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  • Writer's pictureKeenan Eriksson

The Elemental Diet: A Clinically Backed Method to Healing Your Gut Biome

Whenever I hear about effective methods for improving my gut microbiome, I get excited. At this point I’m sure you’ve heard that our gut health matters. If not, here’s the gist, our digestive tract contains healthy bacteria that keep us, well, healthy. 

However, most people don’t know just how influential our gut health is on our being. To put things in perspective, our genetics obviously influence us immensely. Well, consider this, the bacteria in a healthy gut biome represent tenfold more DNA influencing our physiology than our human DNA. 

This is no small thing, poor gut health is being looked at as one of the most influential sources of autoimmune disease, mental health problems such as schizophrenia and autism, diabetes, inflammation, cancer, etc. 

It’s kind of a (really) big deal.

So you can imagine my excitement when my favorite health writer came out with a podcast with his favorite gut health expert. 

Ben Greenfield is my go to source of information for all things health related, and he recently interviewed Dr. Michael Ruscio, author of Healthy Gut, Healthy You, which Ben recommends as his number one source for information on healing the gut. To me this is akin to Bruce Lee giving a number one recommendation to a book about learning to fight. 

I strongly suggest listening to the podcast here

As I listened, it became quickly clear why Ben likes Dr. Ruscio’s work so much: Ruscio puts incredible importance on research and clinical relevance for the methods he uses to heal. Seems like a no brainer right? Not quite. Many practitioners use methods with their patients without research to back it, and sometimes it works but many times it does not. 

There were many great points brought up during this podcast, such as how SIBO can mimic hypothyroidism, and the ways in which melatonin can decrease gut inflammation. However the point I want to talk about with you today is a gut healing diet I’d not heard of before this interview: The Elemental Diet.


What is The Elemental Diet

The easiest way to understand the elemental diet is to think of it less as a diet and as more of a modified fast. Essentially, fasting heals the gut, most notably the small intestine, by giving it a break. However, fasting is not something everyone can do for long periods of time.

Alternatively, the elemental diet may be maintained for up to 3 weeks with no other foods. Essentially, the elemental diet is an antibiotic, hypoallergenic, liquid-based diet which heals the gut biome due to its lack of allergens and low amount of fiber. 

The name elemental comes from the premise that all your food is consumed in its elemental form, or more properly its most basic form. For example, protein is made up of amino acids, so your protein is from already broken down amino acids.

The elemental diet is a liquid diet, and is definitely a precision tool. The best way to use the elemental diet is if you know you have gut health problems, especially if they are inflammation related (IBS, dysbiosis, SIBO.)

The elemental diet actually works by reducing the available food for the bacteria in our gut, which may seem counter-intuitive, but the research supports it and that brings us to the next point.


How It Works

The elemental diet effectively starves the bacteria in our gut, so how does that help heal bacteria-related gut problems? 

The key is inflammation. Inflammation in the gut prevents good bacteria from growing, and has particular consequences for the environment of the small intestine.

Fasting has been shown to increase good bacteria and re-balance the gut by reducing inflammation. 

Furthermore, all types of elemental diets have been shown clinically to improve autoimmunity and decrease small intestinal inflammation:

Changes of faecal microbiota in patients with Crohn's disease treated with an elemental diet and…

Dig Liver Dis. 2012 Sep;44(9):736-42. doi: 10.1016/j.dld.2012.04.014. Epub 2012 May 22.www.ncbi.nlm.nih.govAn altered gut microbiome profile in a child affected by Crohn's disease normalized after…

Am J Gastroenterol. 2013 May;108(5):851-2. doi: 10.1038/ajg.2013.46. Case Reports; Letter; Research Support, Non-U.S…

Think of it like a break for you gut. Our digestive system is actively digesting food, daily, for years. However ancient humans experienced periods of fasting often and among the many benefits, it helped keep our guts balanced. 


Implementing The Elemental Diet

The elemental diet is a fast, and like long term fasting, it is suggested that you work with a medical practitioner during your fast. That said, there are ways to make the elemental diet less extreme if you have concerns. 

More or less, the duration of your elemental diet should correlate with the severity of your gut health problems. The more issues you have, the longer you should do the diet but you should also use more supervision. 

That said, semi-elemental diets, which are less extreme, appear to offer the same benefits as full elemental diets. 

Enteral nutritional therapy for inducing remission of Crohn's disease. - PubMed - NCBI Cochrane Database Syst Rev. 2001;(3):CD000542. Reviewwww.ncbi.nlm.nih.govEnteral nutritional therapy for induction of remission in Crohn's disease. - PubMed - NCBI

Cochrane Database Syst Rev. 2007 Jan 24;(1):CD000542. Meta-Analysis; Reviewwww.ncbi.nlm.nih.govControlled trial comparing two types of enteral nutrition in treatment of active Crohn's disease…

Gut. 1991 Dec;32(12):1492-7. Clinical Trial; Comparative Study; Randomized Controlled

So what is the difference between elemental and semi-elemental? Mainly, it’s taste. Full elemental diets can taste poorly, but the clinical diet seems to indicate that they are not more effective. 

