Elemental Diet – Does it Work for Weight Loss?

Today is the world of social media, where everything is commercialized. Now, the world has turned into a small village where it is way too easy to keep in touch. As a result, there is peer pressure on us to look perfect. This leads to the various methodology of losing weight, improving skin, hair transplant, and even lip fillers. 

There are several ways to lose weight. Popular ones are reducing diet, jogging, gym, strenuous exercise, etc. Some uncommon ways that are in limelight nowadays are water diet, keto diet, an elemental diet, etc. 

What is the Elemental diet?

Let’s talk today about the Elemental diet that how it helps in weight loss. This is a new concept or myth introduced by people who know nothing about the significance of a balanced diet or side effects of using an elemental diet in healthy individuals.

An elemental diet is a kind of diet that is specifically made up of building blocks of food. By building blocks, we mean that instead of carbohydrates, the elemental diet will have monosaccharides in it. Monosaccharides are the simplest form of carbohydrates. The same goes for proteins and fats. Instead of protein, the elemental diet contains amino acids. 

Instead of fats, the elemental diet contains fatty acids. Thus, the elemental diet is composed of monosaccharides, amino acids, and fatty acids. It also contains vitamins and minerals. Electrolytes are also added in certain conditions. In the elemental diet, all nutrients are provided to the body via the gastrointestinal tract. (1)

Purpose of an Elemental Diet

Now, what is the purpose of first creating then preserving this composition of elemental diet? The answer is medical ailments. An elemental diet is composed of different pharmacists based on doctor’s instructions for various diseases. Water and tea are also included in the elemental diet. 

Availability of elemental diet

After preparation and preservation, this one is sold over the counter as a diet for the patients. It is easily available on prescription. It is either in powder form or liquids. To use it, we mix it with water or any liquid and it is available for intake. In patients, it is used for ingestion via the feeding tube. Another way is intravenous therapy.

Composition of an elemental diet 

It is specially formulated to provide all nutrients including minerals. Vitamins are also present in it. Different studies conducted reveal that an elemental diet contains16-18% amino acids, 45-75% monosaccharides and 10-40% fatty acids. This percentage tells us that the highest concentration is carbohydrates as they are easy to digest. The lowest concentration is of fats as they are difficult to absorb. Protein lies in between including both essential amino acids and non-essential amino acids. Those proteins which are reported to cause allergic reactions are not present in the elemental diet. (2) 

What should be the duration of the elemental diet?

Well, the duration of the elemental diet depends upon the condition for which this diet is introduced. The medical practitioner starts the elemental diet with small doses. When the patient starts tolerating small doses, then the medical practitioner gradually increases the dose. If symptoms of intolerance of elemental diet occur like a pain in the abdomen or increase in the frequency of stools (diarrhea) then further increase in dosage is stopped. Most of the time trial period is of three days. As this diet is unpalatable, so patients refuse to take it for a long duration. When it is mandatory, sometimes flavors are added to make it palatable. For some ailments, electrolytes are added to the elemental diet. (3)

How elemental diet works in the digestive system? 

A question arises in our mind that how elemental diet works? Why pharmacists have degraded food into building blocks upon doctor’s advice. Why it is used in diseases related to the gastrointestinal tract? The answer is the basic mechanism of elemental diet is to help your bowel and intestines to take rest. As the food is already broken down and partially digested enough work to do. The gastrointestinal tract just absorbs the already simplified food. 

Diseases in which elemental diet is advised

Now, let’s see in which diseases, elemental diet is prescribed? There are many diseases in which patients find relief from the elemental diet. Most of the diseases are of the gastrointestinal tract. An elemental diet is prescribed to patients who have issues related to the gastrointestinal tract. Most of the patients have trouble digesting normal food. An elemental diet is advised in Crohn’s disease, eosinophilic esophagitis, small intestinal bacterial growth. It is also prescribed in cancer patients. It is advised in patients with eating disorders like Anorexia nervosa. It is used by patients post-operatively who undergo surgeries involving the gastrointestinal tract, for example, gastrectomy. 

Crohn’s disease

What is Crohn’s disease? It is an inflammatory disease in which there is involvement of bowel. This disease can affect any area of the digestive tract. This disease is characterized by pain in the abdomen, abdominal distension and increased the frequency of stools. It can also accompany nausea and vomiting. There is an impairment of the immune system. The main treatment of this disease is dependent on steroids. 

