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 ?

3,820 Comments.

  1. I have found a pasta that is made from rice flour – is this suitable for the diet guidelines ?
    Also how many calories per day should I be having and what example of a daily menu could you give me
    Thank you

    • Hi Sharon,

      Yes, flour-based products from rice, potato, tapioca, and buckwheat are permissible on PHD.

      Calories per day is variable depending on the person. We recommend doing intermittent fasting (16 hour fast/8 hour feeding window) and eating enough so that you are only mildly hungry at the end of the fast.

      A meal plan is in the book.

      Best, Paul

  2. Hi Paul! I was wondering about something pertaining to the fast. I have always worked out with weights in the morning on an empty stomach (fasting) but now I am walking in the mornings, like 3 to 4 miles, and then going to the gym. I tried to do it all on black coffee but I feel better with a little cream so I have energy for the weights. So my question is, should I just do the fasting on the days I don’t go to the gym after walking? Thank you!!!

    • Hi Nancy,

      What I would do is eat a small bit of meat and a small potato just before the start of the gym workout and after walking. That should do more for you than the cream in terms of helping you work out and triggering a good response to exercise.

  3. One more question… I have heard that post menopausal women are more insulin resistant and carb sensitive, so they should cut out carbs. I know you say to have starches, and I feel better eating them, but I just was wondering what your opinion was of that idea? I have def gained some weight and inches since getting older but maybe if I could just stop the potato chips I wouldn’t have to worry!!!

    • Gaining a bit of weight as you get older is normal, but it sounds like you have some tweaks available. I wouldn’t cut starches, but you should have starches in the form of natural whole foods at meals, not potato chips between meals. Good snacks are fruit, vegetables, nuts, and chocolate.

  4. Why is white rice specified. Is there a problem with brown rice and brown rice flour products?

  5. Thank you so much Paul!! I was thinking maybe a half of a sandwich on rice bread would be easy to pack in the morning if I can’t do potato? I can’t wait to try this! I know I shouldn’t eat the chips but I just get cravings for them sometimes, not sure if its the salt or the crunch.. anyway I got some olives to try as a replacement! Thanks again 🙂

    • When I’m missing something crunchy, I eat no name white rice crackers – 14 have 60 calories. $1 a package! Not the best, but better than potato chips!! 🙂

      • My son-in-law describes rice cakes as cardboard that has gone bad, but with enough butter or cream cheese or egg salad … one can even learn to like it. 😕

        Please what are no name white rice crackers – 14 have 60 calories and where can I get some?

      • I’m sure no name rice crackers are made from GMO rice though. I’d prefer to eat a few Jackson’s coconut oil, organic, GMO free potato chips over those.
        http://www.honestchips.com/our-story

        • I live in Canada / Toronto area. I get them at most grocery store. GMO for sure is my guess – certain no health food! 🙂 I rarely eat my non-GMO avocado oil sea salt potato chips (love them) because of the calories though. I gain weight on 1200 a day. The rice crackers are my compromise :). I have trouble stopping with ‘a few’ potato chips!

  6. Hey Nancy, I recently discovered sprouted pumpkin seeds. A couple of different companies make them and my local Whole Foods carries both brands. They’re sprouted with a tiny bit of sea salt. They have a lovely salty-but just the right amount of salty-flavor and great crunch. A tablespoon or two would be yummy as a snack…just a thought! (I sprinkle a tiny bit on salads for that great crunchy texture and bit of salt.)

  7. Hi Paul,

    The latest food plate looks splendid! Both visually and in how clearly it conveys information.

    I noticed that your recommendations for meat, fish, and eggs increased from a min. of 0.5 pounds to 0.7 pounds.

    I’d be curious to know why.

    • Hi Jack,

      These quantities are for a 2000 calorie reference diet, so a petite woman eating 1500 calories per day would still eat less, 0.5 lb would be a good target…. It doesn’t represent a change in our recommendations, more an attempt at greater consistency, since the starch recommendations were based on a 2000 calorie reference diet.

