What if I told you that eating a ton of fermented foods could help treat depression? Or an obsessive-compulsive disorder? Or borderline personality disorder? Sounds pretty appealing, right?

The GAPS diet claims to do just that. But as a registered dietitian with a focus on digestive health – one who’s all about using food to help manage symptoms and promote overall wellness – this set off my spidey sense. So, I had to look into it further.

What is the GAPS diet exactly?

The whole idea behind the GAPS diet (which stands for “Gut and Psychology Syndrome,” btw), is that, by eating certain foods, you can improve both your digestive and psychological health.

The woman who invented the eating plan, Dr Natasha Campbell-McBride, believes that a variety of conditions – everything from learning disabilities to depression – are caused by an intestinal issue known as leaky gut (a.k.a. increased intestinal permeability – try saying that five times fast).

According to the eating plan, going through a series of stages that eliminate various foods will improve the health of your intestinal lining and therefore the symptoms for a host of psychological issues – even serious diagnoses like bipolar disorder and OCD.

The introduction phase – which Dr Campbell-McBride says is important to go through before jumping into the full GAPS diet in order to “heal and seal” the gut lining – is a pretty strict elimination diet that includes six stages, according to the GAPS diet website.

During the first stage, you’re supposed to focus pretty much exclusively on homemade soups, probiotic foods, and ginger, mint, or chamomile tea… and not much else. “Do not introduce vegetables until the diarrhoea starts settling down,” Dr Campbell-McBride’s website says. “When the gut wall is severely inflamed, no amount of fibre can be tolerated.”

In stages two through six of the introduction phase, other foods – like raw, organic egg yolks, fermented fish, pancakes, homemade bread, and apple puree – are added, assuming you tolerated the previous foods well.

The amount of time varies greatly for how long you may need to be in the introduction phase. “Your patient may be able to move through the Introduction Diet faster or slower depending on the stool changes,” says Dr Campbell-McBride. “Let the diarrhoea start clearing before moving to the next stage. … After the Introduction Diet is completed and when your patient has more or less normal stools move into the Full GAPS Diet.”

Once you’ve worked your way through those stages and have those “normal stools,” Dr Campbell-McBride says patients are ready for the Full GAPS Diet, which recommends avoiding all sugar and starches—including grains, sugar, and starchy vegetables—and increasing the amount of fermented foods you eat. You’re supposed to follow the full GAPS diet for at least two years—and even after completing the diet, Campbell-McBride says that you should avoid or limit wheat, processed foods, and sugar.

READ MORE: What’s The Deal With Quinoa Causing Leaky Gut Syndrome?

So, what can you eat on the GAPS Diet?

The short answer? A lot of fish, eggs, and fermented foods.

The long answer? It depends on which stage you’re at, but here’s a more detailed list:

• Homemade meat or fish stock (introduction diet — first stage)
• Probiotic foods that are dairy-based or vegetable-based (introduction diet — first stage)
• Ginger tea, mint or chamomile tea (introduction diet — first stage)
• Raw, organic egg yolks (introduction diet — second stage)
• Stews and casseroles made with meats and vegetables (introduction diet — second stage)
• Fermented fish (introduction diet — second stage)
• Homemade ghee (introduction diet — second stage)
• Avocado mashed into soups (introduction diet — third stage)
• Pancakes made with organic nut butter, eggs, and squash (introduction diet — third stage)
• Sauerkraut and fermented vegetables (introduction diet — third stage)
• Roasted and grilled meats (introduction diet — fourth stage)
• Cold-pressed olive oil (introduction diet — fourth stage)
• Freshly pressed vegetable juices (introduction diet — fourth stage)
• Homemade bread made with nut flour, eggs, squash, and a “natural” fat like ghee (introduction diet — fourth stage)
• Cooked apple puree (introduction diet — fifth stage)
• Raw vegetables (introduction diet — fifth stage)
• Freshly pressed fruit and veggie juices (introduction diet — fifth stage)
• Peeled raw apple, followed by other fruits (introduction diet — sixth stage)
• Baked goods made with dried fruits (introduction diet — sixth stage)
• Fresh or frozen meats, fish and shellfish (full GAPS diet)
• Liver and other organ meats (full GAPS diet)
• Fresh veggies and fruit (full GAPS diet)
• Organic, unsalted butter (full GAPS diet)
• Unprocessed nuts and seeds (full GAPS diet)
• Homemade coconut milk (full GAPS diet)
• Garlic (full GAPS diet)
• Unprocessed honey (full GAPS diet)

What does research say about whether the GAPS diet works?

According to Campbell-McBride’s website, “This programme has evolved through the personal experience of Dr Campbell-McBride’s family and clinical experience with thousands of GAPS children and adults around the world.” Clinical experience is certainly important, but unfortunately, the philosophy of “it worked for me, so it should work for you” is not evidence-based. So I took a look at the literature to see if there is evidence to support this diet’s use in preventing or reversing the many conditions it claims to improve.

