My Nothing-But-Neocate Diet

From time to time, clinicians and parents of children with allergies ask me if I’ve ever tried the Neocate formulas. We here at Nutricia have certainly tasted them all, but tasting and consuming are not the same. After lots of questions from parents about what their little one is feeling and whether or not it’s normal, and given my indiscriminate palate, I decided it was time to really give Neocate a try.

My plan? To go on a nothing-but-Neocate diet for two days. What, exactly, would be allowed? Neocate: specifically any of the Neocate products and a few allergen-free artificial flavors. I decided I could still have plain tea (lack of caffeine could be a real problem for me!). I also decided that, given my usual fiber intake from foods, I would also supplement my all-Neocate diet with prebiotic fiber.

Some folks might say that adding fiber is cheating. However, we already include fiber in Neocate Junior. I took the guidance that I (as a Registered Dietitian) would give anyone: to avoid a sudden and drastic change in fiber intake, up or down. I was able to find a fiber supplement derived from inulin. Inulin is the plant source of the prebiotic fiber that’s included in Neocate Junior, so this would be similar. And the use of other allergen-free artificial flavors? I figured that was okay too, because dietitians who work with children and adults with eosinophilic esophagitis (EoE) allow these when the patients follow an amino acid-based (or “elemental”) diet.

What wasn’t allowed? Anything else! 

With these rules in mind, I used my approximate calorie needs to design a “meal plan” and dove right in.

Day 1 Menu

  • Morning Snack: Neocate Infant
  • Breakfast: Neocate Infant
  • Lunch: Neocate Infant + artificial lemon-lime flavor
  • Dessert: Neocate NutraNeocate Junior, Chocolate (“Chocolate Pudding”)
  • Afternoon Snack: Neocate Splash, Orange-Pineapple
  • Appetizer: Neocate Junior with Prebiotics, Unflavored + artificial grapefruit flavor
  • Dinner: Neocate Splash, Grape + Neocate Junior, Chocolate (“Chocolate Covered Raisin”)
  • Dessert: Neocate Splash, Unflavored + artficial ‘cookies ‘n cream’ flavor

Day 1 Experience:

Day 1 started with Neocate Infant. Does this taste like standard infant formula or milk? Nope. Because Neocate products have amino acids instead of whole protein, Neocate Infant has a different taste and a thinner consistency (it’s more watery). To me it has an herbal undertone, which isn’t so bad. The taste is something most infants either don’t notice or get used to after a day or two.

Smaller amounts were fine, but a full 350 calories of plain Neocate Infant was a lot, even for me! By my last “meal” of Neocate Infant at lunch, I decided to add artificial lemon-lime flavor. So far, so good! I was surprised that I wasn’t ravenous later in the day – I had my doubts that an all-liquid diet would keep me satisfied, but it really did! I managed to go to bed without any food cravings that day. No stomachaches and nothing out of the ordinary. Day one, done!

Day 2 Menu:

  • Morning Snack: Neocate Splash, Tropical Fruit
  • Breakfast: Neocate Splash, Orange-Pineapple + Neocate Junior, Strawberry (“Fruit Salad”)
  • Lunch: Neocate Junior, Tropical
  • Dessert: Neocate Nutra + Neocate Junior, Unflavored + artificial cherry-vanilla flavor (“Chocolate-covered Cherry Pudding”)
  • Snack: Neocate Splash, Tropical Fruit
  • Appetizer: Neocate Junior, Strawberry
  • Dinner: Neocate Splash, Orange-Pineapple + Neocate Junior, Vanilla (“dream-sicle”
  • Dessert: Neocate Nutra + Neocate Junior, Chocolate + artificial strawberry flavor (“Chocolate-covered Strawberry Pudding”)

Day 2 Experience:

Day 2 started with some definite hunger, but the morning snack took care of that. When I arrived at work I found a donut on my desk from a coworker – cue cravings for solid food! It was definitely tough to avoid the snacks around the office that day, but I made it through. The toughest part was probably dinner time. I usually make dinner in our house, so cooking and not eating the food was difficult. (No french fries?!?)

By the end of the day all of the different flavors began to taste pretty similar to me, probably because I tried so many flavor mash-ups. I will say that I definitely found the Neocate Splash is so easy. It surprised me, but it was so easy to grab a Splash instead of having to prepare a meal. Even mixing powdered formula seemed like a chore. I really see how convenient this can be for kids and families on the go, not to mention busy adults!

All Things Considered…

The all-Neocate diet wasn’t nearly as difficult as I thought, and in some ways it actually made life easier. (I’m terrible at meal-planning, which makes for some very last-minute dinners!) I really appreciated having so many flavor options and the ease of Neocate Splash in a ready-to-go format. That said, a third day might have gotten a little routine. I have a lot of respect for the children and adults who stick with amino acid-based diets for a long period of time. It has to be especially tricky for those who have had “real” food, know what it tastes like, and must give it up for an extended time.

And the question many parents would like to ask: How did I feel after two days of Neocate? Pretty normal, actually! There are rumors that amino acid-based diets cause diarrhea or constipation, but that’s not true. My stomach felt a bit more “active” at times, but I never felt queasy, had diarrhea or constipation, or really felt any different than I usually do. I didn’t have any big swings in hunger or fullness, and it was nice not worrying about whether or not I was getting a balanced diet: Neocate took care of that for me.

Sometimes a gradual start or a formula with prebiotics are beneficial. Ask your child’s healthcare team about using Neocate Junior, which has added prebiotic fiber to help support gut health. This could help anyone going from a solid food diet to Neocate (such as those with EoE on an elimination diet). That can include a big change in fiber intake, and prebiotics can help fill the gap.

Feel free to share any questions you have about my experience! How about you, parents: have you ever tried a full serving of Neocate? If so, what did you think?

Rob McCandlish, RDN

Published: 05/12/2011
Carolyn Ricciardi
Hi Trevor, It is possible for adults to do a fully elemental diet for EoE using our Neocate Junior and/or Neocate Splash which are indicated for patients older than 1 year of age. We suggest you discuss following an elemental diet with your doctor or dietitian to determine what volume of formula you would need to maintain your weight. Best of luck to you!
Trevor Wilkinson
Hello Mr. McCandlish, Thank you for taking the time to explain what it is like to take these children’s formulas and try them in the diet as an adult. I have had that question for some time. I was always wondering whether it was okay for an adult to take the neocate amino acid formulas. I have been very frustrated at times with my EoE and wanted to switch to an all elemental diet to see what it is like. However, I was always scared that I would not get anywhere near the amount of calories, fats, carbs, proteins, and other vitamins and minerals that an adult needs. In other words, I didn’t want to get too skinny and be malnourished. Is it possible for an adult to survive off of this diet that you tried for an extended period of time? Thank you so much for your time!
Rob McCandlish
Hang in there Arica, your daughter sounds courageous! Ask her EoE team these questions: 1) Are water flavor drops with "artificial flavors" okay and are there any ingredients I should avoid? (I used a brand that's discontinued - lots of great options.) 2) Can we freeze Neocate for occasional treats? (EoE teams are often okay with this. Some nutrient levels can drop, so they might advise not to freeze every serving when Neocate is used as the sold source of nutrition.) Good luck to you both!
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