      • Paul,

        In general is it ok to take all the recommended supplements at anytime? I take thyroid meds in the morning with selenium and iodine. And the others I take all at once with a meal.

        Also, I recently had female hormones tested and my estiadol was normal, but for 42 yrs old, my progesterone and testosterone were a bit low. I am curious on your stance about hormone supplementation?

        Thanks!
        Amy

        • Hi Amy,

          I recommend taking supplements with the lunch.

          I don’t have a position on hormone supplementation. It can help, but I’m not familiar with the pros and cons, so I leave that to the doctors.

          Best, Paul

  8. Hi Paul

    I am 24 year old male from India.

    I was not obese but i wanted to loose some fat so I started on a low carb Paleo approach,

    I lost the fat but also lost muscle mass.

    And i had dry eyes, dry mouth and constipation.
    I came across your article on dry eyes, after that I bought your book and now my diet looks like this.

    After waking up -1 table spoon of honey with warm water

    then some exercise in the sun like walking and sun salutation.

    Breakfast – Lots of Fruits and almonds(Is it okay because in the book u advised not to mix omega 6 and fructose, but i really want to have fruits and almonds).

    Lunch – 3Cheese Omlets cooked in Ghee , mix vegetables cooked in Ghee, Yogurt, Sprouts.

    Dinner – Rice with potato with little Ghee and some leftover vegetables.(Carbs at night for circadian rhythm)

    After dinner – Milk with turmeric,ghee and little sugar.

    The problem is i still get dry eyes once in a while
    I am a student and have to study(brain work) a lot,
    Q1 should i further increase my carbs.?
    Q2 Is my diet okay?

  9. Dear Mr. Paul Jaminet,
    What is your take on Wild Rice (not really rice) and Quinoa? Are these allowed?
    Also you mentioned no Soy at all, but what about Non-GMO Natto and Tempeh?
    Thanks in advance.

  10. Paul,

    What is your opinion of arsenic contamination in white rice? Thank you.

    • Don’t eat rice grown in arsenic-rich soils. Most food rice will be fine. Arsenic may be beneficial in low doses, so small doses are OK. Also mix up your starches. Don’t rely on a single staple crop.

    • To elaborate on Paul’s comment: The soils in the US south (Texas, Arkansas, Louisiana, Mississippi, etc.) are among the most arsenic-rich in the world, so I avoid rice from that region. Rice from California or most locations in Asia is probably fine.

  11. How can I contact someone to find out if there is a Retreat in the future? I see dates that have already passed on the website.
    Thank you.

  12. Love your book. I have a question on safe starches. Do you think there is any benefit to sticking with starches that would be more native to your ancestry? Meaning, rice, tapioca, plantains, etc. would not have been available to my ancestors in Scandinavia and the British Isles. As far as I know, I come from Celtic stock (meaning NW Europe & part of Iberia), and I think they were mainly hunter gatherers. Just an interest of mine. I love food anthropology. Wondered if you have any personal insights. Thanks!

    • Hi Hope, No, I don’t think there is any benefit to eating foods historically specific to your locale. Locally grown organic plants may have beneficial microbes so they would be better for fermentation, but apart from that, foods that are healthful for humans anywhere are healthful for humans everywhere.

  13. Hi Paul!! What is your opinion of using digestive enzymes that are plant based? I heard they are good for you but I don’t know if I need them…

  14. Paul, a silly question, but one that has me intrigued. Have you had your IQ measured? I guess it must be pretty high. Right?

  15. Hi Paul can you please tell me your opinion of using plant based supplemental digestive enzymes? How does a person know if they need them? I have noticed they are added to protein powder but I know you don’t recommend protein powders. But I was still wondering about the enzymes..

