Nutritional Adequacy of the Specific Carbohydrate Diet in Pediatric Inflammatory Bowel Disease

Abstract

Introduction: The specific carbohydrate diet (SCD) is an exclusion diet used as a therapy in inflammatory bowel disease. The aim of this study was to evaluate the nutritional adequacy of the SCD.

Methods: Prospective dietary data for 12 weeks were analyzed for pediatric patients on the SCD. Intake of 20 key nutrients was compared to dietary recommended intake levels and nutrient intake data from similarly aged children from The National Health and Nutrition Examination Survey National Youth Fitness Survey in 2012.

Results: Nine patients enrolled, with 8 patients completing the study. Six of 8 individuals completing the study had gained weight, 1 individual had weight loss, and 1 had no change in weight. Energy intake was significantly greater than 100% of the recommended daily allowance (RDA)/adequate intake for 64% of daily intakes completed for this study. The majority of participants' daily intakes met or exceeded the RDA for vitamins B2, B3, B5, B6, B7, B12, C, A, and E. One hundred percent of participants' intakes were below the RDA for vitamin D. Seventy-five percent of daily intakes were less than the RDA for calcium. The upper limit was met or exceeded for magnesium in 42% of daily intakes. Average vitamin A intake was significantly greater than the upper limit (P = 0.01).

Conclusions: Nutrient intake of pediatric inflammatory bowel disease patients on the SCD was adequate when compared with a healthy peer reference population, but adequacy was variable when compared with the dietary recommended intakes. Close monitoring with a multidisciplinary team for patients using the SCD as an alternative or adjunct therapy is recommend to ensure positive outcomes for overall patient health.

Trial registration: ClinicalTrials.gov NCT02213835.

Conflict of interest statement

Conflicts of Interest: None of the authors have a conflict of interest in regards to this article except for David Suskind who has written/published Nutrition in Immune Balance (NIMBAL).

Figures

Figure 1

Height, weight, weight velocity, and BMI z-score for Specific Carbohydrate Diet (SCD) patients. Each color shows the profile of an individual patient.

Figure 2

Percent of Recommended Daily Allowance (RDA)/Adequate Intake (AI) for energy and protein. Specific Carbohydrate Diet (SCD) patient data are displayed in blue. National Youth Fitness Survey (NYFS) data are displayed in red. Circles shown on boxplots are means.

Figure 3

Percent of Recommended Daily Allowance (RDA)/Adequate Intake (AI) for vitamins. Specific Carbohydrate Diet (SCD) patient data are displayed in blue. National Youth Fitness Survey (NYFS) data are displayed in red. Circles shown on boxplots are means.

Figure 4

Percent of Recommended Daily Allowance (RDA)/Adequate Intake (AI) for minerals and trace elements. Specific Carbohydrate Diet (SCD) patient data are displayed in blue. National Youth Fitness Survey (NYFS) data are displayed in red. Circles shown on boxplots are means.

Figure 5

Percent of Upper Limit (UL) for vitamins, minerals, and trace elements. Specific Carbohydrate Diet (SCD) patient data are displayed in blue. National Youth Fitness Survey (NYFS) data are displayed in red. Circles shown on boxplots are means.