Laura Schoenfeld: I will say that I don’t typically work with patients where I’m putting them on an SCD or GAPS Diet. I can’t speak for Kelsey here, but the patients that I work with are usually ones coming from a diet like that and I’m trying to help them reintroduce foods. The reason for that is because I find that those diets tend to be extremely restrictive. GAPS is much more restrictive than SCD, but SCD is also restrictive, and I don’t see those diets as being long-term solutions for people for their gut health. If somebody has a really severely dysbiotic gut and they want to do a short SCD or GAPS Diet just to kind of calm everything down and stop feeding the microbiota that are causing the problem, I think it’s OK to do that for a period of time, but I’ve really seen a lot of pretty severe problems come from either a too-long SCD or GAPS Diet, or I’ve actually seen people that went on these diets for pretty much no reason. I think they just believed that the diet would be healthier and they wanted to fix some minor health problems that they thought were caused by leaky gut, and they actually caused their gut health to get worse. Not only did they feel worse on the diet, but then when they started trying to reintroduce foods, they started having symptoms that they hadn’t had before.
So I don’t typically use the SCD Diet or GAPS Diet. The main reason for that is because I see more results with clients who, if they do have a gut dysbiosis issue or a gut infection, treating that gut infection with antimicrobials as opposed to trying to cure it with a diet. The point of the SCD and the GAPS Diet is to, hopefully, improve those health conditions like SIBO or just general gut dysbiosis, any sort of major gut infection, any sort of gut-brain disorder, which, again, short term can potentially have benefits, but unfortunately these diets, if they’re not done correctly or if they’re done for too long, they end up actually causing issues with the microbial balance, as well. I would say that that is something you want to be really careful about as far as when you’re going to use it. Make sure that you’re looking at what the actual problem is and if there’s some kind of antimicrobial protocol that is appropriate for that person’s gut health, and realize that the antimicrobial treatment is going to be a lot more effective than trying to starve out the bad bacteria or the parasite or whatever you’re trying to starve out using those diets. Those diets typically are just a symptom reliever and they’re not actually fixing anything for the long run. Again, if you do them for too long, you’re going to end up causing changes in the beneficial flora that rely on those fibers and those carbohydrates in order to really survive. The problem there is that if you’re cutting out a ton of the beneficial flora by doing these super-restrictive diets, once a person starts eating carbs and fibers again, there’s not as much beneficial flora to keep the problematic flora controlled. So what can happen is you just get a regrowth of all the pathogens that you were trying to get rid of in the first place when people try to reintroduce foods. That’s the main problem I see. Again, I’m not saying that SCD and GAPS are a bad thing, but I personally don’t use them because that’s just not really my clientele. I’m usually helping people get off those kinds of diets if they were on them in the first place.
Laura, you were asking to clarify. “So only use these diets during….” I’m assuming you meant antibacterial treatment, not “antibotanical,” or botanical antimicrobial treatment. Actually I don’t even really think these are appropriate to use during treatment. I think they can be used for a very short term to help calm symptoms if somebody is just having severe gut issues, really bad diarrhea or really bad constipation, things that are really not being helped by more moderate approaches, something like a low-FODMAPs diet. I like to start there with my clients that have gut symptoms because a lot of times that can really help their gut symptoms improve to the point of tolerance as far as day-to-day quality of life is concerned and then actually look into what’s the cause and treat the cause and not just try to reduce the symptoms using the diet. My personal approach is I try to minimize how much restriction is happening, and the SCD and GAPS Diet are very, very restrictive, and I think there would have to be a very severe case that wasn’t really responding to other treatments like antimicrobials, things like probiotics, prebiotics, that kind of stuff, that is going to help rebuild the flora after doing an antimicrobial protocol. It’s really tough because I think a lot of people have seen some really good outcomes with the GAPS and the SCD Diet, so I don’t think they’re just completely useless. I just don’t see them being the most helpful for long-term improvement of gut symptoms.
Hopefully that helps. If anyone wants to have any sort of elaboration on any of that, feel free to let me know. Like I said, I might have a little bit of a bias coming from the fact that most of my clients are people who have gone into more restrictive diets than is really appropriate and trying to get them out of those without causing health problems. That’s really my niche, so I’m usually not putting people on a more restrictive diet unless it’s something like, like I said, if somebody’s on a normal Paleo diet and they’re having a bunch of gut symptoms. Then maybe we’ll do short-term low FODMAPs just to help them feel a little better at first, at the same time trying to figure out why they’re having those symptoms, getting them tested for SIBO, getting them tested for any sort of infections or parasites, that kind of thing. Yeah, I really try to not put people on super-extreme diets because I think there’s just a really high risk of malnutrition, and once you’re being malnourished, your body is not as able to deal with things like immune function. It does slow down your gut function if you’re undereating, and it’s really easy to undereat on those diets.