Explaining the GAPS

Thomas Cowan, MD, is a physician in private practice in San Francisco, California, a board member of the Weston A. Price Foundation, and one of a few physicians in the US who are willing to support GAPS patients.  Visit Dr. Cowan's website at http://www.fourfoldhealing.com.  The following is an excerpt explaining the GAPS diet from his Fourfould Healing Newsletter, December 2008.

“The theory of this diet is that we have millions of intestinal villi, which are tiny finger-like hairs projecting into the intestine. These villi increase dramatically the surface area of the intestinal lining, making it a more effective semi-permeable barrier, which means it keeps unwanted things out of our bloodstream while absorbing the nutrients. These villi are covered with a layer of healthy intestinal flora, in some estimates about five to seven pounds of millions of varied bacteria, viruses, yeast and other microbes.

These healthy bacteria are vital for healthy life. They make vitamins, they digest food, they make antibiotic substances to keep down pathogens and they function as our immune system. I tell my patients that this system is analogous to a lush meadow with a thick layer of soil (the villi) covered by a lush layer of grass (the healthy bacteria). When both are intact, the meadow is healthy, but if you went to the meadow and stripped off the grass (this would be the equivalent of using an antibiotic in a person, or even not eating probiotic food), a whole cascade of catastrophic events will follow. First, you will get erosion of the soil, then the soil that's left will be weak and unsupportive of healthy grasses. Weaker varieties of grass will grow or even no grass at all. Next, as the soil develops erosion cracks, poisons, runoff, etc., will start to seep into the ground water. At this point the land is dying.

This is exactly what happens inside us. First we strip our grass, then the soil erodes - the villi get weak and blunted, and then can't support healthy micro-orgnisms. The cracks develop, and finally poisons seep into our groundwater, the blood. We now have foreign proteins in our blood, which either directly poison our nervous system (i.e. autism) or create antibody formation in reaction to these abnormal proteins, which is the whole process of auto-immune illness. Diseases which are the direct result of this process include not only intestinal diseases such as IBS (Irritable Bowel Syndrome), ulcerative colitis and Crohn's disease, but all the auto- immune problems such as eczema, asthma, rheumatoid arthritis, and on and on. It is not a stretch to confirm what natural medicine has claimed for literally thousands of years: The majority of human illness starts in the gut and must be healed by treating the gut.

There is one more part of the GAPS diet theory which is crucial to understanding how this illness comes about and why it is so debilitating. These intestinal villi are the sole site in the body where production of an enzyme called disaccharidase occurs. Just as lipases digest lipids (fats) and proteases digest proteins, these disaccharidases digest disaccharides. When the villi become blunted, they lose the ability to make this important enzyme, and we lose the ability to digest disaccharides. When we keep eating foods with disaccharides and can't digest them, they become perfect food for the pathogens that always reside in our gut, particularly species of candida. We then produce an overgrowth of candida, other yeasts, clostridia and other potent pathogens - and these often make unhealthy proteins instead of the B vitamins made by our healthy gut flora.

At this point we are deeply immersed in an unhealthy vicious cycle: poor gut flora, eroding villi, cracks in our intestinal walls, poor enzyme products, eating food we can't digest, worse flora, more erosion, worse nutrition, more leaking, worse and worse immune function, more and more toxicity, finally the diagnosis of auto-immunity or a neurological problem. This is GAPS. Luckily it is totally reversible, and many of these patients can be restored to full health.

The therapeutic strategy is fairly simple: Restore the gut flora, heal the villi, seal the cracks. We heal the villi with the Nourishing Traditions diet with a particular emphasis on soup broth, the magic gut restoring food. We replant the villi grass with probiotic foods and Biokult (a probiotic developed by Natasha Campbell-McBride for the GAPS program), and until we are healed we completely avoid all foods which contain disaccharides: grains, most beans, potatoes, sweet potatoes, most sweeteners, milk (but not other cultured dairy products), and a few other foods. I use this program extensively in my practice now as a transition to the full Nourishing Traditions diet for those who suffer from the above mentioned illness.”