The GAPS Diet: Know-How this Diet works; Do’s & Don’ts!

Your gut is intimately connected to all other parts of your body. Made up of trillions of beneficial microbes, your gut microbiome is thought to have a significant effect on health and disease. It is well established that what you eat has a significant effect on your gut health, which in turn affects various aspects of health, including your brain function. Gut health has always been the subject of extensive research and numerous diets have been designed to improve gut health, such as the elimination diet, low FODMAP diet, low residue diet, elemental diet, and microbiome diet. A common concept among these diets is that they include foods that are easy to digest. This allows the gut to heal itself.

One such diet is the GAPS diet, which eliminates grains, sugars, and refined carbohydrates and replaces them with probiotic foods and other nutrient-dense foods. In theory, it can be used to treat conditions affecting the brain, such as autism. However, researchers are yet to fully explore this diet.

This article looks into the working of the GAPS diet, how to follow it, and its benefits. We also provide sample meal plans for the diet.

What is the GAPS diet?

GAPS is an acronym for Gut and Psychology Syndrome. The diet was invented by Dr. Natasha Campbell-McBride, who holds degrees in medicine, neurology, and human nutrition. She developed the GAPS diet in 2004 after studying the relationship between gut, nutrition, and brain health.

The concept behind this diet is that a diet high in carbohydrates causes your sugar levels to spike, which triggers inflammatory responses in the body and results in a leaky gut. A leaky gut refers to a condition in which your gut barrier becomes more permeable than usual. This allows pathogens and toxins from the food and environment to enter your bloodstream, leading to inflammation and digestive problems. The GAPS theory claims that a leaky gut is often the underlying cause of neurological problems as these foreign substances can affect the functioning of your brain, which causes brain fog and conditions like dementia and autism.

The GAPS diet aims to treat these conditions by healing your gut and reducing toxicity in the body by preventing toxins and pathogens from entering your system.

Dr. Cambell-McBride mentions in her book how the GAPS diet helped her first child to recover from severe autism, a developmental disability that affects how a person communicates and interacts with others. She is now a big advocate of the diet and believes that it can treat many neurological and psychiatric conditions, including:

• Autism
• Attention deficit hyperactivity disorder (ADHD)
• Dyslexia
• Dyspraxia
• Depression
• Bipolar disorder
• Eating disorders
• Obsessive-compulsive disorder (OCD)
• Gout
• Childhood bed wetting
• Schizophrenia
• Tourette’s syndrome

The diet is generally used to treat children, especially for conditions that don’t have a specific medication in mainstream medicine, such as autism. It is also helpful for children with allergies and food intolerance. 

The GAPS Diet Protocol

The GAPS diet eliminates grains, pasteurized dairy, starchy vegetables, soy, sugar, and processed foods from the diet. It is divided into three phases:

• The Introduction Phase
• The Full GAPS Diet
• The Reintroduction Phase

Phase 1: Introduction Phase – Elimination

Dr. Campbell McBride recommends following the introduction diet before taking up the full GAPS diet. 

This phase is also known as the gut healing phase and aims to reduce digestive problems quickly. It is the most challenging part of the diet as it eliminates most foods. The introduction phase may take three weeks to a year to complete, depending on your symptoms. 

The introduction phase is broken down into 6 steps:

• Step 1: Consume homemade bone broth, chamomile, or ginger tea with honey, and fermented vegetable juices. People who can tolerate dairy can have homemade kefir, yogurt, and fermented whey.

• Step 2: Add foods like fermented fish, homemade ghee, raw organic egg yolks, and stews made with meat and vegetables. 

• Step 3: Add in avocado, GAPS pancakes, fermented vegetables, sauerkraut, and scrambled eggs made with ghee, goose fat, or duck fat.

• Step 4: Add roasted or grilled meats, vegetable juice, cold-pressed olive oil, GAPS milkshake, and GAPS bread.

• Step 5: Introduce fruit juice, raw vegetables, such as lettuce and peeled cucumber, cooked apple puree, and small amounts of non-citrus fruits.

• Step 6: Add in more raw fruits, including citrus fruits.

Keep in mind that you may be sensitive to certain foods. Thus, it is important to introduce new foods one at a time, and move on to the next stage when you are sure you can tolerate the foods you introduced. You can tell whether you can tolerate a particular food by watching out for digestion problems, such as gas, bloating, and abdominal pain, and through your bowel movements.

Phase 2: The Full GAPS diet – Maintenance phase

Once you can tolerate all the foods listed in the introduction phase, you are ready to follow the full GAPS diet. The full GAPS lasts 1.5-2 years. However, its duration is individualized and may be less for some people. In this phase, it is advised to eat the following foods:

• Organic eggs
• Meat, fish, and shellfish
• Animal fats, such as raw butter, ghee, duck fat, lamb fat, and lard
• Vegetables
• Fermented foods, such as sauerkraut, yogurt, and kefir

In addition to this, you can also eat a moderate amount of nuts and GAPS baked goods made using nut flour. There are certain other recommendations that you must keep in mind during this phase. These include:

• Avoid canned and packaged foods
• Do not eat fruit and meat together
• Drink bone broth with each meal
• Consume a lot of fermented foods
• Choose organic foods as much as possible
• Consume animal fats, or cold-pressed olive oil or coconut oil with every meal

In this phase of the diet, you should refrain from all other foods, especially refined carbohydrates, artificial colorings, and preservatives.

