Ruth posted - I am just starting out on this new adventure of the SCDiet. I am a bit scared of this whole situation and a bit uncertain about everything you have to do since I have had to sort of piece everything together from various websites and the book. I have a lot of questions.
1.Is everyone who is following the SCD program while they are taking medication? Answer - Yes, continue to take all your medications as prescribed. Medication is usually necessary, especially in the early years. SCD is an important component of digestive healing but it is not a substitute for consulting a physician. Digestive healing takes time and medications help buy that time.
2. I fear that the medication I am taking is perhaps not working well enough. I want to find a better way than the prospect of continuously moving on to stronger, more potent medications or even surgery. My gastroenterologist doesn't believe this diet will help, so I am kind of doing this on my own. Answer - Welcome! Glad you found us, sorry you had to. You have come to the right place for digestive healing. Thousands have been helped on SCD. Medical doctors are trained in the more urgent aspects of medical care. We on SCD do not think that doctors are currently getting adequate training in nutrition and our experience has been that even nutritionists and dieticians are not trained in the difference in the ease of digestibility of similar nutrients. For instance, a typical nutritionist will not distinguish between honey and sugar. From a nutritional point of view, both foods are sugars. However, on the SCDiet there is a world of difference between honey and sugar. Based on Elaine Gottschall's research, there is a major difference in ease of digestion between a monosaccharide (honey) and a disaccharide (sugar).
3. My doctor says the diet has not been researched. Answer - This diet was developed by a physician, Dr. S. Haas, who published a technical book in 1951 based on treating over 600 patients. Elaine Gottschall researched why his wonderful diet worked and then wrote her book, Breaking the Vicious Cycle.
4. So you are saying that while on the SCDiet, I should remain on my medication and then check along the way for improvement? Answer - Yes and continue to see your doctor and take other diagnostic tests as he or she directs.
5. I want to be medication free someday. When do most people lower their medications? Answer - There is no specific timetable. When you are completely symptom free for at least a year, you can consider gradually easing away from medications or down shifting to milder ones. Two years for ulcerative colitis. It is best to be conservative. The gut is a very long organ. The small and large intestine combined are about 27 -30 feet long. There can be relapses from going off medication too soon. Digestive healing is a very personal and individual process.
The Specific Carbohydrate Diet is complementary with traditional medical treatments. Continue to take all prescribed medicines while you are healing. Digestive healing takes time, lots of time. On the SCDiet, most of us started to feel better very soon and those awful symptoms: the gas, the bloating, the pain, the dashing to the bathroom were soon markedly reduced or eliminated.
The length of time it takes depends on how your body responds. Breaking the Vicious Cycle cautions (page 64 of the May 2010 edition) that certain medications have very specific procedures for how they are to be reduced. Always discuss these matters with your doctor.
6. I feel unsure as I am doing this on my own. Answer - Individual questions about SCD can be answered on the list serve http://health.groups.yahoo.com/group/BTVC-SCD. We wrote this wiki to try to cover every aspect life of using SCD as thoroughly as possible as a quick start guide. This is an old, established diet with a proven track record. Take a look at some of our success stories. See Success Stories - In Our Own Words
I have a question. Breaking the Vicious Cycle has long lists of allowable foods on the SCDiet. How do I know which ones to start with? How do I begin? Do people get their information about moving from stage to stage from pecanbread.com's diagram of stages to go through? Pecanbread.com is geared to kids. How do I keep all this straight in my head?
Answer - Even though pecanbread.com is designed for kids, some find using their stages handy. This website has many useful articles for those on the SCDiet. Elaine did not put in stages as she did not think they were necessary. Each food should be added one at a time, a little at a time to test for tolerances. Since we are all individuals with individual tolerances, in the end, it is somewhat a matter of trial and error.
Cheryl posted - I am looking to start with the Intro Diet. Do I eat the homemade yogurt while on the intro diet or do I wait until after? After the intro diet, do I just randomly follow the legal/illegal list? (legal and illegal have nothing to do with the law. They are the terms Elaine uses in her book for permitted or not permitted foods on the SCDiet). Is there an order of introducing foods? I am confused.
