Homemade Elemental Diet
What is the Elemental Diet?
Elemental diet is a hypoallergenic liquid diet that contains pure amino acids (hydrolyzed proteins) and medium chain triglycerides (MCT). Elemental diet is easily digestible which requires minimal digestion and easily tolerate by patients with gastrointestinal (GI) issues.
The elemental diet allows the gut to rest and repair and can be used intermittently.
What is the Elemental Diet used for?
The elemental diet has been studied for the treatment of Small Intestine Bacterial Overgrowth (SIBO) in Irritable Bowel Syndrome (IBS) patients. Symptoms of IBS include abdominal pain or cramping, bloating, flatulence, not fully emptied after passing the stools, mucus in the stools, nausea, sensitive bowels, alternating diarrhea and constipation and either constipation or diarrhea.1 After 2 weeks on the elemental diet, 80% IBS subjects had a normal lactulose breath test (LBT) and 20% IBS subjects had a normal LBT after 3 weeks. The study concluded that the elemental diet is “highly effective in normalizing an abnormal LBT in IBS subjects, with a concomitant improvement in clinical symptoms.”2
In a controlled and double-blind pilot study published on the Clinical Experimental Rheumatology Journal shows that the tender joints were significantly improved for 10 patients with rheumatoid arthritis after 3 weeks on the elemental diet.3
Another study published on Gut BM Journal shows that 85% patients with Crohn’s disease were treated successfully with the elemental diet. The long-term outcome of the treatment was assessed over a 5 year period.4
In summary, the elemental diet is used for SIBO, IBS, IBD, Crohn’s disease, ulcerative colitis, allergies, food intolerance, rheumatoid arthritis, Candida*, Cystic Fibrosis, pancreatitis, gastrointestinal issues and underweight individuals due to malabsorption.
Is the Elemental Diet safe?
Yes. A study published in the Gastroenterology Journal shows that the elemental diet is safe for human for at least 12 days. The study shows that the elemental diet does not affect on “serum biochemical and hematological parameters, hepatic secretion of bile salts, pancreatic secretion of enzymes under standard stimuli, and transit time of radio-opaque markers”. The study also shows that a significant weigh loss during the first 4 days of treatment and the diet did not induce any pancreatic lesion. Serum cholesterol and uric acid concentration were also reduced. Furthermore, the study also found that “the elemental diet may produce beneficial changes other than those related to pancreatic secretion.”5
How long should I stay on the Elemental Diet for?
The longest period the elemental diet was studied for is 3 weeks. In most cases, the elemental diet is for 2 weeks however some individuals might need to stay on the elemental diet for 3 weeks as their symptoms still persist after 2 weeks. Patients with Crohn’s disease might find improvements on a 4-week elemental diet.10
Elemental Diet contraindications
Weight loss, low blood sugar, fungal overgrowth may be exacerbated, cold hands and feet, and not suitable for those with kidney diseases.
Homemade Elemental Diet Recipe
The original Homemade Elemental Diet recipe was created by Dr Allison Siebecker on the SIBO Info website.6 However, I find the Jo Mar Labs Amino Acids: Black Label Pure Form 21 Blend is expensive and not available in Australia so I substitute it with the Collagen Peptides as it is highly digestible and easy to be absorbed. I also use MCT oil and lecithin in my formula as they were used in the studies.3,5
Medium-chain triglyceride (MCT) oil is used as fat substitute because it is easier to digest than long chain fats. MCT oil is an instant source of energy and can be converted into ketones to fuel your brain. Studies show that MCT oil promotes weight loss, optimizes the growth of good bacteria, supports the gut lining, ketone production, may help reducing lactate buildup, increases fat burning exercise, may help managing epilepsy, Alzheimer’s disease, and autism, fights yeast and bacteria overgrowth especially Candida albicans, Clostridium difficile, reduces cholesterol, reduces the risk of heart disease, reduces C-reactive protein (CRP), helps control blood sugar level, supports diabetes management, and improves insulin resistance.7
Studies also show that Lecithin may help lowering the cholesterol, improving cardiovascular health, improving digestion especially ulcerative colitis and IBS, enhancing the memory, neurological and nervous system conditions, reducing Alzheimer’s symptoms, soothing and moisturizing the skin.8
Collagen Peptides (Bovine) is also known as bovine cartilage or beef collagen and a food supplement which has an absorption rate of over 90% compared to only 27% or less in food. It’s a naturally occurring protein found in the cartilage, bones and hides of cows. This type of collagen is very similar to what we have in our bodies and provides a healthy dose of types I and III collagen. Thankfully Nourished Collagen Peptides are a source of amino acids, especially high in glycine, proline and lysine. Researchers believe that collagen peptides can be used for long-term treatment of osteoarthritis and osteoporosis. It improves digestion by increasing gastric or stomach acid, builds muscles and repairs tissues, promotes better quality sleep, improves skin quality, reduces the wrinkles, decreases puffiness and fights various other signs of aging.9
Disclaimer: This recipe has not been formally tested. Its safety, tolerability and effectiveness is unknown. Please consult with your doctor or healthcare practitioner before commencing the elemental diet and its period length.
