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 ?

3,838 Comments.

  1. No grains? Interesting, is that solely because of the high toxin content which I presume comes from non-organic farming?

  2. No grains? Interesting, is that solely because of the high toxin content which I presume comes from non-organic farming? :mrgreen:

    • No! Have you read much of the Perfect Health Diet?

    • The toxin content is not from farming technique. It is because the plants can’t run away from the grazing animals that co-eveloved with them and so were under pressure to protect their seeds with toxins that disrupt digestion. These are natural plant toxins and because the plants evolved these defense in part to protect agains predation by herbivorous mammals, and we are relatively close biologically to these animals the toxins wreck havoc with our biology too.

      The counter-intuitive preference for white rice over brown rice is because when cooked, white rice is largely toxin free, because most of the toxins are in the outer layer of the seed and milled away, with gentle moist cooking deactivating any remaining toxins.

      It is not about pesticides.

  3. What would be a better macro-nutrient strategy for optimal nutrition, assuming one is within about 5lbs of their goal weight? (Adult male, moderate activity)

    1) 1500 calories, Fat 65% Carb 15% Protein 20%

    2) 2000 calories (supplementing an additional 500 calories with coconut oil and olive oil) this changes the ratio to:
    Fat 73% Carb 12% Protein 15%

  4. The perfect health diet project is significant, because it aspires, in the service of the truth, to attain a comprehensive understanding, rooted in foundational principles, of one of the most basic goods: vegetal flourishing in man. The Perfect Health Diet is the first treatise to have grasped the essence of what it means for man to flourish vegetally, i.e., the fundamental principles of the flourishing of man insofar as man can be regarded in terms of the mode of the vegetal. Such an undertaking presupposes the apprehension of an enormous body of scientific knowledge as well as the development of a scientifically and philosophically correct framework in which to comprehend this knowledge.

    It is possible to imagine a separate treatise written on the topic of animalistic flourishing, i.e., the flourishing of man insofar as man can be regarded as a mere animal. Such a study could be called “treatise on the athletic and perceptual capacities required in sports”.

    The treatise on human flourishing, i.e., what it means for man to flourish as a human being, has already been written: it is called “Nicomachean Ethics”.

    The treatise on what it means to become a person, i.e., to be responsible for one’s soul, has already been written: it is called “Groundwork for the Metaphysics of Morals”. Here, “soul” is used in a Socratic, as opposed to in an Aristotelian sense.

    The text on what it means to seek enlightenment through spiritual exercises is called Plato’s Apology.

    All of us can agree that the Cartesian picture of the body, in which the body is literally regarded as a machine, is misguided. However, what does it mean to reject this picture? It means first and foremost to assert that we are biological organisms with an evolutionary history. But how should we interpret that assertion in light of everything else we know about ourselves? For, on the one hand, this has led to a way of thinking in which we regard ourselves as animals. But, like the Cartesian picture, this idea also has the potential to engender its own mythology, in which everything distinctive about human beings ends up being framed in a scientistic and distorted manner.
    On the Aristotelian picture, we are not animals, in the sense of being mere animals. We are Rational animals, i.e., human beings. And with Kant, we can say that as human beings, we are the beings who are capable of being persons. And with Socrates we can say that as persons we may seek spiritual fulfillment through the spiritual exercise of the practice of the love of wisdom. It is an empirical fact, that all persons, at least, all persons we know of, are human beings. And humans are biological organisms with an evolutionary history. But nothing learned in the course of scientific reflection can impugn the fact that we are persons or can impugn the conceptual legitimacy of the concept of a person. In fact, the very coherence of the concept of science, depends upon the prior intelligibility of the concept of a person. (These are not statements of opinion, but are uncontroversial philosophical statements regarding the great chain of being, grounded in the categorial structure of the order of things.)

