The diet is based on the fact that
starches and sugars require the lining of the small intestine to break them
down for absorption. If the enzymes on the surface of the small intestine are
damaged or impaired, carbohydrates are available to intestinal bacteria and
yeast to multiply in a vicious circle. The proposed mechanism is that the
surface of the small intestinal wall is damaged leading to impaired digestion
and malabsorption of disaccharides (two carbon sugars
such as lactose, sucrose, maltose, etc.). Since the sugar is not broken down
and absorbed, it becomes available for fermentation by bacteria and yeast,
which overgrow in the presence of abundant sugar. Toxic by-products of bacteria
and yeast injure the lining of intestine and enzymes necessary for carbohydrate
digestion and absorption. The cycle begins again... Excessive mucus (along with
the cells that secrete mucus - goblet cells) may also be produced as the body
tries to protect itself.
Carbohydrates can be categorized into single
sugars (called monosaccharides) that
require no digestion in order to be transported from the intestine into the
blood stream. They are glucose, fructose, and galactose.
Double sugars (called disaccharides) require splitting into the
single sugars glucose, fructose or galactose by
intestinal wall enzymes. The four main disaccharides are lactose (found in
milk), sucrose (table sugar), maltose and isomaltose
(found in corn syrup, malted foods, and candies). The two types of starches
(called polysaccharide) are amylose and amylopectin and are made up of long strands of sugars. Amylose contains straight and unbranched
chains of sugars while amylopectin is branched. Amylopectin is harder to digest and therefore especially a
problem when there is damage to the intestinal enzymes. Fiber is a
starch for which man does not have the intestinal enzyme to digest.
Impaired digestion of sugars have been
found in celiac disease (gluten enteropathy),
soy-protein intolerance, cow's milk protein intolerance, diarrhea in infancy
and children, intestinal parasite infections (Giardia),
cystic fibrosis, and Crohn's disease. Lactose
intolerance represents a common form of this condition in which lactase, the
enzyme that breaks down milk sugar (lactose) is damaged, impaired, or absent.
Unknown to most doctors is that often there is a combination of affected
enzymes. Some starchy foods that were assumed to be digested completely are, in
fact, incompletely digested by most "healthy" people.
The Specific Carbohydrate Diet is a method
to break the cycle of malabsorption-overgrowth-injury.
It has been reported to help Cystic Fibrosis, Celiac Sprue,
Crohn's Disease (Regional enteritis), autism,
functional diarrhea, Irritable Bowel Syndrome,
Ulcerative Colitis, and yeast overgrowth.
In following the diet it is almost as
important to remember that what is not eaten is as important as what is
eaten. Fanatical adherence for at least one month is required.
This concept has been derived from Elaine Gottschall's book, Breaking the Vicious Cycle. I
encourage you purchase her book.
ALLOWED: All fresh or frozen organic beef, lamb, pork,
poultry, fish, and shellfish. Canned fish. Eggs. Natural cheddar
cheese, Colby cheese, Swiss cheese, brick cheese, uncreamed
dry curd cottage cheese.
AVOID: Processed meats such as hot dogs, bologna, turkey
loaf, spiced ham, breaded fish, canned meat if they
contain starches such as whey powder, lactose, sucrose, etc. Processed cheeses
and cheeses not listed in left column.
ALLOWED: Fresh or frozen artichoke (not Jerusalem type),
asparagus, beets, dried white navy beans, lentils, split peas, broccoli,
Brussels sprouts, cabbage, cauliflower, carrots, celery, cucumbers and dill
pickles, eggplant, garlic, kale, lettuce of all kinds, lima beans, mushrooms,
mustard, olives, onions, parsley, peas, pumpkin, spinach, winter and summer
squash, string beans, tomatoes, turnips, watercress. Cold pressed vegetable
AVOID: No grains such as arrowroot, barley, buckwheat,
bulgur, corn, millet, oats, rice, rye, triticale, or wheat. No flour, germ,
pasta, starch, or cereal products from these. Potatoes (white
or sweet), yams or parsnips. Beans (sprouts, soybeans,
mung, fava and garbanzo).
Amaranth flour, Jerusalem artichoke flour or powder, quinoa
flour, or other grain substitutes such as cottonseed, tapioca, sago.
Seaweed, margarine, chocolate, carob
ALLOWED: Fresh raw, cooked, frozen, or dried apples,
avocados, apricots, ripe bananas, berries of all kinds, cherries, fresh or
unsweetened shredded coconut, loose dates that do not stick together (glazed or
with added sugar), grapefruit, grapes, Kiwi, kumquats, lemons, limes, mangoes,
melons, nectarines, oranges, papayas, peaches, pears, pineapples, prunes, dark
raisins, rhubarb, and tangerines.
AVOID: Canned fruits. Dried fruit that
has been glazed with corn syrup or sugar such as many brands of banana chips.
Molasses, ketchup, agar-agar, carrageenan,
Raw or plain roasted almonds, pecans, Brazil nuts, filberts, hazelnuts,
walnuts, unroasted cashews and chestnuts. Peanut butter without any additives.
AVOID: Roasted peanuts or peanuts in salted mixtures. Beernuts, glazed
Tomato and vegetable juices.
Orange juice, bottled or canned grape juice, pineapple juice, some brands of
apple juice, weak tea or coffee or chicory, herbal teas
AVOID: Cow, goat, soy, rice, coconut milk products. Instant coffee or tea, Postum, coffee
substitutes. Beer, wine, tonic water, soda, etc.
For a sweetener - try raw tupelo honey,
black strap molasses, or fructose. I
have several e-mails of people disputing the use of these sweeteners based on
the original specific carbohydrate diet, but my own experience and patients
have used these in modest amounts without any problems.