Specific CHO Diet

The diet is based on the fact that starches and sugars require the lining of the small intestine to break them down for absorption. If the enzymes on the surface of the small intestine are damaged or impaired, carbohydrates are available to intestinal bacteria and yeast to multiply in a vicious circle. The proposed mechanism is that the surface of the small intestinal wall is damaged leading to impaired digestion and malabsorption of disaccharides (two carbon sugars such as lactose, sucrose, maltose, etc.). Since the sugar is not broken down and absorbed, it becomes available for fermentation by bacteria and yeast, which overgrow in the presence of abundant sugar. Toxic by-products of bacteria and yeast injure the lining of intestine and enzymes necessary for carbohydrate digestion and absorption. The cycle begins again… Excessive mucus (along with the cells that secrete mucus – goblet cells) may also be produced as the body tries to protect itself.

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Carbohydrates can be categorized into single sugars (called monosaccharides) that require no digestion in order to be transported from the intestine into the blood stream. They are glucose, fructose, and galactose. Double sugars (called disaccharides) require splitting into the single sugars glucose, fructose or galactose by intestinal wall enzymes. The four main disaccharides are lactose (found in milk), sucrose (table sugar), maltose and isomaltose (found in corn syrup, malted foods, and candies). The two types of starches (called polysaccharide) are amylose andamylopectin and are made up of long strands of sugars. Amylose contains straight and unbranchedchains of sugars while amylopectin is branched. Amylopectin is harder to digest and therefore especially a problem when there is damage to the intestinal enzymes. Fiber is a starch for which man does not have the intestinal enzyme to digest.

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Impaired digestion of sugars have been found in celiac disease (gluten enteropathy), soy-protein intolerance, cow’s milk protein intolerance, diarrhea in infancy and children, intestinal parasite infections (Giardia), cystic fibrosis, and Crohn’s disease. Lactose intolerance represents a common form of this condition in which lactase, the enzyme that breaks down milk sugar (lactose) is damaged, impaired, or absent. Unknown to most doctors is that often there is a combination of affected enzymes. Some starchy foods that were assumed to be digested completely are, in fact, incompletely digested by most “healthy” people.

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The Specific Carbohydrate Diet is a method to break the cycle of malabsorption-overgrowth-injury. It has been reported to help Cystic Fibrosis, Celiac Sprue, Crohn’s Disease (Regional enteritis), autism, functional diarrhea, Irritable Bowel Syndrome, Ulcerative Colitis, and yeast overgrowth.

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In following the diet it is almost as important to remember that what is not eaten is as important as what is eaten. Fanatical adherence for at least one month is required.

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This concept has been derived from Elaine Gottschall’s book, Breaking the Vicious Cycle. I encourage you purchase her book.

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PROTEINS

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ALLOWED: All fresh or frozen organic beef, lamb, pork, poultry, fish, and shellfish.Canned fish. Eggs. Natural cheddar cheese, Colby cheese, Swiss cheese, brick cheese, uncreamed dry curd cottage cheese.

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AVOID: Processed meats such as hot dogs, bologna, turkey loaf, spiced ham, breaded fish, canned meat if they contain starches such as whey powder, lactose, sucrose, etc. Processed cheeses and cheeses not listed in left column.

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VEGETABLES

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ALLOWED: Fresh or frozen artichoke (not Jerusalem type), asparagus, beets, dried white navy beans, lentils, split peas, broccoli, Brussels sprouts, cabbage, cauliflower, carrots, celery, cucumbers and dill pickles, eggplant, garlic, kale, lettuce of all kinds, lima beans, mushrooms, mustard, olives, onions, parsley, peas, pumpkin, spinach, winter and summer squash, string beans, tomatoes, turnips, watercress. Cold pressed vegetable oils

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AVOID: No grains such as arrowroot, barley, buckwheat, bulgur, corn, millet, oats, rice, rye, triticale, or wheat. No flour, germ, pasta, starch, or cereal products from these.Potatoes (white or sweet), yams or parsnips. Beans (sprouts, soybeans, mung, fava and garbanzo). Amaranth flour, Jerusalem artichoke flour or powder, quinoa flour, or other grain substitutes such as cottonseed, tapioca, sago. Seaweed, margarine, chocolate, carob

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FRUITS

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ALLOWED: Fresh raw, cooked, frozen, or dried apples, avocados, apricots, ripe bananas, berries of all kinds, cherries, fresh or unsweetened shredded coconut, loose dates that do not stick together (glazed or with added sugar), grapefruit, grapes, Kiwi, kumquats, lemons, limes, mangoes, melons, nectarines, oranges, papayas, peaches, pears, pineapples, prunes, dark raisins, rhubarb, and tangerines.

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AVOID: Canned fruits. Dried fruit that has been glazed with corn syrup or sugar such as many brands of banana chips. Molasses, ketchup, agar-agar, carrageenan, jams, jellies.

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NUTS

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ALLOWED: Raw or plain roasted almonds, pecans, Brazil nuts, filberts, hazelnuts, walnuts, unroasted cashews and chestnuts. Peanut butter without any additives.

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AVOID: Roasted peanuts or peanuts in salted mixtures. Beernuts, glazed nuts, etc.

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BEVERAGES

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ALLOWED: Tomato and vegetable juices. Orange juice, bottled or canned grape juice, pineapple juice, some brands of apple juice, weak tea or coffee or chicory, herbal teas

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AVOID: Cow, goat, soy, rice, coconut milk products. Instant coffee or tea, Postum, coffee substitutes. Beer, wine, tonic water, soda, etc.

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For a sweetener – try raw tupelo honey, black strap molasses, or fructose.  I have several e-mails of people disputing the use of these sweeteners based on the original specific carbohydrate diet, but my own experience and patients have used these in modest amounts without any problems.