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 ?

3,322 Comments.

  1. I just got a paleo baking book and they use only maple sugar. Its very expensive though.. is that a good sugar?

    • Maple “sugar” or maple “syrup”? Any concentrated source of sugars, including maple sugar AND syrup and honey, are only marginally better than eating table sugar. Although you don’t have to totally eliminate it, avoiding them as much as possible, FOR YOU, is recommended.

      Paleo isn’t just about WHAT is “allowed” in your diet but also, HOW MUCH (ratios). I come across people who think that they are on a Paleo Diet but eat way too many “dessert” items and as a result of thinking of dessert first, eat way too few vegetables. BIG problem, that.

      • I just saw this.. Thank you. I didn’t keep the book because I would rather just have a banana for something sweet anyway and avoid the sugars other than in fruit! It was very complicated and used a lot of nut flour and coconut milk and arrowroot also, and maple sugar.. its fun to bake sometimes but I don’t want to overdo eating nuts and they are good as a snack alone!

      • Christopher, you’re right on. If we eat more vegetables than a vegetarian, we’ll be in good shape. In other words, many paleo folks fall into the same traps as vegetarians — too much reliance on prepackaged and processed foods.
        If we JERF 95-99% of the time, and save thing that contain concentrated sweeteners and non-grain flours for special days like holidays or a tiny cheat on a rare occasion, then it’s not a big deal.
        The trick is rarity, and moderation on those rare occasions. I find that one bite of a PHD friendly treat that I’ve made for my household on such an occasion, is no less enjoyable than a whole piece. Just a taste is enough to satisfy my curiosity and palate.
        Now at 1.5 years on PHD, in the past 6 months I’ve reduced my dark chocolate intake (and I was eating 85-100% and only 1-2 oz/day) to more sporadically now, because I’ve found that the more often that I any eat sweets (other than PHD fruit), the more that I want it (both in quantity and frequency).

  2. Hi Paul I have a question.. I have Hashimotos and my Dr says my labs are perfect. I am on Synthroid .88. My Free T3 is 2.6, Free T4 is 1.42, and TSH is 1.5. I think my T3 could be higher. What can I do to improve my body’s ability to convert T4 to T3? Should I take ashwaganda or curcumin? I am following the PHD as best I can and avoiding beef and eating veggies, eggs, white rice etc. My Vit D is 52. I do feel tired a lot and I want to feel better. I am 61, normal weight, etc. Any advice ? Thank you!!

    • Thank you, that’s very sweet of you. Looks fantastic. Will try it for the family. I’m not meant to eat egg whites (bad reaction according to cyrex test) or dairy but will probably make this for my husbands supply!
      I think because of my intolerance to eggs and dairy I am baking more just to test out recipes which the whole family can eat. I have neices’s with severe lactose intolerance and IBD. They even react to butter.
      Anyway I do feel my sensitivities are improving. I have tried egg whites several times now and don’t get the bad crampy tummy like I used to after I first eliminated them (and reintroduced). I never realised I had food sensitivities until the test results and then eliminating and reintroducing which gave me sever tummy cramps that I never experienced in my life before (after eating 1 egg, previously I ate an egg or 2 daily for 2 years). But things are definately improving 🙂 I hope I wasn’t sounding too negative before!

      • If u avoid egg whites then healthy family eats has no-egg desserts. She uses gelatins eggs instead and tells you how to make them. Her butternut cake, lemon tart and sticky ginger pudding all look amazing.
        Oh and comfy belly has some lovely bread recipes but they call for eggs.
        Vanilla ice cream made with honey and yolks only (I used duck yolks) would be a good option. See Ted Allen’s recipe on Foodnetwork.con or ones on the Nourished Kitchen blog. I say vanilla because it requires the least sweeteners IMO although banana would too.
        Re chocolate bars: all of mine are 95-100 organic with no fillers. Now 70 tastes very sweet to me. I also choose brands like Santosha, Lucy, and Gnosis that only use coconut.
        Make sure that you’re eating 1 lb of sweet veg/fruit daily. Things like berries, bananas, Kabocha, sweet potatoes, pomegranate seed, can be quite satisfying. I go thru phases and right now rarely eating chocolate, just not craving it.

