Autism and GAPS Diet: An Evidence-Based Review 2024

Some children diagnosed with "autism" are improving through use of special diets, supplementation regimens and detoxification protocols tailored to their individual needs. There's a vast "underground" movement of parents who are sharing their experiences and successes and there are enlightened doctors who have been able to help children with autism when conventional medicine falls short. The Gut and Psychology Syndrome (GAPS) protocol is among the most important treatment strategies out there, but there are also many others.

The GAPS nutritional protocol was created by Dr. Natasha Campbell-McBride, whose son was diagnosed with autism. She understands that there's a very important connection between damaged gut flora in pregnant women and developmental problems in their children, especially autism.

Establishing normal gut flora in the first 20 days or so of life plays a crucial role in the maturation of your baby's immune system. It's important to realize that babies who develop abnormal gut flora have compromised immune systems, which puts them at higher risk for suffering vaccine reactions.

According to Campbell-McBride, in children with GAPS the toxicity flowing from their gut throughout their bodies and into their brains continually challenges their nervous system, preventing it from performing its normal functions and process sensory information.

Other researchers are now starting to back up her findings. For example, one 2013 study confirmed that autistic children have distinctly different microbiome compared to healthy children. Notably, they had fewer healthy bacteria, such as Bifidobacterium. Children diagnosed with autism also had markedly higher levels of toxic volatile organic compounds (VOCs).

The GAPS Nutritional program might be important for most, as the majority of people have such poor gut health due to poor diet and toxic exposures, but it's particularly crucial for pregnant women and young children.

The best way to prevent GAPS is for the mother to avoid processed foods, sugar, antibiotics (including CAFO meats and antibacterial soaps) and birth control pills prior to conception. These cause pathogenic yeast and fungi to grow and also cause leaky gut that allows undigested protein fragments to sneak into the bloodstream contributing to autoimmune disease.

This can then be followed by breastfeeding and avoiding the use of antibiotics during (intra-partum) and after delivering.

It's also a good idea to make sure your baby's microbiome is healthy before getting any vaccinations. Fortunately, it's possible to rather inexpensively identify GAPS within the first weeks of your baby's life, which can help you make better-informed decisions about vaccinations, and about how to proceed to set your child on the path to a healthy life.

The entire process for identifying children who would be at risk for developing autism from a vaccine is described in her book, "Gut and Psychology Syndrome: Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia."

This article explores the features of the GAPS dietary protocol and examines whether there’s any evidence behind its purported health benefits.


GAPS stands for Gut and Psychology Syndrome. It’s a term that Dr. Natasha Campbell-McBride, who also designed the GAPS diet, invented.

Her theory is that a leaky gut causes many conditions that affect your brain. Leaky gut syndrome is the term used to describe an increase in the permeability of the gut wall (1Trusted Source).

The GAPS theory is that a leaky gut allows chemicals and bacteria from your food and environment to enter your blood when they wouldn’t normally do so.

It claims that once these foreign substances enter your blood, they can affect your brain’s function and development, causing “brain fog” and conditions like autism.

The GAPS protocol is designed to heal the gut, preventing toxins from entering the blood stream and lowering “toxicity” in the body.

However, it isn’t clear if or how leaky gut plays a role in the development of diseases (2Trusted Source3Trusted Source).

In her book, Dr. Campbell-McBride states that the GAPS dietary protocol cured her first child of autism. She now widely promotes the diet as a natural cure for many psychiatric and neurological conditions, including:

  • autism
  • ADD and ADHD
  • dyspraxia
  • dyslexia
  • depression
  • schizophrenia
  • Tourette’s syndrome
  • bipolar disorder
  • obsessive-compulsive disorder (OCD)
  • eating disorders
  • gout
  • childhood bed-wetting

The diet is most often used for children, especially those who have a health condition that mainstream medicine may not fully understand yet, such as autism.

The diet also claims to help children who have a food intolerance or allergy.

Following the GAPS diet can be a years-long process. It requires you to cut out all foods Dr. Campbell-McBride thinks contribute to a leaky gut. This includes all grains, pasteurized dairy, starchy vegetables and refined carbs.

The GAPS protocol is made up of three main stages:

  • the GAPS introduction diet
  • the full GAPS
  • a reintroduction phase for coming off of the diet

The introduction phase is the most intense part of the diet because it eliminates the most foods. It’s called the “gut healing phase” and can last from three weeks to one year, depending on your symptoms.

This phase is broken down into six stages:

  • Stage 1: Consume homemade bone broth, juices from probiotic foods and ginger, and drink mint or chamomile tea with honey between meals. People who are not dairy intolerant may eat unpasteurized, homemade yogurt or kefir.
  • Stage 2: Add in raw organic egg yolks, ghee and stews made with vegetables and meat or fish.
  • Stage 3: All previous foods plus avocado, fermented vegetables, GAPS-recipe pancakes and scrambled eggs made with ghee, duck fat, or goose fat.
  • Stage 4: Add in grilled and roasted meats, cold-pressed olive oil, vegetable juice, and GAPS-recipe bread.
  • Stage 5: Introduce cooked apple purée, raw vegetables starting with lettuce and peeled cucumber, fruit juice, and small amounts of raw fruit, but no citrus.
  • Stage 6: Finally, introduce more raw fruit, including citrus.

