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 ?


  1. I make rice pudding with a quart of milk (whole or 2%), 1/2 cup well rinsed white rice and 1/2 cup of the COSTCO product (powdered stevia and inulin that measures just like sugar). Simmer uncovered stirring often until it thickens. Then remove from heat and add vanilla extract and a few raisons if you like them. Chill in a dish (sprinkle top with cinnamon)covered with a t-towel and lid so the condensation doesn’t fall into the rice pudding. Once cool, if too thick, add a little more milk.

  2. Hello Paul or anyone who might have a suggestion!

    I have gotten myself to the point of a 16 hour intermittent fast, although sometimes. I will have a tablespoon of cream in my coffee/tea, it does not seem to effect it. I feel very energetic during the fast and get a lot done in the morning, but when I finally eat, I end up getting really tired! Does anyone else have this happen?

    Thank you,

    • This happens to me. I ponder if its excessive blood flow heading to the gut to digest food. But i also think it may have something to do with metabolites that come from helminths/other organisms when they feed.

  3. yes! the same thing happens to me. i feel great and full of energy until i eat. then i want a nap. a long nap!

    • Ladies, that sounds like blood sugar dysregulation. My understanding is that IF may not be ideal for people with this issue, and that while many women do fine on IF, men in general may do better on it than women. In general our hormonal systems are more complex and fluctuate more during the day and over our lifetimes than men’s. I’ve tried it several times, and for my body 12-14 hours is that maximum fast that works OK. Probably not what you want to hear, but that’s my 2 cents.

    • I’ve had similar experiences in the past. There are a number of possible explanations here. Susan mentioned blood sugar dysregulation, which is possible if you’re having anything high-glycemic in the lunch. It could also be that you’re eating more than your gut can handle after the fast, so that makes you tired–especially if it’s a meaty meal, which could mean you have low stomach acid–in which case, supplementing betaine HCl and/or digestive enzymes might help. We also have a natural dip in energy in the afternoon, that can be amplified by carb intake. You could experiment with different portions of protein, carbs, and total food in your lunch, and/or try those supplements. If you feel great until you eat, it doesn’t seem like the fast itself is a problem for you–I would more suspect digestive issues.

      • Frazier,

        That is great insight. I do have digestive issues, bc I suffer from chronic sinusitis I am frequently on long term antibiotics and steroids in the winter months. I also have GERD, which I must take sporadic omeprazole. I am doing the best I can to repair and improve with PHD. I have gained weight but I am still at a healthy weight for my height, 5’8 and 143 lbs. I broke my fast with 2 egg yolks, half an avocado and some yogurt. That is pretty rich. Maybe berries and cream would be a better way to go. I am wondering if I could use betaine HCI instead of omeprazole. Outside thyroid meds, and necessary antibiotics, it is the only medication I have left to get rid of!

        • Chris Kresser has a great article series/ebook on GERD that should help clear things up for you.
          And some tips that can help when quitting omeprazole include tapering it off gradually (for someone taking it daily), taking DGL 20 minutes before meals, and taking ¼ tsp baking soda in ½ cup of water (or as much as it takes, maybe half or twice those amounts) to relieve reflux when it happens away from food. I would probably get used to that change before adding betaine HCl.

          • Frasier,

            Thank you, I just took the time to read those Chris Kresser pieces. Very interesting. I would not be surprised if I did have SIBO SINCE I have been on so many antibiotics, so it seems complicated to address GERD and SIBO at the same time. He recommends Prescript Assist as his preferred probiotic, and I have heard mixed reviews on it, but it might be worth a try. I am also going to test out the baking soda as well:)

        • Amy – Just a thought. Do you eat dairy? I have eliminated all dairy (except for butter) because it gives me chronic sinus problems (and eczema outbreaks.) Just a thought.

          • Susan,

            I have not given up dairy, it has been on my radar. Wheat was fairly easy to give up. I have also greatly reduced my red meat intake to 3 times per month bc I have Grave’s antibodies. After reading Paul’s piece on Neu5gc, Imdecided to err on the side of caution. However, I have greatly increased my seafood intake, and I know that can cause issues for people. I love cream in my tea, cheese and yogurt. But I am considering doing an elimination to test it.

            Also, I have reduced my fat, yesterday I had 25% protein, 40% carbs and 35% fat. That is too many carbs, should I swap and do 40% fat and 35% carbs? When I dropped my fat intake, I naturally replaced with carbs!


  4. Susan,

    Thank you. I looked it up and It does sound like me. I actually get nauseous if I eat too early in the morning. I am going to go back to 12-13 hours and see how I feel. My baseline cortisol level in the morning is 11. Not horrible, but it probably effects how my blood sugar levels fluctuate. Do you find that you need to eat every 2 to 3 hours?


    • I agree with all the points this very helpful conversation has mentioned.

      Another thing that can make people feel a little nauseous, tired, shaky, or revved up — or cause them to experience acid reflux — is their pattern of taking supplements: which ones at which time of day, with food or not, with what kind and quantity of food, dividing up a daily dose over the day or taking it all at once, and so on.

      Even if it’s a supplement that is supposed to be relaxing for most people, like magnesium, or energy-increasing, like some of the B vitamins, sometimes it can have the opposite effect for an individual.

      Another example is melatonin, which is normally best taken about half an hour before you want to go to sleep, but has been found to work better for some people when taken 3-4 hours before their target bedtime (such as some people with delayed phase sleep disorder).

      So that I don’t feel a little queasy or have acid reflux when I take supplements, I need to have a substantial amount of food, normally, when I take them, and I handle them best when I pause and take them about 4 bites before the end of meal.
      There are some supplements that I just can’t take in the evening, not even with a substantial dinner, because 3 or 5 hours later when I lie down to sleep, I’ll get acid reflux from them.
      The same goes for supplements that are meant to be taken on an empty stomach / first thing in the morning — there are only a few kinds that I can actually do that with, without distressing my digestive system.

      I am a middle-aged woman with several hormonal issues and I also find that a 10-to-12 hour eating window (and corresponding 14-to-12 hour fasting time) are more comfortable and manageable for my body than an 8-hour eating window would be. I can’t eat a whole lot of food at a meal without feeling over-stuffed, and I also prefer to have some decent time between meals (or I will feel unpleasantly full all day), so to get in an adequate amount of food each day (even though I would guess that my intake is still below the recommendations of the PHD diet for a shorter, lighter female), I need to have a longer eating window with 3 slightly smaller meals which are each spaced a few hours apart.

      The main thing for me is to stop eating 3 hours minimum before I lie down to sleep, or I’ll have acid reflux. Being strict about that (first and foremost in order to protect my throat from my GERD) also makes it easy for me to manage to get in at least a 12-hour fasting time, even if I don’t get a full 8 hours of sleep, because before I know it in the morning, the 12 hours is up.

