Therapeutic Diets: Which diet should I choose????

Therapeutic Diets: Which diet should I choose????


Are you confused about which therapeutic diet you should choose? You aren’t alone! With so many to choose from, it is no wonder that some people have a lot of trouble figuring out their diet and nutrition.


Kathryn  knew she wanted to change her diet to get healthier and maybe even lose a little weight, but she didn’t know how to go about it. She kept hearing about so many different diets and the more she read about it online, the more confused she became. While it is always best to work with a health practitioner such as a Naturopathic Doctor or a nutritionist when making a serious diet change so that you have all of the support you need, I wanted to break it down for you so that you have some idea which approach may be the best for your specific situation.




Many people seeking relief from chronic GI conditions will turn to diet modifications and a nutritional approach.   The bottom line is if you suffer from chronic health issues, you MUST address diet.  Gut bacteria can be modified and  nurtured through the diet, for better or for worse.  Most of these therapeutic diets restrict gluten,  grains and starches, at least for part of the diet, and at least for a time period .  There are many similarities and whichever one you choose to start with  will depend upon your individual goals, your  needs, your individual food intolerances and which one actually works the best for your body!


SCD (Specific Carbohydrate Diet)

The Specific Carbohydrate Diet was designed by the late Elaine Gottschall  MSc to help people with GI and inflammatory disorders.  It restricts certain carbohydrates such as grains and sugars that are difficult to digest and allows easily digested carbohydrates from fruits and vegetables.  The following foods are allowed on the SCD:

  • Vegetables (except canned)
  • Legumes (except the ones noted below)
  • Unprocessed meats, poultry, fish, and eggs
  • Natural cheeses (except those listed below)
  • Homemade yogurt fermented at least 24 hours
  • Most fruits and juices without additives
  • Nuts, peanuts in the shell, natural peanut butter
  • Oils: olive, coconut, soybean, and corn
  • Weak tea and coffee
  • Unflavored gelatin
  • Mustard and vinegar

The following foods are not a part of the SCD diet:

  • Sugars: lactose, sucrose, high-fructose corn syrup, fructose, molasses, maltose, isomaltose, fructooligosaccharides, and any processed sugar
  • All canned vegetables
  • All grains: anything made from corn, wheat, wheat germ, barley, oats, rye, rice, buckwheat, soy, spelt, and amaranth
  • Some legumes: chickpeas, bean sprouts, soybeans, mung beans, fava beans, and garbanzo beans
  • Starchy vegetables: potatoes, yam, parsnips, seaweed products, agar, and carrageenan
  • Canned and processed meats
  • Dairy: milk, milk products, ice cream, whey powder, commercial yogurt, heavy cream, buttermilk, sour cream, and the following cheeses: ricotta, mozzarella, cottage cheese, cream cheese, feta, processed cheeses, and cheese spreads
  • Canola oil, commercial mayonnaise, commercial ketchup, margarine, baking powder, and balsamic vinegar
  • Candy, chocolate, carob

The Specific Carbohydrate Diet eliminates dairy (except for a homemade yogurt) , grains, and other starches.  This diet usually frowns on raw vegetables and tomatoes as these can be hard for someone with a compromised digestive system to breakdown without a lot of gas and bloating.  If someone is having severe GI issues, then steps are often made to eliminate the raw vegetables and especially tomatoes (cooked or raw). The SCD is different from the other therapeutic diets that I will mention in that it allows legumes. Many of the other diets do not allow legumes as for some people they can exacerbate a GI condition. For many people legumes are fine and the SCD may be a good choice for those who choose to be vegan.


SIBO Specific Food Guide

Allison Siebecker, ND, who practices in Oregon  and works a lot with SIBO patients has created this handy guide specifically for SIBO patients.  She utilizes the SCD a lot and has modified it specifically for SIBO.

Here is a link to her online dietary  resource with a handy graphic:



Biphasic Diet


Another version of a therapeutic SIBO  diet is the Biphasic Diet by Nirali Jacoby, ND, a Naturopathic Doctor who practices in  Australia.

Here is the link which also includes some recipes:  




The FODMAPS diet is based upon the idea that Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAPs) are found in the foods we eat. FODMAPs are sugars that are poorly absorbed in the small intestine and reach the large intestine where they produce gas and attract water.


 The FODMAPS diet was created in Australia and is often used for IBS and SIBO. The main concept is that these sugars, or FODMAPS, feed gut bacteria and can increase gas, bloating, diarrhea and constipation.  My main source of what is and is not allowed in the FODMAPS diet is GESA, or the Gastroenterological Society of Australia.  You will find many iterations on the FODMAPS diet on the internet, but the main source is on the link!



I like this chart in particular because it breaks down the foods which contain the individual sugars such as excess fructose, fructans, lactose, Galacto-oligosaccharides (GOS) and Polyols.  I find that some of my patients eventually can tolerate some of the sugars, but not others once they heal.  Some strains of the gut microbiota may be more susceptible to overgrowth from one of the sugars, but not others.  The concept is that if treatment is successful that the patient can eventually add in certain foods again, depending upon his or her response.

Long term restriction of carbohydrates can effect the bowel flora and the balance of the microbiome, so it is important to eventually incorporate prebiotics which often include fructans and GOS into the diet in order to keep the microbiome in a healthy balance for healthy functioning of  neurotransmitters, the immune system and other bodily systems that need to be considered.


I use a version of the FODMAPS diet for SIBO and IBS in my practice. This is especially important when it is important to keep bacterial overgrowth to a minimum and it is usually very effective.