  3. Hi Susan! I ordered the instant pot! Can you tell me the name of that book again about broth? Also what do you recommend as a good first PHD recipe in the pot? Thanks!

    • Nancy, it’s been awhile, but I think that we talked about “Nourishing Broth” by Sally Fallon and Dr. Kaayla Daniels. Almost everything in that book is PHD, except for anything with beans in it. They aren’t big proponents of pressure cooked stock, so I’d say just use the book for background education on stock and recipes if you’re going to do a fast pressure cooked stock. But you can also use the slow cooker function on the IP and follow their cooking instructions too. My taste preference is for rich chicken stocks using plenty of aromatics (onions, carrots, celery, herbs, peppercorns, bay leaves) and plenty of matrix materials (carcasses, feet, skin, etc). Something that would be equally delicious to drink as use for a soup base…that’s just my approach. If you look at their broth recipes, many of them use these ingredients.
      Good luck!

  4. Thank you Susan! Yes it has been a while but now is a great time of year for soups and broth. I know the thing does everything but I don’t want to get obsessed with food haha!! So just the PHD delicious recipes for me and this pot will help since Im not much of a cook and its so much faster too 🙂

    • Nancy, also checkout the website the domesticman.com
      Russ Crandall follows PHD most of the time and he states if a recipe is PHD friendly (all or most of them are). He has many recipes on his website and he uses and loves the Instant Pot! He is also extremely responsive to questions posed on the comments section of his blog/recipe posts, so if something isn’t clear, just ask him. I seem to recall even some videos of him making soup with the Instant Pot — try using those two words in his search box and maybe that will help find them.
      He also has two great cookbooks:
      The Ancestral Table
      and his new one:
      Paleo Take Out and a Safe Starch recipe guide

      • Thanks Susan! I have ancestral table but I would love to see how he uses the IP!! Also what are your favorite recipes? They have a cool FB page where everyone helps each other and posts recipes. Have you seen it?

        • No, I’m not a big FB user so I haven’t seen it. So far I’ve only made:
          Chicken Stock on 120 min hi pressure using my standard recipe (carcasses, reserved bones and skin, 2-3 feet, onion, carrot, celery and leaves, maybe parsnip, parsley, dill, bay leaf, peppercorns and filtered water) and turkey stock using same time and recipe as chicken. I’ve also made steel cut oats for my husband who is non-PHD using Slow Cook on low overnight for 8 hours. Although I don’t eat them, it was a good test for it’s slow cook feature. So far that’s all that I’ve done in it.

          • Oh thank you for your recipe! I actually made a cheesecake in the thing!! It was a nice treat, just even one little piece 🙂

          • Nancy, please tell me how you made a cheesecake in the IP or provide a link to the recipe/IP instructions that you followed! I’m in charge of dessert on Thursday and I plan to make something paleo and as close to PHD as possible and pumpkin cheesecake is on the possible list. Since it’s a moist bake, I bet the IP works great for that, but never thought to use it until now.

          • Hi Susan! Here is a recipehttp://instantpot.com/fabulous-cheese-cake/ I did it in a 6″ springform pan I got at Jo Ann Fabrics with a coupon. I cooked it for 25 minutes on manual and it came out great! The people on the page called Instant Pot Community are amazing and so helpful. You can post on there and get tons of recipes. Super fun! You have to chill it overnight in the fridge.. it has sugar in it but its soon good!

          • Susan my e mail is ncwatson24@gmail.com. I can probably help you with pictures are links better from there bc Im not sure how to do it on here. I can send you a picture of the cheesecake and some other info..