  5. Hi Amy, I love to eat, and enjoy snacking and often do, but as long as I’ve eaten a big and balanced meal, it’s not because I’m getting shaky. But if I don’t eat an adequate meal, then yes, I might feel like I need to eat something. I don’t think the camp that says it’s better to eat 6 meals a day is necessarily correct, because I do think that blood sugar needs time to reset in between meals. But it doesn’t work if you don’t eat enough or eat well-balanced at meals. Like you, I’ve never been an early morning eater. I naturally prefer to eat around 9-10am, but not much after 10, or I will start to feel a bit deprived/shaky (and it’s not because I’m a light dinner eater — I eat a LOT of food at lunch and dinner). That said, it may be just be force of lifelong habit, but I have a hard time with a heavy meal in the morning. I generally do something relatively light, like berries and nuts with a pinch of salt and spices with either whole raw goat or cow milk (or yogurt or fresh or cultured cream) and then eat lunch around 1-2pm. Then dinner at 6-7, trying to finish by 8pm. So my eating window is 9/10am-8pm, and rarely if ever more than 12 hours.
    The key thing for me is to eat balanced meals per the PhD Apple/Plate and snacks that contain protein and fat, especially if chocolate or fruit is consumed. I think that’s why Paul says berries for breakfast are fine, but put cream on them and also why he consumes his honey in whole milk for dessert.
    In addition to 3 egg yolks each day (usually at lunch), I eat 5-8 oz of animal protein each day, and try to have at least some of that with lunch. When I eat potatoes, which I love, I try to be a good girl and always add a bit of acid and fat like butter or sour cream. (I’m not fat-crazy like some people; I use in in moderation, mainly just to taste, and try to consume most of it within whole food form (i.e., meats, avocado, dairy products, olives, egg yolks, macadamias or other healthy nuts in moderation, etc) rather than as added fat, but it is a great blood sugar regulator and is important for clear thinking (I’m headache prone)). On most days the added pure fat is about 2T.
    If you’re doing cream in your coffee as your breakfast, that might be better than black. But to be honest, coffee may not be ideal while experiencing blood sugar or stress issues. BTW, I’ve tried Paul’s suggestion of doing bone broth with spinach and tomatoes during the 16-hour fast, trying to hold out on real food until the 8 hour window begins…and I think it’s a great idea that might work for you, it just doesn’t work for me…that long a window from real food causes stress and headaches for me. So my “perfect” will just have to be a tiny bit less “perfect” than other true-blue PhDers!

  6. Susan,

    Thanks for all that information! My natural eating pattern is 12 hours, and I think I am going to go back down to a 12-14 hour fast. I recently switched to teecinoo or decaf coffee for the issues you listed above. And I agree with you about the clear thinking part and being shaky. I often get shaky when I have not eaten. And it is a good point about women’s hormones. I am 42 years old and things are definitely starting to change. I notice my energy levels dipping more!


  7. Susan,

    Quick question. You said you take in limited fats. What do you think your protein/carb/fat breakdown is percentage wise? I am trying to lose a little weight, so I have reduced my fats. So I am very curious if uou are still within PHD optimal ranges?


    • Amy,
      I follow the PHD guidelines, percentage-wise. I’ve always eaten tons of veggies and some fruit, so following PhD for me has meant dialing up the fat, protein and supplemental foods and replacing bad (supposedly good) starchy carbs with good ones as defined by PhD.
      But I come from the land of fat phobia, and lived there for 55 years before discovering PhD. So for me the PhD guidelines of 2-4T of added fat per day is where I am, and on most days it’s on the low end of that range, which is still a lot as compared to my prior diet. When I said that I don’t go fat crazy, I meant that I’m not like some of the paleo folks who are into extreme ketosis and who slather gobs of fat on everything they consume. I agree with the Jaminets that it should be to taste, and scaled back a little if you’re trying to drop weight. They use mainly coconut milk as theirs, but I tend to make more traditional North American, South American and European style dishes, so I usually reach for other healthy fats in cooking and plating. I also trim most of the excess fat off of meats before I cook or eat them, and I don’t eat poultry skin (but I save it for stock making because it has good matrix).
      If you’re trying to lose weight, use delicious fats that you like in whatever way they will be most satisfying to you, but limit them to 2T like Paul has said.
      Keep all of the recommended foods in PhD proportions, using the low end of the recommended range for calorie-rich foods, and keep the pleasure foods like chocolate, cheese, nuts and alcohol to a restricted and disciplined level or temporarily omit them.
      I’ve never tried to calculate my ratios by weight or volume. But I’d say that my calorie intake is typically b/w 1300-1800 per day, depending on whether I feel fat, skinny, hungry or full. At first I tried to do everything by the chart, and I still do, but I no longer stress about it. I just try to follow it best I can and be sensible, ie, not overeating because you’re trying to make sure to get the lb of whatever for the day.
      I like Paul’s rule of thumb about palm sized portions.
      BTW, I concur with everything that Frasier said above, except that I have a different opinion on carbs. I considered mentioning HCL and other possibilities, but didn’t want to overwhelm you with suggestions. I never feel tired or sluggish after eating, and I always eat carbs (I am not low carb, I’m moderate carb, exactly like PhD prescribes). But I don’t eat them naked — always in proper proportion, accompanied by the other food groups, almost always prepared in advanced, chilled and gently reheated, and always with acid like lemon juice and added fat. They are far more digestible this way, and the glycemic load drops substantially.
      I’ll also mention that if you drop protein back too far, you’ll get hungry, so don’t do that. I personally aim for 6-8 oz in addition to the 3 egg yolks and 4 oz of liver per wk, and if I’m eating a fatty type like beef or lamb, I trim the excess fat, and I’d of course limit my consumption of things like short ribs that have tons of fat in them. I make and use chicken and beef stock. I hate the tast of the fat in it so I skim it all off, but that’s just me…this is supposed to be to taste, right?! My BMI is at the very low end of the normal range.

      • Susan, I don’t know that we have different opinions on carbs per se. If you don’t get tired in the afternoon, there’s nothing to be “amplified.” Those who do *may* find that saving their carbs for dinner helps. Everyone’s different.

      • Thank you for taking the time Susan, you really give great info. I am definitely going to use some of your guidelines. I was eating probably around 2000-2200 calories! I was getting too much fat. I already dropped 5 lbs just by dropping to 1700, and with 1700 calories, I feel just as full and satisfied! Now I just have to streamline the process. Make potatoes ahead of time as well as rice, remember to use an acid with potatoes and eating protein or fat with chocolate or fruit. Little rules I sometimes forget that can really make a world of difference in digestion and glycemic load!

  8. Frasier, I agree. Apologies: different opinion was probably poor word choice on my part. And actually I very slightly skew more of my carb load at night vs day, as I’ve read that Paul feels it might be advantageous to do that and perhaps load slightly more protein toward midday (haven’t achieved that yet though), while still keeping everything in balance.
    I was just responding to the glycemic concept and wanted to make sure that Amy knew that there were potentially good dietary ways to counteract its impact by using acid, fat and eating them in proper ratios to other food groups at the same sitting.
    You’re preaching to the choir — we’re absolutely individual and unique, and thank goodness for that!
    PhD is a fabulous template that allows for a lot of individualism and customization, which is one of the wonderful things about it.
    I love this PhD community!

  9. Rocco Violetta

    Hi Paul,
    I’m a big fan of your work and I wondered if you could help me because I trust your advice and knowledge. I know your a busy guy but a reply would be greatly appreciated. My mums shoulder sub-located around 5 months ago. It seemed to get better but now she is in more chronic pain than ever, and still in fear of her arm falling out. There seems to be a joint problem that physiotherapists can’t locate. What lifestyle and environmental strategies would be best to implicate in order to promote ligament and joint healing as I believe a holistic style of treatment is preferable ?
    Many Thanks

    • Hi Rocco,

      She should start by providing the nutritition needed to reconstruct joints. The best approach is probably to make chicken feet stock (lots of joint material in chicken feet) and include some in every meal – substitute the stock for water in recipes, or make a bowl of soup with it. In addition, supplement taurine and N-acetylcysteine, silicon, boron, magnesium, maybe a low dose of calcium too.

      Then, focus on circadian rhythm entrainment, which supports healing.

      Best, Paul

  10. I thought I’d look at my calcium intake from home drinking water, which happens to be water company well water. The hardness is 285 ppm, calcium carbonate. (Hard water begins at 250 ppm.) The water company data sheet also shows Ca and Mg at 50 and 38 ppm, respectively. This is equivalent to 50 mg Ca per gallon of water (16 cups). So, if I drink 8 cups of water per day, I’d be consuming 25 mg of calcium, which might be only 5 to 10% absorbable, typical for calcium carbonate. So, my conclusion is that hard drinking water is not very useful for meeting calcium needs.