  5. Hello, i was just wondering what your take on buckwheat was?

  6. Hello Paul and Shou-Ching,
    I am very interested in the PHD. I have bought your book and am reading it with pleasure! Your research is impressive. My family and I are following a classic Paleo plan for 30 days as a “science project” for my teenage daughter, and we will be most likely staying on a similar plan permanently. The way we all feel is so noticeably improved that we are sold. When I saw your book, I thought we would continue long-term on the PHD, since it appears to be more well-rounded and has such good research that it seems it will be a good plan to follow forever.
    I do have a couple of questions. I looked for nut flours to use in baking but it’s not mentioned in your book. I saw your recipe for muffins using rice/potato/tapioca flour, and that looks good, but what about almond flour or other nut flours? Paleo websites have a lot of recipes for baking with these, and it seems like it would be a bit less “dense”. Also, I have had RNY WLS, 13 years ago. Is there anything specific I should be careful about? I have been tolerating the Paloe plan very well so far, and I conjecture that transitioning to the PHD will be smooth. But is there anything you are aware of that is a concern for me?
    Thank you both so much for writing this book! I think it will be so good for our family.

    • Hi Rebecca,

      I don’t recommend nut flours in baking, as they are very fat and calorie rich and various compounds can be oxidized in cooking. Rather, I would use safe starch flours like rice flour, potato starch, tapioca starch, buckwheat flour, and mountain yam powder. Use chopped whole nuts as flavorings.

      Gastric bypass surgery is unfortunate but I don’t think you need to change too much apart from things you are already probably doing. Focus even more on nutrient density and nutrition because you have less small intestine to absorb nutrients. If you get steatorrhea/dumping then adjust fat dosage. I would still do intermittent fasting with an 8 hour daytime feeding window, but you might keep snacks/leftovers on hand throughout the window to help you get enough food. If you feel tired, have low body temperature, disturbed sleep, or hunger during the fast, you may be eating too little food. Get plenty of our supplemental foods.

      Best, Paul

      • What about coconut flour? I’ve read somewhere that the amount of phytic acid was negligible and one study showed that it didn’t hinder the absorption of minerals, but I’d like to hear your thoughts on this before I go out and bake with a lot of it.

        Also, do you have any idea what substitutes are best used for almond flour-based recipes? Any of the flours you listed, a blend, etc?

        Thanks! 🙂

  7. Why are ‘peanuts’ excluded? And why are almonds OK?

  8. America’s Test Kitchen has a good Gluten Free flour blend. Very little brown rice flour in it which probably would be ok with all white rice flour. I’ve found it subs well for most regular recipes. And I use Just Like Sugar or Xylitol or Erythritol instead of the sugar. And add a little Xanthan Gum or extra baking soda/powder.
    America’s Test Kitchen GF flour blend: Makes 42 ounces (about 9 1/3 cups)
    Be sure to use potato starch, not potato flour. Tapioca starch is also sold as tapioca flour; they are interchangeable. See notes below about shopping for rice flours and substituting soy milk powder.
    24 ounces (4 1/2 cups plus 1/3 cup) white rice flour (Bob’s Red Mill)
    7 1/2 ounces (1 2/3 cups) brown rice flour (Bob’s Red Mill)
    7 ounces (1 1/3 cups) potato starch
    3 ounces (3/4 cup) tapioca starch
    3/4 ounce (3 tablespoons) nonfat organic milk powder
    Whisk all ingredients together in large bowl until well combined. Transfer to airtight container and refrigerate for up to 3 months.

  9. Hello Paul,
    I have a friend with type 2 diabetes who has been mostly following a low GI foods for several years now(http://www.mendosa.com/common_foods.htm). She has switched to the PHD diet in the last several months (3-4 months), but is now saying that her hemoglobin A1C level has increased from 6.2 to 7.3 using a finger stick device called A1C check now. Is it the one pound of white rice, potatoes, taro and/or plantains recommended that could be causing the increase? Should she cut back on these? She is not eating sweets. Thanks.

    • Hi Ray,

      One pound is probably too much for a female diabetic. (Women need less, diabetics should eat less.) Then she has to be very careful to reduce the GI of the starches by combining them with fats, acids, vegetable fiber, meat, and a bit of sweet from natural whole plants (fruit, berries, beets, carrots). Also, she should be limiting total calories via intermittent fasting and eating to appetite (Hara Hachi Bu, an appropriate amount of food to start getting mildly hungry after a 16 hour fast). And daily exercise and circadian rhythm entrainment. And key supplemental foods — liver, spinach, carrots, fermented foods, collagen from bones and joints, seafood, egg yolks.