As it turns out, there are no peer-reviewed studies surrounding the GAPS diet. There is research on fixing a leaky gut; however, this research is pretty preliminary (read: it’s too soon to say anything truly conclusive based off of it), and the GAPS Diet has not specifically been studied as a fix for increased intestinal permeability. Oh, and a leaky gut hasn’t even been identified as a cause for the many conditions that Dr Campbell-McBride says it leads to.

Just to drive this point home: A 2014 review looks at the literature surrounding intestinal permeability. The authors conclude, “the research on modulation of gut permeability is just starting.” While they do mention the potential for certain diets to affect intestinal permeability, there is no mention specifically of the GAPS diet.

I spoke with some other nutritionists I know to see if they agreed that the evidence in favour of following the GAPS diet seemed…lacking.

“Intestinal permeability has not been established as a cause for autism, psychiatric, or behavioural disorders,” says Tamara Duker Freuman, a registered dietitian and author of The Bloated Belly Whisperer. “To say that these conditions are (1) caused by a leaky gut, (2) that specific foods we eat cause a leaky gut, and that (3) this protocol identifies the foods which cause your gut to leak is a series of unfounded, non-evidence based claims layered on top of one another.”

“It seems a bit obscure, highly restrictive and not based in evidence,” says Natalie Rizzo, a registered dietitian and author of The No-Brainer Nutrition Guide For Every Runner.

READ MORE: The 4 Best Supplements For Your Gut Issues – And Those To Totally Avoid

So… should you try it?

IMO, this diet seems extremely restrictive and unsustainable, especially given the fact that the full GAPS diet is supposed to be followed for about two years. Furthermore, it limits so many sources of fibre, which feed gut microbes, as well as many other nutrients – and that seems problematic to me. “I can’t imagine how starving your intestinal microbes could do anything but adversely impact intestinal health,” agrees Freuman.

Rizzo is with Freuman and me on not recommending this diet since it isn’t evidence-based. “If someone wanted to do an elimination diet for G.I. reasons, I would recommend they see a registered dietitian and work with them to develop a healthy plan. To follow a certain diet as a cure for neurological conditions seems unsafe”.

The bottom line: I would caution against a diet as restrictive and long-term as the GAPS diet since it may lead to nutrient deficiencies and even disordered eating behaviours – especially since there’s no hard evidence to support it.

^{This article was originally published on www.womenshealthsa.co.za}

^{Image credit: iStock}

Alyssa Lavy

The information on Health24 is for educational purposes only, and is not intended as medical advice, diagnosis or treatment. If you are experiencing symptoms or need health advice, please consult a healthcare professional. See additional information.

Undercover BBC filming shows staff swearing, mocking and taunting patients with learning disabilities.

Patients can take aspirin without raising their risk of another stroke, a study suggests.

Thousands of cannula sleeves have been made by a knitting group since it was set up by a Chester singer.

If you look up body positivity in the dictionary, you'll see a picture of Tess Holliday's face. OK, not really, but she's the definition of the term in our books. If you don't already know why, just take a look at her latest Instagram. 

"I'm a literal work of art," Holliday wrote alongside a close-up shot of her leg tattoos as she relaxes in the tub. Yes, we have to agree, she really is a masterpiece. 

RELATED: Tess Holliday’s Son Hopped in Her Bathtub While She Was Trying to Get Some Self-Care Time—and Her Reaction Is Priceless

If you're thinking that photo looks familiar, that's because this isn't the first time Holliday has shared a picture of herself in the tub. In a post last year, she wrote that she was trying to score a little me time by taking a bath when her son, Bowie, decided to join in. 

“When you have meetings & filming at your house all day, & decide to take a nice, relaxing bath before the chaos starts… but then your toddler sees you trying to sneak into the bathroom & screams until you let him take a bath with you,” she captioned a shot of the two of them in the tub.

True to form, she completed the caption with a message of self-love: “This photo isn’t ‘flattering’, but I don’t care,” she wrote. “I’m proud of my body, & what it’s capable of & how funny & ridiculous my life/motherhood is.”

RELATED: 7 Times Tess Holliday Was Our Body Positivity Queen

Cystic fibrosis (CF) is a complex, life-threatening disease that affects many organs in the body, including the lungs, kidneys, and gastrointestinal tract. It’s caused by a genetic mutation that causes a certain protein to stop working. When this happens, chloride—a mineral that’s vital to cellular hydration—can’t move to the surface of cells, prompting mucus to become thick and sticky in a variety of organs.

“The predominant way CF affects the body is in the gastrointestinal and respiratory system, but it causes a wide variety of complications that affects every system in the body,” Zubin Mukadam, MD, assistant professor of pulmonary and critical care at Wayne State University and Detroit Medical Center, tells Health.

