GAPS diet – the diet for helping with learning disabilities, psychiatric disorders and physical problems
The GAPS diet is based on the SCD (the Specific Carbohydrate Diet). SCD has been invented by a renowned American paediatrician Dr. Sidney Valentine Haas in the first half of the 20th century. Dr. Haas and his colleagues have spent many years researching the effects of diet on celiac disease and other digestive disorders. The results of this research were published in a comprehensive medical textbook “The Management of Celiac Disease”, written by Dr. Sidney V. Haas and Merrill P. Haas in 1951. The diet, described in the book, was accepted by the medical community all over the world as a cure for celiac disease and Dr. Sidney V. Haas was honoured for his pioneer work in the field of paediatrics. Unfortunately, when celiac disease was defined as a gluten intolerance or gluten enteropathy, the SCD got forgotten as outdated information. It was brought back to life by Elaine Gottschall. Following the success of the SCD with her daughter, Elaine Gottschall over the years helped thousands of people, suffering from Crohn’s disease, ulcerative colitis, celiac disease, diverticulitis and various types of chronic diarrhoea. But the most dramatic and fast recoveries she reported in young children, who apart from digestive problems had serious behavioural abnormalities, such as autism, hyperactivity and night terrors. She devoted years of research into biochemical and biological basis of the diet and published a book, called “Breaking the Vicious Cycle. Intestinal Health Trough Diet.”
I have been using SCD in my clinic for many years. Having accumulated valuable clinical experience I had to make several adjustments in the diet appropriate for my patients with the neurological and psychiatric conditions. Through the years my patients named their dietary regime – the GAPS diet.
Implementing the GAPS Diet
1. Introduction Diet
2. The Full GAPS Diet with the typical menu
Some of you will use the diet to treat yourselves, some of you are parents trying to help your child, some will use the diet to help a loved one or a friend. To cover all these cases, I use the term “your patient” in the text.
I recommend that most GAPS patients follow the Introduction Diet before going into the Full GAPS Diet. Depending on the severity of your patient’s condition he or she can move through this programme as fast or as slow as his/her condition will permit: for example you may move through the First Stage in one or two days and then spend longer on the Second Stage.
Following the Introduction Diet fully is essential for people with serious digestive symptoms: diarrhoea, abdominal pain, bloating, some cases of constipation, etc. This diet will reduce the symptoms quickly and initiate the healing process in the digestive system. Even for healthy people, if you or your child gets a ‘tummy bug’ or any other form of diarrhoea, following the Introduction Diet for a few days will clear the symptoms quickly and permanently usually without needing any medication.
In cases of stubborn constipation, introduce freshly pressed juices earlier in the diet, from stage 2: start from carrot juice first thing in the morning and take your cod liver oil at the same time. The juice will stimulate bile production as many cases of persistent constipation are due to poor bile production. When there is not enough bile, the fats in the food do not digest well; instead they react with salts and form soap in the gut, causing constipation. Removing dairy may also help.
People with food allergies and intolerances should go through the Introduction Diet in order to heal and seal their gut lining. The reason for allergies and food intolerances is so-called “leaky gut” when the gut lining is damaged by abnormal micro flora. Foods do not get the chance to be digested properly before they get absorbed through this damaged wall and cause the immune system to react to them. Many people try to identify, which foods they react to. However, with damaged gut wall they are likely to absorb most of their foods partially digested, which may cause an immediate reaction or a delayed reaction (a day, a few days or even a couple of weeks later). As these reactions overlap with each other, you can never be sure what exactly you are reacting to on any given day. Testing for food allergies is notoriously unreliable: if one had enough resources to test twice a day for two weeks, they would find that they are “allergic” to everything they eat. As long as the gut wall is damaged and stays damaged, you can be juggling your diet forever removing different foods and never get anywhere. From my clinical experience it is best to concentrate on healing the gut wall with the Introduction Diet. Once the gut wall is healed, the foods will be digested properly before being absorbed, which will remove most food intolerances and allergies.
Those without serious digestive problems and food intolerances can move through the Introduction Diet quite quickly. However, please do not be tempted to skip the Introduction Diet and go straight into the Full GAPS Diet, because the Introduction Diet will give your patient the best chance to optimise the healing process in the gut and the rest of the body. I see cases where skipping the Introduction Diet leads to long-term lingering problems, difficult to deal with.
If you have decided to go straight into the Full GAPS Diet, keep in mind that about 85% of everything your patient eats daily should be made out of meats, fish, eggs, fermented dairy and vegetables (some well-cooked, some fermented and some raw). Baking and fruit should be kept out of the diet for a few weeks, and then be limited to snacks between meals and should not replace the main meals. Homemade meat stock, soups, stews and natural fats are not optional – they should be your patient’s staples.
