The Diet

The Perfect Health Diet

Here’s our Perfect Health Diet food plate:

PHD_Apple_plate cropped

NOTE: This is our new food plate, updated 2015. Foreign translations of the original food plate may be found here.

We recommend:

  • About 3 pounds [1.4 kg] of plant foods per day, including:
    • About 1 pound [0.45 kg] of safe starches, such as white rice, potatoes, sweet potatoes, and taro;
    • About 1 pound [0.45 kg] of sugary in-ground vegetables (such as beets or carrots), fruits, and berries;
    • Low-calorie vegetables to taste, including fermented vegetables and green leafy vegetables.
  • One-half to one pound [0.25 to 0.5 kg] per day of meat or fish, which should include organ meats, and should be drawn primarily from:
    • ruminants (beef, lamb, goat);
    • birds (especially duck and wild or naturally raised birds);
    • Shellfish and freshwater and marine fish.
  • Low omega-6 fats and oils from animal or tropical plant sources, to taste. Good sources include:
    • butter, sour cream, beef tallow, duck fat;
    • coconut milk or oil
    • palm oil, palm kernel oil, olive oil, avocado oil, macadamia nut butter, almond butter, cashew butter
  • Acids to taste, especially citric acid (lemon juice, lime juice, orange juice, grapefruit juice), lactic acid from fermented or pickled vegetables, vinegars, tannic acids from wine, and tomatoes.
  • Broths or stocks made from animal bones and joints.
  • Snacks or desserts from our pleasure foods: fruits and berries, nuts, alcohol, chocolate, cream, and fructose-free sweeteners like dextrose or rice syrup.

By weight, the diet works out to about 3/4 plant foods, 1/4 animal foods. By calories, it works out to about 600 carb calories, primarily from starches; around 300 protein calories; and fats supply a majority (50-60%) of daily calories.

In the shadow of the apple are foods forbidden because of their high toxin content. Notably:

  • Do not eat cereal grains — wheat, barley, oats, corn — or foods made from them — bread, pasta, breakfast cereals, oatmeal. The exception is white rice, which we count among our “safe starches.” Rice noodles, rice crackers, and the like are fine, as are gluten-free foods made from a mix of rice flour, potato starch, and tapioca starch.
  • Do not eat calorie-rich legumes. Peas and green beans are fine. Soy and peanuts should be absolutely excluded. Beans might be acceptable with suitable preparation, but we recommend avoiding them.
  • Do not eat foods with added sugar or high-fructose corn syrup. Do not drink anything that contains sugar: healthy drinks are water, tea, and coffee.
  • Polyunsaturated fats should be a small fraction of the diet (~4% of total calories). To achieve this, do not eat seed oils such as soybean oil, corn oil, safflower oil, sunflower oil, canola oil, or the like.

We highly recommend certain foods for their micronutrients. These include liver, kidney, egg yolks, seaweeds, shellfish, fermented vegetables, and bone broths.

We also recommend augmenting the diet with certain supplements. See our Supplement Recommendations page. These nutrients are deficient in modern diets due to removal of minerals from drinking water by treatment, depletion of minerals from soil by agriculture, or modern lifestyles that deprive us of vitamin D by indoor living.

We recommend tweaking the diet for certain diseases. Neurological disorders often benefit from a diet that is ketogenic; other conditions may benefit from lower carb diets. These variations are discussed in the book:


See the “Buy the Book” page for other purchase options.

Leave a comment ?

2,827 Comments.

  1. Public Service Announcement: The PUFA content of Trader Joe’s sunflower seed oil is a factor of 10 higher than indicated on the nutrition facts label.

    So it is NOT suitable for PHD — contrary to what several commenters have assumed on basis of the faulty nutrition facts label (see for example http://perfecthealthdiet.com/2012/12/toward-a-happy-phd-in-the-mainstream-new-year/#comment-123526, item #7).

    Trader Joe’s tells me they’re planning on changing suppliers, to a low-PUFA (“high-oleic”) variety of sunflower oil; it should take 6–12 months to make the switch. I’ll post back here once that switch is completed with more details.

    Best,
    -Eric

  2. Hi Paul, I eat about an ounce of dark chocolate just about daily. It’s my one indulgence and brings me great pleasure. I’m not at all overweight. I just read that my favorite bar of dark chocolate (among others) was found to contain lead and cadmium. Should I worry about this?