  16. Hi Paul,
    I have a question about PHD and “morphotypes”
    (for example the classical types: endomorph, mesomorph, ectomorph; or Hyperlipogenetic, Hypolipolytic or mixed types).
    Some authors focused on circadian rhythm and chronobiology think that the diet should change according to the morphotype (macros ratio, timing et cetera).
    Does in make sense in your opinion?
    This is an example: http://www.the-comdiet.com/morphotype-3/

    I hope that you have time. Thank you!

    • More evidence that the popular idea that you should eat a low-carb diet to “starve” Candida is ill conceived. Fungi do just fine with minimal carbs.

      Regarding human aging, it’s a little misleading. The insulin pathway in yeast duplicated and became both insulin and insulin-like growth factor pathways in humans, and only the insulin-like growth factor pathway (which responds to protein) appears to have the anti-aging effects that the insulin pathway does in yeast. So it’s support for a low protein diet for longevity in humans, not a low-carb diet.

  17. That study doesn’t mention Candida (it’s about brewer’s yeast), but isn’t the starving idea specific to the food of Candida albicans, rather than carbs per se? My wife and I did try to starve Candida of its food and it certainly seemed to work for us. There was no attempt to reduce carbs, per se, or to minimise calorie input (as this study modeled) but to cut out all free sugar.

  18. What are your thoughts on Gluten Free Oatmeal?

  19. Aww what about the plant based digestive enzymes 🙁

  20. Hi Paul, I recently was dx with SIBO and just finished a 2 week course of Rifaximin (550mg 3 x day). My symptoms began to slightly improve the last few days on the drug. I’ve done a lot of reading on diet and supplementation recommendations.

    The further I read the more confused I become! In short: eat fruits – don’t eat fruits, simple sugars for quick absorption – no sugar at all; eat starchy foods – don’t eat starchy foods, take probiotics – don’t take probiotics, fermented foods are good – don’t eat fermented foods, etc, etc, etc! I’m afraid to but anything in my mouth!

    I have been quasi doing the PHD for almost 2 years. Initially I was faithful to all things PHD but didn’t feel a significant benefit (except my reflux greatly improved!) I now know that was probably from ongoing, undiagnosed SIBO. My initial reason for going on the diet was to help neurological and orthopedic problems I have.

    Two things I have been religious about are no grains (except white rice) and no legumes. I also use all the right fats now. My sugar consumption is at least 90% less. I have read your book and many posts here on your website but still am unclear as to how to treat the SIBO. What are your “quick and dirty” recommendations? – if there are such things!

    I trust your information more then that from other sites. It always so honest, unbiased and research based! Thank you, “head spinning and belly aching” Libby.

  21. I think it’s difficult to eat four pounds of food every day.
    I cannot bring myself to eat one pound of chard, or one pound of onion, or half a pound of liver.

    Isn’t this too much food?

  22. Peter,

    Paul recommends only 1/4 lb of liver per week. I only eat a half pound of meat or fish a day, which falls within the guidelines. Of course rice, potatoes, beets, etc should and will weigh more than green leafy veggies. Above all, Paul encourages variety. I would never eat a whole onion unless it was sautéed. It basically boils down to 3/4 plant foods and a quarter meat/fish etc. A normal plate may have a 170 gram potato with butter and a spray of lemon juice, a 1/2 lb piece of salmon, a half cup of carrots and a salad. A very normal meal if you do not over think it. The hardest part for me was doing this 3 times a day, so I typically have yogurt and berries for breakfast. Snack on carrots, I “cheat” and use blue cheese dressing or hummus. And then for lunch a little bit of protein with some rice or potato with sauerkraut and a small salad.

    I hope that helps!

  23. Hi Paul. I love your work and contributions! The diet graphic is so perfect! Thank you! I have been following this diet with one exception for 4 years now. Because I’m 6’3 and very very slim, have an active job as a personal trainer, and 61 years old I find I need more calories to maintain energy and overall health. To that end I soak for 12 hours and then sprout for a brief amount of time; black beans, navy beans, pinto beans, chickpeas, and lentils. I cook in a pressure cooker at high heat for an hour plus, and then use in blended drinks, bone stock soups, etc. I’m hoping to minimize any leptin/lectin issues by the long soaks and brief sprouting. Any thoughts appreciated. So far I’ve been doing great.

