Leena Watts
The Specific Carbohydrate Diet (SCD) is a restrictive, grain-free diet designed to help people with conditions such as Crohn's disease, ulcerative colitis, celiac disease, diverticulitis, cystic fibrosis, and chronic diarrhea. The diet is broken down into an introductory phase and five subsequent stages. The introductory phase, also known as the Intro Diet, is the most restricted stage and is meant to last between two to five days. It includes foods such as chicken, turkey, lean pork, broiled fish, beef or chicken broth, ground meat, eggs, cooked carrots, gelatin, and 100% grape juice or apple cider. After the introductory phase, each of the five stages introduces more variety and preparations of food. While there is no strict timeline for each stage, it is recommended to stay on the diet for at least one year after the last symptom has disappeared.
| Characteristics | Values |
|---|---|
| Number of stages | 3 main dietary phases or 5 stages in addition to an introductory phase |
| First stage | Anti-inflammatory step or Intro Diet |
| Duration of Intro Diet | 2-5 days |
| Foods allowed during Intro Diet | Chicken, turkey, lean pork, broiled fish, beef or chicken broth, ground meat, eggs, cooked carrots, gelatin, 100% grape juice or apple cider |
| Foods allowed in Stage 1 | Peeled and cooked fruits and vegetables (apples, pears, bananas, winter squash, zucchini, spinach), homemade nut milks and yogurts |
| Foods allowed in Stages 2 and 3 | Additional fruits and vegetables, although they should be peeled, deseeded, and cooked when appropriate |
| Foods allowed in Stage 4 | Raw fruits and vegetables, more nut flours and nut pieces, and some properly prepared beans (haricot beans, lentils, lima beans, navy beans) |
| Recommended duration of the diet | At least one year after the last symptom has disappeared |
| Monitoring | Close follow-up is required regularly during the first step. Patients should review how they are doing and have a full physical, including a weight check. Laboratory studies such as complete blood count, sedimentation rate, C-reactive protein, and albumin should be checked. |
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What You'll Learn
The introductory phase: 2-5 days of eating specific foods
The Specific Carbohydrate Diet (SCD) is a restrictive, grain-free diet designed to help people with conditions such as Crohn's disease, ulcerative colitis, celiac disease, diverticulitis, cystic fibrosis, chronic diarrhea, and inflammatory bowel disease (IBD). The SCD is divided into three main dietary phases, with each step differing in terms of what can be eaten, its challenges, and how success is monitored.
The first step of the SCD is the introductory phase, also known as the "Intro Diet". This stage is designed to last a maximum of 2 to 5 days and depends on the severity of the individual's symptoms. During this phase, it is important to closely monitor the individual's overall well-being and nutritional status. It is also recommended to create a chart and track symptoms during the first month of the SCD. This can include listing symptoms, indicating their severity, and tracking their progress over time.
The introductory phase involves eating only a few specific foods that are easy to digest and legal for this stage. These foods include chicken, turkey, lean pork, broiled fish, beef or chicken broth, ground meat, eggs, cooked carrots, gelatin, and 100% grape juice or apple cider. It is important to note that if an individual is experiencing diarrhea, it is recommended to eliminate eggs and prioritize meat until it is under control.
After the introductory phase, there are five additional stages in the SCD. Each stage introduces more variety and different preparations of food. It is important to slowly add new foods and closely monitor any changes in symptoms. The goal of the SCD is not to simply eliminate carbohydrates but to consume carbohydrates that are easier for the body to digest and absorb, reducing inflammation and improving overall health.
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Stage 1: Peeled and cooked fruits and vegetables
The Specific Carbohydrate Diet (SCD) is a grain-free diet low in processed foods, added sugars, and food additives. It is designed to help people with inflammatory bowel diseases such as Crohn's disease, ulcerative colitis, and celiac disease. The SCD is divided into three main dietary phases, with each step differing in terms of what can be eaten, its challenges, and how success is monitored.
The first step of the SCD is often followed for just one to two days. During this period, a slight increase in abdominal discomfort may occur, which is usually milder than the GI symptoms from an individual’s IBD. This discomfort is probably related to the “bad” bacteria dying off. This first step is also referred to as the anti-inflammatory step or the diet introduction phase.
During the first step, the diet is restricted to peeled and cooked fruits and vegetables. The allowed foods during this phase include carrots, chicken, beef, fish, homemade broth, gelatin, apple cider or grape juice, dry curd cottage cheese, eggs, and SCD-legal cheesecake. It is important to introduce only one new food at a time, with a two-day interval between new foods.
After a few days of being on the first step, individuals can move on to the regular SCD diet, gradually adding solid foods, including fresh fruits and vegetables, nut flours, lentils, and beans. It is important to closely monitor symptoms and laboratory studies during this time, as well as stool calprotectin levels, to ensure that inflammation is not rebounding.
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Stage 2: Additional fruits and vegetables
The Specific Carbohydrate Diet (SCD) is a restrictive, grain-free diet designed to help people with conditions such as Crohn's disease, ulcerative colitis, and celiac disease. The diet allows some carbs and bans others based on how easily they can be digested. The SCD is divided into three main dietary phases, with each phase differing in terms of what can be eaten, its challenges, and how success is monitored.