Start the day with a cup of still mineral or filtered water. Give your patient the probiotic. Make sure that the water is warm or room temperature, not cold, as cold will aggravate his or her condition. Only foods listed are allowed: you patient must not have anything else. On the First Stage the most drastic symptoms of abdominal pain, diarrhoea and constipation will quickly subside. If, when you introduce a new food, your patient gets diarrhoea back, pain or any other digestive symptoms then he/she is not ready for that food to be introduced. Wait for a week and try again.
If you suspect a real allergy (which can be dangerous) to any particular food, before introducing it do the Sensitivity Test. Take a drop of the food in question (if the food is solid, mash and mix with a bit of water) and place it on the inside of the wrist of the patient. Do it at bedtime. Let the drop dry on the skin, then let your patient go to sleep. In the morning check the spot: if there is an angry red reaction, then avoid that food for a few weeks, and then try again. If there is no reaction, then go ahead and introduce it gradually starting from a small amount.
• Homemade meat or fish stock. Meat and fish stocks provide building blocks for the rapidly growing cells of the gut lining and they have a soothing effect on any areas of inflammation in the gut. That is why they aid digestion and have been known for centuries as healing folk remedies for the digestive tract. Do not use commercially available soup stock granules or bullion cubes, they are highly processed and are full of detrimental ingredients. Chicken stock is particularly gentle on the stomach and is very good to start from. To make good meat stock you need joints, bones, a piece of meat on the bone, a whole chicken, giblets from chicken, goose or duck, whole pigeons, pheasants or other inexpensive meats. It is essential to use bones and joints, as they provide the healing substances, not so much the muscle meats. Ask the butcher to cut in half the large tubular bones, so you can get the bone marrow out of them after cooking. Put the bones, joints and meats into a large pan and fill it up with water, add natural unprocessed salt to your taste at the beginning of cooking and about a teaspoon of black peppercorns, roughly crushed. Bring to boil, cover and simmer on a low heat for 2,5 – 3 hours. You can make fish stock the same way using a whole fish or fish fins, bones and heads. After cooking take the bones and meats out and sieve the stock to remove small bones and pepper corns. Strip off all the soft tissues from the bones as best as you can to later add to soups or encourage your patient to eat all the soft tissues on the bones. Extract the bone marrow out of large tubular bones while they are still warm: to do that bang the bone on a thick wooden chopping board. The gelatinous soft tissues around the bones and the bone marrow provide some of the best healing remedies for the gut lining and the immune system; your patient needs to consume them with every meal. Take off all the soft tissues from fish bones and heads and reserve for adding to soups later. The meat or fish stock will keep well in the fridge for at least 7 days or it can be frozen. Keep giving your patient warm meat stock as a drink all day with his meals and between meals. Do not use microwaves for warming up the stock, use conventional stove (microwaves destroy food). It is very important for your patient to consume all the fat in the stock and off the bones as these fats are essential for the healing process. Add some probiotic food into every cup of stock (the details about introducing probiotic foods follow).
• Homemade soup with your homemade meat or fish stock. Please look for some recipe ideas in the recipe section. Here we will go through some details, specific for the Introduction Diet. Bring some of the meat stock to boil, add chopped or sliced vegetables: onions, carrots, broccoli, leeks, cauliflower, courgettes, marrow, squash, pumpkin, etc. and simmer for 25-35 minutes. You can choose any combination of available vegetables avoiding very fibrous ones, such as all varieties of cabbage and celery. All particularly fibrous parts of vegetables need to be removed, such as skin and seeds on pumpkins, marrows and squashes, stock of broccoli and cauliflower and any other parts that look too fibrous. Cook the vegetables well, so they are really soft. When vegetables are well cooked, add 1-2 tablespoons of chopped garlic, bring to boil and turn the heat off. Give your patient this soup with the bone marrow and meats and other soft tissues, which you cut off the bones. You can blend the soup using a soup blender or serve it as it is. Add some probiotic food into every bowl of soup (the detail about introducing probiotic foods follow). Your patient should eat these soups with boiled meat and other soft tissues off the bones as often as he/she wants to all day.