  5. Hello Paul,

    I have a supplement question. First I wanted to say, I have been one of your followers for many years. I was on Intravenous immunoglobulin once a month for 6 hours a day. I was still on antibiotics all the time and could not keep healthy, and was unsure I would see my daughter graduate, she is 6.. I had given up gluten, but it was not enough for my health, I still felt badly. I started eating for the most part PHD and taking supplements. As of two months ago, my body began making antibodies and I have not been sick since last march and I no longer need IVIG! So thank you so much for all you do. You make a difference.

    I recently started seeing a doctor who tested me for various things via my DNA bc I had unusually low levels of ferritin, b12 and vitamin A. Apparently I do not convert beta carotene from carrots and sweet potatoes. I also had the. MTHFR defect and I am not a good methylizer. In addition to your supplements she added 1000mcg of Hydroxocobalin, 400 mcg methyl folate and 20 mg P5P., and 10000iu once a week vitamin A.The only problem is after I take it, I noticed I become exhausted. I have to lay down and can barely keep my eyes open. I wondered your thoughts on this? I tried to research it, i have found that high levels of B12 can deplete potassium, and that could cause fatigue. I have read other people talking about this, but no one seems to know why.

    I would appreciate your thoughts,
    Thank you!
    Amy

    • Hi Amy,

      I’m glad you are doing better! So happy about the antibodies.

      I’m not a clinician, so take my opinion for what it’s worth. I don’t believe MTHFR alleles call for high doses of folate, B6, and B12. In general ancestral doses of nutrients are the ones we are best equipped to handle, and genetic defects are more likely to lead to an impaired ability to handle unusual intakes, including high intakes, than to problems with ancestral intakes. So I would avoid folate supplementation (but do eat plenty of green leafy vegetables and egg yolks), and supplement B6 and B12 once a week only. The doses you are taking of those supplements are far above anything obtainable in our ancestral environment.

      I think that vitamin A dose is too low to be harmful. If you don’t eat liver, you probably want to take more A. But best would be to eat liver per PHD.

      In general, if undermethylation is a problem, choline from egg yolks and liver is the best solution.

      Best, Paul

    • Amy-

      Would love to discuss your case with you further and your success with this diet. My mom has CVID and has been on IVIG injections for almost 10 years now. Please email me at JSall2011@gmail.com

      Thanks,

      Jordan

  6. Great! That was almost an answer I was expecting from you! I did not feel right taking such a high dose. I eat liver a couple of times a month, it is not my favorite. Eggs I love, and even though I have an autoimmune disease, feel fine eating just the yolks. I am going to adjust my b12 back down to the weekly dose, and on an off week I do not have liver will add the choline and vitamin A via supplements.

    So good to hear from you, thank you…and although my parents and my husband can not believe how well I am doing, it is really my daughter that appreciates it the most:) We go to the park, ride bikes, I even volunteer at her school which I was afraid to do before since kids cough and sneeze and carry germs. But she is the first one to remind me quite often…”Mommy, you are not sick anymore. Let’s go!”

    Thanks again,
    Amy

  7. Hi Paul, what are your thoughts on elevated free fatty acids causing insulin resistance and blood sugar problems? Can a high saturated fat diet have this effect?
    Any thoughts on Kempler’s rice diet, McDougal’s starch diet, or low fat in general for blood sugar/diabetes?

    Thanks.

    • i’ve been agonizing over this!!! I actually developed reactive hypoglycemia on a paleo diet noit limiting carbs. I wondered if all the saturated fat gave me insulin resistance

    • I’ve also heard conflicting claims as to whether or not elevated free fatty acids, and saturated fats in particular, can cause insulin resistance.

      Did anyone find an answer for this?

      • Elevated free fatty acids, or energy generally, causes insulin resistance. Saturated fats aggravate insulin resistance during energy excess and increase insulin sensitivity during energy deficiency.

  8. I see that that mature grain corn is forbidden on your diet, but what about sweet corn? Would it be okay to have an occasional corn on the cob?

