George Yeo 網路自強號

GAPS 腸道與心理綜合症, autism 自閉症, ADHD 注意力缺失過動症, ADD 注意力缺失症, learning disabilities 學習障礙, dyslexia 誦讀困難, dyspraxia 運動障礙, neurological disorders 神經系統疾病, psychiatric disorders 精神疾病, depression and schizophrenia 抑鬱症和精神分裂症, immune disorders 免疫系統疾病, and digestive problems 消化系統問題。


Fussy eaters and failure to thrive

( http://www.gaps.me/preview/?page_id=29 )

To understand this issue well and to learn how to introduce foods into the menu of the fussy eaters, please read the chapter “It’s feeding time. Oh, no!” in the GAPS book. This chapter will provide you with an effective practical structured approach for getting your fussy child to eat pretty much everything you cook.

Most GAPS patients are fussy with food limiting their diet to starchy and sweet foods, particularly children. They get trapped in a vicious cycle of cravings and dependency on the very foods that harm them and refuse all other foods. This problem is particularly pronounced in autism.

The fussy eating habits of GAPS adult and children often lead the carers and parents to a typical mistake in introducing SCD: many of them fall in the trap of swapping the usual sweet and stodgy foods, which their child would agree to eat, to the SCD compatible sweet foods. They discover the delights of SCD desserts: cakes, cookies, breads, etc. As a result the child lives on ground almonds and honey, which does not bring desired benefits and is not a healthy way of eating. Following the Introduction Diet before moving to the Full GAPS Diet will help you to establish an appropriate eating routine for your child without making common mistakes.

Failure to thrive is a common phenomenon in GAPS families. An infant with abnormal gut flora can thrive on breast milk. However, when solids are introduced the child instinctively learns that food (apart from breast milk) makes him/her ill. As the unhealthy digestive system cannot handle solids well and absorbs them partially digested, the child may experience many unpleasant symptoms: a tummy ache, muscle ache, itchy skin, headache, drop in energy, etc. So, quite rightly the infant refuses solids. It is very rare for a child older than six months to get enough nourishment just from breast milk, so without solids the child does not gain weight appropriately or starts loosing weight. The diagnoses failure to thrive usually follows.

The typical weaning foods (based on grains) are completely inappropriate for these children and must not be given to them. Please, look at the page New Baby and follow the structured diet for introducing foods described on that page. Start from warm homemade meat stock mixed with homemade yoghurt. Make sure to give breast only as a reward/top up after your infant had some meat stock with homemade yoghurt from a bottle or a beaker. Your child has to learn that he has to eat something before breast is given. Start from a small achievable target, such as 1-2 teaspoons of the meat stock with yoghurt before the breast is given; gradually increase the amount of the meat stock with yoghurt. Feed every hour and choose times when you and your child are calm and happy. Obviously, if your child is distressed for whatever reason, you have to give breast as a comfort without placing any demands – this is not a good time to try and introduce new foods. As your baby starts consuming good amounts of meat stock with yoghurt, gradually introduce all other foods described on the page New Baby. Keep using your breast milk as a reward for another year or so. It is not common in our culture to breast feed longer than one year. However, these children benefit greatly from breastfeeding for longer: till the age of 18 – 24 months at least.

An article from the ‘GAPS Companion’ a handbook for beginners. By Linda Paterson GAPS Nutrition Consultant from www.gapsaustralia.com.au

Question: My child is a fussy eater and self limits his diet. How am I able to get him to eat the GAPS food?

This is one of the more common questions I am asked and understandably so. This was my number one question too. I sought answers everywhere including standing up at seminars and asking several experts how this could be achieved yet fussy eating was an understatement. I wanted my son to eat these healing foods but I asked myself, "How could he achieve this with his extreme food aversions and oral sensory issues?"

He would only eat 5 foods so we gave him the GAPS alternatives to what he liked like crumbed chicken nuggets with almond meal cooked in lard. (Big mistake) He ate it but it was by no means providing him with healing foods. All it did was eliminate the offending foods he needed to avoid and provide him with self limiting alternatives. He did have withdrawals from dairy and grains and seemed to do much better without them but he was just plugging along with his fussy little eating habits and made very little progress.

It was not until I decided to implement strict Applied Behaviour Analysis (ABA) strategies (explained in the GAPS book under the chapter marked 'it's feeding time! Oh, no!') to see if we could get him to eat the things his little body desperately needed that we saw an amazing change. I thought if I was going to do this, I needed to commit 100% and be well prepared, firm and consistent with my approach. The other key factor was to not give in to him and avoid giving him any other food if he refused to eat what we offered.

ABA needed to be planned with realistic goals and highly motivating rewards. We strategically designed some intervention tools tailored to his needs that we knew he could work with and enjoy. With the use of the tools and ABA strategies we started to introduce the new foods with the GAPS Introduction Diet. All we gave him for two weeks was homemade soup and meat stock. This was very difficult to give him as he gagged, screamed, self harmed and vomited. When he learnt that he could get a reward that was highly desirable he complied with our requests. We worked as a husband wife team together in the first few days in doing this. After a few days he began to detox and got sick with some symptoms getting worse. He even went off eating his food altogether which we latter learnt was common at this stage. Although this was worrying, we nursed him through the detox stage as if it was a bad virus or flu and gradually continued with giving him his soup and stock in small amounts until he could tolerate it. By the middle of the second week, he asked for seconds and then thirds and we thought ‘hey ho stop your belly is full now’. He actually wanted and desired the food that he completely struggled with only ten days ago and wanted lots of it.

