The GAPS program was developed by Dr. Natasha Campbell-McBride who developed it first to treat her own child (see references below).
The premise of the GAPS program is that people on the autistic spectrum have inflamed gut lymph nodes and colitis resulting in impaired immunity and leaky gut syndrome. Casomorphins (peptides from casein) and gluteomorphins (peptides from gluten) effect the brain causing psychiatric symptoms.
The GAPS diet most resembles a cross between the Specific Carbohydrate Diet (SCD) and the Traditional Foods (TF) movement.
The SCD was created by Dr. Sidney V. Hass in his book Management of Celiac Disease. The diet was out-of-favor when discovered by Elaine Gottschall, who popularized it in her book Breaking the Vicious Cycle.
The basic premise of SCD is that those with gut issues can easily absorb monosaccharides, but not disaccharides or polysaccharides, which are avoided, thus eliminating refined sugar, lactose (most dairy except yogurt), all grains and starches from the diet. Much more information on SCD is available via references.
In a sense, the TF movement was begun by Weston A. Price, a dentist who's curiosity about the lack of dental issues in primitive societies led him to research diet and nutrition and resulted in his book Nutrition and Physical Degeneration. The modern TF movement was begun by Sally Fallon (Morell) and Mary G. Enig who wrote Nourishing Traditions and founded WAPF. The movement has since expanded to non-WAPF groups and has a large Internet presence.
TF emphasizes nutrient-rich foods such as healthy fats (animal fats from meat and dairy, palm and coconut oils), pastured or wild-caught meat, fish and eggs, raw dairy products, homemade broths made from bones, fruits & vegetables, fermented foods, and reduction of anti-nutrients such as phytic acid and lectins via soaking, sprouting or fermenting grains, seeds and nuts. Cod liver oil and butter oil are highly-prized foods in TF.
As a cross between SCD and TF, GAPS eschews processed foods, emphasizing consumption of animal fats and meat broths to heal the gut, fermented foods and probiotics to correct the gut flora, and avoidance of disaccharides and polysaccharides.
detailed description of GAPS diet
In the following sections, I describe my impression of the diet followed by links that include Dr. Natasha Campbell-McBride's description within each section. This allows both a brief summary and the details, depending on your choice.
One can begin either with the introductory diet or the full diet. The six-stage introductory diet is intended to heal and seal the gut very quickly, thus reducing gastrointestinal dysfunction rapidly and allowing the introduction of dairy products earlier than otherwise. It also behaves like an elimination diet, having you gradually add foods and check for reactions as you go. Some start on the introductory diet first, but other start on the full diet and may later choose to do the introductory diet. Some have great results on the full diet and never do the intro. The introductory diet may last only a few days per stage, or up to several months, depending on symptoms as one goes along.
The full diet is expected to continue for up to 2 years, again depending on how one reacts to it.
Finally, the program contains directions for how to transition from the full diet.
Stage 1 basically is soup, soup and soup, with a bit of ginger tea for variety.
The allowed foods are
- meat, poultry and fish broths
- boiled meats, poultry and fish
- well-boiled non-fibrous veggies (artichoke, asparagus, beets, broccoli, carrot, cauliflower, green beans, kale, leeks, lettuce, mushrooms, onion, parsley, peas, pumpkin, rutabagas, spinach, summer squash, turnip, winter squash and zucchini - exclude all types of cabbage and celery)
- sauerkraut juice or whey
- ginger tea made with grated ginger root and sweetened to taste with honey
show/hide Dr. Campbell-McBride's intro diet stage 1 description
Stage 2 adds:
- eggs (for those without allergies), preferably cooked with whites solid & yolks runny
- stews & casseroles, flavored with unrefined sea salt and herbs
- fermented fish (something you will NOT ever find me eating!)
