George Yeo 網路自強號

謹以此文分享給需要幫助的父母, 原文是英文, 因為小弟覺得機器翻譯翻得太差了, 所以在下方人工翻譯, 若有錯誤, 敬請網友不吝賜教. 感謝!

專有名詞對照: 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。

發展障礙主題之一 -- 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 diet

( http://gaps.me/preview/?page_id=28 )

GAPS diet - the diet 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

 This website has not been designed as a replacement for the GAPS book, but as a source of additional information. Please, read the GAPS book first to understand how and why this particular diet works, why other diets are inappropriate for the GAPS patients and how to implement the appropriate diet correctly.

The GAPS diet is based on the SCD (the Specific Carbohydrate Diet). SCD has been invented by a renowned American paediatrician Dr. Sidney Valentine Haas in the first half of the 20th century. Dr. Haas and his colleagues have spent many years researching the effects of diet on celiac disease and other digestive disorders. The results of this research were published in a comprehensive medical textbook “The Management of Celiac Disease”, written by Dr. Sidney V. Haas and Merrill P. Haas in 1951. The diet, described in the book, was accepted by the medical community all over the world as a cure for celiac disease and Dr. Sidney V. Haas was honoured for his pioneer work in the field of paediatrics. Unfortunately, when celiac disease was defined as a gluten intolerance or gluten enteropathy, the SCD got forgotten as outdated information. It was brought back to life by Elaine Gottschall. Following the success of the SCD with her daughter, Elaine Gottschall over the years helped thousands of people, suffering from Crohn’s disease, ulcerative colitis, celiac disease, diverticulitis and various types of chronic diarrhoea. But the most dramatic and fast recoveries she reported in young children, who apart from digestive problems had serious behavioural abnormalities, such as autism, hyperactivity and night terrors. She devoted years of research into biochemical and biological basis of the diet and published a book, called “Breaking the Vicious Cycle. Intestinal Health Trough Diet.”

I have been using SCD in my clinic for many years. Having accumulated valuable clinical experience I had to make several adjustments in the diet appropriate for my patients with the neurological and psychiatric conditions. Through the years my patients named their dietary regime – the GAPS diet.

Implementing the GAPS Diet

1. Introduction Diet
2. The Full GAPS Diet with the typical menu

Some of you will use the diet to treat yourselves, some of you are parents trying to help your child, some will use the diet to help a loved one or a friend. To cover all these cases, I use the term “your patient” in the text.

I recommend that most GAPS patients follow the Introduction Diet before going into the Full GAPS Diet. Depending on the severity of your patient’s condition he or she can move through this programme as fast or as slow as his/her condition will permit: for example you may move through the First Stage in one or two days and then spend longer on the Second Stage.

Following the Introduction Diet fully is essential for people with serious digestive symptoms: diarrhoea, abdominal pain, bloating, some cases of constipation, etc. This diet will reduce the symptoms quickly and initiate the healing process in the digestive system. Even for healthy people, if you or your child gets a ‘tummy bug’ or any other form of diarrhoea, following the Introduction Diet for a few days will clear the symptoms quickly and permanently usually without needing any medication.

In cases of stubborn constipation, introduce freshly pressed juices earlier in the diet, from stage 2: start from carrot juice first thing in the morning and take your cod liver oil at the same time. The juice will stimulate bile production as many cases of persistent constipation are due to poor bile production. When there is not enough bile, the fats in the food do not digest well; instead they react with salts and form soap in the gut, causing constipation. Removing dairy may also help.

People with food allergies and intolerances should go through the Introduction Diet in order to heal and seal their gut lining. The reason for allergies and food intolerances is so-called “leaky gut” when the gut lining is damaged by abnormal micro flora. Foods do not get the chance to be digested properly before they get absorbed through this damaged wall and cause the immune system to react to them. Many people try to identify, which foods they react to. However, with damaged gut wall they are likely to absorb most of their foods partially digested, which may cause an immediate reaction or a delayed reaction (a day, a few days or even a couple of weeks later). As these reactions overlap with each other, you can never be sure what exactly you are reacting to on any given day. Testing for food allergies is notoriously unreliable: if one had enough resources to test twice a day for two weeks, they would find that they are “allergic” to everything they eat. As long as the gut wall is damaged and stays damaged, you can be juggling your diet forever removing different foods and never get anywhere. From my clinical experience it is best to concentrate on healing the gut wall with the Introduction Diet. Once the gut wall is healed, the foods will be digested properly before being absorbed, which will remove most food intolerances and allergies.

Those without serious digestive problems and food intolerances can move through the Introduction Diet quite quickly. However, please do not be tempted to skip the Introduction Diet and go straight into the Full GAPS Diet, because the Introduction Diet will give your patient the best chance to optimise the healing process in the gut and the rest of the body. I see cases where skipping the Introduction Diet leads to long-term lingering problems, difficult to deal with.

If you have decided to go straight into the Full GAPS Diet, keep in mind that about 85% of everything your patient eats daily should be made out of meats, fish, eggs, fermented dairy and vegetables (some well-cooked, some fermented and some raw). Baking and fruit should be kept out of the diet for a few weeks, and then be limited to snacks between meals and should not replace the main meals. Homemade meat stock, soups, stews and natural fats are not optional – they should be your patient’s staples.

Start the day with a cup of still mineral or filtered water. Give your patient the probiotic. Make sure that the water is warm or room temperature, not cold, as cold will aggravate his or her condition. Only foods listed are allowed: you patient must not have anything else. On the First Stage the most drastic symptoms of abdominal pain, diarrhoea and constipation will quickly subside. If, when you introduce a new food, your patient gets diarrhoea back, pain or any other digestive symptoms then he/she is not ready for that food to be introduced. Wait for a week and try again.

If you suspect a real allergy (which can be dangerous) to any particular food, before introducing it do the Sensitivity Test. Take a drop of the food in question (if the food is solid, mash and mix with a bit of water) and place it on the inside of the wrist of the patient. Do it at bedtime. Let the drop dry on the skin, then let your patient go to sleep. In the morning check the spot: if there is an angry red reaction, then avoid that food for a few weeks, and then try again. If there is no reaction, then go ahead and introduce it gradually starting from a small amount.

