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 ?

3,323 Comments.

  1. Paul,

    That was an excellent lecture, although I may struggle a bit staying off antibiotics, I am on Augmentin right now. After rereading your book, I added 200 mcg chromium and upped my vitamin C for improved immunity. It is easiest for me and I feel the best with a 12 hour feeding window, although I’m trying to shorten it to 10 hours. My sleep cycle has greatly improved.

    I know the idea is not to count calories, but so I can eyeball, would you say 1600 calories is adequate? And if I lower my fat to say 55%, and remain at 20% protein, then my carbs would go up to 25%? I want to make sure I understand your recommendations.

    Thank you,
    Amy

    • Hi Amy,

      1600 calories is OK, but you want to get at least 500 calories carbs per day and 300 calories protein per day as a minimum, so you have to limit fat to less than 50%, and also strive to make your fats nutrient-dense (e.g. egg yolks and whole food fats are better than oils).

  2. Paul,

    Ok, I was eating way more fat. This is specifically for weight loss, correct? for maintenance, do you begin to add a little more fat…or are these amounts appropriate long term? This breakdown is more like 45% fat, 35% carbs and 20% protein, which is a bit different breakdown than original 65/20/15. Obviously, my first priority is optimal health, secondary is the slight weight gain. I don’t want to mess anything up, since I started PHD almost 2 yrs ago, i have improved greatly!

    Thanks for your responses,
    Amy

    • Hi Amy,

      We adjusted our estimate of optimal macronutrient ratios in the 2012 Scribner edition of the book to 30% carb, 15% protein, and 55% fat. On weight loss diets, you want to restrict fat but not carbs or protein, because fat is stored in adipose cells but not carbs or protein. So you want the same number of calories (e.g. 30% * 2000 calories = 600 carb calories, 15% * 2000 = 300 protein calories) but can reduce the fat calories from 1100 to 700 or so, but you have to make sure you are keeping all the fat-associated nutrients, thus you should only cut the micronutrient-less oils, not egg yolks or bone marrow or the like.

      • Are coconut oil and butter from grass fed/ grass finished cows considered micronutrient-less oils? Is cheese and acceptable way to obtain fat calories for weight loss?

  3. Well that clarifies everything! I missed the changes somehow, so I appreciate you reiterating it for me. Thank you so much, Happy New Year!

  4. Is there a way to get an updated version of the book on my kindle?

  5. Hi Paul,
    I am 18 years old and suffer from stubborn eczema that won’t seem to go away. Nutritionally, what would be your best strategy to get rid of it? I eat a lot of butter, would that do my skin good?
    I greatly admire your work .
    Thankyou
    Nigel

    • I am curious as well.. my eczema flares up in the winter. I’ve found that using a humidifier in the bedroom and applying a confrey/plantain salve during the day helps a lot.

      • Jane, how do you make the salve, or if you buy it, is there a store/brand that you prefer? I don’t think I have eczema, but my knuckles and thumb/index fingers get raw and might be reacting to dishwashing soap or maybe too much hand washing due to having an elderly dog (i.e., hand feeding her, dealing with her incontinence and other sanitation issues). Do you avoid soap with SLS and if so, do you think it helps? If so, maybe I should too.

        • My eczema shows up on my face (lovely, right?). I find most soaps too harsh, especially since I have dry skin which gets worse with the eczema this time of year. I seldom wash my face. When I do I use simple homemade scrubs like honey and sugar or ground uncooked oatmeal.
          For shampoo I use Dr bronners. For bidywabodywash I usually don’t. Ive read a bit about the microbiome that lives on our skin and it may be important to not wash it away constantly, so I avoid most soaps (except for hand washing which I also use Dr bronners for).
          eczema is an inflammatory reaction to food sensitivities, chemical sensitivities, allergies, weather…so it made sense to me to try the salve. Comfrey and plantain are anti-inflammatory. I get mine from beedazzled.com but you can find many various similar slaves on etsy.com. I find this one doesn’t clog my pores or cause acne breakouts so I’m happy with it. It may be just as helpful with other skin areas. It is a general healing salve.

          • Oh I also use Dr Bronner for washing dishes. If you find it doesn’t irritate your hands it’s a great soap as you can use it for so many things. If you have an empty foam soap dispenser just add water and a splash of dr Bronner for instant foam soap.

            I think a salve would very likely help heal your hands and keep moisture in between washings. You may want to consider if you are washing them too much.

  6. Hi Paul,

    We have read your books and have been on a PHD diet for about a year and generally doing well. However, I am writing to find out if you have any suggestions regarding my 3.5 year old with histamine intolerance.

    She is a breast fed baby (3 years) and due to circumstances with her sister was weaned on a GAPS diet (broth, yoghurt, egg yolk, etc). Within 3 months we realised intolerances, first to dairy ferments then to sauerkraut and broth of any origin. It took a long time to figure out but it happens to be the histamine rich or triggering foods. Hence although on a PHD diet, she can no longer have fermented foods, broth or shell fish. This has alleviated most of her symptoms (stomach aches, wind, burning bowel movements). We are seeing a specialist nutritionist who has carried out some tests to reveal some SIBO (organic acid test) and inadequate balance of good bacteria. No Protozoa, parasites or fungi detected (Genova full test).

    For the last three months she has been taking a natural antimicrobial Caprin, a number of probiotics, collagen, vit C, multimineral and Immunoglobulin G. She is just starting on olive leaf extract too. We are not seeing much improvement since removing the histamine foods.

    I would be very interested on any thoughts you may have regarding her diet or any antimicrobial products.

    Also could the cause of her histamine intolerance be related to having been weaned on a high histamine GAPS weaning diet?

    Many thanks.

    • Hi Maryam,

      I don’t think the intolerance was caused by eating a high histamine diet, but rather from eating a diet too low in carbohydrates to support immune function and gut barrier integrity. It may also have had insufficient fiber, especially resistant starch, to support a proper gut flora.