On the second week we started him on stage two of the GAPS intro diet with lamb casserole and vegetables. We got all the ABA tools and items out ready to go through it again but to our amazement he ate it and was really enjoying it without any ABA intervention. He then wanted to eat bananas and other fruits and foods that we could never get him to eat before. I did not think he would eat the banana so I gave it to him and to my surprise he ate it and asked for another and then asked for an apple. Unfortunately we could not give him the second banana or any other fruit because we wanted to stick to the intervention plan. I never would have believed it if I had not seen it with my own eyes. It was at this point that I said to my husband “parents need to know this!” So here I am telling people that it is possible and they can do what seems impossible to achieve. As a result, I have had the pleasure of watching many other committed parents who thought it was not possible, to see their own little fussy eaters transform in ten days.

If all it takes is 100% commitment from parents, good healing food, an individual ABA plan with a few dollars spent on some very motivating rewards, then it is well worth it! I would have paid hundreds just to have someone get him to eat some nourishing foods but instead we did it ourselves and all the money went into our son with his rewards. If you think that you can do this then I strongly support your success as I have seen others achieve this who thought it was not possible. There is something about the healing properties in the meat stock and soup that begins to repair the microvilli and entrocytes in the gut wall that consequently interrelate with the mind, taste and adjustment with sensory issues with food.

It somehow changes all this so it is well worth the effort to give it a go. I know it can be more difficult with older children but where there is a will there is a way. Just keep talking to your children and educate them if you can. You know your child better than anyone else and you will find the best motivators and strategies to implement an ABA plan if you wish. Remember, the best desired outcome for fussy eaters is achieved by combining ABA with the implementation of the GAPS Introduction Diet.

Have faith, give it all you have and think of food as your love. What do you have to lose?

By Linda Paterson GAPS Nutrition Consultant
An article from the ‘GAPS Companion’ a handbook for beginners. www.gapsaustralia.com.au


挑食者與發展障礙

欲明瞭這個問題並學習如何將食物引入挑食者的菜單，請參閱我寫的 GAPS 書這章 “用餐時間到了. 噢, 我不要! (It’s feeding time. Oh, no!)”。本章將提供您一個有效的實用的結構化方法讓您的挑食孩子吃完所有您煮的食物。

大多數 GAPS 患者們挑剔限制自己的飲食的食物，並喜愛澱粉類食物和甜食，尤其是兒童。他們掉進對這些食物的渴望和依賴的惡性循環，這傷害了他們並使得他們拒吃其他食物。這個問題在自閉症兒童身上特別明顯。

GAPS 成人和兒童們的挑食習慣常常導致照顧者和父母在引進 SCD (Specific Carbohydrate Diet, 特定的碳水化合物飲食) 時犯一個典型的錯誤：許多照顧者和家長拿孩子們願意吃的東西和孩子們交換，但是這種東西對 SCD 相容的甜食而言卻是常見的甜食和不易消化的食物。他們發現 SCD 甜點的樂事：蛋糕、餅乾、麵包等，孩子待在磨碎的杏仁和蜂蜜裡，沒有帶來預期的效益，而且那不是健康的飲食方式。依循進入全 GAPS 飲食 (Full GAPS Diet) 前的導入飲食 (Introduction Diet) 階段可幫助您在不重蹈覆轍的情形下為您的孩子建立一個適當的飲食常規。

在 GAPS 家庭裡，未能茁壯成長是一個普遍的現象。具不正常的腸道菌群的嬰兒可以靠吸母乳茁壯成長。然而，開始引入固體食物後，孩子本能地得知這些食物（有別於母乳）讓他生病。由於不健康的消化系統無法好好地處理固體食物和只部分地消化吸收，孩子可能會遇到許多不愉快的症狀：肚子痛、肌肉疼痛、皮膚瘙癢、頭痛、沒活力等，所以，嬰兒當然拒絕固體食物。超過六個月大的孩子只從母乳得到足夠的營養，這是非常罕見的，不吃固體食物的孩子體重逐漸跟不上甚至開始變輕，臨床診斷通常如此。

對這些孩子來說，典型的斷奶食品（基於穀物製造出來的）是完全不合適的，不能給他們。請參閱新生嬰兒頁 (page New Baby) ，並依結構化的飲食習慣，引入該頁描述的食品。從溫暖的自製肉湯混合自製優格開始。在確定您的嬰兒可以用奶瓶或杯子喝您自製肉湯混加優格後，您可以親餵嬰兒一些母奶當作獎勵。您的孩子必須學習喝母奶前一定要先吃一些食物。從一個小的可實現目標開始，例如在喝母奶前先喝一到二茶匙的肉湯加優格，然後逐漸增加肉湯加優格的量。每小時選擇你和你的孩子平靜和快樂的時候餵一次。顯然，不論什麼原因，只要那時你孩子情況不佳，則無條件給他吸母奶 - 因為此時不是嘗試引入新食物的好時機。當您的寶寶開始喝肉湯加優格並有相當量的時候，逐步引入書裡新生嬰兒頁 (page New Baby) 裡描述的其他食物。請用母乳當作獎勵，持續一年左右，在我們的文化裡，餵母乳超過一年並不常見。然而，這些孩子從長期吸母奶裡獲益極大，至少一歲半到二歲。