  11. Hello,

    This is a long shot, but so many people seem knowledgable on this board with such a wide array of information. After I got pregnant my Grave’s antibodies came back and They effected my right eye, lower inferior muscle, developed scar tissue and I developed strabismus. My eye has been pulled down about 2 mm, and although not terribly noticeable makes me self conscious and gives me headaches. The doctor said the only option is surgery. In effort to try other angles including PHD, is there anything that has been shown to breakdown scar tissue, even if attributed to autoimmune disease?


    • No idea, but Serrapeptase came to mind. Apparently it’s meant to ‘eat up’ dead cells and inflammation in the body.

      Just did a search and this came up:

      Not sure what Paul thinks about serrapeptase but apparently from what I’ve read there are no known negative side effects.

    • Hi Pat,

      I’d be cautious about enzymes or anything that can chemically attack scar tissue, as it will be likely to attack healthy tissue too.

      Rather, I’d try to stimulate natural healing by supporting extracellular matrix reconstruction with ECM-rich soup and stew stocks, taurine, glycine, N-acetylcysteine; and then try to stimulate breakdown of the scar tissue with light massage, scraping, or acupuncture. Basically, minor injuries will draw the immune system to the site and lead them to break down scar tissue in the course of healing the minor wounds you’ve just inflicted.

      • Thanks for your response Paul, I will definitely add glycine and taurine. I was nervous about NAC only bc I have Graves antibodies, and you mentioned in a post many moons ago that these antibodies could be a chronic infection, and I was afraid NAC might make me have negative side effects.

        Also, the scar tissue is behind my eye, would you think light massage on my eye would be enough. I have thought about acupuncture, but it can not directly reach the scar tissue as it is, as I said before, behind or behind and under at the inferior rectus muscle.

        Kind regards,

      • Paul,

        I do not want to overdo a good thing. I just started taking OptiMsm, is that something like Taurine or work in the same way?

        Also, in theory would wearing an eye patch force that eye to do more work and recalibrate it?


  12. Claire,

    Thank you, I will look into that. I am willing to try different things. I tried Avogen, that did not do a thing except make my skin really nice! But at $60 a month, it was just too expensive. I definitely will do some research not this.


  13. I’ve been pretty low carb for some time now and am finding that I have gotten fatter as the years have gone on. As recently as 3 years ago I was 178. Now I am 195. I ditched all grains and didn’t lose an ounce. I’ve added rice back into my diet. From the first mouthful of food I get a flushed feeling and within minutes I am feeling drowsy. I have to take a nap and that offers no relief as I feel hazy the rest of the day. My resting heart beat goes up, too. It’s the same feeling I would get when I’d eat pasta or popcorn.

    I notice that my pants are feeling tighter, too. I’ve been doing this for 4 days.

  14. hi,

    Is the PHD good for perimenopausal women? I am 47 and I have gained 8lbs in the last year. I am 5’4 and currently 108lbs and 8lbs is too much for my body. I have been doing pretty much low carb (around 70-80net carbs from vegetables and a little fruits) for the last year and am scared to introduce starches. I introduced few tbsps of rice in the last 2 days but my weight went up 1lb. Is that normal? How many grams of fats and protein and carbs do I need to take to lose this weight?

  15. Nancy, when eating more carbs you will retain a little more water. If you just gain a pound or two, I wouldn’t worry about losing it for now. If you keep gaining, then you may need to make adjustments. There is no set number of grams we can prescribe for you. And if your metabolism is low from eating too low carb (how is your energy?), it may take some time for it to reset before you stop gaining and start losing weight.

    • the only thing is that everywhere you read on the internet it says for perimenopause you should restrict carbs. I noticed my energy was better with a bit of carb but again everyone says it’s better to be fat burner than a carb burner. it’s all so confusing.

      • Energy is vital! Some women have less tolerance for carbs after menopause; others don’t—so you have to do what makes you feel best. Moderate carb is still “restricted” compared to how a lot of people eat. You would also benefit from adding exercise, especially the weight-bearing kind, if you’re not doing that already.

  16. Anyone know of a good, nutritious package bone/crtilege broth? My attempts to make this – first with lamb bones, then with chicken wing bones – were too disgusting to stomach. I’ve seen a couple kinds of broth in a health food store that state they’re made from simmering bones but under the nutrition info it says 0% calcium, which makes no sense to me

  17. Paul,

    Quick question, I cannot seem to find info on. My thyroid stimulating immunoglobulin is 300, so I have graves antibodies. Is 225mg of iodine too high?


    • Hi Amy,

      Yes. In general you shouldn’t supplement iodine with hyperthyroidism. (Though there is a school of thought that with Graves one should go to very high doses of iodine, which has the effect of inhibiting thyroid hormone production. But the moderate, normally desirable doses of iodine will just get converted to thyroid hormone and make you feel worse.)

  18. I apologize, I think I am confused! I no longer have a thyroid bc of radioactive iodine, so no iodine at all, I eat a good amount of shellfish. Are you saying that iodine through diet is ok, and do not additionally supplement?

    Thank you:)

    • Hi Amy,

      I misunderstood. If you don’t have a thyroid then you can take as much iodine as you want. The Graves antibodies don’t matter.

      • Paul,

        No, I did not give you that important detail! Thanks for clarifying!


      • Paul,

        Can you please elaborate how perimenopausal women should incorporate carbs in their diet? A lot of sites suggests they should go really low on carbs. My estrogen levels are low, I eat very clean and exercise and has a sluggisg thyroid (using natural supplements) but it seems like nothing works and the more I try new things the more my weight is going up. I have gained 6-7lbs in the last year and my frame is petite so it’s a lot for me.

  19. I’m having an especially bad bout of acid reflux and terrible headaches for the last 3 days. Does anyone have any suggestions for tweaking the diet? Any suggestions at all would be much appreciated. Thank you all so much!

    • Both my girlfriend and I also started experiencing acid reflux not too long after starting PHD… It’s been several months, but we still haven’t been able figure out why (if we do, I’ll definitely let you know).

      Paul suggested it may be due to deficiency of vitamin A, vitamin D, or choline. So you may wish to try those (although they didn’t work for us).

      Best of luck.

      • Are you eating a greater volume of food? More fat? (Either of those gives my husband reflux).Have you tried a digestive enzyme that includes bile salts? Weird that if you have a deficiency in Vit A, D or choline causing it, why that wouldn’t have caused it before PHD?

        • We’re eating the same volume of food, and the same quantity of fat, as we used to. (We were already eating PHD macronutrient ratios before we adopted PHD.)

          We’ve tried digestive enzymes, but not one that includes bile salts. Do you have a specific recommendation?

          For us, I don’t think it’s caused by deficiency of vitamin A, D, or choline; we get plenty of these from diet (and vitamin D supplements), and supplementing extra didn’t help.

          • I like Mercola’s digestives ( Without them, my digestion is not great at all. Worth a try. Do you have gall bladders intact? What changes did PHD involve in your diet then?

          • Alright, I’ll give that a try, once I finish my current list of things to try (so in a couple of weeks).

            Yes, my gall gladder is intact.

            The biggest changes I made in adopting PHD were replacing wheat with rice, replacing high-PUFA nuts (e.g. walnuts) with low-PUFA nuts (e.g. macadamias), mostly-replacing chicken with beef/lamb, replacing my multivitamin with Paul’s recommended supplements, and eating liver.

