The Specific Carbohydrate Diet™ (SCD™) and other grain-free or starch-free dietary interventions.
The SCD™ is based on the premise that limiting the diet to simple sugars (usually for at least a year) will starve out toxic organisms in the gastrointestinal (GI) tract and restore gut integrity and immune function.
It eliminates starches and most sugars, and consists mainly of meats, fish, eggs, vegetables, fruits, nuts, and seeds. Although it was used previously for adults with IBD and other GI disorders, some parents of children with autism who have tried the SCD™ have reported relief from symptoms like diarrhea and constipation, and after a time, from multiple food intolerances. Some significant behavioral improvements have also been reported.
There are several different theories about why the SCD™, and related programs advocated by DAN! doctors may be beneficial for certain children with Autism Spectrum Disorders.
Theories about the effectiveness of a grain-free and/or starch-free diet:
- It is theorized that yeast and bacteria in the gut are responsible for causing damage to the gut lining, and their continued presence is preventing it from healing properly. This could be responsible for allowing peptides such as those from gluten and dairy to pass into the bloodstream and affect brain function.
- It is possible that the yeasts and bacteria that live in the gut actually cause or contribute to behavioral disruptions. The finding of dermorphin (an opiate substance produced by bacteria) in the urine of some autistic children may indicate that in some cases this is where the abnormal behaviors are coming from.
- Many children with autism have multiple food intolerances, often unidentified. High on that list are corn, rice, and other grains. Eliminating all of these foods for a time may allow the GI immune system to stabilize, and will usually provide relief from GI problems like constipation and diarrhea.
The most promising things about this type of intervention are:
- Some children with autism and their parents have found that food intolerances are greatly reduced after a year or so, and some foods can be safely re-introduced.
- Removing starchy carbohydrates results in a much more healthful diet, as "carb-addicted" ASD children will usually begin to accept more meat, vegetables, and fruit.
- Behavioral improvements such as better sleep, eye contact, and increased cognitive function have been reported by many, and are usually apparent within a month.
The most difficult things about this type of intervention are:
- Many of the children are already on an extremely limited diet due to allergies, intolerances, and sensory issues, and they may have problems getting adequate nutrition on this diet.
- There is often an initial adverse reaction to the removal of sugars and starches which is similar to that which is seen with anti-fungal treatment. This is called a "Herxheimer reaction" or "die-off reaction," as yeasts and bacteria die, and release toxins along with their stronghold in the gut. This effect usually lasts from a few days to a few weeks, and is generally considered to be a good sign which will result in improvements after it is over.
- There is much conflicting information on the Internet and on various support lists about which diets are "best." Further, some of the reasons given for a food being excluded are not always clear. For a table that compares the recommendations for food restrictions on the GF/CF Diet, the SCD™, and the BED, click here.
How strict does this diet need to be?
For GI disorders like ulcerative colitis and Crohns Disease, it has been reported that strict adherence to the SCD™ is required for healing and the relief of symptoms. In the case of autism disorders, many people believe that such rigor is necessary to the achieve full results, while others have noted that cutting a substantial amount of starches and sugars will yield significant benefits, and that the level of adherence can be fine-tuned to meet the needs of the individual and the family.
The Dairy Debate:
Most of the grain-free diets allow dairy products, however, they were not designed for children on the autism spectrum. Many children with autism are seriously affected by opiate peptides resulting from improperly digested milk and wheat proteins (see studies). Most autism medical practitioners who support dietary interventions are adamant that it is important to keep the dairy out of the diet, regardless of claims that certain yogurts or cheeses will be tolerated after the gut has healed.
Those who maintain that specially-prepared goat-milk yogurt should be introduced after some time on the SCD™ argue that:
- Although the benefits of the SCD™ are not limited to those who use this goat yogurt, it has been reported to have sped up healing and led to improvements in health and functioning in some ASD children and others on the SCD™.
- After the gut has healed, some ASD children will tolerate this yogurt, which is abundant in beneficial bacteria.
- The special way that the yogurt is processed may not eliminate casein and lactose, but seems to reduce the quantity.
The arguments against using specially-prepared goat-milk yogurt are:
- De-natured milk proteins - goat or otherwise - can still become opiate peptides during the digestive process. Although a mild short-term regression might be due to a die-off from the natural probiotics in the yogurt, some children have been reported to experience opiate-like symptoms such as change in pupil size, severely increased stimming, pain insensitivity, and serious behavioral regressions.
- There is some concern that even after some time on the GF/CF diet, each dietary infringement raises the sensitivity of the opiate receptor sites, and it is theorized that this could allow these children to react adversely to all kinds of opiate exposures, including the body's natural endorphins. 3. We have no way of knowing when the gut is fully healed, which children can tolerate this yogurt, and which cannot. It is unclear whether the yogurt would be safe for every child after some period of time, or whether there are some children for whom it will never be safe.
- The main benefits of such a yogurt are the quality and quantity of probiotics contained within. These can be obtained in high-quality dairy-free capsules and powders. Milk fat may also be helpful as a nesting ground for these probiotics, but the benefits of this should be obtainable using ghee, which is a form of clarified butter in which the proteins have been almost completely removed.
We do not believe there is sufficient data to support either argument, and we caution parents against those who claim that they have such data. As with any intervention, we recommend that you look for facts, listen to opinions, and make up your own mind. Until there is considerably more science behind diets like the SCD™ for autism, and until we fully understand the mechanism by which dairy is doing damage in these children, our current stand on this issue is to continue to avoid dairy products for children who have reacted adversely to them in the past.
For a table of foods allowed on the SCD™, click here.
For more information on the SCD™, you can buy or borrow a copy of "Breaking the Vicious Cycle" by Elaine Gottschall, or use other resources on the Internet to fully understand the guidelines for the SCD™, including the ASD & SCD™ Website at http://www.pecanbread.com/.
There are several other sources of information about grains, health, and chronic illness. A well-known advocate of the grain-free diet is Dr. Joseph Mercola. You may also be interested in reading about the Paleolithic Diet or the SCD™ at the Healing Crow website. Another similar approach can be found at the Body Ecology Diet website: www.bodyecologydiet.com and at our BED summary.
For a comparison of the many published low-carbohydrate diets that are most commonly used for weight-loss or health in adults, visit http://www.lowcarb.ca/atkins-diet-and-low-carb-plans/.