First stage:

• Homemade meat or fish stock. Meat and fish stocks provide building blocks for the rapidly growing cells of the gut lining and they have a soothing effect on any areas of inflammation in the gut. That is why they aid digestion and have been known for centuries as healing folk remedies for the digestive tract. Do not use commercially available soup stock granules or bullion cubes, they are highly processed and are full of detrimental ingredients. Chicken stock is particularly gentle on the stomach and is very good to start from. To make good meat stock you need joints, bones, a piece of meat on the bone, a whole chicken, giblets from chicken, goose or duck, whole pigeons, pheasants or other inexpensive meats. It is essential to use bones and joints, as they provide the healing substances, not so much the muscle meats. Ask the butcher to cut in half the large tubular bones, so you can get the bone marrow out of them after cooking. Put the bones, joints and meats into a large pan and fill it up with water, add natural unprocessed salt to your taste at the beginning of cooking and about a teaspoon of black peppercorns, roughly crushed. Bring to boil, cover and simmer on a low heat for 2,5 - 3 hours. You can make fish stock the same way using a whole fish or fish fins, bones and heads. After cooking take the bones and meats out and sieve the stock to remove small bones and pepper corns. Strip off all the soft tissues from the bones as best as you can to later add to soups or encourage your patient to eat all the soft tissues on the bones. Extract the bone marrow out of large tubular bones while they are still warm: to do that bang the bone on a thick wooden chopping board. The gelatinous soft tissues around the bones and the bone marrow provide some of the best healing remedies for the gut lining and the immune system; your patient needs to consume them with every meal. Take off all the soft tissues from fish bones and heads and reserve for adding to soups later. The meat or fish stock will keep well in the fridge for at least 7 days or it can be frozen. Keep giving your patient warm meat stock as a drink all day with his meals and between meals. Do not use microwaves for warming up the stock, use conventional stove (microwaves destroy food). It is very important for your patient to consume all the fat in the stock and off the bones as these fats are essential for the healing process. Add some probiotic food into every cup of stock (the details about introducing probiotic foods follow).

• Homemade soup with your homemade meat or fish stock. Please look for some recipe ideas in the recipe section. Here we will go through some details, specific for the Introduction Diet. Bring some of the meat stock to boil, add chopped or sliced vegetables: onions, carrots, broccoli, leeks, cauliflower, courgettes, marrow, squash, pumpkin, etc. and simmer for 25-35 minutes. You can choose any combination of available vegetables avoiding very fibrous ones, such as all varieties of cabbage and celery. All particularly fibrous parts of vegetables need to be removed, such as skin and seeds on pumpkins, marrows and squashes, stock of broccoli and cauliflower and any other parts that look too fibrous. Cook the vegetables well, so they are really soft. When vegetables are well cooked, add 1-2 tablespoons of chopped garlic, bring to boil and turn the heat off. Give your patient this soup with the bone marrow and meats and other soft tissues, which you cut off the bones. You can blend the soup using a soup blender or serve it as it is. Add some probiotic food into every bowl of soup (the detail about introducing probiotic foods follow). Your patient should eat these soups with boiled meat and other soft tissues off the bones as often as he/she wants to all day.

• Probiotic foods are essential to introduce right from the beginning. These can be dairy - based or vegetable - based. To avoid any reactions introduce probiotic foods gradually, starting from 1-2 teaspoons a day for 2-5 days, then 3-4 teaspoons a day for 2-5 days and so on until you can add a few teaspoons of the probiotic food into every cup of meat stock and every bowl of soup. Start adding juice from your homemade sauerkraut, fermented vegetables or vegetable medley (please look in the recipe section) into cups of meat stock (do not add the vegetables themselves yet, as they are too fibrous). These juices will help to restore normal stomach acid production. Make sure that the food is not too hot when adding the probiotic foods, as the heat would destroy the beneficial probiotic bacteria. In my experience a large percentage of GAPS people can tolerate well-fermented homemade whey and yoghurt right from the beginning. However, some cannot. So, before introducing dairy, do the sensitivity test. If there is no reaction on the sensitivity test, then try to introduce some whey from dripping your homemade yoghurt (dripping will remove many dairy proteins): start from 1 teaspoon of whey added to the soup or meat stock. After 3-5 days on 1 teaspoon of whey per day, increase to 2 teaspoons a day and so on, until your patient is having ½ a cup of whey per day with meals. At this stage try to add 1 teaspoon per day of homemade yoghurt (without dripping), gradually increasing the daily amount. After yoghurt introduce homemade kefir. Kefir is far more aggressive than yoghurt and usually creates a more pronounced “die-off reaction”. That is why I recommend introducing yoghurt first before starting on kefir. If your patient had no reaction to yoghurt, then you may be able to introduce kefir almost from the beginning. For those who clearly react to dairy, please look at p.95 in my book.

• Ginger tea, mint or camomile tea with a little honey between meals. Most people know how to make mint or camomile tea. To make ginger tea, grate some fresh ginger root (about a teaspoonful) into your teapot and pour some boiling water over it, cover and leave for 3 - 5 min. Pour through a small sieve.

In extreme cases of profuse watery diarrhoea exclude vegetables. Let your patient drink warm meat stock with probiotic foods (preferably whey or yoghurt), eat well-cooked gelatinous meats (which you made the stock with) and consider adding raw egg yolks gradually. Do not introduce vegetables until the diarrhoea starts settling down. When the gut wall is severely inflamed, no amount of fibre can be tolerated. That is why you do not rush to introduce vegetables (even very well-cooked).

Second stage:

• Keep giving your patient the soups with bone marrow, boiled meats or fish and other soft tissues off the bones (particularly gelatinous and fatty parts). He or she should keep drinking the meat stock and ginger tea. Keep adding some probiotic food into every cup of meat stock and every bowl of soup: juices from sauerkraut, juices from fermented vegetables or vegetable medley, and/or homemade whey/yoghurt.

• Add raw organic egg yolks. It is best to have egg yolks raw added to every bowl of soup and every cup of meat stock. Start from 1 egg yolk a day and gradually increase until your patient has an egg yolk with every bowl of soup. When egg yolks are well tolerated add soft-boiled eggs to the soups (the whites cooked and the yolks still runny). If you have any concerns about egg allergy, do the sensitivity test first. There is no need to limit number of egg yolks per day, as they absorb quickly almost without needing any digestion and will provide your patient with wonderful and most needed nutrition. Get your eggs from the source you trust: fresh, free range and organic.

• Add stews and casseroles made with meats and vegetables. Avoid spices at this stage, just make the stew with salt and fresh herbs (look for a recipe of Italian Casserole in the recipe section). The fat content of these meals must be quite high: the more fresh animal fats your patient consumes, the quicker he or she will recover. Add some probiotic food into every serving.

• Increase the daily amount of homemade yoghurt or kefir, if introduced. Increase the amount of juice from sauerkraut, fermented vegetables or vegetable medley.

• Introduce fermented fish, starting from one piece a day and gradually increasing. Look for the recipes in the recipe section.

• Introduce homemade ghee, starting from 1 teaspoon a day and gradually increasing.

Third stage:

• Carry on with the previous foods.

• Add ripe avocado mashed into soups, starting from 1-3 teaspoons and gradually increasing the amount.

• Add pancakes, starting from one pancake a day and gradually increasing the amount. Make these pancakes with three ingredients: 1) organic nut butter (almond, walnut, peanut, etc); 2) eggs; 3) a piece of fresh winter squash, marrow or courgette (peeled, de-seeded and well blended in a food processor). Gently fry small thin pancakes using ghee, goose fat or duck fat, make sure not to burn them.

• Egg gently fried or scrambled with plenty of ghee, goose fat or duck fat. Serve it with avocado (if well tolerated) and cooked vegetables. Cooked onion is particularly good for the digestive system and the immune system: melt 3 tablespoons of duck fat or ghee in the pan, add sliced large white onion, cover and cook for 20-30 minutes on low heat until soft, sweet and translucent.

