Debate and concern about the Specific Carbohydrate Diet [2]

Book Review
Mon, 14 Apr 1997 4:40:21 GMT

The book review below was passed on to me by my wife.

It always amuses me to see how something that hasn't been confirmed by scientific method is dismissed out of hand as untrue. That is flawed logic. Annecdotal evidence is the start of all scientific research -- it is what leads to the hunch and the hypothesis.

Likewise the claim that the book it is based on outdated research is a meaningless claim. All research is made by standing on the shoulders of giants who went before us. It would be a different story if the reviewer were citing new studies that contradict Elaine's hypothesis.
But that wasn't done.

Harold Hirsch

From 1997 Winter --- CSA/USA, Inc. Lifeline Magazine Page 6


Book Review

From Celiac News, the newsletter publication of the Canadian Celiac
Association...Summer Edition J 1996, Volume 10, Issue Number 2, page 12.

Mavis Molloy, RDN of the Canadian Celiac Association (CGA) Professional Advisory Board presents a series of standards for reviewing a publication in the Book Review column of the Summer Edition of their association newsletter, Celiac News.
Excerpts from her excellent review are shared for use and consideration when examining a new publication whether that is a reference volume, cookbook or journal article.
The Book Review centers on the publication, Breaking the Vicious Cycle by Elaine Gottschall. This book along with several others currently being promoted in the market should never be recommended for persons with Celiac Disease.
Following are quotes and excerpts from Mavis Molloy's review:

"Breaking the Vicious Cycle is not recommended as a credible source for the dietary treatment of Celiac Disease. The material is virtually the same as Gottschall's first book 'Food and Gut Reaction' except for the addition of a foreword written by a Dr. Ronaid L. Hoffman, a new chapter called the Brain Connection and several new recipes. Her first book cannot be recommended nor can we recommend this one.'
"Gottschall hypothesizes that disaccharide/polysaccharide intolerance teads to a decrease in absorption of these sugars causing bacterial overgrowth and an increase in bacterial by-products and mucous production, thereby injuring the small intestinal surface leading to further carbohydrate Intolerance and malabsorption, etc. Hence' the 'vicious cycle.' She theorizes simplistically, that it is this cycle which leads to many intestinal problems such as, Celiac Disease, Crohn's Disease, Ulcerative Colitis, Diverticulitis, Cystic Fibrosis' and Chronic Diarrhea. This theory is not scientifically tested and is only supported anecdotally."
'The Specific Carbohydrate Diet' (SCD) is proposed to work by using predominantly 'predigested' carbohydrates which are completely absorbed by the intestine thereby depriving the bacteria in the intestine of food and breaking the 'cycle.' "
"The SCD 'eliminates' all grains, starches and disaccharides. This translates into no wheat, rye, oats, barley, triticale, corn, rice, millet, buckwheat, amaranth, quinoa, cottonseed, cereal bran, fluid milk, commercial milk products, processed and canned meats, canned vegetables, and apple juice except pure apple cider."' The following listing represents summaries and excerpts from Ms. Molloy's eight concerns regarding this book:

1. The SCD is not nutritionally balanced, making it difficult to meet all nutritional requirements.

2. The author used outdated scientific data to substantiate her claims.

3. The author leads you to believe that the SCD is virtually disaccharide-free; however, the fruits and vegetables allowed contain significant amounts of disaccharide.

4. The author quotes medical and research data but selects only facts which might lend credibility to her theory.

5. The author claims that her diet works for individuals with Celiac Disease who are not responsive to the gluten free diet. She outlines the criteria for diagnosis of Celiac Disease as established by the European Society of Pediatric Gastroenterology (ESPGAN). She then goes on to claim that many celiac patients who do not fulfill the ESPGAN criteria may benefit from her SCD. This is a fallacy and illogical because those patients who do not fulfill the ESPGAN criteria do not have Celiac Disease and would not be expected to respond to the gluten-free treatment.

6. The author claims that other intestinal conditions give rise to the same villous atrophy as found in Celiac Disease. This is simply not true. Changes and observations seen in other conditions would not be confused with Celiac Disease by any competent diagnostician.

7. Much of the information presented in the new chapter on 'The Brain Connection' is anecdotal. There is simply no substantiated evidence supporting the effectiveness of the gluten-free diet in the treatment of schizophrenia (or other variances and classifications of mental illness).