    • Hi Steve,

      As long as they are soaked and well cooked in a pressure cooker, I think they are fine. I would try to find dehulled beans, that would be my only modification to what you are doing.

      Best, Paul

  24. unhulled! I hate auto correct!

    • You might look at Blue Mountain Organic’s website. I was on it the other day and noticed that they sell sprouted EVERYTHING it seemed — all beans, nuts, seeds, grains and pseudo grains and their flours, and I think the beans were de hulled too. Prices seemed reasonable, especially considering organic and the time savings. The shipping is costly though, because they use FedEx, so I haven’t ordered anything yet.

  25. Hi Peter,

    I am thinking about doing a LCHF diet without going into ketosis. The thing is that I am really skinny, 5’10/119lbs! So I think I need to at least eat 3000 k cals a day. I am thinking about having my macro as 75% from fat/10% from protein/15% from safe carbs so eating about 250g fat/80protein/110carbs. The thing is that I do not think I can not tolerate white rice or white potatoes well so I will be getting my carbs from sweet potatoes, green veggies and berries. Of course all organic. Does this sound reasonable? I am asking because I heard that high fat without being ketosis can be harmful or even with a moderate carb intake?

    I want to eat a moderate amount of protein because a couple of years back I went on a paleo/high protein diet and I developed symptoms that resembled kidney/liver damage. Frequent urination, erectile dysfunction(at the age of 23!) ,loss of hair, voice change, and fatigue. I know I ate way to much protein, mostly ground beef, eggs, nuts and bacon with very little carbs and other fats. Do you have any idea on what might of have happened? I think I ate too much protein and damaged my kidneys, even though all my tests came back normal. Slowly things are getting better.

    I will also be trying out antibiotics later on down the road because I have neuro/psycho symptoms like paresthesia, cognitive impairment, paranoia, ocd and vision problems.

    If you could help it would be much appreciated!

    • “Frequent urination, erectile dysfunction(at the age of 23!), loss of hair, voice change, and fatigue. […] mostly ground beef, eggs, nuts and bacon with very little carbs and other fats.” I would guess too little carbs from this, especially if your liver and kidney markers tested normal.

      My questions for you: Why LFHC, and why without ketosis? What makes you think you don’t tolerate white rice or potatoes?

    • “Frequent urination, erectile dysfunction(at the age of 23!), loss of hair, voice change, and fatigue. […] mostly ground beef, eggs, nuts and bacon with very little carbs and other fats.” I would guess too little carbs from this, especially if your liver and kidney markers tested normal.

      My questions for you: Why LCHF, and why without ketosis? What makes you think you don’t tolerate white rice or potatoes?

    • Hi AD,

      A few questions/comments:

      1. Are you hungry eating less than 3000 calories? Skinny people do not, in general, require more calories than normal-weight people (although there are of course exceptions).

      2. The Perfect Health Diet would generally recommend 30% carbs, not 15% carbs. Also, it is possible that your kidney/liver damage might be due in part to metabolic stress from eating too few carbs (which requires the liver to manufacture carbs from protein, and the kidneys to dispose of the resulting waste products). So, if I were in your position, I would eat more carbs.

      3. Sweet potatoes, berries, and vegetables are all deceptively-low in carbs. To get 30% of a 2000-calorie diet from net carbs (not including fiber or carbs used up by the digestive process), you would need to eat around 2 pounds of sweet potatoes every day (in addition to some berries and vegetables); for a 3000-calorie diet, around 3 pounds.