  9. Hi Paul,

    I’m looking for a healthier flour to bake with for my kids. I usually use tapioca but it has almost no micronutrients. And I am a little concerned about cyanide residues (should I be?).

    I recently found Tigernut flour. It’s made from little root vegetables. Would you consider this a safe starch?

    Thanks!
    Jen

    • Good question. I recently came across tigernuts.
      I was thinking about this reccently and found out about cassava flour, apparently has more nutrients compared to tapioca but perhaps has the same issues with cyanide? (if that is an issue, I’ve not worried about it before)

    • Jen, I bake for my family. I use mainly coconut and almond flour. I’ve seen but I’m not personally familiar with tigernut. But my impression is that is more like cassava and coconut, i.e. a more granular/coarse texture. But for a fine textured flour, it’s tapioca, arrowroot, rice flour or chestnut flour. I’ve heard two professional chefs and bakers claim that chestnut makes the very best cakes. For breads, cookies, etc, I find coconut and/or almond to be just great. For that matter, you could make or buy any type of nut flour, and you can even find it sprouted from some sources. One other tidbit that I’ve discovered is that for grain-free baking, duck eggs are superior to chicken — they help give breads and cakes more rise, and even traditional bakers prefer them.

    • I’ve had good results using chestnuts (for cookies) or sweet potatoes (for brownies) instead of flour in baking. The basic idea is to cook thoroughly whatever you use and then blend it into a paste, and that’s then your flour replacement. (Also, blended dates make for an excellent sweetener.)

      It may take some experimentation, depending on what you try, but there are plenty of solid recipes for sweet potato brownies on the web.

      • Tyler, I agree with everything you’ve said, and twice in the past 2 yrs I’ve used Primal Palate cake recipes that called for soaked and mashed dates. It does work very well. However, I believe that with PHD the jury is still debating their use due to very high fructose (of course also tried of any dried fruit). But at least there’s fiber. And if it’s a 12+ slice cake that used 10 dates, personally I’m not going worry about it — again these are very rare occasions.

        Other fantastic ways to naturally sweeten cakes and breads are bananas, applesauce and beets. Best chocolate cake that I’ve made (paleo or not) was with beets.

        Re flour — you can also find plantain flour, though I haven’t used it before, so I don’t know its best applications.

        Russ Crandall’s The Ancestral Table has a good summary of what flours work best for what, and I think that might be one of the $3 kindle books on the paleo bundle next Tues (I believe that PHD is on that list too, Paul!?). Some of the baking specific paleo cookbooks have similar summaries and Cooks Illustrated does too in their ATK gluten-free book. Primal Palate’s newest book is also on the list!

  10. I use Ditching the Drive Thru by J Natalie Winch as I start my journey into clean healthy eating. Her book is great because it discusses where to find the best foods, and how to get rid of the processed foods and how much better family health becomes all the way around! It’s a fantastic resource, her site is http://spikehornpress.com/product/ditching-the-drive-thru/. A great book on learning how to eat much better!

  11. PHD calls for 1lb veggies, 1 lb of sweet plants, 1 lb safe starches, and 0.5-1 lbs of meats among other supplemental foods (egg yolks, bone broth, more fats)

    I was trying to wrap my head around what this looks like as actual food so I created the PDF linked to below.

    This is a 2 meal (1 day) example with real food images and a full nutrient breakdown. It’s almost perfect, following the macro and micro requirements of PHD, just a few things slightly off.

    https://www.evernote.com/l/AAOXfE3PxTpO764y8lBep3fhL7m6j2nUy38

    Hope you find it helpful!

    Cheers,

    -Josh

    • Very well done Josh! Thank you!

      • Love the book, I have a read a lot of diet and health books in the last few years and yours has been by far the most informative/actionable read. Thanks!

        • Hey Josh,

          Cool work.

