The elemental diet dates back to 1932 and is one of the most utilized tools by functional medicine practitioners. It is useful for a variety of gut-related conditions and even conditions outside the gut. The elemental diet is a liquid diet that reduces inflammation in the gut, heals the gut barrier, and has an antibacterial effect.

The elemental diet is done with Elemental Select powder from Moss Nutrition. A full elemental diet can be done with 100% of daily calories coming from Elemental Select or a partial elemental diet with 25-75% of calories coming from Elemental Select and the rest from whole food sources. Elemental Select is mixed with water or in a blender with ice and consumed by slowly sipping the mixture over the entire day in divided doses.

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The elemental diet may be helpful for the following conditions:

• IBS-C and IBS-D
  
• SIBO
  
• Crohn’s disease
  
• Ulcerative colitis
  
• Diversion colitis
  
• Eosinophilic gastroenteritis and esophagitis
  
• GERD
  
• Gastritis
  
• Multiple food sensitivities
  
• Leaky Gut
  
• Constipation and diarrhea
  
• Short bowel syndrome
  
• High ileostomy output
  
• Ileal fistulas
  
• Pancreatitis
  
• Pancreatic insufficiency
  
• Pancreatic fistulas
  
• Bile-acid-induced diarrhea
  
• Refractory Celiac disease (gluten-free diet fails to resolve issues)
  
• Malabsorption
  
• Rheumatoid arthritis
  
• Eczema
  
• Psoriasis
  
• Stroke recovery
  
• Critical illness recovery
  
• COVID-19 and other viral illnesses
  
• MCAS
  
• Histamine intolerance
  
• Anemia
  
• Asthma
  
• Dermatitis herpetiformis
  
• Chronic kidney disease
  
• Cystic fibrosis
  
• HIV
  
• Cerebral palsy
  

How does an elemental diet work?

The elemental diet is purely vitamins, minerals, amino acids, medium chain triglycerides for fat, and simple carbohydrates. This means that digestion is not required so almost everything gets absorbed regardless of gut function.

It is also void of any food-based compounds such as whey, pea, hemp, rice, soy, gluten, dairy, eggs, nuts etc. which makes it entirely hypoallergenic. There is virtually nothing in the elemental diet that the immune system can react to.

This is a game-changer for those with food sensitivities and gut problems. There is also no fiber in the elemental diet, so it won’t exacerbate SIBO or IBS.

The elemental diet also allows your digestive organs to rest. The stomach doesn’t have to pump out as much hydrochloric acid, the pancreas doesn’t have to make so many enzymes, and the gall bladder can rest as well.

The elemental diet contains all the right amino acids for healing the gut barrier. For those with leaky gut syndrome or malabsorption, it can rapidly heal the gut.

The elemental diet reduces pathogenic bacteria in the gut and can also improve healthy bacteria diversity. This helps reduce inflammation in the gut so the microbiome can become more balanced. This is why the elemental diet is so effective for SIBO, IBS, and IBD.

How to follow an elemental diet?

Elemental Select from Moss Nutrition contains 150 calories per scoop, and total daily calories should be determined by a healthcare professional. 

The first option is a Full Elemental Diet with 100% of daily calories consumed from Elemental Select.

Sample 1,500 calorie/day protocol:

10 total scoops/day = 1,500 calories

4 scoops in the AM divided into 4 separate 8-ounce glasses of water. Mix 1 scoop with 8 ounces of water and sip slowly over a 20-60 minute period. Repeat for the next 3 scoops. Alternatively, all 4 scoops can be mixed with 32 ounces of water and sipped slowly over a 1-4 hour period.

3 scoops around lunch time. Same consumption guidelines as noted above sipped slowly over a 1-3 hour period.

3 scoops around dinner time. Same consumption guidelines as noted above sipped slowly over a 1-3 hour period.

Alternatively, all 10 scoops in 10 glasses of water can be sipped slowly over the entire day without breaks.

The second option is a Partial Elemental Diet with 25-75% of calories consumed from Elemental Select and the rest from whole food sources. There are multiple options:

Elemental Select in the AM and lunch time and a whole food dinner.

Elemental Select in the AM only with a whole food lunch and dinner.

Elemental Select around lunch and dinner time with a whole food breakfast.

Elemental Select in the AM and around dinner time with a whole food lunch.

The partial elemental diet can be tailored for each individual’s schedule and preference. The whole food eaten during the partial elemental diet should be void of any foods that are known allergens, sensitivities, or intolerances such as gluten or dairy. If there is a history of issues with FODMAPs then these should be avoided as well.

Additional Elemental Diet Protocols:

“3-Day Gut Reset” – 100% of calories come from Elemental Select to reduce inflammation in the gut, give the digestive system a break, clear pathogenic bacteria and food toxins.

2-4 day partial elemental diet – this gets the body used to the product and to see if it is helpful for symptoms.

7-21 day treatment (IBS/SIBO): 100% of calories come from Elemental Select. This is based on the Pimentel paper.

1-12 week treatment period: 100% of calories come from Elemental Select. In this case, you would want to see if EPA/DHA HP Select Liquid oil dosed 1 teaspoon once or twice a day for essential fatty acids is tolerable.

1-12 week partial elemental diet with 25-75% of calories coming from Elemental Select.

Half elemental diet for 1-2 years.

Ongoing partial elemental diet to maintain gut health.