      4. Could you tolerate taro? That would make it easier to get more carbs.

      Best,
      -Eric

  26. Thanks for tip Susan!

  27. How good is kefir as a source of carbs? I know potatoes or rice are much preferable, but I like kefir so much that I drink it in large quantities and not always leave “space” for rice or potatoes…

    • I think the carb content of kefir is likely zero because the bacteria consumes the sugars to produce lactic acid. Anyway, carbs from dairy products are not a good source because lactose is not digested unless your body produces the lactase enzyme, which it probably doesn’t unless you are from the Netherlands perhaps.

  28. Netherlands? Please ‘splain.

    Pretty soon Paul will need to rewrite his book for us non-pop-culture savvy / non-scientific types.

    • A high percentage of people from Nordic and Scandinavian regions produce the lactase enzyme which is needed to fully digest lactose, the sugar in milk. This is probably due to milk being a stable in the traditional diet of these populations.

      Don’t quote me on that though. I can’t remember exactly where I read it, but I’m sure it was in one of the main paleo books. Maybe it was in the PHD.

      Fermented milk products e.g. cheese, kefir, yogurt, should be ok since the sugars are converted by the bacteria to acid, but you won’t be getting any carbs from them.

  29. I’ve heard or read the same thing. As a genetic group, something like 85% of them produce the enzyme, vs 25% or less for most other genetic groups. Don’t quote me on those figures, though…it’s just the gist of what I heard or read. I don’t think they are the only genetic group with high lactase, there might be a few others, but the Nordics seemed to be the largest group.

    But as I understand it, regardless of what we came into the world with, our lactase production typically declines with age (along with many other things).

  30. Hello Paul
    If you can find the time can you give your opinion on the amount of calcium in bone broth as some are stating that far less calcium is found in the broth than was first expected.
    Thankyou Marcus

  31. I understand that parboiled rice has less starch (and therefore carbs) than regular white rice. But does anyone know the proportions? 1/2 as much? 1/3 as much?

  32. I just finished reading the book and I’m excited to try the PHD out and see if I too experience the wonderful benefits. I have a few specific questions, though. The food plate lists most but not all foods, so I’m not sure where some foods fall in the categories. Specifically, how much fermented dairy (yogurt, kefir, buttermilk, sour cream) would be acceptable, and which category does it fall under? What about milk, cheese, and cream cheese? I am putting butter and cream in with the other good fats.

    I also wonder how diligent everyone is about meeting the exact numbers. I have long hated any regimen where I have to weigh things, enter data in a tracker app, or follow menu plans religiously. I’m hoping that by avoiding gluten, unsafe grains, seed oils, beans, and sugar, I can meet most of the guidelines of the PHD. But will I get enough calories, and in the right ratios, if I don’t tally everything?

    • Hi Kelli Mae,

      Foods like yogurt or milk are fairly complete foods so they basically just reduce the quantity of other food you eat, without affecting proportions. Butter, cream, and sour cream count as fats and should fit in the 2-4 tablespoons per day rule for flavoring and cooking fats.

      There’s no need to enter data in a tracking app. Just eat roughly equal proportions of meat/fish, starches, sweet plants, and veggies (a little lighter on the meat than the other three), and flavor to taste. Do intermittent fasting; eat enough that you are not more than mildly hungry at the end of the next day’s fast.

      Best, Paul

  33. Can people who are on the PHD share their experiences at the very beginning? Did you feel “off” for a few days as your body started getting less carbs, or did you feel great right away? Did you track everything or just avoid certain foods? What did you add in that made you feel great? Were there any foods you felt like you were eating more of than you thought you would in the beginning? I’m JUST starting out and I’d like to have some shared experiences to compare mine to 🙂

  34. can you explain your reasoning for advising against eat legumes? thanks

    • They’re highly toxic in their raw state, safe if you soak them 12 hours and cook in pressure cooker or long simmer. Industrial food preparation methods are inbetween and there is evidence for low-level toxicity which can lead to, e.g. early cognitive decline.

