Dr. Ruscio’s Elemental Diet Shakes: Is this formula the Best or are there Better Alternatives?

The elemental diet is a meal replacement diet consisting of easy-to-digest liquids that offer all the nutrients your body requires. It is generally recommended for people with severe digestive problems or those who are unable to meet their nutrient requirements due to other conditions, such as anorexia nervosa or cancer. This gluten-free diet is also recommended for people who have had surgeries on a part of their intestine. This helps your bowel to recover from injury or illness as it reduces the load on your bowel without compromising on nutrition. In addition to this, some people use elemental formulas to supplement their diets. Although the diet has been around for decades, it has recently gained popularity as an outpatient protocol.

Dr. Michael Ruscio is a functional medicine practitioner, clinical researcher, and the author of the best-selling book, ‘’Healthy Gut Healthy You’’. He has established himself as one of the most prominent voices in the field of alternative medicine. He helps people improve their digestive health and recover from various gut-related issues, such as the leaky gut syndrome, SIBO, IBS symptoms, and celiac disease. This article looks into what an elemental diet is, how to follow it, and its benefits and drawbacks.

What is an elemental diet?

The elemental diet comprises nutrients in a pre-digested form. Elemental formulas contain carbohydrates, proteins, and fats that have been broken down into sugars, amino acids, and fatty acids. They also contain essential vitamins, minerals, and electrolytes to meet all the nutritional needs of your body. Since the nutrients are already present in their simpler forms, they require the least digestion. They get absorbed in the upper part of your gastrointestinal tract and allow your bowel to rest. Elemental formulas generally contain more proteins and carbohydrates than fat (about 1-2% fatty acids), since fat is more difficult to digest. 

How does Elemental Diet work?

The central idea behind the elemental diet is to reduce digestive activity. Following an elemental diet requires you to replace all regular foods with elemental formulas. This means that you can only consume elemental formulas and no solid foods. The permitted liquids in this diet include water, black tea, and black coffee.

Elemental formulas are available in both powder and liquid form and can be directly consumed by dissolving in water or as a drink. Some people are not capable of digesting or metabolizing whole foods, making it difficult for them to meet their caloric and nutrient needs. An elemental diet can be administered through a feeding tube, a process known as enteral feeding. The diet is usually performed under the guidance of a medical doctor and registered dietician who suggests the type of formula and amount, which varies from person to person.

You must consume enough calories during the treatment to ensure you are taking enough calories to feel satiated. Therefore, experts generally recommend a higher amount of calories to make sure you feel full during the diet. Many health experts also recommend adding healthy fats to the shakes, such as medium-chain triglyceride (MCT) oil. Moreover, elemental formulas should be consumed slowly to prevent stomach discomfort and cramping.

The duration of this diet depends on the condition and its symptoms. You may be required to follow the elemental diet for 3 to 5 days in case of acute symptoms, or for several weeks to reboot your digestive system completely. People usually follow the elemental diet until their symptoms have subsided. However, some people have to follow the full elemental diet indefinitely, such as those who have a part of their intestine removed.

What conditions can the Elemental Diet treat?

The elemental diet can be used to treat many serious health conditions, including:

• Small Intestinal Bacterial Overgrowth (SIBO)
  In a healthy individual’s gut, most microbes are present in the large intestine. However, in the case of SIBO, there is excessive bacterial overgrowth in the small intestine. This can lead to digestive problems, including gas, bloating, and stomach pain.
  
  These symptoms typically arise when you have a certain food. The gut bacteria act on the fiber present in the food and releases a lot of methane or hydrogen, depending on the type of bacteria. If left untreated, SIBO can also lead to serious long-term consequences, such as malnutrition, anemia, and kidney stones. Moreover, SIBO can be difficult to treat as the bacteria may become resistant to antibiotics. A low-FODMAP diet is generally recommended for patients with SIBO, which eliminates certain carbohydrates from the diet. However, it does not help in some cases.
  
  Since the elemental diet contains pre-digested forms of proteins, carbohydrates, and fats, there is no undigested food in the lower gastrointestinal tract to feed the bacteria, causing them to starve and die off.

• Autoimmune Diseases
  An autoimmune disease occurs when your immune system attacks its own healthy cells by mistake. Some of the common autoimmune diseases include rheumatoid arthritis, Crohn’s disease, celiac disease, lupus, and inflammatory bowel disease (IBD). Following an elemental diet can help reduce gut inflammation and prevent autoimmune reactions. It also helps prevent the development of autoimmune diseases that may be triggered by food allergens.

• Irritable Bowel Syndrome (IBS)
  IBS refers to a cluster of symptoms that affects your gastrointestinal tract. These symptoms may include gas, constipation, diarrhea, and cramping.
  
  The elemental diet can help manage symptoms of IBS by reducing intestinal permeability, limiting dietary antigens, and improving the composition of your gut microbiome, which plays a key role in controlling your gut health.