• Introduce the sauerkraut and your fermented vegetables (your patient has been drinking the juices from them for a while now). Start from a small amount, gradually increasing to 1-2 tablespoons of sauerkraut or fermented vegetables per every meal.

Fourth stage:

• Carry on with the previous foods.

• Gradually add meats cooked by roasting and grilling (but not barbecued or fried yet). Avoid bits, which are burned or too brown. Let your patient eat the meat with cooked vegetables and sauerkraut (or other fermented vegetables).

• Start adding cold pressed olive oil to the meals, starting from a few drops per meal and gradually increasing the amount to 1-2 tablespoons per meal.

• Introduce freshly pressed juices, starting from a few spoonfuls of carrot juice. Make sure that the juice is clear, filter it well. Let your patient drink it slowly or diluted with warm water or mixed with some homemade yoghurt. If well tolerated gradually increase to a full cup a day. When a full cup of carrot juice is well tolerated try to add to it juice from celery, lettuce and fresh mint leaves. Your patient should drink the juice on an empty stomach, so first thing in the morning and middle of afternoon are good times.

• Try to bake bread with ground almonds or any other nuts and seeds ground into flour. The recipe (please look in the recipe section) requires only four ingredients: 1) nut flour; 2) eggs; 3) piece of fresh winter squash, marrow or courgette (peeled, de-seeded and finely sliced); 4) some natural fat (ghee, butter, goose or duck fat) and some salt to taste. Your patient should start from a small piece of bread per day and gradually increase the amount.

Fifth stage:

• If all the previous foods are well tolerated try to add cooked apple as an apple pure: peel and core ripe cooking apples and stew them with a bit of water until soft. When cooked add some ghee to it and mash with a potato masher. If ghee has not been introduced yet add duck or goose fat. Start from a few spoonfuls a day. Watch for any reaction. If there is none gradually increase the amount.

• Add raw vegetables starting from softer parts of lettuce and peeled cucumber. Watch your patient’s stool. Again start from a small amount and gradually increase if well tolerated. After those two vegetables are well tolerated gradually add other raw vegetables: carrot, tomato, onion, cabbage, etc.

• If the juice made from carrot, celery, lettuce and mint is well tolerated, start adding fruit to it: apple, pineapple and mango. Avoid citrus fruit at this stage.

Sixth stage:

• If all the introduced foods are well tolerated try some peeled raw apple. Gradually introduce raw fruit and more honey.

• Gradually introduce baking cakes and other sweet things allowed on the diet. Use dried fruit as a sweetener in the baking.

As I mentioned before, your patient may be able to move through the Introduction Diet faster or slower depending on the stool changes: let the diarrhoea start clearing before moving to the next stage. You may have to introduce some foods later than in this programme depending on his/her sensitivities. Make sure that you carry on with the soups and meat stock after your patient completed the Introduction Diet at least once a day.

After the Introduction Diet is completed and when your patient has more or less normal stools move into the Full GAPS Diet.

Your patient needs to carry on completely avoiding starches and sugar for two years at least. It means avoiding all grains, sugar, potatoes, parsnips, yams, sweet potato and anything made out of them. The flour in your cooking and baking can be replaced with ground almonds (or any other nuts or sunflower or pumpkin seeds ground into flour). In about 1 - 1.5 years you may be able to introduce new potatoes, fermented buckwheat, millet and quinoa, starting from very small amounts and observing any reaction. Wheat, sugar, processed foods and all additives will have to be out of the diet for much longer.

Slowly increase the amounts of fermented foods. You can ferment vegetables, fruit, milk and fish (please look in the recipe section). I would also recommend reading a wonderful book by Sally Fallon “Nourishing Traditions”, it will provide you with a lot of good recipes. Eating fermented foods with every meal will help your patient to digest the meal without using supplements of digestive enzymes. Make sure to introduce all new fermented foods into the diet very gradually starting from 1-2 teaspoons a day.

The best foods for the GAPS person are eggs, meats and fish (bought fresh or frozen, not smoked or canned, and cooked at home), shellfish, fresh vegetables and fruit, nuts and seeds, garlic and olive oil. As well as eating the vegetables cooked it is important to have them raw in the form of salads and sticks. In this form they will provide your patient with valuable enzymes and detoxifying substances, which will help in digesting meats. Raw fruit should be eaten on their own, not with meals, as they have a very different digestion pattern and can make the work harder for the stomach. At that stage let your patient to have fruit as a snack between meals. Remember, that about 85% of everything your patient eats on a daily basis should be savoury - made out of meats, fish, eggs, vegetables and natural fats. Sweet baking and fruit should be snacks between meals in limited amounts.

It is very important for a GAPS person to have plenty of natural fats in every meal from meats, butter, ghee, coconut and cold pressed olive oil. The fat content of the meal will regulate the blood sugar level and control cravings for carbohydrates.

If your patient gets a tummy bug or any other form of diarrhoea go back to the low fibre diet for a few days: remove all nuts, raw vegetables and raw fruit out of the diet; go back to meats cooked in water and meat stock, fish, eggs, fermented dairy and cooked vegetables (skinned, de-seeded and well cooked with meats as soups and stews) until diarrhoea completely clears. After the stools stay normal for a week introduce raw vegetables slowly, one at a time and starting from small amounts. When vegetables are introduced, try to introduce nuts, seeds and fruit gradually.

It is important for your GAPS patient to balance the meals so that his or her body pH stays normal. All protein foods, such as meats, fish, eggs and cheese leave an acid ash in the body, which may aggravate his or her condition. Vegetables are alkalising, so you need to combine meats, fish and eggs with good amount of vegetables cooked and/or raw. Raw fruit, vegetables and greens have particularly strong alkalising ability. Apple cider vinegar is very alkalising, it is good to have it every day: just add one teaspoon of cider vinegar into every glass of water your patient drinks. Hot water with cider vinegar will makes an excellent warming and alkalising drink. Fermented foods are also alkalising.

It is very important to avoid processed foods (any packet or tinned foods). They are stripped from most nutrients that were present in the fresh ingredients used for making these foods. They are a hard work for the digestive system and they damage the healthy gut flora balance. On top of that they usually contain a lot of artificial chemicals, detrimental to health, like preservatives, colorants, E-numbers, etc. Try to buy foods in the form that nature made them, as fresh as possible.

Do not use a microwave oven, as it destroys food. Cook and warm up food using conventional oven and stove.

Foods to avoid:

• Sugar and anything that contains it.

• Molasses, maple syrup, corn syrup, any other syrup.

• Aspartame in any form, it is a potent neurotoxin (brain toxin).

• Sweets, cakes, biscuits, chocolates, ice – creams.

• All alcoholic beverages. An adult can have good quality wine with meals occasionally but not beer or spirits.

• Tinned and processed foods, always read the ingredients label, beware of sugar, lactose, maltose, starch, corn flour, preservatives, flavourings, colours, yeast. It is best not to buy processed foods at all.

• Grains: rice, corn, rye, oats, wheat and anything made of wheat flour (breads, pasta, biscuits, cakes and anything from the bakery, anything with bread crumbs or batter), buckwheat, quinoa, millet, couscous, spelt, semolina, tapioca, etc. After about 1 – 1.5 years you may be able to slowly re-introduce buckwheat, millet and quinoa (fermented to start with), but not wheat, rye or rice.