  35. Hi Paul,

    Are nut butters as healthy as nuts? In “The End of Illness”, David Agus argues that blending fruits and vegetables exposes their inner flesh to oxygen, which (within fractions of a second) causes oxidization of nutrients such as vitamins (e.g. C, A) contained therein. Is it conceivable that blending nuts has a similar effect; could it lead to degradation of vitamins, antioxidants, etc.?

    Thanks, Jesper

  36. Hi Paul, and thanks a lot for all your answers.
    I love canned tuna in olive oil. Its very convenient and I have one can everyday with rice crackers. Are you concerned with BPA or mercury toxicity? Which of the two do you find more likely to be harmful?

    • Jorge, I’m sure that Paul will give you a precise answer, but thought that I would share this with you too.

      There are probably non-BPA can sources out there (although I’ve heard that some of the alternatives to BPA that are being used can also be damaging).

      For methyl mercury which is the type that can be ingested and accumulated from eating fish, some people are able to eliminate it from their bodies efficiently, while others less so (there are lab tests to measure for that, if you’re interested — I’ve done them myself).

      However…based on everything that I’ve read (and my common sense), one can of tuna a day is probably not a great idea from several standpoints: 1) it’s one of the highest-mercury level fish in the sea; 2) it’s not fresh (fresh is always best), and for anyone who tends toward high histamine levels, canned fish would be a major contributor (this may not be an issue or concern for you); and 3) IMPO, eating a can of the same thing every day doesn’t lend itself to a rich and varied diet.

      One of the traps I’ve fallen into in the past when following a certain diet protocol, is having the same go-to foods, because they are convenient. (And before that, when I was working in a 24-7-365 high stress profession, I ate tuna fish sandwiches (bad on many counts, I realize now) several times per week because it was easy, fast, and frankly required little or no time to eat because I didn’t have to do much chewing, so I do understand the convenience and yummy taste!) But what I realize now, and something that I really appreciate about the PHD approach, is that a richly varied diet is important — different veg, fruit, protein, and fat sources, etc, from day to day, and while it requires extra effort and planning, I do believe that it’s well worth it and more satisfying and it can also avoid long-term build ups of food intolerances.

      But…if you’re a super busy person with a demanding lifestyle, and I understand what that’s like(!)…what about the idea of mixing it up and using canned sardines, salmon, instead, or at least more often? There are some very good brands that offer sustainable wild canned fish, like Wild Planet (Whole Foods carries it) or Vital Choice.

      Just some non-scientific things to consider for your meal plans and overall well-being.

      • FYI on Vital Choice, I have ordered salmon from them – it doesn’t even come in a can. The salmon is sealed in foil, that comes in cardboard.

        • David, thanks for that info! I’ve never tried Vital Choice but have heard excellent things about them. I’m lucky to have a fantastic source of fresh (not frozen) Alaskan wild salmon year-round, so I haven’t tried any of the packaged options yet personally. But that could come in handy for emergency kits and/or travel.

      • Great answer, Susan! I just wanted to mention that there’s an argument supported by Chris Kresser and others that the selenium in ocean fish protects against mercury.

        • Also want to mention that you can find tuna and anchovies in glass jars.

        • Thanks Frasier & Paul!

          Frasier, actually Chris is my current personal clinician, directs my testing and is addressing my health issues (like SIBO/IBS/dysbiosis/mutliple markers with high oxidative stress and inflammation/compromised methylation, etc).

          Chris says that my methyl mercury levels are not drastically high, but elevated such that he recommends that I avoid/limit high-mercury fish (tuna, swordfish, etc.). I then asked about adding a selenium supplement; he said some form of supplementation is a good idea, but to skip taking a supplement and continue with the supplemental selenium-rich foods, as I’ve been doing. (He knows (and loves!) that I follow PHD and that I’ve been eating 2-4 brazils/day along with about 1-2 oz of other nuts and seeds as condiments on any given day (the varieties that PHD recommends).) So for someone with my health profile, he didn’t think a selenium supplement was better than modest ingestion of selenium-rich foods, like a few brazils/day.