• Probiotic foods are essential to introduce right from the beginning. These can be dairy – based or vegetable – based. To avoid any reactions introduce probiotic foods gradually, starting from 1-2 teaspoons a day for 2-5 days, then 3-4 teaspoons a day for 2-5 days and so on until you can add a few teaspoons of the probiotic food into every cup of meat stock and every bowl of soup. Start adding juice from your homemade sauerkraut, fermented vegetables or vegetable medley (please look in the recipe section) into cups of meat stock (do not add the vegetables themselves yet, as they are too fibrous). These juices will help to restore normal stomach acid production. Make sure that the food is not too hot when adding the probiotic foods, as the heat would destroy the beneficial probiotic bacteria. In my experience a large percentage of GAPS people can tolerate well-fermented homemade whey and yoghurt right from the beginning. However, some cannot. So, before introducing dairy, do the sensitivity test. If there is no reaction on the sensitivity test, then try to introduce some whey from dripping your homemade yoghurt (dripping will remove many dairy proteins): start from 1 teaspoon of whey added to the soup or meat stock. After 3-5 days on 1 teaspoon of whey per day, increase to 2 teaspoons a day and so on, until your patient is having ½ a cup of whey per day with meals. At this stage try to add 1 teaspoon per day of homemade yoghurt (without dripping), gradually increasing the daily amount. After yoghurt introduce homemade kefir. Kefir is far more aggressive than yoghurt and usually creates a more pronounced “die-off reaction”. That is why I recommend introducing yoghurt first before starting on kefir. If your patient had no reaction to yoghurt, then you may be able to introduce kefir almost from the beginning. For those who clearly react to dairy, please look at p.95 in my book.
• Ginger tea, mint or camomile tea with a little honey between meals. Most people know how to make mint or camomile tea. To make ginger tea, grate some fresh ginger root (about a teaspoonful) into your teapot and pour some boiling water over it, cover and leave for 3 – 5 min. Pour through a small sieve.
In extreme cases of profuse watery diarrhoea exclude vegetables. Let your patient drink warm meat stock with probiotic foods (preferably whey or yoghurt), eat well-cooked gelatinous meats (which you made the stock with) and consider adding raw egg yolks gradually. Do not introduce vegetables until the diarrhoea starts settling down. When the gut wall is severely inflamed, no amount of fibre can be tolerated. That is why you do not rush to introduce vegetables (even very well-cooked).
• Keep giving your patient the soups with bone marrow, boiled meats or fish and other soft tissues off the bones (particularly gelatinous and fatty parts). He or she should keep drinking the meat stock and ginger tea. Keep adding some probiotic food into every cup of meat stock and every bowl of soup: juices from sauerkraut, juices from fermented vegetables or vegetable medley, and/or homemade whey/yoghurt.
• Add raw organic egg yolks. It is best to have egg yolks raw added to every bowl of soup and every cup of meat stock. Start from 1 egg yolk a day and gradually increase until your patient has an egg yolk with every bowl of soup. When egg yolks are well tolerated add soft-boiled eggs to the soups (the whites cooked and the yolks still runny). If you have any concerns about egg allergy, do the sensitivity test first. There is no need to limit number of egg yolks per day, as they absorb quickly almost without needing any digestion and will provide your patient with wonderful and most needed nutrition. Get your eggs from the source you trust: fresh, free range and organic.
• Add stews and casseroles made with meats and vegetables. Avoid spices at this stage, just make the stew with salt and fresh herbs (look for a recipe of Italian Casserole in the recipe section). The fat content of these meals must be quite high: the more fresh animal fats your patient consumes, the quicker he or she will recover. Add some probiotic food into every serving.
• Increase the daily amount of homemade yoghurt or kefir, if introduced. Increase the amount of juice from sauerkraut, fermented vegetables or vegetable medley.
• Introduce fermented fish, starting from one piece a day and gradually increasing. Look for the recipes in the recipe section.
• Introduce homemade ghee, starting from 1 teaspoon a day and gradually increasing.
• Carry on with the previous foods.
• Add ripe avocado mashed into soups, starting from 1-3 teaspoons and gradually increasing the amount.
• Add pancakes, starting from one pancake a day and gradually increasing the amount. Make these pancakes with three ingredients: 1) organic nut butter (almond, walnut, peanut, etc); 2) eggs; 3) a piece of fresh winter squash, marrow or courgette (peeled, de-seeded and well blended in a food processor). Gently fry small thin pancakes using ghee, goose fat or duck fat, make sure not to burn them.
• Egg gently fried or scrambled with plenty of ghee, goose fat or duck fat. Serve it with avocado (if well tolerated) and cooked vegetables. Cooked onion is particularly good for the digestive system and the immune system: melt 3 tablespoons of duck fat or ghee in the pan, add sliced large white onion, cover and cook for 20-30 minutes on low heat until soft, sweet and translucent.
