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Nutritional Therapy for IBD
Improving the Care of Patients with Crohn’s Disease and Ulcerative Colitis through Nutrition
Overview of Therapeutic Diets
Comparing and Contrasting Therapeutic Diets
While each of the therapeutic diets are unique in their approach, all of the therapeutic diets presented here have certain underlying principles in common. They all seek to eliminate food items that have been shown to be harmful in general (eg, processed foods and additives) as well to eliminate, restrict, or limit food items with potentially damaging effects in IBD (eg, gluten, sugar, and/or dairy). At the same time, they all strive to increase the quantity and variety of beneficial fruits and vegetables and focus on generally healthy whole foods.
The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) has recently provided recommendations regarding specific dietary components, food groups, and food additives that may be prudent to increase or decrease in the diet of patients with inflammatory bowel diseases to control and prevent relapse. This consensus may provide additional perspective when reviewing the food categories contained in these charts.
These tables are provided as a simplistic overview of the basic requirements of the diets and are intended to illustrate the similarities and differences between the diets. They offer a bird's eye view of restricted and allowed foods. They are not an all-inclusive list of the allowed and restricted foods, nor do they define all the rules of each diet. Thus, they should NOT be used as a guide to following any of the diets. When a diet is chosen, patients should work with a dietitian to implement the diets and properly progress through the phases/stages, referring to the documentation provided by the diet creators.
Stages/Phases Used in the Tables
All of the diets provide some guidance, if not official stages/phases, for introducing foods when beginning. Required adherence to therapeutic diets is generally more strict than most traditional diets, which tend to allow for deviation in moderation. That said, all of the diets do allow for testing other foods to some degree, either via a compliance goal or via reintroductions after sustained remission, noting that such additions are only incorporated into the diet if tolerated and may need to be consumed in moderation. Adding foods outside the allowed parameters of the diet may or may not be successful and, for some diets, is not recommended even if allowed.
With some exceptions as noted below, the Food Table is based on the last and most inclusive phase or stage of the diet (most foods allowed) that does not involve adding back in random tolerated food choices. Remember, when beginning a therapeutic diet, if stages/phases are recommended or required, all of the potentially allowed items may not be available at once. The phase/stage presented for each diet is as follows:
SCD and mSCD
The final stage of SCD and mSCD are described in the table. While SCD does not have official stages (it does have an introductory diet to last no more than 5 days and a short list of advanced foods) , the stages described on pecanbread.com are often adopted by patients with symptoms and active disease. These stages are not part of the official diet but can be used as a guide when food introduction proves difficult. Both SCD and mSCD allow for introduction of other healthy foods outside the normal parameters of the diet after sustained remission (generally recommended to wait until 1 or 2 years of sustained remission). Because these food additions could be anything tolerated by the patient, they are not included in the food table. Many recommend sticking with the diet as written and not deviating outside the defined parameters, so addition of foods should be considered carefully.
IBD-AID
The IBD-AID defines three phases based on the level of symptoms present and it is extremely important to begin the diet at the proper phase. The table represents the foods allowed in the third and final phase of the diet, intended for those in remission. The IBD-AID aims for 80% compliance or above, noting that better results may come with better compliance. Any foods added within the 20% noncompliance buffer are not included in the table.
AIP
The AIP is a little different from the other diets. The AIP begins with a restrictive Elimination Phase, which must be followed for a minimum of 30 days, but may require longer use. It then shifts to a Reintroduction Phase in which patients test adding back in other foods. In the Maintenance Phase, the foods that were tolerated in the Reintroduction Phase are incorporated back into the diet. Unlike some other therapeutic diets in which reintroductions are de-emphasized or cautioned against, AIP emphasizes and encourages the adding back in of tolerated foods to achieve healthy diversity. Our table represents the Elimination Phase of AIP, which is actually the first and most restrictive phase of the diet, and not the most inclusive phase as with most of the other diets. This was done because the Elimination Phase is the only phase to define specific foods as being allowed and not allowed. It is important to note that while AIP may look very restrictive as defined in the table, the actual diet used in Maintenance Phase likely will include more diversity than suggested in the table, but that diversity will be highly individualized.