The Paleo Diet


The Paleo diet is based upon what our early hunter-gatherer pre-agricultural ancestral humans would have eaten.  Anthropological studies have shown that very early humans, if they managed to escape starvation, bacterial infections or accidents, lived a fairly long lifespan free of the chronic degenerative diseases that modern humans suffer from.  Remote modern day hunter-gatherer tribes eating their native diets enjoy good health free of these disease. After they are introduced to our modern Western diet they often succumb to the same chronic degenerative diseases that the rest of the modern world suffers from. Here is my handout that I give to my patients who are embarking on the Paleo Diet.


What is the Paleolithic Diet?

The Paleolithic diet is the way humans ate over 10,000 years ago- a time period before farming and processed foods.  It was the hunter-gatherer method of obtaining food for survival. The diet is rich in fiber, protein and healthy fats. It is low in processed foods, is filling and contains an ample amount of vegetables. There is usually no need to count calories or carbohydrate grams. The diet is good for fat- loss, blood sugar control and digestive health.

What foods can I eat on the Paleolithic diet?

  •  Meat, poultry, eggs, and fish – Ideally, grass-fed animals and wild fish
  •  Nuts and seeds- raw, nut butters (no peanuts)
  •  Fruits- all except bananas
  •  Vegetables- all
  •  Healthy fats- Coconut Oil, Olive Oil, Palm Oil
  •  Herbs & Spices
  •  Honey, Maple Syrup, Stevia

What foods are not allowed on the Paleolithic diet?

  •  Wheat and gluten containing grains
  •  Corn, barely, oats, rice, rye
  •  Processed soy- soy milk, protein powders, imitation meat made from soy
  •  Legumes- beans, peas, peanuts
  •  Dairy
  •  Oils- corn, soybean, safflower, imitation butter
  •  Sugar- sodas, fruit juices, high fructose corn syrup, agave, table sugar, artificial sweeteners (aspartame and sucralose)



The strict  Paleo Diet includes grass fed or organic meats and wild caught fish, veggies, tubers,  fruits, nuts, seeds, eggs, and natural oils such as olive or coconut oil.   That is it basically.  The main mistake I see people on the Paleo Diet making is that they are eating huge portions of the meat and a little big of veggies and fruit.  The proper way to do the Paleo Diet is to eat smaller portions of meat with large portions of veggies and fruits.

For those who have severe Autoimmune Disease, there is a variation on the Paleo Diet which is known as the Autoimmune Paleo Diet or AIP for short.  

The basic difference is that it removes nuts, seeds and eggs from the already restrictive Paleo Diet.  It can be useful to really control inflammation and antibody production in those who are severely autoimmune or in the midst of an autoimmune flare-up.  Because the AIP is even more restrictive than the plain old Paleo Diet,  a lot of creativity is needed to make this diet doable and not so restrictive. Here are a few links for AIP recipes:


The Ketogenic Diet


The ketogenic diet has been around for quite a while. It was originally used for children with epilepsy to control siezures and now is used for  a wide range of conditions such as weight loss, diabetes (diabesity), and even cancer. Research by Dr. Seyfried of Boston College has shown that it slows tumor growth since sugar and carbs feed cancer cells.


The ketogenic diet is based upon the idea that burning fat for fuel is preferable to burning sugar and carbs. The ketogenic diet has been shown to suppress inflammation and help the mind work clearer and supports increasing muscle mass. It is also an amazing way to lose weight when done under supervision.

There are many variations of the ketogenic diet out there. There are specific ones for epilepsy, cancer and other conditions. Some of the ketogenic diets are very “hard-core”.  I offer the Ultra Lite Food Plan for weight loss at my clinic, which is ketogenic in its function, and then there is the officially trademarked “Keto” plan which is a little bit different.


Here is some basic info on the ketogenic diet.

More information on the Ultra Lite Food Plan can be found here:



The GAPS Diet


The GAPS diet  (Gut And Psychology Syndrome) is often used to treat patients with autism, learning disabilities, psychological and behavioral conditions. It is based upon the premise that when your gut is wacky, you produce inflammatory Cytokines which affect the brain. Cytokines can contribute to and worsen brain fog, mood swings,  depression, bipolar disorder, ADHD and other conditions along the autism spectrum.  Many people have found that their conditions improve when following the GAPS protocol. The basis of the GAPS diet is paleo, again, but there is an intro period.  There is a lot of overlap and similarities with GAPS, Paleo, SCD, etc, because there are basic truths that in order to heal the gut lining you need to avoid carbs and grains and this will also help heal the gut lining, improve insulin metabolism, prevent diabetes and maybe even cancer. The GAPS diet is the work of Dr. Natasha McBride.  Here is her website for more specifics.

Kathryn was happy to receive some nutritional guidance from me. We ended up doing the Ultra Lite ketogenic diet together and she lost a few pounds, got rid of the chronic joint pain that was plaguing her ( a side benefint as she hadn’t mentioned it as a primary goal when we first met), and now has more energy and is sleeping better also.

I have a practice that specializes in digestive health. I can work locally in Colorado or remotely. I work with people who live all around the world. If you are interested in working one on one with me, I offer a FREE 15 minute phone consultation to see if we are a good fit for each other. You can schedule that online here .  You can also call (303) 443-2206 to schedule M-F 9-5 Mountain time. If you want to jump right in, you can immediately schedule your initial visit. I hope to hear from you soon




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