Review of "GAPS: Gut and Psychology Syndrome", by Dr Natasha Campbell-McBride

Having heard a great deal about this book and, more specifically, the GAPS Diet itself over the years, I was very keen to finally get into it properly, rather than just in passing, as I had previously done. I distinctly remember glancing at the allowed and forbidden foods lists a good few years ago, and when I saw that potatoes and rice (my two totally 'safe' foods at the time) where no-no's, I thought "oh forget it", and put the book back on the shelf.

So, it may come as no shock that this is probably the most daunting book I have ever read! It's important to note that it is not directly aimed at people with digestive problems, but rather it proposes a regime for children and adults suffering from mental health issues such as autism, learning disabilities, schizophrenia, ADHD etc. Due to the fact that an overwhelming majority of children/people suffering with these conditions have been found to have damage to their intestinal lining and/or a severely impaired digestive system, Dr Campbell-McBride, herself a parent of a child with such problems, made the link between physical and mental health, and in particular, the condition of the digestive system and its link to the brain. This led to the evolution of the GAPS diet. So, the repair of the digestive system that it intends is actually a means to an end: a healthier brain. However, due to its success, it has attracted attention from people solely with digestive problems, many of whom have been helped by following the proposed regime. 

This book is crammed full of information. Just reading it was a true educational experience.

Please note: I approached this book purely as someone with IBD, interested in the gut-healing claims and theory of the proposed diet, as well as the general information on body chemistry and digestion provided, so that is all I will be commenting on. I only skimmed the information on the serious psychological conditions this book was originally meant to help, purely out of interest, and so I cannot and will not comment on the claims made in that regard.

This book is crammed full of information. Just reading it was a true educational experience. Dr Campbell-McBride really gets into the details of the digestive system and process, from the life cycle of the enterocytes lining the gut wall to how proteins and carbohydrates are digested by both healthy and unhealthy digestive systems. She pays exceptional attention to the issues of toxicity, low stomach acidity and imbalanced gut flora, citing these as key reasons for improper digestion, damage to the intestinal membrane and resulting gut permeability and the associated allergies, intolerances and autoimmune responses. Indeed, the importance she places on supplementation with the correct probiotics cannot be overestimated. The explanations behind her reasoning are extremely detailed, clear and compelling.

As far as the GAPS Diet itself is concerned, it is largely based on the older Specific Carbohydrate Diet (SCD), with some extra tweaks. The reasoning behind what to avoid in terms of food is based on how foods are absorbed in our digestive tract, and how the molecular structure of foods makes them either easy or difficult to break down and digest. In brief, the GAPS diet eliminates all grains, starchy vegetables, sugar, starchy beans and peas, and lactose. There are then further limitations depending on the severity of a person's symptoms. In general, however, foods that are recommended include meat and several animal by-products (animal fats in particular), non-starchy vegetables, fruit and fruit juices, nuts and seeds and, very importantly, fermented foods (such as sauerkraut and kefir).

The diet is presented in various stages, starting with the Introduction Phase (particularly important for severe digestive conditions), the main Diet itself, and a phase for re-introduction of other foods. There is no specific timeline for each stage or for moving between stages, as it is stressed that this is a highly individual matter, and will depend on each person's system and the extent of the original damage to the gut lining. However, it is recommended that someone follows the GAPS Diet (not including the Introduction Phase) for 1.5 - 2 years.

Overall, a fair few of the nutritional recommendations, such as the heavy reliance on meat and the abundant use of saturated animal fat, may seem somewhat controversial.

The diet is very restrictive, this goes without saying. So I freely admit that when I saw the length of time for which this restriction should ideally continue, I balked! Then, as if that wasn't daunting enough, when it comes to the food itself, there are absolutely no shortcuts. Basically you can seemingly never just buy anything and eat it ever again. You must instead make absolutely everything from scratch. For instance, fermented dairy products such as yoghurt or kefir, are much easier for the human gut to handle, and even come with a host of beneficial healing properties. However, commercially available fermented dairy products are not fermented long enough to make the milk suitable for GAPS people, and they are also often pasteurised, which kills off the good bacteria and enzymes etc that make it beneficial. As a result, only home-fermented dairy products are recommended for the GAPS diet. The same applies for things such as ghee, sauerkraut, meat stocks and broths.

While I can fully appreciate the reasoning behind this, it just adds to the daunting feeling, as it is made abundantly clear how much time and effort is required in order to commit to this diet. Yes, improving your health is absolutely something you should spend a lot of time and effort on, no argument. However, my worry with very strict and restrictive long-term regimes is what happens when there is inevitably a day where said time and effort cannot be spent, when life gets in the way? Personally, when I have been restrictive with my diet and have fallen off the wagon, the fall has been hard, and getting back on the wagon even harder. Hence my concern and trepidation.

My one complaint with the book itself is that is can really get repetitive at times. A lot of the same information is repeated in multiple chapters. Now, this is not a problem for someone who might go directly to a specific chapter, in fact it would be extremely helpful. However, it does get a little tiring if you are reading the book from cover to cover, as I did.

Even if you come to the conclusion that the GAPS Diet is not for you, you will still get a great deal out of this book.

Overall, a fair few of the nutritional recommendations, such as the heavy reliance on meat and the abundant use of saturated animal fat, may seem somewhat controversial. This is largely due to our exposure to certain nutritional information over the years, and in particular the increase in popularity of the plant-based diet and its health benefits. However, as you read, there is certainly a solid foundation to the GAPS Diet theory, and no shortage of people who have been greatly helped by it. I am, therefore, inclined to conclude that, as ever, it comes down to the individual. One man's medicine is another man's poison, right? 

I would highly recommend this book, both for the plethora of useful information it contains, as well as for the diet itself. Even if you come to the conclusion that the GAPS Diet is not for you, you will still get a great deal out of this book. I myself may not be ready to go full-on GAPS right now, but I have decided to incorporate certain elements and go from there.