“... in many autistic children, bacterial and fungal overgrowths are etiologically significant in the cascade of events that result in autism or one of the other autism spectrum disorders.”-- Jaquelyn McCandless, Children with Starving Brains
“...the use of chelation agents that encourage pathogen overgrowth creates an even greater incentive to get the gut as healthy as possible prior to initiating the chelating process... preventing any known sources of inflammation will help the child’s health improve and make chelation both more effective and shorter in duration.” --Jaquelyn McCandless, Children with Starving Brains
“A sensible and harmless form of warfare on the aberrant population of intestinal microbes is to manipulate their energy (food) supply through diet...By depriving intestinal microbes of their energy source, their numbers gradually decrease along with the products they produce.”--Elaine Gottschall, Breaking the Vicious Cycle
Autism and GI Problems (written by Jody Goddard)
Recent research shows that more than 50% of children with autism have GI symptoms, food allergies, and maldigestion or malabsorption issues (Horvath). It’s obvious from talking to parents that GI problems are a major concern in children with autism. Listservs dealing with autism have discussions on GI issues all the time. Antifungal use, both prescription and alternative remedies, is a common topic. Parents have tried “anti-yeast” diets, prescription drugs and natural remedies, but nothing seems to be “the answer” to the chronic microbial problems their children face. Many parents wish to pursue chelation for their children, but are unable to do so because of their inability to get their children’s gut pathogens under control.
Altered intestinal permeability was found in 43% of autistic patients, but not found in any of the controls (Harvard University). Intestinal permeability, commonly called “leaky gut”, means that there are larger than normal spaces present between the cells of the gut wall. When these large spaces exist in the small intestine, it allows undigested food and other toxins to enter the blood stream. When incompletely broken down foods enter the body, the immune system mounts an attack against the “foreigner” resulting in food allergies and sensitivities. The release of antibodies triggers inflammatory reactions when the foods are eaten again. The chronic inflammation lowers IgA levels. Sufficient levels of IgA are needed to protect the intestinal tract from clostridia and yeast. The decreasing IgA levels allow for even further microbe proliferation in the intestinal tract. Vitamin and mineral deficiencies are also found due to the leaky gut problem.
An example of the problems created by the vitamin deficiencies that occur within a leaky gut is vitamin B12 deficiency. B12 absorption is inhibited early in this process as microbes enter the small intestine because B12 is absorbed in the ileum (last section of the small intestine). Vitamin B12 is essential for metabolism of fats and carbohydrates and the synthesis of proteins. Vitamin B12 is involved in the manufacture of the myelin sheath, a fatty layer which insulates nerves in the brain. It is also essential for the formation of neurotransmitters. A compound known as intrinsic factor, which is secreted by the cells lining the stomach, is necessary for the absorption of vitamin B12. (The New Encyclopedia of Vitamins, Minerals, Supplements, & Herbs)Another important function of B12 is repairing damaged, flattened microvilli. With sufficient B12 and folic acid in the bloodstream, the intestinal cells and microvilli can rejuvenate every 3-4 days.
In a healthy intestinal tract the small intestine and stomach are not inhabited by bacteria. When the flora balance in the colon is lost, the microbes can migrate into the small intestine and stomach, which hampers digestion. The microbes compete for nutrients and their waste products overrun the intestinal tract. One of the toxins produced by yeast is actually an enzyme that allows the yeast to bore into the intestinal wall. The yeast also produce other toxins such as organic acids, which can also damage the intestinal wall.
Bacterial growth in the small intestine destroys enzymes on the intestinal cell surface, which prevents carbohydrate digestion and absorption. The last stage of carbohydrate digestion takes place at the minute projections called microvilli. Complex carbohydrates that have been broken down by the enzymes embedded in the microvilli can be absorbed properly and enter the blood stream. But when the microvilli are damaged, the last stage of digestion cannot take place. At this point only monosaccharides can be absorbed because of their single molecule structure.
*All diagrams from Breaking the Vicious Cycle
In the small intestine, the body should absorb the nutrients needed from what is eaten. But in the case of malabsorption, the undigested carbohydrates left in the small intestine cause the body to draw water into the intestinal tract. This pushes the undigested carbohydrates into the colon where the microbes can feast on it. This allows for even more proliferation of the unwanted microbes and continued increase in malabsorption problems.
Low intestinal carbohydrate digestive enzyme activity was found in 43% of patients with autism. (Horvath) Recent studies point out that ongoing carbohydrate malabsorption keeps the digestive system constantly weakened, leading to systemic disorders. Suspected carbohydrate malabsorption should be treated to ward off further damage to the body’s digestive system. (GSDL)
Most intestinal microbes require carbohydrates for energy. The Specific Carbohydrate Diet limits the availability of carbohydrates. By depriving these microbes of their food source, they gradually decrease in number. As the number of microbes decreases so do the toxic by-products they create.
