Perfect Health Diet: Weight Loss Version

We started 2011 with a discussion of Experiences, Good and Bad, On the Diet; which led us into the issue of weight loss, especially for peri-menopausal and older women.

This is an especially poignant issue for erp, who is 76 years old and would like to lose weight for her upcoming knee replacement surgery, but cannot walk.

This is the toughest possible scenario for weight loss:

  • Whether for genetic (X vs Y chromosome) or hormonal reasons, women are more prone to putting on weight than men. (Men are more prone to diabetes.)
  • Hormonal changes after menopause seem to make it tougher for women to lose weight.
  • A petite woman doesn’t need as many calories as a larger person … but her micronutrient needs, and thus her appetite, may still be high.
  • Aging brings more efficient energy utilization and reduced energy expenditure. Thus, the elderly have a smaller energy “sink” in which to dispose of excess fat. A teenager can eat like a horse and stay thin; not so an older person.
  • An injury that prevents walking makes it even harder to burn off fat. Walking is a tremendous aid to fat loss.

Designing a weight loss diet for someone like erp really forces a hard look at how to optimize a weight loss diet. Get it even a little bit wrong, and the diet either won’t work for weight loss, or will be malnourishing.

The Three Keys for Weight Loss

The three keys for an effective and healthy weight loss diet, as I see it, are:

  1. Elimination of food toxins. Food toxins are the primary cause of obesity and you can’t expect to cure a condition by causing it!
  2. Perfect nourishment. The diet should be as nourishing as possible. The dieter should be in the “plateau range” of every nutrient – vitamins, minerals, organic molecules, carbs, protein, and fats.
  3. Calorie restriction. You have to be in energy deficit to lose weight.

The main food toxins to avoid are fructose, polyunsaturated fat, and wheat (see Why We Get Fat: Food Toxins). In my advice to erp, I suggested replacing some of her fruit with “safe starches” like potatoes, and replacing her PUFA-containing nuts with low-PUFA macadamia nuts or other foods.

But the harder part is achieving a calorie restricted diet when so few calories are being expended, and yet avoiding malnutrition. How may that be done?

Eat Protein and Carbs; Reduce Fat

This may surprise many readers, since we’re fat-friendly, but there should be no reduction in carb or protein consumption on weight loss diets. Calorie restriction should come out of fat.

The Perfect Health Diet “plateau range” for carbs and protein is 600 to 1200 calories. Eating less than 600 combined carb+protein calories per day raises the specter of either protein deficiency (leading to hunger) or glucose deficiency (leading to zero-carb dangers).

So if a typical daily intake is 400 carb calories and 300 protein calories, there’s really not much room to cut protein or carbs.

Remember that the body doesn’t have a significant store of carbs; the body’s total glycogen supply amounts to about a day’s needs. Nor does it have a store of protein, apart from skeletal muscle; and you don’t want to lose your muscle.

But it does have a large store of fat – those adipose cells that you want to shrink.

So to conserve muscle and reduce fat tissue, you have to eat your normal allotment of protein and carbs while restricting fat intake. As long as there is no serious dysfunction of adipose cells, they will release fat as needed to meet the body’s fat needs. And that’s what you want – fat being moved out of adipose cells to be burned.

So your calorie-restricted weight loss diet will be just as nourishing as your regular diet. Only the source of the nourishing fats – adipose cells instead of food – will be different.

Eat Nourishing Fats

But not all fat can be removed from the diet. The reason is that not all nutrients found in fat-containing foods are stored in adipose cells.

You see, fats are stored in adipose cells as triglycerides. But we need to get other lipid molecules, not just fatty acids, from food. The really crucial molecules are the phospholipids, especially phosphatidylcholine.

Choline, inositol, and a few others are organic molecules are bonded to fats in cellular membranes. We need to obtain these from our foods in order to be well nourished.

Diets low in choline strongly promote obesity. Therefore, anyone seeking to lose weight should be sure to eat a choline-rich diet.

The easiest way to do that is to eat 3 eggs a day and a ¼ pound beef liver once a week.

Another type of lipid that may be missing from adipose cells are omega-3 fats. Balancing the omega-6 to omega-3 ratio is helpful against obesity, and most people are omega-3 deficient. So eating up to 1 pound of salmon or sardines per week may assist weight loss.

Beef and lamb – meats that are low in omega-6 fats – would be good choices for any additional meat.

Be Super-Nourished

The body’s appetite regulation mechanisms are highly attuned to your micronutrient needs. Micronutrient deficiencies will tend to induce a strong appetite for food, as your body tries to get you to obtain more nutrition. This could be a major reason why “empty calories” such as cotton candy are fattening.

Our book has some examples of “micronutritious foods”: variety meats, bone soups, seaweed, shellfish, eggs, and vegetables.

Nutritious, low-calorie foods like bone soups can be very helpful for weight loss. Soups can also be a good way for someone who doesn’t like vegetables to obtain them.

In addition, I would recommend that every person on a weight-loss diet take our full supplement regimen: a daily multivitamin, D, K2, C, magnesium, copper, chromium, iodine, and selenium. Also, I would suggest taking our optional B vitamins: thiamin, riboflavin, pantothenic acid, biotin, vitamin B6, vitamin B12, and choline (note the exclusion of niacin and folic acid).

Keeping Calories Down

What is the minimum calorie intake that meets all these nutrient considerations?  Eggs, salmon, and beef have more fat than protein, so if you’re aiming for 400 carb calories and 300 protein calories, you’ll probably eat at least 500 fat calories per day. So it would seem to be impossible to go below about 1200 calories per day while still being well nourished.

The place to cut calories, then, is the extra fats. Perfect Health Diet favorites like butter, coconut oil, and cream are, sadly, top candidates for reduction.

Of course, the more active you are, the more you can include those fats.

For less active people, the Weight Loss Version of the Perfect Health Diet becomes similar to a lot of popular diets. Many diets recommend a roughly even calorie distribution, with 30-40% of carbs, protein, and fats. This is what a calorie-restricted version of the Perfect Health Diet should look like too.