  3. Paul, in your book you mention Homocysteine only few times. Whats your opinion about Homocysteine test results? Should we worry about its values? Should we even consider this test?

  4. Paul, do you think this will bring hope to all those people who suffer from undiagnosed brain infections?
    http://hopkinsinhealth.jhu.edu/community/featured-research/diagnosing-brain-infections-with-genome-sequencing

    • Hi Jorge,

      Yes, I’m very glad they are working on it. The downside is that progress will be very slow because they seem to rely on brain tissue specimens and those are rarely available.

      Best, Paul

  5. It is very confusing, annoying, upsetting and just makes me sad really, that there is still such a controversy and disagreements between doctors and scientists over what a good diet to avoid heart disease is. The main areas of vehement disagreement seem to be over meat, eggs, saturated fats.

    What is your response to people like dr. Fuhrman? He says: “Saturated fats have not been shown to be safe and healthy, and foods rich in saturated fat should be minimized: less meat, butter and cheese in favor of more beans, intact whole grains, vegetables, and nuts and seeds”
    http://www.drfuhrman.com/library/were-we-wrong-about-saturated-fat.aspx

    He is not the only one – others like greger, ornish, mcdougall, Esselstyn say similar things – meat, saturated fat, eggs and cholesterol are all bad and should be replaced with beans, nuts, seeds and more vegetables.

    • There’s a book out there called the Perfect Health Diet that lays out what they think is the best diet based on current science. Have you read it?

      • ralph, here is the thing and I sympathise with your frustration. There is NO PERFECT DIET. I love Paul’s book and think it is certainly one of the best books out there for overall guidance and detail. And Paul is totally awesome and available too! It’s just that every person is so individual.

        Take joints: you can find evidence that more grain, no grain, more meat, no meat, no nightshade, yes! nightshades! go on do vegan etc… but, yeah FAT! all work for some folks. Why? Too many reasons to list here. You need to find your way and comfort zone in your own journey. You can go too far and get depressed and then the beer and pizza diet will work.

        Sorry not meaning to be a pain I have been every place on my journey, at times riding on rollerskates and spinning a nice side of grass-fed meat above my head. Keep going, keep reading, but make sure you don’t get too disheartened.

    • The thing about those people you mention is that some of them place their vegetarian or vegan advocacy before everything, and that of course includes historical and scientific evidence. McDougall wouldn’t even let you eat nuts, maybe an avocado here and there if you feel naughty. He would disregard the fact that the people from the Blue Zones eat and highly value animal products, even if they indeed consume large ammounts of starch in the form of legumes and grains. Don’t pay attention to his jokes about eating a little piece of turkey on Thanksgiving -you know he ain’t doing that.

      You can always derive your own synthesis. For instance, Paul no longer recommends adding oils if you consume fat (and you should) from whole sources. Think that many in the ancestral community still proclaim that supplementing with oils is a good thing. He has somehow relaxed his possition towards properly prepared legumes, although he doesn’t recommend consuming them on the basis that people will simply buy the processed stuff. And if anything, PHD is pretty much plant based.

    • Dr. Michael Greger today on NutritionFacts.org. eggs increase oxidized LDL. Wish Paul would comment. Here is the text:
      Maria Fernandez has received nearly a half million dollars from the egg industry and writes papers like “Rethinking dietary cholesterol.” She admits that eggs can raise LDL cholesterol, bad cholesterol, but argues that HDL, so-called “good cholesterol,” also rises, thereby maintaining the ratio of bad to good. To support this assertion, she cites one study that she performed with Egg Board money that involved 42 people.

      If we look at a meta-analysis, a measure of the balance of evidence, the rise in bad is much more than the rise in good with increasing cholesterol intake. The analysis of 17 different studies showed that dietary cholesterol increases the ratio of total to HDL cholesterol, suggesting that the favorable rise in HDL fails to compensate for the adverse rise in total and LDL cholesterol. Therefore, increased intake of dietary cholesterol from eggs may indeed raise the risk of coronary heart disease.

      The Egg Board responded (as seen in my video, Does Cholesterol Size Matter?) by saying that the increased heart disease risk associated with eating eggs needs to be put in perspective relative to other risk factors, arguing that it’s worse to be overweight than it is to eat eggs, to which the authors of the meta-analysis replied, “Be that as it may, many people do not find it a major hardship to cut back on egg intake, whereas most people find it impossible to lose weight permanently.”