In the lungs of a CF patient, mucus becomes clogged in the airways and bacteria and other germs can get trapped. In the pancreas, mucus buildup prevents the release of digestive enzymes that help the body absorb food and nutrients, resulting in malnutrition. In the liver, thick mucus can block the bile duct, causing liver disease. And in men, CF can affect the ability to have children, according to the Cystic Fibrosis Foundation.

RELATED: Signs and Symptoms of Pneumonia

“When a channel to certain organs, specifically the lungs, become dehydrated, this can lead to chronic inflammation and chronic infection,” Don Hayes, Jr., MD, medical director of lung and heart-lung transplant programs for Nationwide Children’s Hospital and The Ohio State University Wexner Medical Center, tells Health. “This is why CF is a progressive disease that causes persistent lung infections and limits the ability to breathe over time.”

Cystic fibrosis and the family tree

More than 30,000 people are living with CF in the United States, according to the Cystic Fibrosis Foundation, and more than 75% are diagnosed by age 2.

“We do a lot of newborn screening,” says Dr. Mukadam. “However, a lot of kids get missed because there are over 1,700 genetic mutations that could prompt CF, and most genetic tests only screen for the most common mutations.”

In order to have CF, a person needs to have inherited two copies of the defective gene—one copy from each parent—and both parents must have at least one copy of the defective gene.

RELATED: 13 Worst Jobs for Your Lungs

If people only have one copy of the defective CF gene, they are a carrier and can pass the disease onto their children, but they won’t develop it themselves. About 1 in 30 people in the United States are carriers, according to the American Lung Association.

“I’ve had a couple of patients who want to have children,” Dr. Mukadam says. “If someone has known CF, we will screen their partner. If that person doesn’t have the CF gene, the baby won’t have CF. However, there’s a one in two chance that the child will be a carrier of the disease.”

Cystic fibrosis symptoms

CF can cause a wide range of symptoms, including breathing difficulties like wheezing and shortness of breath. According to the Cystic Fibrosis Foundation, people with CF can also have salty-tasting skin, as a result of sodium and chloride imbalances in the body.

Other symptoms of CF include chronic coughing and chest colds (which can include phlegm), frequent lung infections (including pneumonia or bronchitis), and digestive issues—like greasy and bulky stools, constipation, or other types of difficulty with bowel movements.

Children with CF may not meet growth or weight-gain milestones, despite having a good appetite. And most adult males with CF (about 98%) are infertile, meaning they’re not able to produce children without assisted reproductive technology.  

How doctors treat CF right now

There is no cure for cystic fibrosis, but daily treatments can help patients manage symptoms and delay long-term damage. However, these treatments are extremely time-consuming: They often include taking 25 to 35 pills a day, as well as inhaled medications that relax and clear the airways.  

“Patients might be on inhaled antibiotics that can take 45 minutes to one hour of treatments twice a day,” says Dr. Mukadam. “Generally we recommend these airway clearance treatments to get secretions up and out of the lungs.”

RELATED: What Causes Shortness of Breath?

Treatment for CF can also include enzyme and vitamin supplements, anti-inflammatory drugs, and the use of mechanical devices to help clear airways—all of which can take a toll on patients. “I don’t know any other disease that has this big of a treatment burden,” says Dr. Hayes.

What the future looks like for CF patients

While CF is a daily challenge, Dr. Mukadam says that treatment advances in recent years have made for an “exciting story”—especially when comparing survival rates in the 1970s and 1980s with today.

“Back then, the median survival was 16 to 18 [years of age],” he says. “Today for those patients with CF who were born in 2017, half will survive to the age of 48.”

One major reason for the better survival statistics is new, gene-based medications that work to correct the protein that’s deficient in CF patients.

“There are two triple combination medications that should be available by the end of 2019 that help the mutation gene function better,” Dr. Mukadam says. “We already have a couple of medications out, and we’re seeing patients experience improved gastrointestinal and respiratory function—and these new medications show even better promise.”

RELATED: How to Keep Your Lungs Healthy, According to Doctors

In addition, researchers are working on different antibiotics to work in the lungs. “These medications that help cough the mucus out will make a difference,” Dr. Mukadam says.

And while most CF drugs are currently approved for children 2 and older, he points out, newer drugs are approved for patients as young as 6 months. “Our goal is to try to get these medications to kids at a younger age,” Dr. Mukadam says, “so the lungs don’t get as injured and won’t devolve as quickly.”

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

Sepsis survivor Tom Ray wants better awareness and faster diagnosis of the potentially deadly disease.

Native Americans’ use of fire to manage vegetation in what is now the Eastern United States was more profound than previously believed, according to a Penn State researcher who determined that forest composition change in the region was caused more by land use than climate change.

Many ways to approach the Riemann Hypothesis have been proposed during the past 150 years, but none of them have led to conquering the most famous open problem in mathematics. A new paper in the Proceedings of the National Academy of Sciences (PNAS) suggests that one of these old approaches is more practical than previously realized.