I’m Confused, too

Comment/question of the Day:  Where do I start?  I read about the GAPS diet, and it just confused me.

Yeah.  Me, too.  Mostly confused about how I got on board with this thing!

“I looked at that diet you do, and I could never do that.”
“That’s crazy.”
“I can’t take away all those foods from my kids.  They [I] would die without their cereal.”

Confusion CornerThere are dozens of sites talking about GAPS and what it is.  I’m glad–because it took all of them to convince me to jump in.  My mantra is

“Moderation in all things.  Including moderation.”

And GAPS doesn’t sound too moderate to the average American.  It sounds wacky, tobaccy.  Beyond granola cruncher.  Moving into weirdo.

I can’t even tell you the hours I have spent reading, trying to validate this nutritional rehabilitation program to myself.

To start, I read Breaking the Vicious Cycle by Elaine Gottschall (I highly, highly, highly recommend this book.  Did I say I highly recommend this book?!)–

and Gut and Psychology Syndrome by Dr. Natasha Campbell-McBride.

Regarding Gut and Psychology Syndrome:

#1  Do not be deterred by the title!  I so wish it was named something else!  The word “psychology” scares most people off!  (Poor word choice, but she indicates in the book that her patients came up with the name.)  Really, if you have a chronic ailment that medical doctors just slap a prescription onto and say “Live with it”–than this book may help you a lot.  Think along the lines of headaches, stomach aches, constipation, diarrhea, fatigue, joint aches, muscle aches, strange unexplained rashes, poor focus, unexplained moodiness, hyperactivity, tics, autistic tendencies, refractory seizures, and more.

#2 I found it necessary to read the book in order to lay out her recommendations based off of her years of clinical practice.

#3  After reading the book, it can still be confusing.  But at least you have “rules” and something to guide you.  It is a great springboard to appreciating the complexity of nutrition and the human body, including your own–or your kids.  However, YOU will have to be the one to sort through things like:  Does my body function properly on dairy?  Do I react to eggs?  Do I do better with probiotic foods (like sauerkraut) or with probiotic supplements?  Her book is at times confusing because her subject matter is the human body, which cannot be reduced to a simple formula.  Some people can eat dairy and some can’t.  Some can eat nuts and some can’t.  Some respond horribly to probiotics and some don’t.  Just because it’s on “THE DIET” doesn’t mean your body functions optimally “on it.”  Human illness cannot be reduced to a simple “one size fit all fix.”  If you think GAPS alone will “cure” you, you are making the same mistake that people accuse medical doctors nowadays of making.  You will fail.

#4 Medically and scientifically speaking, the book will require further substantiation for the curious and skeptical reader.  Some statements are oversimplified or not quite medically correct, but that is to be expected.  One, it is for the lay population.  Two, we just don’t medically have a grasp on the material matter.  But if you read around, medical research is beginning to produce studies which support some diseases being seated in the gut and altering disease by modifying the gut environment.

#5  It does verge on the edge of too “holistic” for me.  Sorry.  It just does.  I detest the word “detox” and “toxins.”  I’m not convinced about magnesium baths and coffee enemas (and a few other things).  But I just sift through and take what I need without deviating too far from the basic points.  Kind of like I do with a Sunday sermon.  It’s not a Bible.  She’s a preacher/teacher.  Not God.

I have listed several sites below that I have visited that recap what GAPS is.  The links should take you to the author’s specific post on “What is GAPS?”:

♦SIBO (Small Intestinal Bowel Overgrowth), this particular page has a very good “nutshell” summary regarding SCD and GAPS with links to other good sites:  http://www.siboinfo.com/diet.html
♦GAPS Guide: I find the site a bit difficult to navigate (not complaining!) but this person wrote a book called GAPS Guide, which really breaks down GAPS and makes it approachable for anyone!  Lots of good info.   http://gapsguide.com/
♦What Can You Eat on The GAPS Diet:  A nice, simple breakdown.   http://www.healthhomehappy.com/2012/11/what-can-you-eat-on-the-gaps-diet.html  ”
♦What is GAPS?:    http://www.lovingourguts.com/what-is-gaps-2/
♦What is the GAPS Diet?:  http://nourishedkitchen.com/what-is-the-gaps-diet/
♦The GAPS Diet:  What It Is and Why You Might Consider Doing It:  http://nourishedkitchen.com/what-is-the-gaps-diet/
♦Gut and Psychology Syndrome website  (This link will take you to where the introduction diet is explained.):  http://www.gaps.me/preview/?page_id=28
♦The Full GAPS Diet:  http://gapsdiet.com/The_Diet.html
♦A nice GAPS section:  http://fatlovingfoodies.com/gaps/what-is-gaps/

