My Experience with the Specific Carbohydrate Diet

By Todd:

Eight years ago, soon after moving to Chicago from Puerto Rico, I was diagnosed with Ulcerative Proctosigmoiditis, more generally known as Ulcerative Colitis (UC).  I was told that UC is an incurable disease and I would need to be on medication (Asacol) for the rest of my life.  My doctor did not stress the importance of diet other than to mention that some foods such as dairy and spicy foods cause problems in some patients.  He recommended continuing a regular diet unless any particular food caused problems.  Unfortunately, Asacol was very expensive and not covered by my insurance. I did some research on the internet to see if there were any good alternatives.  One method of treatment was through a strict diet called the Specific Carbohydrate Diet (SCD).  “Letting food be my medicine” was an appealing idea but this particular diet appeared too tedious, unappetizing, and time consuming, especially for a working college student. I quickly ruled out the dieting option.    There wasn’t a cheaper generic version for Asacol in the United States, so I resorted to buying generic versions of the drug online from overseas pharmacies, usually in India.

The medication did a pretty good job at controlling the symptoms.  Flare-ups and diarrhea became more mild and less frequent as the months and years went by.  Around four years after my diagnosis, I decided to stop drinking milk mainly because I no longer craved it.  By that time I was experiencing symptoms once every few months at most.  In 2011, we scheduled a colonoscopy because it had been about 5 years since my diagnosis.  By the time of the colonoscopy, it had been many months since my last flare-up.  My doctor saw no evidence of ulcerative colitis during the procedure, and he wondered if I had been misdiagnosed in the first place.  But after reviewing the colonoscopy and biopsy reports from when I was first diagnosed, he concluded that I did have (and still had) the disease – I was just controlling it very well by taking my medication and doing whatever else I was doing.  So the obvious thing to do was to keep it up, which I did for the next three years with no symptoms that I can recall.

For many years my diet had been very high in carbs, with low amounts of fat and protein.  By the fall of 2013, I had become an avid runner which in turn got me very interested in nutrition.  As I learned more about nutrition, it became apparent that my diet was not balanced.  I made some incremental changes such as eating scrambled eggs instead of a big bagel for breakfast.  Soon after that, I read a book by Phil Maffetone which recommended limiting high gycemic foods such as refined grains, potatoes, sweets, and other processed foods.  It points out that the conventional high-carb diet is very different from what humans ate during most of our evolutionary history, and argues that the changes in our diet brought about by the agricultural and industrial revolutions are unhealthy and at least partly responsible for high rates of obesity, heart disease, and chronic inflammatory conditions.  For endurance athletes, such a diet tends to inhibit the body’s ability to burn fat, which is important for aerobic endurance.  To me it made a lot of sense to try to eat more like our ancient ancestors, by simply eating foods that are more or less in their natural state, but ironically such a diet can be extremely inconvenient these days.

With my new enthusiasm for nutrition, I became curious about the SCD again, so I started reading about it.  Some people with ulcerative colitis and Crohns swear by it, claiming that it controls their symptoms or even that it “cured” them.  Some have tried the diet and not had the desired results.  Many have tried the diet and failed to stick with it, which is not surprising.  It calls for absolutely no grains such as wheat, corn, or oats; no refined sugar; no dairy that isn’t thoroughly fermented; no potatoes.  Foods that contain even a small amount of the above are also forbidden on the diet.  Most ingredients used as preservatives are also forbidden.  Consequently, most processed or canned foods are off limits.  The main idea of the diet is that some types of carbohydrate (such as disaccharides and certain starches) are difficult to digest and therefore sit in the gut and become food for bacteria, potentially leading to an overgrowth and imbalance of bacteria in the gut.  The waste products of the bacteria can irritate and damage the gut, inhibiting absorption, resulting in even more undigested food for bacteria.  The cycle continues until the gut is severely inflamed and ulcers develop.  This vicious cycle is what the diet is designed fix; hence the prohibition of foods containing complex carbs.  The beauty of the diet is that it forces you to eat mostly fresh, whole foods… just what we suspect our ancient ancestors survived on for millions of years.  I noticed that the SCD is very similar to the diet advocated by Phil Maffetone for endurance athletes. Feeling motivated, I decided to give the SCD a chance and see if it could help me stop medicating for ulcerative colitis and, at the same time, improve my overall health and fitness. 