      Fine, Fernandez admitted, eggs increase LDL, but she claims that the increase is in large LDL, arguing that large, fluffy LDL particles are not as bad as small, dense particles. Indeed, large LDL only raises heart disease risk of women by 44%, instead of 63% for small LDL. Light large buoyant LDL still significantly increases our risk of dying from our #1 killer. The difference is similar for men: large LDL only increases risk of heart attack or death by 31%, instead of 44%. As the latest review on the subject concluded, LDL cholesterol has “clearly been established as a causal agent in atherosclerosis … Regardless of size, LDL particles are atherogenic.” Yet Egg Board researcher, Fernandez, wrote that the formation of larger LDL from eggs is considered protective against heart disease, relative to small LDL. That’s like saying getting stabbed with a knife is protective–relative to getting shot!

      Health practitioners should bear in mind, she writes, that “restricting dietary cholesterol puts a burden on egg intake” and leads to the avoidance of a food that contains dietary components like carotenoids and choline. She wrote this in 2012, before the landmark 2013 study showing that choline from eggs appears to increase the risk of stroke, heart attack, and death, so she can be excused for that. But what about the carotenoids in eggs, like lutein and zeaxanthin, which are so important for protecting vision and reducing cholesterol oxidation? As I explored previously, the amounts of these phytonutrients in eggs are miniscule. One spoonful of spinach contains as much as nine eggs. Comparing the predictable effects on eye health of organic free-range eggs versus corn and spinach, the effect of eggs is tiny.

      What about the effects of eggs on cholesterol oxidation? We’ve known for decades that LDL cholesterol is bad, but oxidized LDL is even worse. Therefore, according to Fernandez, since eggs have trace amounts of antioxidants, eggs may prevent cholesterol oxidation. But the science shows the exact opposite. Consumption of eggs increases the susceptibility of LDL cholesterol to oxidation. The researchers found that not only does eating eggs raise LDL levels, but also increases LDL oxidizability, in addition to the oxidizability of our entire bloodstream. This was published 18 years ago, yet Fernandez still tries to insinuate that eggs would reduce oxidation.

      She acknowledges receiving funding from the American Egg Board, and then claims she has no conflicts of interest.

      This is why a site like NutritionFacts.org can be so useful, because even when a paper is published in the peer-reviewed medical literature, it can misrepresent the science. But who has time to check the primary sources? I do!

  6. Wow. In a perfect world: Live in a big city, have a “healthy” income so you can afford these special foods and a personal assistant to find, fetch and fix all the meals and snacks for you. I’m just looking for a way to get off processed sugar, eat healthier and still feel satisfied -It’s become a real problem for me. How depressing. Happy for all who can do even a fraction of these money, resource and time consuming solutions.

    • Sheli – I am 70 yrs old, retired and live in a modest budget, but I do it.

      I do it by keeping things simple. No sugar, no wheat, no processed food.

      What do I eat?

      Meat, poultry and fish/shellfish – simple grilled or baked. A couple of eggs a day – fried or scramble.

      A baked Russet or sweet potato with some butter.

      Steamed vegetables or a mixed salad with a little salad dressing.

      A piece of fruit for dessert.

      It’s frugal, simple and doesn’t take a lot of time.

      It’s the way people used to eat when I was growing up in the 1940s and 1950s. Meat, potatoes, vegetables and fruit. Real natural unprocessed food. Simply cooked.

      And… I’m saving a lot of money on food.

      Try it !!! It really is easy. And.. I feel great….

    • and…

      3 meals a day.

      Protein
      Safe starch (potato, winter squash or white rice)
      Vegetables

      at every meal.

      Fruit – once or twice a day as dessert.

      That’s it. Very very very easy.

      No fancy ingredients. No expensive ingredients. No time consuming recipes.

  7. Does IF intervene with any strenght and muscle gains obtained from weightlifting?

  8. Amazing, always appreciate your quick response.
    Regards.

  9. I have asked this question before in other sites as well and thus far have never got an answer. Here it is: According to the Pritikin Program, The McDougall Program and Dr. Caldwell Esselstyn, author of Prevent and Reverse Heart Disease, all claim that their method of a low fat (10%) diet will stop the progression of heart disease, and in many cases the reversal of it. Are the claims true of these well respected doctors? Question: Can the same be said of the Perfect Health Diet? Will the LCHF eating methods or PHD stop the progression of heart disease or even its reversal?