      From here, I would make sure she is getting adequate carbs (remember young children need 40% of calories as carbs) and fiber; get her adequate copper (beef/lamb liver or supplements) and molybdenum (occasional supplements) for diamine oxidase and monoamine oxidase; vitamin C, collagen, optimize vitamin D, liver or supplements for vitamin A. Also be sure to tend to circadian rhythm entrainment, and consider slightly extending her overnight fast.

      Best, Paul

    • apologies the supplement mentioned isn’t immunoglobulin G but Immuno-gG (colostrum).

      • Thank you so much for your response Paul.

        We did add back the starches hesitantly at first but then with reading your book wholeheartedly. She is definitely craving less carbs now than before. She has rice, potato (often cooled), sweet potato and bananas. We also have lamb liver and lamb heart once a week. She is very keen on her meat though and I think that she is having more than the 7-10% of calories. Should I try to restrict this?

        For supplements we are giving one capsule of a multi (Thorne Citramins II), which has 30mcg of Molybdenum daily. I hope this is adequate for her at 17kg?

        I forgot to mention she does get vit D supplements too.

        Once again thank you so much for your considered response.

        Best,

  7. Hi Paul. I usually am fasting 5 or 6 hours before I go to bed. I was just reading: “…if you eat your last meal at 6pm and don’t go to be until
    10 or 11pm, you could be putting your body into a “catabolic” state before bed.This can potentially stop your body from rebuilding muscle and recovering the way it needs to while you sleep. So, taking into consideration all the vitally important processes taking place while you sleep, getting the right nutrition about two to three hours before bed seems to be the “sweet spot” for increased GH production and more efficient fat loss.” Your thoughts? thanks.

    • I don’t believe this is true. If you eat enough food during the afternoon your body will have sufficient reserves to build tissue at night. Afternoon eating is better than evening eating in fact. It is undereating that is the problem.

  8. Hi,
    I purchased your book and have been reading it for quite some time now. I have a few questions as I am quite puzzled about a certain few things.

    Firstly,
    I understand that we should not consume too much oily fish due to lipid peroxidation, however on the diet recommendations it says to consume 0.5- 1 lb meats and oily fish is included in this.

    I currently consume around 3 servings of fish every day and If however I was to cut down my fish intake to 1 or 2 servings per week, what could I replace my intake with? Does this mean I would have to replace this with beef, lamb or pork so that I am eating these meats daily and only consuming oily fish twice per week?

    Also, I usually fast for a minimum of 16 hours everyday and consume all of my calories in 1 large meal. Therefore, as I am eating 3 servings of fish daily and in one meal, does this mean that due to the large amount of omega 3 I am consuming in one sitting, that peroxidiation will be a lot higher?

    Also, I eat some fruit with my meal which means I am getting some fructose in there also. So 3 servings of oily fish and fructose all in one go = a high level of peroxidation, right? What should I do to rectify this? do I need to eliminate fruit from my diet completely?

    I hope that you can help me with this as I am quite puzzled at the moment.

    Thanks very much.

    • Hi Roberto,

      Have the oily fish 2 servings per week and non-oily seafood (white fish, shellfish – molluscs and crustaceans) other days. You could also have beef and lamb – it’s good to eat organ meats from beef or lamb at least once a week, including some liver.

      It’s fine to eat the fish in one meal. It’s fine to eat fruit with the meal. No, don’t eliminate fruit, we recommend 1 pound of fruit per day.

      Best, Paul

  9. Hello Paul,
    What would be your suggested strategies in order to build muscle? im 19 and want to be as healthy as possible. Do i need protein powders etc?
    A reply would be greatly appreciated!
    Rocco

  10. Once you get access to a variety of resistance exercises, whether body weight, barbells, dumb bells, resistance machines, etc. then the question is how much of each kind of exercise. This question implicitly includes another question: how do you quantify the amount of exercise?

    One method of quantification that applies to both resistance training and high intensity interval training is “Time Under Load.” You can time your sets in resistance exercises and time your intervals in interval training.

    If you take each set or interval to near failure, which means you could only continue for another second or two without compromising your form or slowing drastically, then the number of points you get for the set or interval is the square root of the number of seconds the set or interval lasted.

    When your point total reaches 12, then you have done enough intervals or sets, and you can go on to some other kind of exercise.

    • A couple of examples that will clarify my cryptic instructions:

      In the case of the bench press warm up with 36 second sets, working up from a very light weight (ten pounds or just the bar itself) until you reach a weight that you can barely pump for 36 seconds without slowing drastically. Recover and do another set to near failure with the same weight.

      The warmup sets do not contribute points since they were not (and should not be) done to near failure. If your recovery was long enough, you should have been able to do approximately 36 seconds on your other counting set, as well. If so your points for the bench press exercise amount to two times the square root of 36, i.e. 2 time six, which is twelve. Time to move on to another exercise.

      This time you are running steep uphill sprints with a five pound weight in each hand, either on an actual hill or on an inclined treadmill.

      Warm up with eight to ten 36 second intervals, working up from a slow walking pace (say two miles per hour) until you reach a speed that you can barely maintain for 36 seconds without slowing drastically. Recover and do another interval to near failure at the same speed.

      The warmup intervals do not contribute points since they were not (and should not be) done to near failure. If your recovery was long enough, you should have been able to do approximately 36 seconds on your other counting interval, as well. If so your points for the uphill sprint intervals exercise amount to two times the square root of 36, i.e. 2 time six, which is twelve. Time to move on to another exercise.

      If you work out like this four days per week, your weekly point total for each exercise will be close to fifty. Over a two or three month period, you may be able to bring your weekly point total for each exercise up to 100.

      Other ways to get twelve points (besides two 36 second intervals to near failure) are

      one interval of 144 seconds to near failure

      three intervals of 16 seconds to near failure

      four intervals of 9 seconds each to near failure

      one set of 25 seconds and another set of 49 seconds, both to near failure

      two intervals of 20 seconds each plus one interval of 9 seconds (all to near failure)

      etc.