8. The SGD is based on an outdated version of the gluten-free diet. 1951 information needs to be validated and brought up-to-date.
Any book which makes sweeping claims to cure a disease must be viewed with caution. Books such as this one written to appeal on more of an emotional level rather than an objective' scientific level typically represent theories and ideas which need to be questioned. There was a time when books with an introduction and review by a medical professional could be looked on with a higher level of acceptance and a rationale for generai direction and use, this is not the case with Breaking the Vicious Cycle.
When dealing with a condition such as Celiac Dlsease for which the real cause and the real cure may not yet be known; where we are dealing with well-researched theory and practice, but may not yet have all the answers -- there is much room for the next author' the next professional, the next jackass willing to bray" (credited to Will Rogers) -- to do a "sales job" with "their selection of data" and their "approach and rationale" for you the reader or listener, for you the celiac who is actually out looking for good direction and some solid information. But it may not be there; it may not be available-just yet.
For a diet such as the gluten-free diet for which perhaps only two to three percent of the information is presently known and available to us, considerable more research and practice remains to be done. Yes, the other 97 percent is out there someplace, but it may not be in that new coskbook or slick paperback you pulsed off the shelf just last week. The message continues to be -- let the buyer beware! Caveat Emptor! One buys at his own risk. And without a solid, cautious and scrupulous evaluation for many of the publications and cookbooks rushing into the market, one buys and "buys into some new idea or practice" or "is taken in" at an even greater risk.

Book review sent by Harold
Tue, 15 Apr 1997 1:34:07 GMT

It angers and upsets me when I come across these types of reviews. My reply to that woman would be: "then why did it work for me when nothing else would". I am sick of convincing people who just want to be against something instead of giving it a chance. Why doesn't this woman want to let celiac or other patients try this diet? It is clearly not dangerous, so people should be free to try it as they please, without interferance and unfounded reports like hers.
Her whole report is just as anecdotal and unscientific as what she is arguing against. I guess I must learn to ignore these nay-sayers, though it is very difficult!.

The book review
Wed, 16 Apr 1997 2:20:56 GMT

In regards to the book review making the list and making some people angry. I am on the diet and it is not a clear cut answer for me, Asacol is clear cut. I cut down a pill from a rather high dose of 12/day and I have a flare for days/weeks. I have been faithfully on the diet for 4 months and have not had more than 2 weeks of relief from the symptoms.
I am sticking with the diet, I figure it can't hurt.
Let's be honest the SCD is anecdotal and not tested. We really don't hear from individuals where there has been no change or worsening, perhaps there are none, perhaps they are guilty over their lack of success.
Those of you that it is helping have a good likelihood of suffering from "sprue" or another food intolerances.
Or it is possible that you are simply due a break in the flare cycle, or it works. Perhaps Ellen is on to something but it has not been supported by rigorous scrutiny. There have no controlled studies.
I would suggest that we not get too defensive. Take from the diet what works and live and let live. Those of us that have a science background realize that her science is shaky at best. Again don't let legitimate scientific concerns demoralize you or anger you. If it helps you stick with it.

Dave Johnson <>

scd diet it a cure ?
Wed, 16 Apr 1997 4:26:34 GMT

has anyone been cured by this diet ????..originaly i started when i was basically symptom free because i read a testimonial of someone who stated they were tols by the doctor there was no more evidence of chrons this possible ??? i am debating wether i will continue on the diet . whats the longest someone has been symptom free? and has anyone been symptom free long enough to come off of the diet without a relapse ?

noradel <>

Re: scd diet it a cure ?
Wed, 16 Apr 1997 13:28:44 GMT

Dear Noradel,
The only proof I have or need are the results of my last 2 colonoscopies which were taken while I've been on the diet. They show no signs of Ulcerative colitis, and in the place where there once was extensive disease, they now show a totatly healthy colon. May 1st will be 2 years on the diet for me and although I have recently begun straying "just a bit", I do so very tentatively. I've had no reactions to straying yet but am uncomfortable with it and I do make sure to eat my yogurt every day. I've been symtom free for over a year and pray to continue in the same vein.
Love to all, Rachel

Fri, 18 Apr 1997 20:34:51 GMT

Dear Judy,
I know all too well how skeptical of anything new to try, like this diet, can be for those of us suffering with these diseases. The diet worked very quickly for me (in spit of my skepticism).
Elaine says she has about an 80 percent success rate with people trying this diet. These figures far exceed those that coventional medicine seem to be able to. I agree with you that steroids should be avoided unless ABSOLUTELY necessary. Good luck to you in finding releif. A good first step would be attempting the diet.

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