  10. Hello Paul:
    I would like to know how much carb calories should a 19 year-old guy (6 feet tall), who lifts three times (bodyweight, and not so intensely by the way) and sprints weekly (one sprinting session) consume? I know 400 carb calories aren’t enough, but if I choose to eat more I end up eating something like 200 gr (I know that doesn’t sound like a lot, but I also read that carbs shouldn’t be eaten to taste, but rather a little bit less), so I would like to know what’s your opinion on this? The same happens with protein, but I end up eating LOTS of protein (~170 gr/day), and I know this isn’t healthy…

    Thanks a lot in advance!

  11. Hi Paul-
    Several stores in my area are selling potato chips made from either 100% coconut oil, avocado oil or olive oil. Would these be approved (in moderation) or does the high cooking temperatures of the healthy oils (deep fried) make them unacceptable? The only other ingredient added is sea salt. Thanks!

    • Sometimes a treat is in order, and while I rarely purchase or consume pre-packaged food, the coconut oil cooked chips offer a nice diversion. I don’t eat them daily, but if we’re going on a car trip or will be in a place where we can’t cook, or I just want to feel like a “normal” person, I will enjoy some. Try Jackson’s Honest – I think they are the healthiest and best tasting among all of the brands.

  12. TR, I’m always looking for some variety. I don’t like the ones in olive oil, but haven’t seen coconut or avocado anywhere. What are the brands and are they tasty?

    • Hi erp-
      They are very good and hoping they are ok to eat. Boulder Canyon is the brand. King Soopers (Denver area) and Walmart.

    • I’ve seen trafo brand

    • Hi erp, have you tried Jackson’s Honest? They’re incredible!!! They make potato, blue heirloom potato, sweet potato, corn and heirloom blue corn — all made with only coconut oil and sea salt only. They make a few flavored potato (BBQ) and corn (Salsa Fresca) that have other junk in them, but I avoid those. Almost all of their ingredients are organic too. I buy mine at Whole Foods and a few high end super markets in my area. But you can also buy some of them on Vitacost or order them by the case direct from Jackson’s Honest. My husband is not paleo, and he LOVES them. Enjoy!

      • Thanks. I’ll try Whole Foods.

        • I don’t know where you live, but on the SF Peninsula Whole Foods has them, and I’m pretty sure that they carry them in Seattle. If they don’t have them at your WF, then ask them to bring them in. The corn chips have been harder to find (I don’t eat corn regularly, but occasionally I do) but one specialty store started carrying them right after I ordered a case direct from Jackson’s (a few families shared them with us). Nice thing about all of their corn and potatoes is they are organic/non-GMO and the blues are heirloom varieties.

  13. Does White rice and white potatoes cause inflammation in the body?Do starches feed candida?I’ve had this bad post nasal drip for years and haven’t been able to pinpoint the cause.

    • Hi frankie,

      From (http://perfecthealthdiet.com/2011/10/jimmy-moore%E2%80%99s-seminar-on-%E2%80%9Csafe-starches%E2%80%9D-my-reply/):

      “Dietary carbs can feed Candida in the gut, but they also feed competing probiotic bacteria and promote intestinal barrier integrity and immune function, and thus their effect on the gut flora is complex. More importantly, ketosis promotes systemic invasion by Candida and glucose is needed for the immune defense to Candida, so a moderate carb intake is helpful to the defense against systemic Candida. As Candida is an effective intracellular pathogen that can flourish systemically, this is a very important consideration. No one with a Candida infection should eat a ketogenic diet… consult our ‘Results’ page for a few cases in which fungal infections were exacerbated on very low-carb diets and cured on our diet.”

      Best,
      -Eric

    • @frankie…I finally found out my sinus problems were caused by potato chips. I would eat a tiny bag at my break during work and it took me forever to figure out what what was making my nose run all the time. I am not allergic to potato chips either.

    • After quite a while of experimentation, I discovered that my sinus problems/post-nasal drip were caused by dairy. No dairy = no sinus problems…. none 🙂

  14. Could this be a food histamine issue?Is PND always almost a fungal issue?

    • What is PND?

      • post nasal drip

      • @ Cheryl PND is post nasal drip

        • I have a nasal polyp and was constantly trying to figure out what was causing inflammation in my sinus cavities. I never really had post nasal drip just a runny nose and a lot of sinus pain. And I read that chronic sinusitis was fungal but I have no idea why potato chips bothered me yet I can eat potatoes I cook myself. I get migraines from chocolate which I thought was histamine related.