      In general, for a given exercise add up the square roots of the number of seconds to near failure for each interval or set of that exercise (except the warmup sets or intervals). When you reach or surpass the desired number of points, go on to the next exercise.

      In my humble opinion this is the simplest and most flexible system that gives you optimal stimulation for increases in anaerobic fitness, including both size and strength of your muscles, for both beginners and advanced athletes.

      It also stimulates aerobic fitness adequate for all athletes except long distance runners and others specializing in endurance events. Though strength and interval training are not are not by themselves adequate for these endurance athletes, they are still an essential part of their training.

      This method bypasses all of the complexities of finding “one rep max” equivalents, etc.

      Enjoy,

      Forest

  11. We assume it is optimal to eat the largest meal between 12PM-3PM, and I assume that that recommendation is relative to a 12-12 schedule starting at 6:30 AM.

    We also assume it is optimal to combine intermittent fasting with daytime feeding.

    On a 6:30 AM 6:30 PM light-dark schedule, then, it really seems as though the best eating window would be 8-hours, from 9:30 AM to 5:30 PM.

    However, if one eats breakfast (9:30 AM) and then a large meal in the afternoon (2:00 PM) , one will not be hungry for supper at all. And so, perhaps supper would just consist of a snack, or would even be skipped altogether?

  12. Dr. Jaminet,

    Happy New Year! I hope the holiday season was enjoyable for you and your family.

    I am contacting you again out desperation. Previously, I contacted you regarding a clotting disorder, including two PE/DVT events, and its treatment with warfarin.

    I had a really unfortunate experience with my former hematologist (he is also an oncologist). He treated me for nearly 2 years and despite my self-advocacy and in-depth research, I could never get him to agree to directions to take in my treatment.

    He was content to simply have me on coumadin indefinitely without trying to determine the cause of my unexplained tendency towards hypercoagulation. He dismissed the possibility of cancer, which I asked him several times, without ordering any testing.

    I finally decided to find a new hematologist. While looking for one, I fell ill with intense fatigue, caused by a hemoglobin of 4. And finally after an episode of severe vomiting, was hospitalized and diagnosed with stage IV adenocarcinoma.

    I’ve been receiving chemotherapy since March 2014 and I am doing fairly well. But I am now confused about my diet.

    For many years I adhered to a low carb/ketogenic diet. In hindsight, I see that my diet tended to be too low carb (similar to the Polish diet). I understand that that my have to contributed to my condition. I switched to the Perfect Health Diet in 2012, when discovered your work.

    I have read your blog entry “An Anti-Cancer Diet”. But I am wondering if you can direct me to any updated info re: PHD for people with cancer. I am using the supplement recommendations. But I want to alter my diet to be more inline with PHD. You see after losing 100 lbs of bodyweight (from 244 pounds down 151 pounds at a height of 6’7”), I was directed to
    eat anything I could keep down, with emphasis on anything. That principle has evolved into what I believe to be an unhealthy diet. I want to change that.

    I apologize for the wordy, rambling nature of this request. But my life has been turned upside down by a condition which could have treated much earlier if I’d been able to get that physician to work with me as a partner in my care. So, now I tend get off on that tangent when it comes to health issues.

    Anyway, I would be extremely grateful for any direction you can provide me with.

    Thank you in advance.

    Regards,
    David Brown

  13. Hi Paul, someone recently forwarded me a media release regarding the sugar (Neu5gc) that is prevalent in high quantities in red meat. A study has been published that hypothesises that this sugar can trigger an inflammatory immune response in humans and may be the reason for red meat’s supposed link to increased rates of diabetes bowel cancer etc. apparently humans can’t synthesise neu5gc but it is found in high levels in certain cancerous tissues. I wonder what your take on this is???? A URLs for the media release follows
    http://www.iflscience.com/health-and-medicine/possible-link-between-red-meat-consumption-and-increased-cancer-risk-identified

  14. Hello,
    Thank you for sharing !
    You give us many tips to optimize our diet. Your proposals are a tremendous help. Do you have information about food chronobiology?

    Jyves LT ( France)

    • Hi Le Treust,

      Yes. We recommend intermittent fasting 16 hours per day, eating only in the daytime, with most calories in the afternoon.

      Best, Paul

      • What if it is stressful for a healthy and lean person to do intermittent fasting, but the stress has nothing to do with poor (macro or micro) nutrient status, etc.? Is it still wise to do it, day after day, without any break?

        What if 16-hour fasting leads to physical fatigue, impaired sleep, and decreased cogitative/cognitive/creative power, but 13-14 hour fasting does not, despite making a concerted effort to eat a sufficient quantity of calories during the eating window?

        The scientist who popularized the concept of an 8-hour feeding window says that he himself only fasts for 12-hours a day. Moreover, 9-12 hour (daytime) feeding widows have also now been studied, and they seem to also be effective (for preventing diseases of civilization).

        In light of the chronobiological research, I would venture to guess that daytime feeding (a feeding window of 12 hours or less during daylight), in which the bulk of calories are concentrated in the afternoon, e.g., 12-2 PM, is just as important for health, if not more important than intermittent fasting. For, as long as the mice are eating during their “12 hour daytime”, they are OK, whether or not they do 16-hour fasting.

        There may be additional benefits/protections from combining intermittent fasting with daytime feeding, and I’m positive there are independent benefits from fasting once and a while (say, once a week). But I wonder if 16-hour fasting should be done day after day, in a lean, healthy, well-nourished person, if it is always experienced as a mild form of stress?

  15. ❓ Hello,
    I hope you don’t mind me emailing you some possibly stupid questions?…
    I’m really new to this and am struggling a bit. My main concern is that I’m constantly hungry!! More so at night. It’s to the point that it wakes me up in the early hrs. I eat roughly 1600 calories a day and aim to have a meat ( mainly fish ) a sweet potato and loads of veg at each meal. If I snak its fruit or nuts. I know you recommend 1lb of veg a day, how much is that in grams?
    I do exercise 3-5 times per wk. despite that I’ve put on 4lb because Im constantly hungry and find myself having to eat a lot.
    Any advice would be greatly appreciated
    Thank you 😀

    • Why are you eating so little?