本文出自一本初學者手冊 ‘GAPS 指南 (GAPS Companion)’ 裡的一篇文章，由 GAPS 營養顧問琳達·帕特森 (Linda Paterson) 撰寫，網址 http://www.gapsaustralia.com.au/。

問：我的孩子是個挑食者，他會自我限制他的飲食。我該怎麼讓他吃 GAPS 食物呢？

這是我問過可以理解的較常見的問題之一，也是我的頭號問題。我四處找答案，包括在研討會上站起來客氣地請教專家該怎麼實現不挑食，我希望我的兒子吃這些能幫助他腸道壁癒合的食物，但我自問，“在他對這些食物極端地反感和口腔感覺問題的情形下怎麼做到這一點？”

他只會吃五種食物，所以我們給他他喜歡的 GAPS 替代品像是碎雞肉塊裹杏仁粉用豬油烹調熟。（這是個大錯誤），他吃了，但這食物沒辦法幫他癒合腸道壁，家長要做的事是幫他避開違規食物並且吃他不吃的食物。他確實有從奶製品和穀物裡提取，似乎在沒有他們的情形下做的更好，但他只是埋頭苦嚼，對改善挑食進展甚微。

這個問題直到我決定實施嚴格的應用行為分析（Applied Behaviour Analysis or ABA）策略（GAPS 書裡的章節 - 用餐時間到了. 噢, 我不要! (It’s feeding time. Oh, no!) 有解釋）看到，如果我們能給他吃他小小的身體迫切需要的營養，則我們會看到一個驚人的變化。我想，一旦我決定要這麼做，我需要 100％ 投入並充分準備，堅定不移地貫徹我的方法。另一個關鍵因素是如果他拒絕吃我們提供的食物，則不要給他任何其他的食物。

ABA 需要用現實可行的目標和高度激勵獎勵制訂計畫。我們配合小孩的需要策略地設計一些可介入小孩領域的工具，我們知道他樂於配合去做。使用這些特製工具和 ABA 策略，我們開始引入 GAPS 導入飲食 (GAPS Introduction Diet) 新食物，我們給了他兩個星期的自製湯和肉湯。這是非常困難的，因為他緊閉嘴巴，大叫一聲，自我傷害和作嘔。當他知道若他符合我們的要求可以得到獎勵，這非常令人嚮往。過程中，我們頭幾天就像個夫妻工作團隊一起工作。幾天後，他就開始排毒並呈現患病反應，一些症狀越來越嚴重，他甚至完全沒食慾，後來我們才知道在這個階段裡這是很普遍的現象。雖然這令人擔憂 (如果它是一個糟糕的病毒或流感)，但是我們照顧他通過排毒階段，並逐步繼續給他喝湯和少量肉湯，直到他能耐受它。第二週過一半時，他要求第二匙肉湯接著要求第三匙肉湯，我們認為 ‘嘿，該停了，你的肚子滿了!’，他只花了十天就擺脫了他之前動不動就想吃的那些食物並且吃正確的食物吃得更多。

在第二個星期，我們開始給他 GAPS 導入飲食 (GAPS Introduction Diet) 這個階段的二項食物 - 羔羊鍋和蔬菜鍋，我們準備用所有的 ABA 工具和項目去進行這件事，令我們驚喜的是他高興地吃完了這兩樣食物而且我們準備的 ABA 工具都沒派上用場，然後，他想要吃我們以前給他吃但他一直不肯吃的香蕉以及其他水果和食物。我沒想到他會吃的香蕉，所以就給他香蕉，出乎我的意料，他吃了，而且還要求再吃另一個水果蘋果。非常可惜，我們不能給他的第二根香蕉或其他水果，因為我們要嚴格執行計畫。如果我沒親眼看到，我永遠都不會相信我們突破了。在這一點上，我對我丈夫說 “父母需要知道這一點！(parents need to know this!)” 所以，我在這裡告訴大家，這是做得到的，大家完全可以做到心裡覺得似乎不可能實現的事。對此，我有個小樂趣 - 靜觀許多滿心認為不可能的家長看自己的小挑食者過十天後的變化。

如果所有需要的是來自家長、良好的能幫助癒合腸道壁的食品、一份花幾元錢為個人設計的非常激勵獎勵的 ABA 計畫這樣的承諾，那麼它是值得的！我會花幾百塊錢請人想辦法幫我給我的小孩多吃一些滋補食品，而今我們自己做到了，並且，這些錢進了我們兒子的口袋成了他的獎勵。如果你認為你能做到這一點，那麼我強烈支持你成功，因為我看到其他人做到他認為不可能的這一點。肉湯裡有某物質是關於癒合傷口的，它開始修復腸道壁裡的微絨毛和腸的吸收細胞 (Enterocytes, or intestinal absorptive cells)，接著關聯到頭腦、味覺、和調整對食物的感覺問題。