Response - Some people start by doing the Intro - that is a special chicken soup found on page 89 of Breaking The Vicious Cycle (May 2010 edition). While it is generally recommended, some do not do it and it does not really matter. If you do the Intro, just do the chicken soup for 2 days. Introduce yogurt gradually as with any other food.
Wendy posted - I have been making chicken soup all my life so I did not pay attention to a special recipe. I just started with chicken soup and other foods on the diet.
Marilyn posted - My intro was roast beef, roast pork and cooked zucchini because I was too sick to cook and these were the only things that I could direct my husband to make from my bed. To make a roast, all I had to tell him was to set the oven at 350 degrees F, and cook for 20 minutes per pound. Come to think of it, I can not remember how he made the zucchini? He is a very smart guy but he can burn water.
Do I need to use organic foods? Answer - No! Using organic foods are not necessary. Elaine intentionally did not specify organic foods because organic foods are not required for digestive healing with the SCDiet. She did not want anyone to feel excluded from healing with SCD because they could not access or could not afford organic foods. Eating organic foods is completely optional.
If you broke your arm, your doctor would put the arm in a cast to heal and you would not use that arm for a period of time until the bone has reset. Then there would be a period of time of physical therapy to regain full use of the arm. With digestive matters, one can not turn off the system. We have to continue to eat. The SCDiet is a selection of foods that have been analyzed not only for their nutritional value but for their biochemical structure to determine ease of digestibility.
How can I keep this all straight?
With SCD, what you do not eat is even more important than what you do eat. The basic principles of SCDiet can be put into two sentences. No starches, no grains and no sugar except honey and saccharine are allowed. In the beginning, all foods are cooked, peeled and seeded.
No Grains, No Starches and No Sugar Except Honey
No grains? Then it is okay if I can eat rice, right? Answer - No rice. Rice is a grain.
What about corn? Answer - No corn on SCD. Corn is a grain.
So there is no wheat, no rice, no corn? Answer - Correct. Also, no products that are made from these grains: no corn starch, no corn meal, no corn flakes, no wheat flour, no rice bran, etc.
What about soy? Answer - No soy products are allowed.
What about beans and lentils? Answer - Only those beans listed in the book are allowed. Also, be aware that beans and lentils are an advanced food and should not be tried in the early stages. Later, the beans allowed may be carefully introduced. It is important to note beans should be soaked, the soaking water discarded and then the beans rinsed again to get rid of water soluble starches.
Question - So no grains and no starches means there are no carbohydrates, right? Is this a no carb diet?
Answer - No, it is a specific carbohydrate diet. Some people confuse grains with carbohydrates. There are carbohydrates in vegetables, fruits, nuts and bananas. The SCDiet is targeted to digestive healing. Specific carbohydrates have been selected by a physician and Elaine's research that are easier to digest. Carbohydrates are either monosaccharides (simple sugars - fructose and glucose e.g. honey), disaccharides (sugars like table sugar - sucrose or milk sugar - lactose) or polysaccharides (starches such as wheat flour). In a proper digestion process, the polysaccharides and disaccharides are converted into monosaccharides.
Since monosaccharides are the easiest to digest, monosaccharides are SCD permissible. Disaccharides are to be avoided. As fruit ripens, the enzymes in the fruit break down the sucrose into monosaccharides. That is why only ripe fruit is allowed on the SCDiet.
Lactose is a sugar found in dairy and is not allowed on SCD. However, if the lactose has been consumed in the process of making aged cheeses (in general, the harder ones then it is okay. SCD foods includes a wide variety of aged cheeses. Yogurt is allowed on SCD if it has been processed for 24 hours so that the yogurt bacteria have completely consumed any lactose.
Elaine Gottschall studied the structure of carbohydrates and noted on pages 28 and 29 (May 2010 edition) that those carbohydrates that had a simpler physical structure were generally easier to digest. Digestive enzymes could more easily attack (and properly process) the linear structure of the amylose type than the more complex structure of the amylopectin type. SCD selects carbohydrates that are contain more of the simpler amylose type structure.
Because SCD permissible foods are easier to digest and to make things easier on your gut, it is advisable to eat smaller meals, more frequently. Plan to eat something at least every two hours. Always have some permissible food with you when you are out and about as you cannot depend on availability on the outside.
