Diving Into the Elemental Diet (and Mixing Some Up)

Shivan Sarna and I recently sat down to discuss the elemental diet, how it can help heal your gut, and why Elemental Heal is the best tasting formula on the market. The elemental diet can be a game changer for those who have not responded to other therapies and our palatable formula makes doing the elemental diet much easier!

Shivan Sarna: I’m here with Dr. Michael Ruscio. And he and I have had a lot of discussions about elemental diets. And if you have SIBO, IBS, IBD, maybe you’ve heard about them by now.  If you haven’t, what it is—we’ll have him explain it since he’s our expert today. But he has his own formulation that he has recently developed. Thanks for being here, sir.

Dr. Michael Ruscio, DC: Thank you.

SS: Cheers! We’re going to actually mix some up and taste it while we’re here live on tape, just have the experience. And tell me what the elemental diet is and how this came to be.

[Continue reading below]

Dr. R’s Fast Facts Summary

Semi-Elemental Diet – A hypoallergenic liquid diet and powerful healing tool

  • Antibacterial
  • Low in fiber and prebiotics
  • Gives intestines break
  • Anti-inflammatory
  • Molecule size varies and impacts taste but not clinical effect
  • Easy to digest

Semi-elemental vs. Elemental diet

  • Most elemental shakes are difficult for people to drink because of the foul taste.
  • The elemental diet contains fully digested proteins whereas the semi-elemental diet contains partially digested proteins.
    • There is clinical evidence to support that patients can derive just as much benefit from the semi-elemental diet as the elemental diet.
  • Semi-elemental diets tend to taste better and are more filling.

How to drink Elemental Heal

  • Best when blended with a few ice cubes.
  • Sip it slowly throughout the day
  • Our formula calls for the addition of fat:
    • Udo’s Oil 3, 6, 9 blend is a good option – works well for most.
    • MCT oil (medium chain triglyceride oil) can also work well, especially if you are constipated. Do not use if prone to diarrhea.
    • Coconut oil, olive oil, cod liver oil or fish oil. Follow the dosing instructions for the oil listed on the Elemental Heal bottle.

Other semi-elemental formulas are available however they usually contain undesired ingredients such as corn, soy or preservatives.

  • Despite this, these formulas work well for some so they are worth a try if you do not tolerate the other formulas.
    • EleCare by Abbott *my favorite of these three
    • TwoCal HN by Ross Nutritional
    • Peptamen by Nestle
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DrMR: Sure. Sure.

SS: Elemental Heal.

DrMR: So the elemental diet, Elemental Heal, is essentially—you can think of it like a meal replacement shake, so a complete meal replacement, that’s very SIBO friendly, very gut friendly, and hypoallergenic.

And how this came about was patients were benefitting from using elemental diets. But the ones on the market really tasted bad.

SS: Like vomit. That’s what I’ve heard they were compared to.

DrMR: Yeah, Vivonex Plus I feel like tastes like postage stamp glue. And I can choke down pretty much anything. But even I said to myself, “Whew! This is a tough sell.”

But in reading much of the research for my book, I uncovered that in many of the comparative trials, pretty much all the data shows that a semi-elemental formula, which this is, works just as well as a fully elemental formula. But the semi-elemental formulas tend to taste a lot better.

SS: What’s the difference?

Semi-elemental vs. Elemental Diet

DrMR: The difference is with how much the protein molecules are broken down. You have a protein molecule. When it’s semi-digested, it’s semi-elemental. When it’s fully digested down to its amino acids, it’s fully elemental.

Now, that difference may sound subtle. But it has a fairly sizeable impact on the taste. And so we’ve been using this in the clinic for a couple of years now. We’ve been using semi-elemental formulas in the clinic. And the results are great.

I should say that this is not the only version that will work for people. Any elemental or semi-elemental should work well. This one is one that will taste good. There are others similar to this like Peptamen and TwoCal HN and—

SS: Two Cal-A-Gen?

DrMR: TwoCal HN, which is by—

SS: I was like, “Two California gentleman.” Two Cal—wait. Say it again.

DrMR: TwoCal HN.

SS: Okay.

DrMR: And there’s also Elecare. Both of those, I believe, are by Abbott Pharmaceuticals. And those work. And those taste good. But they do have some ingredients that people don’t like. I don’t have a big problem with them if people feel well. But they do have some corn syrup solids and some artificial flavorings and sweeteners.

SS: That’s why they taste good.

DrMR: This one does not.

How to Drink Elemental Heal

Funtional Medicine FormulationsSS: Okay. And normally, you would follow the instructions.

DrMR: Normally, you’d put this in a blender. It blends really well in a blender. It’s not necessarily made to mix.

SS: Okay. I’ve never put mine in the blender. Just so you know.

DrMR: Oh my God! You’ve got to start doing that.

SS: Yeah, okay.

DrMR: In the blender with some water and a few ice cubes. Then you are in good shape.

SS: I bet that’s much better. But this is fine though.

DrMR: Yeah. Cheers!

SS: Cheers! Cheers! Thank you.

Cold water, for sure, I think improves it big time. The fact that I’m not hacking or gagging is huge because I’m so picky and a supertaster. But this is fine. It’s very soothing actually.

DrMR: It’s not going to taste like a sundae in a blender. But it doesn’t taste bad. It’s got a neutral taste with a little bit of sweet but not anything near to the point where it would be considered overpowering.

And yeah, essentially what you do when you’re doing these exclusive elemental diets is you would make this. I put mine in one of those Hydro Flask bottles that keep the fluid very cool. And I’ll make a good-sized batch. And I’ll just sip on it throughout the morning, evening, afternoon. And when you get to the bottom of one batch that you’ve made, just make another. And when I say “make,” water, ice—

SS: What we just did, yeah.