它在某種程度上改變了這一切，所以它是非常值得努力的方向。我知道它可能對年齡較大的兒童較為困難，但是那還是有方法。如果可以的話，只要保持與孩子交談，教育他們。若你希望你的孩子比別人更好，你會找到最好的動機和策略，以實現 ABA 計畫。請記住，對挑食者而言，最好的期望結果是結合ABA 與 GAPS 導入飲食 (GAPS Introduction Diet)。

有信心，如你愛地給孩子你所有的和所想到的。你有什麼損失呢？

本文出自一本初學者手冊 ‘GAPS 指南 (GAPS Companion)’ 裡的一篇文章，由 GAPS 營養顧問琳達·帕特森 (Linda Paterson) 撰寫，網址 http://www.gapsaustralia.com.au/。


GAPS recipes

( http://www.gaps.me/preview/?page_id=30 )

GAPS recipes for helping with learning disabilities, psychiatric disorders and physical problems, such as autism, hyperactivity and attention deficit, dyslexia, dyspraxia, depression, schizophrenia, bipolar disorder, obsessive-compulsive disorder, eating disorders, epilepsy and more

The main list of recipes you will find in the GAPS book, as well as many SCD books and websites. In addition to those I will describe a few more recipes here.

Fermented foods are essential to introduce, as they provide probiotic microbes in the best possible form. Supplements of probiotics settle in the upper parts of the digestive system and generally do not make it all away down to the bowel, while fermented foods will carry probiotic microbes all away down to the end of the digestive system. Fermentation predigests the food, making it easy for our digestive systems to handle, that is why fermented foods are easily digested by people with damaged gut. Fermentation releases nutrients from the food, making them more bio-available for the body: for example sauerkraut contains 20 times more bio-available vitamin C than fresh cabbage.

You can ferment any food. Here I will put a few recipes for you to consider (you do not have to introduce them all). Try to experiment and make your own recipes. You can ferment by adding kefir or yoghurt culture to food or using traditional methods, such as the one for making sauerkraut.

Fermented foods should always be introduced gradually: they are teaming with probiotic bacteria and live enzymes which may cause a “die-off reaction”. You’ll meet people who will tell you that they “cannot tolerate” fermented foods: the reason is that they suddenly had a sizeable helping of a fermented food and got a serious “die-off reaction”. Never start from more than 1 teaspoon of any probiotic food per day. Depending on the severity of the condition, different people can introduce fermented foods quicker or slower. If on 1 teaspoon per day your patient gets a “die-off reaction”, let him or her settle for a few days or longer, then increase the amount to 2 teaspoons per day. Once 2 teaspoons are well tolerated, add another teaspoon. Continue increasing the daily amount of the fermented food gradually keeping the “die-off reaction” under control. It is a good idea to introduce no more than 1 or 2 fermented foods at a time. I usually recommend to start from homemade yoghurt and juice from homemade sauerkraut, which in many cases can be introduced at the same time.

Sauerkraut

Sauerkraut is an ancient digestive and detoxifying food, very popular in Eastern Europe. You have to make it at home as commercially available sauerkraut may have been pasteurised or processed in some other way, which will make it much less potent. Initially just add juice from the sauerkraut into your patient’s meals; then gradually introduce the cabbage itself. Sauerkraut stimulates stomach acid production and is a great ally in digesting meats. Majority of GAPS patients have low stomach acid production, which starts the whole digestive process from the wrong foot. Regular consumption of sauerkraut over time will help your patient to restore normal stomach acid production. Please follow the instructions for making sauerkraut in the recipe section of the GAPS book. Sauerkraut does not require adding any fermenting bacteria to it, as cabbage and other fresh vegetables have these bacteria naturally living on their surface. Do not forget to add natural unprocessed salt before kneading the cabbage: the salt will stifle any putrefactive microbes until the good bacteria produce enough lactic acid to kill them. Another important point is to knead the mixture very well in a large bowl using your hands; you may want to ask somebody with strong hands to do that for you. Knead until the cabbage and carrots release a lot of juice (salt in the mixture will hep to do that), so when you leave it to ferment, the cabbage is completely drowned in its own juice. If for whatever reason there is not enough juice in the cabbage, add some water to the mixture. Fermentation is an anaerobic process: if the cabbage is exposed to air, it will rot instead of fermenting. Having made the sauerkraut once you will see just how easy it is to do and how little time it takes to make this wonderful healing remedy.

Homemade yoghurt and kefir

You can get a commercial starter in a sachet or use some live commercial natural yoghurt or kefir as a starter. Please follow the instructions for making yoghurt in the GAPS book. You can make kefir following the same instructions using the kefir starter or commercial natural kefir. From your first batch of yoghurt and kefir you can make many more, just leave about a cup to use as a starter for the next batch. If you make yoghurt or kefir from organic unpasteurised (raw) milk, then do not heat it, just add the starter and ferment. Only pasteurised milk needs heating, as pasteurisation makes milk vulnerable to contamination by pathogenic microbes. Raw milk is usually well protected by its own probiotic bacteria and other factors.