CDED
The CDED is managed a little differently from the other diets. The CDED is divided into three phases. The first two 6-week phases are grouped together as the Induction Phase, which is used for inducing remission. The first six-week phase of the Induction Phase limits insoluble fiber to prevent bowel obstructions. The second 6-week phase adds back in many of those vegetables by week 10. The Induction Phase is the most important phase of the diet and is required for efficacy. The Maintenance Phase is used after remission is achieved and is intended to sustain that remission. However, the principles of the diet are best represented by the Induction Phase, with the Maintenance Phase opened up to include some foods not recommended in order to promote better long-term compliance if necessary. The published studies to date generally look at the Induction Phase, so the scientific evidence is strongest at this time for the Induction Phase and still in progress for the Maintenance Phase. However, a patient may like to know what the diet might look like long term, so it was decided that the most complete picture would be provided by showing data for both the Induction Phase and the Maintenance Phase separately. The Maintenance Phase requires five contiguous days following the diet as written, then allows for a maximum of two contiguous days (generally weekends) that allow two free meals per day (maximum of four free meals per week), excluding only hot dogs, sausages, soft drinks, luncheon meats, bacon, and frozen dough from those free meals. Those free meals are not included in the table.
Food Table
| Diets are Similar with Regard to the Following Foods: | ||||||
| Allowed | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Fish | Allowed |
Allowed |
Allowed |
Allowed |
Weeks 1-6: 1 portion lean fish per week |
One portion of lean fish or other seafood per week, 1 can tuna per week |
| Red Meat (not processed) | Allowed |
Allowed |
Allowed, leaner cuts emphasized |
Allowed. Grass-fed organ meats encouraged |
1 portion of lean steak per week after week 6 (not recommended) |
1 portion of lean steak per week only |
| Honey | Allowed |
Allowed |
Allowed, local organic encouraged |
Allowed |
Max 3 TBSP per day |
Max 3 TBSP per day (no limit on weekends) |
| Allowed or Selectively Allowed | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Poultry | Allowed |
Allowed |
Allowed, no skin |
Allowed |
Fresh chicken breast only (mandatory) |
Chicken allowed (no wings or skin) |
| Vegetables other than starchy vegetables and nightshades, which are listed separately | Allowed |
Allowed |
Allowed |
Allowed |
Weeks 1-6: Cucumbers, carrot, spinach, lettuce allowed in limited quantities. Onion, garlic, ginger allowed. |
No Leeks, Celery, or Large Amounts of Kale |
| Fruits | Allowed |
Allowed |
Allowed |
Allowed in moderation (2-3 servings per day) |
Weeks 1-6: Bananas, apples, avocado, strawberries, melon, orange juice in limited quantities, lemon juice (fresh squeezed) as a condiment allowed. |
No persimmons, pomegranate, cactus fruit, passion fruit |
| Fats/Oils | Most Allowed; No soybean oil, limit processed oils like canola oil |
Most Allowed; No soybean oil, limit processed oils like canola oil |
Allowed: Limit oils high in omega-6 and saturated fats |
Fats from grass-fed organic meats allowed, unrefined oils allowed; no seed oils, no processed vegetable oils |
Only olive oil and canola oil allowed |
Only olive oil and canola oil allowed |
| Exclude | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Processed Meat | Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
| Artificial Sweeteners | Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
| Processed Foods/Preservatives/Artificial Additives | Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
| Exclude or Restrict | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Grains other than wheat, corn, oats, and rice, which are listed separately | Exclude |
Exclude |
Barley is allowed if not celiac. |
Exclude |
Quinoa allowed after week 6 |
Allows quinoa |
| Dairy | Allows homemade 24-hour yogurt and cheeses aged 30 days or more |
Allows homemade 24-hour yogurt and cheeses aged 30 days or more |
Some allowed: Aged cheese, dry curd cottage cheese, cultured cottage cheese, plain kefir, plain yogurt |
Exclude |