          • Interesting. If Digestive Enzymes don’t help, all you could try is one by one, swap out the new stuff e.g. eat boiled potatoes instead of rice for a week; eliminate the mac nuts for a week; have no beef then no lamb for a week; etc. e.g. my sister cannot digest read meat (but the digestive enzymes might help there). My husband finds the meat he eats out at restaurants very hard to digest; but not the stuff I cook (organic, grass fed) – not sure why. Maybe the PUFAs? hormones?

          • How about HCL? Sounds counterintuitive but works for some people, my husband included.

          • If it was HCl, you would think the problem would have been there before PHD too. Same for H.Pylori, or if it was insufficient probiotics.
            I’m allergic to mold and get wicked eosophageal pain from stuff like aged/moldy cheeses, vinegar, soy sauce (fermented), wine, etc.

          • @Donna: I’ve tried precisely the experiment you described, which produced no results. But I still haven’t tried (yet) adding back in the old foods I ate prior to PHD — when I eliminated macadamia nuts, I didn’t add back in walnuts; when I eliminated rice, I didn’t add back in wheat.

            @Ellen: I’m scared to ingest HCl, as it has the potential to further damage the esophagus or stomach.

          • Eric, have you experimented with isolating the various safe starches? For example just eat potatoes for your starch for a few days, then rice, and so on. Do you two eat a lot of things prepared with the starch flours?

            Even though you were eating the same macro ratios, did you change the type of starches or vegetables?

          • @Ellen: Yes; potatoes are better than sweet potatoes or rice, but the difference is relatively minor.

            We rarely bake with starch flours (a couple of times a month).

            Vegetables are the same as before; starches changed by virtue of eliminating wheat.

          • Yes; potatoes are better than sweet potatoes or rice, but the difference is relatively minor.

            We rarely bake with starch flours (a couple of times a month).

            Vegetables are the same as before; starches changed by virtue of eliminating wheat.

      • I started PHD about 18 months ago and it helped tremendously but I still have some reflux and headaches and I can’t seem to pinpoint a cause. Well, I guess I should be happy that I feel much better than before adopting PHD! 🙂 I had a colonoscopy last week and didn’t eat anything for almost 48 hours. The symptoms started a day or two after I started eating again. So I suspect it must be something I’m ingesting…or perhaps my gut is just adjusting to having food in it again!

      • I narrowed down the cause/trigger of my reflux* a couple of years back to dark chocolate 🙁

        * tho my reflux was lpr/silent reflux/nighttime reflux

        • But it wasn’t the caffeine? Do you know what about it bothered you? Did Cocoa or Cacao powder bother you?

          • caffeine drinks were fine.
            so my guestimate was that it was due to theobromine, which is present in dark choc (& cacao).

            from memory, there are studies that show that theobromine can relax and/or weaken the LES (lower esophageal sphincter).

            after eliminating the dark choc, things slowly improved over weeks, i presume as my LES repaired/strengthened itself.

            i also eliminated caffeine drinks at the time, but later reintroduce with no issue.
            i was never game enough to reintroduce the dark chocolate to test the theory…& never will.

            just my n1 theory tho at the end of the day, based on a weakened les.

        • What kind of chocolate was it? It could have been mold or soy lecithin. Did you try other chocolates, perhaps a high end one? Maybe a high end 100% bar to rule out or in cocoa itself.

          • There’s no easy way to test in my case Peter…
            I do not have an acute (reflux) reaction to chocolate, or anything else for that matter.
            It takes months yo develop in my case (LPR).

          • …it takes weeks or months to develop in my case…and months to fix/reverse

  20. For the elderly using creatine, should we start out with a low dose like 1/4 teaspoon? What positive effects should we expect to see that might determine the optimal dosage?

  21. I got your book and I’m getting ready to try your safe starches. I was doing the wahls protocol because I was diagnosed with full body small fiber neuropathy with autonomic dysfunction. My stomach felt gross and I was always hungry and unsatiated. I added back in some rice crackers and it made that feeling go away. I was previously very healthy and strong. No one can find a cause. After full work up and spinal tap, they cannot find out what is assaulting my nervous system. I have a high ANA, but no other positive blood tests. I also get bit by a tick now and then, so there’s that.
    If a small amount of starch makes my stomach feel better with each meal, which would you recommend for someone with so much neurological damage? I do not need to lose weight or have diabetes.
    I tried to go grain and starch free for a month and I was bloated and unhappy.

  22. Dear Paul,
    I bought your book and I follow strictly your diet and supplement schedule since 2 years ago. However, I suffer from muscle craps very often (at least once a month). They tend to hapen around my back or neck and they are quite painful and last about 4 days. I am 39 years old and very healthy otherwise, except for IBS and an axiety problem which I control with SSRIs under medical supervision. Any help would be highly appreciated! Thanks in advance.

  23. Nutritionist Trudy Scott deals with anxiety issues. Perhaps there is an underlying cause not addressed?

  24. My mother began taking SSRIs about a month ago and last week began experiencing minor tremors, never before having had them, so I’ve seen them cause tremors first-hand.

    Like Paul says, my understanding is that SSRIs can be magnesium muggers (along with other critical minerals), requiring an increase in the consumption of magnesium to compensate.

    I’ve never taken any type of SSRI or similar, but I suffer from leg cramps unless I consume extra magnesium. For several years, it’s been critical to eat 1/2-1 banana each day (no other form of high-magnesium food worked for me). If I forgot during a day, I would get the cramps in bed that night, like clockwork. I’ve also been a migraine sufferer for many years, and now believe that adequate magnesium is critical for me to reduce/minimize them. Migraines are also linked to constipation/dehydration/lack of electrolytes; the magnesium helps with constipation and electrolytes. (I’ll also say that I use a small amount of salt at each meal now (vs. none before PhD), and that may be helping too.)

    This past year I’ve become fully entrenched into PhD, and began supplementing with 200 mg of magnesium at night (more ideally 100 at lunch, 100 with dinner for better absorption, but I usually forget at lunch so it ends up all at dinner). That has totally eliminated the night cramps, though I still eat an occasional banana for added insurance (and I love them, and they just make my whole body and head feel good, so it’s a good excuse). The brand that I take is Doctor’s Best (100% chelated, high absorption), 2 per day.

    You may need to play with the magnesium dose. My understanding is that 200-400mg is safe. Though I find that 400 is too much for me. I weigh 116. Depending on your body chemistry and size, you may need the higher dose, especially since SSRIs are notorious magnesium muggers. But if you experience loose bowels, you’ll need to dial the dose back to somewhere under 400. Everyone says it’s best for everyone to start with 200 mg and gradually increase toward 400, but only if necessary and as tolerated .

    There’s another product called CALM that I’ve heard wonders about. It’s powdered magnesium drink, without junk in it (magnesium citrate, organic flavors and organic stevia). Unflavored is apparently the most popular by far. Whole Foods and good health food stores carry it. Supposed to do wonders for both anxiety and mag deficiency. Their suggested dose is 200mg. Just depends on if you prefer a drink or a pill:

    • Is there an effective way to test for calcium/magnesium levels?
      I’ve heard magnesium RBC blood test is good but what about for calcium?

  25. Dear Paul,

    I have read PHD book pretty thorougly.

    Following the Diet for last 6 months.

    lost 5 or 6 pounds and now it is 150 lbs for my height of 5′ 10″. Sleep and exercise remain the same before and after PHD.

    Got a SCARE after my first blood test done few days ago. Appreciate your feed back.

    Lipids Before PHD ( ldl – 158, hdl- 48, total – 233, tryglycerides – 135 )

    Lipids After PHD ( ldl – 253, hdl- 57, total – 338, tryglycerides – 138 )

    TSH before 4
    TSH after 20

    glucose before – 102
    glucose after – 94

    Iodine after 61

    Vitamin D after – 15


    Thanks for all the work you do.