Remember, that kefir contains more potent probiotic microbes than yoghurt, as a result kefir will produce a more pronounced “die-off reaction”. That is why I recommend to introduce yoghurt first, then start introducing kefir. Both should be introduced slowly and gradually controlling the “die-off”. Kefir, apart from probiotic bacteria, contains beneficial yeasts. That is why it is essential to introduce for people with yeast overgrowth. A healthy human gut contains plenty of beneficial yeasts, as well as beneficial bacteria and other microbes. In order to get rid of the “bad” yeast, we need to replace it with the “good” yeast.

By dripping your yoghurt or kefir through cheesecloth you can separate it into cottage cheese and whey. Pour the whey into a clean glass jar with a tight lid and keep it in the refrigerator to use as a starter for fermenting different foods, such as vegetables, fish, beans and grains (when your patient is ready to have them). The cottage cheese is delicious with some honey, fruit, soups or as a savoury snack.

Fermenting vegetables with whey

With whey (or the commercial starter for yoghurt or kefir) you can ferment vegetables. Take some cabbage (white, red or any other variety), beetroot, garlic, cauliflower and carrot, slice them into nice mouth size pieces or shred them roughly, add some salt to taste and pack loosely into a wide-mouth glass jar. Take 1/2 litre of cold water and dissolve the contents of yoghurt or kefir sachet in it. Alternatively add 4-5 tablespoons of your homemade whey into the water. Add this water to the jar until it completely covers the vegetables (if the vegetables are not quite covered, just top it up with more water). Close the jar and leave to ferment at a room temperature for 7-10 days. The vegetables will become soft and tangy to taste. Introduce the juice from these vegetables as soon as they are ready. Start from one teaspoon of the juice added to soups and stews. Gradually increase the amount of the liquid and start introducing the vegetables themselves again starting from a small amount. These vegetables and the liquid are an excellent probiotic food and will assist digestion.

Vegetable medley

This simple recipe will provide you with delicious fermented vegetables and a wonderful beverage to drink. In a 2-3 litre wide-mouth glass jar put half a cabbage roughly cut, a medium size beetroot sliced, a handful of peeled garlic cloves and some dill seeds or fresh dill. The vegetables should fill no more than 2/3 of the jar. Add 1-2 tablespoons of Celtic salt, a cup of whey and top up with water until the jar is full. Float a small dish on top of the brine to keep the vegetables submerged in the brine. Leave to ferment for 1-2 weeks at a room temperature. When ready the vegetables will be soft and tangy. At that stage move the jar into the refrigerator. Drink the brine diluted with water with your meals or between the meals and eat the vegetables with the meats. When the brine and the vegetables will start getting low, add fresh cabbage, beetroot and garlic, some salt, top up with water and ferment at a room temperature again. You can also add a few rosettes of cauliflower, sliced carrot, Brussels sprouts and broccoli. You can have this vegetable medley going forever as long as you keep feeding it with more fresh vegetables.

Beetroot kvass

Using a knife slice medium size beetroot finely (don’t grate it in a food processor as that destroys the beetroot and will make it ferment too quickly producing alcohol). Put the beetroot into a two-litre jar, add 1-2 tablespoons of Celtic Salt, 1 cup of whey, 5 cloves of garlic, a teaspoon of dill seeds and fill up with water. Let it ferment for 2-5 days in a warm place. After that keep in the refrigerator. Drink diluted with water. Keep topping the water up in the jar so your kvass will be going for a long time. When it stars getting pale then the beetroot is spent, so make a new one.

Kvass

You can make kvass from any combination of fruit, berries and vegetables; try to experiment. A good recipe is apple/ginger and raspberry kvass. Slice a whole apple including the core, grate ginger root (about a teaspoonful) and get a handful of fresh raspberries. Put them all into a one-litre jar, add ½ cup of whey and top up with water. Let it brew for a few days at a room temperature, then keep in the refrigerator. Drink diluted with water. Keep topping up your brew with water until the fruit is spent, then start again.

Probiotic tomato juice

Blend well 1 cup of whey, 1-2 tablespoons of tomato pure, 1 cup of water and some salt to taste. Chill and serve.

Fermented fish

You can use homemade kefir or whey as a starter. For a one-litre jar you need 3-4 fresh herrings or mackerel. Skin the fish and remove the bones, cut into mouth size pieces. Put the pieces of the fish into the jar mixing with slightly crushed peppercorns, a few slices of white onion (optional), coriander seeds, bay leaves and dill seeds or dill herb. In a separate jug in ½ litre of water dissolve 1 tablespoon of sea salt and 3-4 tablespoons of your homemade whey. Pour this brine into the jar with the fish until the fish is completely covered; if the fish is not covered just add more water. Close the jar tightly and leave to ferment for 3-5 days at a room temperature, then store in the fridge. This fish does not keep long, so consume in the next few days. Serve with avocado and onions.

Another way to ferment fish: buy some fresh sardines (also works for herring and mackerel), de-scale the fish, cut the heads off and clean the belly out. Put into a suitable size glass jar or a stainless steel pan. Add 1-2 cups of whey, 1-2 tablespoons of salt (per 1 litre), a teaspoon of black pepper corns (freshly crushed), 10 bay leaves and ½ a teaspoon of coriander seeds (freshly crushed). Top up with water so the fish is completely covered with water, you may want to float a small plate on top of the fish to keep it submerged in the brine. Cover the pan or put the lead on the jar and let it ferment for 3-5 days at a room temperature. When the fish is ready take the meat off the bones, cut into bite-size pieces and serve with avocado, fresh dill and some chopped red onion.