So, the perfect day in a weight loss diet: soup, potatoes or other safe starch, salmon, eggs, vegetables. Not too much fat in the sauces!

A good meal might look like this:


Mash the sweet potato with eggs instead of butter, and this would fit our weight loss recipe.

Conclusion

It’s a little humbling that I’ve started 2011 with 5 posts on the subject of healthy weight loss, but have only scratched the surface of this complex topic.

For instance: In the book we used the rubric “metabolic damage” to describe the biological dysfunction associated with obesity. But we never really chased the complex biology of exactly that damage consists of – and how it can best be healed.

Today, I’ve presented what I believe is the best strategy for healthy weight loss. But other techniques – such as ketogenic dieting, intermittent fasting, exercise, and more – can contribute to healing the metabolic damage of obesity. As 2011 goes on, I’ll return to this topic.

I am intensely interested in the experiences of anyone trying to lose weight using our diet, and I hope that together, we can understand the disease of obesity better, and figure out good ways to achieve both healthy weight loss and a permanent recovery from metabolic damage of all kinds. So please, if you are trying to lose weight, keep me posted on your experiences, whatever they may be!

Related Posts

From 2011:

From 2010:

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396 Comments.

  1. Hello – I came across your book as I was exploring diets to help with leaky gut. Being familiar with the GAPS diet but not particularly compelled to try it, I am excited by your approach. I have a lot of digestive challenges and as such a great many food intolerances wich will limit my choices on the diet, at least initially. One of these intolerances seems to be to rice, or an grain for that matter. As I get healthier nd my gut heals, I do hope that I will be able to expand the variety of the food I eat. However, I still wonder about the toxicity of rice. I have been coming across a lot of research that shows rice is greatly susceptible to arsenic and now even lead. What re your thoughts about this?

    Also, what are your thoughts about the importance of food combining?

    Thank you!

    • Hi Lucy,

      arsenic, when present, is mostly found in the bran. The arsenic gets in there if it’s in the environment, like in some of the Southern US states. Northern US or Asian rice is probably low in arsenic.

      Rice does have some toxins but they are destroyed by heat. If you react poorly to rice it’s probably from gut flora, not from the rice itself.

  2. Thank you very much Paul,
    Have joined group so will check it out.
    Thank you and your wife for all the research
    you have done. Great job.

    Kind Regards
    Paula

  3. I know you’ve spoken about the benefits of BCAAs in other areas (such as ketosis) but how about in conjunction with weight loss? It’s said BCAAs will help to retain muscle and increase fat loss on a calorie restricted diet. What is your opinion on this?

  4. Hmmm. I’m on board with much of your dietary advice, but the idea that decreasing fat intake is the best way to lose weight strikes me as false, both based on personal experience and based on research. I briefly Googled and found this: http://www.ncbi.nlm.nih.gov/pubmed/15533250 and I know I’ve read several other similar studies.

    Staying on a low-fat diet is also harder for most people. A low carb diet often suppresses appetite, which helps people stick to the diet.

  5. Hi Paul,
    I have bought the book read as much as possible and am excited to get started, I have depression, PTSD and a tummy that can flare up at a moments notice, I also have a weight problem now that I am keen to resolve.

    After reading the weight loss info I have come to the following conclusions if you can let me know if my thinking is correct.

    I can easily follow an 8 hour window of eating as I often do without food because of tummy issues anyway.

    the fasting bone soup are you saying eat this everyday as a meal for weight loss as opposed to when fasting? or in addition to the main meal?

    when you say mash the potato with egg do you mean cooked? also you recommend fish in the ideal meal yet state somewhere else beef is good for choline, also i can easily do without the cream but like my veggies stir fried so would I still be able to use a little clarified butter or olive oil?

    I really want to be well and lose the weight so I don’t want to be doing anything wrong from the outset so any further guidelines or info would be greatly appreciated.

    • Hi JD,

      Use joint material and tendons in these soups and stews to get more collagen. From bones, get 3 to 7 bowls a week for calcium. These soups and stews should be part of a meal.

      Eggs are more digestible cooked, and the whites should always be cooked, but yolks need not be cooked.

      Fish should be eaten twice a week. Beef is excellent and we recommend beef or lamb at least twice a week.

      Yes, you can use butter or olive oil. They are not forbidden, I am just recommending that you use less if trying to lose weight.

  6. Apologies Paul
    forgot to ask about drinks, i love my coffee, rooibos tea, and in sparkling water with fresh fruit juice are these drinks okay.

    Occasionally at the weekend I add vodka to the sparkling fruit juice 😀

    • Avoid drinking calories when trying to lose weight. So coffee and tea are ok (as long as you are fine with the effects of the drinks) but fruit juice is not. Adding e.g. some lemon juice to water for flavoring is fine of course.

    • Hi JD,

      As Wout says, don’t drink anything with sugar in it. You can flavor water with acids, eg lemon juice, vinegar, ascorbic acid (vitamin C powder), etc.

      Alcohol once in a while is OK.

  7. Hi Wout,

    your reply is much appreciated can you tell me if no sugar squash is allowed instead then?

    Can I have a piece of fruit to eat or is that a no no as well?

    Also would you mind having a little look at my post above it re the bone soup and weight loss as I am a little confused reading between the different posts of what is allowable or not concerning weight loss.

  8. Hi Paul

    Thanks for your reply, I thought I would eat a bowl of bone soup every day in fasting hours and then eat salmon x2 a week, liver x1 a week, beef x1, and chicken x3 a week, however not sure where eggs would fit as the soup and one meal would probably suit me and be enough.

    I am sorry if I sound a little dim with my questions but this type of eating regime is very new to me and I am trying to wrap my head around all that detailed information you provide in your book and then try to apply it to my own needs.

    I would never have considered eating potatoes before for example, I honestly do not know why I have put so much weight on in the last year unless its medication as I really don’t feel I eat that much and I can go for a long time without bothering to eat at all.

    but there must be something I am doing wrong and I keep trying to figure it out.

    once again thanks for your help on the matter.

    • Hi JD,

      Don’t overdo the bone soup, you can actually get too many minerals that way. A couple of times per week is enough.

