Part Three - GAPS and a Brief Synopsis of the Diet

November 13, 2010

Natasha Campbell-McBride MD: Gut and Psychology Syndrome (Lecture 11/12/10, Friday 10-5)

GAPS was born from the SCD. Since perhaps my patients were different, I adapted the diet so that we introduce beneficial bacteria using a commercial probiotic supplement, and then lots of fermented foods. It involves detoxification measures as well. GAPS is a lifestyle change.

The basics:

Avoid: all grains, starchy vegetables, sugar, other commercial sweeteners, milk sugar (lactose), starchy beans including soy, all processed foods, all “food additives.”

Stick to this diet for at least two years. Build up new, healthy enterocytes, We're not eliminated just lectins, or casein, or gluten… We're removing starch, which is the perfect food for pathogens in the gut. Starch is the number one thing that has to go. Sugar is a white poison. Native peoples used to chew foods from which we now extract sugar, and never consumed them in the huge quantities we do today. When you eat sugar cane or sugar beet as whole foods, there are so many other enzymes and substances that we metabolize. For example: sugar is a hungry substance. For every gram that our body digests, we need 66 mg of magnesium to process it. High blood pressure is highly correlated with magnesium deficiencies. Calcium is involved in contraction of blood vessels, and hardly anyone in this culture is deficient in it, but with a deficiency of magnesium, blood vessels have no way to relax.

Sugar, refined sugar, has to be out of the diet for life.

Most people can't digest lactose on their own, but many people have bifido bacteria and other beneficial strains in their guts that can digest lactose for them. Usually, GAPS folks don't have these strains.

All beans contain some starch. They are allowed later, when the gut flora and lining gets better, but only soaked and fermented.

Why “no processed foods”? If you eat commercially processed foods, you cannot guarantee that they don't contain detrimental ingredients. GAPS means cooking fresh food on a daily basis.

The GAPS Recommended foods, and some details about them:
Foods that are Nutrient Dense. We don't want to put a huge burden on the digestive system, so we start with non-challenging foods, ones that contain a lot of nourishment. Vegetarians don't want to hear this, but all animal foods are best for this...

Animals “designed” to eat plant foods have long digestive systems, involving LOTS of bacterial digestion that converts the carbs to fatty acids so the animal can better digest all the plant matter. Animals who evolved to digest other animals have only one stomach, that contains no bacteria, and which has lots of acid and pepsin, to break down animal protein (not plants)--like ours. Plants are difficult to digest, and that's why every culture in the world has figured out ways of preparation them that makes them more nutritious and digestible.

Meats are the GAPS mainstay: first, we do well boiled meats, all kinds, including fish. Organs are very nutritious, particularly raw. We eat the skin, the rear end, the legs, the wings, every drop of fats. It's not so much the premium cuts, or the steaks, or the chicken breast that we need.

We eat good quality eggs, non-starchy vegetables, and eventually fermented dairy, cold extracted honey, RIPE fruit, and soaked/fermented nuts and seeds.

If honey in a hive reaches 45-47 degrees centigrade, the bees mobilize all their resources to cool it down. In fact, if the temperature goes higher than this, bees will not eat their honey. Enzymes and other micronutrients are destroyed at this point, and it is no longer much more than simply a concentrated source of sugar. I use honey as a sweetener in my book, but it is best to use only dried fruit when baking. Honey is better consumed raw, as a whole food.

We make meat and fish stock using parts from the whole animal, including the meat AND the bones. These broths contain single amino acids and other substances from which enterocytes can be fed, and that supports the healing of the gut lining. Bone marrow is another of the most nutritious substances on earth. It's particularly good for children. Joints and cartilage need long cooking, and should be eaten and are particularly good for GAPS. These contain building blocks for the gut lining, and also for our own collagen stores.

Fermented foods are incredibly important. They are easy for the digestive system to deal with, and are also teaming with probiotic bacteria. These create die off, by attacking candida, listeria, etc., and the toxins cause symptoms to be worse at the beginning. Fermented dairy, if there is no allergy, are some of the easiest foods to digest. Dairy must be fermented at home, in order to ensure that all lactose is gone.

Veggies should be fermented for long enough to complete the fermentation process. At 2-3 days, there is usually still active fermentation happening (if lots of gas is being produced in your saurkraut jar, and it fizzes when you open it, not only will it produce gas in you, but it's also not finished fermenting). You need to ferment until lactic acid is produced in enough quantity to slow the microbial action.

Ferment all nuts when first introducing them. This will breakdown leptins, and oxalates, among other substances--many people react to these, although many don't, and in any case, fermenting will break these down.

GAPS is divided into three stages: intro, full, and eventually the introduction of fermented grains and fermented beans and potatoes.