However, due to various side effects like Cushing syndrome, doctors opt for the inflamed area of bowel is at rest and it starts healing. Elemental diet provides nutrients to the body. As it is in simplified form, so gut doesn’t have to work a lot. It is absorbed easily. As a result, the diet is free of allergens, so symptoms don’t aggravate. Patient health is improved due to the availability of all nutrients and the gut is healed as it is at rest. Studies show that the flora of intestine is abnormal in this disease. Elemental diet use leads to the eradication of flora, thus eliminating the cause of disease. 

Eosinophilic esophagitis

This disease is characterized by pain in the chest and heartburn. It is an inflammatory disorder. This disease manifests as dysphagia. In this disease, there are raised levels of IgE and eosinophils.  These levels are raised because of the presence of allergens in diet. An elemental diet is free of all allergens thus helps in healing of the inflamed esophagus. It improves symptoms of eosinophilic esophagitis. 

SIBO

Elemental diet seems to be helpful in patients who are suffering from SIBO. Now, what is SIBO? As the name suggests, this disease is characterized by the overgrowth of bacteria in the small intestine. The patient presents with pain in the epigastrium and sometimes abdominal distension. It is associated with different disorders of the gastrointestinal tract in which bowel movements are impaired. It is diagnosed by breath tests and in severe cases by a culture of the duodenum. The elemental diet is easily digested. As this diet is already broken down into elements, there is no need for any metabolism and bacteria don’t thrive on any metabolites. Hence, the growth of bacteria is restricted. Thus, there is an improvement in the symptoms of patients suffering from SIBO. 

Irritable bowel syndrome

This syndrome is characterized by pain in the abdomen and indefinite pattern of bowel movements. In some patients, diarrhea is the main complaint while in others constipation is a predominant symptom. The elemental diet seems to be helpful in patients who are suffering from irritable bowel syndrome. 

Surgery involving gut 

Elemental diet seems to be helpful in patients who have undergone surgeries Involving the gastrointestinal tract. An elemental diet is an effective remedy for all such conditions in which a person is unable to digest food properly. The major bulk of elemental food is absorbed in the small intestine thus large intestine is duty-free. An elemental diet is helpful in gastrostomy. In gastrostomy, there is rapid emptying of food contents from the stomach thus helping it to heal. The same is the case with Ileostomy. An elemental diet is of great significance in rectal surgeries as feces are produced in less amount, thus avoiding contamination and promoting healing. Some studies suggest improvement in high ileostomy after opting for an elemental diet. (4) 

Malabsorption syndrome 

An elemental diet is significant in the treatment of Malabsorption syndrome as it provides nutrition to the body, thus maintaining a healthy weight. 

Cancer patients 

The elemental diet seems to be helpful in patients suffering from cancer. Elemental diet provides nutritional support to cancer patients undergoing chemotherapy. This diet helps to improve post-radiotherapy and chemotherapy side effects, for example, oral mucositis. (6)

Patients with eating disorders 

Elemental diet seems to be helpful in patients with eating disorders, for example, anorexia nervosa. Various studies have shown that there are chances of healthy weight gain and improvement of nutritional status in patients with anorexia nervosa when we put them on the elemental diet. 

Why do people consider elemental diet for weight loss?

An elemental diet is considered for weight loss because of many reasons. Some common reasons are discussed here. 

Nutrient-rich diet

As the elemental diet provides all nutrients carbohydrates in monosaccharides form, proteins in amino acids form, fats in the form of fatty acids, so people consider it for weight loss. Even minerals, vitamins and in few diets electrolytes are added. Moreover, these nutrients are present in balanced form according to body needs.

No risk of malnutrition

As all nutrients are present, one need not worry about any nutritional deficiencies or malnutrition that can occur in severe dieting. This theory compels a person to opt for an elemental diet for weight loss. 

Easy availability 

An elemental diet is easily available over the counter. It is available in most drug stores, so one doesn’t have to make special meals and salads at home according to specific recipes by our dietitian. 

Calories calculation

Calories are pre-calculated in an elemental diet. Exact calories are mentioned on these powder sachets or liquids so we don’t have to waste time by estimating calories.  

Complications of elemental diet when used as a weight-loss method

There are several complications associated with elemental diet when used as a weight-loss strategy. 

Rise in blood sugar

Elemental diet has been reported to raise blood sugar in diabetic patients. A major bulk of the elemental diet is of carbohydrates, so this much amount of glucose can raise blood sugar levels in diabetic patients. Hence this diet is suitable for non-diabetic persons. For diabetic patients, it can lead to hyperglycemia and related complications.

Depletion of the normal flora

Elemental diet has been reported to deplete natural flora like bacteria, yeast, etc.