The advantages of "cooked, peeled and seeded" means that the toughest parts of a food are eliminated and the fibers are broken down by cooking. It is also important to chew your food thoroughly to make a paste before swallowing.
String beans do not have to be peeled, just well cooked. Most people can tolerate very soft seeds such as those found in zucchini, or tiny seeds like the ones on the surface of strawberries. There is nothing wrong with raw food per se but in the beginning, we take advantage of the fact that cooking breaks down some of the toughness in the food structure. As with all things on SCD, each must test their personal tolerances.
Question - What should be my first objective on SCD?
Answer - The first order of business on the Specific Carbohydrate Diet is to find a core of foods that are well tolerated by you so that you have a "safe food" list. Safe foods mean foods (and beverages) that you can eat comfortably without triggering problematic digestive symptoms.
A good place to start after the chicken soup is with roasted or broiled meats and steamed or boiled vegetables such as zucchini, carrots and green beans. Vegetables may be fresh or frozen. Do not be in a rush to add fruits other than bananas. All fruits contain fructose which is a sugar. Strawberries and blueberries are usually tolerated before the more fleshy fruits.
Each person must test each new food for themselves to see if it is tolerated. Try just little bit of a new food the first day. If it is tolerated and there are no bad reactions, try a little more. Keep doing this until you know that you can handle a decent portion. If well tolerated, that food item is added to your safe food list and you move to the next food. If you have been a parent, the process is just like when you introduced your baby to solid food.
How do I keep track of all this? Answer - It is helpful to keep a food and event log. See Keeping a Food and Event Log
You will quickly discover the truth about the Standard American Diet (SAD). It is SAD that almost all prepared foods have ingredients in them that those on the SCDiet cannot eat as they have added sugar, high fructose corn syrup, corn starch, flour or other items not permitted on SCD. These items are not permitted because they are not being digested properly in those with sensitive or impaired digestive systems.
You will also discover the food industry has a lot of tricky wording about ingredients. Avoid vague descriptions. There is nothing automatically natural about "natural flavors." At the very least, it usually means that sugar has been added.
"Pure" is a magic word in food products that is music to our years, but it is rarely found. Pure baking soda means only baking soda - no additives.
"Kosher" means that a food has been prepared according to traditional Jewish dietary laws and that a rabbi has certified that this is so. Using kosher products can be handy for those on SCD because the ingredients are held to a strict standard. It is important for users of SCD to know exactly what is in our food.
Kosher salt is just salt, solely salt. Kosher products generally do not permit additives or artificial dyes. The word, "kosher," or "strictly kosher" should be on the label. With non food products, there may be a small "k" on the label. Kosher products do not contain any pork or pork products. Milk products and meat products are not mixed.
On SCD, we are not only concerned with the actual listed ingredients, but also whether chemicals or foods that are not allowed on SCD are used in processing. For example, fresh garlic is allowed but garlic powder is not because starches are frequently used as an anti-caking agent to make the powder pour better and these starches are no listed in the ingredients.
Also, in America, there is a 2% rule. That means ingredients below 2% do not have to be listed. This is a problem for those of us on the Specific Carbohydrate Diet. It is not useful for us to list brand names that are okay because companies can change their formulations, making a previously allowed product, not allowed. Each of us has to check for ourselves, every time.
Individual spices are usually allowed on SCD but not spice combinations as these may contain anti-caking starches or non-permissible components (often not listed).
Fresh and frozen vegetables are allowed on SCD; however, canned vegetables are not permitted. The problem with canned vegetables is not listed in the ingredients. Processors often add sugar or maltodextrin (a type of sugar) to the cans. Because it is considered a "processing aid," they do not have to list it on the label as an ingredient.
Everyone must walk their own walk on SCD. Different types of digestive diseases, the length of time that one was sick before finding SCD, the severity of the disease, genetics and allergies all play a part in requiring a personal solution within the overall SCDiet umbrella. As you go along, building your own personal inventory of safe foods, understand that it is slow going at the beginning. For each recipe, you have to test each food individually to see if it is well tolerated before doing the recipe.