Exclude |
1 yogurt allowed per day (other dairy on weekends) |
| Sweeteners other than honey and artificial sweeteners, which are listed separately | Exclude |
Maple syrup allowed |
Exclude |
Allows date sugar, maple syrup, maple sugar, molasses, evaporated cane juice, coconut sugar |
Allows refined sugar (4 tsp per day max) |
Allows refined sugar (4 tsp per day max; unlimited on weekends) |
| Alcohol | Some allowed: dry wine, vodka, gin, rye, Scotch, bourbon, whiskey |
Some allowed: dry wine, vodka, gin, rye, Scotch, bourbon, whiskey |
Some allowed on limited basis: dry wine, vodka, gin, rye, Scotch, bourbon, whiskey per patient tolerance |
Exclude |
Exclude |
1 cup of wine or beer allowed on weekends |
| Emulsifiers | Exclude |
Exclude |
Exclude maltodextrin, carrageenan, polysorbate-80, carboxymethylcellulose (CMC). Some emulsifiers, such as guar gum, may be protective. |
Exclude |
Exclude |
Exclude |
| Diets Differ for The Following Foods: | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Seafood other than fish, which is listed separately | Allowed |
Allowed |
Allowed |
Allowed |
Excluded |
1 portion of seafood or lean fish per week, 1 can tuna per week |
| Wheat/Gluten | Exclude |
Exclude |
Exclude wheat. Gluten in barley is allowed if not celiac. Gluten in rye is unknown. |
Exclude |
1 slice whole grain bread allowed per day after week 6 |
2 slices whole grain bread allowed per day (1 cup cooked pasta may be substitued for bread twice per week) |
| Corn | Exclude |
Exclude |
Exclude |
Exclude |
Allowed after week 10 |
Allowed |
| Oats | Exclude |
Allowed (gluten-free oats only): |
Allowed (gluten-free oats if celiac), steel cut and oat groats encouraged, longer cooking times and additional water may be required |
Exclude |
1/2 cup dry oatmeal per week allowed after week 6 (gluten-free oats preferred but not mandatory) |
1/2 cup dry oatmeal allowed per week (gluten-free oats preferred but not mandatory) |
| Rice | Exclude |
Allowed: |
Organic rice allowed in limited amounts after 6 months and if health is stabilized |
Exclude |
Unlimited rice and rice flour or noodles are allowed |
Unlimited rice and rice flour or noodles are allowed |
| Dried Legumes/Beans | Certain dried legumes allowed: Peanuts, navy beans, lima beans, black beans, lentils, split peas; soaking required |
Certain dried legumes allowed: Peanuts, navy beans, lima beans, black beans, lentils, split peas; soaking required |
Allowed, may need to vary texture and take digestive enzymes prior to consumption |
Exclude |
1/2 cup dry beans/legumes allowed per day after week 6 |
1 1/2 cup dry beans/legumes allowed per day |
| Fresh Legumes/beans (peas, green beans, etc) | Allowed |
Allowed |
Allowed, may need to vary texture and take digestive enzymes prior to consumption |
Exclude: Peas and green beans are not allowed but are one of the first foods recommended for reintroduction. |
Allowed after week 10 |
Allowed |
| Starchy Vegetables (potatoes, sweet potatoes, yams, turnips, parsnips, etc) | Exclude |
Some allowed: Sweet potatoes, maybe white potatoes, organic preferred to avoid bud product: |
Most Allowed: Exclude white potatoes |
Allowed if not nightshades |
Weeks 1-6: Potatoes only allowed |
Allowed |
| Nightshades (tomatoes, tomatillos, white potatoes [not sweet potatoes], eggplant, peppers, goji berries, etc) | Most allowed: no white potatoes |
Allowed |
Mostly Allowed. Exclude White Potatoes. |
Exclude |
Weeks 1-6: Tomatoes and Potatoes allowed. |
Allowed |
| Nuts | Allowed |
Allowed |
Allowed |
Exclude |
8 almonds or walnuts allowed per day after week 6. |
8 almonds or walnuts allowed per day |
| Seeds | Most allowed: no chia or flax |
Most allowed: no chia or flax |
Allowed |
Exclude |
Exclude |
Exclude |
| Eggs | Allowed |
Allowed |
Allowed: encourage omega-3 eggs |
Exclude |
Allowed (mandatory: 2 per day) |
Allowed |
| Cocoa | Exclude |
Allowed (only 100% cocoa powder, not Dutch processed) |
Allowed |
Exclude |
Exclude |
Allowed |
| Coffee | Allowed |
Allowed |
Allowed |
Exclude |
Exclude |
Allowed: Black coffee allowed (any coffee allowed on weekends) |
| Formula (PEN; eg, Boost®, Ensure®, Pediasure®, Modulen IBD®) | Exclude |
Exclude |
Exclude: encourage whole food smoothies and supplements |
Exclude |
Allowed (recommended) |
Allowed |
| Food Table Organized By Food Type: | ||||||
