by Sue Kira, Naturopath & Clinical Nutritionist
Gut and Psychology Syndrome (GAPS) is the name, and a book with this title, created by Dr Natasha Campbell-McBride and inspired by the Specific Carbohydrate Diet (SCD) created by Dr. Sidney Valentine Haas.
After working with hundreds of children with conditions such as ASD, ADD, ADHD, inflammatory bowel diseases, leaky gut syndrome, depression, anxiety, auto-immune diseases, and a range of other disorders both neurological, psychiatric, immunological, and digestive, Dr Haas developed a program to effectively treat these conditions. Part of his program is a diet to help detoxify and clean up the digestive system to assist the body and brain to function optimally.
In the GAPS protocol, there are 6 stages within the Introductory GAPS diet, followed by the Full GAPS diet.
These stages (or levels) are designed to remove foods that feed unfriendly bacteria, yeasts, fungi and parasites to help the gut to heal and reduce inflammation. The amount of time spent at each level of the diet will be determined by the symptoms and what your practitioner advises.
Further information about these foods and how and when to introduce them follows. Your GAPS certified practitioner can help you to determine the progress of the Introductory phase and when it will be appropriate to move onto the Full GAPS diet.
The following information has been checked to be certified true GAPS friendly but do check with your certified GAPS practitioner to ensure these foods suit the level of the program you are prescribed.
- Gut repair support to heal leaky gut
- Rebalance probiotics in the micro-biome (gut microbes)
- Reduce toxic overload from bad bacteria strains in the gut
- Prevent toxins from entering the bloodstream
- Easy to digest foods to help the gut and body to heal itself
- Boost general immunity
- Reduce food sensitivity
- Improve neurological function
- Support the healing of inflammation in the bowel
- Help to reduce candida yeast infection
- Support detoxification of the liver
- Reduce anxiety and depression
- Improve autism spectrum disorders
The GAPS diet can be somewhat restrictive
The diet is restrictive compared to most people’s diets and because many kids who need this diet are fussy eaters, this can create challenges when getting kids to eat foods they don’t want to try. Because of poor compliance with some kids, the diet is often used for a short period of time and then stopped, which doesn’t provide enough time to show the benefits.
However, compliance is usually much better for adults when they see the advantages of the diet, so they are happy to eat what is needed to get the required results.
With the right attitude from parents and the loving support of the whole family by doing this diet together, amazing results have been seen, not only in kids, but for adults with various health conditions.
The GAPS diet can be hard to follow if you are a vegetarian or vegan
It is possible, but care needs to be taken to ensure you are getting all the nutrients you need. Professional health care advice may be needed to make this possible unless you feel very equipped to work out all your nutritional needs.
If possible, it is easier to follow the diet and include animal proteins until healing has occurred, and then gradually re-introduce vegetarian/vegan eating.
Note on high histamine and histamine intolerance
Another disadvantage is that if you or a family member has histamine intolerance or high histamine levels (which can be assessed by your health practitioner) then this diet may aggravate symptoms as many of the foods, namely the fermented foods and long cooked bone broths, are high in histamine.
If this is the case, simply leave out the fermented foods and long cooked bone broths and have short cook broths. Also for more advice, go to the Low Histamine Diet.
In time, the core diet minus the fermented foods and long cooked bone broths, will heal the histamine intolerance and then the fermented foods can be reintroduced very slowly in small amounts, which will feed the good bacteria and reduce excessive histamine levels.
