A new study from Cedars-Sinai has revealed that a specialized, more palatable version of the elemental diet may improve symptoms of gastrointestinal disorders related to an imbalance in gut microbiota. Published in Clinical Gastroenterology and Hepatology, the research also explored whether enhancing the diet’s taste—long a barrier to adherence—could help patients stick to its strict protocol.
The elemental diet is a low-fat liquid formulation designed to be easily digested, providing all essential nutrients needed for a healthy diet. Previous studies have suggested that the diet can help alleviate symptoms associated with gut conditions like small intestinal bacterial overgrowth (SIBO), intestinal methanogen overgrowth (IMO), Crohn’s disease, and eosinophilic esophagitis, among others.
The diet is thought to work by reducing inflammation, balancing the gut microbiome, healing the gut lining, and offering complete nutrition without additives and allergens that often trigger irritation. However, its low adherence rate has been a challenge, largely due to its strict guidelines and unappealing taste.
SIBO and IMO are conditions where harmful bacteria or methane-producing microbes grow excessively in the gut, and while antibiotics are commonly used to treat them, they are not always effective.
“Elemental diets are designed to give the digestive system a break by providing easily absorbed nutrients,” explained Ali Rezaie, MD, corresponding author of the study and medical director of the GI Motility Program at Cedars-Sinai. “This reduces stress on the gut, helping it heal and function better.”
In the study, 30 adults, aged 18 to 85, diagnosed with SIBO or IMO adhered to the modified, more palatable elemental diet for two weeks. This was followed by a two-week period where participants returned to their normal diet. Researchers tracked changes in the gut microbiome, symptom relief, breath test results, and any side effects.
The results were promising. Most participants tolerated the diet well, reporting no serious side effects. One key finding was a reduction in harmful microbes associated with digestive issues, including a significant decrease in methane levels, which returned to normal for many participants.
Moreover, 83% of the participants reported feeling better, experiencing relief from common symptoms like bloating and discomfort. These outcomes suggest that making the elemental diet more palatable could help restore gut balance and alleviate symptoms of SIBO and IMO.
“The positive results indicate that improving the taste of the elemental diet could make it more accessible and easier for patients to follow, ultimately improving adherence and quality of life for those struggling with traditional treatments,” said Mark Pimentel, MD, executive director of the MAST Program at Cedars-Sinai.
Building on these encouraging findings, Rezaie and his team plan to conduct larger studies to examine the long-term effects of the elemental diet and address the socioeconomic barriers to its use.
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