- homemade ghee (clarified butter)
show/hide Dr. Campbell-McBride's intro diet stage 2 description
Stage 3 adds:
- pancakes made from nut butter, eggs & shredded squash
- scrambled eggs
- sauerkraut & other fermented vegetables (I assume all cabbages including boy choy, brussel sprouts, napa cabbage, and celery can be added now also)
show/hide Dr. Campbell-McBride's intro diet stage 3 description
Stage 4 adds:
- roasted and grilled meats (but with less enthusiasm for the Malliard reaction than I have!)
- olive oil
- vegetable juice diluted with water or whey, starting with carrot juice and adding celery, lettuce & mint juices
- non-sweet baked goods made from nut flours/meals, eggs, shredded squash and fats
show/hide Dr. Campbell-McBride's intro diet stage 4 description
Stage 5 adds:
- cooked apples
- raw veggies, starting with cucumber and the soft bits of lettuce
- fruit juices added to the vegetable juice (except no citrus)
show/hide Dr. Campbell-McBride's intro diet stage 5 description
Stage 6 adds:
- raw apples, and then other fruits
- more honey
- sweet baked goods sweetened with dried fruit
show/hide Dr. Campbell-McBride's intro diet stage 6 description
IMNSHO, the best thing about the full diet after the intro is that COFFEE is allowed! ;) Others will be more pleased to see tea and alcohol (dry wine and spirits).
The full diet also adds nightshades (tomatoes, eggplants and peppers, but no potatoes). It allows some dried beans, mostly white navy beans, and cheeses (see lists of recommend foods and foods to avoid for details).
show/hide Dr. Campbell-McBride's full diet description
show/hide list of recommended foods
show/hide list of foods to avoid
transitioning off the full diet
Once transitioned off the full diet, one will basically be eating a TF diet.
The steps of transition are:
- add new potatoes and fermented non-glutenous grains (buckwheat, millet and quinoa)
- start trying sourdough bread from wheat and rye to see if gluten is tolerated
- add non-fermented non-glutenous grains (buckwheat, millet and quinoa)
- add starchy vegetables, grains & beans
- never go back to eating SAD
show/hide Dr. Campbell-McBride's description of transition
When reading online, one mostly hears about the diet. However, in the book, it is clear that the program is a three-prong approach; supplements and detox are important to recovery also. There is an entire section devoted to supplements, with a chapter on each.
The basic supplements recommended are:
- In addition to the probiotics consumed in fermented foods; it is recommended to take a good probiotic product.
The criteria are that it should contain as wide a variety of types of known beneficial bacteria as possible (lactobacilli, bifidobacteria, saccaromyes-type yeast, non-pathogenic e. coli, peroxide-producing bacteria, and soil bacteria). Within each type, the widest variety of bacteria species should be included. Finally, for adults, the dose is 15-20 billion cells/day.
Bio-Kult is the officially recommended GAPS probiotic supplement but is very expensive; I plan to use a similar but cheaper product called GUTPro.
- The book makes the point that human milk, presumably an ideal food for humans, contains 48% saturated fat, 33% monounsaturated fat and 16% polyunsaturated fat (PUFA). A large portion of this is handled by the diet with the inclusion of lots of animal fats, coconut oil and olive oil.
Within the category of PUFAs, most of us get plenty of omega-6 fatty acids but are lacking in omega-3s. So generally, we need to supplement omega-3s.
Furthermore, most GAPS people cannot convert from the parent fatty acids to the useful forms we need most, from LNA to EPA and DHA (omega 3 fatty acids) and from LA to GLA and DGLA (omega 6 fatty acids).
Finally, there is evidence that we need more EPA than DHA.