  15. Hello, I was wondering if you would behave a sale on your book any time soon. I missed the November sale by a few days and have been waiting for another sale. Thank you for your tme!

  16. Hi,

    I’m halfway through the book, and wondering where tomatoes fit in.

    Tomatoes being a fruit do they count toward the sweet plant pound per day, or being only 48 calories per pound do they fall in with the vegetable pound per day (with onions, roots, green leafy vegetables etc.)?

    I’m sorry if you’ve addressed this elsewhere, but I’ve been looking and haven’t been able to find the answer.

    Thank you for all your hard work and dedication! This is amazing, life changing stuff!

    • Hi Jake, they are a fruit. The Jaminets discuss them as a sweet non-starchy plant or fruit. As a practical matter, I usually factor them into my sweet count, along with berries, bananas, etc. However, personally, I almost always eat 1 tomato per day (regardless of whether or not I’ve met 1 lb of sweet from other sources) because they are a top source of lycopine and of course potassium.
      When the Jaminets talk about non-starchy vegetables, I believe that they loosely mean the crunchy ones and all greens. (There is also some cross-over of semi-starchy or semi-sweet root veggies like carrots, parsnips, turnips, beets, sunchokes etc, between crunchy vs starchy; but unless I’m eating a big serving of one of the starchier ones in lieu of a starch, then I tend to ignore the starchy aspect of them.)

  17. My annual physical showed elevated creatinine and hemoglobin A1C, so I did a follow-up to retest, and the results are still elevated. Here they are:
    CREATININE 1.47 mg/dL (good range: 0.76 – 1.27 mg/dL)
    HEMOGLOBIN A1C 5.9% (good range: 4.8 – 5.6%; Pre-diabetes: 5.7 – 6.4; Diabetes: >6.4)

    I don’t know whether or not I should be concerned. I am 41 years old, not at all obese or even overweight, have good muscle tone, am generally healthy, eat a diet that’s generally close to the Perfect Health Diet on most days (gluten maybe once a month or so, low-moderate carb on most days, low sugar, low veg. oil, high sat. fat, many vegetables, protein largely from grass-fed kefir, wild caught seafood, grass-fed collagen, whey and beef) and am very active (two or three days per week of brief intense cardio, one heavy weight day (Body by Science) and many days of competitive sports. I also supplement with creatine one or two times per week. I’ve read that lots of athletics together with high protein and creatine supplementation can elevate creatinine. I’ve also read that ketosis might be associated with high creatinine. I have none of the symptoms associated with pre-diabetes or kidney dysfunction, so not sure if I should be concerned, how I should follow up or what, if anything, I need to do about these results. Any ideas would be appreciated.

  18. Heidi – Can’t find your link from your comment. What company / product are you complaining about? If it is Garcinia Cambogia,or something else, go through your credit card people. They may be able to help you by registering a dispute with the company. They (TD VISA) were very helpful for me and I got $700+ back.

  19. This question is aimed squarely at Paul. I hope you can respond……..

    I’m an overweight (but not too much) 45yr old male from the UK. I’ve got a cholesterol level of 9.4. I also have very raised blood pressure.
    I’ve been having investigations including running ECG’s etc and am due a CT scan in a couple of weeks to check my heart condition out.
    I’m already getting the lifestyle info from GP’s : Go on Statins, Reduce your fat intake, cut down the salt etc etc………..
    I’ve never believed in this sort of advice but now I’m looking at the possibility of heart disease, I’m having a wobble about what’s correct nutritionally 🙁
    I’m doing the book at the moment (just started) but wondered what you’d say to someone in my position. Cheers, Rich

    • Hi Rich,

      I would say implement our diet & lifestyle, and related natural remedies, ASAP, beginning with healing the gut (e.g. vitamin A / liver, vitamin D / sunshine, vitamin C, taurine, glycine, intermittent fasting, circadian rhythm entrainment, iodine, 3 egg yolks per day, 3 tbsp vinegar per day, lemon/lime juice, green leafy vegetables).

      Statins are on option you should think over. They may reduce your risk of a heart attack in the short term. After you have implemented natural lifestyle improvements you should see if you can get off them. Do not let your LDL cholesterol go below 130 mg/dl = 3.36 mmol/L while on statins.

      Best, Paul

      • Hey Paul, Thank-you so much for taking the time to reply, that’s really cool of you and very much appreciated.