      As for eggs, you don’t need to eat the egg whites, and you can put the 3 daily yolks in your soup (but it would break your fast a little) or in coffee (http://www.marksdailyapple.com/primal-egg-coffee/ ) or any other way you fancy.

      As for diet soda, there was a recent study in obese diabetics where they showed an insulin response to no-sugar sweetened drinks. It was pretty convincing for the obese diabetic case, and there’s this meta analysis as well showing a link between obesity and diet soda consumption: http://www.mensjournal.com/health-fitness/nutrition/the-diet-soda-paradox-20130723
      All in all, diet drinks don’t seem like a great idea.

      Eating a few pieces of fresh (not dried) fruit a day is ok.

  9. Thank you Wout,

    It is becoming clearer 😀

  10. Sylvia Schwarzkopf

    Hi Paul,
    If I do not eat 3 egg yolks a day, should I supplement with Choline?
    If yes, which one is best to use?
    Thank you so much.

    • Hi Sylvia,

      Yes – supplement with choline.

      They’re all good. If cost is no issue, get both plain choline and a phospholipid mix composed primarily of phosphatidylcholine.

  11. I can’t believe the advice here is the same that I’ve heard my whole life–eat a 1,200 calorie low fat diet. I realize you emphasize nutritionally dense foods, but 1,200 calories is too low for most people (even the sedentary). Maybe an elderly, bedridden women could do well on that, if, as you suggest, meals were precisely planned to ensure adequate nutrition. Pretty disappointing.

    • Instead of disappointed, you should be happy that what people have been telling you all along turns out to be right after all 🙂

      However, the details really do matter, a lot. The weight loss PHD diet needs to maintain absolute carbohydrate and protein intake versus the normal version, to keep immunity high and stress low. Furthermore, the foods need to be nutrient dense because the fat soluble nutrients will be coming from less fat.

      In the end, you’re still be consuming the regular 2000kcal diet, but 800kcal of that will be coming out of your own fat stores.

    • Hi Mary,

      First, 1200 is not advice, that is the minimum food intake consistent with good health in an overweight person. At Perfect Health Retreats the typical food intake is 2000-2400 calories a day and everyone has been losing weight without difficulty.

      But, the elderly do need fewer calories, and elderly women can maintain weight quite well on 1500 calories a day. If you want to lose fat, eg as erp did (at age 77, preparing for knee placement surgery), it may be desirable to search out the minimum food intake that provides good nourishment.

      Our diet is not low fat. Even at 1200 calories, it includes typically 500 fat calories in order to get key fat-associated nutrients. We are suggesting reducing fat compared to a high-fat baseline.

  12. Sylvia Schwarzkopf

    Paul, it is incredible that you so tirelessly reply to everyone. Thank you and thank you again.

  13. 😛 I don’t understand how you say that there are 500 calories of fat in the diet even at 1200 cal. I did some math and a pound of potatoes is roughly 350 calories and a pound of lean 90 percent lean 10 percent fat meat is roughly 800 calories so just for the protein and carb portions you end up near 1200 calories. Most of these calories are not fat. Do you mean that a person should get 500 calories from fat on top of the 1200 calories from protein and carbs?

    • Hi Lisa,

      First, we don’t recommend lean meats. Most meats are about 40-50% protein and 50-60% fat — call an 800 calorie portion of meat 350 protein calories and 450 fat calories. A pound of safe starches is about 400 calories. Add in a 100 calories of fruit; we don’t count vegetables as calorie sources, but people should eat a pound or two of those; and a bit of fat and vinegar as a salad dressing and flavoring agent for starches and vegetables — now we’re at about 1400-1500 calories. You can trim that very slightly but that’s about what you need to be well nourished.

  14. Hello…..I am trying to get an idea of my proper macro breakdown. I am a 5’1 female 99#. I lift weights 5x a week. Currently, my breakdown is 30%c, 40%p, 30%f from 1600 Cal/day. From your diet standpoint I am getting too much protein, but I want to maintain lean muscle as well as build strength. Would you reccomend a different breakdown? Thanks, Giovanna

    • Hi giovanna,

      Well, I think if you ate a bit more carb and a bit less protein, more like 40% carb and 30% protein, it would be better for you. Also I think that is a weight loss diet, are you trying to lose fat? If not then I think it might help you to eat more calories by adding healthy fats, eg egg yolks. Remember also that good nourishment and healing is more important than the specific number of calories you are eating.

      • I rely don’t understand why you aren’t more emphatic about this woman upping her calories. She weighs 99 pounds and works out 5 days per week!!! And your asking if she wants to lose fat?!?! I realize there are petite people in the world, but c’mon. (My 18-year-old niece is tiny, but she weighs close to 120.)

  15. Thank you Paul. Not really a weight loss goal as it is to increase lean mass. When I put my numbers into a calorie calculator, 1600 seemed appropriate. Maybe more calories would be beneficial.

  16. Hi, can you tell me which if any of the supplements you recommend can cause sleeplessness? I originally started taking the supplements with dinner and noticed that I suddenly had difficulty getting to sleep. Since that revelation I’ve taken them in the morning with breakfast….except for yesterday, when I didn’t remember until mid-afternoon. Another sleepless night resulted. Any ideas? thank you – Linda

  17. Hi Paul,

    Thank you so much for providing so much information on thus website! I got back from a four month stance in Mexico recently to find that I had gained 15 pounds! I have always been fairly thin but am really not comfortable at this new weight. I lost 6 pounds initially doing very low carb but began to worry about metabolic injury as my sister has had thyroid problems in the past.

    I am a 22 year old female- 5’10” and about 146 pounds. I am lightly active, and really feel like I can’t relax til I lose that last ten :/

    I am a little worried that I try to cut too much but I’m confused trying to figure out the right ratios. Would 100 grams of carbs and 60 grams of protein be enough for me each day? I like to flavor my starches and veggies with butter if possible. I felt good on vlc but felt like my metabolism was slowing down as I wasn’t hungry very often. Are there any sample menus available for the weight loss plan? I am confused by the percentages.