          Just thought you and others might be interested to hear that.

          • Good to know—I was referring to the selenium in the fish, not supplementing it. I know that it’s only one part of his views on mercury, and I get that he’s using caution in elevated cases.

          • Frasier, yes, got that too, that there’s some already in fish. Was just wanting to clarify that apparently he and Paul have similar views on the potential need for some form of supplementation.
            Aren’t Chris’ articles fantastic?!

            Just an FYI for readers…Chris’ presentation on the Mental Wellness Summit on Friday (which was focused on gut health and its influence on mental wellness) was outstanding also. If you register for the summit now (even though it’s over), he was one of the voted encore speakers and the encore panel (includes Kelly Brogan and David Perlmutter also –also excellent) is still available for free today. Enjoy!

          • And here’s the link to register and access the encore presentation (it was actually yesterday, but they added a 24-hr extension thru today):

            http://mentalwellnesssummit.com

  37. Thank you very much Susan! Your advice makes a lot of sense, and even though I am a busy person, I will try my best to follow your recommendations and make my diet a bit more varied.

  38. Hi Paul, I was wondering if you had any ideas or thoughts on how fructose intolerance occurs ? I have no family members with Fructose Intolerance and I’m really interested in how this might manifest in the body .. And why I suddenly got this intolerance in my mid thirties? So much information you put forward makes sense ( I’m in Australian so unfortunately can’t get to your retreats)
    Many thanks Sharyn

  39. What a blessing it has been to find this website.

    About a year and a half ago, I started keto diet. I am a very disciplined person with a pretty strong will power. I was able to get through keto flu and was eating tons of fat and vegetables and very low carbs. I felt good. I do not have a weight problem. But I do have a lot of allergies. For a while, i felt a lot more energy from keto way of eating. Then a year into the diet, one week- something just broke down.. Within a week I got yeast infection, ear infection, eye infection, I could barely move, very high fever, cough, running nose, weird itchy red circle around my lips with pus coming out, psoriasis everywhere (very itchy too), severe constipation, constant thirst, could not sleep or would sleep all day, memory loss, hair loss (I had (and now restoring) my long hair.

    I went to doctors. Took allergy pills, flu meds, more vitamins than I have already been taking. I got into a very deep and dark depression with suicidal thoughts. Mind you, I have a great life – had great childhood, financially stable, etc. No meds helped. Throughout all of this I kept eating keto. To make this already long story short, I was not sure what was going on and read about some reset diet where you eat rice and drink tea and water and nothing else for a couple of days. So I decided to try it. I ate some rice and within hours, my symptoms eased. It has been months and I am still fixing all the health issues. I also began taking some candida cleanse supplements that help. I read that Paul said that keto feeds candida. And I think it did. In a big way. I now eat rice or tubers with every meal and feel so much better. I think keto has a place to exist but can be very dangerous. And thank you Paul for your work.

    • Helene, keto is great, but most people will need to do periodic “carb refeeds” in order to sustain it long term without developing thyroid and other issues resulting in an immune system vulnerable to infection (candida or otherwise). I fell into this trap myself with some of the same symptoms, and it’s taken a while for me to recover. I haven’t attempted keto since, other than IF with Bulletproof coffee. I’m glad you’re on the road to recovery, and I wish you the best!

    • I agree Helene, that keto diets can be dangerous. I too have strong will power and used very low CHO ketogenic diets on and off for many years. I never experienced the symptoms that you did. I always FELT good when using it. For that reason I would use them for extended periods.

      But after some research, I now believe that keto diets contributed to the adenocarcinoma of the duodenum and small intestine I was diagnosed with in 2013. I emailed Paul to get more info on the subject but unfortunately never heard back.

