Specific Carbohydrate Diet (SCD)

What is a specific carbohydrate diet (SCD)?

A specific carbohydrate diet eliminates select carbohydrates from your diet. This eases symptoms of digestive disorders like inflammatory bowel disease (IBD). People who follow a specific carbohydrate diet don’t eat grains or grain products. They avoid bread, pasta and cereal. The diet is also very low in sugar and lactose (a sugar naturally found in milk and dairy products).

Who developed the specific carbohydrate diet?

U.S. pediatrician Dr. Sidney Haas developed the specific carbohydrate diet in the 1920s to help children with celiac disease. This digestive and autoimmune disease affects people of all ages. It causes symptoms like diarrhea, bloating, gas and weight loss. It can affect a child’s growth and development.

The diet gained greater popularity in the late 1980s after Elaine Gottschall published a book called "Breaking the Vicious Cycle: Intestinal Health Through Diet." In her book, Gottschall described how the diet improved her daughter’s IBD symptoms.

What are carbohydrates?

Carbohydrates (carbs) include fiber, starches and sugars found in certain foods and beverages. Your body changes these carbs into sugar (glucose) to give you energy.

There are two types of carbohydrates:

• Complex carbohydrates are healthier for you because they contain vitamins, minerals and fiber. They also take longer to break down, so they don’t spike your blood sugar. Complex carbs are typically starchy and fibrous foods. They include whole-grain products, beans, nuts, legumes, fruits and vegetables.
• Simple carbohydrates like foods high in sugar break down quickly. This causes a fast rise in your blood sugar (giving you energy), followed by a fast drop (leaving you fatigued). Milk and fruits have natural sugars. Added sugars show up in sweet treats like cookies and ice cream. You also find them in some condiments like ketchup and salad dressings. Simple carbohydrate foods include those made with sugar substitutes and non-nutritive sweeteners.

How does a specific carbohydrate diet work?

Medical experts are still researching how this diet helps. It may be that people with certain digestive disorders are unable to break down some carbohydrates. As a result, undigested food particles stay in the intestines where bacteria grow and feed on them. This can lead to an overgrowth of harmful bacteria that irritates the intestines, which may lead to worsened gut symptoms and inflammation.

The specific carbohydrate diet eliminates hard-to-digest carbs. You only eat carbohydrates that are easy for your digestive system to break down and absorb. This keeps the harmful bacteria from growing, which may help you feel better and reduce inflammation.

This diet is also low in processed foods, food additives, and preservatives. Some of these foods, additives, and ingredients have been linked to gut inflammation. Avoiding these additives may be another reason people feel better on this diet.

Who needs a specific carbohydrate diet?

Children and adults with certain conditions may benefit from a specific carbohydrate diet. These chronic diseases include:

• Juvenile idiopathic arthritis.
• Types of IBD like Crohn’s disease, ulcerative colitis and microscopic colitis.

In her book, Gottschall suggests that diet might also be helpful for diverticulitis, celiac disease, cystic fibrosis, and other chronic diseases. There has been no research confirming that a specific carbohydrate diet is helpful for these diseases.

What foods are allowed on a specific carbohydrate diet?

You can eat these foods when you follow a specific carbohydrate diet:

• Additive-free meats, poultry, fish and shellfish.
• Additive-free and sugar-free oils, white vinegar, cider and mustard.
• Additive-free and sugar-free coffee, tea and fruit juice.
• All-natural, sugar-free peanut butter.
• Cheeses like sharp cheddar, Colby, Swiss and dry curd cottage cheese.
• Fresh, frozen, raw or cooked vegetables, including string beans.
• Fresh fruits or frozen, cooked or dried fruits without added sugar.
• Eggs.
• Homemade yogurt that ferments for at least 24 hours.
• Honey.
• Legumes like dried navy beans, lentils, peas, split peas and lima beans. Also, unroasted cashews and unroasted peanuts in the shell.
• Nuts, peanuts and nut flours.

What foods are not allowed on a specific carbohydrate diet?

You should not eat these foods when you follow a specific carbohydrate diet:

• Grains like barley, corn, oats, quinoa, rice and wheat.
• Grain products like bread, cereal and pasta.
• Candy, chocolates and other products made with sugar, high fructose corn syrup, or fructo-oligosaccharides (FOS).
• Canned or processed meats.
• Canned vegetables with additives.
• Certain legumes like soybeans, chickpeas and bean sprouts.
• Dairy products high in lactose like mild cheddar, store-bought yogurt, milk, cream, ice cream and sour cream.
• Powdered spices like curry, garlic and onion.
• Seaweed.
• Starches like potatoes, sweet potatoes and turnips.
• Sugars including molasses, corn syrup, maple syrup, fructose, sucrose and other processed sugars.

How do you start a specific carbohydrate diet?

You should talk to your healthcare provider before starting a restrictive diet. Your provider may recommend keeping a food journal to track the foods and drinks you consume. You can also use the journal to track symptoms and improvements. In her book, Gotschall recommends an introduction period of two to five days where you limit your diet to a few easy-to-tolerate foods. You then slowly add in other foods.

What are the benefits of a specific carbohydrate diet?

Following a specific carbohydrate diet may put a digestive disease into remission. This means you have no symptoms. One study of 200 people with Crohn’s disease found that close to half of those who followed the diet saw an improvement in symptoms. They experienced less pain, fatigue and sleep problems.

What are the risks of a specific carbohydrate diet?

It can be challenging to eliminate certain foods and food groups from your diet. This is especially difficult when socializing or dining out. This diet can also be high in food costs, as you eliminate many low-cost options such as grains. In addition, a specific carbohydrate diet increases your risk for malnutrition and may lead to unhealthy weight loss. Your body may not get enough calcium, as well as vitamins B, D and E. Your provider may recommend seeing a registered dietitian to ensure you don’t miss important nutrients.

What is the outlook for people who follow a specific carbohydrate diet?

Some people follow a specific carbohydrate diet for life. Others are able to gradually reintroduce foods after going one year without symptoms. Some people transition to a modified specific carbohydrate diet that includes rice, oats, potato, and quinoa. If symptoms return, you can resume the diet.

When should I call the doctor?

You should call your healthcare provider if you experience:

• Blood in your stool (rectal bleeding).
• Chronic stomach upset, including gas, bloating and diarrhea.
• Chronic pain.
• Extreme weight loss.
• Unexplained fatigue or weakness.

A note from Cleveland Clinic

If you have an IBD or another type of digestive disorder, you may get symptom relief by following a specific carbohydrate diet (SCD). But you should consult with your healthcare provider before starting this diet. A specific carbohydrate diet eliminates all grains and grain products and greatly reduces your intake of sugars. Instead, you eat carbohydrates that are easier for your body to break down and absorb. It can be challenging to cut out entire groups of foods. The diet may also put you at risk for malnutrition and unhealthy weight loss. If your provider thinks this is the best dietary approach for you, they can help you get started.