    Thanks do much, I am really hoping to get into the groove of a plan so I can stop worrying and focus on my studies again!

    • Hi Shannon,

      That’s on the low side for carbs and protein, it would be enough for a petite or elderly women but for a younger 5’10” woman I’d get more. Butter is excellent, please do that; also vinegar on starches. There are some recipes and a sample meal plan in the book. For weight loss, you really don’t do much different than the regular diet. Do intermittent fasting and adjust food quantities so that you are only slightly, mildly hungry at the end of a 16-hour fast. Tend to circadian rhythm entrainment and nutrition — supplemental foods like liver, egg yolks, bone and joint material, spinach, and seafood are very important. Keep normal PHD proportions between meat/fish, starches, fruits, and vegetables.

      • Wow, thank you very much for the reply, I will try to up those amounts a little.

        In Mexico I experienced amenorrhea, some hair loss, and cycling periods of chronic fatigue. These symptoms seem to be improving some but I am hoping your diet will really get things into shape

        Very grateful to your dedication to spreading your insights. Thank you!

        • I was a little worried about trying intermittent fasting as I’d read it causes a stress reaction in women more than men, but I guess the only way to know is to try it out!

          • What causes the stress is undereating. You have to be sure to eat as much food in 2 meals / 8 hours as you would in 3 meals / 12 hours without intermittent fasting.

        • I was a little worried about trying intermittent fasting as I’d read it causes a stress reaction in women more than with men, but I guess the only way to know is to try it out!

  18. I am in a similar position to erp in that I have severe myalgic encephalomyelitis (I am largely housebound and bedbound so extremely inactive) and am going through the menopause so may have hormonal issues affecting my ability to lose weight.

    I’ve just discovered the PHD and was hoping to start by losing about 10 lbs that I need to shift but I am allergic to eggs! They gave me eczema. Can you suggest what I can do? Is my best bet to just take the normal PHD and reduce the overall intake but keep its normal proportion?

  19. Paul, thanks for the details here. Question.
    Given my size — 350lbs, 6’1″ male — I typically target eating between 1800-2000 cals a day. I typically burn about 4,000 cals a day and more on the 5-6 days a week I exercise. so at 2K a day intake I would have a deficit of 2K if I burned 4K. Does this mean I should be eating about 700 cals in protein and safe carbs and about 1300 cals in fat? That is, it seems like from the book that the fat cals are the ones that I rase or lower based on my caloric need. If I can get this straight in my head it would really, really help.

    The book is great, feel great, great being off sugar and flour. Just ordered my supplements from your site. Thanks for the help.

    • Hi Lonce,

      You want to get at least 600 carb calories and 300 protein calories per day. Remainder in fat, amount is not important so long as you are well nourished (eg, egg yolks, liver, meat, etc).

      • So to get to 1800-2000 I should be doing.
        600 carbs
        300 protein
        1000 fats (about)

        Does that sound right?

        I really can’t seem to eat liver, I keep trying. So I am adding some supplements you suggest and a couple of times a week eating 90% dark chocolate. Any other suggestions on that? Thank again for the help on this.

        One last question, if you will induldge me, is it important to use ceramic when making bone broth? You reference that and was not sure if I could use stainless or other metal pans.
        Thank you very much!!!

        • Yes.

          If you can’t eat liver, supplement vitamin A (30-40,000 IU/week) from cod liver oil, choline, and maybe copper.

          We favor ceramic, but it is not essential.

          • Hi Paul 🙂 In the book you recommend supplememting copper if you can’t stomach liver (I can’t), but does this mean that I should perhaps not supplement copper and add fermented cod liver oil and choline? I am already eating 3 pastured egg yolks per day.

  20. Hi Paul
    Is it ok to use coconut oil everyday? 1tbsp max per day? I have Hashimoto’s and I read somewhere I can benefit from taking it. I just started increasing my carb intake eating a minimum of 100g of carbs from asian sweet potatoes/rice and I’m feeling much better than when I was vlc/low carb. I was just wondering if I can keep the CO everyday.

  21. Paul, what’s the rule of thumb for figuring out my min caloric needs where I am still fully nourished? Is BMR a good tool?
    I am a female, 32 years old and 5’6″.
    Currently eating all the nutritious foods per your suggestion on this blog — approx 1,500 calories and typically 36%/43%/21% of fat/carbs/protein breakdown. But not losing weight as much. My theories:
    1) need to give more time to nourish my body (Although I have been paleo for 2 years and higher carb now for 2 months.)
    2) thyroid issues/stress
    3) eating too many calories
    4) maybe my body needs a different protein/carb/fat ratio.
    Thank you!

    • I am 155 lbs, by the way. And when I eat, I am not starving afterwards so don’t think I need to up calories.
      Thank you!

    • Hi NewYorker,

      I wouldn’t eat fewer calories than that. I think that’s a reasonable fat/carb/protein division. I’m going to have a free weight loss guide soon which will have some more tips. I would focus on intermittent fasting circadian rhythm entrainment, exercise, keeping omega-6 down, micronutrition up.

      • Excellent! Thank you for your quick reply.

        • Quick follow up because couldn’t find this in your book. How many times a week should I do IF? Also, do you think protein fasting once a week is a good idea if trying to achieve weight loss? Thanks a million times again.

  22. Paul, what’s your view on doing Protein Fasting 1-2 times a week to promote even more autophagy (i.e. not eating any protein all day)? Do you think it could interfere with weight loss? I saw this BBC segment on the benefits of reducing protein consumption …here is the link….watch from minute 23:50 to 26:00…http://vimeo.com/54089463

    • Does protein stimulate IGF1 though? Loren Cordain claimed that high-glycaemic foods do to a greater extent, along with stimulating insulin.

  23. I’m confused. If I adjust the macro ratios and decrease the fat % as described, how do I determine calories needed? If I’m currently eating about 2000 and maintaining, will adjusting the macros and decreasing fat cause weight loss or should I also carve out about 500 calories per day? I need to lose 25 pounds.

    • Hi CSB,

      PHD is about optimizing health first, and symptoms like obesity second. For many people, obesity solves itself as the health is addressed.