Quell a flare. If your symptoms are flaring, you can use the elemental diet for 2–4 days to bring down inflammation rapidly and get your immune system back in balance.

Additional Elemental Diet Uses:

Post-holiday gut reset.

Before, during, or after workouts.

Don’t feel like cooking.

Take a day off from regular food – one day a week liquid-only day.

On-the-go meal replacement.

Gain weight and lean muscle mass after illness or surgery.

Sip all day and then have one large whole food meal.

How to transition off the elemental diet?

Add regular food that is anti-inflammatory, low allergen, and low FODMAP for 1–2 weeks.

Food should be cooked thoroughly.

Smaller meals at first.

Some will do best on a partial elemental diet for 1-2 weeks after full elemental diet.

If there are many food sensitivities, slowly reintroduce foods every 1-2 days. This can help isolate problematic foods.

Probiotics and Prebiotics may be useful depending on the case presentation.

The LOFFLEX Diet should be followed for 2 weeks if the individual has Crohn’s disease. The LOFFLEX – or Low Fat/Fiber Limited Exclusion diet (or LOFFLEX) – is a diet that has been specifically developed for people with Crohn’s disease as a way of reintroducing foods into the diet following a liquid diet.

It works on the principle that high fat and fiber-rich foods can trigger Crohn’s disease symptoms and these foods are avoided during the reintroduction stage along with some other foods which may affect symptoms.

For at least two weeks after the elemental diet, eat foods that are low in fat and fiber, as well as avoiding specific foods that trigger symptoms.

Optional Supplements During and After the Elemental Diet

The following probiotics from Moss Nutrition may be helpful while transitioning off the elemental diet: BacilloSpore Select: (Spore-based probiotic.) 1 twice a day with food. Optional choices are Probiotic Select (Lacto-Bifido blend) or Saccharomyces boulardii taken 1 twice a day with food. If an individual can tolerate all three probiotics, it is best to take all of them. Probiotics may need to be taken for at least 6 months to maximize benefits.

Icelandic Cod Liver Oil Liquid by Moss Nutrition: 1 teaspoon contains EPA & DHA, 5,000 IU of vitamin A and 460 IU of vitamin D. 1 teaspoon a day. Take note of the total vitamin A intake from this oil and Elemental Select so as not to overdose on vitamin A. 10 scoops of Elemental Select has 5,000 IU of vitamin A. Do not exceed 10,000 IU of vitamin A a day for longer than 8 weeks.

EPA/DHA HP Select Liquid: 1 teaspoon once or twice a day for essential fatty acids. This is especially useful for those with inflammatory bowel disease.

Prokinetics can help support the migrating motor complex, which tends to be dysfunctional in SIBO and IBS. This complex is active in between meals and helps move stool through the gut.

Motility Select by Moss Nutrition is the prokinetic I recommend dosed 3 capsules 1–2 times a day in between meals. A prokinetic may be helpful after the elemental diet to improve bowel movements.

What about medications during the elemental diet?

Continue to take medications as prescribed by your prescribing healthcare practitioner. Your prescribing healthcare practitioner should be notified that you are following an elemental diet.

Elemental Diet Reactions

Some people will have diarrhea, abdominal discomfort, bloating, constipation, gas, cramping, fatigue, or generally not feeling well. This usually goes away after the first day or two, and it can also be a sign that a partial elemental diet would be a better fit instead of going 100% elemental.

Make sure to drink plenty of water and rest as much as possible. Light to moderate activity is ok, but avoid doing anything high intensity or that pushes your body too hard.

What makes Elemental Select different?

Elemental select contains the Reginator amino acid blend, which is superior for lean muscle gain and muscle function. This minimizes the chance of losing muscle on the elemental diet and also can improve physical function and performance. These amino acids also help to repair the gut barrier, improve immune system function, and reduce inflammation.

Elemental select contains fat in the form of medium chain triglycerides, which are easily absorbed and readily used for energy. It also contains some carnitine to enhance fat metabolism.

The carbohydrate source is non-GMO dextrose and tapioca maltodextrin for easy absorption and utilization.

The vitamins and minerals are in the preferred forms such as:

Vitamin B6 is in the pyridoxal-5-phosphate form.
Folate is in the methyltetrahydrofolate form.
B12 is methylcobalamin.
Selenium is selenomethionine.

There is also extra glutamine in Elemental Select to provide more robust gut barrier healing properties. It has a pleasant vanilla flavor, and it isn’t too sweet like most elemental formulas on the market.

Dr. Hedberg’s Final Thoughts on the Elemental Diet

I’ve used the elemental diet for many years with patients who suffer from a variety of gut-related conditions, autoimmune diseases, skin conditions, infections and more with excellent success. It can be a real game changer for many patients who are looking for rapid relief.

Elemental Select is highly versatile and can be tailored to what works for each patient so there is no strict protocol for anyone. Some patients will stay on it for long periods consuming the shakes for 1 or 2 meals a day on an ongoing basis to keep their guts healed and to minimize flares.

I always have it on hand just in case I get COVID-19 or other respiratory viruses as it takes all the stress off of my digestive system so my body can deal with the infection.

Ask your healthcare practitioner about Elemental Select to begin your healing journey today.

The elemental diet should only be followed under the supervision of a licensed healthcare professional.

Hedberg Institute Members can download my elemental diet protocol by logging in and visiting the Practice Tools page.

Click here to learn more about the Hedberg Institute Membership.