Thursday, December 18, 2008

Specific Carbohydrate Diet: Facts

Ok, if you have Crohn's Disease, you can't avoid hearing about The Specific Carbohydrate Diet, mostly because the proponents of this diet are anything but quiet about it. I personally have strong feelings about this diet, but I've decided to post the facts, followed by my opinion and let you decide for yourself:

The Facts
  • "There's little scientific evidence to show whether it is truly effective or which patient population it helps."
  • "It's getting mixed reviews from both patients and physicians."
  • Some people are actually helped by this diet, and are vocal supporters. But the percentage of people it helps versus people it does not help is unknown.
  • There is the potential for nutritional deficiencies on this diet.
  • You should never stop current treatments and replace them with trying a new diet plan.
  • You should always consult your doctor and continue regular monitoring when trying a new diet plan.
Source: http://www.ccfa.org/about/news/scd

My Opinion
  • This blog receives frequent comment-spam and emails trying to blatantly push the Specific Carbohydrate Diet, as well as some that are vague and friendly, but if you follow their links or suggestions far enough it leads to SCD websites. This makes me suspicious. And annoyed. *
  • Different diet plans help or bother people differently. Two people with Crohn's Disease may have totally different food sensitivities. The SCD may in fact just happen to coincide with what helps some people. Just like my diet of no dairy, fibre, spice, acid, caffeine, or gassy vegetables helps me.
  • Keeping a food and symptom journal will help you determine foods that worsen or improve your symptoms. Take this journal to your doctor for help analyzing it.
So, to be clear, I do NOT recommend the Specific Carbohydrate Diet. I tend to be practical and if there's no science behind it, and the people running the websites for it have to resort to spamming blogs and forums to get recognition, then I just can't see it as credible. That being said, if you're curious about it or any other diet plan, or curious to study your own food tolerances, talking to your doctor should be priority number one.

Now, all you SCD fans out there, feel free to post your stories here, but DO NOT include links. Note that I will NOT publish SCD slanted comments in other posts on this blog, so you can stop spamming this blog already.

* Let the comment flaming begin. Note that I will NOT publish comments that contain SCD links. Period.

8 comments:

  1. Wow. Your blog, your opinion and a strong one at that. Which I respect. However, I will simply share a positive experience if I may. Without links. I have followed the diet for almost 2 yrs. At the time, it was simply sheer desperation as the meds were having no effect and I was at my wits end. I don't believe in fad diets and all that hoopla. I just figured, what is the worst that could happen. I'll try it for a month and see if there is any improvement. Well 48 hrs in, the bleeding stopped, 1 week later the mucus decreased. 2 weeks, the pain was almost gone. 2 months and my toilet visits were down to 4 or 5 a day. 6 months later I was off my meds (my choice, the book never recommends stopping meds without doctors advice) and have been for a long time. My last physical had my doctor scratching his head, he does not believe in the diet but he said my blood was amazing, my hemoglobin so high he was flabbergasted. Now scientifically speaking I don't know if the diet has merit as I am not doctor but I know it worked for me. And as a person who suffered the pain of Crohn's naturally I would want others to know what did work for me just in case one other person could be spared. Nothing wrong with that.

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  2. Perhaps one of the reasons people are staying away in droves from this comment area is your inappropriate rudeness (for example, calling people “spammers”) to people who are reaching out to you with sincere concern. Most people I’ve encountered through my own research of the diet have been generous, inquisitive, and caring. They are also open-minded, and willing to think “outside of the box.”

    The feeling of suspicion you described is mutual. What possible interest could YOU have in squashing and censoring information about the SCD?

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  3. *sigh* I am not referring to people with legitimate comments (like the first one above) as spammers. However when I receive several comments in the format of one generic sentence like "Nice blog!" followed by half a dozen links to SCD related websites, then yes... I call that spam. Because, that's what spam looks like. If you have an actual story of your experience, good or bad with the SCD then I'm happy to accept them. And no, people are not "staying away in droves", you may notice that I only average a couple comments per blog post, so this one, is right about average.

    You may also notice that I am NOT squashing information about the SCD, because if you look above you will see I provide a link to the Crohn's and Colitis Foundation of America's article on the SCD, which I consider to be the most reputable resource for information on Crohn's.

    Rather than posting passionate but incorrect comments to defend the SCD from my legitimate concerns, how about telling us about some studies or research supporting this diet for Crohn's sufferers? Or about your own experiences.

    This is exactly my point.

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  4. Alright. I’ll do my best to provide some science. Studies are only in the planning stages as yet (I think) because there are not a lot of drug companies anxious to fund them. I've already provided my personal experience (awhile ago), but it was rebuffed because of the links that accompanied it. To sum that up, the diet worked for me.

    Anyway, here is a description of the science behind the SCD diet, from the Breaking the Vicious Cycle website:
    “The foods that are allowed on the Specific Carbohydrate Diet are based on the chemical structure of these foods. Carbohydrates are classified by their molecular structure.
    The allowed carbohydrates are monosaccharides and have a single molecule structure that allow them to be easily absorbed by the intestine wall. Complex carbohydrates which are disaccharides (double molecules) and polysaccharides (chain molecules) are not allowed. Complex carbohydrates that are not easily digested feed harmful bacteria in our intestines causing them to overgrow producing by products and inflaming the intestine wall. The diet works by starving out these bacteria and restoring the balance of bacteria in our gut.
    The Specific Carbohydrate Diet is biologically correct because it is species appropriate. The allowed foods are mainly those that early man ate before agriculture began. The diet we evolved to eat over millions of years was predominantly one of meat, fish, eggs, vegetables, nuts, low-sugar fruits. Our modern diet including starches, grains, pasta, legumes, and breads has only been consumed for a mere 10,000 years. In the last hundred years the increase in complex sugars and chemical additives in the diet has led to a huge increase in health problems ranging from severe bowel disorders to obesity and brain function disorders. We have not adapted to eat this modern diet as there has not been enough time for natural selection to operate. It therefore makes sense to eat the diet we evolved with.
    The Specific Carbohydrate Diet was clinically tested for over 50 years by Dr Haas and biochemist Elaine Gottschall with convincing results. From feedback from the various lists and other information at least 75% of those who adhere rigidly to the diet gain significant improvement.”