    • Hi Koosu,

      That’s not good. At least the blood glucose improved. Vitamin D is very low, are you tending to that?

      The hypothyroidism should certainly be treated with T4 thyroid hormone. Experiment to find the smallest dose that relieves symptoms. Ask your doctor to measure for Hashimoto’s autoantibodies and if you have hashi’s, cut back on red meat, replacing beef/pork/lamb with chicken/duck/fish/seafood. Measure iron status and donate blood if you have an excess. Finally, if you are too low carb, increase carbs. Make sure iodine supplements are limited to 225 mcg per day. Be sure to be well nourished, especially extracellular matrix (chicken feet/bone/joint/tendon stocks); vitamin C; vitamin A; taurine. Get sunshine, tend to circadian rhythm entrainment.

      Best, Paul

      • Hi Paul,
        Thanks for your reply.

        I am 51 and have been very active. Play high intense sports and run 20 miles a week. If time permits I could run a lot more. I have run 3 marathons before I got busy with family life. From that angle, currently I am not feeling fatigue or anything. That is why time flew by(6 months) after PHD for this blood test. But blood test tells me something else. That is high TSH! Do you see any strong reason for this?

        Adjustment to PHD consisted of
        1)cutting grains,legumes
        2)cutting sugar
        3)Adding Lamb
        4)Adding coconut oil and purified-butter(ghee)
        5)Adding broth(1.25 cups daily)
        6)Adding 2 whole boiled eggs daily
        7)Adding potato
        8)Adding liver weekly

        Also, couple of my relatives and my wife are following PHD and their blood test after 3 months came out good. When I compare mine with their diet, they have yet to add #5,6,8 (from above list). They also consume less #4 than me.

        Therefore, my main suspicion for this high TSH/cholesterol is more(than necessary)portion of #4,5,6,8.
        Is this a possibility? I plan to bring this down without any medication since recent dietary change has clearly triggered this.

        Appreciate your usual feed back.


        • Hi Koosu,

          I think it’s probably Hashimoto’s and what happened is that you have an infection with a Hashimoto’s-causing bacteria and when you started eating more red meat autoantibody production flared up.

          So, although the foods you eat would be great for most people, you may need to switch away from beef/lamb/pork and toward seafood, fresh water fish, chicken, and duck. Switch your liver to chicken liver, your broth to chicken feet stock, cut down on the butter and lamb.

          • Paul, I would be really interested to know how to tell if you have a Hashi’s-causing bacteria. How would this be diagnosed? And would it be treated with antibiotics?

          • That makes sense Paul. Will keep you posted on progress. Thanks for your time.

          • Paul,

            If you refer back to my correspondence, after following PHD for 7 months, My Total cholesterol and TSH became way too high

            than my original normal levels. i.e Total cholesterol (338) and TSH ( 20).

            It has been since 4 months and I got my latest blood test results yesterday. I am glad to mention that total cholesterol is 280

            and TSH is 10

            As per your suggestion, I made adjustmentments to the PHD diet for the last 4 months as follows:

            Replaced red-meat with chicken ( and some more fish than before)
            reduced fat intake ( may be by half –> I was probably having too much fat before)
            Reduced egg intake (this is just for this period only)
            Stopped read-meat broth (this is just for this period only)

            another note: my “Hashimoto’s autoantibodies” was in normal range even in my last blood test

            I Will continue with this adjustments until everything becomes normal and start adding broth and eggs back into diet.

            Will keep you posted.

            Thanks for all the work you do.

            – Koosu

          • Hi Koosu,

            I think if you treat your hypothyroidism with levothyroxine, to bring TSH down to about 2, your cholesterol will normalize immediately and your recovery from the hypothyroidism will proceed faster.

            Best, Paul

          • Thanks Paul, happy Christmas & New Year!!

  26. Hi Paul! When I was diagnosed with Hashimoto and celiac about 10 years ago the dr I had then told me to avoid iodine, so since then I don’t go out of my way to take it, like in a pill. They even told me to avoid sushi. Was that an old way of thinking? I don’t like to mess with meds so I just take my little .88 synthroid every day and go on.. I don’t even know if I should try to go off of it. This world of wellness gets so complicated. My biggest complaint is I run out of energy sometimes. I stopped trying to be a hero in the gym at 61 and I am doing more walking now. I would like to try eating beans to get resistant starch but Im kind of afraid of them. What is your opinion of taking the Bobs red Mill potato starch? Also do you think inulin is ok? Thank you!! 😎

    • Hi Nancy, yes, I think that’s mistaken. You can compound the hypothyroidism with iodine deficiency. … You should test different doses of synthyroid, as you heal you’ll need less. … I would eat soaked and pressure cooked beans before Bob’s Red Mill potato starch (sorry bob).

    • Someone on this blog research Eden’s canned beans and said they were properly (according to PHD) soaked and pressure cooked. Would be a time saver. Their cans also have no BPA.

      • Hi Paul, like Nancy I also have Hashi’s (never been medicated) and am a little fearful of the whole iodine thing, particularly after reading Dr. Datis Kharazzian’s book. I also have a largish thyroid nodule that I don’t want to grow any more! I’m scared of 2 things: the iodine damaging my thyroid and exacerbating Hashi’s and not being able to get the iodine and co-factor balance correct. I’ve done an iodine loading test in the past and that made me feel worse but it did show a slight lack of iodine although I don’t know how accurate it is. Thanks Paul!

        • Hi Kim,

          Does your nodule produce excess thyroid hormone when you take iodine? If so then you’ll have to avoid it. Otherwise, a low daily dose of iodine, around the RDA, should support thyroid function and healing. Do avoid very high doses.

  27. Hello Paul,
    Is black eye pea considered safe or are you referring only to green peas? Thanks

  28. Thank you Paul!! I will try beans! Also I think I have a brilliant idea! What do you think of eating baby food sweet potato occasionally for resistant starch also? Wouldn’t that be super convenient and easy??

  29. Is this diet good for those who have ankylosing spondylitis? Also, are almonds and pumpkin seeds safe to eat?

  30. Haha Paul so true!! What was I thinking? I never fed my babies baby food either I always made it myself! And that was 28 years ago 😆 I guess I will have to get a rice cooker and go back to cold rice with kimchi!!

  31. Hi all,

    I just wanted to share with you this piece of research:

    I tend to eat much more fruit than what PHD recommends (I just love it) and I am afraid of becoming diabetic overtime. Perhaps having 500mg of quercetin with my fruit could offset the negative effects of too much fructose/glucose? What are your thoughts about it?

  32. I had been doing paleo for several months, but until I bought your book… something was missing. I have found that the “something” was safe starches. I am now following the basic tenets of PHD – 3 egg yolks, 10 ounces of protein (beef and chicken… sometimes shrimp), about 10 – 14 ounces of safe starches (baked potatoes and winter squash… sometimes white rice), about 10 ounces of hearty vegetables (1 fruit and some steamed carrots)and a small quantity of other vegetables (maybe steamed cabbage or broccoli/cauliflower or a salad with lettuce, peppers, mushrooms, cucumber). I have 1 1/2 TB of butter on my potato and usually use another TB of butter in cooking. I do not eat liver or fermented vegetables. I take a multi-vitamin/minerals (Centrum Silver) and K2, magnesium and C. I get vitamin D from sunshine.

    However, I need to lose 50 lbs. Although I feel great on PHD, I am not losing weight with the quantities that I mentioned above. I walk about 15 minutes per day and do pilates for 1 hour 3 times per week. I am 70 years young.

    Where do I cut to lose weight? Protein? Fat? Safe starches? Or should I cut proportionally across all categories.

    I am looking for a slow gradual weight loss. It took me 10 years to put on the excess 50 lbs. I want to lose it slowly and gradually in a healthy way.