        I’m doing the fasting, eating ‘clean’ but I’m going to be 100% honest and say that the book can be a hard read at times ! ! I don’t know if you’ve considered it, but I really thing a Dummies version of the PHD would be an absolute bonus to anyone who’s already bought the book. I’m sure alot of people have said the same or if they haven’t, they’ll be agreeing with this comment.

        Anyway, I’ll keep to the fasting. On breakfast days, I’ll have three eggs (whole) and a banana. I’m mainly eating chicken for lunch (I’m a plasterer by trade and I grab it hot from the supermarket for convenience). I’m getting plenty of organic butter into my food and also taking a teaspoon of coconut oil straight off the spoon every day. I’m drinking lots of water and eating alot more veg than I usually do. Dinner is generally a tuna steak or some chicken with veg but I’ll start mixing those meats up.

        I’m going to look at supplements now and also see what Circadian Rhythm Entrainment means ! !

        Thanks again for the reply, I truly appreciate your time.

  20. I have a question for Paul regarding the intermittent fasting. You indicate that we should fast 16 hours, eat all meals with eight hours, and that in the 16 hour period we can eat coconut oil. My questions are:

    * Can you describe what specifically triggers autophagy and why coconut oil does not affect this? Is the requirement for the cell to start autophogy that it run out of *both* glucose *and* protein?

    * If we eat coconut oil should this be done only near the end of the 16 hour period, when we get up in the morning for example? If you eat coconut oil early in the fast won’t that delay the exhaustion of glycogen from the liver?

    • Autophagy is triggered by shortage of macronutrients or specific shortages of protein or carbohydrate; or by innate immunity after detection of bacteria or viruses inside the cell. Coconut oil does affect autophagy by removing the low-calorie trigger for autophagy, but because longer fats don’t enter the brain and ketones are an autophagy trigger, they don’t prevent neuronal autophagy. Yes, I think it’s best to take coconut oil only at the end of the fast, so that you are ending the fast for most of the body but continuing it for the brain. I would say wait until hour 15.

  21. Hey Paul,

    I hope you and your family are well. Since I came off my IVIG 14 mos ago I have been doing great, until now. I don’t make certain serotypes for E. COLI bc of my primary immunodeficiency and I developed a UTI with an antibacterial resistant e. Coli. The antibiotics I have used so far I have not been able to clear it. What would you recommend to optimize PHD. I am not having fungal issues, so ketogenic? Up my MCT OIL? Cut fructose out for now? Any supplements that might help? I am not sure which way to go here.

    Thanks,
    Amy

    • I would support antimicrobial peptides with vitamin A and D, use probiotics (AO+Mist, yogurt) on the urinary tract outlet to provide competing bacteria, and look into what pH of urine is best for eliminating E coli, then achieving that with alkalinizing or acidifying nutrition.

  22. Great, I will do all of that! Thank you!

  23. It seems to me there is an important idea here with fasting that is never directly addressed. There is a trend in research now show that many bacterial and viral pathogens are good at turning off the innate immune system. This allows them to become long term parasites in the body, and over time they accumulate and create a significant disease burden on health. Controversial researcher Trevor Marshall has the theory that many of these pathogens turn off the vitamin D receptor, which is critical for innate immune response in the cell.

    Wouldn’t fasting’s ability to promote the cell eating these organisms as food bypass the innate immune response entirely? If yes, then fasting might be the *only* way to control populations of these more pathological organisms that disable innate immune response. That seems like a HUGE idea that should be made clearer, maybe even devote a presentation to it.

    Perhaps the original condition of humans involved constant periods of starvation, so fasting may be a critical of our evolutionary response to pathogens.

  24. Can anyone answer me this question please ?

    I’m finding the fasting really easy. I have a meal at about 6 / 700pm and am happy not to eat again until 11.00am the next morning.

    Is this OK to do everyday, and will it speed things up for me (weight loss etc) or is it best to eat one day, fast the next……….

    Look forward to some advice here. I’ve been doing this nearly 2 weeks now and I’m losing some weight and feeling better already.
    Cheers Guys, Rich

    • Yes, you should fast every day.

      Best, Paul

      • Thanks very much for that Paul. I’m actually enjoying the fasting and I very much appreciate you taking the time to answer questions on here. That’s more or less unheard of with most authors.