Fermented grains

When you are ready to introduce some grain, first try them fermented. To ferment grains such as buckwheat, millet and quinoa wash them, cover with water and add ½ cup of whey. Leave to ferment at a room temperature for a few days: quinoa for 1-2 days, buckwheat for 2-3 days, millet for 4-5 days. When the fermentation is complete, drain the liquid out and cook the grain in your homemade meat stock or water with some salt (for 1 cup of grain 2 cups of meat stock or water). When it is cooked all the liquid should be completely absorbed and the grain should be soft and fluffy. Have it with meats and vegetables or bake with it using it instead of flour. Introduce gradually, starting from 1-2 spoonfuls a day and watching for any reaction. Do not forget to serve grains with plenty of natural fat: butter, ghee, olive oil, coconut oil or any animal fat; the fats will slow down the digestion of the grains and help to control the blood sugar level.

Baked beans

Baked beans, which are produced commercially, are full of sugar and should be avoided. You can make your own baked beans at home. Please, do not rush with introducing beans and pulses, as they are generally hard to digest.

Soak 500g of white navy beans (haricot beans) in water for 12-24 hours, drain. Rinse well in cold water, drain. Soaking and rinsing removes some harmful substances from the beans (lectins and some starches). Cover the beans with water again and add 4-5 tablespoons of your homemade kefir, yoghurt or whey. Leave to ferment for a week at a room temperature. After rinsing your beans are ready to be cooked. In a large pan put 1,5 litres of water, 1 tablespoon of cider vinegar, 1 teaspoon of sea salt, 4 tablespoons of tomato puree, a pinch of cayenne pepper, a pinch of black pepper, 5-6 bay leaves, a sprig of rosemary, a bit of thyme, couple of cloves and 100g of butter. Cover the pan with a lid and put it into an oven. Cook at 120 0 C for 4-5 hours. Stir occasionally. If the water evaporates before the beans are ready, add some more. If at the end of cooking there is too much water left, just take the lid off and leave the pan in the oven for 15-20 minutes at a higher temperature (150-180 0 C).

Serve hot or cold. These baked beans will keep in the fridge for a long time.

You can make a variation of this dish by adding a whole chicken or duck, cut into pieces, sausages, pieces of lamb, beef or pork, chopped onion, carrot and garlic before putting the pan into the oven. This variation makes an excellent meal.


GAPS 食譜(製作方法)

GAPS 食譜篇是為了幫助有學習障礙、精神障礙和生理上的問題，如自閉症、多動症和注意力缺陷、閱讀障礙、運動障礙、抑鬱症、精神分裂症、雙相情感障礙、強迫症、飲食失調、癲癇症和更多

您可於 GAPS 書裡還有許多 SCD 書籍和網站找到主要的食譜(製作方法)，除了這些，我將在此介紹一些更多的食譜。

發酵食品是一定要引入的，益生菌微生物為他們提供最好的形式。吃下益生菌補充品後，發酵食品會帶著益生菌微生物降到消化系統的末端，這些益生菌們在上消化道定居了下來，通常不降到腸道，我們的消化系統很容易處理這些預先消化 (predigests) 的發酵食物，這就是為什麼腸道受損的人們可以容易地消化這些已發酵完成的食物。發酵反應促使食物釋放出更多對身體生理所需的營養成分，例如：發酵大白菜 (sauerkraut) 含有的維生素C比新鮮大白菜 (cabbage) 含有的維生素C多二十倍以上。

您可以發酵任何食物。在這裡，我舉幾個食譜供您參考（您不必全部引入它們）。嘗試進行實驗並製作自己的食譜。您可把克菲爾 (kefir) 或優格 (yoghurt) 添加到食物裡發酵或用傳統方法發酵食物，像是製作發酵大白菜(泡菜)。

應逐步引入發酵食物：發酵食物與益生菌 (probiotic bacteria) 和活酶 (live enzymes) 結合後，可能引起 “好轉反應 (die-off reaction, 或稱為去病反應)”。你會遇到人們跟你說他們 “無法耐受” 發酵食品: 原因是他們的身體突然得到發酵食物相當大的幫助後引起嚴重的 “好轉反應”。開始引入益生菌食物時，每天不要超過一茶匙 (teaspoon) ，應依每個人病情的嚴重程度決定是快還是慢引入發酵食物。如果您的病人每天才一茶匙就引起 “好轉反應”，則多穩定幾天再進展到每天二茶匙。等病人對二茶匙耐受性良好後，再往上加。繼續逐漸增加每天的發酵食物並控制 “好轉反應”。這是個同時引入一到二種發酵食物的好主意，我通常建議從自製優格和來自自製發酵大白菜的蔬果汁開始，在許多情況下，可以同時引入。

發酵大白菜 (Sauerkraut)