    • Hey Susan,

      You should search the site for “weight loss” and you’ll find a lot of great info, but generally Paul and Shou-Ching recommend cutting your calories from fat when you’re trying to lose weight. You still need to get the recommended daily protein and carbs. Don’t stop eating egg yolks. And make sure your circadian rhythms are good. Bone broth soups are great for weight loss on this diet.

  33. Thanks a lot Paul. Your advice is always invaluable!!

  34. What should the macros be for a 2800 calorie diet?

  35. I love this page!! Everyone is so helpful and the focus is always on wellness. Everything else I read says to not eat starchy carbs and when I tried that I felt terrible. I wish I could do bone broth. I want to get an instant pot so the house won’t smell while I’m making it. No one in my family wants me to try to make it anymore because of that, and also I can’t make it taste good… Anyway Im trying. I am avoiding beef bones due to Hashimotos. I’m limiting beef to an occasional bacon cheeseburger but thats it. I grew up in a Jewish household so chicken soup was the big thing anyway. I am on the road to looking better and feeling even better so anyway I’m happy! 🙂

    • Hi Nancy
      Bone broth is not going to taste good by itself – it’s just boiled bones after all. Use it as the base for soup stock and then you’ll be set.
      Good luck.

    • Nancy,
      See if the smell improves by doing one of the following before making the broth: Either spread the bones/tendons/stuff on a roasting pan and stick it in a very very hot oven for 10 minutes before putting it into the stock pot, OR add them to a boiling pot of water for up to 10 minutes, drain, and start over with new water.

      I think it smells and tastes much better. And I disagree with our friend PeterC, in that if the broth is boiled with a few vegetables and then salted well i find it delicious. Cooking it with onions and carrots, etc, also somehow frees up more of the bone nutrients.

      But in my dreams I have an outdoor kitchen for cooking tasks that overpower the household.

      I’ve noticed Instant Pot price has been dropping on Amazon lately.

      • I think you’re agreeing with me, not disagreeing. To me, the broth is just the boiled bones. If you put stuff in it, it’s soup stock or possibly even soup. Boiled bones by themselves are going to smell like boiled bones.

    • Nancy, when you said that the house smells bad and the broth tastes bad, did you mean beef broth or chicken broth? In either case, it should not!!! I’m a huge believer in making things the most healthy way, but if it is not DELICIOUS, then what’s the point? Friends and family rave about the flavor of my stock, even when it’s reheated with a pinch of salt.

      My 91 YO mother, who recently began suffering from depression and anxiety, drinks several cups of mine a day, and began drinking it when she was finding it difficult to swallow any food or water. At first he gave it a few trial sips, proclaimed that it was “utterly delicious”, proceeded to guzzle down the whole mug and asked for a refill. She’s been drinking several cups a day for weeks now and always asks when I’m bringing her more. And now she’s back to eating and drinking with ease at her prior levels.

      IMO, that’s how good it should taste and how healthy it should be. Otherwise, why put in all of the effort?

      SO….I follow Russ Crandall’s approach (the long-hand stovetop versions on his website, not his book). He follows PHD, but he’s also a great international chef, and his attitude about food and the gastronomic joy it should should bring is aligns with mine. For beef bone broth, he roasts his bones (and MEATY bones) and vegetables first for about 45 min, then makes the stock. I wrote to him before using his recipe because like yours, my first batch did not smell or taste good either, so I’d previously been turned off and given up. But he told me that for best flavor, to use some meat/meaty bones during the roasting and for the first 1-2 hours of simmering. Also, I use a whole bunch of aromatic herbs, spices and veggies. (Veggies are only a problem if you plan to store your broth in the fridge for more than a few days. I chill it overnight and then transfer to silicone ice cube trays and then to freezer bags, so all of my long-term storage is in the freezer, thus veggies are not a problem.)

      I won’t write out here all of my mods to his beef broth recipe, but I agree with him that 2 lb of meaty bones like cross-cut shank and meaty ribs, or oxtail are imperative for best flavor. After roasting and ~ 2 hrs of simmering, if you remove them to the fridge (to reuse for successive stock rounds with the same bones) or if you’re not making more rounds with the bones, then strip them of the meat and put it in the fridge and return the bones to the pot for the cooking duration. After just 1 use, the meat is still delicious for eating in a quick stew, etc. I’ll also mention that I skim all the fat off of my broth. IMO, it smells and tastes horrid, so I only use purely skimmed broth.

      Here’s his recipe for chicken stock, and I do everything as he describes, with all of the same ingredients with these exceptions:

      1) 1-2 organic carcasses, or purchased backs and necks, skin included. (IOW, I never use a whole fresh chicken). Whenever I make whole or chicken parts, after cooking I strip the bones and skin and freeze them for stock. (I do this with beef and lamb too.) Skin has tons of matrix in it. (My strong preference is for pastured and heritage breed birds, if available. They have much stronger bones and matrix, so the health benefits are very compounded. Your broth will be like hard jello!)
      2) 2-3 organic chicken feet per batch, if I have them. I don’t clip off the talons because the membrane totally encases them and when it’s removed, you’re left with a pristine talon.
      3) Omit garlic, but include a few thick slices of organic ginger root, if you have it on hand – it makes for a really delicious stock, but it does not taste like ginger. Not a deal breaker, but a nice tweak.
      4) Same as for the beef broth, I add all of the herbs and peppercorns, after the boil and de-scum process to make the scum removal quicker/easier.
      5) Yes, he’s right: 24 hrs will make for the most delicious stock. But from a maximum health standpoint 6-8 hrs is the maximum (according to Sally Fallon’s broth book); otherwise, you’re breaking down the gelatin too much which isn’t as beneficial. I usually go for 8 hrs, sometimes longer if I want it super rich, like for gravies, sauces.

      I plan to purchase an IP to speed up the process, so I haven’t experimented with best flavor yet, using that method. I’ve been waiting for the Bluetooth re-release, but it just got recalled (!!!) so I’ll probably break down and buy the low-tech version.

      Best of luck! It’s really worth giving it another try!

      • All I can say is…Thank You Susan and PeterC!! I can’t do beef but will try your suggestions for the chicken! I think bone broth is just chicken stock with cider vinegar in it and I agree that if its not delicious, whats the point!!!!

        • You’re welcome Nancy! Two other fine points on chicken stock making:

          1) According to Sally Fallon & Dr. Daniel’s book “Nourishing Broth”, you should heat up the stock on medium heat and when it just starts to begin to boil, you should reduce is to a very low simmer, so that it’s just gently bubbling. I do that until I’ve removed the majority of the scum, then I reduce it a little more so that the bubbles come up singly (i.e., not a rolling simmer). This takes some fine tuning with the burner over the course of cooking. This is all to preserve the integrity of the gelatin. (IOW, they say you should never boil it.)

          2) Similar to my beef broth, I remove all of the fat that floats to the top after refrigeration. I cool my stock slightly on the stove, then strain through cheesecloth and transfer to mason jars, just like Russ shows on his website. When cool enough to refrigerate, I do so overnight. Then the next day I run a knife around the circumference of the jar and lift out the plate of fat with whatever utensils work best. I’m not fat phobic, but the residual fat doesn’t taste great and looks ghastly.

          BTW, their broth book is excellent for explaining the science and health benefits and best practices of broth making, so I use it mainly for understanding technique and the reasons behind them. But IMO my broth ingredients (Russ’ recipes, tweaked) result in better tasting broth.