| Seafood, Poultry, and Meat | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Fish | Allowed |
Allowed |
Allowed |
Allowed |
Weeks 1-6: 1 portion lean fish per week |
One portion of lean fish or other seafood per week, 1 can tuna per week |
| Seafood other than fish, which is listed separately | Allowed |
Allowed |
Allowed |
Allowed |
Excluded |
1 portion of seafood or lean fish per week, 1 can tuna per week |
| Poultry | Allowed |
Allowed |
Allowed, no skin |
Allowed |
Fresh chicken breast only (mandatory) |
Chicken allowed (no wings or skin) |
| Red Meat (not processed) | Allowed |
Allowed |
Allowed, leaner cuts emphasized |
Allowed. Grass-fed organ meats encouraged |
1 portion of lean steak per week after week 6 (not recommended) |
1 portion of lean steak per week only |
| Processed Meat | Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
| Grains | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Wheat/Gluten | Exclude |
Exclude |
Exclude wheat. Gluten in barley is allowed if not celiac. Gluten in rye is unknown. |
Exclude |
1 slice whole grain bread allowed per day after week 6 |
2 slices whole grain bread allowed per day (1 cup cooked pasta may be substitued for bread twice per week) |
| Corn | Exclude |
Exclude |
Exclude |
Exclude |
Allowed after week 10 |
Allowed |
| Oats | Exclude |
Allowed (gluten-free oats only): |
Allowed (gluten-free oats if celiac), steel cut and oat groats encouraged, longer cooking times and additional water may be required |
Exclude |
1/2 cup dry oatmeal per week allowed after week 6 (gluten-free oats preferred but not mandatory) |
1/2 cup dry oatmeal allowed per week (gluten-free oats preferred but not mandatory) |
| Rice | Exclude |
Allowed: |
Organic rice allowed in limited amounts after 6 months and if health is stabilized |
Exclude |
Unlimited rice and rice flour or noodles are allowed |
Unlimited rice and rice flour or noodles are allowed |
| Grains other than wheat, corn, oats, and rice, which are listed separately | Exclude |
Exclude |
Barley is allowed if not celiac. |
Exclude |
Quinoa allowed after week 6 |
Allows quinoa |
| Vegetables, Legumes, and Fruits | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Dried Legumes/Beans | Certain dried legumes allowed: Peanuts, navy beans, lima beans, black beans, lentils, split peas; soaking required |
Certain dried legumes allowed: Peanuts, navy beans, lima beans, black beans, lentils, split peas; soaking required |
Allowed, may need to vary texture and take digestive enzymes prior to consumption |
Exclude |
1/2 cup dry beans/legumes allowed per day after week 6 |
1 1/2 cup dry beans/legumes allowed per day |
| Fresh Legumes/beans (peas, green beans, etc) | Allowed |
Allowed |
Allowed, may need to vary texture and take digestive enzymes prior to consumption |
Exclude: Peas and green beans are not allowed but are one of the first foods recommended for reintroduction. |
Allowed after week 10 |
Allowed |
| Starchy Vegetables (potatoes, sweet potatoes, yams, turnips, parsnips, etc) | Exclude |
Some allowed: Sweet potatoes, maybe white potatoes, organic preferred to avoid bud product: |
Most Allowed: Exclude white potatoes |
Allowed if not nightshades |
Weeks 1-6: Potatoes only allowed |
Allowed |
| Nightshades (tomatoes, tomatillos, white potatoes [not sweet potatoes], eggplant, peppers, goji berries, etc) | Most allowed: no white potatoes |
Allowed |
Mostly Allowed. Exclude White Potatoes. |
Exclude |
Weeks 1-6: Tomatoes and Potatoes allowed. |
Allowed |
| Vegetables other than starchy vegetables and nightshades, which are listed separately | Allowed |
Allowed |
Allowed |
Allowed |
Weeks 1-6: Cucumbers, carrot, spinach, lettuce allowed in limited quantities. Onion, garlic, ginger allowed. |
No Leeks, Celery, or Large Amounts of Kale |
| Fruits | Allowed |
Allowed |
Allowed |
Allowed in moderation (2-3 servings per day) |
Weeks 1-6: Bananas, apples, avocado, strawberries, melon, orange juice in limited quantities, lemon juice (fresh squeezed) as a condiment allowed. |
No persimmons, pomegranate, cactus fruit, passion fruit |
| Dairy | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Dairy | Allows homemade 24-hour yogurt and cheeses aged 30 days or more |
Allows homemade 24-hour yogurt and cheeses aged 30 days or more |