When an individual is taking monosaccharides, amino acids, fatty acids, all food in simplified form, there is not much work for intestines to do and not much food for bacteria to digest. If the elemental diet is prolonged, it will result in the depletion of all bacteria. Bacteria can’t survive without food which is not available because of the elemental diet. These bacteria not only includes the bad one bacteria but also the good one. Good one bacteria are those that maintain a healthy flora of intestine and also protect them from infections.

Clostridium difficile colitis

Clostridium colitis is observed in patients on the elemental diet. In the absence of normal flora, a person is more vulnerable to diseases. A person can suffer from Clostridium difficile colitis. This colitis is characterized by abdominal colic and raised body temperature (fever). Clostridium difficile infection is also caused by the use of metronidazole that eliminates the natural flora of the intestine, especially bacteria. 

Unpalatable taste

An elemental diet is not palatable so it is difficult to take orally. Some flavored elemental diets are available but they are not well appreciated for oral intake. As the intake method for the elemental diet was feeding tube or intravenous, so oral intake is not taken into account while preparing this diet.

Depression 

Depressions and irritability are reported in patients who are on an elemental diet for a long duration. As elemental diet does not have a variety like salads, fruits, pulses, etc. A person feels irritated and bound. A person feels depressed as he or she is unable to enjoy a normal variety of food. Moreover, the diet is in liquid or semisolid form.

He or she tries to remain super busy as any free time will lead to a craving for a solid diet and ultimately frustration. 

Expenses of an elemental diet

An elemental diet is not a cost-effective diet. One powder sachet or liquid comes in packing of 300-400 calories. So many powder sachets or liquid infusions per day are required. They can cost hundreds of dollars. For a long duration, this is an expensive regime as compared to other ways of losing weight.

Die-off reaction

These reactions are reported with an elemental diet. Due to depletion of all normal flora including bacteria and yeast, substances are released in the body which causes die-off reactions. They may present as flu. Symptoms resolve in a few days.

Not suitable for rapid intake

An elemental diet is not suitable to take at a rapid pace. As this diet is formulated for Intravenous route or by feeding tube at a specific pace, this is not practically possible to take it as a normal diet. When taken orally, it can cause pain in the abdomen. So you have to follow a specific time duration or pace in which you empty your glass of elemental diet. (5)

Can’t be used for a long duration

A solely elemental diet is not recommended for a long duration. Studies reveal the maximum duration for the elemental diet is 3 months, not more than that. So, the one using it for 3 months for weight loss can’t pursue it any longer.

Chronic Constipation

Constipation is a common complaint of people who are on an elemental diet.

As this diet is in refined form, there is no fiber present. Due to lack of fiber, a person on the elemental diet suffers from constipation. This constipation is then treated by adding any prokinetic, for example, domperidone, Metoclopramide, etc.

Requires medical surveillance

The elemental diet requires strict medical surveillance. The doctor has to monitor weight so he can assess the exact calorie deficit.

Symptoms should be monitored, so we can assess whether the elemental diet is improving the disease or exacerbating it. Most importantly, serum electrolytes, so electrolytes or salts can be added accordingly. Deranged electrolytes can cause many complications, for example, hyperkalemia can lead to arrhythmias.

The Bottom Line 

After understanding, what is elemental diet and reviewing its potential benefits and side effects, we have realized that opting for an elemental diet for weight loss is not the right choice. We have reviewed that elemental diet is designed for specific medical conditions like Crohn’s disease, eosinophilic esophagitis, bowel surgery, etc. This diet can be utilized only for a short duration. This diet can only be taken under the strict surveillance of a medical person. This diet is not designed for weight loss or specifically for oral intake. So after reviewing all the facts, if we are asked that, If the elemental diet is the right choice for weight loss? The answer is “No”.

So what one should do for weight loss? The answer is acknowledged ways, like eating a balanced diet and doing moderate exercise, should be followed.  These ways are not only helpful but they are also natural. In this way, we will lose weight while remaining healthy and enjoying food. Another important point is weight loss strategy should follow a moderate pace. Rapid weight loss, though seems alluring, has its negative outcomes like malnutrition, gall stones, muscle cramps, and menstrual irregularities, etc.  

References:

https://www.functionalnutritionlibrary.com/elemental-diet-sample/

https://www.healthline.com/nutrition/elemental-diet

https://en.wikipedia.org/wiki/Elemental_diet

https://www.researchgate.net/publication/270909998_Elemental_diets_role_in_treatment_of_High_ileostomy_output_and_other_gastrointestinal_disorders

https://www.spandidos-publications.com/mco/10/1/159

https://www.ncbi.nlm.nih.gov/pubmed/30225745

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