  36. Thank you Susan! I’m going to look for that book. Its hot here in North Carolina now so I’m going to wait till it cools off to start cooking. I never did much cooking growing up so this will be a new adventure! Now that I’m Celiac I don’t like to go out much and my ‘fast food’ is an apple or sliced chicken or turkey but I do like kimchee and slowly but surely I will get this all in place! I appreciate all the help! Where do you live, if you’re close by lets cook! 🙂

    • You’re welcome, Nancy! I live in the SF Bay Area. While we aren’t as hot or humid as NC, I don’t like turning on the stove or oven this time of year either.
      That’s why I’m getting an Instant Pot, and you should too! With chicken stock (since there’s no searing involved) it’s just a one step process in that marvelous appliance.

      • Susan when you get one please send me the link! Im looking for a good price. Ill probably get it next month!! Will the recipes in the book you recommended work with the pot? Im going to the bookstore today! Its going to be 97 here today, so Im getting out early! SF Bay? Great i’ve always wanted to visit there!! 😆

        • Nancy, to my knowledge, the sole US distributor is Amazon. Their price is around $132 which is substantially lower than it used to be. About 6 weeks ago is was on their “daily deals” page for around $115, and that’s the very lowest I’ve seen it. I suspect that was because the new Bluetooth model was set to launch a few days later, so they wanted to clear some inventory. But I doubt we’ll see a discount like that again, so I’d just go ahead and take the plunge. You should get the DUO60 7-in-1 (Programmable 6 qt):

          Any of the recipes in the book that call for a slow cooker will work on the slow cooker setting without even having to think. BTW, the book is on Amazon which is probably the lowest price. Any of the other recipes in the book can be made in it too, using a combination of settings.

          I believe that the Jaminets and Russ have been making high pressure broth lately using the Instant Pot, which obviously takes much less time to make. From what I can tell, Sally Fallon is not a fan of this method, so there isn’t an emphasis on high pressure cooking in the book. Opinions differ on high pressure. I believe that the Jaminets say that if you follow their method, there will still be adequate health benefits. But again, I’m into flavor as much as health benefits, and not having tried that method, I don’t know how the taste compares.

          Also, remember that I’m not recommending the book for recipes, but rather for information about science, health and technique. You can absolutely use the recipe that I gave you for my chicken stock (Russ’ recipe with my tweaks) or Russ’ recipe straight up on his website. These will result in great flavor and ready to drink stock (or as PeterC calls it: soup).

  37. Thank you so much Susan! I have never done much food prep in my life other than veggies. I was in the Army so I always ate the food in the mess hall (before I was diagnosed celiac) After that it was always fast food or someone else did the meat. So its weird for me to think about pigs feet and animal parts and heads and necks. I am a little squeamish. But I know all chefs deal with it so I have to get over it because I am devoted to wellness, and flavor of course! Reading up on it is a great start and I love the book!

  38. Bradely Hasse

    Paul, I am working on a wellness program. Do you have a policy on using the PHD recommendations and food plate? I would like to share the PHD with the class. I would credit you of course.

  39. Paul,

    I heard you in a recent podcast and it seems that you have changed your stance on legumes (or at least softened it). Your diet schematic has them in the Do Not Eat category but you talked about eating them being alright if they are properly soaked/prepared.

    I have followed your diet recommendations for some time now but I’ve recently been convinced by the arguments of Chris Kresser and Angelo Coppola that legumes OK and are indeed proper elements of a healthful diet, as evidenced by the presence in many of the Blue Zone dietary patterns. That even though they have toxic elements on a reductionist view of them, that in practice (given proper preparation) they are not harmful. And that many of those elements are actually helpful to us in small doses (i.e. hormesis, and who knows what ways). And, not least, that they are quite beneficial to our gut microbiome.

    Of course this depends on individual tolerance.

    I wonder if you’re planning to write a post clarifying your position on this issue as I think there’s a lot of interest, and probably some confusion resulting from the difference between your book/website and your recent comments. I would sure feel better having your advice align with Kresser and the evidence that Angelo has put forth, but of course I want you to call it as you see it.

    • Hi Nathan,

      We’re using the writing of our cookbook as an opportunity to revisit all these issues and we’ll figure out how to publish updated recommendations when that is done.

      • I think it would also be interesting if you included more recommendations, where applicable, for people who don’t follow the your diet guidlines completely.

        That sounds odd, but here’s what I mean:
        For example take vegetarians, or people who have a lower fat intake, or people who eat a small breakfast instead of IF, or even people who eat a breakfast that is as large as their lunch or dinner…

        Perhaps there are some general “good practices” that these people would do well to be aware of, given their alterations of your template.

    • Yes, I didn’t read the whole thing but enough to get the gist. It is typical of CarbSane. We present a simple syllogism:
      – Our brains evolved to benefit us; what they drive us to do is probably good for us, at least if we are living within an ancestral template (e.g. natural whole foods diet).
      – The brain generally likes to eat a diet that is about 50% fat.

      Both of these are true. The latter point is why Doritos are 50% fat. CarbSane’s post doesn’t refute either of these. She shows a figure from our cite supporting point 2, from 12 mouse strains that preferred 30% to 80% fat, with median close to PHD fat recommendations. And then she goes off on a tangent, whether the mice like food so much that they overeat it and get fat. That’s not relevant because many factors play into obesity and lab mice in shoebox cages and unnatural environments eating unnatural purified nutrient pelleted diets are not living “ancestrally.”

      Recent studies have demonstrated that mice respond totally differently to natural whole foods diets compared to purified nutrient pelleted diets of the same macronutrient composition. So the point CarbSane tries to make is unsupported.

  40. Hi Paul,

    I had wondered if you noticed this article from Calories Proper back in February:

    For best entrainment eating a meal with light on-set after the longest fasting period is best?

    • Yes, I saw that post, but I didn’t see that any of the papers cited supported the eating at light onset prescription. It seems to me that as long as you don’t eat at night and concentrate food intake in the afternoon, the food clock will sync up to the light clock.

  41. Thanks for the quick response, Paul. I have your book and enjoy reading it. You are my go to resource when I see conflicting information.

    This is a totally different question that I hope you will have time for. In your book you give 3 sources of ill health: toxins, infections, nutrient deficiency. Where does sleep apnea fit into that? And do you think it is reversible? I have searched your site and book and cannot find much about it. There was one incidental comment under vitamin C supplementation where you call it an ‘oxidative stress disorder’. I wasn’t sure if that was the cause or the effect. Any information is greatly appreciated. I really don’t won’t to be on a cpap forever. Thanks.

  42. Hi Paul! I am going to the next retreat! I am feeling good and I can’t wait to feel even better! Thank you for all you do! I hope its in NC again because I live here in Greensboro, even though Im from Miami I think the beaches here are beautiful, and the mountains too 🙂

  43. Yay!!! Thank you!! Me too! I’m going to get a friend to come hopefully, I have told him all about you and he wants to be healthy too!! As soon as you have the dates I am signing up!

  44. Hi Paul,

    I recently added what I eat in a typical day into the nutritiondata tracker to see if I am getting my micros and what not.

    I was baffled to find that my omega 3 to 6 ratio was way out of whack. According to the website, the omega 6 content of all the food I eat in a day equates to 15g and the omega 3 only 3g. So, a 1:5 ratio. Not great considering I eat half a can of wild salmon every day, and I was thinking that might be excessive.

    How could this be? I follow the PHD, I don’t even eat nuts or seeds. I usually have 2 Tbsp of Olive Oil on a salad but that can’t account for such a high ratio. Robb Wolf recommends olive oil as a good fat to cook with so how can his diet have a 1:3 ratio?

    I know this is probably a difficult question to answer without me listing everything I eat but this can’t be right at all.

    Is the USDA website wrong with regard to omega3/6 content of foods? If so, how can it be trusted for nutritional content of anything?

    • Same thing happens to me when I look at the data by using Cron-o-meter! I use only coconut oil, olive oil, butter; homemade mayo. Salmon, sardines, albacore tuna, grassfed beef, pastured eggs. I go light on almonds & other nuts.