發酵大白菜 (也稱為泡菜) 是一種古老的助消化的解毒食物，在東歐 (Eastern Europe) 很受歡迎。您必須儘可能地在家裡自製泡菜因為市售泡菜可能已被其它方式加熱殺菌過 (pasteurised) 或人工加工過 (processed) ，這大大削弱它的效力。剛開始時只要加點泡菜汁到您病人的餐點裡，然後逐漸地引入大白菜本身。泡菜會刺激胃酸生產，是胃消化肉類時的偉大盟友，多數 GAPS 患者具有低胃酸生產的現象，整個消化過程就從這個錯誤的根開始。經常食用泡菜一段時間可幫助病人恢復正常的胃酸生產，請按照我寫的 GAPS 書裡的製作方法自製泡菜。不需要添加任何發酵的細菌到泡菜裡，例如大白菜和其它的新鮮蔬菜，這些細菌 (好菌) 已在其表面的自然地生活。揉大白菜之前，不要忘了添加天然未加工的鹽：鹽將扼殺任何腐爛的微生物 (壞菌) 直到好菌們產生足夠的乳酸 (lactic acid) 殺死壞菌。另一個要點是要用手在大碗裡徹底揉勻混合物，您可能需要找手力氣大的人幫你揉，直到白菜和胡蘿蔔釋放出大量的果汁（混合物裡的鹽熟知做到這一點），大白菜將被完全淹沒在自己的果汁裡發酵，如果大白菜沒有足夠的果汁，可加一些水到混合物裡。發酵是一種厭氧過程 (anaerobic process)：如果大白菜暴露於空氣中，它會腐爛，而不是發酵。一旦您自製了一次發酵大白菜，您就會知道這是件多麼容易做的事並且是件在短時間內可進行超棒的癒合補救的事。

自製優格和克菲爾 (Homemade yoghurt and kefir)

你可購買市售小包裝酵母或使用一些活性的市售的天然優格或克菲爾當作發酵的啟動器 (starter)，請按照我寫的 GAPS 書裡的步驟製作優格。您可依照書裡講的製作步驟使用克菲爾啟動器 (kefir starter) 或市售天然克菲爾自製克菲爾。製好第一批優格和克菲爾後，您可以留下其中一杯作為下次自製更多的優格和克菲爾時的啟動器。如果您使用有機未經加熱殺菌的生乳 (raw milk) 製作優格或克菲爾，那麼千萬不要再加熱它，只需添加啟動器即可發酵，只有那種加熱殺菌的奶需要加熱，加熱殺菌使牛奶容易受到病原微生物的污染，生乳通常已被自己的益生菌和其它因子很好保護住。

請記住，克菲爾內的益生菌微生物能力勝於優格，食用克菲爾會產生更明顯的 “好轉反應 (die-off reaction, 或稱為去病反應)”，這就是為什麼我建議先引入優格然後才開始引入克菲爾。引入這二個時應慢慢引入並逐漸控制 “好轉 (die-off, 或稱為去病)”。和益生細菌不同的是克菲爾包含有益酵母菌，這就是為什麼對腸道裡大量 (壞的) 酵母菌過度生長的人們而言它是必要引入的，一個健康的人其腸道內含有大量的有益的酵母菌以及其它的有益細菌和微生物，為了擺脫 “壞” 酵母，我們需要拿 “好” 酵母來取代它。

把優格或克菲爾滴在包乾酪的紗布 (cheesecloth) 上過濾，可分離出小片乳酪 (cottage cheese) 和乳清蛋白 (whey)。把乳清蛋白倒到一個乾淨的玻璃瓶中，蓋緊蓋子放到冰箱保存以當做日後發酵其它食物例如蔬菜、魚、豆類和穀物（如果您的病人已經可以食用穀物）的啟動器。加一些蜂蜜、水果、湯到小片乳酪上當成可口小吃味道很不錯。

用乳清蛋白發酵蔬菜 (Fermenting vegetables with whey)

您可用乳清蛋白（或市售針對優格或克菲爾的啟動器）發酵蔬菜。拿一些大白菜（白色、紅色或任何其他種類）、甜菜根 (beetroot)、大蒜、花椰菜、胡蘿蔔，切成像嘴巴大小的片狀或大約是這樣，加少許鹽調味，鬆散地放入廣口玻璃瓶，放入半公升冷水以溶解優格或克菲爾小包，或者加四到五湯匙您自製的乳清蛋白到水中，把水加到罐子裡直到完全覆蓋蔬菜（如果沒有完全覆蓋蔬菜，請再加更多的水），密封罐子置於室溫下七到十天，蔬菜會變得柔軟和味道濃郁，在病人可以吃發酵蔬菜後，儘快引入這些蔬菜的汁，把蔬菜汁加入湯和燉菜，從一茶匙開始，逐漸增加其量並從少量開始引入蔬菜，這些蔬菜和液體是極好的益生食品，可助消化。

混合蔬菜 (Vegetable medley)