Semi-elemental diets use food particles that are not as fully broken down, but taste better and seem to work just as well. 

As far as which elemental diet to use, and how, these are the recommendations of Dr. Ruscio in his Elemental Diet Instructions:

1. Commercial semi-elemental diet — Elemental Heal by Functional Medicine Formulations *my preference 

Elemental Heal uses a whey protein isolate, is lactose free and casein free and hypoallergenic; non-GMO, no corn, no preservative or artificial sweeteners. The carbohydrate is provided by tapioca maltodextrin. 

2. Commercial elemental diet 

Physicians Elemental i. Available in Original and ‘Dextrose-Free’. I would recommend starting with the original version unless you are sensitive to carbs, in which case Dextrose-Free may be a better fit, as it contains 10 grams less sugar. This is a subtle difference, so if you need a truly low carb version of the elemental diet, the homemade version may be best. ii. Prescription not needed, but only available through a licensed healthcare provider.

Other commercial semi-elemental formulas EleCare by Abbott

3. Homemade elemental diet — see appendix section for instructions. This includes two versions; one high carb and one low carb. 4. Other commercial semi-elemental formulas TwoCal HN by Ross Nutritional Peptamen by Nestle 5. Prescription elemental diet — Vivonex Plus by Nestle *if you have a doctor who is willing to work with you and write this prescription. The taste is hard for many to get past.

Long story long, here are the main decisions you need to make regarding using the elemental diet:

1. How Severe Are Your Symptoms? 

  • Do you have gut health problems? Have you confirmed gut health problems via testing? Do you have SIBO, Dysbiosis, IBS, Crohns, etc. Keep in mind that gut health problems do not always manifest in any physical digestive issues such as bloating or pain. Personally, when dealing with symptoms of chronic fatigues syndrome and heart palpitations, the biggest problem I found through testing was gut dysbiosis. Gut health problems can be the root cause of fatigue, mood problems, inflammation, and even mental health problems.

2. How Long Will You Participate? 

  • Generally, the more severe your gut health issues, the longer you’ll want to try an elemental diet. However, remember that the elemental diet is essentially a form of fasting. It can be maintained for up to 3 weeks, but you may want to “test” it with a 3 or 4 day trial and see how you feel. 

3. What Kind of Elemental Diet Will I Use? 

  • You can’t just buy the ingredients for an elemental diet off the shelf, so you need to decide if you’re going to learn the extensive details necessary to do a home-made diet, or buy a pre-made formula. Furthermore, you need to decide whether to do a purist elemental diet, or the more popular semi-elemental diets. As discussed earlier, semi-elemental diets appear to be just as effective and also taste better.

  • Elemental Heal by Functional Formulations is Dr. Ruscio’s number one preference, but there are other options. Just make sure that whatever you use is a legitimate, high quality product. I recommend using something that is recommended by functional medicine practitioners rather than something generic. 


In Conclusion

Gut health problems are the source of many of our health problems, and addressing them with a healthy lifestyle is essential for anybody with concerns about their health or longevity. However, not all doctors are implementing effective, backed methods for treating our gut health. 

That said, one of the most effective and well researched methods for healing the gut is to use The Elemental Diet, a form of modified fast that heals the gut by starving bad bacteria of fiber and removing allergenic foods from one’s diet. 

Generally, the worse your gut-related health problems, the longer you can participate in an elemental diet. It is recommended that you do no more than 3 weeks on the diet, and that the longer you go, the more supervision you use. Work with a medical supervisor, especially if you are addressing severe problems. 

Also keep in mind that gut health problems do not always manifest in digestive issues. You might be like me and have severe gut dysbiosis that is causing your anxiety, chronic fatigue, and heart palpitations, but you never get bloating or digestive issues. The gut biome is the source of billions of bacteria that influence our physiology, and that influence goes far beyond digestive issues. As an example, bacteria in our guts create the neurotransmitter serotonin, which influences whether we have depression or anxiety disorders as well as our perception of reality. 

If you try an elemental diet, use a quality product such as Elemental Heal by Functional Formulations. Lastly, if you’re interested in becoming a gut health expert and really taking charge on healing your gut, look into the work of Dr. Michael Ruscio, especially his book Healthy Gut, Healthy You.


FDA Compliance Statement: The information presented on Keenan Eriksson Fitness has not been reviewed by the FDA or any other medical body and is not intended to cure, treat, or prevent any illness or disease. Consult a doctor before using any of the content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition. Content on this website is for educational purposes only.

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