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By: by Amino Science
Proponents of the GAPS diet—a strict, multi-phase elimination diet that involves cutting out grains, pasteurized dairy, starchy vegetables, refined carbohydrates, and more—claim it can successfully treat neurological and psychological conditions, including autism.
But increasing numbers of scientists, doctors, and nutrition professionals are raising concerns about the highly restrictive nature of the diet and the lack of data supporting its supposed benefits.
To help you make sense of the controversy, we explain the origins of the GAPS diet and how to implement the various phases. Then, we dig into the claims about GAPS diet health benefits.
GAPS, which stands for Gut and Psychology Syndrome, is a term created by Dr. Natasha Campbell-McBride.
Campbell-McBride believes the modern world can damage our gut health in a multitude of ways, and that gut bacteria imbalances are the underlying cause of many health problems, all of which can be treated using the GAPS diet she invented.
According to Dr. Campbell-McBride, imbalances in gut bacteria populations can prevent children from properly digesting and absorbing food, which in turn causes them to develop a variety of symptoms—some related to digestion, and some not. Many of those symptoms, Campbell-McBride says, are caused because harmful gut bacteria transform the undigested food into toxic substances that clog the body and brain. When these toxins flood the brain, they can interfere with sensory processing and keep children from learning and developing skills. This can result in condition such as hyperactivity, dyslexia, and autism.
The purpose of the GAPS diet, Campbell-McBride writes, is “to detoxify the person, to lift the toxic fog off the brain to allow it to develop and function properly. In order to achieve that we need to clean up and heal the digestive tract, so it stops being the major source of toxicity in the body and becomes the source of nourishment, as it is supposed to be. As more than 90% of everything toxic floating in our blood (and getting into the brain) comes from the gut, healing it will drop the level of toxicity in the body dramatically.”
As she concocted the GAPS diet, Campbell-Mcbride drew heavily from the work of Dr. Sidney Valentine Haas. In the early 1900s, Dr. Haas developed a food-based treatment plan for patients with celiac disease that came to be known as the Specific Carbohydrate Diet (SCD). The enduring popularity of the diet is due largely to the efforts of Elaine Gottschall, who claims that when Dr. Hass used the SCD approach to treat her daughter’s severe ulcerative colitis, it brought about miraculous changes. Haas was 92 at the time, and after he passed away, Gottschall decided to devote her life to introducing SCD—which she believed cured her daughter—to others. Based on the testimonials of others who tried SCD, Gottschall promoted it as a treatment for colitis, cystic fibrosis, and autism.
Campbell-McBride learned about SCD when her first child was diagnosed with autism. Frustrated by the lack of effective conventional treatments, she decided to take matters into her own hands. And thus the GAPS diet was born. In her 2004 book, Gut and Psychology Syndrome, she states that the GAPS diet—which is essentially a more restrictive version of SCD—cured her son’s autism.
Though individuals of all ages can and do adopt the GAPS diet, it was designed for children and is still most often sought out by parents whose children have difficult-to-treat conditions.
Following the GAPS diet is a year-long process that requires cutting out all foods that Campbell-McBride believes contribute to gut imbalances. The diet is divided into three phases: the introduction phase, which is intended to detoxify the body; the maintenance phase, during which the gut has time to repair and heal; and the reintroduction phase, for transitioning off the diet.
The GAPS diet prohibits sugars and starches, meaning no bread, pasta, rice, potatoes, or traditional desserts. We’ll get into the specifics of what you can eat later on, but for now, it’s enough to know that the diet centers on broths, meats, fats, nuts, and some vegetables and fruits.
The GAPS diet intro phase is by far the most intense. The foods you can eat during this phase, which is broken down into six stages, are exceptionally limited. Depending on how your body responds, this phase can last from three weeks to a full year.
Comments from the FAQ section on her website indicate that the introduction phase can be quite brutal. Common side effects include severe stomach pain and bloating, vomiting, diarrhea, and constipation. Campbell-McBride warns that you can also expect “die-off phases”—as harmful bacteria die, she states, they release toxins, causing symptoms to temporarily intensify.
During the introduction phase, you pare your diet back to a few simple liquids. As you move through the stages, you introduce small amounts of a single new food at a time. If you experience a negative reaction, then you should continue to restrict that food for a few more weeks. The standard for determining whether you’re tolerating the foods is whether you’re having normal digestion and bowel movements. You can also test for sensitivities, according to Campbell-McBride, by placing a small amount of a food on your wrist and waiting to see if it causes a reaction. Most medical professionals consider this test useless.
This phase typically lasts between one and a half and two years. While less restrictive than the GAPS diet intro phase, the diet still requires you to restrict yourself to the following foods:
All other foods should be avoided, especially refined carbohydrates and any preservatives or artificial colorings.
