Understanding the stages of the Specific Carbohydrate Diet
What is the Specific Carbohydrate Diet?
For a full intro into the Specific Carbohydrate Diet see Getting Started with the Specific Carbohydrate Diet.
For children who are struggling with inflammatory bowel disease, like Crohn’s Disease or Ulcerative Colitis you may want to check out Seattle Children’s Hospital article: “Can the Specific Carbohydrate Diet Treat Inflammatory Bowel Disease?” Listen to some of their success stories!
Overview of the Stages of the Specific Carbohydrate Diet
The Specific Carbohydrate Diet is broken down into a short introductory phase and five proceeding stages. The initial stage of SCD is called the “Intro Diet”. Details on how to implement this stage of the protocol are outlined below. The Intro Diet is designed to last 2-5 days maximum, and depends on the severity of the child’s symptoms. Once the Intro Diet is complete, there are five additional stages. Each stage introduces more variety and preparations of food. Stage 1 introduces peeled and cooked fruits and vegetables such as apples, pears, bananas, winter squash, zucchini, and spinach.1 This is also the stage in which homemade nut milks and yogurts are permitted. Stages 2 and 3 add additional fruits and vegetables, although it remains important to peel, deseed, and cook them when appropriate. Stage 4 begins to permit raw fruits and vegetables, more nut flours and nut pieces, and a handful of properly prepared beans such as haricot beans, lentils, lima beans, and navy beans.1 Stage 5 allows dried fruit, dried meat, whole nuts, and properly prepared black and kidney beans.
Do we HAVE to do an intro diet or all of the stages of SCD?
No. As I detail in my course, The Complete Specific Carbohydrate Diet Course, there are several options for starting SCD, including skipping the intro diet, doing a slow introduction of SCD, or doing a full intro diet. Be aware that patients who have the most severe symptoms, like those with uncontrolled Ulcerative Colitis or Crohn’s Disease, are going to have the best results if they do the full introduction diet and all of the stages. The severity of symptoms typically dictates the the degree to which patients need to be strict on the SCD. I go through all of these options fully in my course, including ways to make the SCD be less-restrictive for kids. I also go through options for different types of introduction diets, including the difference between the intro diet in Breaking the Vicious Cycle, and other ideas for intro diets.
How are the stages of SCD implemented?
Each stage is implemented based on the healing process rather than a strict timeline. Some children heal faster than others and may move through the stages at an accelerated pace. On the other hand, some may need more time in each stage to allow for adequate healing. New foods are introduced gradually. The quantity of a new food should be limited to a small portion until tolerance is determined. This provides time to discover if that new food is well tolerated by the child. If it is not well tolerated, continue to remove that food until further healing has taken place. Once the gut has had more time to heal, it may be appropriate to try again. Only well tolerated foods should be fed, with slow introduction of new foods to tolerance.
In the days of SCD, all fruits and vegetables should be peeled, deseeded, and cooked to reduce the burden of breaking them down in the small intestine. Ripe, brown speckled bananas and avocados are the only fruits that may be eaten raw in the beginning. Once diarrhea and cramping have subsided, raw fruit and vegetable juices diluted with water may be introduced. Applesauce, pear sauce, and mashed ripe bananas are the best fruits to begin with.
If a child has had difficulty digesting dairy in the past, begin with dairy free SCD until the child’s symptoms have resolved. Consider adding Goat yogurt after the symptoms have resolved. It is okay to be consumed daily if tolerated. Yogurt is an important part in promoting healing in a damaged gut.1
A note on nuts: Although nuts and some legumes are permitted on SCD, they can be difficult to digest and are certainly not required. Nuts, especially whole nuts, should be implemented after several months of healing has taken place. Nut butters and flours are typically easier to digest than whole nuts. Once nuts are reintroduced (assuming they’re well tolerated), nut flours can be used in a variety of baked goods. Remember to go low and slow. For example, start with 1⁄4 of a nut muffin and increase to tolerance.
*Keep in mind that although SCD eliminates certain carbohydrates, the primary focus is on introducing easy to digest foods to allow the gut time to heal. Simply eliminating carbohydrates and then consuming large quantities of raw fruits, vegetables, and nuts is counter to the goal of SCD.
What is the SCD Intro Diet?
The Intro Diet is the most restricted stage of SCD and is only meant to be followed for two to five days maximum,1 and only with the approval of the child’s physician. Legal foods during the Intro Diet include chicken, turkey, lean pork, broiled fish, beef or chicken broth, ground meat, eggs, cooked carrots, gelatin, and 100% grape juice or apple cider. If the Intro Diet is too difficult or restrictive for the child, simply skip to the next stage and include easy to digest foods that the child tolerates well. If a child is having “brisk diarrhea”, eliminate eggs and prioritize meat until it’s under control.2
I include several ideas for how to keep this stage fun for kids in my Complete Specific Carbohydrate Diet Course.
Eggs can be prepared any way the child prefers. If they won’t eat them, try cooking them flat and cutting them into fun shapes1. Gelatin and grape juice can be turned into jello or frozen into popsicles1. Ground meat can be used to make bite-sized meatballs or patties. I recommend making a big pot of chicken broth with shredded, pureed, or meatball chicken and cooked carrot coins. A large batch of cooked carrots can be pureed and eaten like mashed potatoes. The puree could be mixed with an egg and fried in a small amount of coconut oil or animal fat to make pancakes. Preparation is key during this initial phase and spending one to two days preparing a large batch of soup, meatballs, pureed carrots, and homemade gelatin should make the Intro Diet less difficult.
The quantity of legal foods consumed during the Intro Diet is unlimited. Remember to limit this phase to just two to five days, depending on the child’s symptoms. If the child’s most severe GI symptoms improve after day two, move on to Stage 1.