• Breakfast cereals are highly processed products with virtually no nutritional value, they are full of sugar, salt, trans-fatty acids and other harmful substances. They should be out of the diet forever.

• Starchy vegetables and anything made out of them: potato, parsnips, yams, Jerusalem artichoke and sweet potato. In about 1 - 1.5 years you may be able to introduce new potatoes.

• Milk should be out at this stage. However, the GAPS person can have soured milk products, such as natural hard cheese, live natural yoghurt and kefir, crème fresh or soured cream, butter and ghee. There are many substances in milk, which could cause trouble, such as milk sugar lactose, casein, immune complexes, etc. Soured milk products do not contain lactose and are pre-digested by the fermenting microbes, which makes fermented milk products very easy to digest for us. I would recommend using only organic milk products and introduce them one at a time, starting from small amounts. If you were not able to introduce any dairy in the Introduction Diet, then please look at page 95 in the GAPS book, it will explain how to introduce dairy safely. If you have introduced homemade yoghurt, kefir and ghee as a part of the Introduction Diet, then gradually introduce fermented cream and butter. When that is well tolerated try natural mature cheeses. You may want to try goat’s or sheep’s milk products first as they are often better tolerated by the GAPS people, than cow’s. In about 1,5 -2,5 years and when all fermented dairy products are introduced, your patient may be able to drink raw unpasteurised organic milk. Introduce it gradually starting from 1-2 teaspoons a day. A GAPS person must never have pasteurised milk!

• Fruit juices apart from freshly pressed. Unfortunately fruit juices (not freshly pressed by you) are a source of processed sugars and can contain a lot of fungi and moulds in them, which your GAPS patient might react to.

• Beans and pulses are generally hard to digest. The two varieties that your patient can have are white (navy) beans also called haricot beans, fermented and cooked at home, and fresh green beans. Commercially available baked beans have almost 40% sugar and should be avoided. You can make your own baked beans at home (please, look in the recipe section).

• Coffee is a strong irritant for the digestive tract, try to avoid it. Strong tea is not advisable either. Natural herbal teas (no flavourings added) and ginger tea are fine. Ginger tea is a well-known folk remedy for digestive problems.

• Soft drinks are not allowed at all, they are full of sugar and various chemicals, which are very damaging for GAPS people.

• Anything with colours, preservatives, flavourings and other chemicals.

• Soya and anything made out of it. It interferes with thyroid function in the body and negatively affects hormonal balance, as it contains oestrogen – like compounds. It is important to avoid all synthetic oestogens, such as from soya, contraceptive pill, many other drugs, domestic cleaning chemicals, laundry detergents, toiletries, etc.

Recommended foods:

• Buy fresh or frozen meats, fish and shellfish. Make sure that they are not smoked, salted or preserved in any other way. Your patient needs to have gelatinous meats every single day (meats around bones and joints, skin and brown meats on the poultry). It is important for him or her to have all the fats on the meat, eating lean muscle meats will not be good for GAPS.

• Liver and other organ meats should be eaten on a regular basis. They can be cooked any way you like. It is very nourishing and is the best remedy for many nutritional deficiencies.
• Eggs - the yolk is best eaten raw, the white should be slightly cooked, like for example in soft boiled or fried eggs. Make sure that you find good quality eggs, free-range organic eggs are the best. Your patient should have minimum 2-3 eggs a day as they are particularly good for restoring neurological functions.

• Fresh vegetables – all types of vegetables are recommended, apart from starchy vegetables, like potatoes, parsnips, sweet potato, Jerusalem artichokes and yams. You can cook vegetables by steaming them, stewing, roasting, grilling or stir-frying. It is particularly good to eat them as a homemade soup or stew with plenty of garlic, added at the end of cooking. Your patient should have plenty of cooked vegetables with every meal, as they are better digested than raw vegetables and are more nourishing. It is also important to have fermented and raw vegetables with every meal in a form of salads with olive oil and fresh lemon juice or as a snack. Raw and fermented vegetables will help in digesting proteins and detoxifying. However if your patient gets diarrhoea then cook all vegetables until diarrhoea clears.

• Fresh fruit. It is important that the fruit should be ripe. After completing the Introduction Diet introduce local seasonal ripe fruit gradually. At that stage start your patient’s day from a bit of fruit and offer some fruit between meals. He or she should not have fruit if there is diarrhoea. When the diarrhoea has cleared he or she can start from having cooked fruit (peeled, de-seeded and well cooked with a good dollop of butter, ghee or coconut oil) and then raw, introduced slowly.

• Avocado is a wonderfully nutritious fruit. Make sure it is ripe and serve it with meats, fish, shellfish and salads.

• Butter is better than any so-called healthy substitutes. You can cook with it or add it into ready dishes. Butter should be bought organic and unsalted, because non-organic butter contains a lot of pesticides and antibiotics, which the cows consume. Cold pressed virgin olive oil is very good for your patient, use it in salads and ready dishes liberally. It is not a good idea to cook with olive oil because it changes its chemical structure when heated. Frying is best done with animal fats: pork dripping, lard, lamb fat, goose fat, duck fat, ghee and butter. Coconut oil and palm oil are two plant oils, very good to use for cooking. These fats do not alter their structure during cooking. They can even be re-used. Collect your own fats after roasting meats. Avoid all common vegetable cooking oils, margarines and other processed fats: they are very harmful to health.

• Nuts and seeds are a wonderful source of very good nutrients. Nuts should be bought just shelled – not salted, roasted, coated or processed in any other way. This way they are an excellent source of essential fatty acids and many nutrients. However, nuts and seeds contain enzyme inhibitors, which may make them difficult to digest for some people. If you feel that it is a problem for your patient, as soon as you bought nuts to remove the enzyme inhibitors try to do the following: soak the nuts in salty water over night (1 tablespoon of sea salt per litre of water), in the morning drain them, rinse the salt off and dry in your oven at the temperature 50C for 3-24 hours (keep checking them as different nuts take different time to dry). Your patient can also eat nuts and seeds straight after soaking without drying them. Once they are dried keep them in an airtight container or well-sealed plastic bag. They become nice and crunchy and make an excellent snack food together with dried fruit. You can grind nuts and seeds (sunflower and pumpkin) into flour consistency to make bread, pancakes and even cakes at home. My book will provide you with recipes. Ground almonds or almond flour is available in health food shops.

• If your child would like to have a milk-like drink, nut/seed milk can replace all other milk while you are gradually introducing dairy. You can use almonds, sunflower seeds, sesame seeds and pine nuts to make milk. Blanched almonds make the best milk. You can add a teaspoon of flax seeds to make the milk thicker. Soak a cup of almonds in water for 12 - 24 hours, drain. Blend in a food processor with water: for 1 cup of nuts/seeds add 1-2 cups of water. A good juicer will crash the nuts/seeds well, making a paste, which you would blend with water. Mix well and strain through cheesecloth or a fine strainer and you have got milk. You can add some soaked dates or raisins, when blending, they will make the milk sweet. If you find that the milk is too rich, just add more water. You can add some of freshly pressed apple juice or carrot juice into it to make a very tasty and nourishing drink for your child. You can “milk” the same cup of almonds a few times. Just keep the paste covered with water in the refrigerator.