There are also recommendations about what you should eat when. For instance, meals should be made up of meat plus vegetables, and should always include bone broth and healthy fats. You should also consume as much fermented food as you can tolerate. Stay away from packaged and canned foods though, and never eat meat and fruit together.
If you adhere to the full GAPS protocol, you’ll spend a minimum of a year and a half on the diet. After you’ve experienced normal digestion and bowel movements for at least six months, you can begin gradually reintroducing small amounts of prohibited foods. The reintroduction phase can last quite some time. It’s recommended that you introduce each food individually by eating a very small amount, and then, if you experience no digestive issues over the next two to three days, gradually increasing portion sizes for that food. Then you repeat that process all over again to introduce the next food.
The GAPS diet does not prescribe a specific order for reintroducing foods, but does recommend beginning with new potatoes and then trying fermented, gluten-free grains.
Once you’ve transitioned off the diet—which some never do, finding they feel so good on it, they have no desire to try out banned foods—it’s strongly advised that you continue to eat a whole-foods based diet.
And now, as promised, we’ll cover some of the foods you’re most likely to encounter in GAPS diet recipes. While this isn’t a complete list of all the foods you can eat on the GAPS diet, it does offer a clear picture of what following the diet entails. As you’ll see, grains and starchy vegetables are all out, while meat and healthy fats are liberalized.
And now, we arrive at the heart of the controversy. Are there GAPS diet health benefits associated with following the highly restrictive protocol? According to Campbell-Mcbride, its creator, using the GAPS diet to heal the gut can treat and even cure conditions such as:
However, there are no published studies to support any of these benefits. While experts agree that there is evidence indicating dietary changes can help children and other individuals dealing with some of the issues Campbell-McBride claims the GAPS diet can treat, the link between diet, gut bacteria, and health outcomes is far more complex than Campbell-McBride claims.
According to Zoe Connor, a leading pediatric dietician who specializes in working with children with autism, some aspects of the GAPS diet could benefit children with undiagnosed food intolerances. She spoke with Anthony Warner, who gained fame “Exposing lies, pretensions and stupidity in the world of food” as The Angry Chef, about the GAPS diet. Connor believes it’s also possible that adopting a low-carbohydrate diet could be a helpful complementary treatment for children with subclinical epilepsy. Changing your diet, and adding probiotics in particular, may even help decrease certain behaviors associated with autism. “Just the action of pushing a child with autism to make significant changes in eating may have a knock on effect in making their behaviour less rigid in other areas or indeed empower parents to feel able to tackle other problems areas,” said Connor. She believes dietary changes should be taken seriously, and seriously studied.
But that’s not to say she’s a fan of the GAPS diet. Far from it. “‘If a child followed GAPS to the letter they could be seriously harmed or even die,” she said. We’ll get into the risks of the diet in the next section. Instead, she hopes researchers will examine why some people feel the diet does work to understand what, exactly, is happening." If it is because they have undiagnosed conditions,” she said, “then we can treat that condition using diet or medications and the child can then have a much more varied, adequate, less expensive and less inconvenient diet with the same improvements.”
One of the factors driving the intense outcry surrounding the GAPS diet is that it’s directed toward children. According to Campbell-McBride, the younger a child is when the protocol is adopted, the better the chances of its success. Parents who are desperately looking for a solution to their child’s health issues place them on this extremely limited diet, which has no scientific evidence to support it.
Campbell-McBride states that symptoms such as vomiting, severe stomach pain, distended stomachs, and extreme diarrhea or constipation, as well as increases in the symptoms you’re trying to eliminate with the GAPS diet, are totally normal. Given time, the diet will work and your gut will begin to heal. In the FAQ section of her website, she suggests that parents ignore doctors who tell them their children should be eating more varied diets.
Dieticians have raised concerns that the introductory phase—which can last up to a year, remember—could put people at risk of calcium, iron, potassium, niacin, magnesium, and zinc deficiencies. And the maintenance phase could cause you to overdose on vitamin A, a real possibility if you keep it up for the recommended length of time. Some critics of the GAPS diet also worry that the large amounts of bone broth you consume could increase your lead intake to toxic levels.
Since there’s no hard data on the diet, however, the risks are about as unprovable as the benefits. If embarking on the GAPS diet, it can helpful to supplement with certain nutrients such as essential amino acids to safeguard your health.
On her site, Campbell-Mcbride also makes a number of claims that are bizarre, concerning, and flat-out false. Here’s some of the most striking examples, compiled in part from an excellent article written by Dr. Harriet Hall (aka The SkepDoc), a retired family physician who writes about pseudoscience and questionable medical practices, and in part from The Angry Chef’s article about the GAPS diet mentioned earlier. 
Without testing, it’s impossible to say definitively whether the GAPS diet helps or harms the people who try it. But the concerns raised by various experts make a compelling choice for exploring alternate approaches and waiting to see what the data, if it’s ever collected, reveals.
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