Benefits 

The major benefits of the elemental diet are:

• Treatment of digestive disorders
  Evidence suggests that the elemental diet can be used to treat digestive disorders by starving off the bad bacteria and allowing your digestive tract to rest and heal.
  
  A study conducted on 93 participants with SIBO showed that 85% of the volunteers had normal lactulose breath tests after following the elemental diet for 21 days. Abnormal lactulose tests indicate the person has SIBO. What’s more, about 50% of these patients experienced an improvement in symptoms ^[1].

• Reduced inflammation
  Both acute and chronic inflammation can impact your digestive health and life quality. The elemental diet helps reduce intestinal inflammation by reducing irritants in your GI tract and improving your nutritional status.
  
  A study conducted on 15 patients diagnosed with Crohn’s disease showed that following an elemental diet could help reduce the signs and symptoms of acute Crohn’s disease ^[2].

• Relieved Eosinophilic Esophagitis
  Eosinophilic esophagitis (EoE) is a chronic immune condition of the esophagus, the muscular tube that connects your mouth to your stomach. People with EoE have white blood cells built up in their esophagus, known as eosinophils, which damages the lining of the esophagus and may result in difficulty swallowing, reduced appetite, heartburn, and pain. Evidence suggests that an elemental diet can be effectively used to treat EoE.
  
  A study conducted on 21 patients with EoE showed that the elemental diet completely eliminated the symptoms of the condition among 88% of the participants. It also helped reduce inflammation significantly ^[3].

• Reduced Pancreatitis Pain
  Following an elemental diet may help reduce pain due to chronic pancreatitis, which may be attributed to the amino acids present in elemental formulas.
  
  A study conducted on 17 patients with chronic pancreatitis showed that following a low-fat elemental diet for 8 weeks helped alleviate pain in 15 out of 17 patients, out of which 10 patients reported complete relief from pain ^[4].

• Weight loss
  Some people may follow the elemental diet to lose weight, although it is not intended for this purpose. Also, there are no clinical studies specifically on this topic, many clinical studies have shown that people with digestive conditions who have been treated with the elemental diet experienced significant weight loss.

Drawbacks

While the elemental diet is effective at treating certain health conditions, it has the following drawbacks:

• Requires medical supervision
  The diet needs to be followed under the supervision of a trained medical professional. Some people may need additional medical supervision, such as those with an eating disorder, which could get triggered by avoiding food. That said, if you want to try the elemental diet briefly to see if it helps your gut issues, then it is generally safe. 

• Difficult to follow long-term
  It is very difficult to follow the elemental diet in the long run as it only includes elemental formulas (liquid diets) and eliminates all solid foods from the diet. Limited food choices may cause irritability and fatigue, especially if you have an emotional relationship with food. Additionally, parents may feel guilty for having their children stop eating food. 

• High in carbohydrates
  Elemental formulas are generally high in carbohydrates and low in fat, which can cause blood sugar spikes. This may be a problem for people who need to control their blood sugar.

• May require fat supplementation
  The elemental formulas are low in fat, compared to carbohydrates and proteins and you may not be able to meet your daily fat intake needs without taking supplemental fats.

• Expensive
  Following an elemental diet can be very expensive for everyday use, which may not be feasible for everyone.

Who can benefit from the Elemental Diet?

It is advisable to take up the elemental diet only if you suffer from a severe health condition and if it is recommended by your doctor. Since the elemental diet is high in carbohydrates, it is not suitable for diabetic people.

Furthermore, if you don’t have any particular health condition and are only looking to lose weight, using an elemental diet as a complete meal replacement can be unnecessarily expensive and restrictive for an otherwise healthy person. Plus, elemental formulas aren’t necessarily better for weight loss. Eating a balanced diet is a more healthful and effective approach for people who want to lose weight.

The difference between an Elemental and a Semi-Elemental Diets

In a majority of cases, a person meets their daily nutrient requirements only by consuming elemental formulas. However, some people get some nutrients from elemental formulas and the remaining from solid foods. This is known as a half- or semi-elemental diet.

A doctor may recommend a semi-elemental diet for people with less severe symptoms. It is also recommended for children who may have a hard time giving up on food completely. Following a half-elemental diet is also a good idea when you are transitioning back to a regular diet.

Lifestyle changes to cope with the Elemental Diet

Everyone’s experience will be different with the elemental diet. It is common to experience mood swings, fatigue, hunger, diarrhea, bloating, and other die-off symptoms during the treatment. On the other hand, some people feel even more energetic on an elemental diet.

A healthcare practitioner can look out for signs that may not agree with you. In addition to this, the following lifestyle changes can help you cope with the diet better:

• Plan and prepare
  Since the diet will lead to a lot of changes in your routine, it is essential to plan this diet well in advance. Incorporate more fasting periods and wind down on food before starting. Consume more smoothies and soft foods to allow your gut to get used to the liquid-based diet.
  
  You may ask someone in your family to cook meals for other family members if you don’t want to be surrounded by food while you are on an elemental diet. Additionally, you must keep your elemental formula handy so that you don’t go hungry, especially if you are outdoors. 