The three fat supplements recommended are:
- a nut/seed oil blend to supplement the parent fatty acids, containing a high ratio of omega-3:omega6 - possible products include Udo’s Choice Oil 3-6-9 Blend and Barlean's Organic Oils Balance Omega Twin
- cod liver oil, preferably fermented (more details in following section)
- fish oil containing more EPA than DHA- possible products include Carlson's Very Finest Fish Oil and Barlean's Organic Oils Fresh Catch Fish Oil (though the book eschews enteric-coated tablets due to the presumed digestive issues of GAPS people, complete wusses like my husband may find the Kirkland Signature product better than nothing)
- cod liver oil (CLO)
- Dr. Campbell-McBride recommends CLO not only as a source of EPA than DHA but as necessary sources of vitamins A and D. She specifically recommends fermented CLO and most seem to use Blue Ice Fermented CLO. For those who cannot afford the fermented product, a good choice is Twin Labs emulsified CLO. Though Dr. Campbell-McBride recommends the liquid oils, those who cannot tolerate the taste might try the WAPF-recommended Carlson Super CLO capsules or the similar Swanson product.
- digestive enzymes
- Low stomach acid prevents pepsin from breaking down proteins and also interferes with the hormones secretin and cholecystokinn, which signal the stomach, liver, gall bladder and pancrease to do their things. As such, a supplement containing Betaine HCl and pepsin is recommended.
Though some folks take digestive enzymes as well, Dr. Campbell-McBride feels that straightening out stomach acid will reboot the pancreas to produce them properly.
- vitamins & minerals
- Due to absorption issues, supplements are largely a waste of money for GAPS people. We generally have lots of deficiencies, whether outright or borderline, but pills are unlikely to help until the gut heals. Once it does heal, the diet is intended to provide necessary nutrition. If one does choose to take supplements, it is important that they don't contain any ingredients from the verboten list.
- changing up household cleaning products - as those of us with a frugal mindset already knew, most cleaning can be accomplished with vinegar, lemon juice and baking soda
- changing personal care and makeup products - the skin absorbs what is put on it, directly to the bloodstream (many pharmaceuticals are using this method of delivery), thus you really should not be putting anything on your skin that you wouldn't eat - that a cosmetic is labeled non-toxic is not good enough, it should be edible!
- juicing begins in stage 4 and is a big part of the detox - some of the recommended combos are:
- pineapple, carrot & beet stimulates stomach acid and pancreatic enzymes
- carrot, apple, celery & beet is liver-cleansing
- green leafy vegetables, tomato and lemon chelates heavy metals
- cabbage, apple & celery cleanses the kidneys
- black elderberry is recommended, especially during flu season, a few TB added to juice or a tea made from the dried flowers - I personally use elderberry syrup
- detox baths are recommended, on one night add either a cup of apple cider vinegar, baking soda or seaweed powder to the tub and on the next add a cup of Epsom salts
- houseplants detox the air and are especially helpful in bedrooms - but make sure they don't get moldy
Should you buy the book?
IMO, the most annoying thing is that there is not a Kindle version available. I have been through this book in it's entirety 3 or 4 times, plus gone back to look up information repeatedly. For a book I use this much, it is annoying not to be able to search it instantly!
And my criticism of the book is simultaneously my primary reason for recommending it: I own few books I have read so much.
You can certainly do the program without the book; there is enough information to do so on the web. Even the official GAPS web site has enough information to allow you to follow the program without the book. But there are several reasons I think you should get the book.
First is motivation, as this program is a HUGE lifestyle change. The book "sells" you on the program, which I really feel needs to be done so you fully get it. I think it would be difficult to commit to the program, and stay committed, without the book.
Second is really understanding the program thoroughly. That's not just about motivation, but about making decisions that are not specifically covered. When you understand the reasoning behind the program, it is much easier to use your judgement about items not explicitly covered in the book or GAPS FAQS
Finally, there is just SO much info in the book that can't possibly be covered by any of the online summaries. Every time I pick it up, I learn something. I could run this blog just discussing ideas in the book for years!
- Dr. Campbell-McBride describes how she developed the GAPS program for her own son
- Dr. Campbell discusses why gut issues cause psychiatric issues
- official GAPS web site
- Specific Carbohydrate Diet from Breaking the Vicious Cycle
- Principles of Healthy Diets by WAPF
- Traditional Foods defined by KerryAnn @ Cooking Traditional Foods
- GAPS diet from official GAPS web site
- Dr. Campbell-McBride's blog
- GAPS FAQS