The specific carbohydrate diet (SCD), popular among patients with inflammatory bowel disease (IBD), is associated with distinct changes in the intestinal microbiome, researchers at Rush University have found.
Link to these important findings in a dowloadable document written in the Journal of the Academy of Nutrition and Dietetics, August 2015, Volume 115, Issue 8, pages 1226-1232. The article is written by Samir Kakodkar, MD, gastroenterology fellow, Azam J. Farooqui, MD, resident in internal medicine, Sue L. Mikolaitis, MS, RDN, dietitian and research coordinator, and Ece A. Mutlu, MD, MSCR, MBA, associate professor of medicine, Department of Medicine, Section of Gastroenterology, Hepatology, and Nutrition, Rush University, Chicago, IL.
If you are not on the SCD and would like to participate in a clinical trial, follow this link: Clinical Trial Title:
The Specific Carbohydrate Diet: Does it change the intestinal microbiota and metabolome?
SCD Yogurt More Potent Than Commercial
The excerpts below are from the website GutHarmony.net, which is a blog about living with and working with the SCD. The author talks about her friend who periodically tests samples of her own SCD yogurt, in this January 9, 2017 post.
"Morana has a PhD. in molecular biology and prepares SCD yogurt for her whole family on a regular basis... Being a scientist by profession, a dedicated parent, and, as she admits, a bit of a perfectionist, Morana periodically sends SCD yogurt samples to be checked in a specialized lab in Switzerland. The lab is called SQTS (Swiss Quality Testing Services) and they also test commercial yogurts. Morana was told by the lab that commercial yogurt normally contains around 5,000 000-10,000 000 CFU/gram Lactobacilli and around 20,000,000 CFU/gram Streptococcus, so as you can see below SCD yogurt is much more potent! Morana notes regarding the lab results below, “I was comparing different starters and times of incubation. However, I have to add I omitted to test for Streptococcus thermophilus in addition to Lactobacilli (I have just found out this lab can do that, too) and I am planning on doing that soon. I hope the probiotics count will be even higher then.”
... In Conclusion
"Note the wide variations in bacteria counts in different yogurt preparations. This is enough to merit large scale SCD yogurt testing and analysis. Clearly different SCD dieters ingest different amounts of probiotics based on how they prepare their yogurts. This might explain some of the variations in the efficacy of SCD on different dieters. It can also help us determine what the best methods and starters are to ensure maximum bacteria present in the yogurt many of us prepare diligently. If we already bother with home preparation of this staple – we should know what parameters will help yield ideal results."
Read entire blog post here.
A Harvard-led study released in March, 2014, examined the intestinal bacteria of 447 children newly diagnosed with Crohn's disease (CD). These children had not yet received Crohn's specific treatment. Compared with 222 healthy control subjects, the study found:
The study included a large sample size drawn from 28 North American GI centers--making it the most statistically relevant study of its kind.
Link to info about this 2014 study.
Research from JPGN
Journal of Pediatric Gastroenterology and Nutrition, June 2004, Volume 39
After sharing two case studies of children who were symptom free after following the SCD, JPGN reaches this conclusion:
"Conclusion: The apparent effectiveness of the Specific Carbohydrate Diet in Crohn’s Disease warrants more study. There is current interest in the manipulation of intestinal flora using probiotics and prebiotics. If this diet works by changing the bacterial flora of the bowel, then it adds weight to the role of bacteria in the pathogenesis of Crohn’s Disease."
Read complete article.
Seattle Children's Hospital
Follow this link to read the complete article from December 2016 about the groundbreaking SCD Study at Seattle Children's Hospital. Excerpts below are quoted from the Seattle Children's Hospital website. Seattle Children's now sends home information about the SCD with any child diagnosed with an irritable bowel disease, offering it as a drug-free way to heal.
"Can diet alone be used to treat Crohn’s disease and ulcerative colitis (UC)? It’s a question Dr. David Suskind, a gastroenterologist at Seattle Children’s, has been researching for years.
Today, he finally has the answer: yes.
In a first-of-its-kind-study led by Suskind, published today in the Journal of Clinical Gastroenterology, diet alone was shown to bring pediatric patients with active Crohn’s and UC into clinical remission.
“This changes the paradigm for how we may choose to treat children with inflammatory bowel disease,” said Suskind.