• Introduce the sauerkraut and your fermented vegetables (your patient has been drinking the juices from them for a while now). Start from a small amount, gradually increasing to 1-2 tablespoons of sauerkraut or fermented vegetables per every meal.
• Carry on with the previous foods.
• Gradually add meats cooked by roasting and grilling (but not barbecued or fried yet). Avoid bits, which are burned or too brown. Let your patient eat the meat with cooked vegetables and sauerkraut (or other fermented vegetables).
• Start adding cold pressed olive oil to the meals, starting from a few drops per meal and gradually increasing the amount to 1-2 tablespoons per meal.
• Introduce freshly pressed juices, starting from a few spoonfuls of carrot juice. Make sure that the juice is clear, filter it well. Let your patient drink it slowly or diluted with warm water or mixed with some homemade yoghurt. If well tolerated gradually increase to a full cup a day. When a full cup of carrot juice is well tolerated try to add to it juice from celery, lettuce and fresh mint leaves. Your patient should drink the juice on an empty stomach, so first thing in the morning and middle of afternoon are good times.
• Try to bake bread with ground almonds or any other nuts and seeds ground into flour. The recipe (please look in the recipe section) requires only four ingredients: 1) nut flour; 2) eggs; 3) piece of fresh winter squash, marrow or courgette (peeled, de-seeded and finely sliced); 4) some natural fat (ghee, butter, goose or duck fat) and some salt to taste. Your patient should start from a small piece of bread per day and gradually increase the amount.
• If all the previous foods are well tolerated try to add cooked apple as an apple pure: peel and core ripe cooking apples and stew them with a bit of water until soft. When cooked add some ghee to it and mash with a potato masher. If ghee has not been introduced yet add duck or goose fat. Start from a few spoonfuls a day. Watch for any reaction. If there is none gradually increase the amount.
• Add raw vegetables starting from softer parts of lettuce and peeled cucumber. Watch your patient’s stool. Again start from a small amount and gradually increase if well tolerated. After those two vegetables are well tolerated gradually add other raw vegetables: carrot, tomato, onion, cabbage, etc.
• If the juice made from carrot, celery, lettuce and mint is well tolerated, start adding fruit to it: apple, pineapple and mango. Avoid citrus fruit at this stage.
• If all the introduced foods are well tolerated try some peeled raw apple. Gradually introduce raw fruit and more honey.
• Gradually introduce baking cakes and other sweet things allowed on the diet. Use dried fruit as a sweetener in the baking.
As I mentioned before, your patient may be able to move through the Introduction Diet faster or slower depending on the stool changes: let the diarrhoea start clearing before moving to the next stage. You may have to introduce some foods later than in this programme depending on his/her sensitivities. Make sure that you carry on with the soups and meat stock after your patient completed the Introduction Diet at least once a day.
After the Introduction Diet is completed and when your patient has more or less normal stools move into the Full GAPS Diet.
The Full GAPS Diet
Your patient needs to carry on completely avoiding starches and sugar for two years at least. It means avoiding all grains, sugar, potatoes, parsnips, yams, sweet potato and anything made out of them. The flour in your cooking and baking can be replaced with ground almonds (or any other nuts or sunflower or pumpkin seeds ground into flour). In about 1 – 1.5 years you may be able to introduce new potatoes, fermented buckwheat, millet and quinoa, starting from very small amounts and observing any reaction. Wheat, sugar, processed foods and all additives will have to be out of the diet for much longer.
Slowly increase the amounts of fermented foods. You can ferment vegetables, fruit, milk and fish (please look in the recipe section). I would also recommend reading a wonderful book by Sally Fallon “Nourishing Traditions”, it will provide you with a lot of good recipes. Eating fermented foods with every meal will help your patient to digest the meal without using supplements of digestive enzymes. Make sure to introduce all new fermented foods into the diet very gradually starting from 1-2 teaspoons a day.
The best foods for the GAPS person are eggs, meats and fish (bought fresh or frozen, not smoked or canned, and cooked at home), shellfish, fresh vegetables and fruit, nuts and seeds, garlic and olive oil. As well as eating the vegetables cooked it is important to have them raw in the form of salads and sticks. In this form they will provide your patient with valuable enzymes and detoxifying substances, which will help in digesting meats. Raw fruit should be eaten on their own, not with meals, as they have a very different digestion pattern and can make the work harder for the stomach. At that stage let your patient to have fruit as a snack between meals. Remember, that about 85% of everything your patient eats on a daily basis should be savoury – made out of meats, fish, eggs, vegetables and natural fats. Sweet baking and fruit should be snacks between meals in limited amounts.