Some allowed: Aged cheese, dry curd cottage cheese, cultured cottage cheese, plain kefir, plain yogurt |
Exclude |
Exclude |
1 yogurt allowed per day (other dairy on weekends) |
| Nuts and Seeds | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Nuts | Allowed |
Allowed |
Allowed |
Exclude |
8 almonds or walnuts allowed per day after week 6. |
8 almonds or walnuts allowed per day |
| Seeds | Most allowed: no chia or flax |
Most allowed: no chia or flax |
Allowed |
Exclude |
Exclude |
Exclude |
| Sweeteners | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Honey | Allowed |
Allowed |
Allowed, local organic encouraged |
Allowed |
Max 3 TBSP per day |
Max 3 TBSP per day (no limit on weekends) |
| Artificial Sweeteners | Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
| Sweeteners other than honey and artificial sweeteners, which are listed separately | Exclude |
Maple syrup allowed |
Exclude |
Allows date sugar, maple syrup, maple sugar, molasses, evaporated cane juice, coconut sugar |
Allows refined sugar (4 tsp per day max) |
Allows refined sugar (4 tsp per day max; unlimited on weekends) |
| Other | ||||||
| Food | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Processed Foods/Preservatives/Artificial Additives | Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
Exclude |
| Eggs | Allowed |
Allowed |
Allowed: encourage omega-3 eggs |
Exclude |
Allowed (mandatory: 2 per day) |
Allowed |
| Fats/Oils | Most Allowed; No soybean oil, limit processed oils like canola oil |
Most Allowed; No soybean oil, limit processed oils like canola oil |
Allowed: Limit oils high in omega-6 and saturated fats |
Fats from grass-fed organic meats allowed, unrefined oils allowed; no seed oils, no processed vegetable oils |
Only olive oil and canola oil allowed |
Only olive oil and canola oil allowed |
| Cocoa | Exclude |
Allowed (only 100% cocoa powder, not Dutch processed) |
Allowed |
Exclude |
Exclude |
Allowed |
| Coffee | Allowed |
Allowed |
Allowed |
Exclude |
Exclude |
Allowed: Black coffee allowed (any coffee allowed on weekends) |
| Alcohol | Some allowed: dry wine, vodka, gin, rye, Scotch, bourbon, whiskey |
Some allowed: dry wine, vodka, gin, rye, Scotch, bourbon, whiskey |
Some allowed on limited basis: dry wine, vodka, gin, rye, Scotch, bourbon, whiskey per patient tolerance |
Exclude |
Exclude |
1 cup of wine or beer allowed on weekends |
| Formula (PEN; eg, Boost®, Ensure®, Pediasure®, Modulen IBD®) | Exclude |
Exclude |
Exclude: encourage whole food smoothies and supplements |
Exclude |
Allowed (recommended) |
Allowed |
| Emulsifiers | Exclude |
Exclude |
Exclude maltodextrin, carrageenan, polysorbate-80, carboxymethylcellulose (CMC). Some emulsifiers, such as guar gum, may be protective. |
Exclude |
Exclude |
Exclude |
Food Table Overview
| OVERVIEW OF GENERALIZED SIMILARITIES (Some diets may be outliers in some categories): | ||
| Food Type | General Consensus | Details |
| Seafood/Poultry/Red Meat | Allowed | Allowed on all the therapeutic diets. CDED does not recommend red meat, restricts the amounts of red meat and seafood, and limits poultry to chicken excluding skin, wings, and organ meat. IBD-AID suggests limiting saturated fats. |
| Vegetables (nonstarchy) | Allowed | Allowed on all therapeutic diets. AIP excludes nightshades. CDED excludes a few specific vegetables. |
| Fruits | Allowed | Allowed on all therapeutic diets. CDED excludes a few specific fruits. |
| Honey | Allowed | Allowed on all diets. Limited to 3 TBSP per day on CDED. |
| Fresh Legumes | Mostly Allowed | Allowed on all diets except AIP. |
| Eggs | Mostly Allowed | Allowed on all diets except AIP. |
| Coffee | Mostly Allowed | Allowed on all diets except AIP and the Induction Phase of CDED. |
| Dried Legumes | Mixed | SCD and mSCD allow specific dried legumes (soaking required). IBD-AID allows dried legumes. AIP excludes them. CDED limits the quantity. |
| Vegetables (starchy) | Mixed | CDED allows starchy vegetables, SCD excludes starchy vegetables, other diets restrict certain starchy vegetables. |
| Nuts | Mixed | SCD, mSCD, and IBD-AID allow nuts (nut butters may be easier to digest in early stages/phases). CDED allows a limited amount of walnuts or almonds per day. AIP excludes nuts. |
| Seeds | Mixed | IBD-AID allows seeds (may need to be pureed in phase I/II). SCD and mSCD do not allow flax or chia. Seeds are not allowed in AIP or CDED. |