          About the cronometer breakdown for the first day, when it says 60 g of sugars you can expect half of that to be fructose, so 30 g of fructose total. (i.e. something like 15 g of fructose, 15 g of glucose, and 30 g of sucrose — the sucrose being 50% fructose)

          Which is totally alright. I listened to a recent podcast with Paul, and he elaborated that he believes 25 g of fructose per day to not so much be the upper limit (that one should steer clear from reaching), but the optimal amount.

          (In fact, the advice to eat 1 lb. of sweet plants per day and to target 25 g of fructose per day happen to be one and the same.)

          With sweet potatoes the carbohydrates are evenly split between sugar and starch, meaning they’re really a hybrid sweet plant/starch. So 8 oz. of sweet potatoes and 4 oz. of rice are together like 1/4 lb. of starches. Which may end up being a lower than usual day for starch/glucose.

          By the way, you may already know this, but raw potato starch is predominantly indigestible. It’s really just a source of fiber. In other words, it wouldn’t be a replacement for eating, say, potatoes or any other starchy food. Consuming powdered raw starch is something quite novel, and I’m not sure enough is known about the gut microbiota to say whether that’s a good thing.

          Personally I would just eat plenty of vegetables to get fiber, as you’re already doing.

          One thing I’m curious about is how come you add most of your oil intake to your morning coffees vs. splitting it throughout cooked meals?

          Well, good luck. Part of the fun is of course figuring out what works best for yourself. And following that eventually becomes second nature.

    • Great job Josh !!! Thanks for doing that !!!

      Although I’ve been following PHD for a while, I’m a visual person and that is very helpful as a reminder. You’ve also give me a great idea. Put my protein on one small plate and then make sure that I fill up a large dinner plate with veggies. I don’t eat enough vegetables and go too heavy on the protein and safe starches… i.e. I’m a meat and potatoes kinda person. I need to really make myself eat more vegetables and in a greater variety. My new “plate” arrangement … thanks to you….. should help with that.

      • If I don’t eat the vegetables before anything else they won’t get eaten 🙁 But if you stuff your face with a huge plate of greens you will be surprised how hungry you still are.

        I also like to make smoothies, like the one I show in the PDF for this reason to get tons of veggies really fast.

        • Great job Josh, and I agree with your comment here in general. However, as an IBS/SIBO sufferer, and as someone who has historically loaded up on veggies, both raw and cooked (I’ve always adored them), I have found that in recent years (north of age 50) one needs to be more cautious and moderate their consumption, especially veggies that are raw or contain high amounts of insoluble fiber, like greens (which I happen to adore). So I’ve had to actually take the opposite approach when eating, namely:
          1) Eat pretty much dead-on the proportions outlined in PHD, but not much heavier on the veggies than outlined, and not too much in one sitting;
          2) consume them with some form of fat (i.e., even as a snack);
          3) and eat them AFTER consuming some of the other component of the apple diagram, and in particular protein and fat, and continue intermixing them throughout the meal.
          Just mentioning this for some readers who may have digestive issues. Chris Kresser has an excellent article on this — title is something like “are you eating TOO MANY veggies”.
          Kudos Josh!

          • Susan,

            Gotcha! Yes I suppose that condition would make a difference. Thanks for elaborating, it wouldn’t have crossed my mind.

    • Thanks Josh. Nice visual. Useful to send to others new to PHD. I’m a petite slim person but I probably eat more than that in a day though! 😕
      I have almost half a plate of rice with a meal and I probably eat more fat than you’ve included too. We do eat veggies. I like to make vegetable/potato soup most days for lunch as that really helps us to eat more of them, and then we have the meat on the side.

      On the other hand my 4 year old just doesn’t like to eat potatoes (white or sweet) unless mixed in soup. I don’t like cooking various options for meals so when we do have potatoes she ends up being low carb for that meal. This worries me for a child. She has no problem eating rice.

      • I keep homemade sugar free rice pudding around for when I need a safe carb top up. If your daughter likes rice pudding…..?