      Best, Paul

      • Hello Paul,
        Thank you. How much resistant starch should she eat daily: 1/4 cup, 1/2 cup or 1 cup a day since 2 cups is too much. I’m afraid she may exclude all resistant starches. Also, she is eating low carb veges, meat, fish, beef liver, a little cheese, yogurt, fermented veges (excluding carrots and beets). She wants to decrease her total carbs to 50-60 grams a day; would that put her in ketosis? She exercises about 6 days a week and includes weights in her workout but needs to include the circadian rhythm entrainment. Please help.

  10. I know there are some people who do well with a pound of starch a day, but a type II diabetic may not be that person. Eric Westman MD (of the New Atkins for a New You) is a metabolic doc at Duke who has had good results with very low carb diets in type II’s. However, if she decides to try it, please know that some people have a VERY rapid response to low carb and need to modify their medications aggressively in the first few weeks, sometimes the first DAY. It should be closely monitored. Her A1C is too high and she could easily be damaging the small vessels in her eyes, kidneys, etc.

  11. Hi Paul,

    Love your book. Thank you!! Just started Intermitnt Fasting but I see p 399-400 you recommend alternate days fasting. what if I do it everyday – I imagine I would get better health benefits from it and lose more weight. Is that right?? Or am I better to stick with alternate days?? Also I have joint pain in the right knee and shoulder and feet. Any tips on that one? thanks Paul,
    Best regards,
    Fiona

    • Hi Fiona,

      We recommend daily fasting of 16 hours, daily feeding within 8 hours all in the day time. Although many studies were done on alternate day fasting, we think the circadian rhythm benefits of daily feeding outweigh the advantages of more strenuous fasts, for the most part.

      Joint pain – eat collagen (bones, joints, tendons in soups and stews) and vitamin C; vitamins A (liver, spinach, carrots), D (sunshine), K2 (aged cheese, fermented foods, supplements); circadian rhythm entrainment.

      Best, Paul

  12. Is this precooked or post cooked for food weights. Because the precooked amounts are HUGE after cooking or small when it comes to meat. Just wanted to clarify.

    • Hi Lanta,

      With gentle cooking methods, such as we recommend, cooked weight should be very close to precooked weight. The exceptional case is white rice, for that our weights are after cooking.

  13. Is black rice noodles ok? I just recently had some. My starches are mainly sweet potatoes and rice, although I may ditch the rice and do only potatoes. I eat between 100g to 150g of carbs a day. Is this bad? I haven’t been tested yet, but it seems I might be hypothyroid. I’m underweight, 5’2 100lb, suffer from extremely dry skin, bloating (possibly the result of the broccoli and bell peppers I eat on a daily basis) acne, cold hands and feet, BO (my armpits) and irregular sleep. My fruits I eat are mainly berries and sometimes bananas.

  14. Do you have any opinion on the use of “Einkorn” for a grain flour in the diet? It is highly nutritious per the label.

  15. Hello Paul,
    Do you have any insight on this article about arsenic in chicken meat? Does this apply to the egg yolk as well? Thanks.

    http://www.globalresearch.ca/fda-finally-admits-chicken-meat-contains-cancer-causing-arsenic/5353189

  16. Hello,

    I have OCD and Ankylosing Spondylitis. I’m 64. Are there certain foods on your proper diet list that might not be proper for me? What might actually help these illnesses? Anxiety/panic disorder along with joint pain is not fun. Thank you for any information. David

  17. Anyone have any experience with Guillain Barre syndrome and a paleo style diet? My uncle has it and has to do expensive treatments monthly.

  18. Hi Paul, hope all is well for you. I can not wait until your next book! You have helped me so so much in the past, just as a reminder I have immunodeficiency and graves and I wanted to let you know, I have reduced my medication to half, and in owe part of my thanks to you. The unfortunate problem with illness is that new things pop here and there. Recently, my husband, myself and daughter relocated. During the move I developed occipital neuralgia, one doctor thought from the shingles virus, another from compressed nerve. I started taking methylized vitamin b’s since folate is an obvious concern, hoping to help what has become an obnoxious often nauseating headache. I would love to hear from anyone on the board or you about this condition. My doctor gave me gabapentin, but I won’t take it because of too many side effects. I thought you had said you suffered from neuropathy or neuralgia. Any thoughts on alternative avenues outside of heavy anti convulsants and pain killers!

