Specific carbohydrate diet
Specific carbohydrate diet (SCD) is a restrictive diet first described by Sidney V. Haas (1870–1964) in 1924 to treat celiac disease, and further refined in his 1951 medical textbook The Management of Celiac Disease. It was later re-popularized in 1987 by Elaine Gottschall, the mother of one of Haas's patients.
The SCD is a gluten-free diet since no grains are permitted, and the SCD was a popular treatment for celiac disease decades before gluten was discovered. The diet can prevent further gut damage in people with celiac and might help manage flares in people with Crohns disease.
In 1924, the first Specific Carbohydrate Diet for the treatment of children with celiac disease was the banana diet. Haas described a trial with 10 children, and 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 of four children with celiac died. After more research, he described the Specific Carbohydrate Diet as a treatment for celiac disease and inflammatory bowel disease 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 Haas's patients, whose 1987 book Breaking the Vicious Cycle: Intestinal Health Through Diet outlines the diet and provides guidelines and recipes. Gottschall also claims SCD treats Crohn's disease, ulcerative colitis, diverticulitis, cystic fibrosis, chronic diarrhea, and autism.
Details and effectiveness
Gottschall's Specific Carbohydrate Diet 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.
A 2017 review on SCD and other exclusion diets said that SCD "is one such exclusion diet that appears to have a positive effect in IBD."
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.
The Crohn's & Colitis Foundation of America point out that there have been only limited studies of the SCD in relation to Crohn's Disease and ulcerative colitis, and while "there is no evidence to suggest that any particular food or diet causes, prevents or cures inflammatory bowel disease", they also say that "dietary recommendations are generally aimed at easing symptoms during flares".
- Hou JK, Lee D, Lewis J (October 2014). "Diet and inflammatory bowel disease: review of patient-targeted recommendations". Clin. Gastroenterol. Hepatol. (Review). 12 (10): 1592–600. doi:10.1016/j.cgh.2013.09.063. PMC 4021001. PMID 24107394.
- Haas, Sidney Valentine; Haas, Merrill P. (1951). The Management of Celiac Disease. Literary Licensing. ISBN 978-1-258-19621-9.
- Brown AC, Roy M (2010). "Does evidence exist to include dietary therapy in the treatment of Crohn's disease?". Expert Review of Gastroenterology & Hepatology (Review). 4 (2): 191–215. doi:10.1586/egh.10.11. PMID 20350266.
- "A Brief History of Celiac Disease" (PDF). Impact: The University of Chicago Celiac Disease Center, Summer 2007. Summer 2007. Retrieved 2017-04-28.
- "The Specific Carbohydrate Diet". Crohn's & Colitis Foundation of America. 1 June 2012. Retrieved 28 April 2017.
- "Dr. Sidney Valentine Haas Dies". The New York Times. December 1, 1964. Retrieved 2017-04-28.
- Guandalini, S (2008). "Historical Perspective of Celiac Disease". In Fasano, Alessio; Troncone,, Riccardo; Branski, David. Frontiers in celiac disease. Basel: Karger. p. 6. ISBN 9783805585262.
- Gottschall, Elaine (2004). Breaking the Vicious Cycle: Intestinal Health Through Diet. Kirkton Press.
- Lane, ER; Zisman, TL; Suskind, DL (2017). "The microbiota in inflammatory bowel disease: current and therapeutic insights". Journal of Inflammation Research. 10: 63–73. doi:10.2147/jir.s116088. PMC 5473501. PMID 28652796.