Some will tolerate a particular food long before another person. After a few weeks, you can try making the SCD yogurt.Yogurt
SCDiet is based on eating foods that research has shown will be completely digested and absorbed in the small intestine so as not to feed the bacteria in the large intestine (colon). Bacteria do not take holidays and they work both nights and weekends. A tiny amount of food is a feast to bacteria. Therefore, as much as possible, those on SCD practice fanatical adherence. We try to keep non-permitted substances out of all our food and supplements to the greatest extent possible. There are no days off from SCD.
You must maintain a strict attitude. If you tolerate a little bit of impermissible food here and if it did not make you sick, you try a little there, and so on, gradually, you have left the Specific Carbohydrate Diet. Then, if you run into trouble, it is harder for someone to help you. There is no such thing as cheating. Cheating simply means that you have left SCD.
As with other auto-immune reactions, a relapse can be very strong. It may take a while to get back on track. The "easy to kill" bacteria go first and the tougher ones are left behind. If you give the tougher ones the opportunity to overgrow, they will be harder to gain control over.
The foods on SCD are delicious. In time, you will prefer them. These foods heal and they also make you feel good.
There are many wonderful cookbooks out there. See Cookbooks and Websites. Be aware that at present, there is no licensing of SCD counselors or SCD authors and no SCD police. Some cookbooks that claim to be SCD compliant may have items in it that are not permitted on SCD.
Each of us must examine every recipe to see if all the ingredients are appropriate for us at our stage of healing. Also, note that most of the SCD cookbooks recipes contain advanced foods that may not be well tolerated by beginners. Every ingredient in a recipe should be tested by you beforehand to see if it is well tolerated.
For beginners, we recommend that you start simple and stay simple. With perseverance, you will soon build an inventory of a wide variety of delicious foods that you can enjoy and digest properly. A list of some popular SCD cookbooks is at Cookbooks and Websites
Many find it easier to adapt their own favorite recipes by substituting permitted ingredients for the ones that are not permitted on SCD.
The medical advances of the last 50 years have conditioned us to take a pill and feel all better in a week. There is no easy pill for healing the gut. According to Wikipedia, the average length of the small intestine is 22 - 23 feet long and the large intestine (colon) is 5 - 6 feet long. It is kind of amazing that all this can fit neatly into our bodies. If you imagine stringing the two intestines out to their full combined length of 27 - 29 feet, that is longer than the width of many a house and longer than the length of many an apartment.
Considering the many feet of potentially messed up gut, and it is not surprising that healing all of it will take lots of time. The healing may be progressing slowly down the line. Not all parts may heal at the same rate. We have no way of knowing the actual state of our insides. A colonoscopy only views the insides of the colon. What we are aware of is whether we are having the awful bathroom symptoms or the absence of bathroom problems. The important thing is to be able to live our lives to the fullest, not which particular foods we are eating or how long we are on SCD.
Digestive healing takes patience, lots of patience. Patience not to rush to raw foods or exotic foods, not to push for eating foods that failed your first tests, not to change things too fast. Stay in the slow lane. In the long run, the slow lane will be the fastest route to healing as it minimizes relapses.
On the SCD list serve (http://health.groups.yahoo.com/group/BTVC-SCD), we write about yummy recipes, honing our yogurt making skills or taking probiotics, but we must always remember that our digestive problems are primarily auto-immune diseases. We cannot assume that our bodies will react in proportion to what we actually did. A small mistake can have a big reaction.
Chronic means forever. We are told there is no cure, only remission. Remission means that we can go about our lives and that is just great.
Elaine counseled that digestive healing takes time. On page 70 (May 2010 edition) of Breaking The Vicious Cycle, she wrote, "Many cases of celiac disease, spastic colon and diverticulitis appear to be cured by the end of a year. Other disorders such as Crohn's disease and ulcerative colitis take much longer with the minimum of two years on the diet. A rule of thumb is to stay on the diet for at least one year after the last symptoms disappear."
It is not useful to think about "trying" SCD out or judging SCD after a few weeks or experimenting foods that are not permitted, no matter how well one feels on the outside, in a time frame that is shorter than one year.
After that time, one year after the last symptoms, it is recommended that one expand carefully and slowly into foods beyond SCD foods, carefully testing each food one at a time. Be prepared to drop back at the first sign of trouble.
Going completely of the diet and letting down your guard is never recommended. You will soon start regularly eating things beyond your capacity to digest them. This may not seem to be a problem on day one or day two but your digestive problem may return with a vengeance. If it does, it will be much harder to get back under control.
