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5 reasons we don't typically recommend the SCD diet

5 reasons we don't typically recommend the SCD diet

Updated on
August 18, 2023
Medical reviewer
Medically reviewed by
Brittany Rogers, MS, RDN
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Written by
Romanwell Dietitians

Important note: As with any discussion about diet, it’s important to remember that there’s no one size fits all approach to diet that works for everyone. If you’re currently on the SCD and you’re (1) working closely with your gastroenterologist and IBD-focused registered dietitian, (2) the diet has been helping you, and (3) you don’t feel restricted - great! Keep doing what you need to do to feel your best. However, if you do feel restricted on your current diet or feel that it’s not sustainable, you may find this post helpful.

Have you heard of the specific carbohydrate diet (SCD)? The specific carbohydrate diet is a whole foods diet that eliminates all grains, certain starches, and most milk products.

In this post, we share 5 reasons why we typically don't recommend the SCD for people with Crohn's disease or ulcerative colitis. 

1. There’s insufficient research to recommend its use

The 2023 dietary guidelines do not recommend the SCD for induction or maintenance of remission in individuals with Crohn’s disease or ulcerative colitis due to the current lack of research supporting its use.

2. It didn’t outperform the Mediterranean diet

The largest and highest quality study we have on the SCD found that it didn’t outperform the Mediterranean diet in helping people with Crohn’s disease achieve symptom remission (when you don’t have symptoms but may still have inflammation).

Since the Mediterranean diet is more expansive, researchers recommend trialing that diet over the SCD when possible. Both diets helped about 45% of Crohn’s disease patients reach symptom remission.

3. It doesn’t consider food preferences including certain cultural foods

Rice, for example, is a staple of many traditional cultural cuisines and is sometimes consumed multiple times per day. Restricting or eliminating foods like these may make one feel restricted on their diet.

When everyone at home eats a traditional meal with rice, and you can’t, that can lead to decreased food-related quality of life.

(Note: most prescriptive diets don’t consider your food preferences or cultural influences on food so this is not an SCD-specific drawback, but rather a challenge with most diets).

4. It may lead to increased fear of certain foods

The list of “illegal” foods on the SCD may increase fear around eating those foods, when in reality, we don’t have sufficient evidence that supports complete restriction of any particular food at this time.

5. It’s not nutritionally complete diet

Due to the exclusions of certain foods, individuals following the SCD are at an increased risk for nutrient deficiencies, unless they are followed closely by an IBD-focused registered dietitian and gastroenterologist.ď‚Ž

Work with an IBD-focused dietitian

If you feel restricted on your current diet and want help implementing a non-diet approach to food that keeps your diet expansive and nutritionally complete, reach out to learn how we can help.

Our IBD-focused registered dietitians can help you safely and sustainably expand your diet to include the foods and meals you love without triggering your symptoms.

Request a call to learn if our IBD nutrition program is right for you.

References

  1. Bischoff SC, Bager P, Escher J, Forbes A, HĂ©buterne X, Hvas CL, Joly F, Klek S, Krznaric Z, Ockenga J, Schneider S, Shamir R, Stardelova K, Bender DV, Wierdsma N, Weimann A. ESPEN guideline on Clinical Nutrition in inflammatory bowel disease. Clin Nutr. 2023 Mar;42(3):352-379. doi: 10.1016/j.clnu.2022.12.004. Epub 2023 Jan 13. PMID: 36739756.
  2. Lewis JD, Sandler RS, Brotherton C, Brensinger C, Li H, Kappelman MD, Daniel SG, Bittinger K, Albenberg L, Valentine JF, Hanson JS, Suskind DL, Meyer A, Compher CW, Bewtra M, Saxena A, Dobes A, Cohen BL, Flynn AD, Fischer M, Saha S, Swaminath A, Yacyshyn B, Scherl E, Horst S, Curtis JR, Braly K, Nessel L, McCauley M, McKeever L, Herfarth H; DINE-CD Study Group. A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn's Disease. Gastroenterology. 2021 Sep;161(3):837-852.e9. doi: 10.1053/j.gastro.2021.05.047. Epub 2021 May 27. Erratum in: Gastroenterology. 2022 Nov;163(5):1473. PMID: 34052278; PMCID: PMC8396394.
  3. Fitzpatrick JA, Melton SL, Yao CK, Gibson PR, Halmos EP. Dietary management of adults with IBD - the emerging role of dietary therapy. Nat Rev Gastroenterol Hepatol. 2022 Oct;19(10):652-669. doi: 10.1038/s41575-022-00619-5. Epub 2022 May 16. PMID: 35577903.

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