CYBERMED LIFE - ORGANIC  & NATURAL LIVING

Dietary Modifcation: Elemental Diet

An elemental diet is a diet that proposes the ingestion, or in more severe cases use of a gastric feeding tube or intravenous feeding, of liquid nutrients in an easily assimilated form. It is usually composed of amino acids, fats, sugars, vitamins, and minerals. This diet, however, lacks whole or partial protein due to its ability to cause an allergic reaction in some people.

The elemental diet is used mainly in the treatment of individuals with Crohn's disease as a form of nutritional therapy. Crohn's disease is a type of inflammatory bowel disease causing inflammation of any area of the gastrointestinal tract and is able to occur in people of all ages, but often diagnosed in people between the ages of 20 and 30. The most common indication of having Crohn's is blockage of the intestine, and sores and ulcers around the area of the affected tissue. This includes the bladder, vagina, rectum, and anus. Other problems may also include skin problems, arthritis, and inflammation of the mouth or eyes.

Nutritional problems that result from Crohn's are due to inflammation of the small intestine that cause diarrhea. This leads to malabsorption of important nutrients in the small intestine, causing malnutrition, fever, fatigue, and weight loss.

The elemental diet consists of a mixture of essential amino acids with non-essential amino acids, fat, and sugars. Water-soluble vitamins, fat-soluble vitamins, and electrolytes are often added. The elemental diet is commonly introduced over a period of three days to patients, successively increasing in strength on each day to reduce the likelihood of diarrhea and abdominal colic. It can be given orally or through nasogastric tubes if patients are intolerant to the liquid.

Patients are restricted of all foods; however, certain exceptions in some patients are made for tea and coffee (without milk) and given Vivonex [clarification needed] as the elemental diet. Other elemental diets such as Elental can be used that provide similar results. The elemental diet provides a high nitrogen source for patients from amino acids and acts as a medical bypass. Because the diet consists of the individual dietary components of food in their simplest form, the body does not have to do work to digest them. They prevent the food from "reacting" with the gut, preventing the occurrence of symptoms. The resulting positive nitrogen balance and alterations in the bacterial flora of the gut are likely to have beneficial effects in patients, helping to alleviate the symptoms of Crohn’s. However, due to the diet's consisting of fully broken down amino acids, the digestive loading is shifted from the gut to the liver. As such, liver function (via blood tests) should be monitored.

The elemental diet is also used to treat Small Intestinal Bacterial Overgrowth (SIBO) with a 14-day elemental diet showing 80% efficacy and a 21-day elemental diet showing 85% efficacy.

As beneficial as the elemental diet is in patients, there are a few disadvantages. A common disadvantage is the taste of the elemental diet. Many patients are unable to tolerate the taste, even if the diet is flavoured, and choose to receive it through intragastric administration. Possible nausea and diarrhea can result from the high sugar content which can also complicate hyperglycaemia in patients with pre-existing diabetes.

  • Plant-rich mixed meals based on Palaeolithic diet principles have a dramatic impact on incretin, peptide YY and satiety response, but show little effect on glucose and insulin homeostasis: an acute-effects randomised study📎

    Abstract Title:

    Plant-rich mixed meals based on Palaeolithic diet principles have a dramatic impact on incretin, peptide YY and satiety response, but show little effect on glucose and insulin homeostasis: an acute-effects randomised study.

    Abstract Source:

    Br J Nutr. 2015 Feb 28 ;113(4):574-84. Epub 2015 Feb 9. PMID: 25661189

    Abstract Author(s):

    H Frances J Bligh, Ian F Godsland, Gary Frost, Karl J Hunter, Peter Murray, Katrina MacAulay, Della Hyliands, Duncan C S Talbot, John Casey, Theo P J Mulder, Mark J Berry

    Article Affiliation:

    H Frances J Bligh

    Abstract:

    There is evidence for health benefits from 'Palaeolithic' diets; however, there are a few data on the acute effects of rationally designed Palaeolithic-type meals. In the present study, we used Palaeolithic diet principles to construct meals comprising readily available ingredients: fish and a variety of plants, selected to be rich in fibre and phyto-nutrients. We investigated the acute effects of two Palaeolithic-type meals (PAL 1 and PAL 2) and a reference meal based on WHO guidelines (REF), on blood glucose control, gut hormone responses and appetite regulation. Using a randomised cross-over trial design, healthy subjects were given three meals on separate occasions. PAL2 and REF were matched for energy, protein, fat and carbohydrates; PAL1 contained more protein and energy. Plasma glucose, insulin, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP) and peptide YY (PYY) concentrations were measured over a period of 180 min. Satiation was assessed using electronic visual analogue scale (EVAS) scores. GLP-1 and PYY concentrations were significantly increased across 180 min for both PAL1 (P= 0·001 and P< 0·001) and PAL2 (P= 0·011 and P= 0·003) compared with the REF. Concomitant EVAS scores showed increased satiety. By contrast, GIP concentration was significantly suppressed. Positive incremental AUC over 120 min for glucose and insulin did not differ between the meals. Consumption of meals based on Palaeolithic diet principles resulted in significant increases in incretin and anorectic gut hormones and increased perceived satiety. Surprisingly, this was independent of the energy or protein content of the meal and therefore suggests potential benefits for reduced risk of obesity.

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