To follow the GAPS diet, you must avoid:
- Processed foods
- All grains, gluten, and dairy products
- Processed sugar from sugar cane or sugar beets
- Starchy carbs (breads, cereals, pastas, rice, crackers made from grains, potatoes, sweet potatoes, corn)
- Artificial chemicals, preservatives, and any artificial additives of any kind
- Grain fed meat, poultry, and eggs. Pasture fed or organic are good choices
- Farmed fish and large high mercury risk fish like tuna, shark(flake), swordfish, Mahi-Mahi, and Mackerel
- Eat fruits on their own, not with other foods
- The GAPS diet is broken down into stages to allow the gut to heal, so many fibrous foods are initially omitted to not aggravate the delicate gut lining
- agar-agar (gel often used in vegan jellies)
- apple juice – commercial
- baker’s yeast
- balsamic vinegar
- bean sprouts
- cannellini beans
- canned fruit or veggies
- chickpeas/garbanzo beans
- chocolate & cacao
- coffee (instant)
- corn, cornflour/starch
- fish, smoked or tinned with sauces
- milk from packet or can
- coconut milk from packet or can (home-made or additive free is fine)
- mung beans
- nuts that are roasted/salted (soaked/fermented activated & re-dried fine)
- potato, white, red or sweet
- sausages – commercial (home-made without additives are fine)
- sugar or sucrose of any kind (honey is fine)
Apart from the above foods there is a large list of foods to avoid which are published in the Gut and Psychology Syndrome book and website – https://www.gapsdiet.com/
As a guide, the introductory phase of the diet is essential for people with serious digestive symptoms such as diarrhoea, severe constipation, reflux esophagitis, abdominal pain, severe bloating, and severe gas/flatulence, especially if smelly.
The Introductory GAPS Diet is done over 6 stages to gradually allow the gut to heal (leaky gut) and to re-establish good gut health by sealing the tight junctions between the cells lining the gut.
The GAPS diet is also designed to allow inflammation of the gut to settle because the foods consumed have an anti-inflammatory effect. Removing inflammatory foods also assists the healing process of the gut.
The regeneration process also involves using probiotic beneficial bacteria from fermented foods and drinks. Without good bacteria, there cannot be any true healing of the gut.
Apart from the probiotic rich foods recommended throughout the GAPS diet, probiotic supplementation (not acidophilus) is also advised throughout the GAPS program. Speak to your health care practitioner about the best type for you.
The time taken for each stage will depend on your symptoms, severity and what has been prescribed by your health practitioner.
Be guided by how your body feels. Do not move onto the next phase of the GAPS Diet until the symptoms have cleared.
Once symptoms are clear, you can then move onto the next level, but if you notice a recurrence of any symptom, go back to the previous level until settled. Then re-introduce the next level foods again, one at a time, until you establish exactly what food or foods upset you. Then leave those foods out at this point.
If you suspect you may be allergic to a particular food that is coming up, then before eating that food try a sensitivity test. Take a drop of the food substance (mixed with a little water and mashed if needed) and place the drop on the inner wrist. Allow to dry, leave on overnight and check for angry red irritation in the morning. If it is clear, then it should be fine to eat a small amount to test, but if there is redness, swelling, or itchiness then leave this food out at this point.
I recommend you stay on each level for at least a week, however, this could take longer, depending on reactions to various foods. If there are no symptoms after a week, then move onto the next level and add one food at a time (minimum of one day apart). Monitor and keep a diary of any foods you react to, as well as safe foods to add to your ‘safe foods’ list.
It’s a back-and-forth process as you work through each level/stage to find out what foods you react to and what foods are safe. Remember, if there is a reaction, go back to your core non-reactive foods until symptoms settle again before re-introducing the next food/s.
By the end of the 6 levels, you will have a list of safe foods and reactive foods. You may be able to consume the reactive foods later after more healing time has passed. Re-check in 6 months unless you previously had a severe reaction.
Correct cooking methods are essential.
All foods in the Introductory GAPS Diet up to Stage 4, must be steamed or boiled in water or simmered in broth. There are to be no raw, fried, baked or BBQd foods.
