pfw,

For 50 grams a day you can get the low GI carbs -- berries (if you don't have any diverticulitis where the tiny seeds get stuck), purple sweet potatoes (I don't believe these are nightshades; the Japanese and okinawan varieties have more antioxidants), green apples, vegetables that you are not allergic too (or better juice them like celery, kale, watercress, cilantro, carrots, etc)...

Have you considered the high value of vitamin D for GI dysbiosis? Neonomide (friend and commenter at HERE) has had quite a lot of success with vitamine D, beta-alanine and carnosine for recovery and maintenance of remission of his Crohn's.

Get your 25OHD vitamin D blood level to 70 ng/ml. This is the level which maintains me asthma-free (and my kids) -- we're all off our our inhalers. vitamin D has HEEEYGE immuno modulation benefits for all organs, particularly the GI tract.

Maintain good trace minerals and magnesium. Mag malate is a good easily absorbed source which does not induce loose stools (oxide is the worst; avoid). Bone broths/marrow-soups are great for collagen and calcium and minerals!

Glutamine? Very specific amino acid the enterocytes. Regrows the shortened damaged villi.

Omega-3 and vitamin A? Taurine? All found in fish/sardines/anchovies of course -- all very helpful also in rebuiding the GI tract.

Ayers talks about avoiding feeding the Klebsiella -- probiotics are important to balance and prevent overgrowth of the bad gut bacterial like Klebsiella and the prebiotics (food) to feed the good bacteria are vital as well. I added some veggies and green apples but I actually have found the easiest to feed them with metamucil/konsyl 1-2 tsp a couple of times per week when I don't eat veggies (too lazy). If you take probiotics, don't forget to cycle them which mimics random evo/paleo eating...

Sounds like you have made amazing progress! Would love to hear later what works the best for you...

-G

Perhaps coconut water would be an option, like this one: http://www.vitacost.com/Vitacoco-100-Pure-Coconut-Water-11-1-fl-oz Fifteen grams of carb, no fiber. Apparently, a lot of people are liking it as a sports drink because of the electrolyte balance, plus it's relatively natural. I'd just check into the processing options is all.

I have AS, which is a klebsiella-powered autoimmune condition like Crohn's. I've followed Ebringer's zero-starch protocol (as described in Carol Sinclair's book) and understand there are a lot of veggie options that provide carbs with only trace amounts of starch. I know your goal is zero, but rather than jump into yams and sweet potatoes from dairy and meat, you may want to try adding in veggies with virtually no starch and see how you do. Kleb will always be in your system, it's about controlling the population, and my understanding is that these very small amounts of starch are OK and will not lead to overgrowth.

For the starch content of vegetables, try this:

STARCH CONTENT OF FOOD

Do you test your food with iodine? I'm sometimes very surprised at what has starch when I do.

Hmmmm...I may be way out in left field, but had pretty severe ulcerative colitis which resoved through VLC/LC/"clean" eating over a couple of years. It was severe enough that after I was clear for 3 years I had an anal repair surgery to fix a large/healed fissure and some prolapse. No symptoms since late 02 and repair done in 05 and no problems since.

I do fine with what are considered to be non-low starchy carb veggies - all kinds of salad herbs and lettuces, tomatoes, all kinds of bell peppers, broccoli, kale, all kinds of greens like mustards, onions,cauliflower, little yellow "summer squash," okra, eggplant,green beans, wax beans, mushrooms, brussels sprouts cabbage,zucchini.

Some people have problems with the cruciferous veggies re: gas/bloating. I do not. Or it is minimal and non-problem producing. I saute okra, yellow squash and cabbage and quick sort of stir fry them and do very well with them that way - also brussels sprouts and kale. Anyhow, some people have problems with those and broccoli and cauliflower. I can eat them cooked or raw (broccoli, cauli cabbage) now with little problem. And I eat LOTS of them.

Having "been there" with a like disorder, I am very happy for you. I'd say take it slowly. And experiment with cooking carefully.

And if I am out in left field, then I apoloigze and hope you find the info you need!

My thought regarding ZC v LC diets for IBD related disease, are that in the initial stages of recovery (if you are in an acute, 10-20 bowel movements/day scenario) a ZC approach may be needed to kick start remission.

However for most people (who are not on a viscious downward malabsorption spiral) a LC approach will most likely be sufficient to head into remission. As we know, KP bacteria are comensal. We will never get rid of them completely. People with the HLA-B27 marker, or IBD just need to starve them enough to re-adress the balance within the colon. The immune system like balance.

In my journey to better health, I learnt the hard way that I couldn't get well, and I mean sustainably better, not a "quick fix" better, unless I took a balanced approach to my eating habits. I can understand the desire to be ZC, because mentally it is nice to think we will "exterminate" the badbugs. However, reality is different. The human gut, mind and body can only maintain long term health through balance. Any extreme approach (though maybe necessary in some for a month or two) in the long run will fail. I carry this approach to all areas of life, health and politics too!

