Specific Carbohydrate Diet
The specific carbohydrate diet (SCD) is a diet for children on the spectrum who have major gut issues, such as inflammation, constipation or diarrhea, or abdominal pain. It is based on the book, “Breaking the Vicious Cycle” by Elaine Gottschall, and anyone who attempts this diet must buy and read that book. It is also recommended that you join one of the Yahoo groups devoted to the subject, such as Pecanbread, or Elaine’s Kids.
This diet is based on the fact that when the gut is inflamed, many of the naturally occurring digestive enzymes in the gut are gone, and foods cannot be digested normally. The most common enzyme deficiency is the disaccharidase enzymes. This class of enzyme’s job is to split di-saccarides (two sugar molecules hooked together) into mono-saccharides (a single sugar molecule). All of these sugar compounds are carbohydrates, but only monosaccharides can be absorbed easily, and don’t require enzymes for digestion. So the SCD is basically a disaccharide-free diet. Unfortunately, all starches are disaccarides – such as all grains (even GF/CF grains), potato, rice, corn, table sugar, etc.
The only naturally occurring monosaccharides are found in fruit and honey and vegetables. So the SCD is mainly meat, eggs, fruit, non-starchy vegetables, nuts, honey, and soaked and cooked white navy beans. I think of it as a kind of “cave man” diet – it is very similar to what a cave man would have eaten. This diet is actually very healthy when done properly. The fruit and vegetable smoothie recipe on this website (Connor’s “Milkshake”) is SCD compliant. Finding tasty recipes can be a challenge, but there are good internet sources for that. My son did this diet for almost two years, and loved slivered almonds sautéed in Ghee and honey over low heat, until coated and lightly browned for a crunchy and sweet snack.
The book was originally written for colitis patients and not autistic patients, so it calls for 24-hour fermented yogurt, and allows some kinds of cheese, which of course contain casein. I recommend doing the SCD without the yogurt and cheese for most kids, although there are some that are able to add these in as the gut heals. However, some will still react to the casein, so use caution.
Unfortunately, a lot of the foods on SCD are high in Oxalates (such as the nuts and some vegetables). It is still difficult to know in advance which child needs SCD and which child would benefit more from LOD. Try not to go too heavy on the nuts on this diet until it is clear how the child is responding. It may take 2-3 weeks before any improvement in obvious GI function is noted (i.e. “trophy poops”), but some respond sooner. Overall, this diet can be a god-send for some patients, so it is worth a try.