      • You know, some people, especially women in menopause, do have slower metabolisms. Granted, there may be a thyroid issue underlying it to some degree. Like Georgie, I can’t eat much more than 1600-1800 cals without gaining weight. And I’m hungry almost all of the time too, though not as ravenous as she seems to be. My mother only eats ~1300 cals to maintain her weight, although she is 90 yrs old, but she goes to the gyms 3 times a week and dances too.

      • I’m a bit of a past fat and calorie phobe. I’m still really struggling to
        Make sense of eating more. In my head 1600 is a lot.
        I’m never used to be hungry , even after training but since I started to adopt PhD I’m ravenous! I was just wandering if that normal?
        The hunger is much worse at night and I’ve put on weight….
        Thanks everyone

        • Paul says hunger is a sign we are undernourished in some of the macronutrients.

          I feel full on about 1600 to 1800 calories a day trying to follow PHD (53, female, 125 lb., height 5’5″, moderate activity).

        • Georgie, you might want to read the weight loss sections of Paul’s book. He talks about leaving carbs at the PHD standard % but increasing protein and decreasing added fat. I think he says something like reduce the standard 4T of added fat to 2T of added fat (or less). If you’re eating 3 egg yolks and the full spectrum of recommended protein sources (or any of the pleasure foods like nuts, cheese or chocolate) then they all contain some fat. The only way to keep from feeling hungry on a weight loss diet is to increase protein. I seem to recall that the PHD book says you can safely go down to about 1300-1500 calories doing this. One other thought: some people do not tolerate dairy well and find that it causes weight gain. You could experiment with excluding it too.

          • And one other thought: you might want to rethink your exercise program. I’m not a guru at all, but I’ve been listening to a lot of primal health gurus like Mark Sisson and Neely Quinn who talk a lot about the right amount, type and timing of working out for weight loss. For example, more and more of them are saying burst training is optimal and that running is not. Since you sound very athletic, you probably already are tuned into these sources and info, but wanted to mention in case not. BTW, Neely Quinn’s experience was the same as yours: i.e., exercising a lot and gaining weight.
            And last point, of course weight doesn’t tell the whole story. I think that at some of Paul’s health retreats that he has reported people gaining a few pounds at them, but it was all muscle, and not fat!

  16. I’m no expert but 1600 calories while exercising 3x a week seems to low.
    Eat more.

  17. There is the potential for confusion surrounding the distinction between “daytime feeding” and “intermittent fasting”, especially when the feeding windows are expanded to 12-hours. This is because the feeding windows in the time-restricted fasting studies have been situated within the “daytime”, and so it is difficult to separate the effects of “fasting” from the effects of “daytime feeding”. In any case, it is clear that the scientist behind the studies regards “daytime feeding” (and not “fasting”) as the really operative concept, since what is primarily responsible for the beneficial outcome is the synchronization of the various “bio-clocks” via the environmental and behavioral “clock-setters”.

    Paul’s speculation regarding the optimal compressed eating-window within the limits of a 12-hour daytime is thus very important and profound. For, it is becoming increasingly evident that daytime feeding and intermittent fasting must be combined.

  18. Hello Paul!
    Thank you for providing this ‘treasure chest’ of information 🙂

    I have a question regarding food combining – specifically mixing high starches (eg rice/potatoes/yuca) with high protein (meat/fish)

    In your opinion, is digestion more efficient when a meal is primarily either starch OR protein?

    The only reasonable/logical information on this subject I have found is by ‘Dr Kaslow’ [Source: http://www.drkaslow.com/html/food_combining.html%5D
    I’ve summarised his main reasoning:


    Proteins are digested largely in the stomach, by the gastric juice (hydrochloric acid, pepsin)
    The stomach must be acidic in order [for pepsin] to digest protein.

    Carbohydrates are digested largely in the small intestine, principally by the alkaline pancreas secretions.
    Amylase splits the starch only in an alkaline medium.

    With a mixed high starch & high protein meal:
    When passing through the stomach, carbohydrates can inhibit the secretion of hydrochloric acid in the stomach and also combine with some of the free hydrochloric acid there.

    In the small intestine, more alkaline secretions would be needed to neutralize the acid stomach contents before starch digestion could begin.

    …So it would seem that digestion of both food types would somewhat impede each other?

    Thanks

    James

    PS:
    Apparently, bone broth/gelatin can imporve digestive action when combining high starch and high protein:

    “Dr. Francis M. Pottenger, however, found that if gelatin is included as part of the meal, digestive action is distributed throughout the mass of food and digestion of all components proceeds smoothly.”

    [Source: http://www.westonaprice.org/health-topics/why-broth-is-beautiful-essential-roles-for-proline-glycine-and-gelatin/%5D

    • I think the food combining idea is nonsense. It works the other way – mixed food types are digested better, not separated types. They should have called it “food separating” too.

      • Thanks for your reply Paul. I was only focusing on protein starch combinations, the reasoning seemed to have some biological sense (re digestion).

        James

      • That’s good to hear, Paul. I always thought this was true, even after reading Body Ecology Diet, which advocates this separation. I kind of follow it, actually, but only by chance and not as a rule (had rice and beef today).

  19. Is there a fair amount of resistant starch in those frozen bags of stir fry rice? Ingredients are just white rice and various vegetables

  20. Just wondering. Is black rice good to eat as an occasional alternative to white rice?

  21. How does black rice differ from brown rice? Also, is black rice enriched? By the way, Paul, thank you so much for responding so readily.

    • Hi Cathi, black rices are varieties of rice with higher anthocyanin content, like purple potatoes. http://en.wikipedia.org/wiki/Black_rice. Brown rice is also acceptable on PHD but considered not as good as white rice (unless, perhaps, pressure cooked). Black rice varieties can be sold with the bran like brown rice or de-hulled like white rice.