• You can also make coconut milk. Bring to boil (but do not boil) 1 cup of unsweetened shredded dried coconut and 1 cup of water. Cool down and blend well in your food processor. Strain through cheesecloth or a fine strainer.

• It is better to replace the table salt in your patient’s diet with unprocessed salt. The salt, which is sold in shops has been processed to remove all natural minerals apart from the NaCl. The human body needs all those minerals, that is why we must consume natural unprocessed salt. You can get very good quality sea salt called Celtic Salt or a Himalayan Crystal Salt.

• Garlic is very important to eat every day. It will help to normalise your patient’s gut flora and stimulate the immune system. It is important to have it raw with meats or cooked as a part of the meal. Work on using a whole head of garlic every day (not just a few cloves).

• Unprocessed honey is the only sweetener allowed (in baking it is better to use dried fruit as a sweetener). Locally produced honey is usually the most reliable.

For a full alphabetic list of foods to avoid and recommended foods, please look in the GAPS book.

Start the day with a glass of still mineral or filtered water with a slice of lemon. It can be warm or cool to personal preference. Have half a cup of homemade yoghurt or kefir.
Instead of drinking water and yoghurt/kefir separately, you can make a refreshing drink: mix well half a cup of yoghurt/kefir and half a cup water and drink first thing in he morning.

If you have a juicer your patient can start the day with a glass of freshly pressed fruit/vegetable juice diluted with water.
You can make all sorts of juice mixes, but generally try to have 50% of therapeutic ingredients: carrot, small amount of beetroot (no more than 5% of the juice mixture), celery, cabbage, lettuce, greens (spinach, parsley, dill, basil, fresh nettle leaves, beet tops, carrot tops), white and red cabbage, and 50% of some tasty ingredients to disguise the taste of therapeutic ingredients: pineapple, apple, orange, grapefruit, grapes, mango, etc. Your patient can have these juices as they are, with some yoghurt/kefir or diluted with water.

Every day our bodies go through a 24 hour cycle of activity and rest, feeding and cleaning up (detoxifying). From about 4am till about 10am the body is in the cleaning up or detoxification mode. That is why many of us do not feel hungry first thing in the morning. Drinking water, yoghurt/kefir and freshly pressed juices will assist in this process. Loading the body with food at that time interferes with the detoxification. It is better to have breakfast around 10am when your body has completed the detox stage and is ready for feeding. At that stage we usually start feeling hungry, which is the body’s way of letting you know that the detoxification is finished. Children may be ready for their breakfast much earlier than adults.

Breakfast choices

• A variation of English breakfast: eggs cooked to personal liking and served with sausages and vegetables, some cooked, some fresh as a salad (tomato, cucumber, onions, celery, any fresh salad greens, etc.) and/or avocado and/or meat. The yolks are best uncooked and the whites - cooked. Use plenty of cold pressed olive oil as a dressing on the salad and eggs. Mix a tablespoon of pre-soaked or sprouted sunflower and/or sesame and/or pumpkin seeds with the salad. Sausages (full fat) should be made of pure minced meat (full fat!) with only salt and pepper added (any fresh vegetables or herbs also can be added to the mixture). Make sure that there are no commercial seasoning or MSG (Monosodium Glutamate) in the sausages. I recommend finding a local butcher, who would make pure meat sausages for you on order.
• Avocado with meat leftovers, fish or shellfish, vegetables raw and cooked, lemon and cold pressed olive oil. Serve a cup of warm meat stock as a drink with food. Don’t forget to add some probiotic food.
• Pancakes made with nuts ground into flour are nice to have on the weekends, when you have more time for cooking in the morning. These pancakes are delicious with some butter, sour cream with honey, or as a savoury snack. If you blend some fresh of defrosted berries with honey, it will make a delicious jam to have with pancakes. Weak tea with lemon, ginger tea or mint tea.

Lunch

• Homemade vegetable soup or stew in a homemade meat stock.
• Avocado with meat, fish, shellfish and raw or/and cooked vegetables. Use olive oil with some lemon squeezed over it as a dressing. Serve a cup of warm homemade meat stock as a drink with some yoghurt/kefir.
• Any meat/fish dish with vegetables.

Dinner

One of the dishes from the lunch or breakfast choice.
After dinner half a cup of yoghurt or kefir.

 

The strict GAPS diet should be adhered to for at least 1.5 – 2 years. Depending on the severity of the condition, some people recover quicker, others take much longer. Your patient needs to have at least 6 months of normal digestion before you start introducing foods not allowed on the GAPS diet. Do not rush with this step.
The first foods you will be able to introduce are new potatoes and fermented gluten-free grains (buckwheat, millet and quinoa). The recipe section will explain how to ferment grains.

Introduce one food at a time and always start from a small amount: give your patient a small portion of the new food and watch for any reaction for 2-3 days. If there are no digestive problems returning, or any other typical for your patient symptoms, then in a few days try another portion. If there are no reactions, gradually increase the amount of the food. These are starchy foods, so do not forget to serve them with good amounts of fat (butter, olive oil, any animal fat, coconut oil, etc.) to slow down the digestion of starch. Do not rush with the introduction of these new foods, it may take several months to do it properly.

Once new potatoes and fermented grains are introduced, try to make sourdough with good quality wheat or rye flour. You can make pancakes or bread with the sourdough. I would recommend a wonderful book by Sally Fallon “Nourishing Traditions” for a wealth of recipes. Once sourdough is well-tolerated you may be able to buy commercially available good quality sourdough breads.
At that stage you may find that your patient can digest buckwheat, millet and quinoa without fermenting them prior to cooking. Gradually you will find that you can introduce various starchy vegetables, grains and beans.

YOUR PATIENT WILL NEVER BE ABLE TO GO BACK TO THE TYPICAL MODERN DIET FULL OF SUGAR, ARTIFICIAL AND PROCESSED INGREDIENTS AND OTHER HARMFUL FOODS. USE THE YEARS OF FOLLOWING GAPS NUTRITIONAL PROTOCOL FOR DEVELOPING HEALTHY EATING HABITS FOR THE REST OF YOUR LIFE !

In conclusion:

At the first glance the GAPS diet appears to be very hard work. However, it is a very wholesome and healthy diet and will allow your patient to heal and seal the gut lining and lay a strong foundation for good health for the rest of his or her life. It means that majority of GAPS people do not have to adhere to a special diet for the rest of their lives: once the digestive system starts functioning normally, they can gradually introduce most wholesome foods commonly eaten around the world. Some people achieve this target in 2 years, some take longer – it depends on the severity of the condition and the age of the person: children generally recover quicker than adults.
Once introduced, the GAPS diet is no more difficult than any normal cooking and feeding the family. And shopping is very simple: just buy everything fresh and unprocessed. Reading the GAPS book will provide you with essential information and many recipes.

Good luck!