      If you’re currently not eating PHD, you should first eat PHD without counting calories. Only if after doing that for a while and you’re not noticing any weight loss, should you look at decreasing calories.

      In that case you’ll indeed have to lower your calories, but only after establishing your baseline on PHD.

      I must admit that personally, I first lost a bunch of weight (twice) using a 500kcal/day deficit. I felt cold and hungry all the time and I got a couple of colds, but it worked quickly. After 2 months I was very tired of doing it and quickly regained.
      Only by discovering PHD was I able to maintain my weight (and lose my in-belly fat while gaining muscle – perks of the young male!).
      So I don’t have experience doing CR with PHD.

  24. Hello Paul,

    in your book you recommend eating oily fish twice a week. Is there reason to not eat it more often?

    I really like sardines and salmon and eat them every day. But I have history of mercury poisoning in the past so it worries me a little.

    According to Chris Kresser however, fish like sardines has a lot of selenium and little mercury, so there should not be a problem.

    What are your thoughts?

    Thank you,
    Vlad

  25. Good day, Paul

    In yr view, if I replace MCT oil with Cod Liver Oil during fasting period, will it impede weight loss?

  26. If the body didn’t have enough fat and needed it wouldn’t it just use glucose to make fat, leading to greater stores of fat?

  27. Just wanted to check in: my partner is at 27% bodyfat and wants to cut down to 20%. That’s about from 167lb to 150. We will be trying this diet prescription to the letter, except possibly for one thing: a cheat day. Would one day eating much more food keep the weekly metabolism higher? It would also certainly increase odds of sticking to it until the weight is lost.

    • Hi Seth,

      Nobody is 100% compliant to any diet, and they shouldn’t feel guilty about that, but I don’t like the concept of a programmed cheat day. If you are doing PHD correctly, it should be delicious and satisfying. It is not a restrictive diet. If you feel the desire for a cheat day, then you should think about whether you’ve implemented PHD incorrectly. On the other hand, if the “cheat” is due to social convenience, eg a need to eat with friends and be socially compliant, then I don’t think there’s much harm in it.

  28. Looking forward to your upcoming weightloss guide!
    I read your book, but am still struggling, myself.

    I am 5’5″, 140lbs, and was primal for a couple years, keto for a few months where I lost about 6lbs, then switched to PHD since I missed rice and fruit and promptly gained the 6lbs back (water weight I assume).

    I am following your guidelines except for the consistent IFing, so I’d like to try that and see if that makes a difference. Right now I am for 1200-1300cals a day but do not see the scale budging except for normal monthly fluctuations.

    For IFing, I have a couple questions. Firstly, since some calories appear to be allowed during the fast, is there a hard cutoff of what will or won’t break the fast? Could I get a nonfat latte from starbucks without breaking the fast?

    Also, bone broth. I might have to try this in the mornings. Can you eat it every day? Also, how do you make it cheaply? Whenever I go to the store to find marrow bones, they’re like 6 dollars a pound, with recipes calling for 3-5lbs of bones. I can’t afford $20 for just broth!

  29. Jessica,

    I was right where you are a year ago – only I weighed more. I am 5’4′ and weighed (generally) 145. I had weighed between 135-138 throughout most of my 30s and 4os, but gained weight almost overnight during the most intense year of menopause. Last fall, after dieting at 1100 calories per day for 3 months with no results (shocking, since I am a great dieter and hadn’t had trouble losing weight ever in my life), I decided to try IFing. It didn’t work using the 16/8 program, but it did work using Dr. Johnson’s up day down day diet (you can google it). I was able to eat literally whatever I wanted as long as I stayed within the calorie range suggested on his website. I used the 2000/500 scheme for the first 2 weeks, and then modified by doing the 25 – 30% weight loss numbers. I got down at one point to 125 pounds, but after I stopped doing up day down day, I have landed at 128-130. I am still eating an average of 1400-1500 calories a day – that seems to be what I can handle without gaining, and eating nourishing foods, it’s plenty. I feel totally satisfied. If I ever need to “lose a few” I just go right back to up day down day – and it comes off. It’s difficult – but doable. I was a long time low carber, but was able to eat spaghetti, pizza, – anything, and still lose weight. I lost the 20 pounds in about 3 months, then went to maintenance – 1600/800, then gradually switched to 1400-1500 per day. Lately, I’ve been playing with my own “feast or famine” idea, where I “feast” and eat 2000 one day, and then do a few days of 1100-1200 (which is usually all I really want), then do a 1700 day, then a few 1300 days – I guess it’s called calorie cycling. I had tried this scheme to lose weight at one time – didn’t work, but it’s nice for maintaining now, rather than doing the 1600/800 day after day.

  30. can you give me an example how to eat 100g of carbs divided in two meals (i just started trying you IF protocol).. I was doing “low carb” (vegetables) paleo so I want to start slowly to avoid reactive hypoglycemia. So without counting vegetables 3 medium white potatoes or sweet potatoes + sugary vegetables will do?

  31. Paul,
    5 days a week, sometimes less, I make my husband an egg drink to take to work. He has it later in the morning. It consists of 3 egg yolks from pastured eggs, 2 TBSP butter, 2 TBSP Coconut Oil, nutmeg, cinnamon, pinch of Himalayan Salt, and boiling water — usually 2-3 cups….blended together and put into his thermos.

    If he decides to follow the weight loss version of the PHD, should I cut back or eliminate the butter/oil?

    Also, on days that we have the ingredients, I make him a fruit (banana, pineapple, mango, blueberries) smoothie with yogurt, (adding coconut water or milk if needed) and add 2 egg yolks. Regarding the fructose, would these need to take a back burner too?

    Our coffee is made with non-homogenized local milk, mixed with tsp butter and a TBSP coconut oil.

    Our lunches and suppers consists mainly of safe starches, vegetables, and grass fed beef, or pastured chicken, or seafood. We have eliminated grains and sugars (with rare exceptions), enjoy restaurant dining occasionally, and when visiting out of town family or vacationing, we do what we can.