    Thank you,
    Amy

  19. Have had illeostomy for 32years. Have very little advice on eating. I also have Type 2 diabetes–13 years. I’ve tried very low carbon and vegan many times. They just lead to hinges. Re: illeostomy–any suggestions?

  20. Hi Paul,

    I am a 29 year old male and been having some libido issues/ED the last year. Could be the fat and carb restricted diet that I have been following, as the situation has improved somewhat since i increased my fat and carb intake along with implementing PDH. Can you recommend any special attention to some nutrition or just generally following the PHD?

    Ray

    • Hi Ray,

      Libido/ED is basically dependent on vascular health. Eat liver, egg yolks, spinach, beets, get daily sunshine, vitamin K2 (aged cheese, fermented foods, supplements), daily exercise, intermittent fasting, circadian rhythm entrainment (read chapter 42 closely). Yes, follow the PHD, just do it more thoroughly.

      Best, Paul

  21. ❓ I am wondering if sourdough white bread that has had a long, slow, natural fermentation, could not be considered a “safe starch”? I’ve read that our metabolism handles such bread much better than bread made rapidly and with commercial yeast. Allergic individuals appear to be able to eat such sourdough safely. Any anti-nutrients that survived the refinement of the flour would be more than neutralized by natural fermentation.

  22. Hi Paul,

    What would you recommend for acid reflux(low acid stomach) and damaged eosphogus ?

  23. * oesophagus

  24. Hi Paul,

    I was wondering what you used in your book to calculate the fructose/glucose content of foods. For example you say carrot has 69 calories of glucose per 450g and 43 calories of fructose per 450g. Is there some sort of database you are using? Also, how can you be sure this is correct?

  25. Hello Paul,
    Do you typically alternate between Kimchi and fermented vegetables? Do you perfer one over the other now? I read your post on Kimchi several years ago and you mentioned something about the rate of stomach cancer? Please clarify. Thanks in advance.

    • Hi Ray,

      Just don’t put a lot of spices in your kimchi and it should be fine. We do mix up the vegetables, it is not cabbage all the time. The more variety, the better.

  26. Hi Paul,

    Please if you could answer, how to restore lining of stomach and oesophagus?

    • Eat extracellular matrix (bones, joints, tendons, stomach) in soups and stews; extra vitamin C (about 1/10 the bowel tolerance dose daily); extra silicon/seaweed; general PHD advice including supplemental foods (liver, spinach, carrots, beets), sunshine, intermittent fasting, circadian rhythm entrainment.

  27. Kathy Forrest

    I am just starting on your PHD. I do have your book. I cannot find any information on organic quinoa. Is it considered a grain and therefore not allowed?

      • Kathy Forrest

        Paul. Thank you for your quick response. The link is quite informative.
        I will use the quinoa in moderation. Your other safe starches are fine with me. I do have a shellfish allergy but salmon is ok. I’m finding it difficult to find wild salmon but will continue to keep searching.
        I,too love your book. Being a carbohydrate addict has left me tired and lethargic, not to mention overweight. Although I find your diet challenging, especially for breakfast, I already feel “better” after just a few days of trying it.
        Your comments posts are also very helpful. Thank you for your well researched information. I look forward to a healthier and happier future.

  28. Hi Paul. I’ve been eating 3 eggs a day. Do you think that the amount of arachidonic acid in 3 eggs should be a source of concern?

  29. Hi Paul, happy 4th for you tomorrow! It’s being difficult for me to have the cooked staple food you recommend (rice, potatoes, plantain, etc.). I’m having three bananas a day instead. Do you think this is a bad idea? Should I be cautious about this?

  30. Does liverwurst count as a source of liver?

    • Yes, but I wouldn’t necessarily trust industrial creators of liverwurst. If you buy liver and prepare it yourself, you’ll know it’s been well handled and cooked properly.

  31. I love your book and the diet. My only conundrum is meal timing. My work schedule doesn’t accommodate the 16 hour fasting regimen or an 8 hour, daytime only eating schedule. Any suggestions for working around an erratic work schedule?

    • Bring as much food as you can to work and eat it in the afternoon. Then cook in the evening, but eat most of it as leftovers the next day.