The Specific Carbohydrate Diet (SCD) is intended to stop the vicious cycle of malabsorption and microbe overgrowth by removing the source of energy from the microbes. The SCD allows simple monosaccharides that do not need to be broken down in order to be absorbed.
By following the SCD, malabsorption is replaced with proper absorption. Inflammation is decreased and the immune system can return to normal. Once the immune system is returned to adequate levels, it can begin to keep in the intestines microbes in proper balance.
The SCD allows simple carbohydrates, but prohibits complex carbohydrates. The diet is started by following an introductory diet, which consists of a limited selection of foods. After the introductory diet, the next stage of the diet allows many more foods, but requires that all fruits and vegetables be peeled, seeded and cooked in order to make them more easily digested. Raw fruits, vegetables, nuts and seeds are added to the diet later. To properly follow this diet, it is imperative to read Breaking the Vicious Cycle by Elaine Gottschall. The book details the progression of allowed foods as well as providing many delicious recipes.
The Specific Carbohydrate Diet is the only diet that targets the malabsorption issues that are so prevalent in children with Autism. By removing the foods that cannot be properly broken down, the energy source for the unwanted gut pathogens is eliminated. With their food source taken away, the microbes die off and the proper gut flora balance can be restored. The vicious cycle of malabsorption, inflammation and food allergies seen in children with autism is broken and healthy digestion can begin.
Specific Carbohydrate Diet Food List:
PROTEINS
ALLOWED: All fresh or frozen beef, lamb, pork, poultry, fish, and shellfish, eggs, natural cheeses (see appendix of BTVC for full list of allowed cheeses), homemade yogurt (recipe in BTVC) and dry curd cottage cheese.
NOT ALLOWED: 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 appendix.
VEGETABLES
ALLOWED: Fresh or frozen (with no added sugar or starch). Artichoke (not Jerusalem type), asparagus, beets, dried white navy beans, lentils, split peas, broccoli, brussel 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.
NOT ALLOWED: No canned vegetables allowed. 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.
FRUITS
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, grapefruit, grapes, kiwi, kumquats, lemons, limes, mangoes, melons, nectarines, oranges, papayas, peaches, pears, pineapples, prunes, dark raisins, rhubarb, and tangerines.
NOT ALLOWED: Canned fruits. Dried fruit that has been glazed with corn syrup or sugar such as many brands of banana chips. Molasses, ketchup (unless homemade), agar-agar, carrageenan, jams, jellies.
NUTS
ALLOWED: Almonds, pecans, Brazil nuts, filberts, hazelnuts, walnuts, unroasted cashews and chestnuts. Peanut butter and other nut butters without any additives.
NOT ALLOWED: Roasted nuts or peanuts in salted mixtures. Beer nuts, glazed nuts, etc.
BEVERAGES
ALLOWED: Tomato and vegetable juices. Tropicana 100% orange juice, Welch’s grape juice, pineapple juice, some brands of apple juice, weak tea or coffee, herbal teas (peppermint and spearmint only). Milkshakes made with homemade yogurt, fruits and sweetened to taste with honey. Freshly squeezed vegetable or fruit juices made from the list of allowed foods.
NOT ALLOWED: Cow's milk, goat's milk, soy milk, rice milk, canned coconut milk. Instant coffee or tea, postum, coffee substitutes, soft drinks.
SOURCES
Books:
Breaking the Vicious Cycle, by Elaine Gottschall, M.Sc.
Children with Starving Brains, by Jaquelyn McCandless, M.D.
The New Encyclopedia of Vitamins, Minerals, Supplements, & Herbs, by Nicola Reavley
Articles and Websites:
“Altered Immunity & The Leaky Gut Syndrome”, Zoltan P Rona, M.D., M.Sc.
“Lactose Intolerance Breath Test-Application Guide”
Great Smokies Diagnostic Lab
“Gastrointestinal Microflora Studies in Late-Onset Autism”
Finegold, et al
Finegold Abstract
“Preliminary Findings in Gastrointestinal Investigation of Autistic Patients, 2002”
Harvard University and Mass General Hospital
Harvard Abstract
“Gastrointestinal Abnormalities in Children with Autistic Disorder”
Horvath, et al
Horvath Abstract-PubMed
“Abnormal Intestinal Permeability in Children with Autism”
D’Eufemia, et al
D'Eufemia Abstract-PubMed
Internet Support Groups:
PecanBread Yahoo Group
To read the Elaine’s Children Archives:
Read Elaine's Children
Internet Information Sources:
Elaine Gottschall’s Website
Breaking the Vicious Cycle
Pecanbread.com
Deals specifically with SCD and Autism
Includes testimonials on recovery and improvement in Autism
SCD Web Library
Specific Carbohydrate Diet
SCD Recipe
“Whatever Happened to the Cure for Coeliac Disease?”, Elaine Gottschall
Nutritional Therapy Today, Vol. 7, No.1, 1997, page 8-11 taken from
SCDiet.org Archives
Websites where SCD products are sold:
Lucy's Kitchen Shop
Digestive Wellness
SCDiet.com
PARENT’S REPORTS ON SCD
More success stories can be found on the Pecanbread.com website
From Sue:
This morning, Adam asked me:
“What is a jungle?”