      • So Paul, since you raise the comparison of purple potatoes — are they OK too as a diversion from white? Also, when we you say “white potato” generically, where do the “heirloom” varieties sold at farmers markets, like Yukon Gold, Nicola, German Butterball, Finn, etc, fall — in or outside of the category? And what about plain red skinned potatoes sold in supermarkets? In other words, how do you define “white potato”? Does it include only russets and the nameless white potatoes sold in supermarkets, or is it more broadly any whitish-fleshed potato, regardless of name and skin color?

        • yes, purple potatoes are great. Heirloom varieties are good too, and red bliss potatoes. There’s no such thing as a bad potato. I like fingerlings a lot.

          I use “white potato” generically to distinguish the whole potato group from sweet potatoes and yams.

          • Thank you Paul! I love them ALL too, so that is great news! I try to achieve great diversity in my diet, within the broad parameters of PHD, and this helps a lot!

  22. Thanks, Paul. Does the black rice need to be cooked in a pressure cooker if it is not de-hulled? I’ve ordered your book and I’m looking forward to having many other of my questions answered in the book.

  23. Are the weights of foods (i.e. 3 lbs of plant foods and 1/2 to 1 lb of animal foods) the weights before cooking or after cooking?

    • Generally you should use gentle cooking which keeps the weights the same before and after. The exception is white rice — weight is after cooking. Generally, the weight to use is whichever one is heavier, that includes the water content.

  24. Any remedies or suggestions for mood (irritability) and trouble sleeping? Thanks!

  25. Is spelt flour an acceptable choice for making bread, etc.? I didn’t see spelt addressed in the book. Thanks!

  26. I have purchased your book from Amazon and eagerly await its arrival on Monday. In the meantime, 3 questions. (1)I’m not sure how one can eat 1 lb of safe starches plus 1 lb of sugary starches plus non-sugary/non-starchy vegetables and stay within a range of 200 – 600 calories from carbs daily ? (2) Also, a 5’3″ woman and a 6’3″ man would surely not eat the same amounts? I’m hoping that your book goes into more detail about how much of what to eat daily is recommended. (3) Also, on this page of the website, you include fruits and berries in the “sugary” vegetable category, yet in the “apple” graphic fruits and berries are in the leaf of occasional foods. That has me confused. Thank you for all of your hard work on this issue. I have already started implementing your plan even before my copy of the book arrives. After trying Paleo/Primal and feeling as those it was a close fit, but not quite “it”…. I believe that your plan is my solution to good healthy eating. Thank you !!!

    • Hi Susan,

      1 lb of starches has 500 calories of carbs and 1 lb of fruit/berries has 200 calories. So that would be 700 calories. The amounts are approximate, but we aim for 600, 700 is close to 600, and 1 is a round number.

      The key thing is to keep the proportions of starches, fruits, and meat and vary quantities according to appetite.

      We are updating the apple, we’ll have the new apple soon which will be clearer.

      Best, Paul

      • Hi Paul,

        Thank you for your help and your quick response. I really appreciate it !!

        I shall eagerly await the new apple.

        I am trying to avoid (after an initial trial period to learn approximate values) counting calories or weights.

  27. Hi Paul,
    Your articles are great and your website looks awesome! The recipes are good ideas too. I love living healthy as well and enjoy sharing my how to lose weight and gain muscle tips with other people on my blog. It is so easy to lose weight with healthy living! My blog is http://www.healthdietvitality.com , feel free to look around!
    Thanks!

  28. Hello, after studying the book I had a couple questions. When looking to gain weight, once eating the 600 carb and 300 protein calories which fats are more beneficial to consume to build muscle and not just adipose tissue. Also what should the typical daily mono/sat/poly ratios look like on a typical day? And lastly you mentioned children need more carbs( around 30-40%), would the same go for a recovering anorexic and does that 40 take into account the carbs formed from the breakdown of fats in the diet? Sorry for so many questions. I just want to rid myself of anorexia once and for all and endorse longevity. So far you book has helped me a lot, Whether this is the greater intake of saturated fat which gives me much clearer thinking/energy or something else in the diet but I feel much less anxious and compelled to exercise as before. Cheers for you great work and theories. Im a firm believer between health, diet and lifestyle choices

  29. Hi Paul,

    Do you know of a place (in or close to Cambridge MA) to find collagen-rich beef bones (e.g. Ox Feet or Knuckle bones) from naturally-raised animals?

    I’ve had luck finding marrow-rich bones from naturally-raised animals, but I can only seem to find collagen-rich bones from industrially-raised animals.

    Thanks!
    Eric

  30. Hi! I just found out my cholesterol is 257 and triglycerides are 83, HDL 75 and LDL 165. I am 61 and have celiac and hashimotos. Does that sound ok? They just told me to go on a low fat diet and loose weight. I’m just wondering if Im good according to ratio, etc? Thanks!! I love my egg yolks!

    • Hi Nancy,

      Your HDL is perfect but your LDL is a bit high. This commonly indicates that you are slightly too low carb, or possibly iodine deficient or iron excess. Try supplementing iodine 225 mcg/day, eating more carbs, and getting your iron status tested and donating blood to reduce ferritin to 50-100. Triglycerides are a bit high too which suggests you need to improve your gut health — autoimmune disorders commonly result from a loss of gut integrity / SIBO / dysbiosis so that is not a surprise. Don’t stop eating egg yolks! For further reading: http://perfecthealthdiet.com/category/biomarkers/hdlldlcholesterol/

  31. Thank you so much!! Should I stop taking a fiber supplement that has probiotics in it and just take probiotics? I was afraid of iodine because of having hashimotos but I’ll try it. Can I just do kelp? I wish I could donate blood but I can’t because I had hepitatus when I was younger .. Thank you for your answer!! Im going to cut out dairy and do more cardio. Now I mostly lift weights because I like it!

    • Hi Nancy,
      You can still get your blood drawn (if your ferritin is over 100. Check book for correct units), It’s called a Phlebotomy.