    I would love to know your thoughts regarding the questions I raise above. Thanks, Paul!
    Lisa

  32. Hi Lisa,

    In what order do you make that egg drink? How do you prevent the yolk from coagulating?

    Also, yours sounds like a great diet implementation, have you been doing it for long?

    Are you doing any moving, like walking for 20 minutes every day?

    To answer your question if Paul doesn’t get to it: yes reduce added fat for the weight-loss versio

  33. Hi,
    I am not sure where to post this. I looked up fasting on the website but didn’t find an active forum, so I am posting here.
    My problem is that I have recently(January) moved to france and become a student. I sit, all the time becuase I am either working or studying. Of course I have gained weight and would like to get rid of about 10-15 pounds and most of what I’ve gained is in the hips and but. I am interested in using intermittant fasting to help myself because finding time to exercise on my schedule this semester is impossible. However, I have horrible reactions to fasting. If I just try not to eat between lunch at 12h where I eat a huge salad (including eggs, potatoes and ham-the only choice for meat) an my next course at 18h without a snack I am unable to function. I have to eat regularily in between meals or my hypoglycimia is so strong I can’t function (can barely walk in the worst cases) and later I binge (eat lots of candy and chips) to try to recouperate the carbs missing. I have tried the over nigh fast by going without breakfast and I can’t make it to lunch. I am dying, cranky, shaky etc. What is my bodies problem? How can I do this so as to help my immune function which is extremely low and also lose some weight. Also i should note that I have celiac disease and adrenal fatigue syndrome, meaning that my adrenals do not function optimally, are extremely reactive, and don’t really make all the hormones they should and I know they play a big part in keeping blood sugar regular.

    Also, bone broth is not an option for me as I live in a dorm. I don’t think it would help much anyway as when my sugar is low, the only thing that fixes it is sugar and protein.

    Thanks! I appreciate any adivce that could maybe help me out.

    -Melannie

    • Hi Melannie,

      After relentless experimentation for the last four years, here is what works for me.

      1. Establish a 12-hour light dark schedule: from 6:30 AM to 6:30 PM

      2. Use as many circadian rhythm light-therapies as possible, such bright light emitters (found on perfecthealthdiet.com). Use the bright light emitters all day long. Get sunlight and work near windows. After “sunset” use “f-lux darkroom” on the lowest monitor illumination, while also wearing orange goggles; if you must use other lights then get the night light from “lowbluelights.com”.

      3. Do meditation deep breathing during the “sunrise”; use the light-wake-up alarm (found on perfecthealthdiet.com)

      4. Do HIT exercise for 7 minutes, around 45 minutes after waking. Try something like the “seven minute workout”, featured on nytimes.com. Do the “100-up”. See Paul’s running videos on youtube. Do “jump rope” with perfect posture, but without a rope. Deadlift and squat with a 20-pound medicine ball. Carry a medicine on top of the head with one arm. Throw the medicine ball above head and catch, with robust posture. Do rows with the medicine ball, in safe deadlift position.

      5. Break the fast 1 hour prior to waking with generous amounts of 100% dark-chocolate (such as baking chocolate) and generous amounts of coconut milk in tea. (The Tibetans break their fast with pure fat and, as far as I know, do not experience heart failure.) Breaking the fast within an hour of waking will prevent symptoms of exhaustion, stress, constipation, brain fog, anxiety and overeating that stem from delaying breakfast for hours. Furthermore, animal and plant fats preserve without refrigeration, and so I believe it is not natural-historically inauthentic to break the fast early in the morning with pure fat. (In other words, I believe our ancestors did just that.) Breaking the fast with pure fat, preferably plant fats, such as dark chocolate and coconut milk provides valuable nutrients such as potassium and magnesium; moreover, limiting oneself to pure fat does not interfere with autophagy or ketosis, according to many nutrition authorities.

      6. Take the vitamin line made by the company Mega Food, along with other suggestions found on perfecthealthdiet.com, to fill in any remaining gaps, such as additional magnesium or lithium or K2 or D or silicon. Supplement with small amounts of kelp granules for iodine. (Do not take synthetic iodine).

      7. Expose oneself to faces and social dialogue after, or soon after, breaking the fast with plant fats.

      8. Establish an 8-hour meal-eating-window (or narrower) that includes protein and carbs and fats that ends at 6 PM, a half hour prior to “sunset”.

      9. Construct a make-shift standing desk from a box and history of art books.

      10. Expose yourself to nature sounds, such as continuous loops of waves, rain, etc.

      11. Practice good posture, throughout the day, by means of deep breathing and traditional yoga poses.

      12. Get regular cardio for optimal brain-function.

      13. Play a musical instrument.

      14. For the most part, listen to your body. It is sage.

      Best,

      Euthyphro

      • 15. Fall asleep at 9 PM and wake at 6:30 AM. (Briefly waking in the middle of the night is normal.)

      • 16. Supplement the diet with (a) small amounts of fermented cod liver oil, (b) generous amounts of shellfish (such as oysters, shrimp, clams, muscles, sea urchin) and (c) generous amounts of nitrate rich vegetables such as arugula, beet greens, butter lettuce, and rhubarb, to increase blood flow to the brain, genitals and other extremities.

  34. ps, I apologize for all the spelling mistakes, I had to dash this off before work. Gotta go. Thanks again!!

  35. Thanks for sharing what works for you. I so appreciate it! 🙂

  36. quick question though, one can achieve autophagy during a 12 hour fast? I thought it had to be 14-16?

    • Some people argue that fat alone will not disrupt autophagy, since autophagy is the result of protein and carb deprivation.

      I believe that if you are having trouble with intermittent fasting, it is best to first fix your circadian rhythms with a 12-12 schedule. Fixing your ciracdian rhythms will automatically reduce your appetite and make your physiology more efficient and tremendously improve the quality of life more than anything else. Use light therapies, go outside three times a day for a walk without a hat or sunglasses, confine social interaction, faces and drama on TV to daylight hours, use a make-shift standing desk and do dynamic mobility exercises and deep breathing throughout the day, use f-lux darkroom at night.

