The Elemental Diet: Who It Benefits and How To Use It

If you have a gastrointestinal condition, like Crohn’s disease or SIBO, and have tried various treatments without any success, an elemental diet may help instead.

The elemental diet uses a specially designed formula of pre-digested macronutrients that are easily absorbed by your intestinal tract. This, in turn, addresses mild to chronic digestive issues like malabsorption and leaky gut syndrome. Since your digestive health affects other aspects of your body, the elemental diet may also help improve non-digestive problems like rheumatoid arthritis.

In this article, we will explain what the elemental diet is, how it works, and the health issues it targets. We’ll also detail who should use an elemental diet, how long to follow it, and what the possible side effects may be. Lastly, we’ll share some tips on how to adhere to the elemental diet for more success.

What Is the Elemental Diet?

The elemental diet is a meal replacement formula available in liquid or powder form. The elemental diet formula consists of macronutrients (proteins, fats, and carbohydrates) that are already broken down into simple elements (amino acids, fatty acids, and simple sugars, respectively), hence the name “elemental diet.” The formula may also contain essential vitamins and minerals for complete nutritional intake.

Two characteristics define the elemental diet. It:

  • Consists of pre-digested macronutrients
  • Antibacterial and anti-inflammatory

Some elemental diets use a hypoallergenic formula while others may contain dairy-, corn-, and soy-sourced ingredients. Always read the ingredient label before purchase and consult your doctor on the type of elemental formula that’s most suitable for you. 

With that said, the elemental diet formula can also be used as a dietary supplement or exclusively consumed for some time under medical supervision.

How Does the Elemental Diet Work?

Since the elemental formula consists of pre-digested macronutrients, it’s easily absorbed within the first few feet of the small intestine without over-stressing your digestive system. This means your digestive system can rest from digesting whole foods, allowing it to reset and regenerate for a healthier gut.

In addition, the elemental diet is free of prebiotics and fibers. Since prebiotics and fiber feed your gut bacteria, the lack of it in the elemental diet formula reduces bad bacteria in your digestive system for a more balanced gut microbiome.

Furthermore, some elemental diets, like the one created by Dr. Michael Ruscio, use a hypoallergenic formula free of inflammatory foods (for instance, gluten, dairy, and soy). This lowers the likelihood of an immune response while reducing gut inflammation. It’s also worthy to note that mass-produced elemental diets usually don’t contain gluten or dairy, but may include problematic ingredients such as corn, soy, and inflammatory oils. As such, a hypoallergenic elemental diet formula may be more successful in improving your symptoms. 

What Does the Elemental Diet Treat?

The elemental diet is used to manage and improve various GI issues and symptoms, including: 

  • Autoimmunity: The elemental diet has been shown to be as effective as anti-inflammatory drugs in reducing inflammation for autoimmune conditions like rheumatoid arthritis [1].
  • Celiac disease: For patients who did not respond successfully to a gluten-free diet, the elemental diet has helped reduce inflammation and repair damage [2].
  • Eosinophilic esophagitis (EoE): This condition is often triggered by inflammatory foods, like wheat, soy, and dairy. Hypoallergenic elemental diets free of these food allergens can be used as medical food to reduce inflammation and subsequently improve symptoms to the point of remission [3].
  • Gut reflux: Anecdotal evidence suggests that short courses of elemental diets may improve gut reflux symptoms. Still, more research is needed to confirm the diet’s effectiveness.
  • Inflammatory bowel disease (IBD): Aside from the specific carbohydrate diet (SCD), the elemental diet is often used in the dietary management of inflammatory bowel disease, specifically Crohn’s disease [4]. Also, an elemental diet may be more effective than anti-inflammatory drugs (corticosteroids) in sustaining remission [5] and preventing relapses [6] of IBD.
  • Irritable bowel syndrome (IBS): As IBS and SIBO patients often experience overlapping symptoms, the elemental diet used in treating SIBO is also successful in managing IBS symptoms.
  • Leaky gut: Many elemental formulas contain the amino acid L-glutamine, which repairs and strengthens your intestinal lining [7], thereby helping to heal leaky gut.
  • Malabsorption: As the elemental formula consists of easily digestible nutrients, it may address malabsorption to promote healthy weight gain in underweight individuals.
  • Small intestinal bacterial overgrowth (SIBO): Aside from the low-FODMAP (fermentable oligo-, di-, monosaccharides, and polyols) diet, the elemental diet is also commonly used in SIBO treatment. While comprehensive research is still needed, a 14-day elemental diet showed normalized lactulose breath tests and improved IBS symptoms in the majority of SIBO patients [8]. 

For numerous GI problems, the elemental diet has proven to be as effective, if not more effective, than prescription drugs. Unlike the elemental diet, drugs are often linked to adverse side effects [9]. As such, your doctor may recommend the elemental diet as the first line of treatment.

Who Should Use the Elemental Diet?

