Milly Gaines
Carbohydrates are essential for energy, but an excessive intake can be detrimental to health. A carbohydrate-controlled diet is recommended for people with specific medical conditions, such as diabetes, inflammatory bowel disease (IBD), Crohn's disease, and celiac disease. The Specific Carbohydrate Diet (SCD) and the Consistent Carbohydrate Diet (CCHO) are two approaches that aim to manage carbohydrate consumption to alleviate symptoms associated with these conditions. The SCD eliminates sugars and hard-to-digest carbohydrates, while the CCHO focuses on consuming a consistent amount of carbohydrates daily to stabilize blood sugar levels. These diets require careful planning and consideration of individual needs, and they should be undertaken with medical supervision.
| Characteristics | Values |
|---|---|
| People with the following diseases | Crohn’s disease, celiac disease, inflammatory bowel disease (IBD), and other digestive disorders |
| Type of diet | Low-carb, strictly limiting carb intake |
| Purpose | To manage blood sugar levels and weight |
| Other names | Constant carbohydrate diet, controlled carbohydrate diet |
| How it works | Eating the same amount of carbohydrates every day |
| Number of carbohydrates | 185 carbohydrates each day, or 20 to 50 grams, depending on recommendations |
| Considerations | Proteins and fats, body size, activity level, and appetite |
| Risks | Boredom, frustration, and overconsumption of carbohydrates |
| Other diets | Ketogenic diet, Diabetes Plate Method |
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What You'll Learn
People with type 1 or type 2 diabetes
Diabetes is a chronic disease that affects the body's ability to process carbohydrates effectively. When carbohydrates are consumed, they are broken down into glucose (a type of sugar) and absorbed into the bloodstream, raising blood glucose levels. In people without diabetes, blood sugar levels remain within a stable range throughout the day. However, for those with diabetes, blood glucose management becomes challenging.
For individuals with type 1 or type 2 diabetes, the pancreas may not produce enough insulin or the body's cells may not respond effectively to the insulin produced. This results in hyperglycemia, where there is an excessive amount of glucose in the blood. On the other hand, consuming too few carbohydrates can lead to hypoglycemia, or low blood glucose levels. Therefore, maintaining a balanced carbohydrate intake is crucial for people with diabetes to avoid both "highs" and "lows" in blood sugar levels.
A low-carbohydrate diet is often recommended for individuals with type 1 or type 2 diabetes as it can help improve blood glucose control. By restricting carbohydrate intake, blood glucose levels can be lowered, reducing the risk of diabetic complications. This approach has been supported by organizations such as the American Diabetes Association (ADA) and the British Dietetic Association (BDA). Additionally, low-carb diets have been shown to decrease the need for diabetes medication.
When following a low-carb diet, it is essential to choose nutrient-dense carbohydrates that are rich in fiber, vitamins, and minerals while minimizing added sugars, sodium, and unhealthy fats. Non-starchy vegetables like lettuce, cucumbers, broccoli, tomatoes, and green beans are excellent choices as they have a high fiber content and a minimal impact on blood glucose levels. Whole, minimally processed carbohydrate foods, such as certain fruits, whole grains, and beans, can also be included in moderation. It is recommended to limit refined, highly processed carbohydrates, including sugary drinks, refined grains, and sweet snacks.
It is important to note that individuals with type 1 or type 2 diabetes should consult their doctor or a registered dietitian before making significant dietary changes. Medication dosages may need to be adjusted when adopting a low-carbohydrate diet to avoid potential health risks. Additionally, long-term adherence to a low-carb diet can be challenging, and more research is needed to understand its extended effects on overall health.
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People with Crohn's disease
One study found that out of 200 people with Crohn's disease who followed the SCD, close to half experienced an improvement in symptoms, including less pain, fatigue, and sleep problems. Several other studies have also shown that the SCD can lead to clinical remission in patients with Crohn's disease, with improvements in inflammatory burden. However, it is important to note that the SCD may also increase the risk of malnutrition and unhealthy weight loss, so it is recommended that individuals consult with their healthcare provider before starting this or any other diet.
The SCD can be challenging to follow, as it requires eliminating certain foods and food groups, such as grains, which can be difficult when socializing or dining out. It can also be expensive, as many low-cost food options are eliminated. Additionally, individuals following the SCD may need to supplement their diet with certain nutrients, such as calcium and vitamins B, D, and E, to ensure they are getting adequate nutrition.
There are also other dietary approaches that have been shown to be effective in managing Crohn's disease. For example, the Mediterranean diet has been shown to reduce inflammation and has been compared to the SCD in its effectiveness in treating Crohn's disease. The polymeric diet and Crohn's disease exclusion diet have also been found to be effective in inducing remission in children and young adults with Crohn's disease.
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Those with celiac disease
Celiac disease is a digestive and autoimmune disease that affects people of all ages. Symptoms include diarrhoea, bloating, gas, and weight loss, and it can also impact a child's growth and development.