It is very important for a GAPS person to have plenty of natural fats in every meal from meats, butter, ghee, coconut and cold pressed olive oil. The fat content of the meal will regulate the blood sugar level and control cravings for carbohydrates.
If your patient gets a tummy bug or any other form of diarrhoea go back to the low fibre diet for a few days: remove all nuts, raw vegetables and raw fruit out of the diet; go back to meats cooked in water and meat stock, fish, eggs, fermented dairy and cooked vegetables (skinned, de-seeded and well cooked with meats as soups and stews) until diarrhoea completely clears. After the stools stay normal for a week introduce raw vegetables slowly, one at a time and starting from small amounts. When vegetables are introduced, try to introduce nuts, seeds and fruit gradually.
It is important for your GAPS patient to balance the meals so that his or her body pH stays normal. All protein foods, such as meats, fish, eggs and cheese leave an acid ash in the body, which may aggravate his or her condition. Vegetables are alkalising, so you need to combine meats, fish and eggs with good amount of vegetables cooked and/or raw. Raw fruit, vegetables and greens have particularly strong alkalising ability. Apple cider vinegar is very alkalising, it is good to have it every day: just add one teaspoon of cider vinegar into every glass of water your patient drinks. Hot water with cider vinegar will makes an excellent warming and alkalising drink. Fermented foods are also alkalising.
It is very important to avoid processed foods (any packet or tinned foods). They are stripped from most nutrients that were present in the fresh ingredients used for making these foods. They are a hard work for the digestive system and they damage the healthy gut flora balance. On top of that they usually contain a lot of artificial chemicals, detrimental to health, like preservatives, colorants, E-numbers, etc. Try to buy foods in the form that nature made them, as fresh as possible.
Do not use a microwave oven, as it destroys food. Cook and warm up food using conventional oven and stove.
Foods to avoid:
• Sugar and anything that contains it.
• Molasses, maple syrup, corn syrup, any other syrup.
• Aspartame in any form, it is a potent neurotoxin (brain toxin).
• Sweets, cakes, biscuits, chocolates, ice – creams.
• All alcoholic beverages. An adult can have good quality wine with meals occasionally but not beer or spirits.
• Tinned and processed foods, always read the ingredients label, beware of sugar, lactose, maltose, starch, corn flour, preservatives, flavourings, colours, yeast. It is best not to buy processed foods at all.
• Grains: rice, corn, rye, oats, wheat and anything made of wheat flour (breads, pasta, biscuits, cakes and anything from the bakery, anything with bread crumbs or batter), buckwheat, quinoa, millet, couscous, spelt, semolina, tapioca, etc. After about 1 – 1.5 years you may be able to slowly re-introduce buckwheat, millet and quinoa (fermented to start with), but not wheat, rye or rice.
• Breakfast cereals are highly processed products with virtually no nutritional value, they are full of sugar, salt, trans-fatty acids and other harmful substances. They should be out of the diet forever.
• Starchy vegetables and anything made out of them: potato, parsnips, yams, Jerusalem artichoke and sweet potato. In about 1 – 1.5 years you may be able to introduce new potatoes.
• Milk should be out at this stage. However, the GAPS person can have soured milk products, such as natural hard cheese, live natural yoghurt and kefir, crème fresh or soured cream, butter and ghee. There are many substances in milk, which could cause trouble, such as milk sugar lactose, casein, immune complexes, etc. Soured milk products do not contain lactose and are pre-digested by the fermenting microbes, which makes fermented milk products very easy to digest for us. I would recommend using only organic milk products and introduce them one at a time, starting from small amounts. If you were not able to introduce any dairy in the Introduction Diet, then please look at page 95 in the GAPS book, it will explain how to introduce dairy safely. If you have introduced homemade yoghurt, kefir and ghee as a part of the Introduction Diet, then gradually introduce fermented cream and butter. When that is well tolerated try natural mature cheeses. You may want to try goat’s or sheep’s milk products first as they are often better tolerated by the GAPS people, than cow’s. In about 1,5 -2,5 years and when all fermented dairy products are introduced, your patient may be able to drink raw unpasteurised organic milk. Introduce it gradually starting from 1-2 teaspoons a day. A GAPS person must never have pasteurised milk!
• Fruit juices apart from freshly pressed. Unfortunately fruit juices (not freshly pressed by you) are a source of processed sugars and can contain a lot of fungi and moulds in them, which your GAPS patient might react to.
• Beans and pulses are generally hard to digest. The two varieties that your patient can have are white (navy) beans also called haricot beans, fermented and cooked at home, and fresh green beans. Commercially available baked beans have almost 40% sugar and should be avoided. You can make your own baked beans at home (please, look in the recipe section).