In addition, I have read quite a bit on the mapping on the human microbiota and gut bacteria, which are immensely fascinating and a puzzle piece to put together why these diets can make a difference in such far-reaching conditions as autism, headaches, irritable bowel, inflammatory bowel, and fibromyalgia (to name ONLY a few)!

You know how they’re mapping the “human genome”?  Well, they’re doing the same now with the bacteria that live on us.  They’re that important!  Hopefully, with time, lots of time, I can post some of these fascinating findings!

In trying to wrap my arms around this GAPS diet thing and explain it to myself and friends, I have broken it down into outline form as follows below.  I am NO expert on this.  Zero.  Nada.  Zippo.  The Gut and Psychology Syndrome book is what you must have to really explain it–as much as Dr. Campbell-McBride herself can.:

I.  THINGS THAT GO INTO A MOUTH ON GAPS
A.  FOODS EXCLUDED and INCLUDED ON GAPS

      B.  INTRO GAPS and FULL GAPS
II.  LIFESTYLE ADJUSTMENTS SUGGESTED ON GAPS
III.  TWEAKING GAPS IS REQUIRED FOR YOUR SUCCESS

I. THINGS THAT GO INTO A MOUTH:

A.  Foods to Exclude and Include:
1.  Exclude:

a.  All grains (soy, rice, corn, wheat, barley, quinoa, oats, buckwheat, and any grain I’ve forgotten)
b.  Most starchy vegetables/legumes/roots, including those added as thickening agents (potatoes, sweet potatoes, most beans, tapioca, arrowroot, gums)
c.  Refined sugars and artificial sweeteners (white sugar, brown sugar, maple syrup, aspartame, agave, stevia)
d.  Products from concentrated fruit (fruit juice from concentrate, jam with fruit concentrate)
e.  Artificial colors
f.  Artificial preservatives and stay low on naturally occurring preservatives (like sulfites, nitrates, etc)
g.  Commercial dairy (dairy is the trickiest part of many of these diets–it’s a tricky substance for our bodies to digest and process)
h.  Limited caffeine and limited dry red or white wine

2.  Include:

a.  High quality meats, poultry, fish, and shellfish (preferably grass-fed, free-range, wild-caught, no hormones, and no antibiotics)
b.  Organic fruits and vegetables
c.  Probiotic sources, preferably from food sources that have not been heat treated (sauerkraut, pickles, kim chi, yogurt), but if not tolerated or additional supplementation needed, a reliable probiotic supplement (although BioKult is recommended in the book, Dr. Campbell-McBride’s website states somewhere it is not necessary)
d.  Homemade broths, ideally made with the bones and consumed daily
e.  Sources of vitamin A and D, like liver and fermented cod liver oil, as well as eggs
f.  Eggs, free range preferred
g.  Nuts, should be soaked and processed as desired (into flour or nutbutter)
h.  Offal (organ meats, such as liver)
i.  Good sources of omega 3s, like the eggs, fish, grass-fed meats mentioned above or also in the form of a good supplement.
j.  Oils with good profiles (olive oil, coconut oil, among some others)/ghee(butter that has had its proteins heated and poured off, leaving only the hopefully pure, protein-free fat behind)/animal fats
k.  Limited amounts of honey
l.  Properly prepared dairy from high-quality source IF DAIRY IS TOLERATED.
m.  Supplements tailored for each individual:  fermented cod liver oil, digestive enzymes, fish oil, betaine HCL, among others.  But unless I’m misreading, she really recommends tailoring it to each person.  The book can guide you.