      • Thank you, Paul and Donna. I’ll give it a shot. Will try the fast on non-personal training days and nibble leftovers/eggs, etc. between clients. So much for that “eat a healthy breakfast” prescription I was raised with.

  32. The only thing that works for me is to make food/meals ahead (cook, store or freeze in portions) and carry them around with me for wherever I am – office, car, airplane, & to other people’s home if need be (thermos, freezer bags). One dish meals work well (meat, starch, veggies, fat) and snacks (boiled eggs / yolks, potatoes, homemade mayo; Greek yogurt with berries, bananas; homemade liverwurst & rice crackers,l raw veggies; canned wild salmon with beets, peas; broth soup with meat, starch, veggies; etc). Takes prep but then zero time for prep during the week.

  33. Forest Simmons

    Peter Attia (who maintains ketosis as much as possible) uses something called Super Starch to fuel extreme endurance exercise in order to minimize insulin spikes before and after exercise. Is Super Starch a safe starch? I know it is a processed non-whole food, but is it “safe”?

    • Hi Forest, I believe it is not digestible starch, but a form of resistant starch made from corn. It is “safe” but not what we would consider a “safe starch.” Personally I would recommend the Bob’s Red Mill Unmodified Potato Starch instead.

  34. Hi, love the book! Started out eating paleo and progressed into “clean-eating” instead, and your book is a welcome and informative contribution for that.
    I have two questions: why don’t you differentiate your advice for males/females? Should both eat the same amount of carbs/protein/fat?
    And second: do you consider coconut flour as a safe flour for baking?
    Thanks!

    • Hi S,

      Males and females do not need the same amount of foods, but they do need similar proportions of macronutrients and food types. They should eat to appetite, and be aware of symptoms of undereating or overeating. Intermittent fasting can help to normalize appetite.

      Coconut flour is ok but it does not have much in the way of carbs, it is mainly fiber. So I wouldn’t consider it a “safe starch,” more like a fiber supplement.

  35. Please talk about severe insulin resistance and how to eat myself back to health. Has caused a rampant yeast attack in my body.

    • Hi Louise,

      To start with, eat sufficient carbs. They are essential for anti-fungal immunity and also for insulin sensitivity. There are many other things which can influence immunity and insulin sensitivity, see our book.

      Best, Paul

      • Well, I guess the candida diet (no carbs, no sugar, high protein) trying to starve those nasty yeast biofilms for 6 weeks has exacerbated the problem!! I have purchase kindle and hardback of book and will devour it right along with a big bowl of white rice. Thank you for responding so quickly.

        • Unfortunately the “candida diet” should be called the “pro-Candida diet” because it promotes fungal infections.

          • I am so confused by all the differing “expert” recommendations. Tell me specifically why you think your allowed catbs are anti-fungal. It goes against everything I have gleaned from research. I just know I cannot sustain a lifetime of no fruit, no starches and low carbs so I am hoping you will have a definitive answer. I have read your book and could not find my answer. Please help!

          • Hi Louise,

            You might start by reading the introduction to this paper: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2423099/, about the loss of immune function on ketogenic diets. Although the paper is about E coli, the immune functions that are impaired are even more important for fungal infections. It’s quite common for people on low-carb diets to develop fungal infections.

  36. Paul, what are symptoms of under- and over eating?

  37. Grains? its not in the ‘Do not eat’ list… really? It would be better if you can explain it to me.Again, I’m confused with alcohol.

  38. Paul, is there a list of “count” / “don’t count” vegetables? I know you said to count the starches (potato, plaintain, rice), but I am confused when it comes to the “sugary” vegetables description. So, do carrot and onion get counted, but not broccoli for example?

    Thank you for any clarification.

  39. Taylor Kilpatrick

    Hey Paul,

    I was wondering if dairy milk is ok to drink if it is organic?? And is organic whey protein ok to use if it is free of soy and from grass-fed cows?? And is canned wild alaskan salmon safe to eat vs eating frozen salmon (I was worried about the omega 3 rancidity).

    Thanks,

    Taylor Kilpatrick

    • Yes, it’s OK to drink organic whole milk, just don’t get too much of it. Frozen salmon would be better, but canned salmon is probably better than no salmon at all.