• Coffee is a strong irritant for the digestive tract, try to avoid it. Strong tea is not advisable either. Natural herbal teas (no flavourings added) and ginger tea are fine. Ginger tea is a well-known folk remedy for digestive problems.
• Soft drinks are not allowed at all, they are full of sugar and various chemicals, which are very damaging for GAPS people.
• Anything with colours, preservatives, flavourings and other chemicals.
• Soya and anything made out of it. It interferes with thyroid function in the body and negatively affects hormonal balance, as it contains oestrogen – like compounds. It is important to avoid all synthetic oestogens, such as from soya, contraceptive pill, many other drugs, domestic cleaning chemicals, laundry detergents, toiletries, etc.
• Buy fresh or frozen meats, fish and shellfish. Make sure that they are not smoked, salted or preserved in any other way. Your patient needs to have gelatinous meats every single day (meats around bones and joints, skin and brown meats on the poultry). It is important for him or her to have all the fats on the meat, eating lean muscle meats will not be good for GAPS.
• Liver and other organ meats should be eaten on a regular basis. They can be cooked any way you like. It is very nourishing and is the best remedy for many nutritional deficiencies.
• Eggs – the yolk is best eaten raw, the white should be slightly cooked, like for example in soft boiled or fried eggs. Make sure that you find good quality eggs, free-range organic eggs are the best. Your patient should have minimum 2-3 eggs a day as they are particularly good for restoring neurological functions.
• Fresh vegetables – all types of vegetables are recommended, apart from starchy vegetables, like potatoes, parsnips, sweet potato, Jerusalem artichokes and yams. You can cook vegetables by steaming them, stewing, roasting, grilling or stir-frying. It is particularly good to eat them as a homemade soup or stew with plenty of garlic, added at the end of cooking. Your patient should have plenty of cooked vegetables with every meal, as they are better digested than raw vegetables and are more nourishing. It is also important to have fermented and raw vegetables with every meal in a form of salads with olive oil and fresh lemon juice or as a snack. Raw and fermented vegetables will help in digesting proteins and detoxifying. However if your patient gets diarrhoea then cook all vegetables until diarrhoea clears.
• Fresh fruit. It is important that the fruit should be ripe. After completing the Introduction Diet introduce local seasonal ripe fruit gradually. At that stage start your patient’s day from a bit of fruit and offer some fruit between meals. He or she should not have fruit if there is diarrhoea. When the diarrhoea has cleared he or she can start from having cooked fruit (peeled, de-seeded and well cooked with a good dollop of butter, ghee or coconut oil) and then raw, introduced slowly.
• Avocado is a wonderfully nutritious fruit. Make sure it is ripe and serve it with meats, fish, shellfish and salads.
• Butter is better than any so-called healthy substitutes. You can cook with it or add it into ready dishes. Butter should be bought organic and unsalted, because non-organic butter contains a lot of pesticides and antibiotics, which the cows consume. Cold pressed virgin olive oil is very good for your patient, use it in salads and ready dishes liberally. It is not a good idea to cook with olive oil because it changes its chemical structure when heated. Frying is best done with animal fats: pork dripping, lard, lamb fat, goose fat, duck fat, ghee and butter. Coconut oil and palm oil are two plant oils, very good to use for cooking. These fats do not alter their structure during cooking. They can even be re-used. Collect your own fats after roasting meats. Avoid all common vegetable cooking oils, margarines and other processed fats: they are very harmful to health.
• Nuts and seeds are a wonderful source of very good nutrients. Nuts should be bought just shelled – not salted, roasted, coated or processed in any other way. This way they are an excellent source of essential fatty acids and many nutrients. However, nuts and seeds contain enzyme inhibitors, which may make them difficult to digest for some people. If you feel that it is a problem for your patient, as soon as you bought nuts to remove the enzyme inhibitors try to do the following: soak the nuts in salty water over night (1 tablespoon of sea salt per litre of water), in the morning drain them, rinse the salt off and dry in your oven at the temperature 50C for 3-24 hours (keep checking them as different nuts take different time to dry). Your patient can also eat nuts and seeds straight after soaking without drying them. Once they are dried keep them in an airtight container or well-sealed plastic bag. They become nice and crunchy and make an excellent snack food together with dried fruit. You can grind nuts and seeds (sunflower and pumpkin) into flour consistency to make bread, pancakes and even cakes at home. My book will provide you with recipes. Ground almonds or almond flour is available in health food shops.
