Breaking the Vicious Cycle - Intestinal Health Through Diet
by Elaine Gottschall BA, MSc

The book describes the Specific Carbohydrate Diet (SCD) which was formulated by Drs Sidney and Merrill Haas. Carbohydrates can be divided into three main categories namely monosaccharides, disaccharides and polysaccharides. The SCD advocates eating only monosaccharides and the book explains in detail the reasons why such a diet has been successful for many patients with bowel problems including Crohn's Disease, Ulcerative Colitis, Coeliac Disease and Diverticulitis. It likens the diet to that of the elemental diet which has often been beneficiary for IBD patients.

The theory on which the diet is based claims that if the normal equilibrium of bacteria in the colon is disturbed for any reason, its microbes can migrate into the small intestine and stomach hampering digestion, competing for nutrients and overloading the intestinal tract with their waste products. Once bacteria multiply within the small intestine a vicious cycle develops characterised by an increase in the production of gas, acids, and other products of fermentation which perpetuate the malabsorption problem and prolong the intestinal disorder. A harmless form of warfare on the aberrant population of intestinal microbes is to manipulate their energy (food) supply through diet. Most intestinal microbes require carbohydrates for energy and the SCD severely limits the availability of carbohydrates. By depriving intestinal microbes of their energy source, their numbers gradually decrease along with the products they produce.

This deprivation is carried out by the elimination of di- and polysaccharides from the diet as these carbohydrates have to be broken down into monosaccharides in the small intestine before being digested. Whilst this is happening any microbes present are gorging themselves and multiplying. To protect itself from this proliferation of microbes, the gut produces excess mucus which can eventually lead to ulceration. The SC Diet presents a method for breaking the cycle by maximally nourishing the individual and minimally nourishing the intestinal microbes. By this method, undesirable stresses on the intestine decrease.

The diet is based on the principle that specifically selected carbohydrates, requiring minimal digestive processes are absorbed and leave virtually none to be used for furthering microbial growth in the intestine. As the microbial population decreases due to lack of food, its harmful by-products also decrease, freeing the intestinal surface of injurious substances. No longer needing protection, the mucus-producing cells stop producing excessive mucus and carbohydrate digestion is improved. Malabsorption is replaced by absorption. As the individual absorbs energy and nutrients, all the cells of the body are properly nourished, including the cells of the immune system which then can assist in overcoming the microbial invasion.

The second half of the book lists foods which are acceptable on the SCD and those which are not. Various recipes are included which can replace common everyday recipes. In brief, the diet allows fruit, nuts, non-starchy vegetables, honey, butter, fresh juices, some hard cheeses and protein foods such as unprocessed meat, fish and eggs. Disallowed are all grains, cereals, rice, bread, potatoes, milk, soft cheeses, yoghurt, margarine, processed meats, all pre-sweetened foods and drinks and all foods containing any of these sugars and starches (which automatically eliminates most restaurant meals, fast foods and pre-packaged sauces and foods). As can be seen, this is an extremely restrictive diet and one in which no half measure could be allowed. No specific time limits are stated in the book although it does suggest that improvement should be noticed within a week or two and refers to periods of a couple of years on the diet before gradually reintroducing restricted foods to see if they can be tolerated.