B.  GAPS Introduction and Full GAPS

1.  Introduction:

a.  Includes several stages, but it initially does what I call “takes it down.”  It takes your diet and reduces it to broth, boiled meats, and boiled vegetables, in essence functioning as an elimination diet.  It also allows your body a good break from its immune response to things you don’t even know your intolerant of, like eggs, nuts, dairy, certain fruits, etc.
b.  It is not meant to be low carbohydrate.  You have free access to all of the boiled carrots and butternut squash you want to eat.  You can even put a tiny bit of honey in some tea to help you push through.
c.  As the stages progress, foods are added ideally one at a time, spaced apart 3-5 days or more, allowing observation of any food intolerances.  Unfortunately, “taking your diet down” is exceptionally difficult for most of us, and introduction is difficult because foods are added too quickly and you don’t know if you’re reacting to eggs, sauerkraut, or broth.  Or if you’re just a nut case and loopy in the head.  I “caved” several times at the point where you add in eggs and nutbutters, and it took a few trials of “taking” my diet down to sort it out.  But I didn’t panic.  I just accepted my failure, ate my nuts and eggs, and when I was ready, I tried again.  And again.
d.   It drives you bonkers trying to figure out if you should go on to the next stage or not.  This seems to be a repeated confusion point among people; it is hugely dependent on each person’s body–no two snowflakes are the same! Although you may want Dr. Campbell-McBride to say, “You must be on stage 1 introduction for 5 days and stage 2 for 5 days…” and so on and so forth, it just doesn’t work that way.  She gives the best guidelines she can based on what she has seen in her patients.  But each person will need to progress through the introduction at their own body’s pace, being careful for honest introspection as to whether one really had a reaction or not and if they were really on that stage long enough to catch a reaction.  And if you can’t tolerate a food, I don’t think it means you shouldn’t go on.  I couldn’t do dairy.  I couldn’t do eggs.  But I do fine with fried meats and vegetables.  I do fine with a small serving of fresh fruit.  AND THIS IS ALL OPINION, by the way!
e.  Introduction can be confusing and a time where you could become nutrient deprived if not cautious. Sure would be nice to have a nutritionist and GAPS provider to guide you!

2.  Full GAPS:
a.  If you can eat everything on full GAPS you are golden.  Most of us can’t and have learned that by completing the introduction diet.  Some people start with full GAPS and then after they get comfortable with that, they go back and do introduction.  I did introduction too quickly and proceeded to full GAPS without catching a few food intolerances.  It was no biggie, just at various times if I identified an issue, I would “take it down” again to broths, meats, and cooked veggies.  Then, I’d add in a food I wanted to know how I was doing with.  For example, last week I challenged nuts.  I stuck to meats and veggies and added in nuts for the week.  It is long-distance race, not a sprint, but thankfully not meant to be a marathon either!
b.  It is meant to provide nutrient-dense food that doesn’t challenge the body’s defenses, that promotes an environment friendly for repopulation of the GI tract with more beneficial strains of bacteria, and that is suited to an each individual person’s immunological response (not everyone can eat nuts or dairy or eggs–GAPS seeks to find that out for you through the use of the introduction diet–because your body will be in high-inflammation gear dealing with these).
c.  It is meant to be followed anywhere from 6 months to a couple of years or so, depending on response.  After that, “real food” can slowly be added back in–never returning to a lifestyle full of sugar, preservatives, colorants, processed foods.  It is not meant to be a lifetime diet.  But the tools you learn and the foods you enjoy are meant to be used for a lifetime.
d.  Initially, I told my kids they were going to try it for 6 weeks, and I was going for 3 months.  After our positive responses, I upped the ante, shooting for a year.  June will be a year.  I have a feeling we will extend beyond that.

II.  Lifestyle/environmental/personal changes suggested on GAPS:

A.  Destressing as much as possible
B.  Minimizing exposure to things like chlorine, mercury, lead, plastics, and more.
C.  Weaning off of caffeine/alcohol/medications not deemed necessary by your physician/supplements

III.  Tweaking it for each person

A.  A necessary component for success on any dietary modification program, including GAPS
B.  Eliminate certain foods, eat more of others, deviate here or there, add in a supplement, drop a supplement.
C.  The diet is just a springboard for helping you to figure out what it’s going to take to get your body as healthy as it can be.  Some people have to pursue other avenues besides nutrition.