• If your child would like to have a milk-like drink, nut/seed milk can replace all other milk while you are gradually introducing dairy. You can use almonds, sunflower seeds, sesame seeds and pine nuts to make milk. Blanched almonds make the best milk. You can add a teaspoon of flax seeds to make the milk thicker. Soak a cup of almonds in water for 12 – 24 hours, drain. Blend in a food processor with water: for 1 cup of nuts/seeds add 1-2 cups of water. A good juicer will crash the nuts/seeds well, making a paste, which you would blend with water. Mix well and strain through cheesecloth or a fine strainer and you have got milk. You can add some soaked dates or raisins, when blending, they will make the milk sweet. If you find that the milk is too rich, just add more water. You can add some of freshly pressed apple juice or carrot juice into it to make a very tasty and nourishing drink for your child. You can “milk” the same cup of almonds a few times. Just keep the paste covered with water in the refrigerator.
• You can also make coconut milk. Bring to boil (but do not boil) 1 cup of unsweetened shredded dried coconut and 1 cup of water. Cool down and blend well in your food processor. Strain through cheesecloth or a fine strainer.
• It is better to replace the table salt in your patient’s diet with unprocessed salt. The salt, which is sold in shops has been processed to remove all natural minerals apart from the NaCl. The human body needs all those minerals, that is why we must consume natural unprocessed salt. You can get very good quality sea salt called Celtic Salt or a Himalayan Crystal Salt.
• Garlic is very important to eat every day. It will help to normalise your patient’s gut flora and stimulate the immune system. It is important to have it raw with meats or cooked as a part of the meal. Work on using a whole head of garlic every day (not just a few cloves).
• Unprocessed honey is the only sweetener allowed (in baking it is better to use dried fruit as a sweetener). Locally produced honey is usually the most reliable.
A typical menu:
Start the day with a glass of still mineral or filtered water with a slice of lemon. It can be warm or cool to personal preference. Have half a cup of homemade yoghurt or kefir.
Instead of drinking water and yoghurt/kefir separately, you can make a refreshing drink: mix well half a cup of yoghurt/kefir and half a cup water and drink first thing in he morning.
If you have a juicer your patient can start the day with a glass of freshly pressed fruit/vegetable juice diluted with water.
You can make all sorts of juice mixes, but generally try to have 50% of therapeutic ingredients: carrot, small amount of beetroot (no more than 5% of the juice mixture), celery, cabbage, lettuce, greens (spinach, parsley, dill, basil, fresh nettle leaves, beet tops, carrot tops), white and red cabbage, and 50% of some tasty ingredients to disguise the taste of therapeutic ingredients: pineapple, apple, orange, grapefruit, grapes, mango, etc. Your patient can have these juices as they are, with some yoghurt/kefir or diluted with water.
Every day our bodies go through a 24 hour cycle of activity and rest, feeding and cleaning up (detoxifying). From about 4am till about 10am the body is in the cleaning up or detoxification mode. That is why many of us do not feel hungry first thing in the morning. Drinking water, yoghurt/kefir and freshly pressed juices will assist in this process. Loading the body with food at that time interferes with the detoxification. It is better to have breakfast around 10am when your body has completed the detox stage and is ready for feeding. At that stage we usually start feeling hungry, which is the body’s way of letting you know that the detoxification is finished. Children may be ready for their breakfast much earlier than adults.
• A variation of English breakfast: eggs cooked to personal liking and served with sausages and vegetables, some cooked, some fresh as a salad (tomato, cucumber, onions, celery, any fresh salad greens, etc.) and/or avocado and/or meat. The yolks are best uncooked and the whites – cooked. Use plenty of cold pressed olive oil as a dressing on the salad and eggs. Mix a tablespoon of pre-soaked or sprouted sunflower and/or sesame and/or pumpkin seeds with the salad. Sausages (full fat) should be made of pure minced meat (full fat!) with only salt and pepper added (any fresh vegetables or herbs also can be added to the mixture). Make sure that there are no commercial seasoning or MSG (Monosodium Glutamate) in the sausages. I recommend finding a local butcher, who would make pure meat sausages for you on order.
• Avocado with meat leftovers, fish or shellfish, vegetables raw and cooked, lemon and cold pressed olive oil. Serve a cup of warm meat stock as a drink with food. Don’t forget to add some probiotic food.
• Pancakes made with nuts ground into flour are nice to have on the weekends, when you have more time for cooking in the morning. These pancakes are delicious with some butter, sour cream with honey, or as a savoury snack. If you blend some fresh of defrosted berries with honey, it will make a delicious jam to have with pancakes. Weak tea with lemon, ginger tea or mint tea.
• Homemade vegetable soup or stew in a homemade meat stock.