“What is a savanna?”
“Where is Africa?”
(He waited for the answers too).
I am so excited I can hardly type! This is from a child who has always talked, and is fairly high functioning, but his talking and questions are generally FUNCTIONAL or scripted. That is, he can ask for things he wants, ask where Dad or Katie is, where we are going, quote endlessly from Toy Story, mix various scripts from various stories in play. He can respond to most adult questions.
BUT, He has never asked such abstract questions ABOUT something. That is one of the differences that has always pulled my heartstrings - where "neurologically typical" kids are curious about everything, and constantly asking JUST TO LEARN things, Adam never did that.
Wow! This is really big for us.
From Carey:
Well I decided to try it; the kid’s got to eat anyway and she might as well eat healthy foods. Well the rest is history, she has improved to the point that she is not on any medications and the only supplement used at this time is Thropps Ultra-Zyme Plus. That is helping dissolve her lifelong impaction problem and helping much with the constipation. Freedas multi will be the next one added.
Her behavior is better and she is easier to redirect when angry or
frustrated. She has not had one rage episode since starting SCD over 9 weeks ago. She is starting to care about her school work and will often erase ill formed letters to make it look better, before she couldn't have cared less. Erin smiles more and is starting to understand jokes and to tell them herself. Her skin looks a lot better, better color and less acne breakouts. She also has not had one seizure since her die-off period.
From Brandee:
The only way I could get Hannah to eat anything was by hiding it in almond flour bread. In the beginning we were told to avoid eggs due to a 5 on her IgG test for both egg yolks and whites! That made life hard for "me". Anyway, at some point I decided to give the eggs a try and low and behold they did not seem to bother her in the slightest!
I got serious and started "forcing" her to eat some real (non-almond flour bread, 3x a day) food. Like chicken, green beans....believe me I had tried before but all of a sudden Hannah was more willing. I also changed to pecan flour. Well, all of a sudden formed stools everyday!!! Now that she's easier to feed I began branching out and I must say the chicken pancakes were a HUGE success!!!!!!!!! I'm still celebrating. You know if you add a little hone and cinnamon they are delicious for breakfast!
I guess I am writing for those parents who are stressed about picky eaters....Hannah was the worst, but we are seeing a HUGE improvement in that area now!
From Lisa:
Sometime during the 4th week, he began surprising me with new words and phrases. It is rare to hear him say anything new let alone new words every day! His speech teacher recently tested him in an area that he had just been tested in six weeks ago. Six weeks ago, he scored poorly enough that there was a goal made on his IEP related to this test. When she retested him a week ago, he scored a 19 out of 20. She made a comment about how great he is doing receptively. We have not told her about the diet.
During this last week, he is consistently using sentences with 7 and 8 words and in the last few days he has used complex sentences of 10 - 15 words. I have never heard him use sentences like this. Even when he is using shorter sentences, he will say a couple of them in a row to string his thoughts together. We are having simple conversations for the first time! Prior to SCD, he had been using a single 5-6 word sentence or short phrase to communicate.
I am still having a hard time absorbing the fact that this diet is helping him tremendously. I think I am just afraid it will stop. How can something so simple have such a profound affect on my child and why were we so blessed to stumble upon it?
From Maria:
Matthew has been on diet for 6 weeks and his stool is firm started last week. Also, his behaviour has so much improved. Last night he was trying to talk and for a few days now, he has been using "no more" when he had enough.
We are really excited.... aiming towards recovery from autism.
From Libby:
My 26 month old has started potty-training herself (not mom initiated)!!!
She is non-verbal but has some sign language. The number of signs she uses has doubled since adding yogurt (2+ weeks ago) and tripled in general since starting SCD.
She has gained weight for the first time since February and is now on the weight charts again for her age.
She is interested in eating. Previously we had to force food on her. She no longer headbangs in her highchair or fights when we put her in (she even tries to climb in sometimes!).
We have a very long way to go, but we have already made tremendous gains.
From Penny:
Yesterday I weighed Kenzie for the first time in a long time and he has gained five pounds! Proof positive that something is working. Also tonight he ate a beautiful dinner of two baked chicken breasts (plain), cooked carrots, broccoli, red and green peppers and for dessert, three cashew nut butter cookies. I was thrilled and called two people to tell them about it.
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