| Cocoa | Mixed | Cocoa (honey sweetened if sweetened) is allowed on mSCD and IBD-AID and the Maintenance Phase of CDED. It is excluded from SCD and AIP. |
| Grains | Restricted | Wheat/gluten is excluded in all diets except CDED, which allows limited amounts of whole grain bread or pasta per day. Corn is excluded in all diets except CDED, which allows after week 10. Oats and Rice are mixed (mSCD, IBD-AID, and CDED allow oats; mSCD and CDED allow rice). CDED allows Quinoa. IBD-AID allows Barley if not celiac. Other grains are not allowed. |
| Dairy | Restricted | AIP and CDED Induction Phase exclude all dairy. CDED Maintenance Phase allows a limited amount of yogurt per week. SCD and mSCD allows aged cheese and 24-hour fermented yogurt. IBD-AID allows yogurt, kefir, aged cheese. |
| Sweeteners other than honey and artificial sweeteners | Restricted | mSCD allows maple syrup. AIP allows date sugar, maple syrup, molasses, evaporated cane juice, and coconut sugar. CDED allows a very small amount of refined sugar. |
| Oils | Restricted | SCD and mSCD exclude soybean oil. IBD-AID limits oils high in saturated fats. CDED allows only olive oil and canola oil. AIP does not allow seed oils or processed vegetable oils. |
| Alcohol | Restricted | SCD, mSCD, and IBD-AID allow some forms of alcohol, as does CDED on weekends in its Maintenance Phase. |
| Processed Meat | Excluded | All diets exclude processed meats. |
| Artificial Sweeteners | Excluded | All diets exclude artificial sweeteners |
| Processed Foods/Additives/Preservatives | Excluded | All diets exclude processed foods/additives/preservatives. |
Characteristics of the Diets
| Characteristic | SCD - Final Stage | mSCD - Final Stage | IBD-AID - Final Phase | AIP - Elimination Phase | CDED - Induction Phase | CDED - Maintenance Phase |
| Stages/Phases | Intro diet for up to 5 days. No other required stages, although some foods like beans/lentils are advanced. Pecanbread website has suggested stages for those wishing to follow them when symptomatic. |
Intro diet for up to 5 days. Typically, strict SCD is done before modified SCD is attempted. |
Three phases defined based on level of symptoms: Phase 1: Basics, Phase 2: Introduction of more foods/textures, Phase 3: Remission. |
Elimination Phase (minimum of 30 days), Reintroduction Phase, and Maintenance Phase. |
Induction Phase consists of two 6-week phases with a food-list associated with each phase. Induction Phase is followed by the Maintenance Phase. |
Maintenance phase is the last phase of the diet and requires 5 contiguous days following the diet as defined, which then can be followed with a max of 2 contiguous days with 2 free meals per week. Free meals can deviate from the diet with some restrictions. Maintenance phase is preceded by the Induction Phase. |
| Allowed Deviation from Diet | 100% strict for first year or two. |
100% strict for first year or two |
Diet aims for 80% compliance or above, but better results may come with better compliance. |
100% strict for in the Elimination Phase, which lasts a few months or more as needed. Reintroduction Phase allows adding back of foods as tolerated. |
100% strict in the Induction Phase. |
In the Maintenance Phase, four free meals a week are allowed, in which other foods can be consumed (with some restrictions). |
| Limits Amounts of Foods | No |
Yes for the new additions (sweet potatoes, rice, oats, cocoa, and maple syrup) |
No |
Yes for fruits |
Yes |
Yes |
| Mandatory Foods | No |
No |
IBD-AID Essential 8 - mandatory amounts of certain food types should be targeted per day. |
No |
Yes |
No |
| Studied in Children/Adults | Both |
Studies of mSCD in Children are still ongoing. |
Adults |
Adults |
Both |
Studies on Maintenance Phase are in progress. |
| Studied in Ulcerative Colitis (UC)/Crohn's Disease (CD) | Both |
Studies of mSCD for both CD and UC are still ongoing. |
Both |
Both |
CD only |
Studies of Maintenance Phase in CD are still ongoing. |
| Length of Time in Use | Long Time |
New |
Relatively New |
Relatively New |
Relatively New |
New |
| Published Research | SCD Research | Studies on mSCD as it is defined above are still ongoing. | IBD-AID Research | AIP Research | CDED Research | Studies on the Maintenance Phase of CDED are still ongoing. |
