Ali Rezaie, MD: Exploring a Palatable Approach to the Elemental Diet

Although elemental diets are safe and efficacious for a number of gastrointestinal conditions, the notorious bad taste turns many patients away – a new, more palatable version of the standard elemental diet may offer a promising alternative.¹

Results from a prospective trial assessing the compliance, safety, and effect of an exclusive 2-week course of a novel palatable elemental diet in patients with intestinal methanogen overgrowth and/or small intestinal bacterial overgrowth were presented at Digestive Disease Week 2024 and suggest this newer version of the traditional diet may be more feasible for patients with the same health benefits.¹

“With the advent of food engineering, it was made possible to make these palatable, so this is something that we essentially tried for the first time and it's a true elemental diet,” Ali Rezaie, MD, medical director of gastroenterology motility at Cedars-Sinai explained to HCPLive. “It's not that sugar was added to it to make it sweet or something. No, this is a pure, true elemental diet that is now palatable.”

A medical protocol prescribed for certain gastrointestinal conditions, the elemental diet consists of a liquid formula of complete “predigested” nutrition broken down into its most elemental form for easy absorption in the upper digestive tract. Typically, key components including proteins, fats, and carbohydrates are broken down into amino acids, short-chain triglycerides, and short-chain maltodextrins, combined with vitamins, minerals, and electrolytes.²

“They taste like sewage water. You can try, but they’re impossible to drink,” Rezaie said.

In an interview with HCPLive, he highlighted the 100% completion rate in the trial and the fact that 73% of patients objectively normalized their breath test with a 2-week exclusive palatable elemental diet. He also pointed to the potential use of this diet for other gastrointestinal conditions.

“This is a nonprescription, nonmedicinal sort of pathway to treating disease, which is very intriguing as a standalone or even as an adjunct therapy for other things,” Rezaie concluded. “It opens a big sort of alternative door to all these patients, which to me is very exciting.”

References:

1. ^{Rezaie A, Chang BW, Houser K, et al. COMPLIANCE, SAFETY, AND EFFECT OF EXCLUSIVE PALATABLE ELEMENTAL DIET IN MICROBIAL OVERGROWTH: A PROSPECTIVE CLINICAL TRIAL. Abstract presented at Digestive Disease Week 2024, May 18 - 21, 2024.}
2. ^{Cleveland Clinic. Elemental Diet. Treatments & Procedures. November 18, 2021. Accessed May 22, 2024. https://my.clevelandclinic.org/health/treatments/22053-elemental-diet}