  40. This seems typical of some, I began nutritional ketosis 5 months ago, LCHF, 3 months of stellar success and progress in all areas of health, energy, fitness, brain, then these last 2 months I’m declining, with the worst of all being relentless fatigue and exhaustion returning (a 12 year problem for me). So perhaps time to add back some carbs/starch? Various supplements not helping and don’t want to get back on that band wagon. Thus far I’ve been getting carbs only from veg and very little fruit, zero processed anything so no grains, wheat, breads, pasta, starch, etc. I as probably <50 g carbs. I removed the few foods I tested sensitive to. How long is a reasonable time to expect to recognize an effect from adding back or cycling carbs? And any suggestions how how best to reintroduce carbs for this experiment? Thanks!

    • Hi Greg,

      I think you have to reintroduce them as quickly as possible, and you have to expect to have some negative symptoms when you do so. The initial good results from low-carb were a result of suppressing symptoms of an infection, but they weren’t a cure, unfortunately the carb restriction also suppressed immunity and led to new problems. This is a very common situation. When you restore carbs, which you have to do, the original symptoms will probably return.

      I think you have to focus on improving immune function and restoring general health. If you haven’t read our book yet, you should do so.

      Best, Paul

      • Now that freaks me out a little. I was sure hoping low carb or a variation was the answer. My history displayed borderline pre diabetes and Mt Syndrome. I did a year and a half of Lyme Disease abx and anti inflammatories, and same thing, felt great for a few months and then back in the ditch, switched abx but no resolution. I was uncomfortable with the diagnosis given the poor outcome along with ambiguous test results and suspisions from other Drs. But perhaps it’s true and still in there, or it’s another infection entirely. Does your book address healing Lyme or other infections? Can I cute this with diet?

        • Greg-
          On this website, look at the column on the right hand side. You will find what you are looking for under Disease. And get the book!

  41. What are good safe starches for traveling, particularly for long airplane flights? Criteria include doesn’t need refrigeration and doesn’t need (much) preparation at time of eating. I have used rice cakes, puffed rice cereal, and rice chex, but given concerns about denaturated proteins (caused by high-temperature/high-pressure processing), I’m looking for alternatives. Baked sweet potatoes are good for short times (several hours) but don’t have shelf life. How about dehydrated sweet potato chips? What do you think?

    • I travel a lot and have good luck with white rice and baked potatoes. Cold or heated right before the flight.

    • Traditional Japanese rice balls might work for you. You can google and find a bunch of places that teach you how to make them.

  42. Hi Paul,

    I was wondering, I suffer from trochealitis, trigeminal neuralgia, and and occipital neuralgia. I was in the ER on Sunday bc the pain triggered vomiting and I became dehydrated. I still have pain, but it’s tolerable. I want to try the ketogenic version of PHD, but bc of an immune deficiency I suffer from fungal issues. I have begun taking 2 Tbs of coconut oil outside of what I cook with. I just want to approach this safely and wonder the best way to effectively balance the two conditions, if there is a way.

    Thank you,
    A y

    • Hi Amy,

      That’s difficult, fungal infections tend to flare on the ketogenic diet. I would try simply extending the overnight fast to ~20 hours and then eating a lot of food in a 4 hour window in the afternoon, 2 pm to 6 pm would be perfect. Take no calories during the fast except a few low-calorie vegetables in a salted soup to provide electrolytes and fluids. The fasting will help the nerves and carbs and protein eaten in the feeding window will support antifungal immunity.

      Best, Paul

      • Thank you. Long term this sounds like a difficult course, were you speaking more intermittent until symptoms subside and if they came back using or as more long term strategy? Would I keep the coconut oil at 2 tbs? Since I have immune issues, I have been very curious about the root cause being viral or bacterial and want to consider a course of low dose doxycycline. I have read you had success I believe taking 50 mg, 3 days a week for an extended period of time. Trying antibiotics seems like a more benign approach compared to anti seizure meds. But the question I suppose, is timing for me. Knowing when it is a good time to try antibiotics, if at all.

  43. I am worried, my children are eating this diet and are somewhat underwieght….is this designed for the whole family including children that just don’t like the foods and don’t understand that they have to eat them….would a nice bowl of organic oats no sugar be so bad. It would fill thier tummies and let them sleep well.

