The GAPS diet a.k.a. the Gut and Psychology Syndrome diet... A highly, highly restrictive diet, but one that has some important clinical applications that can garner great results.
Created by Dr. Natasha Campbell-McBride, the GAPS diet is a gut-healing protocol based on the Specific Carbohydrate Diet (SCD) and developed to treat people with neuro-psychological and psychiatric problems. Dr. Campbell-McBride recommends it for people with the following conditions (though this is not an exhaustive list):
- Autistic Spectrum Disorders
- Attention Deficit Disorders (ADD/ADHD)
- bipolar disorder
Dr. Campbell-McBride recognized that the rapidly growing incidence of these types of developmental disorders and illnesses simply could not be explained by genetics alone, so she began researching alternate possible causes. Noticing that nearly all people with learning disabilities, psychiatric disorders, and allergies also experience digestive problems (whether current or in the past), she eventually arrived at the conclusion that gut dysbiosis and the ensuing poor digestion and toxicity affect brain chemistry and ultimately produce these symptoms. A disturbance in the normal bacteria of the gut (wherein beneficial bacteria populations are suppressed) not only compromises a person’s immune system, but also allows pathogenic and opportunistic bacteria, viruses, and fungi to grow large colonies that produce toxic substances. These toxins pass through the blood-brain barrier and trigger different neurological and psychological symptoms. According to Campbell-McBride, “re-establishing the normal gut flora and treating the digestive system of the person has to be the number one treatment for these disorders, before considering any other treatments with drugs or otherwise."
The GAPS diet consists of a six-stage introduction phase followed by the full diet. The first stage is by far the most restrictive and includes only:
- homemade meat and fish stocks (always made with bones and joints) as they heal the gut lining and reduce inflammation
- soup made with liquid and boiled meat from homemade stocks and any combination of non-starchy vegetables, except the most fibrous ones (e.g. cabbage, celery) which can be difficult to digest
- fermented foods and their juices to increase the beneficial bacteria in the gut and to restore normal stomach acid production
- ginger, mint, or chamomile tea with honey
The second stage allows all of the foods in the first stage in addition to:
- raw, organic egg yolks and soft boiled eggs, preferably one added to each bowl of soup
- stews and casseroles made only with meat and vegetables (no spices)
- fermented fish
- homemade ghee
In the third stage, a person can add:
- pancakes made from nut butter, eggs, and a piece of winter squash, marrow, or zucchini fried in duck fat or ghee
- fried or scrambled eggs with vegetables
In the fourth stage, a person can add:
- meats cooked by roasting or grilling
- cold-pressed olive oil
- freshly pressed juices
- baked bread made with ground nuts or seeds, eggs, a piece of winter squash, marrow, or zucchini, and duck fat or ghee
In the fifth stage, a person can add:
- cooked apple made into an apple puree
- raw vegetables
In the sixth stage, a person can add:
- raw fruit, which must always be eaten alone and on an empty stomach
- homemade sweets (e.g. baked cakes) that are compliant with the GAPS diet
The duration of each of the stages in the introduction phase depends upon the person. Some people move through very quickly while others take much longer and have more difficulty introducing foods. Once done with the introduction phases, a person can move into the full diet, which should be followed for at least two years.
- fresh or frozen meats, fish and shellfish (but make sure they are not smoked, salted, or preserved in any other way), especially gelatinous meats (around the bones, joints, skin) as they are the most gut-healing
- free-range, organic eggs, at least 2 per day
- fresh, non-starchy vegetables
- fresh, ripe fruit
- plenty of fats, including organic, unsalted butter, coconut oil, extra virgin olive oil, duck fat, goose fat, palm oil, but not including common vegetable oils (canola, corn, etc.) which are inflammatory and bad for health
- raw nuts and seeds, preferably soaked
- garlic, to be eaten every day
- unprocessed honey (the only sweetener allowed on the diet)
Foods to avoid on the GAPS Diet include:
- sugar, molasses, maple syrup, corn syrup, and any other syrup
- artificial sweetener
- alcohol, except for high quality wine with meals on occasion
- tinned/processed foods
- grains (rice, corn, rye, oats, wheat, quinoa, millet, buckwheat, couscous, spelt, semolina, tapioca, etc.)
- starchy vegetables (potato, parsnips, yams, Jerusalem artichokes, sweet potato) – may be possible to introduce after 1 – 1.5 years
- milk products, except for ones that are soured (natural, hard cheeses, kefir and live yogurt, crème freche/sour cream, butter, ghee) as they do not contain lactose and have been pre-digested by microbes
- beans, as they are very difficult to digest
- any fruit or vegetable juices that are not freshly pressed
- coffee and strong teas as they can irritate the digestive tract
- soft drinks
- anything with preservatives, artificial coloring, flavoring, or similar chemicals
- soy, as it interferes with thyroid function and contains estrogen
- contraceptive pills, which throw off hormonal balance
- highly toxic cleaning products, toiletries, detergents, etc.
Though extremely restrictive, the diet was created to ensure that nutrient needs are met. It's built upon nutrient-dense foods and includes specific supplements to make sure that nutrient intake is sufficient. It's not for the faint of heart, but it can be very effective. And for people who have been suffering for a long time or who haven't gotten the results they've been looking for, it can be a real life changer.
My take on it?
Unfortunately no clinical trials evaluating the effectiveness of the GAPS diet have been published thus far, but a study by Dr. Austin M. Mulloy at Virginia Commonwealth University that looks at the diet as a treatment for autism is currently under way. While I personally am not convinced that any diet can "cure" disorders like autism and schizophrenia (even if implemented very early, as Dr. Campbell-McBride recommends), I believe that the diet is capable of significantly improving symptoms along with strengthening the immune system overall. Given the direct connection between the gut and the brain, and that the vast majority of the immune system lives in the gut, any protocol designed to repair the gut wall and re-balance the microbiome should have very positive effects on mental and physical health. In theory the best clinical applications of the GAPS diet are exactly what it was created to heal: Gut And Psychology Syndromes. In my opinion, the full protocol is worth following for patients suffering from significant mental or digestive distress, but for cases that are not so severe, a modified, less strict version of the GAPS diet can be implemented with very good results.