      • This is about 2,200 calories of food. Don’t let it deceive you it is a HIGH fat day of food. I updated the PDF just now to show the butter and oils that go in the coffee to give a more clear idea.

        Half a plate of rice is a lot if you are having it with most meals. Just 8.8oz of rice (~1cup) is 70g of net carbs (carbs minus fiber) which for me at 2,200 calories a day is 65% of my carb intake.

        I’m not saying don’e eat the rice, just saying maybe substitute some of it for more veggies 🙂

    • It’s already been said by a few people, and I’ve never commented on a website before, but I really wanted to make the effort to thank you for your amazingly helpful work. This has made it so much easier for me to visualise and plan my meals. If you ever feel like making more examples or even stringing a few together in a booklet, I’m sure there would be plenty of us willing to purchase them! Similarly, if the brilliant Jaminets ever decide to publish a cookbook, especially a family cookbook (i have a 3 year old and 9 month old and face a daily battle against conventional dietary wisdom) then I’d be first in the bookstore queue!

  12. Josh, your graphic is incredibly helpful!!! Thanks so much for taking the time to map it all out visually. Wow. A lot of people are going to get an instant understanding of how simple this diet is. Thanks again!

    • Glad it is helpful! I made it as my own cheat sheet, really want to get my diet dialed in and being vague about it was holding me back.

      I just updated it to show how the coffee, butter, and oil fit in visually and in the breakdown. Plus added a nutrient breakdown for the smoothie as well.

  13. Josh, that is amazing! I love the visual, but seeing the actual nutrient breakdown is so helpful! Thank you!

  14. Hi Josh,

    Two comments:

    1. Cron-o-meter’s algorithm assumes any difference between reported calorie content of a food and its theoretical prediction (9 * fat + 4 * carbs + 4 * protein) is due to net carbs. This results in cron-o-meter consistently over-estimating carb consumption.

    In your case, cron-o-meter says you have 51.8 g starch + 60.1 g sugar, but 141.7 g net carbs. (Note: 51.8 + 60.1 = 111.9 < 141.7.)

    As a result, even though you're probably getting only about 112 g of carbs, cron-o-meter tells you that you are getting 141.7 g.

    So, I think your carb intake is not too high — and perhaps you should actually add more carbs and reduce fat, not the other way around.

    2. Your copper intake exceeds the maximum amount recommended by PHD. (PHD recommends 2–4 mg.) You could try replacing some of the beef liver with chicken liver.

    Best,
    -Eric

    • By the way, this explains the “paradox” of how you’re eating less than the PHD-recommended quantity of starchy foods (12 oz instead of 16 oz), yet your carb intake manages to be on target according to cron-o-meter. (The explanation: Paul is right, and cron-o-meter is wrong!)

  15. If Vitamin K2 can reverse calcification, then it should help relieve ED when the cause is clogging of the penile artery; but I haven’t heard any such reports.

    I’m glad that we can supplement with Vitamin-A now. (I couldn’t keep eating liver. I dreaded the liver days.) I take 25,000 units of Carlson’s A, twice a week.

    I’ve had a hard time eating potatoes. Get stuck in my throat, but I solved that. I use a Vidalia Chop Wizard (slams a sharp metal grid over the food item) to produce bite-sized pieces and several other veggies and cook in one cup of water. Mix in cooked meat, cheese, tomato sauce, etc. to produce a thick mixture. Very easy to eat due to the water content. I’d add a little more water is my bowls were larger.

    Right after dropping whole wheat bread for, maybe, the tenth time, I began eating this mixture and experienced no constipation this time. In the past, dropping whole wheat always caused bad constipation.

      • Lucky baby!

        For the veggie items, I boil Zucchini, onion, garlic, carrots, green beans (or peas), celery, and potatoes. Then I add cooked ground beef, a chopped up slice of cheddar cheese, marinara sauce, vinegar, salt, black pepper, and cumin powder.