You are reading this post because you need to be here. These digestive conditions are chronic. Do not underestimate them or take them for granted. Auto-immune conditions overreact.
Once you are used to it, you will want to stay with it. It is healthier, you will feel better and your improvement will show in your various routine lab tests.
Cookbooks, including those for SCD are written by those who love to cook. To most of us who do not love to cook, their enthusiasm may seem intimidating at first. You do not need every kitchen gadget on the planet to be successful on SCD. For SCD, we assume that you have access to a basic American kitchen: refrigerator, sink, stove, oven with broiler top and a microwave.
Most of the following, you probably already have in your kitchen: a measuring cup or two, measuring spoons, spatulas, cooking spoons, a ladle, a frying pan, a sauce pan or two, a soup pot, a baking or broiling pan or two, a muffin pan or mini-loaf pan, a colander, an egg beater or portable mixer, a cheese grater, a vegetable parer, a hand chopper, mixing bowls, a rubber spatula, a few kitchen knives, a cutting board, a hand juicer squeezer, a small food scale, a kitchen timer and a garlic press.
That is really all that your need. To this equipment, it would be useful to add a mini chopper/grinder (unless you already own a food processor) and maybe a double boiler (although you can fake one by fitting one pot over another. See the sub section on yogurt makers in the article on yogurt for the wide variety of devices (including your oven) that can be used to make yogurt. See Yogurt You will also need a kitchen thermometer that runs from 50 degrees F to 200 degrees F for the yogurt.
That is really all that you need. We do very basic cooking on SCD. The kind of cooking your great grandmother, or depending on your age, great-great grandmother did everyday. The only difference is that our ancestors would have very much enjoyed the conveniences of frozen food, a quality refrigerator and the convenience of the microwave. They would have become overwhelmed with ecstasy at the availability of an electric chopper/grinder or the ability to order quality, hard to find foods on-line.
After you have been on the diet for a while, after you have developed you own cooking style and know what type of foods suit you and your family, some have found an electric skillet, a crock pot, a food processor, a dehydrator and/or a juicer to be useful. However, they are not needed now so if you do not have them, do not rush out to buy them.
No starches, no grains and no sugar except honey mean that you cannot rely on the availability of suitable SCD food once you leave your kitchen. Right from the start, make an investment in: a bunch of small snap-locking or tight screw on containers, an insulated lunch bag or two, a few reusable blue gel ice packs, some plastic or folding eating utensils and a supply of small disposable plastic baggies.
Carrying your own food will seem strange at first but after a while taking food supplies with you will be second nature. You will be surprised how many others are doing it for various reasons.
For those who are just starting to cook from scratch, here are a few tips.
Eggs in a Recipe
Chicken eggs in America are sold in various sizes: medium, large, extra large and jumbo.
Note that a good cookbook will specify somewhere what size eggs are used in the recipes. For example, Sandra Ramacher in Healing Foods at the very end of the very last page mentions that her recipes are based on using large eggs. If no size is specifically mentioned, the eggs are probably the large size.
You do not need to have all the different size eggs in your refrigerator. Just be aware that you might have to make an adjustment. For example, if you use jumbo eggs, you may find that your mixture may be a little too soupy. To correct that, you may want to add some more of the dry ingredients (such as a little more of the almond flour) until the right consistency is reached. If you normally buy medium size eggs and your mixture seems a little too stiff, the solution is to either add a tablespoon of water or add an extra egg.
Clarifying the Confusion With Using Ounces
The American system of measurement uses ounces. The biggest source of confusion is that there are two things called ounces: dry measure ounces and fluid measure ounces and they are generally different. Dry ounces measure weight and fluid ounces measures liquids which means it measures volume.
Question - If a book says add 8 ounces, what does that mean? How do I know what to do?
Answer - Generally speaking, professional cooks measure ingredients by weight. That means that the term "ounces" usually refers to the dry weight. Having a small food scale is helpful here and most scales have both United States (US) and metric weights.