GAPS 飲食

GAPS 飲食 - 飲食幫助有學習障礙、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

這個網站不是被設計用來取代 GAPS 書籍，這網站只是作為一個附加的信息來源。請您先讀 GAPS 書了解如何 (How) 以及為什麼 (Why) 要這麼安排日常飲食，為什麼對 GAPS 患者而言其他的飲食是不適當的，以及如何正確地實踐適當的飲食。

GAPS 飲食是基於 SCD (the Specific Carbohydrate Diet, 指定的碳水化合物飲食)。SCD 是二十世紀初美國著名小兒科醫生哈斯 (Dr. Sidney Valentine Haas) 發明。哈斯醫生和他的同事們花了很多年時間來研究飲食對乳糜瀉和其它消化系統疾病的影響，這項研究的結果發表在哈斯醫生與 Merrill P. Haas 在 1951 年合著的一本全面的醫學教科書裡，書名 The Management of Celiac Disease (乳糜瀉的管理)。書中所描述的飲食已被全世界的醫學界當作一種治療乳糜瀉 (celiac disease) 的方法，並且，哈斯醫生也因這個創舉在兒科領域獲得榮耀。不幸的是，當乳糜瀉被定義為一個麩質不耐症 (gluten intolerance) 或麩質腸病 (gluten enteropathy)，SCD 就被當成了一個過時資訊而被遺忘。後來，SCD 被 Elaine Gottschall 帶回到生活裡，Elaine Gottschall 的女兒依循 SCD 成功了，數年來，Elaine Gottschall 幫助了數以千計罹患克羅恩病
(Crohn's disease)，潰瘍性結腸炎 (ulcerative colitis)，乳糜瀉 (celiac disease)，憩室炎 (diverticulitis) 和各種慢性腹瀉，但最引人注目的是，她年幼的孩子除了消化問題康復，其它如自閉症 (autism)、多動症 (hyperactivity) 、夜驚 (night terrors) 等嚴重的行為異常也一併康復了。她花了數年研究生化和生物學基礎飲食並且出版了一本書，書名  “Breaking the Vicious Cycle. Intestinal Health Trough Diet. (打破惡性循環，腸道健康從日常飲食開始)”。

多年來，我在我的診所落實 SCD，積累了寶貴的臨床經驗，我不得不為我的神經和精神疾病患者的飲食作出一些調整。這些年來，我的病人命名我給他們的飲食方式為 GAPS 飲食。

實施 GAPS 飲食

1. 飲食簡介

2. 具典型菜單的 GAPS 飲食

你們有些人會用飲食來治療自己，有些人是為人父母的會試圖用這個方法幫助您的孩子，有些人會使用的飲食幫助所愛的人或朋友。為了涵蓋所有的情況，我以下統一用“你的病人”來稱呼。

我建議大多數的 GAPS 患者在進入全 GAPS 飲食前依循本 GAPS 飲食介紹。根據您病人病情的嚴重程度決定他或她是快還是慢通過這個項目，例如，您可以移出第一階段一兩天然後在第二階段停留較久的時間。

完全地依循本飲食介紹對具有嚴重的消化道症狀如腹瀉、腹痛、腹脹、便秘情況下的病人是必要的，這種飲食會快速地減輕症狀，並開始消化系統的康復過程。即使是健康的人，如果你或你的孩子“胃病”或任何其他形式的腹瀉，只要依循本飲食介紹去做，幾天後即可在不需要任何藥物的情形下清除症狀。

以頑固性便秘來說，在第二階段的飲食裡引進鮮榨果汁：早上起床先來一杯胡蘿蔔汁，同時吞下一粒魚肝油，這果汁可刺激膽汁分泌。許多便秘的情況是肇因於膽汁分泌不佳，當沒有分泌足夠膽汁，食物中的脂肪就不易消化，這些脂肪與鹽類化學反應後以皂的形式堆積在腸道，引起便秘。刪除乳製品可能也有幫助。

有食物過敏和不耐受問題的人應該依本飲食介紹飲食以醫治他們的腸道。食物過敏和不耐受，當腸道襯裡被不正常的微菌群損壞，也被稱為“腸漏 (leaky gut)”。在食物通過損壞的腸道壁並被吸收和引起免疫系統反應之前，它們沒有機會被完全消化。很多人試圖找出他們對哪些食物過敏，然而，因為腸道壁受損，所以他們都是吸收進大多數部分的食物但只消化一部分，這可能會導致一個立即或延遲反應（一天、幾天、或甚至二週後）。由於這些反應相互重疊，你永遠無法知道究竟這個反應是來自於之前哪一天吃下的食物。食物過敏測試是出了名的不可靠的：如果某人有足夠的資源花二個星期時間每天測試二次，他們會發現，他們所吃下的食物全都是“過敏”食物。只要腸壁一直是損壞的，那麼，你就會一直被你的飲食玩弄，去除不同的食物 (偏食)，從不會有任何進展。從我的臨床經驗得知，最好是用改善飲食習慣的方式集中精力醫治腸道壁，等腸道壁康復後，食物被消化後才能被正確地吸收，這將消除大多數食物不耐受和過敏。

那些沒有嚴重的消化問題和食物不耐受問題的人，可以相當快速地瀏覽過本飲食簡介。不過，請別誤會，請勿因此跳過本飲食簡介直接進入全 GAPS 飲食，因為本飲食簡介將給你的病人一個優化腸道和身體其他部位的療程最棒的機會。我看到的情況 (臨床經驗) 是，跳過本飲食簡介會導致很難對付宿疾。

如果你已經決定改邪歸正，回到 GAPS 飲食，那麼請牢記，你的病人每天吃的食物約 85％ 要由肉、魚、蛋、發酵乳製品、和蔬菜（一些是煮熟的、一些是發酵的、一些是生的）。烘烤和水果應停一陣子，然後在幾個星期後，被限制在餐與餐之間，而且不能取代正餐。不可選擇家庭自製醃肉、湯、燉菜、和天然脂肪來吃，這些是你病人的忌食之物。

每天起床後先喝一杯礦泉水或過濾後的水，給你的病人益生菌，確認水是溫暖的或室內溫度，不冷，感冒會加重他的病情。只能吃列出來的食物：你的病人必須沒有其它選擇。在第一階段，最劇烈的腹痛、腹​​瀉、和便秘的症狀很快就會消退。如果，當你介紹一種新的食物時，你的病人再次腹瀉、疼痛、或任何其他消化系統症狀，那麼，他就是還沒準備好，等一個星期後，再試一次。

如果您懷疑任何特定食物造成過敏（可以是危險的），則在導入此特定食物前要做敏感度試驗。取一滴問題內的食物（如果食物是固體，糊狀物和混合一點點水），睡前滴在病人的手腕內側，在睡前做，讓它在皮膚上乾掉，然後讓病人入睡。早上檢查這個點，如果出現憤怒的紅色反應 (angry red reaction)，則避免吃這食物幾週，然後再試一次。如果沒有反應，則繼續前進，逐步少量引進。