The following are the preferred foods for the GAPS Diet – Stage 1:
- poultry – chicken, duck, turkey
- fish – preferably fresh
- bok choy
- broccoli – no stalks
- cauliflower – no stalks
- collard greens
- eggplant – peeled
- fermented vegetable juice – 1 tsp with meals. Can be left till stage 2 if you have reacted to them in the past e.g. histamine reaction
- ginger root
- honey – raw
- onions (can be omitted until level 2 if they give you flatulence)
- pumpkin (fresh)
- sea salt
- summer squash
- tea – chamomile, ginger, or mint (with a little honey is fine)
- winter squash
- yogurt (coconut) – fermented for 24+ hours (start slowly 1 tbsp daily)
All foods from stage 1, then add and test one at a time:
- raw egg yolks (pastured/organic). Good to first check the wrist sensitivity test
- coconut oil (introduce gradually because it is strongly anti-microbial)
- avocado (start with no more than ½ small avocado)
All foods from stage 2, then add and test one at a time:
- nut butter (raw and sprouted)
- almond flour (¼ cup maximum)
- coconut flour (¼ cup maximum)
- fermented vegetables. Start with small amounts, a few strands to a teaspoon, then gradually build up the quantity of fermented foods over a few days. If diarrhoea hits then keep the quantity down. With constipation, keep building the level of fermented foods until normal stools occur daily
- cabbage – small amount. Check for wind, gas, bloating
- fresh herbs (cooked)
All foods from stage 3, then add and test one at a time:
- grilled and roasted meats
- carrot juice
- herbs, dried
- extra virgin olive oil
All foods from stage 4, then add and test one at a time:
- applesauce, homemade
- pear sauce, homemade
- cucumber, peeled raw
- mangoes, raw
- tomatoes, raw or cooked
- vegetable juices
All foods from stage 5, then add and test one at a time:
- apple, raw
- coconut flesh
- coconut milk
- kiwi fruit
After the 6 levels have been completed, begin the Full GAPS Friendly Diet. This diet includes all the above foods that have been ‘safe’ for you along the way, plus more of the different types of probiotic foods such as coconut kefir or yoghurt. Avoid any foods that proved to be troublesome.
It is best to follow the Full GAPS Friendly Diet for 18 months to two years (or as advised by your health care practitioner). Then you can gradually re-introduce other foods, starting with fermented grains such as quinoa, buckwheat, and millet. Follow with foods like potatoes and other starchy vegetables. If these are well tolerated, then you can make breads and cakes from the fermented sourdough gluten free grains.
Substances like gluten, sugar and artificial additives are best avoided altogether.
After working with many clients on the GAPS Friendly Diet I can tell you that although some aspects can be complicated, it is a very effective meal plan to help heal gut issues, along with neurological conditions, mental health, allergies and intolerances, and autoimmune diseases.
A summary of food types for the Full GAPS Diet
This list provides an overview of food categories suitable for the Full GAPS Diet:
- Bone Broth (meat stock) – 1 cup with each meal is recommended
- Fruit juice jelly with a good quality additive free gelatine for gut healing
- Steamed (non-starchy) vegetables or lightly stir-fried
- Organic, grass fed animal meats including beef, lamb, turkey, chicken
- Fish (wild caught). Can be tinned fish, additives free (oil/spring water fine)
- Egg yolks, raw or cooked (mixed with honey are fine)
- Fruit – all fresh or frozen in season fruits (additive free)
- Healthy Fats such as avocados, coconut oil and olive oil
- Sprouted nut butter
- Probiotic rich foods such as sauerkraut, coconut kefir, coconut yoghurt, plus fermented vegetable juice from foods like sauerkraut to help digestion
- Sea Salt & other seasonings as per the list below
A detailed list of foods for the Full GAPS Diet
- Beetroot /beets
- Bell peppers/capsicum
- Bok choy
- Brussel sprouts
- Green beans
- Jerusalem artichoke
- Romaine lettuce
- Squash (summer and winter)
Wild caught only – NO farm raised. Canned fish is ok when oil or water packed (provided there are no additives)
- Red Snapper
NUTS AND LEGUMES
Ideally soaked and sprouted or as nut butters
- Almonds (soaked, sprouted or as raw nut butter)
- Brazil nuts
- Coconut (actually a fruit)
- Lima beans (must be soaked)
- Navy beans (must be soaked)
- Pine nuts
- Nut butters
- Nut flours (in moderate amounts – no more than 1/4 cup a day)
FATS/OILS Organic Unrefined
- Avocado oil
- Almond oil
- Coconut oil
- Flaxseed oil
- Macadamia oil
- Olive oil
- Sesame oil
- Walnut oil
Organic, or grass-fed – not grain fed
- Bone Broth
- Eggs (free-range preferably organic)
FRUITS (in moderation)
- Watermelon (seedless)
SPICES AND HERBS
- Black Pepper
- Coriander Seeds
- Sea Salt
- Apple cider vinegar
- Coconut vinegar
- Coconut aminos (a salty tasting sauce made from coconut)
- Coconut teriyaki
- Sea salt
- Mayonnaise – home made from olive oil, coconut oil, egg yolk, seasonings
- Coconut flour
- Almond flour
- Almond milk
- Coconut kefir
- Coconut milk
- Herbal teas
- Raw vegetable juices or smoothies
- Sparkling water
- Spring water (or filtered)
SWEETENERS (in moderation)
- Raw Honey
- Dates made into paste
Before you commence your diet, see your medical or health care professional for qualified guidance about what foods and supplements are best for your body. While on the diet do not stop any medications or supplements previously prescribed unless advised otherwise by your medical or health care professional.