DrMR: And blend. And I’ve done this for four days. I can’t say I’ve done it for two to three weeks. But I didn’t need to do it for two to three weeks. And during that four days, laser-like focus, good energy, good digestion, good sleep. You wouldn’t think you’d sleep well because maybe you’re saying, “I don’t feel like I’m eating that much.” But you can get a good amount of calories in by using this. And it’s just an option for people to use the elemental diet and allow them not to be hindered by the taste.

SS: I instantly am feeling better, by the way.

DrMR: Good.

SS: Definitely. I don’t know if you saw me. I was fighting my blood sugar.

DrMR: You needed a little boost.

SS: It’s been a long day.

DrMR: I’m right there with you.

SS: I’m feeling instantly better. So that’s amazing. Not just from blood sugar but I just had a little more…

DrMR: That’s a good point. So this will pick your blood sugar up quickly. But you should not drink this like this one glass like a meal. The way you should use this is sipping on it. If you’re a little bit low, you can probably have a little bit more, and that will bring you up. But the way you want to use this is like an I.V. drip, just sipping on it throughout the day because it is rapidly absorbed. So if you have a big glass, your blood sugar might go [whistles ascending, whistles descending].

So sip on it throughout the day. And you’re going to have a constant pulse of some calories coming through. That’s one mistake people sometimes make. And when I check in with patients after they’ve done it, more often it’s the people who say, “Yeah, I was tired and hungry.”

AdobeStock131216529WEBAnd I ask, “Did you read the article that we gave you explaining how to do this, outlining that you should sip on it throughout the day?”

“Oh, no. I didn’t read that.”

SS: Yes.

DrMR: Yeah, okay.

SS: “It’s a protein powder. What do I need to read?” Yeah.

DrMR: People are conditioned, I think, to just down your smoothie. But with this, a slow, steady sipping approach is the best.

SS: And this doesn’t have any fat added to it.

DrMR: No.

SS: So the recipe reads that you should add oil to it.

DrMR: Mm-hm. And you can add a couple different types of oil. I discuss that in Healthy Gut, Healthy You. You can do a 3-6-9 omega blend. You can also, if you’re constipated, use MCT oil (medium chain triglyceride oil). That can be laxating. So if you’re more prone to diarrhea, I wouldn’t use MCT. But if you’re constipated, you can use the MCT oil.

SS: And is that coconut oil?

DrMR: It’s coconut derived, yeah.

SS: Okay. Okay. Any other tips? I was also thinking a little splash of black coffee could be good, depending on the time of day.

DrMR: Yeah, and your question leads to the answer I would give to, “Any other tips?” Which is, don’t make this all or none. For some people, they do one small meal a day while doing the elemental. And they still benefit. So don’t build it up in your head where, “Okay. I can either do it two weeks exclusively or nothing at all.” It doesn’t have to be that restrictive.

So get started. And then you can take some liberties. I’d say give yourself a couple days on it exclusively if you can. And then tinker. Maybe you add a little bit of coffee and you say, “Okay. Am I still feeling as well as I was before?” And if you are, continue. Or if you’re getting really hungry, have a small meal.

Don’t think about these things as absolutes because you can make a lot of little modifications. And I think oftentimes people need a doctor or a clinician to tell them, “Oh yeah, you can have one small meal a day.” And as soon as they hear that, they think it’s okay.

AdobeStock69366931WEBBut a lot of times, doctors don’t have all the magical answers. Doctors are just thinking pragmatically. Well, if we know you can benefit from 100% use but you can only do 80% use, logic would suggest you would still benefit.

SS: Yeah.

DrMR: And in this case, we happen to have the research on the hybrid use of the diet. And we know that people will still benefit. But don’t make the boundaries so rigid that if you don’t do it the way that you heard you should do it, you’re going to fail and all bets will be off because you can still benefit.

SS: Well, thank you very much because I know this is a labor of love.

DrMR: It was. It was. And I want to just share what we were doing at the clinic. And I’ll tell you when this really hit me. It was the SIBO Symposium. I believe it was 2016. And I was on the panel with a few other people. And questions about the elemental diet came up. And I was making all these comments about the semi-elemental diets. And no one on the panel or in the audience had heard of any of this.

And I said, “Wow! No one knows about the [semi] elemental diet being as effective as a fully elemental diet. And these formulas are better.”

SS: The semi-elemental proving as effective as fully elemental.

DrMR: Yeah, or the use in the hybrid application. No one had heard of this. And I realized that there’s a wider breadth of knowledge regarding using the semi-elemental diet that I don’t think the SIBO community has really been made aware of. And so I was excited to get this out there to help people because clearly, it can help people. And it’s not as hard nor as bad tasting as the fully elemental solutions are.

SS: Yeah, and you’re coming out with a chocolate? Is this true? Is that a rumor?

DrMR: Yes. Yep, chocolate is a couple months away probably.

SS: Is it going to be more powerful in terms of a flavor than this vanilla?

DrMR: No, I’ve tried it. And it’s just a subtle chocolate flavor. Yeah, it’s not overpowering. And I think that’s important because a really chocolaty drink would probably be nice for the first couple hours. But then after a while, it would become overpowering. And so that’s why I think just a subtlety in the flavoring is important.

Also, the more flavored it is, the more stuff goes into it and the more reactions one can have. So we’re trying to find that delicate balance of some flavor but not too much.

SS: I think this is going to really serve and help a lot of people.

DrMR: I hope so. At the office, it’s been one of the best things to reach in my back pocket for when people aren’t responding to any of the other therapies.

SS: Hope in a jar. Thank you, Dr. Ruscio.

DrMR: Thank you.

What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.


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