      I think that once your circadian rhythms are fixed, then all that is left to do is to simply listen to your instincts and preferences, while restricting yourself to the Perfect Health Diet Food Plate, and while restricting yourself to a 12 hour eating window. — (As a point of categorial-grammar, I do not think that the “brain” has instincts, preferences or desires. It is, rather, a person that has instincts, preferences and desires; the brain is merely the organ that is the physiological precondition of the physiological possibility of a person’s having desires. Moreover, the notion of an “immaterial substance” is categorially incoherent. And thus the soul of a person is not an “immaterial substance”.) — I don’t believe that you should even consciously think about when or what you are going to eat. In fact, I think it likely damages health to do that for two reasons: (1) over thinking things and trying to control everything according to some external template could lead to non-optimal choices; (2) thinking about diet (or supplementation or exercise) causes stress, and stress damages health.

      So, just follow instinct. I believe that the result of following instinct within that structured framework (that consists of the food plate, standing desk, 12-12 light schedule) will automatically result in something like a 14-16 hour fasting window. For, I don’t think you will be inclined to eat the minute you wake up, etc. And I think if you follow instinct you will eat a higher fat breakfast anyway (e.g., consisting primarily of dark chocolate and coconut milk). But eat whatever you want, including some carbs if you feel like it.

      I think that all the diet advice in the world no matter how true it is will be unlikely to improve health if you are always consciously fretting over the implementation of it. In general, dieticians in the ancestral community need to pay more attention to this kind of health risk, I think, assuming their main objective is to promote optimal health for people who do not study the science of diet as a profession. I think that blindly following instinct, within a structured framework, is most likely to improve health, since it is most likely to lead you to the optimal choices for bio-flourishing (more likely than attempting to consciously manage things), and because it lowers the stress related to thinking about your diet, which is actually health damaging.

      • It may be true that one must fix “100 things” to turn one’s health around. However, the daily conscious steps that are required for the implementation of the “100 things” must be very simple and effortless and must not require much or any conscious attention at all. For, as soon as they become more than that, then it becomes a matter of a cost-benefit analysis, in which one must weigh the effort and risks and costs associated with consciously fixing “100 things” with the other goals in life that are more important, such as the care of “the health of the soul”. And so, I think it’s best to figure out a way to simplify the implementation of the “100 things” such that this implementation takes care of itself without conscious effort, seamlessly, and I believe the best way to do that is to just listen to instinct, within an environmentally structured framework (and assuming one is already educated in the art of gourmet cuisine): for, such a strategy is most likely, I think, (1) to lead to the best outcomes, (2) to lead to the fewest mistakes, (3) to require the least effort, conscious attention and time-commitment, thus reducing stress and (4) to free one up to focus on more important things than health, such as the health of one’s soul.

        • “I go around doing nothing but persuading both young and old among you not to care for your body or your wealth in preference to or as strongly as for the best possible state of your soul….Wealth does not bring about excellence, but excellence makes wealth and everything else good for men, both individually and collectively…Now if by saying this I corrupt the young, this advice must be harmful, but if anyone says that I give different advice, he is talking nonsense.” (Plato, Apology)

  37. Hello Paul,

    Just starting out. My basic stats:
    -6’7″
    -315
    -220 lean body mass (have done a lot weight lifting)
    -57 years old, still fairly fit
    -doing 3 – 4 days/week of body weight training now, which leaves me satisfied but quite tired the next day
    -What base amount of calories would you recommend for carbs and protein? (I assume it would be more than 500 cals carbs, 300 cals protein, and 500 fat?
    -I also have suffered from depression most of my adult life and am using anti-depressants
    -In recent years I have had significant loss of mental energy (as measured in the amount of analytical work I can do in one day. Perhaps only 40% of mental work in one day, compared to 7 or 8 years ago.
    My Thanks for any thoughts you have
    PMac

    • Hi PMac,

      For calories, I don’t have a number, rather do intermittent fasting 16 hours every night and eat enough food so that you are only mildly hungry at the end of the next day’s fast. Eat PHD and be well nourished. Let me know how you do.

      Best, Paul

  38. Dear Paul,

    I had a baby 6 months ago and have a lot of weight to lose. I am 5’5.5″ and am about 182lbs. I had stayed between 155-162lbs for about 7 years and 115-125 for 8 years before that. Right before I became pregnant with my last baby, I had creeped up to 185lbs. I’m finally working on losing the weight again, and would ideally like to end up between 125-130lbs. I am breastfeeding, which I know complicates things a bit for the moment, but have lost weight before while doing so. The difference is that I’m almost 30 now, and the weight does not fall off easily anymore. I’ve had hormonal imbalances which probably don’t help as well. For the past few weeks, I have mistakenly been trying to achieve a ketogenic diet. I’ve been adding lots of cream and fats to my food, and yet am weak and hungry feeling. Basically, I’ve been doing a low-carb diet, with lots of extra fat. Do you have any additional suggestions for me in particular, that I wouldn’t of gotten out of the above article? Thank you very much!

  39. Dear Paul,

    could we consider basal metabolic rate* as minimum intake of calories in a (firt of all) nourishing and calorie restricted perfect health diet?

    *
    For men: BMR = 66.47 + (13.75 x weight in kg) + (5.003 x height in cm) – (6.755 x age in years)
    For women: BMR = 655.1 + (9.563 x weight in kg) + (1.850 x height in cm) – (4.676 x age in years)

    [Harris JA, Benedict FG. A biometric study of human basal metabolism. Proc Natl Acad Sci USA 1918;4(12):370-3]

  40. I know this is an older post, but I read it a long time ago and have been tinkering with these ideas off and on ever since. My results with reducing “excess” dietary fat, while keeping carbs and protein the same, have not been very good. It makes so much sense in theory, but the problem with removing the fat is that it reduces my glucose tolerance and increases stress, both of which make me more hungry and less able to lose weight. As much as I get tempted to use less fat in my cooking, eat less fat-dense foods, consciously reduce calories etc., it always backfires on me. Getting to an ideal weight (vs. upper normal range) is hard to do in any recipe like fashion. It seems the best I can do is make my body as comfortable, fed and nourished as possible, and then slip in a little I.F. here and there, stopping way before it freaks out on me. Anyone have similar experiences?

