The Household Physician


by: Elaine Gottschall, MSc

In 1975, Elaine Gottschall became a member of the Department of Cell Science at the University of Western Ontario's Zoology Department. She spent four years there investigating the effects of various sugars on the digestive tract working mainly on the cellular level. She obtained a Master of Science degree in that Department in 1979. Results of her work are published in the journal, Acta Anatomic 123:178 (1985). Subsequently, Mrs. Gottschall worked in the Department of Anatomy of the University of Western Ontario investigating the changes that occur in the bowel wall in inflammatory bowel disease. Her main field of interest is the effect of food on the functioning of the digestive tract and on behavior. Elaine's best known book, Breaking the Vicious Cycle introduces us to the Specific Carbohydrate Diet (SCD) which helps us to heal the intestinal tract and rid it of bacterial and fungal overgrowth. It has been successful in curing Crohn's disease, many cases of ulcerative colitis and other problems. Recent research indicates that it is proving to be a successful dietary intervention in treating autistic children, schizophrenia and other neurological disorders. See
For the amazing story about Elaine's personal journey to heal her daughter, and her discovery of the SCD diet from Dr. Sidney Haas, please see Consumer Health Newsletter, January, 2004.

AUTISM AND GASTROINTESTINAL PROBLEMS In l998, scientists at Harvard University published some marvelous research demonstrating that autistic children are afflicted with serious gastrointestinal problems, very much like Crohn's and colitis, some of them with severe constipation. And guess what! They mentioned my book.

AUTISM AND THE SCD DIET Unbeknownst to me, several years ago, a mother in New Jersey started a website called Elaine's Children. Finally someone told me about the listserv and there are now 700 mothers and fathers of autistic children on the listserv following the SCD diet, and these autistic children are getting better. These mothers had been told to put their children on a "gluten-free" diet, which is the world's worst diet. I hope that any celiacs who are not happy with the results of the gluten-free diet will please try the SCD diet. I will show volumes of peer-reviewed scientific research which prove that anybody with gastrointestinal problems cannot digest all the starch. People on the gluten-free diet are eating gluten-free bread, which is loaded with starch. They are carbohydrate addicts and it is a very bad diet. I won't say that all of autism spectrum disorder children are getting better but there are a number who are actually emerging from the cocoon, turning into beautiful butterflies, as if a web is being pulled off of their brains. These kids have gut problems which doctors did not pay any attention to, and the same diet that was reversing Crohn's disease and colitis is healing these children's guts. I don't know what causes autism. There is tremendous controversy about it, that it may be caused by mercury, etc., but I do know that I am seeing results. These children are coming back to normalcy. I'm currently involved in some basic research on autistic children following the SCD diet with a professor at the University of Arizona.

CARBOHYDRATES Carbohydrates found in food are: 1. Single Sugars (monosaccharides) - glucose, fructose and galactose. Glucose and fructose are found in honey, fruits and some vegetables and galactose is found in yoghurt fermented for 24 hours. 2. Double Sugars (disaccharides) - lactose, sucrose, maltose and isomaltose. Lactose is found in milk and dried milk, regular yoghurt, processed cheese, cottage cheese, etc. Sucrose is table sugar found in most processed foods and pasteurized honey. Maltose and isomaltose are found in corn syrup and candies and dietary starches. 3. Starch (polysaccharides) is present in many kinds of grains and other starchy foods. Starch is composed of thousands and thousands of sugars on a long chain or branched chains, which cannot be utilized by the body until the digestive system breaks them down into single units.

DR. HAAS'S THREE BASIC RULES: Dr. Sidney Valentine Haas wrote the first comprehensive text on celiac disease. He did not use a gluten-free diet. He used the Specific Carbohydrate Diet, which he taught to me and I wrote about it in my book, Breaking the Vicious Cycle.
1. You can have all the fruits and vegetables you like with the exception of potatoes, corn, rice and grain. The sugars in fruits and vegetables are in predigested form, monosaccharides. Bananas must be ripe. An unripe banana contains starch. You can have meat, fish and eggs.
2. You cannot have table sugar, maple syrup or molasses which are primarily sucrose (a double sugar, a disaccharide), that the small intestine must split into simple sugars, which people with gastrointestinal problems cannot effectively do. You may have honey, because honey is a pre-digested sugar.
3. You cannot have fluid milk because it contains milk sugar. But you can make yogurt and ferment it for 24 hours, which will get rid of the lactose. You can have certain types of cultured cheeses because the good natural cheeses like havarti, brick and cheddar do not contain lactose.