The Intro part is further divided into stages. At the beginning it's low fiber, so it's gentle and healing. Fiber has been misguidedly promoted as a health panacea. But fiber is indigestible for the human digestive system. If the gut is already sore, it causes more irritation. At the beginning, we don't eat fruit, or raw vegetables. GAPS patients can spend a long or short time at each sub-stage of the Intro diet, but the third stage is most crucial: once you're eating meat stocks, stews, meats, ferments, eggs, and well-cooked veggies, you don't technically have to go on in order to be healthy. This stage is the most gentle on the digestive system. You can eat this way indefinitely, rebuilding enterocytes, rebuilding the gut lining, before continuing on into full GAPS.

GAPS patients consume the GAPS diet for a couple of years. Some people feel perfectly fine after six months. But there's no date when anyone can tell you for sure that you'll be able to tolerate more foods. You have to figure this out by listening to your body. There's a little voice inside our minds that's called Intuition, and it knows better than I do, better than any doctor, how you're feeling. Listen to your body, and you'll know when to move on.

Some people can eat yogurt and kefir right from the beginning. In any case, it is very important to have organic dairy. Non-organic cows are one of the most abused animals on this planet, and what non-organic cows are fed is a scandal.

For those who can't tolerate dairy, or who start full GAPS without the intro, this is the protocol for introducing dairy:

1. First, try unsalted ghee. The gut lining needs tons and tons of fat. Increase gradually. When trying to determine whether your body can tolerate a given food, look for a definite, _unmistakeable_ reaction. It might be the time of day, and even in the absence of other confusing factors, we humans can imagine all sorts of “reactions” that we attribute to food.

2. Next, add unsalted butter made with cultured cream.

3. Try homemade yogurt, and homemade kefir, and fermented (soured) milk. Kefir produces a far more pronounced die off reaction because it contains beneficial yeasts as well as bacteria. Fermented milk is wonderful for people with diarrhea. In people with constipation, it may be aggravated (not with everyone, but if you've got chronic constipation, remove kefir and yogurt and instead use fermented cream, which has more fat).

4. Introduce home made “cottage cheese” next: drain home made yogurt or kefir in cheesecloth overnight, or up to a few weeks if you want a harder cheese.

5. After this, try commercial, well-fermented, mature, hard cheeses that are aged to remove all lactose.

6. After six months or a year on fermented dairy, try to introduce raw double cream and clotted cream, and/or unfermented raw milk – there will gradually have grown a population of good bacteria that can digest the lactose.

GAPS can provide a low fiber diet for chronic diarrhea: no raw foods, no fruit, no nuts or seeds. Home made meat stock. Meat and fish well cooked in water. Soups and stews with vegetables and meats. Well cooked vegetables. Eggs with raw egg yolks (raw require almost no digestion; cooked are much harder to digest). Homemade sour cream, kefir, yogurt, and cheese, fermented vegetables (initially just the juice).

Natural fats are extremely important. About 40% of every meal [by calories? Volume??] should be fat. Fats are the substance of life, the major building blocks of every cell in the body. To a large degree, we are made out of fats. They're essential for building bones and teeth and brain and muscle. We don't get fat by eating fat: just the opposite. Fat intake produces glucogon [?], which mobilizes the body to burn our own stores of fat for energy.

Butter and ghee, coconut oil and palm oil, cold virgin olive oil--these are all wonderfully healthy. NO margarines or “butter replacements,” vegetable oils, and cooking oils. The fat needs for babies and children is roughly 40 % monounsaturated, 40% saturated, and only about 17% polyunsaturated. Our physiology doesn't really change very much as we grow. This means that the bulk of our fat consumption needs to be monounsaturated and saturated fats, coming from sources like beef, pork, lamb, chicken, duck, etc. (Too many polyunsaturated omega-6 fatty acids are in EVERYTHING processed. Commercially, these poly fats comprise most of what we get, along with their counterparts: trans fatty acids.)

It's not what we were taught, but fish cooked in lard was far more healthy, before restaurants started using vegetable oil that gets boiled and boiled and boiled for months before getting thrown away. The only oil that should be consumed in any quantity is traditionally-cold-pressed olive oil--but use it as a dressing; don't cook with it because much of its benefit comes from its micronutrients, enzymes, phytonutrients--when you cook with it, these are destroyed. Cook with animal fats, which are much more stable with heat, even when heated and cooled repeatedly several times.

...When you roast a duck, it will be sitting in a pool of fat. It will keep in the fridge for a year. It's delicious. The same with all meats! Collect all the fats. Eat the delicious jelly that accumulates on the bottom. This is what our great-grandmothers did...