Hello Jini,

1. What is your opinion on these two products as alternatives to maltodextrin and fructose for the elemental diet:
a) http://proteinfactory.com/store/product ... cts_id=219
b) http://proteinfactory.com/store/product ... cts_id=377

2. I have always heard that taking probiotics and antibiotics (or anything with antibiotic properties, like oregano oil) at the same time is a bad idea. I realize that in your protocol, you suggest taking them at different times of day, but if the probiotics implant as they're supposed to, wouldn't they just be killed by the oregabiotic the next day?

Thanks,
Chris

Hi Chris,

I checked out both products but could not find an Ingredient list (this is different from Supplement Facts chart) to tell me exactly what is in the bottle. Why don't you email them and then post the Ingredient lists so I can check it out.

Both are replacements for maltodextrin though (as neither are sweet), not fructose. The first one (HRS) will hit the bloodstream really fast, the second has a slower uptake. But without seeing the ingredient list, I can't tell if they would be okay.

Regarding probiotics and wild oregano, no ALL the probiotics are not killed off by wild oregano oil - this is evidenced by the difference in symptoms between taking JUST the oregano, and consuming with probiotics as directed. Remember that if wild oregano could kill all bacteria in one day, then we wouldn't need to take it for weeks or months. Also, even when taking prescription antibiotics, you are still advised to take probiotics 2 hours after each antibiotic dose.

take care,
Jini

see edited post below...

Jini,

I spoke with someone at Protein Factory. They said that HRS is simply 100% hydrolyzed rice syrup with no other ingredients. Same thing for rice oligodextrin, which is a hydrolyzed rice starch enzymatically derived from whole organic rice (I believe this is the product: http://www.californianatural.com/html/s ... o/HSPR.htm). OatMuscle has two ingredients: oat powder derived from whole oatmeal, and ascorbic acid.

The HRS is more rapidly absorbed than glucose from maltodextrin or dextrose, so it will produce a hefty insulin spike. The rice oligodextrin has a slower uptake and a more balanced effect on blood sugar. I'm assuming that a 50/50 mixture of both would make a nice carb source for the elemental diet. What do you think? Is there something I'm missing?

The OatMuscle is a great product (I love its taste and the energy I have after drinking a shake with it), but I guess it's not strictly "elemental" because of the fiber.

Chris

One follow-up question: what exactly determines a carbohydrate source's suitability for the elemental diet? I know it can't have any fiber, and should be absorbed fairly quickly, but beyond that I'm not sure how to evaluate potential products like the rice oligodextrin and HRS (hydrolyzed rice syrup).

Should I also be considering what type of carbohydrate the powder is, i.e. is it a monosacharaide, disacharide or polysacharide? I doubt this is the case, because I know corn syrup and corn starch are illegal on the SCD, but maltodextrin (which is hydrolyzed corn starch) is a staple on the elemental diet.

I guess I'm kind of confused now about the elemental diet. I thought it worked by starving all the bacteria in the gut. But in light of the research you mentioned Jini that shows maltodextrin may pass through to the colon and feed the bacteria, and considering you are now recommending taking probiotics throughout the elemental diet... I'm not certain anymore how the diet works and what the goals are with it.

Thanks Jini!
Chris

Yes, some very good questions and very good points.

We're working from three platforms here: the first is what is defined as "elemental" and has been used in clinical trials assessing the efficacy of elemental diets. Hence maltodextrin is the key carbohydrate component of Absorb Plus since that is what all of the elemental products used in the clinical trials contained. Whilst not a monosaccharide, maltodextrin is a glucose polymer - which is/was still considered elemental enough to provide bowel rest.

And the second is what I and many of my readers have found to work best. Hence the recommendation to now start probiotics (and Wild Oregano) at the beginning of the Diet, rather than waiting until the end.

The third consideration is how research has evolved since the clinical trials on elemental diets were carried out - hence the indication that maltodextrin is not completely absorbed into the bloodstream and some residue does indeed pass into the colon. And perhaps this is why in practical application, hundreds of us discovered that we did much better ingesting probiotics at the beginning and throughout the Diet.

The goal of The IBD Remission Diet was and still is: Bowel Rest.

Now, regarding your question about the rice syrup and rice oligodextrin ratio. Yikes! 50/50 would not be a good ratio! In fact, due to its incredibly rapid uptake, I would avoid using it at all. Why don't you just use the rice oligodextrin and sweeten with Stevia? If you do want to use it, then a better ratio would 10/90, or at most 15/85.

take care and hope I answered everything!
Jini

Jini,

Again, I really appreciate your reply and yes, you did answer all of my questions!

Following your guidance from the other post, what's true is that if I check into my body what it likes best is the neither the hydrolyzed rice syrup nor the rice oligodextrin, but the oat powder. It just felt the best, while I was drinking the shakes and afterwards, and its the "cleanest" product with the least processing.

However, it does have a significant amount of fiber in it so I had ruled it out because it's not strictly elemental. I guess this is where the rubber meets the road, huh? If I go by what I feel my body wants and how it responds (symptoms), the oat powder is in. If I listen to my mind and all of the information it has learned about the elemental diet, the oat powder is out.

I suppose I'll sit with it a while longer and see how it settles.

Best,
Chris

Keep in mind that anything that REDUCES the digestion/absorption load on the digestive system is providing a level of "rest" for the GI tract.

No one has done clinical trials on semi-elemental diets, but who's to say there wouldn't be significant benefits from nourishing the body this way? Follow your gut, my dear.....

Not surprising the oat powder feels good, since oats are mucilaginous (like slippery elm and marshmallow root). They coat and soothe the skin and GI tract.

take care,
Jini

Jini,

Are polymeric diets the same as "semi-elemental"? If so, I have seen some studies that suggests they are as effective as elemental diets. I've also seen studies that suggest the opposite.

Chris

Hi Chris,

I think the industry itself can shift around a bit on definitions, but basically it seems that "elemental" formulas are MORE pre-digested than polymeric.

Polymeric formulas can contain disaccharide sugars and whey or casein concentrates. Whereas elemental formulas contain only monosaccharide sugars and whey isolate (but again, there are some variations depending on the manufacturer).

take care,
Jini

Jini et all,

You might be interested in the following research I dug up regarding the effectiveness of polymeric diets vs. elemental diets. There is some controversy (of course), but on the whole, the overwhelming majority of studies below indicate that polymeric diets are as effective as elemental diets in inducing remission in CD.

I was very surprised by this. Could have some interesting implications regarding how liquid diet formulas are designed.

Chris

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

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