        I do have just 1 other question……
        I’ve started following the book with weight loss being one of my main motivators. When I’ve done other online Paleo based weight loss plans, a ‘Cheat Meal’ has always been included once or twice in a 30 day programme. The science being that it shocks your metabolism back into working faster. I’ve always done well on these plans and wondered if a ‘Cheat Meal’ would be a good idea for someone primarily aiming to shed a bit of timber. What are your views on this ? Cheers, Rich

        • I don’t think it’s desirable on PHD. Those other diets are too low-carb and “cheat meals” bring them back towards normal. PHD is already optimized, we believe, so cheating will be detrimental. Which is not to say that you may not have other good reasons to cheat occasionally, e.g. eating birthday cake at a party. It’s just not good to do more than you need to, or to build it in.

  25. I am so sorry to post this, but I fear the entire foundation of the PHD is incorrect:

    On the other hand, when we eat fat along with carbohydrate, this “results in lower blood glucose levels and significantly higher insulin levels compared with those following carbohydrate ingestion alone.”
    http://www.mendosa.com/blog/?p=3667

    It’s insulin spikes and circulating insulin levels that wreak metabolic havoc, NOT elevated blood glucose. Elevated blood glucose is a symptom of metabolic derangement and insulin resistance, not the cause. Eating fat + protein with carbs INCREASES circulating insulin levels, it does not lower them. Thus, the PHD is a recipe for further insulin resistance. Sorry to write this. I love Paul and support his research, but it’s too late. Science will always win in the end.

    • It seems to me that opinions change on an almost weekly basis as far as health and diet go.
      I feel great eating this way and have also lost weight which can only be a good thing. And the south sea health references must say something about the validity of this plan ?

    • What matters is the entire insulin response curve, not the peak point.

      Your point is entirely academic, since there is no handheld meter for insulin measurement, and as a practical matter even endocrinologists are not ordering insulin time series for their patients (I agree they should though).

      Your point is also not quite correct, because research shows the insulin spike with fat is more associated with dairy fats than other types. I found in my own testing on myself that certain types of dairy fats have profound effects on my cholesterol and glucose response. Other fats like coconut oil do not. There is tremendous variability in individuals and for types of fats, and there is no way to extract that variability from studies on populations.

      What works for me to correct this issue is to eat my carbs in the form of certain types of fruit – like blueberries – that only contain monosaccharides. By whatever mechanism, I get a short-lived glucose response and then I quickly go back to normal. With complex carbs I get a 4 to 6 hour rise in glucose that I cannot control.

      I feel that individuals need to test things things on their own biology, and sadly very few people do that in a robust way, so they never learn their genetic variance.

    • (a different) Eric

      Hi Eric,

      Elevated blood sugar can be problematic by itself, c.f. https://en.wikipedia.org/wiki/Glycation#Endogenous.

      For healthy (non-diabetic) individuals, what evidence do we have that insulin response is more significant than the glycation resulting from blood sugar levels?

      I think it is telling that our evolved food reward system favors combining macronutrients.

      Best,
      -Eric

      P.S.: PHD was was not constructed with the goal of minimizing blood glucose, so why do you term that “the entire foundation of the PHD”? Eating different macronutrients in the same meal is only one of the many recommendations PHD makes.

    • Hi Eric,

      Nonsense. Insulin is benign. It serves a coordinating function, and its postprandial elevation is only transient. PHD is a recipe for insulin sensitivity.

      Best, Paul

  26. P One,

    I agree that individuals need to test things on themselves. But there are so many variables….it can be overwhelming to track them all. And most of us are not of a scientific frame of mind.

    I Would love to have more information on how you figured out that coconut oil did not effect you the way dairy fats do. What exactly was your testing method, routine, time period?

    • Elliebelly, for cholesterol I used NMR Lipoprofile to test number of LDL particles, as my proxy for “bad cholesterol”. I went on a diet that consisted of large amounts of dairy cream and the LDL-P went skyrocketing right through red zone of the scale. I removed the cream, substituted coconut milk, and over the next six months LDL-P corrected to low normal range, gradually. My doctor cooperated in helping me to order that test every two months for a year.

      For glucose, I use a glucometer before meal and every hour after meal. I discovered the kind of carbs that minimize my glucose response by repeating that in controlled experiments repeatedly. For me complex carbs and starches result in 4 to 6 hour high glucose. Carbs with monosaccharides and no starch resulted in quickly controlled glucose levels.

