhea and malabsorption
- Autism spectrum disorder GI symptoms (preliminary evidence)
Mechanism of Action
Restricting complex carbs to monosaccharides reduces substrate for pathogenic bacterial overgrowth in the gut lumen
Dosing
| Compound | Dose | Frequency | Notes |
|---|---|---|---|
| Specific Carbohydrate Diet | Only monosaccharide carbs; no grains, starch, lactose, sucrose | Daily | Allow: meat, fish, eggs, vegetables, fruit, nuts, 24h fermented yogurt, honey |
Evidence Grade
GRADE C
Safety & Contraindications
- Restrictive; may lead to caloric insufficiency especially in children
- Requires careful planning to meet calcium and fiber needs
- Homemade yogurt (24-hour ferment) is a central component and requires preparation
- Not a substitute for IBD medications; use as adjunctive therapy