A specific carbohydrate diet (SCD) can be an effective treatment for celiac disease. The diet was originally developed by Dr. Sidney Valentine Haas in the 1920s to treat children with celiac disease. SCD restricts carbohydrates that are not easily digested, such as grains and grain products, and sugars. It does not eliminate or limit carbohydrate intake overall. Instead, it focuses on including carbohydrates that are easier for the body to break down and absorb.
SCD has been shown to be successful in treating celiac disease, with reports of "complete recovery with no relapses, no deaths, no crisis, no pulmonary involvement, and no stunting of growth." It is also said to have a remarkable effect on autistic children, with parents and teachers reporting positive changes in attitude, skills, and responsiveness.
However, it is important to note that eliminating carbohydrates can lead to a condition called "ketosis." Additionally, the diet may lead to malnutrition and unhealthy weight loss. Therefore, it is recommended to consult a healthcare provider before starting any new diet, especially one that eliminates entire food groups.
Overall, a specific carbohydrate diet can be a viable option for those with celiac disease, but it should be undertaken with the guidance of a medical professional.
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People with other digestive disorders
People with Crohn's disease, celiac disease, and other digestive disorders may benefit from following a specific carbohydrate-controlled diet, such as the Specific Carbohydrate Diet (SCD). This diet eliminates sugars and hard-to-digest carbohydrates like grains and grain products, which can ease the symptoms of inflammatory bowel disease (IBD) and other digestive issues. The SCD focuses on consuming easily digestible carbohydrates to prevent the overgrowth of harmful bacteria in the intestines, which can irritate the gut and lead to worsened symptoms.
The Specific Carbohydrate Diet was initially developed by Dr. Sidney Haas in the 1920s to treat children with celiac disease, an autoimmune and digestive disease that can cause symptoms like diarrhoea, bloating, gas, and weight loss. The diet gained popularity in the 1980s after Elaine Gottschall shared how it improved her daughter's IBD symptoms. On the SCD, individuals avoid grains, bread, pasta, cereal, sugar, and lactose, which is a sugar found in milk and dairy products.
Another controlled-carbohydrate approach, the Consistent Carbohydrate Diet (CCHO), is primarily recommended for people with diabetes to manage their blood sugar levels and weight. Unlike the SCD, the CCHO does not eliminate carbohydrates but rather focuses on consuming a consistent number of carbohydrates every day. This consistency helps to stabilise blood sugar levels and prevent spikes or dips. The CCHO diet can be challenging as it requires considering proteins and fats alongside carbohydrates, and individuals must determine their ideal carbohydrate intake based on factors like body size, activity level, and appetite.
For individuals with diabetes who use insulin, the CCHO diet can be particularly beneficial as it helps them better manage their insulin doses. By strictly controlling their carbohydrate intake, individuals with diabetes may be able to reduce or even eliminate their need for insulin. Additionally, the CCHO diet has no side effects, unlike some medications for type 2 diabetes. It is important for those with diabetes to work with a healthcare professional, such as a dietitian or nutritionist, to determine their ideal carbohydrate goals and monitor their blood sugar levels.
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Individuals on intensive insulin therapy
Individuals with diabetes who are on intensive insulin therapy can benefit from a controlled carbohydrate diet like the Consistent Carbohydrate Diet (CCHO). This diet involves counting carbohydrates and eating the same number each day to keep blood sugar levels stable.
On the CCHO diet, a person is typically allowed to eat and drink 185 carbohydrates each day, although this number can vary depending on individual needs and recommendations from a doctor. For example, body size, activity level, and appetite all influence the ideal number of carbohydrates for each person. The CCHO diet can be challenging as it significantly limits variety in the diet, and individuals may get bored or frustrated and consume more carbohydrates than recommended, which can negatively impact health.
To address this challenge, the CCHO diet uses units of measurement called "choices" instead of counting carbs. About 15 grams of carbohydrates equals one carb "choice." Planning a menu and limiting the total number of carb choices in a meal helps keep carb intake and blood sugars more level. For instance, a half cup of rice has about 22 grams of carbohydrates, which equals 1 and a half carb "choices."
The CCHO diet is particularly useful for people who take a synthetic form of insulin. By strictly controlling their carbohydrate intake, they can better manage their insulin doses and control their blood sugar levels. As a result, they may be able to reduce or even stop taking insulin altogether.
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Frequently asked questions
People with Crohn’s disease, celiac disease, inflammatory bowel disease (IBD), and other digestive disorders may benefit from following an SCD. This diet eliminates sugars and hard-to-digest carbs like grains and grain products.
The CCHO diet is a meal plan that involves counting carbohydrates and eating the same number each day to keep blood sugar levels stable. It is intended for people with diabetes, particularly those who use insulin therapy.
To follow the CCHO diet, it is important to work with a healthcare professional to determine carb goals and monitor blood sugar levels. One can use smartphone apps, websites, or books to determine the number of carbohydrates in food. It is also crucial to consider proteins and fats, which can affect carbohydrate absorption.