Hopefully, a cookbook will specify their conventions. Many popular cookbooks use standard American measuring devices and assume that no food scale is used. All measuring is in volume with teaspoons, tablespoons, cups and fractions of cups. There are dry measure measuring cups which have no spout and the measurement goes right up to the rim. There are liquid measuring cups which have a spout and the one cup measurement mark is below the rim. Personally, to save time and avoid confusion, Wendy has converted all the recipes she uses to volume measures only.
If you are outside the USA and want to use American units, it may be easier to order some American standard measuring devices over the internet for use with American unit recipes than have to convert each ingredient to metric. Some of the conversion tables in the recipe books have been rounded maybe because they have focused on ease of use rather than accuracy.
A loose leaf notebook with tabs in which you can make your own cooking notes is helpful in adapting recipes to SCD from a cookbook and in developing your own SCD compliant recipes.
On SCD, you will be using mostly fresh food as opposed to canned or processed food. Once you have perfected a recipe, people usually find that it is more efficient to cook in larger quantities to have plan overs available for another meal or two.
You will probably use your refrigerator and freezer section to the maximum and you want to make these valuable spaces hold as much as possible. You can make your refrigerator (and freezer) larger. Impossible you say; however, here is how you do it.
Lay out all your food storage containers on a table and get rid of the odd sizes. Consider buying storage containers that when closed fit on top of each other. The most useful storage containers can be used in: the refrigerator, the freezer, the microwave and the dishwasher. Measure or adjust the spaces between the shelves in the refrigerator to get an efficient fit.
The sizes you use depend on the size of your family. Wendy posted - We are a family of two and the sizes I selected for most of my storage are the Rubbermaid square containers sizes: 3 cups, 5 cups and 9 cups. The 3 and 5 cups containers use the same lids and they all stack well. For a flat rectangular shape, I use the Snapware's Snap'n Lock in the 4.5 cup size. She finds that the Snapware 4.7 cup size box is great for storing nuts and their 2 cups size is perfect for taking soft or liquid food for lunch on the go.
Two Snapware 10.8 cup rectangular boxes hold almost 5 pounds of almond flour. She stacks them way in the bottom, back corners of her refrigerator. Since they are in that hard to reach place where things used to get lost, she hardly notices that they are there. She has a smaller container (a one quart covered pitcher) for the almond flour for daily use that she keeps on a convenient shelf.
In the cupboard, she stacks the empty bottoms and the tops separately.
She buys her yogurt starter packets in the 12 box bulk size for the sake of economy. She empties most of the boxes and puts the foil starter packets in two 4.7 cup Snapware rectangular boxes. She sticks them in the far back corner of the freezer - space she will not miss. She keeps the box of starter packets that She is using in the refrigerator door and refill as needed.
With these measures, her refrigerator holds a lot more food and things are easier to find.
Digestive healing takes patience. Sometimes there are set backs and one has to be patient. Drop back to your core safe foods and move forward. Mistakes will be made. The important thing is to stay with SCD. Individual questions and problems can be answered on the list serve http://www.health.groups.yahoo.com/group/BTVC-SCD.
Many others have taken this journey and their experiences can help you. Read some of their stories on this wiki and you will see that you are not alone. See Success Storys - In Our Own Words
We have all done these so we thought we would give you an alert on some common beginner mistakes:
You are most welcome here and on the list serve for SCD (http://www.health.groups.yahoo.com/group/BTVC-SCD); however, we would also like to point out that http://www.pecanbread.com also follows SCD and is specifically designed for children and teens with digestive issues.
There are many kid friendly recipes and there are articles on SCD and related topics important to teens and parents. Many of the grown-up SCDieters (who do not have children who suffer from a digestive disorder) use the http://www.pecanbread.com site for the excellent information on SCD. Some like to follow the Pecan Bread beginners' food stages and use their extensive list of SCD compliant recipes. Some of these recipes are designed for kids and they bring out the kid in all of us.
Some new to SCD are confused by the fact that http://pecanbread.com recommends delaying the use of yogurt. This is because Pecan Bread specializes in children on the autism spectrum. These children typically have dairy issues and therefore, http://pecanbread.com recommends delaying the start of eating yogurt until several months of healing have taken place. Moreover, they tend to emphasize goat yogurt versus cow yogurt. For the rest of us, there is no need to delay making and eating SCD yogurt. See Yogurt for instructions on how to make non-dairy as well as dairy yogurt.
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