In the small, prospective study, patients were put on a special diet called the specific carbohydrate diet (SCD) for 12 weeks as the sole intervention to treat their Crohn’s or UC. SCD is a nutritionally balanced diet that removes grains, dairy, processed foods and sugars, except for honey. The diet promotes only natural, nutrient-rich foods, which includes vegetables, fruits, meats and nuts.
At the end of the 12 weeks, eight out of the 10 patients who finished the study showed significant improvement and achieved remission from the dietary treatment alone."
Read complete article.
Read a portion of an interview with David Suskind, MD, author of the study, published February 2014 by On the Pulse:
Interviewer: What else are you working on?
David Suskind, MD: "I’m writing and editing a guidebook on the Specific Carbohydrate Diet, which has been around for more than 100 years. The diet was started by a pediatrician, Sidney Haas. It was used for celiac disease, and it worked really well. It involves taking all grains out of your diet.
The diet has been out there, quietly being used in IBD, but it hasn’t been used in any formal or consistent way. Over the years I have met a number of individuals on the diet, including children at the hospital. Their positive results sparked my interest. We recently published a paper on our patients and their response to the diet. Currently, we have integrated the diet into our IBD Center.
There is much to look forward to in managing and curing gastroenterological disease and I am excited to move forward to make this happen for our patients and their families."
"On a sunny April day in Seattle a new milestone in the science of “diet as medicine” was reached, as Seattle Children's Hospital held its 7th Nutrition Symposium: Nutrition in Immune Balance: Using Diet to Treat Inflammatory Bowel Disease." Read more...
“The PRODUCE Study is going to be a true game changer in how we view IBD and how we take care of patients” – David Suskind
A Groundbreaking Study to Examine Dietary Treatment for IBD
"...Suskind, as part of the ImproveCareNow (ICN) team, is launching a much larger potentially groundbreaking new SCD Study called the PRODUCE study. “We’re hoping to show exactly how the diet changes the microbiome and quiets down the immune system,” Suskind says. The study began recruiting participants in May, 2018.
What is the PRODUCE Study? The PRODUCE Study, which stands for Personalized Research on Diet in Ulcerative Colitis and Crohn’s Disease, is a first of its kind when it comes to studying nutrition intervention in inflammatory bowel disease. The study seeks to determine the effectiveness of the SCD diet in reducing symptoms of IBD, compared to a modified form of SCD.
Unlike previous smaller studies, the PRODUCE study involves multiple ImproveCareNow (ICN) centers (12 centers) with 120 patients. The intervention is exclusively dietary."
Read the entire post about the PRODUCE STUDY on Caleb's Cooking Company blog. Information can also be found here and here.
"Diets come and go, but the Specific Carbohydrate Diet (SCD), which originated almost 100 years ago, remains very popular among many people with inflammatory bowel disease (IBD). Although it's challenging to follow — SCD restricts most carbs — people with IBD say it can alleviate symptoms and even bring about remission.
Now, the first ever large-scale controlled study on the diet is about to begin, raising hopes that doctors will start taking it more seriously.
“The impetus for the study is that patients have been asking for it,” says James Lewis, MD, associate director of the inflammatory bowel disease program at Penn Medicine in Philadelphia, and principal investigator on the study.
The Patient-Centered Outcomes Research Institute last year awarded the Crohn’s & Colitis Foundation $2.5 million to assess whether the SCD or the Mediterranean diet can bring about remission in people with Crohn’s.
Despite the (SCD) diet’s popularity, most gastrointestinal doctor's have paid it little attention, given the lack of scientific evidence to back it up. There are relatively few studies on the role of diet in IBD generally, partly because, as many doctors state, pharmaceutical companies have nothing to gain by financing them.
But Lewis says scientific interest in diet has grown since the Human Genome Project isolated the genetic parts of the genome associated with the risk of developing IBD.
“If you look at these genes, many of them are connected to the way our immune system relates to bacteria and other microorganisms. That has led to a huge interest in the microbiome, which in turn is triggering interest in diet and nutrition,” she says. “What we eat is feeding our microbiome.”
