Science Update

New Study Demonstrates the Efficacy of the Specific Carbohydrate Diet in Patients with Crohn’s Disease

Inflammatory bowel disease (IBD) is an autoimmune condition in most cases, which will result in multiple triggers chronically stimulating the immune system over a long period of time in multiple ways. In addition, the immune system becomes overloaded in an overwhelmed state, losing its ability to function, which leads to chronic inflammation causing symptoms such as diarrhea, abdominal pain and other debilitating symptoms, and anemia. 

Traditional IBD treatments focus on altering immunological function. However, minimal investigation is focused on the microbiome and intestinal barrier function.

According to a study published last week in Nutrients, researchers investigated the efficacy of three versions of the specific carbohydrate diet (SCD) in active Crohn’s disease. The SCD was created by Sydney Haas, MD, a pediatrician, to treat celiac disease. This diet eliminates all grains, sugars (except honey), all milk products (except hard cheeses and fermented yogurt), and most processed foods.

This single center, double-blind study was conducted in 10 pediatric patients between the ages of 7 to 18 with mildtomoderate Crohn’s disease. Each patient was randomized to either the SCD group, a modified SCD including both oats and rice, or a whole foods diet group. Patients were evaluated at baseline, and at 2, 4, 8, and 12 weeks. Assessments included the Pediatric Crohn’s Disease Activity Index (PCDAI), complete blood count (CBC), C-reactive protein, erythrocyte sedimentation rate (ESR), albumin, stool testing, and multi-omics analysis. For the first 2 weeks, all patients went on a strict SCD and were placed on their randomized diet. Each patient received nutritional counseling by a dietitian. Before each visit, all patients completed a 3-day food diary to ensure diet compliance. Meals for the patients were provided and prepared by a study chef. Patients also received a list of allowed SCD foods during the study. 

As a result of the study, all participants achieved clinical remission at 12 weeks. Creactive protein levels significantly decreased in all three groups. In addition, the microbiome composition shifted in every patient over the 12-week period. These results emphasize the significant impact that diet and nutrients play in Crohn’s disease. Each diet had a significant effect on disease severity and inflammatory biomarkers. The more restrictive diets were associated with the largest reductions in inflammation.

For additional support, high-dose probiotics, fish oil, curcumin, glutamine, and mucilaginous botanicals may be helpful due to their demonstrated anti-inflammatory properties. Other common insufficiencies include magnesium, vitamin D, and iron. 

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Suskind DL, Lee D, Kim Y-M, et al. The specific carbohydrate diet and diet modification as induction therapy for pediatric Crohn’s disease: a randomized diet controlled trial. Nutrients. 2020;12(12):3729.