      • Well I’m not sure about cron-o-meter, but I know nutritiondata doesn’t have separate profiles for grass-fed and grain fed meat/dairy products, so maybe that’s the issue.

        Totaling all of the omega 6 from beef, yogurt and butter that I had included in my daily plan, I got 2g. So, converting all of the omega 6 from the meat/dairy I was eating in a my daily plan and assuming grass-fed products are 1:1 ratio of omega 3 to 6 (I can’t remember the exact ratio offhand), that’s 13g omega 6(15g – 3g)and 5g omega 3 (3g + 2g), which gives a ratio of roughly 1:3.

        I didn’t realise the importance of animal product quality to be honest. I just thought as long as I eat paleo foods then everything should be all right. Anyway, I think all of the beef is grass fed in the UK, even the meat in the supermarket, so I’m thankful for that.

        Also, Eggs seem quite high in omega 6. 500 mg more of omega 6 than omega 3 per egg according to nutrition data. So, after 3 eggs you’re already 1.5g up on omega 6 compared to omega 3 😯 . Maybe I’ll start going for those omega 3 enriched eggs.

        • Whoops, I meant 15g – 2g not 15g – 3g in my calculation. I think the imbalance of PUFA’s is killing my brain function. Anyway, I’m away to eat some grass. Gotta get them omega 3’s!

          • Nutritiondata actually does have a couple grass-fed beef and bison entries, but with ω6:ω3 ratios of 3.8:1, 4.9:1 and 6.9:1, they don’t seem likely to be 100% grass-fed. Ted Slanker provides two analyses of his beef which list ratios of 1.86:1 and 0.89:1, and I turned the latter into this Nutritiondata item. Using that (and lots of it) as my main source of fat and eating plenty of seafood, I generally end up around 2:1 ω6:ω3 when I add everything up—but I eat somewhere between PHD and Bulletproof recommendations (example analysis).

            Here are some opinions for and against omega-3 eggs. I personally consider pastured eggs the best choice.

        • And I seem to recall that Paul said they just eat regular / conventionally raised beef? (at least in his first book?)

    • Hi Iain,

      That’s fairly normal. We aim for 3:1 or 4:1 omega-6:omega-3 but 5:1 is fine if levels are not high. The omega-6 is almost all linoleic acid so not very unsaturated, while the omega-3 is more highly unsaturated, so in terms of health impact, the omega-3 packs more of a wallop.

    • That 5:1 figure is still way better than the typical SAD person’s 20…50:1 omega-6:omega-3 ratio. However, if you are still worried, you can always take a teaspoon of cod liver oil (fermented or not) a day to improve your PUFA proportions.

  45. How about organic 100% Maple Syrup?? is it safe or not for perfect health diet?

  46. I read that only certain types of white rice form resistant starch. I am only eating white jasmine rice due to SIBO. I cook it, cool it and then puree it and bake into a “bread.” Will that contain resistant starch? I usually eat it either cooled or even frozen after it is baked.

  47. After being on a zero carb diet for nearly two years, I fear I have trashed my health so much more than it was before I did the low carb diet. I’ve been desperately trying to add in some carbs following the PHD, but I am really struggling. I do believe I have SIBO, so I don’t know if that’s the problem, but even with adding in just a tablespoon of white jasmine rice daily I am getting frequent, excessive urination with incomplete emptying of my bladder. I also find that my urine has a “rice smell” to it. What could be causing this?!

    • BJ, I don’t have a hard answer for you, but a while ago I was in a very similar situation—SIBO with chronic constipation after going VLC for too long and then contracting salmonella. There were a few times when I was so bloated, the pressure on my bladder made it feel like it wasn’t empty when it was. But jasmine rice was the first carb I reintroduced without problems. The quick digestibility due to its lack of resistant starch is what makes it theoretically safer for SIBO. If you’re reacting to it, your SIBO may be too high up, and you might need to start with a course of antimicrobial(s)—I recommend finding an experienced practitioner to help you with this you can. My only other suggestion is to try a small amount (maybe a quarter teaspoon, and work your way up if it goes well) of unmodified potato starch in a glass of water on an empty stomach—since it is almost all resistant starch, there is thought that it might make it further down the intestines before being broken down by bacteria, potentially carrying some of the SIBO with it.

      • *with this if you can.

        Also if you haven’t tried the jasmine rice freshly cooked, it’s possible that it is forming some resistant starch when you cool it (I haven’t seen data on this), and that could be why you’re reacting. (Eating it cold/frozen is also probably a bad idea because it’ll take longer to digest.)

        • Thank you so much Frasier Linde for all that information. I have mostly been cooking/cooling the rice. In fact, I puree it and bake it into a “bread.,” so I have something portable to take with me at times. Perhaps that’s the problem.

          I will try making it fresh always and seeing how that goes. I did try very small amounts – 1/4 tsp or so of potato starch previously and that caused major bloating, gas and my body would just burn up as if I had a terrible fever. This happens quite often when I try to eat new foods.

    • 1) Have you tried white potatoes (white, meaning anything other than sweet or yams?? I have SIBO, and do great on them, although we’re all different.
      2) PHD says to add plenty of fat and acid to rice or potatoes, and one reason is that it dramatically reduces the glycemic index. Are you spreading plenty of butter (or another high fat spread) on the bread before eating it. You might also make sure that you’re eating it together with some leafy greens with lemon juice squeezed on it and some protein, again to level the blood sugar hit among other things. Frequent urination can be a sign of several things — blood sugar issues is one. It seems like some people who have been very low carb for a long time can’t handle carb all of a sudden when they add them back in (Jimmy Moore’s tale of woes on his blog, etc). You might also checkout which foods that you’re consuming are considered diuretics. It sounds like this is a new phenomena that began with rice consumption, but it’s also possible that it’s unrelated. For instance, I use a lot of lemon juice on my salads, meals, in water, and it is a diuretic, and there are many others like coffee, etc. And in my experience they can lead to frequent urination.

      • Thanks for all your suggestions Susan. I will try to respond as follows:

        1. I haven’t yet tried white potatoes. Most are very high in oxalates and I have issues tolerating both oxalates and salicylates, so this really makes it difficult to find veggies that work. I did see that some types of potatoes may work though, so I will give them a try if I can find them. My other fear is nightshades. I’ve always been told to stay away from them due to my compromised gut.

        2. I do add lemon juice to my main meal where I eat the rice. I eat as much fat as I can tolerate, but right now I cannot digest fat at all and end up with gallstones and major pain even when taking ox bile and a gallbladder herbal formula!

        I will have to look into Jimmy Moore’s tale. I haven’t yet done that. I worry about my blood sugar because I do get quite jittery sometimes after having the rice, but I notice this will happen even with one bite sometimes and then sometimes not! I just can’t quite figure it out. I also had my blood glucose levels checked previously before/after eating and they were within the normal range.

        My doctor just ordered more glucose and insulin tests, so I’ll see what those show.

  48. Good Day, Paul

    What is your view on dinner cancelling? This method is quite popular in old classic German diet books. According to which, dinner cancelling stimulates the nightly production of somatropin and melatonin. It is said that these hormones have the ability to delay or slow down the biological aging process.

    And if that is true, what is the latest one should stop eating? Not eating after 3 or 5 pm sounds very impractical

    • Hi Alyona,

      Intermittent fasting, confining food intake to an 8 hour or shorter window in the daytime, is one of the best things you can do for health and for weight loss.

      I recommend setting up a 12 hour personal day, and having a feeding window that starts 3 hours into the day and ends 1 hour before its conclusion. So if your day is 7 am to 7 pm, eat 10 am to 6 pm.

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