    • Hi Shirley,

      It sounds like you need to feed them more carbs, maybe more protein also. Children do need more carbs than adults. A bowl of oats is not terrible, but rice pudding would be even better. See our recipe for Ris a la Mande, for example. Try giving them extra fruit, more starches at meals, and a glass of organic whole milk with a bit of honey for dessert.

      • Thank you! that sounds like a good recipe and I will make that tonight, could you also please suggest a good meal recipe and/or a breakfast idea (FYI peanut allergic)that would be filling/enjoyable for my 4 and 2 year old. A fresh approach might just be what we need.

        • Hi Shirley,

          Peanut butter is forbidden on PHD but tree nut butters like almond butter, macadamia nut butter, or cashew butter can substitute. You can try banana slices with almond butter on top as a snack.

          Breakfast should have a meat/fish/egg component and a carb component. The classic breakfast of eggs, boiled potatoes fried in butter, a piece of fruit, and vegetables to taste would be great. Leftovers are great – mix leftover meat, leftover potatoes or rice, 2 egg yolks, some vinegar, and a diced piece of fruit with some green leafy vegetables and diced tomatoes and microwave.

          Best, Paul

          • Hi Paul,
            Do you have any concerns regarding arsenic exposure for kids ages 2 and 4 eating white rice? Would you limit rice servings per week for kids this young?

            Thanks, love you work!
            Jen

          • Hi Jen,

            Not really, as long as the rice is sourced from good locations (low pollutant, low metal). I’d be more concerned with industrial rice products and syrups as you have no idea where the rice came from, and food producers often buy the cheapest ingredients.

  44. Paul, I tried to skip breakfast and only eat lunch but I get reactive hypoglycemia immediately after eating because (I suspect) a cortisol spike. It could go up to 180 immediately right after eating and 1h after it would be very very low. Now I eat a light breakfast and it still happens but I don’t get the hypoglycemia only the hyper after eating. It goes up to 170-180 if I test right after I finish eating but 1h after it will be fine. What can I do to prevent this from happening/overcome this? Is it a cause for concern and why do you think this happens? I have hashimotos but have no clue if this is relevant somehow.

    • Hi mk, Are you diabetic? There are some complex things going on and I would need a lot more information to say much. But, be sure to tend to hydration and electrolytes (salt, potassium eg bananas/fruit/tomatoes, calcium from bone broth, mineral water) and give yourself some protein to give your body more leeway in handling the stress of fasting. Also work on circadian rhythm entrainment. There is likely some infectious component that is giving diabetes-like symptoms so work on immunity, eg vitamin A, D, C, etc.

  45. No I am not diabetic. I had my blood drawn 2 months ago it was 82. (after following your diet for 6 months). But I did a low carb low fat diet 2 years ago that wrecked my metabolism.. I was underweight and constant hypoglycemic. Then I did a period of eating bread, pasta, rice etc along with fats and that caused me reactive hypoglycemia (that is a totally different thing) and major weight gain. In the period of those bouts of RH my fasting BS was always in the low 70’s. Now I think you’re right that’s probably some infection.. I may have destroyed my metabolism, I before all this I already has hashi’s so that sure wasn’t very clever from me. Now I know better thanks to you.

    • Hi mk, Well, hopefully our diet will be enough to cure you. If you have a chance, consider coming to our next retreat, I may be able to give you more help in that setting.

  46. I am from Portugal so unfortnately I won’t be able to go 🙁 But I thank you for your help and I will keep eating your diet in the hope I’ll get cured from this.

  47. Dear Paul,

    I really enjoy the evidence-based approach you and Shou-Ching take to healthy eating. After going through several diet books and methods, yours was the one I landed on because of the thinking (and research) behind it.

    I am writing with some implementation questions about the PHD, as even after reading your book and the synthesized version from your site, some things are still not clear.

    PHD Recommends:

    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.

    So, does that mean 1 lb of starches, 1 lb of sweet vegetables or fruits, 1 lb of leafy green vegetables?

    Is there anywhere on the site where we can see a pic of a PHD plate?


    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.

    If you can’t get organic organ meats, should you just stick to what you can get grass fed, antibiotic free, etc.?

    Broths or stocks made from animal bones and joints.

    Is store-bought organic chicken broth or beef broth ok?