    • i just checked the ferritin units (i was on my phone before),
      it seems that it probably does not matter…
      ie. in the US they will prob write ng/ml, outside the US, they could be written ug/L, but it works out the same thing…both will be 100

  32. I meant pre biotics!

  33. The PHD book suggests, to eat max. 25 g fructose/day. As vegetables count half glucose, half fructose: does fructose of vegetables also count to the 25 g fructose? Or is only meant the fructose of f.ex. honey and fruits?

    • Hi Jepps,

      Good question. We don’t count vegetables. One pound of vegetables has less than 10 g fructose which I don’t think should be worth worrying about in comparison to the benefits of vegetables.

  34. In the “sugary in-ground vegetables” category…. what other foods would be included… in addition to carrots, beets, onions, fruits and berries?

  35. Is spelt flour an acceptable choice for making bread, etc. or has it developed toxins in it the same as regular wheat? I didn’t see spelt addressed directly in the book. Thanks! ❓

  36. Rosanna Violetta

    Hi Paul,
    What would be your best strategies in a nutshell to improve the gut barrier integrity. My son suffers from autoimmune disease, and Is desperate to relieve his symptoms.
    Thanks ever so much.

  37. Hi Paul:
    I just received your book and am completely intrigued by RS and it’s role in gut health. My question is in regards to systemic candida. I have battling candida for over 5 years. I was diagnosed with gluten intolerance (after seeing an allegist for rash on my throat) then developed thrush shortly after giving up gluten. I went on the gaps diet and became ketogenic and developed histamine intolerance and rash under breasts and on lower left side of back that will not go away. For the last week I’ve been taking herbals (oregano oil, pau d’arco, cloves etc…) Do you recommend slowly adding back in things like potatoes and fruit? I want to make sure I am doing this right, I’ve been suffering for so long….

    My symptoms:
    Slightly hypo TSH was 7.5
    Vit D was 19 (started supplementing)
    High cholesterol
    Adult acne ( I’ve had this since I was 18 and am 37) This has moved to only my neck and jawline
    Lethargy
    Skin Rashes
    I also work out four days a week- boxing, so it’s pretty intense

    Thanks for writing your book and I hope to heal and start living again!!!! 😀

    • Hi Natalie,

      No, I would go directly to PHD. You need the glucose for immunity, mucus production, and gut barrier integrity, and you need the fiber to generate beneficial bacteria to displace the yeast. For the systemic candida, vitamins A (liver) and D (sun/supplements) are key, as are iodine, copper, chromium, and other minerals; next in importance are glutathione supports glycine/collagen (bones/joints/tendons/skin/hooves/feet in soups and stews), vitamin C, and N-acetylcysteine. Then intermittent fasting and circadian rhythm entrainment.

      For acne, make sure you do our zinc regimen, daily pantothenic acid, and vitamin A – maybe a little extra liver. For histamine improve your copper and try supplementing molybdenum occasionally.

      • Thanks for your response. I just started taking evening primrose for my acne. Should I stop and just use the b5 and zinc? Also, is this a good brand of k2?

        http://www.amazon.com/gp/product/B000FGWDTK/ref=ox_sc_sfl_title_1?ie=UTF8&psc=1&smid=A7NFUA2LBC1AC

        Thanks again!

      • Thanks for this summary Paul. After finding I have mild candida based on the Metametrix stool test, I started reconsidering doing low carb (as that’s what I mostly hear online to help against candida) so I was happy to see what you have written above.

        However, my bigger problem is a medium Klebsiella overgrowth. I did an antimicrobial/probiotic protocol recommended to me by my practitioner but I am not convinced it helped that much.

        Would your advice for helping against candida be also relevant for Klebsiella? Or would there be anything different?
        I am doing PHD foods but need to focus more on my supplementation.

        I am reading your book and appreciate all your posts here. I’m trying to learn as much as I can. Thank you

        • Hi Bernadette,

          Klebsiella is different as it is a bacterium that feeds on carbs. However, both Klebsiella and Candida problems will benefit from diversifying the gut flora through fermented vegetables, diverse sources of fiber, and intermittent fasting; and improving immunity with liver, sunshine, iodine, circadian rhythm entrainment.

          • Thanks Paul. So should I still continue to eat PHD safe starches? I still haven’t got the hang of intermittent fasting. I seem to get hungry missing/delaying breakfast. I wonder if that’s the pathogens wanting it’s food?!

          • Hi Bernadette, I would eat starches but you have to experiment regarding amount. If you get negative symptoms from starches, try mixing in dextrose powder as an alternative source of carbs. Getting hungry at breakfast usually means you didn’t eat enough of something the previous day. Electrolytes (salt, potassium, water, calcium, magnesium), protein, and carbs are the most likely.

          • OK thanks. I’ll work on making sure I get enough protein,carbs and electrolytes. I thought I did but I’ll try increasing the amount. I tried experimenting with dextrose a few months ago and it made me feel worse. I started feeling sort of ‘drunk’ and spaced out. I thought that was the candida. Not sure though. I’m feeling better than I was then, so I might try agan.

  38. Hi Paul, on the PHD my cholesterol and triglycerides are finally down where they need to be but my glucose is 103. It has never been high before. Ages ago on Atkins glucose went up and when I went back to the SAD, it was low. I have migraines so I only eat your recomm. amt of starch for ketogenic (about 1/2 cup daily)Am I not eating enough resistant starch? I am concerned that my trig. and chol. will rise if I increase carbs… Any help is so appreciated.

    • Hi Samantha,

      Yes, you’re not eating enough starch and your body is stressed in the morning – the stress hormones lead to higher levels of blood glucose.

      See how much starch you can add without bringing back migraines. Some people have reported they can eat regular PHD and still not have migraines.