第一階段：

•自製的肉類或魚類種群。肉類和魚類提供了快速增長的腸壁細胞的構建塊，在腸道內任何發炎區域，他們有舒緩的作用。這就是為什麼他們幫助消化，已知幾個世紀以來，消化道治療偏方。不要使用市售高湯顆粒或黃金立方體 (bullion cubes)，它們是高度加工的有害成分。雞湯在胃裡特別溫和，對剛導入 GAPS 者來說是非常好的開始。為了烹調出好的肉湯，你需要關節、骨骼、一片連骨肉、一整隻雞、雞或鵝或鴨的內臟、整個鴿子、野雉或其他不貴的肉類。使用骨骼和關節是必要的，因為它們提供了癒合的物質，沒有那麼多的肌肉。你可以要肉店老闆 (butcher) 削減一半的大型管狀骨，如此你可以在烹煮後得到骨髓。把骨骼、關節、和肉類放在一大鍋裡，填滿水，在烹調開始時依需要加入適量天然未加工的鹽，約一茶匙黑胡椒，粗粉碎。煮滾後，蓋上鍋蓋，燜低熱約二小時半到三小時。您可以魚群全魚或魚鰭、骨頭、和魚頭用相同的方式烹調。烹調後拿起骨頭和肉，去掉小骨頭和胡椒粒，篩出魚湯。盡你可能地從骨頭上剝下所有的軟組織，稍後添加至湯給病人吃或鼓勵病人吃骨頭上的軟組織。當它們還溫熱時，提取大型管狀骨的骨髓：在厚木砧板上剁開骨骼。骨頭周圍的膠狀軟組織和裡面的骨髓提供了人體腸道壁和免疫系統最好的療傷補救措施; 你的病人需要每餐攝取。取下所有的魚骨和魚頭上的軟組織保存起來以便等下加到湯裡。您可把肉湯或魚湯放在冰箱裡至少七天或冷凍。持續給病人用餐時喝溫熱肉湯或餐與餐之間喝。不要使用微波爐加熱肉湯，要使用傳統的爐灶（微波破壞食品）。對你的病人來說，喝掉湯裡的脂肪和吃掉骨頭上的脂肪是必要的而且非常重要，這些脂肪是癒合過程中是不可缺少的。添加一些益生菌食品到每一杯湯（引入益生菌食品的詳細作法如下）。

•用自製的肉或魚熬湯。請在烹飪階段尋找一些烹飪方法。在此，我們將透過一些詳細介紹具體地介紹飲食。把肉湯煮沸，加入切碎或切片的蔬菜：蔥、胡蘿蔔、西蘭花、韭菜、花菜、西葫蘆、骨髓、瓠果、南瓜等，小火煮25-35分鐘。您可以平均一下各個蔬菜組合以避免某組合纖維過多，例如所有品種的圓白菜和芹菜的任意組合。刪除蔬菜上特別粗的纖維，例如南瓜皮和南瓜籽，瓠果的心，西蘭花和花菜較老的部分。煮熟蔬菜，他們真的很軟。完全煮熟蔬菜後，加一到二湯匙切碎的大蒜，煮滾，轉熱。給你的病人的喝肉湯，肉湯裡要有你切斷的骨頭骨髓、肉、和軟組織。您可用湯攪拌器攪拌湯。添加一些益生菌食品到每碗湯（引入益生菌食品的詳細作法如下）。你的病人應經常喝完這些湯，吃煮骨頭的肉和其他軟組織，因為他整天都需要這些。

•益生菌的食物有必要從一開始就引入，可以是基於奶製品 (dairy-based) 的食品或基於蔬菜 (vegetable-based) 的食品。為了避免引起反應，引入益生菌食物時，要漸進，從每天1-2茶匙，二到五天，然後每天3-4茶匙，二到五天，直到你可以添加幾茶匙的益生菌食品到每杯或每碗肉湯。添加果汁於自製泡菜、發酵蔬菜、或蔬菜混合（請看看配方中的部分）、肉湯（不加蔬菜本身，因為他們纖維太粗）。這些果汁有助於恢復正常的胃酸生產。確認是否在食物太熱時加入益生菌食品，太熱會破壞這些益生菌。從我的經驗上看，大多數 GAPS 人可接受一開始就食用自製的發酵乳清和優格 (yoghurt) ，有些不能。所以，在引進乳製品前需要做敏感性試驗。如果不會敏感，才嘗試引進一些自製的乳清和優格（滴水將消除許多乳蛋白），把乳清加到湯或肉湯裡，從一茶匙起。每天一茶匙乳清，經過三到五天，增加至二茶匙，直到你的病人每天可以喝加有半杯乳清的湯。在這個階段，試著每天加一茶匙到自製優格裡（不滴水），逐漸增加每日的量。引進優格後接著是引進克菲爾 (Kefir)，克菲爾比優格強烈，通常會產生更明顯的 “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才引入克菲爾。如果您的病人吃優格沒反應，那麼你可以在開始時一併引入克菲爾。對於那些對乳製品有明顯反應，請看我寫的書，第95頁。

•在兩餐之間喝點薑茶、薄荷茶、或加一點點蜂蜜的甘菊茶。大多數人都知道如何製作薄荷茶或甘菊茶。為了製作薑茶，磨碎一些新鮮的薑根（約一茶匙）放到茶壺，倒些開水，蓋上鍋蓋，等3 - 5分鐘，用小篩子過濾。

若遇腹瀉這種極端情形，可讓病人喝溫肉湯加益生菌食物（最好是乳清或優格），吃精心烹製的凝膠狀肉（您煮的湯），並考慮逐步加入生雞蛋的蛋黃。不要引入蔬菜，直到腹瀉緩和下來始可加入。當腸道壁嚴重發炎時，無法忍受大量的纖維。這就是為什麼你不要急於引進蔬菜（甚至是您精心烹製的蔬菜）。

第二階段：

•持續給你的病人帶骨髓的煮熟的肉類或魚類及其他帶軟組織的骨骼（尤其是膠質和脂肪）的肉湯。病人應該持續喝肉湯和薑茶。持續加入益生菌食物到下列每一杯或每一碗湯：酸菜湯、發酵蔬菜或綜合蔬菜湯、自製的乳清或優格。

•添加未加工的有機蛋黃 (raw organic egg yolks)。把原始蛋黃原料添加到每碗湯和每杯肉湯，從每天一個蛋黃開始，逐漸增加，直至病人每碗湯都有蛋黃。當病人對蛋黃的耐受​​性良好，可吃水煮蛋湯（蛋黃還可流動的那種）。如果您覺得您對雞蛋可能過敏，可先做敏感度試驗。沒有必要限制每天食用蛋黃的數量，因為他們幾乎不需要任何消化即可快速地吸收，提供病人最棒的所需的營養。購買來源可信賴的雞蛋：新鮮的、自由放養的、有機的雞蛋。

•添加燉肉和燉蔬菜。此階段勿放調味料，您只需用鹽和新鮮香草（請參閱一個意大利砂鍋烹飪法）去燉。這些食物中的脂肪含量是相當高的：您的病人消耗越多越新鮮的動物脂肪，則您的病人恢復得就越快。給每份食物添加一些益生菌。