    Snacks or desserts from our pleasure foods: fruits and berries, nuts, alcohol, chocolate, cream, and fructose-free sweeteners like dextrose or rice syrup.

    Is there a quantity recommendation with sweets? Like, a measurement in weight? Something visual?

    More questions:

    Here is how I do PHD…

    For each meal, I measure the protein (whether eggs or meat) with a food scale, and then based on the weight, will calculate how to do the rest of it. For instance, 3 large eggs weigh .35 lbs (total). So, (and this is what I did this morning), I would do .35 lbs chard (leafy green), .35 lbs of tomatoes to add in with the eggs for an omelette (non-leafy green vegetable), and .35 lbs of garnet yam (starch).

    For dinner, if I were doing meat (as I did tonight), I would do the same thing. So, let’s say I was cooking .4 lbs of chicken. I would then do .4 lbs spinach (leafy green), .4 lbs white rice (starch), and .4 lbs mix of tomatoes, mushrooms, and zucchini (non-leafy green vegetable).

    Then, for dessert, it would be a smoothie with unsweetened coconut milk, some type of berry and/or mango, banana, spirulina and chlorella, sometimes broccoli, sometimes with MCT oil.

    As I have gotten older, I have been eating somewhat less. I don’t eat exactly 3 lbs of food per day, so my meals are built off of the protein that is included with each meal.

    Do you have suggestions about a more efficient way of doing this? Corrections that should be made?

    Thank you for creating an evidence-based diet plan that has helped me improve my health and quality of life. I recommend this to all my friends because all of the research and thinking behind it.

    Best regards,
    Mike Lydon

    • Hi Mike,

      Thanks!

      It’s about 1 lb safe starches, 1 lb fruits/berries/beets, and 1+ pound diverse vegetables, some of which should be leafy greens or seaweed, some fermented vegetables, some things like mushrooms, onion, garlic, brassica vegetables, tomatoes, asparagus, celery, carrots, etc. You can eat as much of these vegetables as you want but get at least a pound a day.

      Any grass-fed/pastured animal should be in good health, so yes, you can eat their organs.

      Yes, you can always get store-bought organic foods from vendors you trust. But it’s usually cheaper to make it yourself.

      Sweets – if it’s fruit or berries, about 1 pound per day. If it’s honey, much less – maybe a tablespoon per day, but check the nutrition databases to see. We recommend getting about 25 g fructose per day which is the amount in a pound of fruit. If you get 5-10 g fructose from honey on top, you’re not far off, that’s fine. But if you’re getting another 25 g fructose, I’d say that’s too much.

      Your method is pretty good. By now you should be able to drop the scale and just do things visually. Most foods, animal or plant, are close to the same density – 1 g/cm^3 – so if you keep volumes similar, you’ll be in good shape.

      Best, Paul

      • Hello Paul,

        Your reply made to Michael has confused me a little. Would you mind clarifying the distinction between sugary plants and low calorie vegetables.

        In your book you categorize carrots, onions, etc as sugary plants, whereas in your comment here you say that they fall under the low cal vegetable category.

        How do we distinguish a low calorie vegetable from a sugary plant? Maybe something to do with calorie content per unit of weight? or the sugar content?

        • Basically, there’s a rough dividing line at about 80 calories per pound. Most sugary plants (fruits, berries, beets, carrots) have about 200 calories per pound, most vegetables are more like 20-80.

          Cost of digestion is around 40-50 calories per pound, so vegetables don’t deliver net calories, sugary plants do, and they are half fructose, whereas starches are all glucose.

  48. PS, by “sweet vegetables” I just meant mixed, non leafy green vegetables.

  49. Okay, preface page xix under AVOID: milk but do eat fermented or fatty dairy products: butter, sour cream, ICE CREAM, cheese, yogurt. Really? If so the I have found my lifetime diet! Please comment on this.I’m afraid you menat cream, not ice cream?

  50. Hi Paul,

    I love your book. Thank you for the research. Question: all the puffed rice cereals and rice crackers I find are made from brown rice. Where do you find rice crackers or puffed rice cereal that is made from white rice? I have scoured Whole Foods and my local coop. There is not one cracker or puffed rice cereal that is made from white rice. I eat organic only.

    Thank you,

    Van in Los Angeles

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