      Best, Paul

  39. Paul,

    Yesterday, after several days in pain, I found out I have a complex ovarian cyst with nodules. My ob/gyn had put me on 100 mg of progesterone, I am 42 and my levels were low. I am suspecting the addition of hormones may have caused this very painful condition. Show-Ching had ovarian cysts as I recall. My doctor said there is nothing I can do about them, so I was wondering if you had specific recommendations. Slightly lower carbs? More of a certain vitamin? Did Shou-Ching find something that seemed to be effective in addition to PHD?

    Thank you,
    Amy

  40. Consider the EstroSmart supplement by Lorna Vanderhaeghe Perhaps discuss with a naturopath

  41. Hi Paul:
    I’ve been taking des oppression acetate .1 mg 1/2 tab twice daily for the past 15 years (pituitary tumor removed then developed diabetes insipidus) I just looked up the ingredients for the pill I take and am wondering if I should switch to the nasal spray instead.
    Pill ingredients:
    Butylated hydroxyanisole
    “. ” Hydroxytoluene
    Crospovine
    Lactose monohydrate
    Magnesium stearate
    Povidone
    Potato starch

    Nasal spray:
    Sodium chloride
    Citric acid
    Disodium phosphate
    Benzalkonium chloride sol. 50%

    Is there a lesser of two evils ?

    Thanks for all you do!

  42. Hi I took your advice and got my ferritin checked and its 199. Im not sure what to do, is this really bad? Can I lower it by adjusting my diet? I am post menopausal on HRT. I do not take calcium or eat dairy products and I have been eating a paleo type diet with a lot of protein and spinach. Looking forward to your answer as to what to do next!!

  43. Thank ou for your answer. I can’t donate blood though because I had hepatitis

    • You could ask your doctor to prescribe a phlebotomy which is like donating blood only the blood is discarded.

      Or, you can try eating less red meat and taking vitamin C away from meals.

    • Nancy, you might want to listen to this podcast. I know it’s entitled Parkinson’s, but he talks about several related topics like iron overload which is a risk factor for Parkinsons. And to your question, about halfway thru, he talks about how to reduce and avoid iron overload (including Paul’s suggestions) and mentions how to gain free access to his presentation all about it at the ancestral summit:
      http://chriskresser.com/new-research-and-treatments-for-parkinsons-disease

  44. Hi Paul,

    After implementing PHD in 2013 (at 90%, still can’t stomach ruminant liver) in the hopes of correcting my hypothyroid symptoms I saw my health improve (higher energy levels than ever in my adult life) and then deteriorate. After recovering from a bout of gastroenteritis last summer, I was stuck with a pain in my colon and a chronic sore throat. Numerous misdiagnoses later, the sore throat turned out to be an enlarged thyroid with a TSH of 4.76, T4 and T3 within range. Other markers of note are low ceruloplasmin, high IgM with normal IgA and IgG, persistent macrocytosis, and negative TPO antibodies (other thyroid antibodies not tested yet).
    I follow the current recommended intake of iodine (225mcg/day), abide to circadian rhythms, but my goiter keeps getting larger. Are there any tweaks to my diet I should be sure to make? Would a colonoscopy be of any use? My haematologist thinks it might be autoimmune-related, but we’re very far from a diagnostic…

    Thanks for reading until here. And all the help!

  45. Also Sir, I forgot to add one more count.
    25-OH VITAMIN D (TOTAL) 20.36 ng/ml (in first test before PHD).

    After this I started Vitamin D3 supplement 5000IU per day.

  46. Dear Sir,

    I think my first comment is lost somewhere as I can not see it on page. I am rewriting it again. Sorry if any duplicate. And also added here few missing details in previous comment. So please delete previous one and keep this.

    I am suffering from Polymyositis and crohn’s for last 14 years.

    I started Paleo AIP protocol diet 6 months back. My CPK levels came down from 4K range to 1K range. No change in lost muscles or crohn’s symptoms yet. I lost 12KG weight (I was 64KG and after loss was around 52KG, Then gained 2 KG again so now 54KG). Height is 5’8″. Male. Age 38.

    I did more blood tests and found few counts abnormal as listed below,

    IRON : 61.5 µg/dl
    TOTAL IRON BINDING CAPACITY (TIBC) : 314.4 µg/dl

    CREATININE : 0.51 mg%

    TOTAL CHOLESTEROL : 395 mg%
    HDL CHOLESTEROL : 59 mg%
    LDL CHOLESTEROL : 333 mg%
    TRIGLYCERIDES : 121 mg%

    THYROID STIMULATING HORMONE (TSH) : 10.78 µIU/ml

    25-OH VITAMIN D (TOTAL) C.L.I.A 20.36 ng/ml

    —-
    After this I read your articals and book. Then shifted to PHD version of diet with adding White Rice and Eggs + AIP. I also started Vitamin D3 supplement (5000IU per day). Also started Betaine HCL supplement (increased from 1 capsule to 4 for now). After starting 4 capsules per meal, my stool problem afected a little. Now less quantity while in evenings or sometimes just false calls.

    After a month I did test again and results are…

    IRON : 59.6 µg/dl
    TOTAL IRON BINDING CAPACITY (TIBC) : 350.2 µg/dl

    CREATININE : 0.51 mg%

    TOTAL CHOLESTEROL : 385 mg%
    HDL CHOLESTEROL : 49 mg%
    LDL CHOLESTEROL : 318 mg%
    TRIGLYCERIDES : 122 mg%
    THYROID STIMULATING HORMONE (TSH) : 10.25 µIU/ml

    Few years before, and after polymyositis, I did check Thryroid and choelsterol few times but was always normal. I did these tests after many years so do not know in between status. But I suspect that it increased after AIP but not sure.

    I did increased starches as suggested by you, mainly white rice. I eat 2-4 tables spoons of coconut oil and lard.

    Withing one month there is not much change. What period should I wait to see the change? I also little nurvous about TSH values. Please suggest/help. Thanks in advance.

    • Dear Paul Sir,
      Please advise for my concerns about TSH and Cholesterol values and on an average after what time on PHD I can expect change?

      • Hi Sachin,

        Cholesterol you should be able to fix very quickly, in a week to a month. Hypothyroidism typically takes several years to cure but you should see improvements in a month.