• Avocado with meat, fish, shellfish and raw or/and cooked vegetables. Use olive oil with some lemon squeezed over it as a dressing. Serve a cup of warm homemade meat stock as a drink with some yoghurt/kefir.
• Any meat/fish dish with vegetables.
One of the dishes from the lunch or breakfast choice.
After dinner half a cup of yoghurt or kefir.
Coming off the GAPS diet
The strict GAPS diet should be adhered to for at least 1.5 – 2 years. Depending on the severity of the condition, some people recover quicker, others take much longer. Your patient needs to have at least 6 months of normal digestion before you start introducing foods not allowed on the GAPS diet. Do not rush with this step.
The first foods you will be able to introduce are new potatoes and fermented gluten-free grains (buckwheat, millet and quinoa). The recipe section will explain how to ferment grains.
Introduce one food at a time and always start from a small amount: give your patient a small portion of the new food and watch for any reaction for 2-3 days. If there are no digestive problems returning, or any other typical for your patient symptoms, then in a few days try another portion. If there are no reactions, gradually increase the amount of the food. These are starchy foods, so do not forget to serve them with good amounts of fat (butter, olive oil, any animal fat, coconut oil, etc.) to slow down the digestion of starch. Do not rush with the introduction of these new foods, it may take several months to do it properly.
Once new potatoes and fermented grains are introduced, try to make sourdough with good quality wheat or rye flour. You can make pancakes or bread with the sourdough. I would recommend a wonderful book by Sally Fallon “Nourishing Traditions” for a wealth of recipes. Once sourdough is well-tolerated you may be able to buy commercially available good quality sourdough breads.
At that stage you may find that your patient can digest buckwheat, millet and quinoa without fermenting them prior to cooking. Gradually you will find that you can introduce various starchy vegetables, grains and beans.
YOUR PATIENT WILL NEVER BE ABLE TO GO BACK TO THE TYPICAL MODERN DIET FULL OF SUGAR, ARTIFICIAL AND PROCESSED INGREDIENTS AND OTHER HARMFUL FOODS. USE THE YEARS OF FOLLOWING GAPS NUTRITIONAL PROTOCOL FOR DEVELOPING HEALTHY EATING HABITS FOR THE REST OF YOUR LIFE !
At the first glance the GAPS diet appears to be very hard work. However, it is a very wholesome and healthy diet and will allow your patient to heal and seal the gut lining and lay a strong foundation for good health for the rest of his or her life. It means that majority of GAPS people do not have to adhere to a special diet for the rest of their lives: once the digestive system starts functioning normally, they can gradually introduce most wholesome foods commonly eaten around the world. Some people achieve this target in 2 years, some take longer – it depends on the severity of the condition and the age of the person: children generally recover quicker than adults.
Once introduced, the GAPS diet is no more difficult than any normal cooking and feeding the family. And shopping is very simple: just buy everything fresh and unprocessed. Reading the GAPS book will provide you with essential information and many recipes.
The essential supplements for GAPS patients
1. An effective therapeutic strength probiotic.
2. Essential fatty acids.
3. Vitamins A and D in the form of cod liver oil.
Please read the relevant chapters in the GAPS book on these supplements.
In some individual cases, particularly in adults I use digestive enzymes. Children usually do very well without them. The most important intervention here is supplementation of the stomach acid, as GAPS patients usually have low stomach acidity. It is from the action of the stomach acid that the whole digestive process begins. The use of sauerkraut in the Introduction Diet helps to restore normal stomach acid production. Please, read more about it in the chapter Digestive Enzymes in my book.
In some individual cases I prescribe certain vitamin and mineral supplements. However, in majority of cases there is no need for these supplements, particularly at the beginning of the programme. We humans are designed to receive our vitamins and minerals from food, not from pills. Nutrients help each other in their absorption and metabolism, that is why they have to come in a complex physical form of natural food. The body has not been designed to use single, particularly synthetic molecules of vitamins and minerals.
Don’t be tempted to use other supplements. The main treatment of GAP Syndrome is the diet. Supplements may contain many ingredients, sometimes not listed on the label, which irritate the gut lining. You do not want to put a lot of effort into the diet and then upset the healing process in the gut by a pill. If you are strongly recommended to take a particular supplement complete the Introduction Diet first before starting it. By then a fair amount of healing will happen in your gut, so it will be in a better shape to handle the new supplement.
Please, read the relevant chapters in the GAPS book for a full understanding on using supplements.
Read and learn more from the following books:
Gut And Psychology Syndrome by Dr Campbell-McBride.
Internal Bliss. Recipes designed for those following the Gut and Psychology Syndrome Diet