Colleen Webb, RD, of the center for inflammatory bowel disease at the Weill Cornell Medical Center in New York City, believes the study will be particularly useful because it compares the benefits of two healthy diets. Many of her patients are passionate about the SCD, she says, because “the fact is, it often works.” Anecdotal information on its merits has been around for years, she says, but now “patient-reported outcomes are really building. We can no longer ignore it.”"
Read the entire article here.
"NEW YORK, NY – For the first time ever, dietary intervention will be the focus of a major national research study of patients with Crohn’s disease. The Crohn’s & Colitis Foundation of America (CCFA) announced today that it was awarded $2.5 million from the Patient-Centered Outcomes Research Institute (PCORI) to study the effectiveness of the specific carbohydrate diet and Mediterranean-style diet to induce remission in patients with Crohn’s disease. A patient-generated research question posed through CCFA’s patient-powered research network(PPRN), CCFA Partners, served as motivation for this study concept. "
"The study seeks to compare the effectiveness of the specific carbohydrate diet and a Mediterranean-style diet in inducing symptomatic and clinical remission and in reducing the mucosal inflammation in patients with active Crohn’s disease. The specific carbohydrate diet was selected because of its popularity among patients and the evolving medical literature suggesting potential therapeutic benefit. The Mediterranean-style diet was chosen as the alternative diet based on the strong evidence of its role in overall health, indirect evidence suggesting a potential benefit for Crohn’s disease, and easier implementation in routine life."
"Patients will enroll in the clinical trial at local clinical sites and will be randomly assigned to one of the diets. Meals will be provided at no cost for six weeks through a meal delivery service, Real Food Works, and patients will have the opportunity to continue purchasing meals afterward. Patient-reported outcomes will be used to assess disease activity on a weekly basis using the CCFA Partners infrastructure. Disease activity will also be assessed by the treating physician before the study begins, at six weeks, and 12 weeks. Mucosal inflammation will be assessed by measuring the concentration of calprotectin in the feces at baseline, six weeks, and 12 weeks."
As an infant, Jack Woodward suffered from reflux. As he grew older, his abdominal problems always seemed to be present, including diarrhea and stomachaches. The symptoms steadily worsened and in October 2010, at age 7, he could barely move because of abdominal pain. His mom Gisele made urgent calls to doctors near their home in Charleston, South Carolina, but no one would give an appointment earlier than 6 months...
...From ages 7 to 8, Jack's symptoms were more manageable on medication but he stopped growing. In October of 2011, Dr. Gold ordered more diagnostics, including an endoscopy and colonoscopy. The tests showed inflammation not only in Jack's colon but also his small intestine. As a result, Jack's diagnosis was switched from ulcerative colitis to Crohn's disease ...To make matters worse, in February of 2012, five months after Jack's diagnosis of Crohn's, his older sister Kristina was diagnosed with ulcerative colitis. ... Serendipity intervened. Jack and Kristina's visits to Dr. Gold coincided with the start of an SCD pilot study. Dr. Gold explained to Gisele how the SCD had helped other patients in his practice.
...After careful consideration, the family decided that both Jack and Kristina would start the SCD together. Although they didn't participate in the study, they followed the same protocol and stayed under Dr. Gold's medical supervision. The family went through the hard work of understanding the diet, reading labels, and reconfiguring their household food supply.
Six months later, the effort started showing results. If you remember, Jack had stopped growing for one year, during ages 7 and 8. He literally fell off the growth chart for children his age. The inflammation from Crohn's had impaired his body's ability to absorb critical nutrients. But during the first six months on the SCD, something changed. His intestines started to heal, his body began to absorb nutrients, and he grew an inch. One inch in 6 months! His parents sighed with relief, the team at Children's Healthcare in Atlanta celebrated, Jack was getting better ... Kristina fared even better, her symptoms resolved by 6 months. Three and a half years since starting the diet, Kristina has remained completely prescription-free while Jack's medication is limited to Pentasa. They have both grown taller and gained weight--although Jack has not completely compensated for his sickest year when his growth had stopped."
The children enrolled in the study also thrived on the SCD. In the October 2014 issue of the Journal of Pediatric Gastroenterology & Nutrition, the researchers noted "clinical and mucosal improvement" at both 12 weeks, and for those who continued, at 52 weeks. More specifically:
Note: Taking into consideration their own bias toward the SCD, the researchers used an independent evaluator to review the clinical results."