Phase 3: The Reintroduction Phase – Transitioning off the GAPS diet

According to the diet, you should go on to the reintroduction phase once you have experienced normal digestion and regular bowel movements for 6 months. Like the previous stages, this phase can also last for a long time as you reintroduce food gradually over a period of a few months.

The phase of the diet suggests introducing small amounts of each food individually. If you can tolerate them well for 2-3 days, you may slowly increase the portion size. The diet does not give the exact list or the order in which you should reintroduce foods. However, it mentions that you should begin by consuming potatoes and fermented gluten-free grains. Even when you are off the diet completely, it is recommended that you avoid refined carbohydrates, processed and high-sugar foods, and continue to eat whole foods.

GAPS supplements

While the GAPS protocol is the most important aspect of the diet, it also suggests taking various supplements, particularly during the third phase of the diet. These include:

• Probiotics
• Cod liver oil
• Omega-3 fatty acids
• Digestive enzymes

Probiotics

Probiotic supplements restore the balance of friendly microbes in your gut. You are advised to introduce probiotics slowly into your diet. Choose a probiotic that offers at least 8 billion bacterial cells per gram and contains multiple bacterial strains. The Top 10 Probiotics Supplements you’ll discover are listed here.

Essential fatty acids

Followers of the GAPS diet are advised to take both cod liver oil and fish oil daily. They should also consume a nut and seed oil blend that provides omega-3 and omega-6 fatty acids in a 2:1 ratio.

Digestive enzymes

The diet’s founder believes that people following a GAPS diet tend to produce less stomach acid. Dr. Cambell-McBride recommends taking betaine HCl and pepsin before every meal. Betaine HCl is a supplemental source of hydrochloric acid, which is one of the main stomach acids. Pepsin is an enzyme that helps with the digestion of proteins. Additionally, you can take ox bile supplements before your meals for better digestion and absorption of fats.

Foods to Eat while following the GAPS diet

• Bone broth
• Meats, preferably grass-fed and hormone-free
• Eggs
• Fish
• Shellfish
• Animal fats
• Unprocessed hard cheeses
• Fresh fruits
• Non-starchy vegetables
• Kefir
• Fermented foods and beverages
• White navy beans
• Green beans
• Nuts
• Seeds
• Coconuts, coconut oil, coconut milk

Foods to Avoid while following the GAPS diet

• Sugar, artificial sweeteners, and syrups
• Packaged and processed foods
• Starchy vegetables, such as potatoes, sweet potatoes, and yams
• Grains, such as wheat, rice, oats, and corn
• Milk
• Cottage cheese
• Commercial yogurt
• Soy
• Most beans
• Strong tea
• Coffee
• Alcohol, but adults can have a glass of dry wine occasionally.

Sample Meal Plan

The GAPS diet may seem intimidating at first, but it doesn’t have to be all that boring or restrictive if you are willing to learn some recipes along the way. The diet includes a wide range of aromatics, herbs, and spices that you can use to prepare delicious meals. Here is a sample meal plan to help you get started. 

Begin your day with one of the following options:

• A glass of freshly prepared vegetable or fruit juice
• A glass of kefir or filtered lemon water

Breakfast

• Vegetable scrambled eggs: 2 eggs + 1 Tbsp. butter + ¼ cup red peppers + ¼ cup diced white onions + 1 cup spinach + ¼ cup halved cherry tomatoes + salt and pepper

Lunch

• Stuffed bell peppers: 2 large bell peppers (any color) + 1 pound minced meat + ½ large white onion + 1 medium carrot + salt and pepper

Dinner

• Baked fish cutlets: 2-3 fish of choice + 1 egg + 1 cup shredded coconut + 3-5 Tbsp. butter + salt and pepper
• Cauliflower mashed potatoes: 1 large cauliflower cut + butter + finely chopped parsley + salt and pepper

Snack

• Guacamole and vegetable sticks: 2 avocados + ¼ cup diced white onion + 1 clove crushed garlic + juice of 1 lime + handful of fresh coriander + 1 Tsp. salt. Serve with celery, cucumber, or carrot sticks. 

Dessert

• Baked apples: 1 large apple + 1 Tsp. raw honey + 1 Tsp. butter + 1-2 chopped walnuts + ground cinnamon

Benefits of the GAPs diet

Healthy and homemade meals

While carbohydrates are an important source of fuel, we often tend to overeat them. This can be detrimental to our gut health. Moreover, Dr. Cambell-McBride believes that store-bought products don’t have the same effect as homemade foods. Therefore, she encourages people to eat more home-cooked meals that consist of fresh vegetables, fruits, meat, fish, and poultry, and avoid all processed, restaurant-made, packaged, and canned foods.