During the early stages of a new diet, you may experience symptoms such as fatigue, headaches, or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Client name and identifying information changed
When mum Jenny brought her 5-year-old son Thomas to see me he had recently been diagnosed as being on the autistic spectrum, but Jenny didn’t want to just have a label, she wanted to know how to help her son. Because she couldn’t get any answers through the ‘normal medical system,’ Jenny made an appointment with me.
Thomas’ symptoms included daily tummy pains, loose smelly stools several times a day, smelly breath, delayed walking ability (walked on toes), delayed speech (had trouble with many words), a little disruptive at school, regular tantrums, frequently sick with sore throat, bronchitis, ear infections and gastric diarrhoea.
He seemed to have some type of infection every couple of weeks and been on so many courses of antibiotics during his life that Jenny didn’t know how many overall. Not to mention that these antibiotics were the children’s liquid variety made with artificial flavours, colours, and sweeteners to entice kids to take them.
To summarise: Thomas was a sickly child with bad behaviour.
After many tests, we found that Thomas had bad dysbiosis (bacteria imbalances in his gut) and ‘leaky gut syndrome’ (gut pathogens leaking into his blood stream, causing immune and food intolerance reactions).
Jenny already knew he had food intolerances. Even as a baby he screamed within two hours of eating certain foods, but the number of foods affecting him appeared to be increasing. Jenny also said that her son reacted badly to his vaccinations as his poor little immune system couldn’t handle them well.
Thomas was born by C-section and could not be breast-fed because Jenny had a severe dose of mastitis (infection in her mammary glands) and she was put onto high doses of antibiotics. Jenny tried to feed for a couple of days, but it was too painful.
Subsequently, Thomas missed out on good bacteria from his mum at birth but also had doses of antibiotics to top it off. Not a good start for Thomas, and Jenny was not advised how to manage it. Unfortunately, this happens too often but it’s never too late to do something about it.
With this understanding, we knew we needed to treat Thomas’s inflamed gut. We discussed the GAPS diet protocol, plus some probiotic supplements and a few other things he needed. At first Jenny hesitated because Thomas was a fussy eater, but we agreed that the family could go on the diet together without making a big deal out of it. In other words, because these were the only foods available to eat for the time being, Thomas was more likely to accept the situation.
Even though Thomas appeared to not be listening to our conversation, he indeed was. When we finished speaking he asked about his food and said, “Does this mean that I will feel better in my tummy?”. I answered with a smile and said, “Yes, you will feel much better and also not get sick as often and you’ll be able to do your school-work better”.
With that we had his guarantee that he would try to eat what he needed so he could be well. Then he asked for a toy bribe, which was what the family used to get Thomas to do something he didn’t really want to. Smart kid!
Jenny went out of her way to follow the diet plan and to make Thomas (and the family’s) meals as enjoyable and well presented as possible. He coped quite well, and with constant encouragement and acceptance Thomas completed the first six stages of the diet in about three months.
During this time his bowels became normal, he lost his tummy pains, was behaving better and didn’t get sick. Even the school said he was going better with his class work. Brilliant!
We re-tested his stools and found his leaky gut had healed and his bacterial imbalance was much better. His gut still needed some balancing but the family were happy with his progress. I encouraged them to use the full GAPS diet for another six months before introducing any new foods. They were happy to do that as they had found a routine of foods that worked well for them all.
In fact, the whole family felt better for the diet.
They came back after nine months on the diet and Thomas was different. He was more mature (and of course was nearly a year older) but he walked normally, spoke really well and was calm and happy. We organised some tests and he was a picture of health – just the way a healthy six-year-old should be.
I felt if Thomas returned to the doctor who diagnosed autism, he may well have changed his mind about Thomas’s original diagnosis.