GRAINS You cannot have grains. Grains contain starch. How do you bake without grains? In Austria, they bake beautiful nut tortes. You grind the nuts in the blender, almonds, pecans or filberts, and add honey, eggs and spices and bake them. It's delicious.

UNDIGESTED CARBOHYDRATES The food molecules of proteins, carbohydrates and fats must be broken down into their mono form. The blood vessels surrounding all parts of the small intestine and the colon are looking for single sugars, single amino acids or small molecules of fat to take into the bloodstream so they can deliver those nutrients to the rest of the organs - the brain, the thyroid, the lungs, the kidneys and the skin. Food molecules pass through the 23 feet of small intestine, and little by little the proteins, carbohydrates and the fats are made digestible. If any of those molecules, and especially the carbohydrates, are not broken down, they do not harmlessly pass out and get flushed down the toilet. They continue to go down to the colon where they meet an unseen world of bacterial and yeast growth that especially likes to live on the carbohydrates that you do not digest and absorb. They will overfeed the world of microbes. The more food, the more bacterial and yeast proliferation. When these bacteria and yeast grow, they give off by-products like organic acids and toxins. The acidity of the colon will change and will become very acidic as a result of the by-products of the microbes getting nourishment from the carbohydrates that should have nourished you, and as a result of the change in acidity, they mutate. All kinds of things happen down there. But don't think that eating foods that you cannot digest are just going to innocuously land in the toilet. They are going to pass into this unseen world. That's where the bloating is coming from. The undigested carbs give the microbes the energy to reproduce, but in the process they give off hydrogen gas, carbon dioxide gas, and sometimes even alcohol. Sometimes you see intoxication in the autistic children. On the "gluten-free" diet, these starches are not digested and the child may be producing alcohol, lactic acid, acetic acid and toxins. Right here where the small intestine meets the colon and in the colon close to the appendix, is where you have the greatest microbial proliferation of yeast and bacteria. That's exactly where most of the Crohn's disease starts, right in the ileosecal junction. If you continuously get pain there, you better watch your carbs. You better eat the smart ones and not the dumb ones.

THE GOOD AND BAD CARBOHYDRATES I can't say that I know everything about carbs but I'm a little disconcerted about what the media is doing with them. The smartest thing I've heard has come from Dr. Phil. Dr. Phil's got it right. He says there are smart carbs and there are dumb carbs - the smart carbs are those found in fruits and vegetables. The good carbs require very little in the way of digestion. They're already in a form that can transverse the intestinal surface and get picked up by the bloodstream. The sugars that Dr. Haas told me were bad news were lactose, which is a disaccharide, sucrose which is a disaccharide and a few others which come from starch. A starch molecule is composed of hundred of these sugars. Many of you have read The Yeast Connection and you'll go to some practitioner who will tell you not to eat fruits because they have sugar which will feed the yeast but that it's okay to have some grains. Grains contain starch and hundreds of sugar molecules, and the probability of them reaching your colon and feeding the yeast is tremendous. So, they've got it backwards. The parents of autistic children are scared to death to try fruit, because they have been told that the kids have yeast overgrowth.
Yes, we do cook our fruits, we peel them and we go easy with them. We don't give a child two cups of applesauce the first day - we go slowly. But those sugars are the least apt to feed the yeast, whereas the complex sugars - the glucose molecules in the starch, the rice, the grains, the corn, are disaccharides and require tremendous digestive process. Generally the pancreas produces enzymes which will cleave a starch molecule, but even after the pancreas does break some of these links, we are left with two sugars (disaccharides) which have to be broken down by the intestinal cell. That is where the problem is. It can only absorb those carbs in this form of simple sugars. The two sugars that come from starch, maltose and isomaltose are really the culprits in most of these cases and they're coming from starch, not from fruit. The diagrams which illustrate this process are in my book and on my website

PHYSIOLOGY OF DIGESTION Your small intestine is the digesting and absorbing organ, and if you cut it across like an orange and look at it under the light microscope, you see it is covered with hills and valleys and the hills are covered with intestinal cells and on the tip of every one of those intestinal cells are tiny microvilli which complete the digestion of starch and break down the complex sugars. The enzymes are on the top of these tiny microvilli on the top of every intestinal cell and they contain the digestive enzymes like sucrase, lactase, maltase and isomaltase. If the dietary disaccharides are digested by the microvilli on the surface of the intestinal cell, they will then enter the bloodstream and nourish the rest of the body.