•如果已引入自製優格或克菲爾，則每日增加優格量或克菲爾量。增加酸菜湯、發酵蔬菜、或綜合蔬菜的量。

•引入發酵的魚，從一塊開始，每天逐漸增加。請參閱看的食譜配方中的部分。

•引入自製的酥油 (ghee)，從每天一茶匙起，逐漸增加。

第三階段：

•持續進行前面階段的各項食物。

•添加成熟的酪梨 (avocado) 搗碎加入湯裡，從一到三茶匙開始，逐漸增加量。

•添加煎餅 (pancake)，從每天一片煎餅開始，逐漸增加量。這些煎餅需具備三個要素：1）有機奶油堅果（杏仁，核桃，花生等）; 2）雞蛋; 3）一塊新鮮冬瓜 (winter squash)、內饀或綠皮胡瓜（去皮去籽放入食物容器內攪拌均勻）。用酥油、鵝油、或鴨油輕輕炒小薄煎餅，注意不要燒焦。

•用酥油 (ghee)、鵝油、或鴨油的脂肪輕炸或輕炒雞蛋，並伴以酪梨和煮熟的蔬菜一起料理（如果耐受性很好）。熟洋蔥對消化系統和免疫系統特別地好：在鍋裡融化三湯匙 (tablespoon) 的鴨油或酥油，加入切片的大型白洋蔥，覆蓋，煮20-30分鐘的低熱烹調，直到變軟、甜的、和半透明狀。

•引入酸菜和發酵蔬菜（您的病人已經喝果汁一段時間了）。從少量開始，逐漸增加至每餐一到二湯匙的酸菜或發酵蔬菜。

第四階段：

•持續進行前面階段的各項食物。

•逐漸增加用烘烤和燒烤（但不是烤或炸）熟的肉類，去掉燒焦或太褐色的部份。讓你的病人吃加入煮熟的蔬菜和酸菜（或其他發酵蔬菜）的肉。

•開始加入冷壓 (cold pressed) 橄欖油到膳食裡，從每餐幾滴開始逐漸增加量到每餐一到二湯匙 (tablespoon)。

•引入新鮮冷壓果汁，從幾匙胡蘿蔔汁開始，確認果汁是過濾清澈的。喝的時候，可用溫水稀釋或混合的自製優格，給病人慢慢地喝，如果病人耐受性很好，則逐漸提高到每天一杯。當病人對滿杯胡蘿蔔汁耐受性很好時，可嘗試添加芹菜汁、萵苣汁、和新鮮薄荷汁。您的病人應於空腹時喝果汁，上午第一件事和下午中間第一件事是病人的美好時光 (享用果菜汁)。

•嘗試烘焙具磨碎杏仁的麵包，也可用其他磨碎的堅果和種子。配方（請參閱書裡的配方）只要求四個要素：1）堅果粉; 2）雞蛋; 3）一塊新鮮冬瓜 (winter squash)、內饀或綠皮胡瓜（去皮去籽切成薄片）; 4）一些天然脂肪（起酥油，黃油，鵝或鴨的脂肪）和一些鹽調味。給病人每天一小片麵包，逐漸加量。

第五階段：

•如果病人對前面各階段所有的食物的耐受性都良好，則可嘗試加入熟蘋果 (cooked apple) 當作純蘋果 (an apple pure)：削去果皮和核心，放一點點水烹飪，直到變軟。煮熟後，加一些酥油和搗碎的馬鈴薯泥。如果病人還沒引入酥油，則可改用鴨油或鵝油。從每天幾匙開始，觀察病人的反應，如果沒有不良反應，則逐漸增加量。

•加入生蔬菜 (raw vegetables)，從萵苣柔軟的部分和黃瓜去皮開始。觀察病人的糞便，如果耐受性良好，則從少量開始，逐漸增加量。這病人對這兩種蔬菜的耐受性都良好，則逐步添加其他生蔬菜：胡蘿蔔、蕃茄、洋蔥、大白菜等。

•如果病人對胡蘿蔔汁、芹菜汁、萵苣汁、薄荷汁的耐受性不錯，則開始添加水果：蘋果、鳳梨、和芒果。在這個階段，避免柑橘類水果。

第六階段：

•如果病人對以上所有引入的食物耐受性良好，則嘗試吃一些去皮的新鮮蘋果，逐步引入原水果和蜂蜜。

•逐步引入烘焙蛋糕以及可加入的甜東西。例如，在焙培時，用乾燥水果取代糖。

正如我之前提到的，您的病人可以根據大便性狀的改變判斷應較快還是較慢地通過以上各飲食階段：在移到下一階段前，讓腹瀉開始清除。您可能需要依病人的敏感度較遲地引入一些食物。請確認您的病人引入飲食後已達到每天至少一次湯和肉湯。

在引入飲食完成而且您病人的排便都正常之後，就可進入全 GAPS 飲食。

您的病人需要至少兩年的時間徹底避免攝取澱粉和糖。這意味著避免所有穀物、糖、馬鈴薯、歐洲防風草、山藥、紅薯以及用這些食材製作出來的食物。您可把烹飪和烘焙的麵粉換成杏仁粉（或其他堅果、葵花子、或南瓜種子磨成的粉）。在導入全 GAPS 飲食約一年到一年半時，你可引入新馬鈴薯、發酵蕎麥、稷（millet, 亦稱小米）、藜麥（quinoa, 亦稱灰米或小小米），從極少量開始，並觀察任何反應。小麥、糖、加工食品以及所有的人工添加劑必須等到導入全 GAPS 飲食更久以後才行。

慢慢地增加發酵食物的量。您可以自製發酵蔬菜、發酵水果、發酵牛奶、發酵魚類（請參閱書裡的配方）。我也建議閱讀由薩莉·法倫 (Sally Fallon) 寫的一本很棒的書，書名 “養生常規 (Nourishing Traditions)”，這本書提供大量的拿手好菜。每餐吃發酵食物可幫助你的病人在不使用消化酶補充物的情況下消化一頓餐。請確認將所有新的發酵食品引入飲食中，從每天一到二茶匙開始。

對 GAPS 病人來說，最好的食物是雞蛋、肉類和魚類（購買新鮮或冷凍的，不要煙燻的或罐頭的，買好後在家裡裡煮）、貝類、新鮮蔬菜和水果、堅果和種子、大蒜和橄欖油。和吃煮熟了的蔬菜一樣，吃生蔬菜如沙拉 (salad) 和枝葉 (stick) 也很重要。吃這種形式的蔬菜，可提供病人有價值的酶和解毒物質，這些物質有助於消化肉類。病人應自己吃下生水果，而不是隨餐吃，因為生水果有著非常不同的酶切圖譜 (digestion pattern) ，可以為胃更加努力地工作。在這個階段裡，讓你的病人把水果當作餐與餐之間的零食吃。請記住，病人所吃下的食物應約 85% 是鹹的 - 做出來的肉、魚、蛋、蔬菜、和天然油脂。甜的烘焙食品和水果應該當作餐與餐之間的零食限量吃。

之三, 請看這裡 http://tw.myblog.yahoo.com/linuxyeo/article?mid=992<b