If you are going to use the Elemental Diet for Candida albicans overgrowth, omit honey and dextrose as the sugar in honey and dextrose could feed Candida albicans and use Stevia instead. Drinking Licorice tea 2 - 3 times a day can help reducing the sugar craving. Licorice tea is not to be used for those with high blood pressure.
- 2 – 3 tubs of Thankfully Nourished Collagen Peptides (Bovine)
- Clear honey (carbohydrate of glucose and fructose), or Dextrose (glucose)
- MCT oil (Melrose MCT Pro Plus Go for Longer Oil)
- Macadamia, or olive oil
- Lecithin (Wonder Foods Sunflower Lecithin)
- Salt of the Earth Celtic or Earth Salt Himalayan salt – high mineral content salts
- High quality Multivitamin (Percy’s Rhomanga Mineral and vitamin tablets or GenoActive Multi B Plus)
- High quality fish oil (Orthoplex BioActive Lipids or for vegan Udo’s Choice DHA oil vegetarian) x 3 capsules/day
- Iron tablet (Biopractica Organic Iron Plus) (optional for those with low iron level)
- Licorice tea (prevent low blood pressure and not to be used for those with high blood pressure)
- Fresh grated ginger
Daily Protein Requirement
If you’re at a healthy weight, don't lift weights and don't exercise much, then aiming for 0.8–1.3 gram per kg or 0.36–0.6 grams per pound of your body weight. For those who would like to lose more weight, aim for 1.5 gram per kg of your body weight.
Work out how much protein you need per day and divide it by 4.5 g to give you the total tablespoons of Thankfully Nourished Collagen Peptides (4.5 g Protein) you need per day. For example, for an active person weight 42 kg, you will need 1 g protein per 42 kg which means 42 g protein per day or 9.3 tbsp per day (42/4.5=9.3). You could try having more protein during the day and less protein at night as it may affect your sleep. For example, you may have 3.5 tbsp for breakfast, and 3 tbsp each for lunch and dinner. If you feel “heated” in the chest, you probably have too much protein so decrease the amount of protein, maintain at the same dose for 3 – 4 days then increase it slowly to your daily required protein.
Daily Carbohydrates Requirement
You might need between 100 to 150 grams of carbs a day which is about 2 or 3 tbsp honey each meal (2T = 34g carbs or 102g/day, 3T = 51g carbs or 153g/day). If you have diabetes, use Dextrose instead of honey (3.5 T Dextrose = 35 g carb or 105 g/day, 5 T = 50g carb or 150g/day).
Daily Fat Requirement
For women, you’ll need about 111–167 grams of fat per day and about 139–208 grams of fat per day for men. 1 tbsp of MCT oil contains 14 g fat, and 1 capsule of fish oil contains 1g fat.
Work out how much fat you need per day and divide it by 14 g fat to give you the total daily tablespoons of fat you require to eat. For example, for women with 111 g of fat per day, take 2 tbsp of MCT oil (28 g), 3 capsules of fish oil (3 g) and 6 tbsp of macadamia or olive oil a day (84 g). For men with 139 g of fat per day, take 2 tbsp of MCT oil (28 g), 3 capsules of fish oil (3 g) and 8 tbsp of macadamia or olive oil a day (112 g).