If you have intestinal problems in celiac disease or these kids with autism, you do not have any of these microvilli left, or they are covered with layers of mucous. Biopsies show layers of mucous which means that the digestive enzymes cannot contact the sucrose, lactose and starch molecules that are left after pancreatic digestion. But the intestine has wonderful regenerative capacity. The microvilli can regenerate in three days. That is why this diet is so amazing. When someone responds to it after having diarrhea for ten years, they begin to have normal formed bowel movements.

LEAKY GUT SYNDROME Under normal conditions, the cells adhere to each other tightly like Velcro is attaching them. However, three conditions will cause the spaces between the cells to open up: (i) too much alcohol ingestion; (ii) taking drugs like the non-steroidal anti-inflammatories; and (iii) bacterial overgrowth on the small intestinal surface. Many allergists claim that autism is being caused by some proteins getting through these membranes - these leaky guts. If we clear up the bacterial growth and let the cells adhere, the proteins won't get through anymore and cause over-activation in the immune system. So what we're trying to do is get the bacterial proliferation down by not allowing them to have these carbs which are supposed to be nourishing us.

RICE This diet allows no rice at all. People say, how about wild rice, it's really not a grain, it's a grass. No rice at all, none whatsoever. Brown rice is not molecularly different from the other complex carbohydrates. It is a starch, almost unadulterated pure starch.

RAW FOOD You do not necessarily eat raw food on this diet because an inflamed gut will not tolerate raw food at the beginning of this diet. Even though a raw food diet is a wonderful diet for healthy people and I get 75% of my diet in raw foods, for these people with celiac disease, not for maybe two to three weeks until the diarrhea clears up. Raw food is allowable once the intestine heals.

SPROUTED GRAIN I would not use raw at the beginning. I'd wait a week or two. But sprouts are very good for you and they are a perfect example of how a growing organism cannot use a complex carbohydrate molecule to get energy. The actual seed has starch, but a growing plant cannot utilize starch unless it is digested. Under proper moisture and heat, the starch enzymes begin breaking down the starch into monosaccharides. (glucose) and that is what nourishes that young plant and allows it to grow. Therefore, if you want to cut the sprouts off and eat just the young sprouts, the higher up the stem the better, they are legal on this diet. You do not eat the seed pod on the bottom because it still has some starch.

BIOPOLAR DISORDER Even though we have had some success with schizophrenia, I have no experience whatsoever with bipolar. But the brain with its trillions of neurons is the most demanding organ in the body, and if you are not getting the nutrients from a good nutritious diet which this is, and if you are getting bacterial toxins from too much fermentation in your colon, it's bound to effect your brain. So I can't give you the kind of statistics for bipolar disorder that I can give you for the other things, but you could try it; it's a wonderful diet. You don't have to mortgage your home. You just try it for a month or longer. It's a good diet it is going to help many different problems.

OTHER DISEASES There are many diseases (e.g. hepatitis) where the completion of the digestion of carbohydrates, the breaking down of the complex sugars, cannot be performed. It's been well documented in the literature. My diet normalizes weight, but the aim of this diet is not to reduce weight. It is for a community of people who are terribly ill, as my child was, with neurological problems, skin problems, all kinds of problems. About 30% of people with chronic intestinal problems have skin problems. I found out that the diet was indeed reversing many autoimmune diseases. To my knowledge, there are three lupus cases that are well. Many of the skin diseases that accompany gastrointestinal problems were being cured. The wonderful thing is that people on that stupid "gluten-free" diet, who switched to the Specific Carbohydrate Diet developed by Dr. Haas, were getting well.

A NUTRITIOUS DIET This diet is, without a doubt, I think, the most nutritious diet in the world. You get all your vitamins, minerals, and all the nutrients, like essential fatty acids, in your food without having to spend a fortune on supplements. My daughter and I stay on the diet 85% of the time. We do not eat potatoes or rice or yams on this diet. We use butternut squash, acorn squash with a bit of honey and butter, and the squash has a completely different molecular structure to the starchy potatoes. It's a perfectly wonderful diet, very much like the Paleolithic diet. It's gourmet food.

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