      I started PHD a short while prior to being diagnosed. But of course the damage was already done. And although it’s very difficult while being treated for cancer, I continue to work at using PHD.

      It is good that you’ve modified your diet. Stay healthy and strong.

      • Hi David,

        My apologies for missing your email. There is very little evidence about low-carb ketogenic diets and intestinal cancers, though I expect we’ll be seeing much appear in 10-20 years now that low-carb and keto have become popular. However, there is a great deal of evidence linking low-fiber diets to intestinal cancers, and low-carb keto is commonly low in fiber. I think my blog posts explain why it will be difficult to maintain the gut barrier and mucus on a low-carb diet, and those must be sound to prevent cancer.

        I hope the cancer has not come back for you!

        Best, Paul

        • No worries Paul. I know that you are extremely busy with all that you do. You helped me a lot when I asked about blood clots and anticoagulation therapy relative to diet. Due to 2 plus years of poor care by a hematologist/oncologist, the cancer wasn’t detected until it was stage 4 and had metastasized. But I’m still alive a year and half post diagnosis. I must say that your supplement recommendations, which I follow fairly strictly, really help the body stand up to the rigors of chemotherapy. This is evidenced in my blood work and the absence of several common side effects. Keep up the great work. And thank you for the well wishes.

          • David, what an inspiring story. Best of luck in beating the cancer entirely.

          • Using PHD as the base, and adding on many layers of holistic care, someone close to me managed to conquer serious melanoma. I realize that you don’t have melanoma, but holistic cancer care isn’t necessarily based on strict targeting. Email Paul if you want to contact me and learn more. Perhaps he will be kind enough to connect us.

  40. Hi Paul! I decided to ask this question again because I don’t think anyone commented, but I would like to know if its a good idea to take plant based digestive enzymes?

  41. I have SIBO and I tried enzymes and HCL for 6+ months without any apparent effect, good or bad (well, some bad: the burden of taking them and lost $ 🙁 ). However, I wasn’t trying them due to significant digestive issues, but rather because of other symptoms that made me suspect IBS/SIBO (later confirmed with breath testing). Every body is different, as is every case of SIBO, but just wanted to share my experience of no impact. Evidently they have symptomatically helped many people though!

    Unless Paul thinks there is harm in trying them, it might be worth your individual experimentation for a set period.

  42. Hi Paul,
    Have you seen this article or the University of Chicago study referenced in the story?

    http://www.marketwatch.com/story/the-paleo-diet-has-it-wrong-cavemen-did-eat-carbs-2015-08-18

  43. What do you think of the work of Dr. Peter Attia or Maria Emmerich?

  44. When figuring out how much meat to eat, is the 0.5-1.5 pounds pre or post cooked weight? Thank you.

  45. william montano

    i learned about you through my hero dr mercola and i truly believe you have the perfect balanced nutritional plan…i am very interested in obtaining your book but the information in the book is too many years behind….
    ARE THERE ANY PLANS FOR AN UPDATED VERSION OF YOUR MASTER PIECE….ANY TIME SOON?

    blessings to you and your family
    william m

    • Hi William, The book was last updated in 2013 and is up to date. It is still the best diet book on the market. The optimal human diet doesn’t change and the advice is still sound. For a few minor changes, e.g. in supplements, see our Recommendations pages.

      Best, Paul

      • william montano

        salutations to your divinity paul…
        tk you so much for your prompt response…
        i am in 100%….
        i was on a carb restricted diet and lost a lot of weight and hard earned muscle but i started adding complex carbs to my diet and now i feel and look better with a well balanced weight gain..i’m ordering your book rihgt now…

        blessings to all humanity
        william montano

  46. Can we eat backweat on this diet as it is gluten free? It I’d a very healthy food and in Russia we eat it a lot . Also can we eat home made yougurt and cheese from the shop ?

  47. Essentially Kushi’s Macrobiotics.
    What do you recomend for diverticulitis

  48. Any recommendations for iron levels that are too high?

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