Stage 2 of the SCD involves adding additional fruits and vegetables to the diet. In this stage, it is important to continue peeling, deseeding, and cooking fruits and vegetables to ensure they are well-tolerated. Examples of fruits that can be included in this stage are overripe bananas with brown spots and applesauce. Vegetables that can be introduced are spinach, butternut squash, and acorn squash. It is recommended to introduce new items every day or every two days, gradually expanding the diet to include a wider variety of fruits and vegetables such as green beans, peppers, mushrooms, avocados, tomatoes, peaches, pineapple, and plums. This initial step of adding new foods in Stage 2 can last for around 3 to 4 weeks.
If the additional fruits and vegetables are well-tolerated, raw peeled fruits and vegetables may be introduced. It is important to introduce only one new food at a time, with a 2-day interval between new foods, to determine tolerance and identify any connections between specific foods and symptoms. This can be achieved by keeping a food journal to track progress.
The duration of each stage of the SCD may vary depending on individual needs and tolerance. Some individuals may choose to stay on the diet until at least one year after their last symptom disappears, while others may gradually reintroduce "illegal" foods after a year or more on the diet. It is important to closely monitor symptoms and make adjustments as needed.
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Stage 3: Raw fruits and vegetables, nut flours and some beans
The Specific Carbohydrate Diet (SCD) is a restrictive, grain-free diet designed to help people with conditions such as Crohn's disease, ulcerative colitis, celiac disease, diverticulitis, cystic fibrosis, and chronic diarrhea. The diet removes all grains, milk products (except for highly fermented yogurt), and sugar. It allows some carbs and bans others based on how easily they can be digested.
SCD is divided into three main dietary phases, with each step differing in terms of what can be eaten, its challenges, and how success is monitored. The first step of the SCD, also known as the anti-inflammatory step, involves an introductory diet that is followed for two to five days, depending on when symptoms begin to improve. This is followed by the regular SCD diet, which includes fresh fruits and vegetables, nut flours, lentils, and beans.
The third step of the SCD involves the reintroduction of "illegal" foods, which is a controversial topic. Some people may not want to reintroduce any illegal foods, while others may only be able to maintain a strict diet for a limited time before needing to add new foods. The earliest that illegal foods are typically reintroduced is after three months on the diet. This step has no set timeframe, and it is important to do things slowly and one step at a time. It is recommended to closely monitor symptoms and laboratory studies, as well as stool calprotectin levels, to ensure that inflammation is not rebounding.
During the third stage of the SCD, individuals can continue eating the foods introduced in the previous stages, such as raw fruits and vegetables, nut flours, and beans, while also reintroducing some "illegal" foods. This may include dried fruit and raisins without added sugars, meats like fried pork or SCD-legal bacon, and certain legumes like lentils, split peas, and raw cashews. It is important to introduce only one new food at a time and to follow a 2-day interval between introductions to determine tolerance.
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Reintroducing illegal foods: After 3 months to a year
The Specific Carbohydrate Diet (SCD) is a restrictive grain-free diet designed to help people with conditions such as Crohn's disease, ulcerative colitis, and inflammatory bowel disease (IBD). The diet is typically divided into three main dietary phases, with each step differing in terms of what can be eaten, its challenges, and how success is monitored.
Reintroducing illegal foods is a critical aspect of the SCD diet and should be approached with caution and close monitoring. The timing for reintroducing illegal foods can vary, ranging from three months to a year or more. The decision to reintroduce these foods depends on individual progress, tolerance, and the advice of healthcare professionals.
During the reintroduction phase, it is crucial to proceed slowly and one step at a time. Before initiating an illegal food, it is recommended to perform a stool calprotectin test to establish a baseline. This test should be repeated one month after reintroducing the food to monitor any changes in calprotectin levels. If the levels increase significantly, indicating a rebound in inflammation, that particular food should be removed from the diet until the levels normalize.
The reintroduction process allows individuals to gradually expand their food options while closely monitoring their symptoms. It is important to remember that each person's experience with the SCD diet may vary, and adjustments should be made according to individual needs. Some people may be able to successfully reintroduce certain illegal foods, while others may need to maintain a stricter diet.
While the SCD diet has shown promising results for many individuals, it is important to consult with a healthcare provider before starting or making any dietary changes. The diet may lead to malnutrition and unhealthy weight loss if not properly monitored and supplemented. Additionally, the diet has not been extensively studied in medicine, and more research is needed to fully understand its effectiveness and long-term impacts.
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Frequently asked questions
The first stage of the SCD diet is called the "Intro Diet" and is meant to last between 2 to 5 days. It is the most restricted stage of the diet and includes legal foods such as chicken, turkey, lean pork, broiled fish, beef or chicken broth, ground meat, eggs, cooked carrots, gelatin, and 100% grape juice or apple cider.
The second stage of the SCD diet is not time-bound and is implemented based on the healing process. It introduces more variety and preparation of food. This stage includes peeled and cooked fruits and vegetables, homemade nut milk, and yogurts.
The SCD diet should be followed for at least a year after the last symptom disappears. It is recommended to closely monitor symptoms and laboratory studies during this time. Some people may have to remain on the diet indefinitely.