Good luck to you all !

Wow, that's a tough one. If complex sugars are out then fructose and glucose are the only options right? If I am not mistaken all fruits and veggies contain complex carbohydrates, even cellulose is a polysaccharide. That leaves you with honey and sugar. Probably not what you want to eat every day! Liver has about 7-12 grams of carbs, store bought kombucha has 14 grams in 16 oz and 1+1/2 Tbs raw honey has 25 grams. That gives you about 50. Not sure eating liver every day is a good idea though. Of course most might say eating honey every day isn't a great idea either! Might be your best option though...

You might try doing a Targeted Ketogenic Diet (TKD), which means you stay ZC/VLC all the time except you ingest 10-50 grams or so of dextrose right before lifting. I did this for a while, and it improved my performance at that time. A roll of Smarties (the American kind, not the Canadian, which are chocolate) is 5g of pure dextrose.

ETA: There is also coconut oil, which some people say acts somewhat like carbohydrate in giving a burst of energy for athletics. I haven't tried it myself.

Maybe I'm not understanding but if you have been successfully ZC and are feeling great why would you want to change that? If it's an energy thing I'd agree with a previous poster and try coconut oil, you may not be getting enough fat. There is nothing magical about carbs, you don't need them. I have been doing heavy strength training for over a year while ZC, plenty of fat tho, and have endless energy. I fast a lot too. A spoon of coconut oil or a gulp of cream is a wonderful energy boost too. There is nothing wrong with being "ketogenic all the time" so if that is your only concern I wouldn't worry about it..

Doesn't the SCD allow things like honey and fruit juice? Simple sugars usually get absorbed in the small intestine and don't make it to fermentation. So any non-starchy fruit would be up for grabs.

I found that once I was on LC long enough I was able to add back in starch without a problem though, but I had IBS not Crohns.

I would rebuild my gut bacteria so I could tolerate some of the starchy vegetables.

Ayers has a couple posts that implicate highly dysfunctional gut bacteria in Crohn's.

"The bacterial gene compostion of individuals diagnosed with Crohn’s Disease and ulcerative colitis were different and distinct from healthy individuals. Individuals with Crohn’s disease had 25% fewer species of gut flora than comparable healthy controls." http://coolinginflammation.blogspot.com/2010/03/human-gut-flora-genes.html

Have you read/tried Ayers suggests on pectin/inulin rich foods (apples/tomatos & leeks/onions)?

For some people ZC doesn´t mean that recovery is worse. It´s just different. What I have noticed is that it´s easier on zc to not eat enough energy after training, which can make you recovery a bit longer and not as effective. Though if I make sure I eat enough, I usually feel like theres no difference, or even better on zc.

Honey is less processed and still contains its trace minerals. Some feel it also has an antibiotic effect. from my experience, it is definitely antibiotic and good for wound healing when applied topically. I would definitely try honey before I would go with regular sugar. I wonder if maybe some honey mixed with fast proteins might not help with recovery. That's what I would try first, but of course, move slowly and with caution. Cutting back on exercise while you experiment is IMO way safer than risking another Crohn's attack. Also, I am not sure what your goals are as regards to exercise, but 3 times a week should be plenty for a good level of health and fitness. -Eva

Just make sure your small intestine's gut flora is in good health before going hard on honey, lets just say I learned the hard way.

My problem is SIBO and it also caused gastritis so a large volume of food will make me feel bad for a long time. I thought honey would be ideal to get some calories with a minimal volume of food and I was putting my faith on SCD's recommendations which lead me to believe that there would be no problem since it's a simple sugar. Wrong! My problem get much worse and it took weeks to go back to before I had the honey.

I think that the simpler the sugar you eat, the easiest it can be digested by the bacteria in your small intestine, and when this bacteria is mostly bad, it's a bad idea.

Why not just use glucose? I know Peter at Hyperlipid has an ice cream recipe that uses mostly glucose and some honey.

Edit: just looked and realized that he actually uses sucrose. No idea why I thought otherwise. I think dextrose, which is commonly used as an additive in the food industry, is essentially glucose. Though I'm not sure of the health consequences of eating it straight up.

So yeah, just search for dextrose.

Congratulations!

Diabetics use glucose tabs, available at any drugstore.

I think the SCD wants the bananas to be very, very ripe, but I agree that the diet seems inconsistent.

The Bernstein Diabetes Diet book has a list of veg that may be worth a look. http://lowcarbdiets.about.com/od/bernsteinsdiabetesdiet/a/bernsteinfoods.htm.

Here's a list of fruits lower in fructose: http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/low-fructose-diet.pdf

If you do the SCD, I believe it actually allows winter squash and some root vegetables like carrots and beets. These would be good carbohydrate sources.