Example meal plan:
- Breakfast: scrambled or boiled eggs, grape juice gelatin cut into fun shapes
- Lunch: homemade chicken soup with carrot coins and bone broth
- Dinner: broiled fish or meat patty, carrot pancakes (pureed carrot with one egg, cooked with a small amount of fat)
- Snack: bite-sized meatballs, gelatin, grape juice diluted with water
What are stages 1-5 of the Specific Carbohydrate Diet?
Stage 1-5: Elaine Gottschall’s Breaking the Vicious Cycle emphasizes the importance of adhering to the list of legal foods with “fanatical adherence”.2 However, I wouldn’t discount the effects of the diet if you aren’t able to follow it perfectly. Again, the severity of the symptoms will dictate the extent to which you need to be strict on the diet. This diet is extremely healthy, with high levels of protein, minerals, vitamins, healthy fats and more. Even a child including some of the foods will experience nutritional benefits.
That said, do remember that eliminating carbohydrates except for the allowed fruits, vegetables, and honey is essential for creating an environment in which the gut can heal. Although strict adherence generates the best results, even minor changes such as removing nuts/seeds and cooking vegetables should aid digestion. Once the Intro Diet is complete, foods from the Stage 1 list can be implemented one-at-a-time. Remember that the goal is to add easy-to-digest foods to your child’s diet and thus peeling, deseeding, cooking, and mashing may be necessary, especially at the beginning. Raw fruits and vegetables should not be permitted until diarrhea is under control. Then, small amounts may be introduced, little by little. Canned fruits, vegetables, and those that come in a jar are forbidden due to the added sugar.2 Whole fruits and vegetables should be purchased as much as possible and prepared from scratch. Although this takes more time and energy, it ensures the child is obtaining the adequate nutrient density and avoiding unwanted additives. Typically, squash, tomato, string beans, and carrots are well tolerated vegetables.2 Vegetables from the cabbage family such as cauliflower, broccoli, kale, bok choy, arugula, and chard should be avoided until all diarrhea, gas, and bloating has subsided. Legumes may be added after three months on the diet. Soaking legumes overnight and pressure cooking them makes them easier to digest.
Dairy foods are allowed on SCD, but should be avoided during the first month if the child has a history of intolerance. Then, goat yogurt may be permitted to tolerance. Dry curd cottage cheese should be included after the initial month. However, brands made with added milk or cream should be avoided.
Fats are generally harder to digest and should be consumed in moderation towards the beginning of the diet. Animal fats from meat, butter, cheese, and in homemade yogurt are generally well tolerated2. Avocado, coconut products, olive oil, nuts and seeds are introduced later in the diet.
Although certain foods are eliminated on SCD, eating a variety of legal foods is encouraged. Eating any particular food in excess, and to the exclusion of other foods should be avoided. Since those with chronic intestinal distress often suffer from malabsorption, vitamin supplementation may be appropriate at the beginning of the diet. Vitamin A, vitamin B-complex, vitamin C, vitamin D, and vitamin E should be considered early on. Consult with your physician or a qualified nutritionist to determine the dose that’s correct for the child. Once healing has taken place, the child’s gut should be able to absorb adequate vitamins and minerals through consuming a diverse range of SCD legal foods.
During the first month of SCD, it is advisable to create a chart and track the child’s symptoms. List the child’s symptoms across the top of a page and the number of days in the month down the side. Indicate the severity of symptoms using + or – signs at the end of each day. For example, a particularly gassy day may be charted using 3 +’s, while a bloat free day may receive a “-”. If after 30 days the child’s symptoms have not improved, this diet is likely not going to work for them. Many symptoms improve after just three weeks, but a year or more of commitment to the diet generates the best long term results.2
What would my child actually eat?
Here is one sample meal plan:
- Breakfast: scrambled or boiled eggs with sauteed peeled/deseeded zucchini, cooked in a small amount of fat; goat yogurt; nut muffin; blueberries
- Lunch: tuna with mashed avocado and olives over butter lettuce leaves; side of waldorf salad (recipe in BTVC)
- Dinner: butternut squash noodles; sauteed ground beef, tomatoes, garlic, onions, wilted spinach cooked in olive oil.
- Snack: baked pear with cinnamon and honey drizzle and 2 slices of turkey OR banana pancakes made by mixing one mashed banana with an egg and frying in a small amount of butter.
For 30 days of meals, including breakfast, lunch and dinner see my course The Complete Specific Carbohydrate Diet Course. The course includes some of my favorite, delicious, kid-friendly recipes!
Need more information about SCD?
If you have more questions and want to work one-on-one please check out my website: KaylaLayneNutrition.com. I’d love to meet you.
Are you interested in learning more about SCD? Come join my SCD Course!
Resources for the Specific Carbohydrate Diet:
Informational books and websites for the Specific Carbohydrate Diet
Breaking the Vicious Cycle by Elaine Gottschall
Gut Feeling: Gut Healing by Shannon Eavenson
Cookbooks for the Specific Carbohydrate Diet
Eat Well Feel Well by Kendall Conrad
Every Last Bite by Carmen Sturdy’s (also a blog)
Websites for recipe inspiration:
● https://www.everylastbite.com
● https://comfybelly.com
● https://againstallgrain.com
SCD Podcasts:
● The SCD Specific Carbohydrate Diet Podcast with Lee Bernstien
Community support:
https://www.facebook.com/groups/254381904904394/
Citations:
- Pecanbread.com. The Best Method for Healing with SCD. 2022.
- Gottschall, E. Breaking the Vicious Cycle: Intestinal Health Through Diet. The Kirkton Press. 2014.