    From SCD Recipe dot com regarding the original SCD diet book:
    Motivated by success in treating her two sons with the specific carbohydrate diet--ones son with autism, the other with Crohn's--a mother in Washington state has painstakingly worked with lawyers and publishers to reprint the Management of Celiac Disease by Dr. Haas, the originator of the specific carbohydrate diet.
    Originally published in 1951 and previously only available in medical school libraries (or on ebay for $950+), the American Medical Association's journal, the Archives of Internal Medicine, reviewed the book as follows:
    “This timely monograph by Dr. Sidney V. Haas, who introduced banana feeding in the therapy of celiac disease, and his son represents the most extensive report published thus far on the subject. The first two-thirds of the book deal with the historical aspects of the problem, the various theories of etiology, and the methods of treatment proposed by different workers in the field. The remaining pages are devoted to the authors' own experience and opinions.
    On the whole, the subject is treated comprehensively and objectively. The writers' style is clear and direct, and their approach to controversial aspects of the problems of celiac disease is fair and judicious.”

    Source: AMA Archives Internal Medicine 1952;89(1):165
    This is a comment from Raman Prasad, who runs the SCD Recipe dot com site: “For those interested in the background of intestinal disease--before recent headlines, this is a great book. Only now is some of today's research money targeting the areas in which Dr. Haas's book left off.”

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  5. Thank you for providing some information. It's interesting to read about the philosophy about how the diet is structured, and I agree that processed foods are causing a whole slew of problems. However, it seems odd that the diet is also mentioned for Autism and Celiac Disease, which are quite different than Crohn's.

    There are also some contradictions in the diet as mentioned in the CCFA article. And the lack of scientific research is a problem- though understandable since as you say, drug companies don't like to fund research for something as simple (and unmarketable) as a diet plan.

    That said, Crohn's is such that different foods will trigger differently for each person. If the SCD diet helps someone, then by all means, stick to it! Just don't stop your current treatments without the advice of a doctor.

    I'm not on some kind of anti-SCD crusade, I am just bothered by blanket unsubstantiated claims, and by spammy behavior. I admit that after a dozen or so obvious SCD spam comments, I started just deleting most comments that mentioned the SCD. If anyone who previously posted their story would like to re-do so again without links, I will happily publish it.

    One final word from me- I hope all my readers will experiment with new diets or treatments ONLY after consulting with their doctor. After that, if it works for you, excellent!

    Cheers.

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  6. Hi I have a comment about this. I tried this diet a year ago and at first I felt a little better but then I got a ton worse. I talked to my doctor and he put me on a low fiber and residue diet that helped a bit. I agree that different food plans help different people. I think that is why Crohns is so hard to treat because everyone is different. Even the drugs don't affect people the same. I don't know anything about the spamming stuff because I don't have a blog. :)

    Thanks for this blog- I read all you're posts.

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  7. I have a 9 yr old daughter that was just diagnosed with Crohn's disease. Since her diagnosis, I have spend in excess of 50 hours researching both the natural approach to treatment and the medical approach. She was put on Prednisone and the elemental diet and was completely symptom free in 2 days though it it likely going to take much longer than that for the intestines to heal. I understand that the Prednisone is probably the biggest contributor to stabilizing the condition.
    However, looking back, I see that her condition was growing over a period of at least 6 months so it's not as though this came on in a swift attack on the intestines. Now that she is symptom free and under the monitoring of a doctor, what would be the harm it trying a natural means to correct the problem. The doctor has already informed me that on medication, there is no guarantee that she will not relapse and in most cases, the patients do and will eventually require surgery. So, if I don't medicate her condition, she will likely relapse and if I medicate, she will likely relapse but it may take longer.
    So if the medication can't provide a reasonable success, why not try a natural theory first? If we do everything at the same time, and it works, who will ever know what the key factor was? Though if a diet is able to keep things under control, why would I subject a developing child to harsh medications that some of the side effects (though rare) are worse that Crohn's disease itself.
    My question is what is the harm in trying? There is no guarantee either way so why can I not try the least dangerous path first and go from there?

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  8. Hello Anonymous,

    Thank you for your comment and your story. I have nothing whatsoever against trying a diet based approach to managing your IBD. In fact, I strongly recommend that people keep a food journal and give a real effort to finding their trigger foods so they can eat smart and avoid aggravating their condition.

    What I have an issue with is the SCD's claims that they are a 'cure'. It is not a cure. It might help some people to attain remission, but claiming to be a cure is slimy at best. As long as you are being wise about your diet experiments, and following the advice of your doctor - I think trying a diet based approach is a great idea. Certainly better than continuing to eat a ton of trigger foods and medicating yourself up to the ears!

    Be safe, smart and cautious is all I'm saying.

    ~Bright Side

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