During the introduction phase, the diet requires you to introduce foods slowly, starting with small amounts and building up gradually.

The diet recommends that you move from one stage to the next once you are tolerating the foods you have introduced. You are considered to be tolerating a food when you have a normal bowel movement.

Once the introduction diet is complete, you can move to the full GAPS diet.

The full GAPS diet can last 1.5–2 years. During this part of the diet, people are advised to base the majority of their diet on the following foods:

  • fresh meat, preferably hormone-free and grass-fed
  • animal fats, such as lard, tallow, lamb fat, duck fat, raw butter, and ghee
  • fish
  • shellfish
  • organic eggs
  • fermented foods, such as kefir, homemade yogurt and sauerkraut
  • vegetables

Followers of the diet can also eat moderate amounts of nuts and GAPS-recipe baked goods made with nut flours.

There are also a number of additional recommendations that go along with the full GAPS diet. These include:

  • Do not eat meat and fruit together.
  • Use organic foods whenever possible.
  • Eat animal fats, coconut oil, or cold-pressed olive oil at every meal.
  • Consume bone broth with every meal.
  • Consume large amounts of fermented foods, if you can tolerate them.
  • Avoid packaged and canned foods.

While on this phase of the diet, you should avoid all other foods, particularly refined carbs, preservatives, and artificial colorings.

If you’re following the GAPS diet to the letter, you’ll be on the full diet for at least 1.5–2 years before you start reintroducing other foods.

The diet suggests that you start the reintroduction phase after you have experienced normal digestion and bowel movements for at least 6 months.

Like the other stages of this diet, the final stage can also be a long process as you reintroduce foods slowly over a number of months.

The diet suggests introducing each food individually in a small amount. If you don’t note any digestive issues over 2–3 days, you may gradually increase your portions.

The diet doesn’t detail the order or the exact foods you should introduce. However, it states that you should start with new potatoes and fermented, gluten-free grains.

Even once you’re off the diet, you’re advised to continue avoiding all highly processed and refined high-sugar foods, retaining the whole-foods principles of the protocol.

The diet’s founder states that the most important aspect of the GAPS protocol is the diet.

However, the GAPS protocol also recommends various supplements. These include:

  • probiotics
  • essential fatty acids
  • digestive enzymes
  • cod liver oil

Probiotics

Probiotic supplements are added to the diet to help restore the balance of beneficial bacteria in your gut.

It’s recommended that you choose a probiotic containing strains from a range of bacteria, including LactobacilliBifidobacteria, and Bacillus subtilis varieties.

You’re advised to look for a product that contains at least 8 billion bacterial cells per gram and to introduce the probiotic slowly into your diet.

Essential fatty acids and cod liver oil

People on the GAPS diet are advised to take daily supplements of both fish oil and cod liver oil to ensure they’re getting enough.

The diet also suggests you take small amounts of a cold-pressed nut and seed oil blend that has a 2:1 ratio of omega-3 to omega-6 fatty acids.

Digestive enzymes

The diet’s founder claims that people with GAPS conditions also have low stomach acid production. To remedy this, she suggests followers of the diet take a supplement of betaine HCl with added pepsin before each meal.

This supplement is a manufactured form of hydrochloric acid, one of the main acids produced in your stomach. Pepsin is an enzyme also produced in the stomach, which works to break down and digest proteins.

Some people may want to take additional digestive enzymes to support digestion.

The two key components of the GAPS dietary protocol are an elimination diet and dietary supplements.

The elimination diet

As yet, no studies have examined the effects of the GAPS dietary protocol on the symptoms and behaviors associated with autism.

Because of this, it’s impossible to know how it could help people with autism and whether it’s an effective treatment.

Other diets that have been tested in people with autism, like ketogenic diets and gluten-free, casein-free diets, have shown potential for helping improve some behaviors associated with autism (4Trusted Source5Trusted Source6Trusted Source).

But so far, studies have been small and dropout rates high, so it’s still unclear how these diets may work and which people they may help (7Trusted Source).

There are also no other studies examining the effect of the GAPS diet on any of the other conditions it claims to treat.

Dietary supplements

The GAPS diet recommends probiotics to restore the balance of beneficial bacteria in the gut.

The effect of probiotics on the gut is a promising line of research.

One study found that children with autism had significantly different gut microbiota compared to neurotypical children, and probiotic supplementation was beneficial (8Trusted Source).

Other studies have found that particular strains of probiotics can improve the severity of autism symptoms (9Trusted Source10Trusted Source11Trusted Source).

The GAPS diet also suggests taking supplements of essential fats and digestive enzymes.

However, studies to date have not observed that taking essential fatty acid supplements has an effect on people with autism. Similarly, studies on the effects of digestive enzymes on autism have had mixed results (12Trusted Source13Trusted Source14Trusted Source).

Overall, it’s not clear whether taking dietary supplements improves autistic behaviors or nutrition status. More high-quality studies are needed before the effects can be known (15Trusted Source16Trusted Source).