As the elemental diet addresses a wide range of digestive issues and symptoms, it’s beneficial for individuals with: 

  • Impaired gastrointestinal function
  • Malnutrition, malabsorption, or short gut syndrome
  • Bacterial imbalance
  • Food intolerances and sensitivities — after going on the elemental diet, you can slowly reintroduce whole foods to identify food triggers
  • An inflammatory flare
  • A busy schedule — the elemental formula works as a gut-friendly meal replacement to meet your daily nutritional intake

How Long Should You Follow the Elemental Diet?

The duration of the elemental diet is dependent on the severity of your symptoms and health condition. Usually, the more severe your symptoms are, the longer the treatment phase. It’s best to check with your doctor about how long you should follow this diet.

With that said, the elemental diet is usually taken in one of these time frames:

  • For a short-term gut reset to address mild symptoms, the elemental diet is used for 2-4 days.
  • For comprehensive treatment that targets moderate to severe symptoms, the elemental diet is used exclusively for 1-3 weeks.
  • As a meal replacement, the elemental diet may be used in place of 1-2 meals daily in the long term.

It’s important to listen to your body when following the elemental diet. Many individuals use the elemental diet intermittently as a mini-reset and comprehensive treatment for symptoms that alternate between mild and severe with changing lifestyle triggers.

Full Elemental Diet vs. Semi-Elemental Diet

There are two versions of the elemental diet:

  • A full elemental diet formula contains fully digested macronutrients like free-form amino acids.
  • A semi-elemental diet (or half-elemental diet) formula contains partially digested macronutrients like whey protein.

Aside from the different formula composition, the full and semi-elemental diets are prepared and consumed the same way. Both diets are also proven to be equally effective [10].

What Foods Can You Eat on an Elemental Diet?

Whether you’re on a full elemental or half-elemental diet, the elemental formula serves as the sole source of nutrition. With that said, you can supplement your daily nutritional intake with:

  • Healthy oils, like medium-chain triglycerides (MCT) oil (mixed with the elemental formula)
  • Water
  • Coffee and tea (without milk and sugar)
  • Small amounts of whole foods, such as cooked veggies and bone broth
  • Prescription medicines (if any)
  • Supplements, including probiotics and prebiotics, per your doctor’s guidelines

Essentially, the full and semi-elemental diets act as liquid diets. In cases where the patient is unable to feed themselves, the elemental formula may be administered through a feeding tube.

Are There Any Side Effects to the Elemental Diet?

There haven’t been any adverse side effects associated with the elemental diet, particularly for long-term use. Still, some individuals may experience:

  • Abdominal discomfort: In the initial stages, bloating, nausea, and diarrhea are possible if you consume too much of the formula too quickly.
  • Blood sugar spikes: Many elemental formulas are low in fats but high in predigested carbs, resulting in blood sugar spikes. Individuals with high blood sugar levels (i.e., diabetic patients) should consult their doctor before attempting the elemental diet.
  • Mood swings and fatigue: Mood changes and fatigue may occur due to strict food restrictions.
  • A slight regression: In terms of health improvements, a slight regression is expected when you transition from the elemental diet back to regular whole foods. Overall, you will still see significant improvement as compared to before trying the elemental diet.

How To Make Your Elemental Diet Formula Taste Better?

One common issue many people have with the elemental diet formula is its unappealing taste, which can lead to difficulty sticking to the diet long enough to see results. Thankfully, newer formulas like the Elemental Heal are formulated with sweeteners (such as maltodextrin and Stevia) for better taste.

Here are some other ways to make your elemental formula more palatable:

  • Mix the formula with healthy oils, like MCT oil. This not only helps you feel full, it also ensures you meet your daily fat intake since most elemental formulas are low in fats.
  • Blend the formula with ice to make it cold and frothy. You can also keep your drink cold with additional ice cubes throughout the day.

Tip: Prepare this medical food in advance by mixing enough formula for 3-4 hours of consumption. To avoid abdominal discomfort, sip the mixture slowly.

Explore the Elemental Diet With Austin Functional Medicine

If digestive issues are troubling you and conventional medicine hasn’t improved your symptoms, an elemental diet may help where prescription drugs failed. 

Scientifically proven, the elemental diet is effective in managing several digestive issues, from IBD to autoimmunity. Whether it’s addressing food intolerances or correcting bacterial imbalance, an elemental formula can help. 

Still, there are many things to take note of before starting an elemental diet. As navigating the diet alone can be confusing, and even ineffective when used incorrectly, it’s best to approach it under medical supervision. 

This is where Austin Functional Medicine can help you. Our physicians listen attentively to your health concerns before recommending the right elemental diet and treatment period for you. 

Our clinic provides three types of elemental diet formula for different patient needs:

  • The Elemental Heal is ideal for the semi-elemental diet as it has partially digested macronutrients, like whey protein.
  • The Elemental Heal Whey-Free is the perfect medical food for patients who are sensitive to whey or on a full elemental diet.
  • The Elemental Heal Low-Carb is for those interested in a low-carb elemental diet. Unlike most elemental formulas that contain 60 grams of carbs per serving, our low-carb formula only carries 20 grams of carbs with added healthy fats.

Our physicians and in-house nutrition coach work together to ensure your success with the elemental diet. For more information on how this diet can best address your individual health needs, book an appointment with Austin FM today.

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