This book describes the Specific Carb Diet in full detail

The SCD recommends “fanatical" adherence for at least one year after the last symptom has disappeared.  After that time, you can begin to reintroduce some foods as long as no symptoms return.  Since I was already symptom free (on medication), my goal was to stop medicating and strictly follow the SCD for a year.  Also, being symptom free, I could skip over the initial stage of the diet which restricts all but a handful of foods.  

I started the SCD in mid March 2014 and immediately tapered off medication over the course of a month.  It was a little awkward following the diet at first, but by simply eating what I craved among the allowed foods, everything seemed to come into balance within a week or two.  Here’s what I typically ate on the SCD:

Breakfast	-3 eggs scrambled with cheddar cheese and mixed with salsa -A grapefruit -Sometimes bacon -Fish Oil supplement
Lunch	-Often a homemade bean and vegetable soup made from lentils, split peas, or black beans; -Sometimes homemade butternut squash soup -Sometimes chicken fajitas without the tortilla -Sometimes a hamburger without the bun
Dinner	-Often some kind of meat such as pork chops, chicken breast, steak, salmon, or cod; -Sauteed vegetables; -Sometimes spaghetti using homemade sauce with ground beef; spaghetti squash instead of noodles
Snacks	-An all-raw trail mix made from sunflower seeds, peanuts, pumpkin seeds, almonds, and raisins. -Variety of raw fruits and vegetables -Homemade whole milk yogurt (fermented 24 hours) with berries mixed in
During workouts and races	-Water -Honey -Salt tablets
After-workout snack	-Sliced apple with a bowl of dip made from natural peanut butter, honey, chia seeds, and flax seeds
Drink	-Water -Sometimes a dry red wine

Here's an example of the food I bring to work each day.  Normally there is also some kind of bean soup.

I created this spreadsheet to nail down the ingredient proportions and calculate cost.  Pretty cheap, thanks to Winco bulk.

Making a week's worth of lunches. Lentil-vegetable-coconut soup.

Homemade yogurt is super cheap and better than store-bought yogurt.  These are two half-gallon batches fermenting.

The only times that the SCD is difficult is during social occasions and travel.  I started making sure I ate before social events, and then the only hard part was to avoid offending someone, or at least have them roll their eyes at me, which is understandable.   One common remark was "Aren't you already skinny enough?!"  But at the same time I was amazed at how thoughtful and accommodating some of my family and friends were.  On Thanksgiving I was planning on missing out on the pie, but my sister Tricia made a delicious banana cream pie from ingredients allowed on the SCD.  Eating while traveling wasn't too hard as long as I had access to a grocery store and decent restaurants.  The only two times this was a problem was while vacationing in remote parts of Maui and while recording an album in the jewelry district of Los Angeles.

After I had been on the diet for several months, I decided I better talk to my current gastroenterologist about it.  I expected him to be concerned that I had stopped taking medication.  To my surprise, he was actually happy for me and believed that I was doing the right thing.  In fact, he himself had already been eating pretty much the same way for years despite never hearing of the SCD (which was developed in the 1950's).  He went on and on about the importance of diet for a healthy colon, as if he had read the same book that I had.  It was a very encouraging visit that strengthened my resolve to continue.

While I can't say for sure how the diet influenced my running, I am confident that it didn't hurt.  During the first month on the diet, my aerobic fitness measurably declined, but then after a month I was back to where I was before, and then it continued to improve significantly in the following months, well beyond any previous level of fitness.  I can't confidently credit the diet for this improvement because I was also training differently than before.  Since the SCD is relatively low-glycemic, I suspect that my body improved at using fat as an energy source while running. This is evidenced by the fact that while running a marathon after starting the diet, I never hit "the wall" like I did in every previous marathon.  I didn't "carb load" before the race, either.

Finishing my fastest marathon by far (3:03:59), six months on the SCD

In March 2015 I completed my goal of one year on the diet.  I celebrated by eating some of my favorite dishes: Thai curry with white rice, sushi, and extra dark chocolate!  Since that time I have continued to follow the SCD on normal days because I like it, and I believe it is more healthy than what I used to eat.  But now I make exceptions when following the diet is inconvenient.  So far it has worked out great: still no symptoms and no medication!