The GAPS diet is a very restrictive protocol that requires you to cut out many nutritious foods for long periods of time.

It also provides little guidance on how to ensure your diet contains all the nutrients you need.

Because of this, the most obvious risk of going on this diet is malnutrition. This is especially true for children who are growing fast and need a lot of nutrients, since the diet is very restrictive.

Additionally, those with autism may already have a restrictive diet and may not readily accept new foods or changes to their diets. This could lead to extreme restriction (17Trusted Source18Trusted Source).

Some critics have voiced the concern that consuming large amounts of bone broth could increase your intake of lead, which is toxic in high doses (19Trusted Source).

However, the risks of lead toxicity on the GAPS diet haven’t been documented, so the actual risk isn’t known.

Most people who try the GAPS diet are children with autism whose parents are looking to cure or improve their child’s condition.

This is because the main claims made by the diet’s founder is that autism is caused by a leaky gut, and it can be cured or improved by following the GAPS diet.

Autism is a condition that results in changes to brain function that affect how the autistic person experiences the world.

Its effects can vary widely, but, in general, people with autism have difficulties with communication and social interaction.

It’s a complex condition thought to result from a combination of genetic and environmental factors (20Trusted Source).

Interestingly, studies have noted that up to 70% of people with autism also have poor digestive health, which can result in symptoms including constipation, diarrhea, abdominal pain, acid reflux, and vomiting (21Trusted Source).

Untreated digestive symptoms in people with autism have also been linked with more severe behaviors, including increased irritability, tantrums, aggressive behavior, and sleep disturbances (21Trusted Source).

A small number of studies have found that some children with autism have increased intestinal permeability (22Trusted Source23Trusted Source24Trusted Source25Trusted Source).

However, the results are mixed, and other studies have found no difference between intestinal permeability in children with and without autism (23Trusted Source26Trusted Source).

There are also currently no studies that show the presence of leaky gut before the development of autism. So even if leaky gut is linked to autism in some children, it’s not known if it’s a cause or a symptom (27Trusted Source).

Overall, the claim that leaky gut is the cause of autism is controversial.

Some scientists think this explanation oversimplifies the causes of a complex condition. More research is needed to understand the role of leaky gut and ASD.

Some people feel they’ve benefited from the GAPS diet, though these reports are anecdotal.

However, this elimination diet is extremely restrictive for long periods of time, making it very difficult to stick to. It may be especially dangerous for the exact population it’s intended for — vulnerable young people.

Many health professionals have criticized the GAPS diet because many of its claims are not supported by scientific studies.

If you’re interested in trying it, seek help and support from a healthcare provider who can make sure you’re meeting your nutritional needs.

Main Reference: https://www.healthline.com/nutrition/gaps-diet

Related reviews: 

Resources for Parents of Children with Autism

  • Asperger Syndrome and High Functioning Autism Association: This New York-based organization offers great resources for those with higher functioning autism. Ahany also provides a great list of summer programs and day camps in New York, as well as useful questions to ask when choosing any camp or summer program for your special needs child.
  • Autism Beacon strives to supply the best resources for autism treatments. It also offers a broad range of articles on autism, including sensitive topics such as bullying and sexuality.
  • Autism Hwy: Autism Highway was started by Kelly Green after her son Wyatt was diagnosed with autism. It provides an extensive list of autism-related events and specialists. It also includes many fun games that children are sure to enjoy.
  • Autism Society has been providing information for individuals on the spectrum, their family members, and professionals for more than 50 years. It hosts an annual conference and lobbies nationally for policies to help families touched by autism.
  • AutismNow.Org features news, information, an easy-to-use search engine, upcoming events, and even a local agencies map to help you find services and support in your area.
  • Autism Learn, a site is dedicated to the process of teaching autistic children how to learn. It is jam-packed with visually stimulating activities geared toward helping develop skills with people, fine motor control, creating a connected hierarchy, learning about the seasons and weather, money, and much more.
  • Autism and Oughtisms: The mom of 2 autistic boys is the author of this inspirational and informative blog about autism.
  • The Guardian: “The biggest problem for children with special needs? Other people.” The An inspiring story about a mother and her son, who has autism. It discusses one of the biggest challenges parents and their disabled child face. At the end of the article, there are more than 175 comments from others sharing their stories and offering tips and resources.
  • NeedQuest: If you’re in the New Jersey area, this site is chock full of information about early intervention, therapists, camps, schools, sports programs, and more. And even if you’re not in the Garden State, it’s worth checking out the blog which has helpful articles like this one about whether to worry if your child is obsessed with trains, dinosaurs, or something else (as so many of our children on the spectrum are).
  • AngelSense: For parents of kids who are nonverbal or prone to wandering, nothing is scarier than not knowing where your child is. GPS trackers can be a lifesaver – literally. AngelSense is one company that offers them. It also has a blog with valuable tips for keeping kids on the spectrum safe and managing school, outings, water, and other challenges.
  • Sunshine Behavioral Health: A guide on how people in need can find online resources for Autism in United States. Sunshine Behavioral Health is based in California, United States.

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