  41. Hi Paul,

    Thank you for this article, and all that you do. I love your work. I have a question regarding egg consumption. I’m in the process of healing my leaky gut, and I just found out that I’m highly allergic to eggs, so eggs are definitely out of the question. Is it possible to replace the minerals from the eggs with other foods? Should I increase my liver intake?

    Thanks again, I appreciate your time,

    Anita

  42. Hi Paul,

    Thank you so much to you and Shou-Ching for the Perfect Health Diet! It’s such a breath of fresh air to find such a thorough, objective take on the healthy-living literature – and such a thoughtful, scientific analysis with practical and accessible options for implementation.

    My question doesn’t relate to weight loss per se, but this seemed like the best place I could find to post these questions. Have you ever done/thought about doing a blog post on Calorie Restriction Optimal Nutrition (CRON – https://en.wikipedia.org/wiki/CRON-diet) in relation to PHD?:

    1) For someone seeking to try the CRON diet, would you also recommend cutting out fat if the person doesn’t have much extra fat to begin with? Essentially, how would you recommend a long-term sustained reduction of 30-40% of calories? Cut fat or cut protein? (It seems like there are the most deficits to cutting carbs too severely?) Or something else?

    2) Is there any specific reason why you would avoid a CRON diet completely (maybe a post somewhere on this website) – besides avoiding hunger (which is surely no small thing!)?

    3) What would be a minimum supplement strategy for achieving a CRON or even the normal PHD. (One of the few bothers of the diet is the number of supplements required, which seems out-of-sync with the part of the book describing how our ancestors might have been ultra healthy. Surely they weren’t taken lots of supplements! So were they eating more liver? Or is the supplement use just to make our diets *even healthier*?).

    I’ll continue to research these questions on my own, but many thanks for any answers or direction you can provide – in any format.
    – Sam

  43. Hi Paul,
    you recommending 300 calories from protein per day. My weight is 55kg and 300 calories is 1,36g protein per kg. This is not too much with recommendations 0.8 g / kg.
    Best regards
    Emilia

    • Hi emilia,

      The recommendation for 300 calories of protein is targeted at a 70 kg individual eating 2000 calories per day. If you weigh less and eat fewer calories, you may need less protein.

      Try to eat about 600 carb calories per day, which is appropriate for all adults (carbohydrate requirements scale with brain size not body size). Then eat protein and fat to taste; you will naturally gravitate towards the correct intake. (For the average person, that would work out to 15% protein / 30% carbs / 55% fat.)

      Best,
      -Eric

      • Hi emilia,

        To clarify, since this is posted on the “weight loss version” page: The above assumes you are not trying to loose weight.

        If you are trying to loose weight, you want to eat less fat (but the same amount of protein and carbs) as suggested.

        Best,
        -Eric

  44. Hi Eric,
    thank you for all your answers.
    I have a few questions, I’m sorry.
    Currently I am on the Paleo diet and amount of 600 calories from carbohydrates for me is very, very big. All the time I hear that carbohydrates are insulin spikes, shorter life etc. Are you sure 150g of carbohydrates it is not too much? Carbohydrates of plants, in addition to starch and sweet plants do not count?
    Next question. Is it not better to eat every day a little fish, liver, kidneys to provide ingredients every day. If I eat a fish or kidney one day it provides much omega-3 or selenium only on that day?
    And the last question, if the broth from the bones I can cook in slow cooker. Would not it will be a little temperature, lest boil all of those bones?
    Thank you and best regards
    Emilia

    • Hi emilia,

      Yes, 150g of net carbs is a good amount; and that is only counting carbs from starchy and sweet plants (not low-calorie vegetables). A moderate amount of carbs (like 150g) should raise (not lower) life expectancy.

      The body can store nutrients you eat on one day for use another day. So it’s okay to eat a week’s worth of liver (or fish or kidneys) at once.

      I don’t understand your last question.

      Best,
      -Eric

  45. Hi Eric,
    sorry for my English. For me cooking in the slow cooker it is much more convenient. The slow cooker temperature is below 70-80 degrees Celsius and is cooking at low temperatures. It is impossible to cook in a 100% Celsius as in traditional pots. I do not know if the temperature in the slow cooker will not be too low to reach all parts of the bones.
    Best regards
    Emilia

    • Hi emilia,

      A slow cooker will be too low temperature to extract every last bit of nutrition from the bones; so you won’t be able to reuse the bones as many times. But it should still make a good stock.

      Best,
      -Eric

  46. I’m currently doing high protein, semi-low carb, and low fat. I started at 218lbs, and I’m now 212. My calories equal out to 1700. I have been doing this for 9 days total, with 60 minutes of cardio a day, plus about an hour and a half of lifting. I haven’t felt any decreased energy yet, but maybe it is to come later. I’m down 6lbs so far, and everything seems to be smooth sailing. Best prep I’ve had so far.

    Protein- 229g
    Carbs- 140g
    fats- 25g

  47. Hi Eric,
    thank you.
    Best regatds
    Emilia

  48. Hi Eric,
    I have another question.
    Does drinking fresh juice from vegetables is recommended for PHD? Many experts recommend drinking juices due to the enzymes, vitamins.
    Early I drank juices by half a year, but began to have heartburn and burning sensation in the esophagus. Maybe because I drank on an empty stomach?
    Do you recommend wheatgrass juice or powder?
    Best regards
    Emilia

    • It is better to eat whole fresh fruits (1 pound per day) and vegetables (1–1.5 pound per day), instead of only their juices. Eat a wide variety of vegetables and cook most of them.

      I would avoid wheatgrass and other grasses.

  49. Helo Eric,
    how often and how much you can eat chicken livers week? I know that the beef liver eat only 200g due to copper, and as with chicken liver? Can I eat every day?
    My husband is training bodybuilding, and in liver is a lot of nutrients, but is not it harmful to eat it every day?
    How often do you eat the kidney?
    Is innards can be consumed raw in the form of a cocktail?
    T

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