This post is waxing long, but here is an aside:

In May, when I decided I had to figure out how to get my GI tract obeying the laws of gravity (like other parts of my body have no problem doing), I stumbled through a crash course in nutritional semantics:  gluten, gliadin, casein, lectins, phytic acid, glutamine, cod liver oil, vitamin A, vitamin D, essential fatty acids, omega-6, omega-3, mercury, arsenic, maltodextrin, food allergies, food intolerances, probiotics, soil based probiotics, kombucha, kim chi, salicylates, histamines, oxalates, candidiasis, SIBO, traditional diet, Paleo, Primal, SCD, GAPS, raw, grain-free, whole foods–

And should I really go on?

What I thought I knew and what I had learned in medical school was miniscule compared to the information out there.

Confusing.  For sure.  You can’t convince me otherwise.  I’m confused, too.

I started by going gluten-free and dairy-free.  Then gluten-free and dairy-free with no replacements (so no weird breads, cookies, crackers, pasta, pizza crusts, etc).  Then gluten-free, dairy-free and up the vegetables beaucoup.  As I kept reading about people with Crohn’s, ulcerative colitis, celiac, and irritable bowel responding to these diets called SCD and GAPS, I decided I’d like to give these books a read.  First I read about the SCD because the book is nice and short, and the ideas didn’t sound so radical.  The language in GAPS is downright ludicrous to newbies on the nutrition pilgrimage–things like connective tissue off the bones, making bone broths, eating liver, and so on.

The SCD (Breaking the Vicious Cycle) rules seemed to make as much sense as any to my medically honed brain, so I proceeded to read Gut and Psychology Syndrome.  To me, they are exceptionally similar regimens.  In fact, GAPS was developed off of the SCD, and food-wise the allowed and exclude lists on the full diets are about the same.  GAPS has an introduction diet in the book, and after the introduction, you pretty much “land” on the SCD.   The introduction diet of GAPS kind of scared me.  But I thought if I was going to check dietary intervention off of my list of things to try for refractory constipation, I had better try the whole deal.  Breaking the Vicious Cycle did not list an SCD introduction diet, but I have since found an introduction diet for SCD online.

I’m glad I didn’t try the diets without reading these two books.  Breaking the Vicious Cycle reads much more easily to me than Gut and Psychology Syndrome, and I’m glad I read it first.  The GAPS book is downright confusing at times.  I still can’t figure out whether I should be doing bone broths or meat broths.  And the dairy recommendations are like, well…if…then…maybe…but…and do not seem consistent.  On Dr. Campbell-McBride’s behalf, my reading demonstrates just how difficult our bodies find dairy to process, and therein lies the inconsistency from person to person and the difficulty in making dietary recommendations for an individual.

In addition to these two books, another invaluable article that helped explain why I was still dealing with certain issues was The Four Dark Horsemen of SCD.  It is a must read.  Consider stopping to read it now.

Although I have chosen GAPS, I could have chosen any number of similar “diets” out there.  What I liked about GAPS was its focus on probiotic foods and broths to supply quite a few nutrients.  I kept reading in places to supplement things like glutamine and selenium, but GAPS relies mostly on foods rather than mandating supplements, although it does place a role in certain supplements.  I prefer to leave the supplements behind when I can.  I also appreciated the introduction diet being set out rather than me having to dig for it online.  I like that GAPS  focuses on suring up the digestive system so it may do its job for the rest of the body.  We’ll see how that goes for me over the course of a year or two.   Using GAPS and SCD based guidelines, we have seen improvement in many nuisance issues that we took prescription medications for in our family.  I don’t “swear by GAPS”, but without it, I would not have had any “rules” to follow, and it’s nice to know the “rules” to play by in the beginning.  I will never go back to eating the way I did before, but I’d really like to eat wheat and dairy again occasionally without headaches, bloating, and severe, severe constipation.  So let the self-experimentation, the n of 1 continue.

And finally, disclaimer:  I am not a GAPS provider.  I am not a practicing physician.  I am a stay-at-home mom.  I am not suggesting that you try the GAPS diet.  I do the GAPS diet and my family by default.  I read a lot to make sure we have no nutritional deficits due to our eating choices.

~~Terri

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