We recently received this review in the Shoppe listing for Absorb Plus Amino – Coco-Choc flavor:
“Unsweetened coconut chocolate is not elemental, it contains 3g of fiber per serving. I did the elemental diet for 19 days, taking CH4 and H2 measurements with a Food Marble device. After taking this shake, there was a significant increase in gas levels, in other words, it seemed to trigger fermentation, which is what the elemental diet is designed to avoid, at least in SIBO patients. I'm a little disappointed and still have the tub practically full with it this stuff! Stick to the doctor’s formula.”
This comment brings up two important points that I would like to address.
First, is using a hydrogen breath tester after every meal or often actually helpful in making health and nutritional decisions?
And secondly, I want to ask this question in the context of carbohydrates and fiber.
Let's get started…
1. Is using a Food Marble AIRE device beneficial in the pursuit of holistic health?
This work shows that 99% of intestinal gases consist of hydrogen, carbon dioxide and methane.
And the predominantly produced gas is hydrogen:
“H2 is the most common gas produced by colonic bacteria and is formed exclusively by bacterial fermentation of indigestible substrates in the colon. Accordingly, breath H2 has been used as a primary marker for diagnostic testing for carbohydrate malabsorption or bacterial overgrowth in the small intestine.”
Based on this data, Food Marble's website states:
“AIRE detects hydrogen produced by your gut bacteria when they come into contact with foods that have not yet been fully digested. Each specific type of bacteria is only able to break down certain foods, so the foods that produce large amounts of gas in your gut depend on the type of gut bacteria you have. This is one of the main reasons why everyone is completely unique when it comes to digesting food.”
So you have a hydrogen breath tester that allows you to test, at any time of the day, after eating any food, the amount of hydrogen produced in your intestines when that food is digested.
But is that a good thing? Do you fully understand what you are actually testing and what the meaning of the data is?
Is hydrogen bad?
People assume that “hydrogen is bad.” And this finding is likely thanks to the medical interpretation of the data, again: “H2 breath has been used as a primary marker for diagnostic testing of carbohydrate malabsorption or small intestinal bacterial overgrowth.”
However, as you delve deeper into the broader research on this topic, you will quickly come across data like this article that reveals:
“Although some hydrogen-producing bacteria can be classified as “harmful bacteria” with pathogenic properties, their prevalence in the intestine is very low.
Most species of these bacteria are considered “beneficial bacteria,” and in this article we will focus on these hydrogen-producing bacteria that bring extraordinary benefits to human health.”
Wait, what??
Are you saying that the bacteria that ferment the fiber and produce hydrogen gas are GOOD for the body? Hydrogen is actually a useful substance in the intestines – and possibly NOT necessarily an indication of illness?
“Hydrogen has clinical benefits in many diseases, including neurological diseases, cardiovascular diseases, respiratory diseases, diabetes, liver and metabolic syndrome. More than 1,000 articles have been published on the medical applications of hydrogen, including over 90 human clinical trial reports. These articles confirm that hydrogen is highly effective in treating a variety of diseases and that there are no safety issues. Hydrogen molecules are the only species in the human body that directly destroy hydroxyl radicals in mitochondria Therefore, the effects of hydrogen-producing bacteria outperform other beneficial bacteria such as lactic acid bacteria and bifidobacteria, which cannot produce hydrogen.”
Hydrogen breath test – understand the measure in detail
As a short-term measure, interpreting a hydrogen breath test as an instruction to avoid all fiber can be helpful – but only if it is accompanied by a strict protocol to eliminate harmful microbes from the gut and replace them with beneficial bacteria.
Once your gut has a good balance of beneficial bacteria, small amounts of fiber are helpful in helping these bacteria thrive. And as your microbiome improves, add increasing amounts of fiber (mostly soluble fiber, with a smaller amount of insoluble fiber) to help your body maintain a good population of beneficial bacteria.
This paper sets out:
“Preclinical studies have shown a causal impact of fermentable fiber consumption on microbiota diversity, with mice fed diets lacking fermentable fiber developing reduced microbiota diversity over several generations.”
And then if we look at extensive data studies on the human gut microbiota:
“Cross-sectional studies of human populations around the world show that greater dietary fiber intake is associated with increased diversity of the gastrointestinal microbial community.”
Again, it's not just about ALL carbohydrates. I go into detail about soluble and insoluble fiber in my constipation book, Listen To Your Colon.
And I've discussed in detail why an elemental diet must contain a carbohydrate component to be effective – especially in cases where malnutrition and weight loss are present.
Again, once your microbiome is healthy, you will want to consume a certain amount of primarily soluble fiber to support and maintain that healthy microbiota.
Okay, let's move on to the next point in the comment I want to address…
2. Fiber and carbohydrate content in Elemental Shakes
In the review, she pointed out Absorb Plus Amino's Coco Choc flavor 3 grams of fiber per serving. She's right, and that comes from the cocoa powder used to naturally flavor the shake, which the FDA requires us to list as “fiber.”
However, if the cocoa powder is made from fermented cocoa beans (which are then roasted the right way), it contains only trace amounts of mono- and disaccharides. Therefore, it is safe to use as part of an elemental diet. If you use an organic or raw cacao powder, it will likely be properly fermented.
If you want, you can also use an organic chocolate extract (alcohol-free) to flavor your shakes, or an organic chocolate concentrate if you don't want to use cocoa powder.
In this case, if you want to stick with Absorb Plus Amino, the orange mango flavor contains no fiber at all.
Physician's Elemental Diet VS Absorb Plus
Or, as the customer pointed out, you could use Doctor's Unflavored Elemental instead. Good luck with that. Personally, I wouldn't say that elemental shakes that consist only of amino taste “good”. But we've worked long and hard to make AP Amino compatible. Physician's Elemental, on the other hand, is (in my opinion) completely disgusting and inedible in the long term.
Here's how the three products compare in terms of carbohydrate content – and let's add Vivonex (which was used in the clinical trials for SIBO). These are screenshots taken from each company's website today:
Physician's Elemental
Absorb Plus Amino – Orange Mango
Vivonex
Of course, Vivonex (from Nestlè) is the insured product that your doctor will probably recommend to you!
If maltodextrin is already listed, what exactly is the additional “modified cornstarch”? No further comment.
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Jini Patel Thompson is an internationally recognized expert in natural healing for digestive diseases. She healed herself from widespread Crohn's disease and has been medication and surgery free for over 25 years. Jini has appeared on numerous podcasts, TV and radio shows in the US, UK, Canada and Australia, giving people hope and vision on how to heal their colitis, Crohn's disease, diverticulitis and irritable bowel syndrome (IBS) using all-natural methods. Her books on natural healing of digestive diseases have been sold in over 80 countries worldwide. Jini is married and has three children, nine sheep, 11 horses, a cat and three dogs.