這個簡單的配方可提供您美味的發酵蔬菜和極棒的飲料來喝。粗切半個大白菜、一個中等大小的甜菜根切片、去皮蒜瓣、和一些蒔蘿種子或極少數新鮮蒔蘿放入一個二到三公升的廣口玻璃瓶，蔬菜不應超過罐子的三分之二，加入一到二湯匙凱爾特人鹽 (Celtic salt)，一杯乳清蛋白，加水到滿，浮一小盤在鹽水上以保持泡在鹽水裡的蔬菜，擺放在室溫下發酵一到二週後，蔬菜將變得軟和香氣撲鼻。在這個階段，把罐子放到冰箱，在您用餐時或餐與餐之間喝下稀釋鹽水，多吃蔬菜與肉類。當鹽水和蔬菜越來越低後，再添加新鮮的大白菜、甜菜根和大蒜、少許鹽在水面上並再度在室溫下發酵。您還可以添加一些花椰菜上的花、紅蘿蔔片、布魯塞爾球芽甘藍 (Brussels sprouts) 和球花甘藍 (broccoli)。只要您持續補充新鮮蔬菜進去，則您可以一直吃這個混合蔬菜。

甜菜根克瓦斯 (Beetroot kvass)

用刀子切中等大小的甜菜根（不要把它放到食物處理機裡磨碎，這樣會破壞甜菜根，並會太快發酵生產酒精）。把甜菜根放入一個兩公升的罐子，加一到二湯匙的凱爾特人鹽 (Celtic Salt)、一杯乳清蛋白、五瓣大蒜、一茶匙蒔蘿種子，加水到滿。讓它在一個溫暖的地方發酵二到五天，之後，放入冰箱，要喝的時候倒一點出來加水稀釋，保持罐裡滿水位，如此您的克瓦斯將可持續很長一段時間。當它顏色變得越來越淡後，需要換個新的甜菜根，製作新的克瓦斯。

克瓦斯 (Kvass)

您可用任何的水果組合、漿果、蔬菜組合製作克瓦斯，嘗試實驗。一個好的配方是：蘋果/薑和覆盆子克瓦斯。整個蘋果連同內核切片、磨碎薑根（約一茶匙）、一把新鮮的覆盆子，放入一個一公升的罐子，加半杯乳清蛋白，加水到滿，放在室溫下釀造幾天，然後放入冰箱，要喝的時候倒一點出來加水稀釋，保持罐裡滿水位直到水果耗盡，然後重新開始。

益生的番茄汁 (Probiotic tomato juice)

充分混合一杯乳清蛋白、一到二湯匙的純番茄、一杯水和一些鹽調味。冷卻和供應。

發酵的魚 (Fermented fish)

您可以使用自製的優格或乳清蛋白作為啟動器 (starter)。


(尚未翻譯完畢)


Supplements

( http://www.gaps.me/preview/?page_id=31 )

Supplements for GAPS patients, for helping with learning disabilities, psychiatric disorders and physical problems, such as autism, hyperactivity and attention deficit, dyslexia, dyspraxia, depression, schizophrenia, bipolar disorder, obsessive-compulsive disorder, eating disorders, epilepsy and more

The majority of my patients progress very well with the use of the diet and these essential supplements without adding anything else.

The essential supplements for GAPS patients

1. An effective therapeutic strength probiotic.

2. Essential fatty acids.

3. Vitamins A and D in the form of cod liver oil.

Please read the relevant chapters in the GAPS book on these supplements.

In some individual cases, particularly in adults I use digestive enzymes. Children usually do very well without them. The most important intervention here is supplementation of the stomach acid, as GAPS patients usually have low stomach acidity. It is from the action of the stomach acid that the whole digestive process begins. The use of sauerkraut in the Introduction Diet helps to restore normal stomach acid production. Please, read more about it in the chapter Digestive Enzymes in my book.

In some individual cases I prescribe certain vitamin and mineral supplements. However, in majority of cases there is no need for these supplements, particularly at the beginning of the programme. We humans are designed to receive our vitamins and minerals from food, not from pills. Nutrients help each other in their absorption and metabolism, that is why they have to come in a complex physical form of natural food. The body has not been designed to use single, particularly synthetic molecules of vitamins and minerals.

Don’t be tempted to use other supplements. The main treatment of GAP Syndrome is the diet. Supplements may contain many ingredients, sometimes not listed on the label, which irritate the gut lining. You do not want to put a lot of effort into the diet and then upset the healing process in the gut by a pill. If you are strongly recommended to take a particular supplement complete the Introduction Diet first before starting it. By then a fair amount of healing will happen in your gut, so it will be in a better shape to handle the new supplement.

Please, read the relevant chapters in the GAPS book for a full understanding on using supplements.


Additional Reading (您可參閱以下各篇)

GAPS 腸道與心理綜合症, 發展障礙主題 -- How a Physician Cured Her Son's Autism 一個醫生如何治療了她兒子的自閉症 從三歲到十二歲, 完全康復, 請看這裡 http://tw.myblog.yahoo.com/linuxyeo/article?mid=904

GAPS 腸道與心理綜合症, 發展障礙主題 -- GAPS diet 為 GAPS 腸道與心理綜合症患者設計的飲食, 請看這裡 http://tw.myblog.yahoo.com/linuxyeo/article?mid=940

GAPS 腸道與心理綜合症, 發展障礙主題 -- Fussy eaters and failure to thrive 挑食者與發展障礙, 請看這裡 http://tw.myblog.yahoo.com/linuxyeo/article?mid=1019