      I am just starting the PHD intermittent fasting and am quite excited about that. So far I like it and I am very intrigued with the autophagy idea.

      I do wish there was a cost effective way to measure insulin and free fatty acids as I would really like to understand how my body reacts to fasting, to help further refine how long I fast. Doing that outside of a lab environment looks tough, so far.

      • Please tell me what is included in 1.complex carbs/starches and what are 2. carbs with monsacchardies and no starch (or is ‘no starch’ a 3rd category)?

  27. Thanks P, very helpful. So counterintuitive that the complex carbs were worse for you. But the study they did in Israel recently showed how much variation there is amongst us with regard to different types of carbs..

    • Elliebelly, that Israeli study from 2015 exactly agrees with results of my self experimentation from 2014. Simple monosaccharides like glucose created quick rise and fall of glucose, whereas starch-based meals or even disaccharides like sucrose elevated my glucose for much longer periods.

      One theory might be that people with impaired digestion like the enzymes in the gut to efficiently break down complex sugars, so those foods stay undigested in the gut for longer periods, and therefore continuously supply small additional inputs of glucose and fructose over time. That’s just my random hypothesis.

      At this point I must have made 1000 glucose readings on myself, and I think people should become intimately familiar with how their unique chemistry responds to food. I was surprised constantly.

      One of the things I really like about the PHD intermittent fasting is that fasting is one of the most effective ways to lower your fasting insulin levels. So you not only activate autophagy, but you also start to treat your prediabetes or type 2 diabetes as well. I have seen some advocates of intermittent fasting advocate for one day of normal meals followed by 24 hours of fasting. I think you could merge that approach with PHD and do one 16 hour fast, 8 hour feeding, followed by 24 hour fast. Then repeat cycle.

      I realize very few people want to get this involved in their health. I am only prediabetic, but if I were type 2 diabetic I would be all over this fasting idea because I am convinced that almost any type 2 diabetic can completely clear their condition by smart use of fasting and appropriate diet (based on individual testing) during the refeeding periods. I realize all of the testing is a hassle and is also time consuming (it can take months). But a lifetime taking insulin and 10 years off your lifespan because of diabetes is so much worse.

  28. Loving this daily fasting, 16 / 18hrs a day is easy. Its feeling normal after just 2 weeks.
    I’m looking at the book right now and wondering how many black, decaffeinated coffees I can have whilst fasting. Does anyone know ? If its a few then PHD is more than living up to its name so far 😎

  29. whats the deal with cows milk and cheese (I’m talking cheddar cheese)

    I’ve binned the milk totally but have been eating smallish amounts of my favourite cheddar. It’s just occurred to me that maybe I shouldn’t be eating it ! !

    Anyone enlighten me please ? Cheers x

    • Hi Rich, I love cheddar too (all high-to-full fat milk products). They are allowed on PHD under the heading “pleasure foods” (look at the stem of the apple diagram), so good news for us. So if dairy and lactose are desired and tolerated, then they suggest them as healthy pleasure foods, but not required.
      Because they don’t appear on the main part of the apple diagram, then generally concepts like this apply: in moderation, as a snack or dessert or condiment vs central part of the meal plan.
      Personally I use full fat milk, cream, kefir, yogurt, sour cream and various cheeses. If you try to eat all of the foods in recommended quantities in all of the categories on the main part of the apple diagram (the apple itself), along with the recommended supplemental foods, it would be hard to consume much volume in the way of dairy.
      I’ve also read posts by Paul indicating that his family often eats cheese and rice crackers while preparing dinner, and that he often has a glass of milk with honey at about 8pm as his dessert. (He also used to recommend cream with coffee during the fasting period; but now prefers a 0-to-low calorie fast, so he eliminated the cream (to promote autophagy).

      • …sorry…I said stem of the apple; I meant leaf.

        • Thanks Susan, much appreciated. I’ve said it before and I’ll say it again, someone needs to produce a dummies version of this plan. For someone like myself, I find the book too laden with science that I neither understand nor really care about. I just want to eat healthier, feel better and live a bit longer ! !
          Thanks for answering my question. Rich x x

          • I agree!

            As for Paul changing things as he goes along, this is a work in progress and it’s a testimony to his character that he’ll make changes as he learns more about things and risk criticism from those who don’t understand the amazing work that’s gone into this project.

            I for one, would not be a bit surprised if Paul’s group finds a the cause of and cure for cancer.

            😎

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