May help treat leaky gut

Not only does a leaky gut cause autoimmune disease, but it also affects various other health aspects. Consequently, improving your gut health can lead to a number of health benefits, such as better immunity, improved heart health, weight management, and restful sleep. The GAPS diet can help restore your gut health in many ways. These include:

• Removing artificial sweeteners: They are known to disrupt the balance of the beneficial bacteria in the gut and increase your risk of developing metabolic problems. 
  
  
• Increasing intake of fruits and vegetables: Consuming fruits and vegetables promotes the growth of friendly microbes in the gut and helps prevent the overgrowth of harmful bacteria strains.
  
  
• Including probiotic foods: Consuming probiotics help improve the composition of your gut microbiome by increasing the number and diversity of beneficial microbes in the gut. Find Probiotic Foods that you can add to your day-to-day diet.

A case study on a 12-year-old boy with celiac disease and autism spectrum disorder (ASD) showed that a 4-week probiotic treatment could reduce gastrointestinal and autism symptoms ^[1].

May help treat certain conditions

Although there is no evidence that all components of the GAPS diet are effective in treating the conditions it claims to cure, it may help reduce inflammation in the body and improve symptoms of ADHD, autism, depression, and other brain-related conditions among children and adults.

A study conducted on 80 children with autism showed that a gluten-free diet reduced autism and gastrointestinal symptoms ^[2].

What’s more, a review study showed that probiotics have high therapeutic potential for treating symptoms of depression ^[3].

Side Effects of the GAPs diet

• Highly restrictive
• The GAPS diet requires you to avoid many healthy foods for long periods of time.
• Such diets are not enjoyable or sustainable and can be difficult to follow in the long run.
• Additionally, it does not explain clearly how you can ensure you get all the nutrients from your diet. For this reason, malnutrition is the most prominent risk of taking up this diet. This is especially a concern for children who need a nutritious diet for proper growth and development, for whom the diet was meant in the first place.
• Moreover, people with autism already eat a restrictive diet and may not be willing to alter their diets, which can cause extreme restrictions.

Factors that may influence the outcomes of the GAPS diet

• Exercise: Staying physically active is important for optimal and overall health, regardless of the diet you follow. However, since the introduction phase of this diet is quite restrictive, you may perform low-intensity workouts in the beginning and gradually increase your intensity in the subsequent stages.
  
  Seize the opportunity to learn about some Gut Exercises that can help you enjoy better gut health.
  
  
• Stress and anxiety: When you are stressed, it triggers an inflammatory response, increasing the permeability of the gut barrier. Thus, managing your stress can help heal your gut faster. Activities like meditation, breathing exercises, journaling, listening to music, and connecting with your loved ones can help dial down your stress levels.
  
  
• Alcohol and cigarette intake: Tobacco and alcohol impair mucosal immune function and lead to leaky gut. Thus, it is beneficial for you to refrain from alcohol and tobacco during the GAPS diet.

Conclusion

Poor nutrition and increased intestinal permeability can contribute to many behavioral, neurological, and psychological issues. The GAPS diet is a gut-healing diet that claims to treat brain-related conditions by improving your gut health. Followers of this diet are advised to avoid foods that are hard to digest and may be detrimental to gut health. They are recommended to replace them with nutrient-dense and anti-inflammatory foods to help repair the gut.

Although some people claim that they have benefited from the diet, these records are mostly anecdotal. Some health experts have voiced the concern that a lot of the claims of this diet are not supported by scientific evidence. Moreover, the diet is difficult to follow and does not account for nutritional requirements. People following this diet should make sure they get enough nutrients to prevent nutrient deficiencies.

Due to the restrictive nature of the GAPS diet, people with eating disorders are advised not to follow it. Additionally, vegetarians and vegans may find it tricky to follow the GAPs diet as it involves a lot of animal-based products. However, the diet is gluten-free and can be made lactose-free for people who have lactose intolerance.

The GAPS diet is not a replacement for the traditional treatments for autoimmune diseases. However, if you think you can benefit from the GAPS diet, you must seek your doctor’s advice to determine whether taking up this diet would be beneficial for you and to make sure that you are getting adequate nutrition.

Pairing the diet with other vital components of a healthy lifestyle like minimal stress levels, regular exercise, and restful sleep can help maximize your output.

References

1. Grossi E, Melli S, Dunca D, Terruzzi V. Unexpected improvement in core autism spectrum disorder symptoms after long-term treatment with probiotics. SAGE Open Med Case Rep. 2016 Aug 26;4:2050313X16666231. doi: 10.1177/2050313X16666231. PMID: 27621806; PMCID: PMC5006292.
   
   
2. Ghalichi F, Ghaemmaghami J, Malek A, Ostadrahimi A. Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: a randomized clinical trial. World J Pediatr. 2016 Nov;12(4):436-442. doi: 10.1007/s12519-016-0040-z. Epub 2016 Jun 10. PMID: 27286693.
   
   
3. Ibrahim Nadeem BHSc (Honours),Mohammed Z. Rahman MD,Yasser Ad-Dab’bagh MD,Mahmood Akhtar MSc, MPhil, PhD