Mediterranean vs SCD for Crohn’s: What Evidence Suggests (Patient-Friendly Summary)
Last Updated Jan 15, 2026
Food choices matter to many people living with Crohn’s disease, especially when symptoms are active or unpredictable. Two plans that often come up in online searches are the Mediterranean-style diet and the Specific Carbohydrate Diet (SCD). This Mediterranean vs SCD for Crohn’s comparison can feel confusing because both have passionate supporters, and both can be hard to study. Below is a patient-friendly look at what each approach emphasizes, what the DINE-CD study suggests, and how to think about sustainability without turning food into another stressor.
Mediterranean vs Specific Carbohydrate Diet (SCD), what each approach emphasizes
A Mediterranean-style diet is a flexible eating pattern, not a strict rulebook. It generally emphasizes vegetables, fruits, beans and other legumes, whole grains, nuts and seeds, and olive oil, with fish and poultry more often than red or processed meats. Many versions also limit sweets and highly processed foods. Because it is a broad pattern, it can be adjusted based on preferences, culture, budget, and symptom tolerance, for example choosing cooked vegetables instead of raw during rougher stretches. [1]
The SCD diet for Crohn’s is more structured and more restrictive. In the DINE-CD materials, SCD is described as centered on unprocessed meats, poultry, fish, and most fruits and vegetables, while restricting grains, many sweeteners, and much of dairy (with some exceptions like certain cheeses and yogurt). The idea behind SCD is that limiting specific carbohydrates may change gut bacteria and reduce symptoms for some people, although the theory is still being tested. In day-to-day life, the strict “allowed vs not allowed” lists can make planning, eating out, and long-term adherence harder for some patients compared with a Mediterranean-style approach. [2]
What evidence suggests (including a DINE-CD summary) and how to choose sustainably
The best-known head-to-head evidence comes from DINE-CD, a randomized trial that compared SCD vs Mediterranean diet in adults with Crohn’s disease and mild-to-moderate symptoms. At 6 weeks (the main time point), symptom remission was similar in both groups (about mid-40% in each), and the SCD was not superior. Measures of inflammation also did not show a clear advantage for either diet, including fecal calprotectin (a stool marker linked with gut inflammation) and C-reactive protein (a blood marker of inflammation), with C-reactive protein improvement being uncommon overall. This matters because symptoms can improve even when inflammation does not change much, so “feels better” and “less inflamed” are not always the same thing. [3]
Other SCD research exists, but it is often smaller. For example, one small randomized diet trial in children compared versions of SCD and reported clinical remission among those who completed the study, which is encouraging but not enough to prove SCD works for most people or that it is easy to maintain long term. [4]
Sustainability and nutrition quality are a big part of choosing any elimination diet for Crohn’s. Expert consensus documents emphasize routine nutrition screening in inflammatory bowel disease (IBD), watching for malnutrition and micronutrient gaps, and noting that dietary restriction is common and can reduce energy and nutrient intake. The same consensus also highlights that exclusive enteral nutrition (a temporary liquid formula-only approach) has stronger evidence for inducing remission in Crohn’s disease than most popular self-directed diets, which helps explain why diet discussions often work best as part of an overall care plan. [5]