  47. Dr Jaminet,
    I’ve been following Paleo for around 9 months now but I became interested in PHD and am currently reading the UK edition of your book which I’m finding most informative. I can’t however find an answer to this question: Are seeds such as Flax,chai,poppy,psyllium and sesame safe for PHD? I have been using a combination of them to make crackers in my dehydrator and I eat them most days instead of bread for my lunch. Prior to that I was making bread from cashew nut butter and coconut flour. Is this acceptable on PHD please?

  48. Thank you Paul and thank you Susan for the link! I had an iron saturation test done and Friday am going for a consult with a specialist. I just hope she doesn’t tell me I can’t drink my wine! Its not easy getting older and trying to keep my health, and fitness, and I am so grateful for the PHD and being able to get answers and help on this site!!!! My goal is to look good and feel good and be as strong as possible 🙂

  49. Hello Paul,you are providing such valuable information; I’ve been reading your website avidly to fully understand the diet (am currently waiting for the book to arrive).I have been ill for years with physical and mental health problems; after only two weeks on the diet I am feeling so much better already.
    My question is- do eggs count toward the 300 protein calories per day, or are they considered a supplement to this?I usually eat 2 eggs for breakfast, and realised they are a large part of the protein calories if they are included in the total

    • Hi Angela,

      Yes, eggs count, but we recommend eating the yolks only to reduce allergy/autoimmune risks. The amount of protein in 3 yolks is small, about 10 calories I think.

      • Hi Paul, I was confused by this also, but I think that I have discovered where the confusion lies. One large egg is about 70 calories and has 6 grams of protein. Since each gram of protein is 4 calories, then the “protein” calories in one whole egg are 24 calories – even thought the total calories in that one egg are 70 calories. Same with a 3-ounce portion of ground sirloin. The total calories are 196, but it has 24 grams of protein and each gram of protein is 4 calories, so there are 96 protein calories in that 3 oz sirloin even though there are 196 total calories in it. So you are counting NOT the total calories in a protein food, but only the “protein calories.” And, therein, was my confusion about all of this. I know that 1 gram of protein has 4 calories, 1 gram of carbohydrate has 4 calories and 1 gram of fat has 9 calories. So… in each case… you are counting just the “protein” or “carb” or “fat” calories…. NOT the total calories of the food. In the case of the 3 ounces of sirloin, since there are 196 total calories and there are 24 grams of protein which is 96 “protein calories” and 10 grams of fat (at 9 calories per gram) which is 90 calories of fat….. the total 196 calories in the 3 ounce serving of sirloin is NOT 196 calories of protein as Angela and I were both thinking, but… in reality… it is 96 calories of protein and 90 calories of fat. Am I correct? I think that is a hugely important distinction which I have not seen on your website. I have recently received your book and I am hoping that the distinction is in there, but I haven’t had much time to read your book yet. I had the same problem at Mark Sisson’s blog…. he said that to maintain weight, one should eat 100 – 150 carb grams per day and to lose weight, 50 – 100 carb grams per day. So I counted every carb gram in every food that I ate. About 6 months later, I saw his blog post that made an important distinction…. he was talking about only carb grams from STARCHY carbs. He never said that in his original post…… Sometimes I think that experts get so deeply into this that they forget that people new to this kind of thing need these… seemingly small… but incredibly important distinctions pointed out over and over and over again. Thank you for your important work and for sharing it with all of us. I am loving eating this way !!!

        • Hi Susan,

          Your numbers are correct, but also keep in mind that we recommend discarding the whites, and eating yolks only, so the amount of protein is much less.

          I think Mark used to count all carbs but after we argued that you shouldn’t count vegetables, the Paleo community shifted.

          And I think weight loss is easier in the long run on 150 g carb than 50 g.

          • Hi Paul,

            Yes.. I understand about the eggs and only eating the yolks. But my main point was that in your recommended 300 calories of protein, it is not the total calories in a serving of protein, but ONLY the “protein calories” in that serving. That is a huge difference that I don’t think most people understand. And… I absolutely agree with you about the number of carb grams. It was not working for me on Mark’s primal carb recommendations. I find that I feel best at about 125 grams of carbs from potatoes, sweet potatoes and white rice. One more question…. in those carb grams, should I be counting fruit and the “sugary” vegetables like carrots, onions and beets? I am guessing that the answer is yes… but would appreciate confirmation.

          • Yes, some people think “protein” means “meat” and that is totally wrong.

            Yes, we count calories from fruit, berries, beets, and carrots along with starches as carb calories. It is just the low-calorie, non-sweet, non-starchy vegetables we don’t count.

        • Susan’s point is one that has continually made PHD impossible for me to really follow. I try, but it’s only a close miss. Humans think so differently. I do not enjoy or get math, logic, and science. The best I can do is hang out here and listen to everything other people say. It’s helpful.

          • Hi st,

            This is why suggest the rule of thumb – equal sizes on your plate of meat, starch, sugary plant, vegetable. That is sure to come very close to PHD proportions.

          • st – I enjoy the math, but.. it is not necessary. I eat 4 ounces of protein at each meal (3 meals a day), 1 serving of a safe starch (1 med potato or sweet potato or 1 cup of cooked white rice), 1 serving of fruit or carrots or beets and other vegetables as desired. That puts me right in the right spot for following PHD and there is nothing to count !!! I needed to understand the math, but I don’t need it to follow PHD on a daily basis.

          • I don’t think that was clear. Let me try again. I eat 3 meals a day. At each meal, I eat a 4 ounce serving of protein, 1 serving of a safe starch (a small baked potato or a small sweet potato or 1 cup of cooked white rice, 1 serving (4 – 6 ounces) of either a fruit or carrots or beets and other vegetables (lettuce, tomator, cucumbers, brussels sprouts, steamed cabbage, broccoli, cauliflower, etc) as desired. I eat 2 TB of butter each day. And drink lots of water. I feel great eating this way !!!!

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