Clinical trial: novel nutritional formula treats gut microbial overgrowth | Hacker News Reader

Clinical trial: novel nutritional formula treats gut microbial overgrowth

medicalxpress.com

66 pointswglb25 comments

This is an elemental diet, which is not new. An elemental diet uses amino acids, fats, sugars, and vitamins to provide the elements of a human diet (hence the name) without whole or partial proteins, fiber, and other things that gut bacteria like to eat. The bacterial overgrowth subsides because you’re not giving it the food it wants. This means you can’t eat anything other than this diet mix for 2 weeks, no exceptions.

The only novel part about this branded one is that it’s palatable. That’s actually a big advantage because a plain elemental diet tastes so bad that it’s hard to tolerate.

You can search for DIY elemental diet recipes and there are several sources for the amino acid blends they use. People report some success, if they can tolerate the taste.

Here are the ingredients: https://mbiota.com/cdn/shop/files/OriginalFlavor-Nutrition.p...

Study design:

Eligible subjects underwent 1 week of screening, 2 weeks of exclusive oral PED, and 2 weeks of follow-up after returning to their regular diet (Supplemental Figure 1). The primary endpoint was the change in stool microbiome after PED and regular food reintroduction. Secondary endpoints included tolerance, LBT normalization rate, stool form changes, symptomatic response, and adverse events. The PED (mBiota Elemental, Good LFE, Santa Monica, USA) was provided in 300-calorie packets, adjusted eucalorically to each participant’s caloric needs (Supplemental Figure 2).

Additional packets were provided for hunger, with daily consumption documented. Water intake was unrestricted, but other foods were prohibited during the diet phase. After completing the diet, participants transitioned to bland foods (e.g., rice, potatoes, eggs, chicken, beef) for 2–3 days before resuming their regular diet.

It looks it contains mostly amino acids and vitamins, usually found in other fitness supplements. Is there any "secret sauce" that I am missing?

It’s amino acids, fats, and sugar in a ratio that mirrors the elements of a standard diet.

It’s not a supplement. It has to replace your diet completely for 2 weeks, no exceptions.

By consuming amino acids instead of proteins (which are composed of amino acids) and omitting fiber it starves skips straight to absorption and starves the bacterial overgrowth.

It’s an old concept. The unique part of this one is that it supposedly tastes okay.

Yeah, the taste matters if you are going to eat it for 2 weeks :). You will probably still hate it after the first week, but it is just one week of misery instead of two. I did some fasting in the past, leaving only water, tea (no sugar) and peeled apples in my diet. Had to do it for 2 weeks, but only made it to the 11th day. The issue with that one was the low calories, which doesn't correspond well with active work (I did not plan properly to take the second week off). Nevertheless, it helped solve the colitis issue, with which I'd been struggling for a few months. An interesting observation was that up to say day 4 or 5 you actually have more energy and sleep less. But after that it was a bit of a struggle to retain the same levels of energy and be productive at work.

The secret sauce, so to say, is that it's not a supplement, it's all you eat for the duration of the treatment. As someone who was on a liquid only diet for six weeks following a surgery, I can't imagine this being anything short of absolutely miserable.

I actually followed this specific elemental diet for two weeks to treat my hydrogen SIBO, unfortunately without success. I would not recommend this to anybody unless it's absolutely your last chance. I was constantly hungry, cold and lethargic. The shakes taste /terrible/ so I wouldn't really call it palatable. I shiver just thinking about it. I'm sure it works for some people, and I'm happy for them.

Quite amazing success rate for just two weeks of treatment when the alternative is doing multiple rounds of antibiotics for months/years and not even getting that level of success.

Indeed. I am just a bit concerned that the subjects were to return to their "normal" diet after the experiment, which probably was the reason to get this condition in the first place. In a next study it would be interesting to look closer into the functioning of related organs, such as liver and gallbladder (vesica fellea). E.g. did subjects have any biliary sand issues. Correlation with potable water used by the subjects would also be interesting, especially things like mineral composition, pH, organic contaminants (e.g. microplastics) as well as microbial content.

That’s assuming it’s not typically some immunocompromising event as small as a period of stress that allows for the colonization.

Yes, that is a major factor too as well as antibiotics or the combination of the two.

If anyone is willing, please help me understand, not why, but how someone can subsist on a diet with zero fiber. I know folks who can sit down to a plate of nothing more than white rice and meat without petrifying their backside. If I tried to do the same, I'd be using solvents and chipping hammers every morning. Have I missed something? Is this a 99% absorption rate diet? Where does it go?

Fiber is not necessary, and can be the cause of constipation. Your body has ways of managing, and individuals who don't eat fiber have more motility:

https://pmc.ncbi.nlm.nih.gov/articles/PMC3435786/

"Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms"

Fascinating. I intend to do some research on this, but if you're aware of any methods or protocols to retrain the system for increased motility in absence of fiber, drop a link. I'm pretty sure that an abrupt change would not work well for one adapted to fiber and observe such every time the situation arises. Probiotics and physical activity don't affect this for me.

Edit: I see that the report did pretty much exactly what I say doesn't work. This is confusing when considered through my own experience. Definitely interesting though.

Presumably fasting would achieve the same result?

Maybe, but nobody can package and sell you fasting.

Novo Nordisk sure is trying.

Quick, someone make an online course about fasting and sell it for $49.99.

In my personal experience with SIBO, fasting can mitigate symptoms but does not resolve the SIBO.

It requires two continuous weeks. Fasting that long would be devastating.

Journal pre-proof (pdf) https://www.cghjournal.org/article/S1542-3565(25)00241-1/pdf

I wonder if a water only fast would also work.

~350$ per week if you want to buy it.

Pretty sure carnivore or some other no-fiber low carb would be a bit cheaper :)

Don't forget 425 euros to ship to Europe.

Yeah, that's really a dick move.

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