To address your confusion over sugar and bananas: Unripe bananas aren't allowed on the SCD because they're full of polysaccharides (starch), which require extra digestive steps to break down. However, once ripe, bananas are allowed, because by that point the starch has broken down into easily digested monosaccharides (glucose). Refined sugar (sucrose) still isn't allowed because it's a disaccharide (glucose+fructose) and, like starch, requires extra digestive steps to break down. In a person with compromised digestion, di- and polysaccharides may not be able to be broken down in the normal way, thereby causing potentially pathogenic bacteria and yeasts to proliferate in order to finish the job.

The scd is a bit wacky definately.

It disallows glucose even though that requires no digestion and is absorbed in the first two feet of the small intenstine (max). Making it the ideal carbohydrate form for those with severe digestive issues. It claims this is because "most glucose has other sugars". Which seems to be blatently untrue, from what I can tell.

It then allows unlimited high sugar fruit, and honey and disallows table sugar. Honey has maltose which is very very hard to digest (and fructans, which is ditto).

Fruits contain fructose, sucrose and glucose, just like all the other things she bans.

And fructose is only quickly absorbed if its under a threshold (ie fodmap style, eat it on its own, in small servings, and only when theres a good glucose to fructose ratio).

The whole thing is arse backwards.

If you want to avoid these things, and get carbs, your better to do what I did - eat low "fodmap" fruit, in small portions, on its own, even adding glucose to it, to aid fructose absorbtion rate - or just using plain glucose for workouts. Low levels of fructose are quickly absorbed, especially with glucose, and glucose is the quickest carb there is (its what the GI scale is based on).

Also as far as whole foods, there is at least one fruit thats mostly glucose - cranberries. Although its also low sugar, and tart as heck, thus not an easy way to get large dose carbs. However it is nice knowing that a glass of unsweetened cranberry juice (or even with added glucose) is pretty darn safe.

But yeah, thats my advice. Also, you may not need to be zero starch, in the long run. There are very low levels of starch in some foods that dont seem to bother me, and ive got pretty bad issues. Mind you, I have made a table of low fodmap, low starch foods, and listed all there soluble fiber, fructose and starch contents! Your mileage may vary of course...

You could also look at a digestive enzyme, to speed digestion and absorption of foods. Seems like a practical way to prevent stuff from fermenting. Of course, you probably want an animal based prescription ezyme, as those funky vegan ones are made with god-knows-what (one I brought had rice starch in it for who knows what reason)

Nuts, seeds, and fruit.

OP, RE: Chrons... being an autoimmune disease, I wonder if you've thought of an alternative approach to your treatment. One of the things that I believe, and so do some researchers hence the research I've read about into this... is that not being exposed to parasites as our paleolithic ancestors were.

Worms, a little parasite. I'm not certain of what kind they are but with some googling, you can find out. Physicians are successfully treating chrons by having patients drink a small cup of juice once a month with worm eggs in it, giving them the parasite. This gives the immune system something else to attack in the digestive system instead of the digestive system it's self. Success rate so far is very high with this experimental treatment.

give it some thought???

To find the foods that can be eaten on the SCD Diet, go to http://www.pecanbread.com/p/legal_illegal_a-c.htm and you can also see how to eat in stages as your Crohn's improves at: http://pecanbread.com/p/how/stages.html
There are quite a number of fruits & vegetables that can be eaten as well as some varities of properly prepared dried beans, lentils and also winter squash. Honey is okay too.
Good luck!

Oh yes.... I forget to mention, that homemade sauerkraut and having a spoonful with each meal helped hugely to put me into remission. I also did a series of 6 colonic enemas with my sauerkraut juice. This gave me very fast acting relief and I think help sustained my remission.

This was all very interesting and new to me. I have been suffering from moderate to severe Crohns disease for 8yrs and had never heard about low carb or zero carb. I have small bowel Crohns and have absorption issues. I eat lots of carb rich foods when in a period of flaring because it is the only things that will pass without the excruciating pain. Such as potatoes without skins, rice, etc. Anything soft and low residue. I have not been able to eat beef for 8 years and can only eat other meats when I am not flaring. I usually will limit myself to chicken and fish. I tend to stay away from tuna because it seems to be an issue. If I eat salad greens I usually end up with a restricted bowel. I was in remission for 2 years after I had treatment with 6Mp which killed my bone marrow and resulted in a prolonged stay in the hospital and multiple blood transfusions. I believe that the transfusions stimulated the remission and not the 6MP. I need help as I am entering into another period of flares and remission is done. I am open to any advise or information. I have tried to go paleo recently and failed. Just couldn't get enough nutrition in me being as strict as I had to or at least I was doing it wrong. I do believe in the paleo way of nutrition but i am struggling. Trying to regain my normal body weight and appearance and have not had any luck. Before Crohns 6'1" at 195 to 200lbs. after first major flare up lost 65lbs in two month span and have only been able to recover to 165lbs at my max and average probably 155lbs. If anyone can help I am tired of suffering.