• Make time for the diet
  Only do the necessary things during this phase. Use this time to get enough rest and heal yourself. You may need to take a few days off from work, depending on your energy levels.
  Getting enough sleep is also important if you want to get the best results from the elemental diet.
  
  You may even do small, nice things for yourself, such as taking hot water baths, reading a book, and spending more time with your loved ones.

• Exercise if you need to
  Exercise is optional when following the elemental diet. It is okay to avoid exercise during this treatment altogether and conserve your energy. You can do low-impact exercise if you think working out will help you cope better during this time, such as walking stretching, and gentle yoga. In addition to this, performing simple breathing exercises can help you stay calm throughout your journey. It is best to avoid intense workouts during this phase. Here are some exercises for the gut, that you learn about.

How to come off the diet?

It can be challenging to re-introduce food after not eating for 2-3 weeks. Generally, foods are re-introduced in stages after the elemental diet. You must reintroduce foods one at a time to learn how your body responds to them. Start with soft foods that are easy to digest and are least likely to cause an allergic reaction, such as:

• Chicken broth,
• Well-cooked pureed vegetables,
• Soups, and
• Eggs.

It will take about 2-4 weeks to know which foods are tolerated well by your body. 

How to get Dr. Ruscio’s elemental Heal Formula?

You can purchase Dr. Ruscio’s elemental formula, Elemental Heal from their official website, amazon, GNC, Walmart, and other online and offline stores. The formula is free from gluten, casein, and GMO ingredients and is available in vanilla and chocolate flavor.

The pricing for a 1 kg jar is as follows:

• One-time purchase – $64.95
• Subscription – $58.46

The brand provides free domestic shipping on all orders above $100.

Customer reviews

Here is what customers have to say about Elemental Heal.

I took Elemental Heal for 14 days last month and it changed my life completely.

– Miranda D.

My once bothersome digestive issues are now gone. I am SIBO-negative and have also lost 18 pounds. I have resumed running and teaching dance. Amazing product!

– Christy T.

I enjoy the taste and love how it keeps me full.

– Adriana S.

Using Elemental Heal for one or two days helps bring down my histamine levels. I sometimes use it to replace my lunch to manage my histamine levels.

– Sandra B.

Conclusion

Your diet has a huge impact on your gut health, inflammation levels, and overall well-being. Elemental diet formula like Elemental Heal contain nutrients in their elemental forms to provide you with all essential nutrients without adding too much stress to the digestive system.

The elemental diet helps keep food out of the lower digestive tract and can help people with severe health conditions, especially the ones who have been non-responsive to other treatments. The diet can be used under medical supervision to help reduce inflammation flare-ups, starve bacterial and fungal overgrowths in the gut, and prevent autoimmune reactions due to food allergies. People who suffer from these conditions tend to have a damaged gastrointestinal tract, which causes difficulty absorbing food.

Although elemental diets are effective, some patients may experience relapse and require additional treatment. This diet is usually not recommended for weight loss but theoretically, it can be used for this purpose. Elemental diets can last anywhere between a few days to several weeks, depending on the condition.

While the elemental diet is highly restrictive and expensive, the results might just be worth it, as it acts as a powerful gut healing tool. If you think you can benefit from the elemental diet and get a healthy gut, you may talk to your healthcare practitioner about implementing the diet or you could learn more about the 10 Best Gut Health Supplements, that are enriched with Prebiotics, Probiotics, Digestive Enzymes and more to nourish the Good Gut Bacteria.

References

1. Pimentel M, Constantino T, Kong Y, Bajwa M, Rezaei A, Park S. A 14-day elemental diet is highly effective in normalizing the lactulose breath test. Dig Dis Sci. 2004 Jan;49(1):73-7. doi: 10.1023/b:ddas.0000011605.43979.e1. PMID: 14992438.
   
   
2. O’Moráin C, Segal AM, Levi AJ, Valman HB. Elemental diet in acute Crohn’s disease. Arch Dis Child. 1983 Jan;58(1):44-7. doi: 10.1136/adc.58.1.44. PMID: 6830274; PMCID: PMC1628143.
   
   
3. Warners MJ, Vlieg-Boerstra BJ, Verheij J, van Rhijn BD, Van Ampting MT, Harthoorn LF, de Jonge WJ, Smout AJ, Bredenoord AJ. Elemental diet decreases inflammation and improves symptoms in adult eosinophilic oesophagitis patients. Aliment Pharmacol Ther. 2017 Mar;45(6):777-787. doi: 10.1111/apt.13953. Epub 2017 Jan 23. PMID: 28112427; PMCID: PMC5324627.
   
   
4. Ikeura T, Takaoka M, Uchida K, Miyoshi H, Okazaki K. Beneficial Effect of Low-Fat Elemental Diet Therapy on Pain in Chronic Pancreatitis. Int J Chronic Dis. 2014;2014:862091. doi: 10.1155/2014/862091. Epub 2014 Apr 14. PMID: 26464866; PMCID: PMC4590936.