Overview of Therapeutic Diets

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 five 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 introducing 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, they are not included in the food table. Many recommend sticking with the diet as written and staying within the defined parameters, so the addition of foods should be considered carefully.

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 this 20% buffer are not included in the table.

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. It then shifts to a Reintroduction Phase in which patients test adding back in additional foods. In the Maintenance Phase, the foods that were tolerated in the Reintroduction Phase are incorporated long term 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 diet used in the Maintenance Phase likely will include more diversity than suggested in the table, but that diversity will be highly individualized.

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 necessarily recommended in order to promote better long-term compliance. The published studies to date are short-term following the Induction Phase. Thus the scientific evidence is most robust at this time for the Induction Phase and is still in progress for the Maintenance Phase. However, to view what the diet may include long term, it was determined that the most complete picture could be provided by listing foods for both the Induction Phase and the Maintenance Phase separately. The Maintenance Phase requires five contiguous days following the diet, then allows for a maximum of two contiguous days (generally weekends) of 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. Free meals are not included in the table.