Per meal Dose (taken 3x/day for 14 days or 21 days):
- X tbsp of Thankfully Nourished Collagen Peptides per meal
- 2 - 3 Tbs clear honey or 3.5 - 5 Tbs Dextrose per meal
- 1 tsp MCT oil per day for the first week then gradually increase to 2 tbsp a day as it can cause gastrointestinal distress
- 2 – 3 tbsp macadamia or olive oil per meal
- 1/3 tsp Celtic or Himalayan Salt per meal
- 1 tsp lecithin per meal
- 1 tablet Multivitamin per meal
- 1 capsule fish oil per meal or cod liver oil
- Iron tablet per day and taken 2 hours away from the multivitamin
- Licorice tea x 2 – 3 cups a day - help reducing sugar craving and reducing low blood sugar symptoms
- Fresh grated ginger x 2 – 3 cups a day - help with cold hands and feet and eradicate bacteria
Add collagen peptides, honey, MCT oil, olive oil, lecithin and salt in a 500 ml filtered/distilled water. Mix well and sip it throughout the day to reduce hunger. Do not use juice, milk or any other liquids to mix it. 6
- Clear honey should be used as it is easier to absorb. Cloudy honey may have complex pollen proteins.
- Please consult with your doctor or healthcare practitioner before commencing the elemental diet and its period length.
- You may have "Keto flu" symptoms such as aching, fatigue, headache, irritability, difficult focusing (brain fog), sugar craving, dizziness, nausea, muscle cramps and lack of motivation after 3 - 5 days of the diet. Fortunately, it’s temporary, and you’ll likely have more energy than before you started the diet.
- Take it easy on the physical exercise. Avoid spending more than 45 mins at the gym or performing any strenuous exercise. Yoga, Taichi, Qigong, and brisk walking are recommended during the elemental diet.
- After 5 - 9 days of the diet, you may see your stool looks like Meconium (viscous, sticky, thick, super-dark and greenish black stool). It may be the signs of the stool that has been sitting in your gut for a long time. (Yuck! But you'll be glad that it is out of your gut).
- You may lose weight and belly fat. Highly recommend to weight yourself, measure your abdominal circumference, make note of your energy level, sleep quality, appetite, bad breath, flatulence, bloating, depression and moods etc before and after the diet to see how the diet affects you.
- Drink more salt and water on the day that you have "Keto flu", take it easy and have plenty of sleep on that day.
- If you use the Elemental Diet for Candida, you may add PPC Herbs Tri Plex into your Candida regime to kill the parasites (de-worms) as well.
How do I come off the Elemental Diet?
Day 1: Homemade Low FODMAP broth. If tolerate well on the first day, add well-cooked homemade low FODMAP puree vegetables.
Day 2: Steamed Low FODMAP vegetables, slow-cooked meats, eggs, or grains (if tolerate)
Day 3: Transition into a Low FODMAP diet. When the gut stabilized, challenge low FODMAP foods to identify the food group that you are intolerant to.10
- Irritable bowel syndrome (IBS) - Better Health Channel. 2018. Irritable bowel syndrome (IBS) - Better Health Channel. [ONLINE] Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/irritable-bowel-syndrome-ibs. [Accessed 24 November 2018]
- Pimentel, M et al, 2004. A 14-day elemental diet is highly effective in normalizing the lactulose breath test. Digestive Diseases and Sciences, 49, 73-7
- Haugen, MA et al, 1994. A pilot study of the effect of an elemental diet in the management of rheumatoid arthritis. Clinical Experimental Rheumatology Journal, 12, 275-9
- Teahon, K et al, 1990. Ten years' experience with an elemental diet in the management of Crohn's disease. Gut BM Journal, 31, 1133-1137.
- Perrault, J., Devroede, G. and Bounous, G. (2018). Effects of an Elemental Diet in Healthy Volunteers. [online] Gastroenterology. Available at: https://www.gastrojournal.org/article/S0016-5085(73)80127-1/fulltext [Accessed 23 Nov. 2018].
- Siebecker A. 2018. Homemade Elemental Diet. [ONLINE] Available at: https://www.siboinfo.com/uploads/5/4/8/4/5484269/homemade_elemental_diet_options.pdf. [Accessed 24 November 2018].
- O'Brien S. 2018. 7 Science-Based Benefits of MCT Oil. [ONLINE] Available at: https://www.healthline.com/nutrition/mct-oil-benefits#section9. [Accessed 24 November 2018].
- Wilson D. 2017. Lecithin Benefits. [ONLINE] Available at: https://www.healthline.com/health/lecithin-benefits. [Accessed 24 November 2018].
- Price A. 2018. Bovine Collagen Benefits for Skin, Sleep & Muscle Repair. [ONLINE] Available at: https://draxe.com/bovine-collagen/. [Accessed 24 November 2018].
- Kaczor T. 2018. The Elemental Diet for SIBO and Other Gut Conditions. [ONLINE] Available at: https://www.naturalmedicinejournal.com/journal/2017-09/elemental-diet-sibo-and-other-gut-conditions. [Accessed 24 November 2018].