        For dinner I add cooked garlic and onions, and maybe peas, to a mixture of rice and ground beef (or chicken, or sardines); but I usually eat a salad first.

        Mixtures make meal preparation easier and encourage a variety of veggies.

      • I have marveled at the healthy, pleasing appearance of the babies of parents in the Weston A Price organization (and I’m not particularly interested in babies).

        Same with Luke. Exceptionally healthy looking and already handsome!

  16. How come I get constipated on this diet ? 🙁 once I put grains back in its all good again 🙁 do I have not enough fibre? I’ve lost weight and preserved muscle with PHD but its a struggle . I eat my veges and everything doesn’t seem to help 🙁 any ideas?

    • Lack of fiber, or lack of bile / bile conjugation. Try supplementing taurine, glycine, and vitamin C, and eating more fiber. Make sure you are getting vitamin A and vitamin D. See our constipation post for more ideas.

    • I’m doing the things Paul mentions here, but taking vitamin A (50,000 units per week) and glycine (before bed as per Ray Peat) are new for me and maybe made the difference this time (no constipation after dropping whole wheat bread). And, I’m probably at the high end of PHD allowance for fruits and veggies consumption (fiber).

      In the past, on a whole grain-rich diet, morning elimination was an actual imperative, and ruled my mornings, but fortunately before leaving for work. I had absolutely no choice but to visit the toilet within minutes of the first urge–and I don’t think this is natural–having no control.

      The other day I ignored a slight urge and proceeded with my morning walk. After maybe ten or 15 minutes I became increasingly anxious, and barely made it back to my house and toilet–seemingly beginning to lose control. However, after reaching the toilet, I discovered that I did, in fact, still have complete control, despite the pain. This is also a real and appreciated improvement compared to the grain-rich diet.

      Bowel function sometimes seems a mystery and it’s hard to explain day-to-day variations even in the absence of constipation.

  17. Nov 27, 2015
    I have a question regarding the following quote from the website: “The most healthful macronutrient mix is about 30% carb 15% protein 55% fat, with over 90% of the fats saturated or monounsaturated.” Would this apply for each individual meal or for the total daily food intake? I can easily figure for the day but is it necessary to balance each meal?
    Thanks for the help

  18. I have struggled with IBS for 10+ years. Have several friends who are NTP’s and have been on a journey for the past 3 years learning about nutrition. I have tried Paleo, Zero Belly, Trim Healthy Mama, LCHF, 21 Day Fix and a personal trainer. I lost the bloat with Zero Belly and Paleo and learned that wheat is the culprit for my IBS but that I bloat every time I eat anything with carbs. I am so fearful about bringing them back into my diet. But I can, my question is about the fasting and how many meals a day. Is it just 2 meals a day? I eat 6 small meals now and found that more protein is what helps me from over eating. If I do not eat every few hours, I get sick and my IBS flares up. With my busy lifestyle, I am a college student, business owner, manage finances for my church and have a family. I do not understand the fasting part of the program.

  19. Hello,
    I purchased your book around a year and a half ago and have made some changes to my diet since then. I have been into weight lifting and advanced nutrition for around 8 years now and have learned a hell of a lot from your book over the past year and a half. I am having a bit of a problem when trying to attain saturated fat, as I believe over half of my calories should be saturated fat. When I go out shopping I am constantly trying to look for healthy saturated fat sources, however the only sources I have been buying are avocado, coconut, oils for cooking such as duck fat and coconut oil, cashews, almonds and soured cream. Other than the sources I have listed I cannot seem to find any answers to what other sources I could include in my diet, as I have been consuming coconut, avocado, cashews, almonds and soured cream everyday for over a year now and was thinking that there must be more sources than this. If over half of our diet should consist of saturated fat then surely there should be loads of sources out there? If you could recommend me some good sources of healthy saturated fat it would be much appreciated. Thanks very much,
    Ravi

    • You don’t eat meat/eggs/cheese?

    • My primary source of saturated fat is beef. And then the addition of poultry, coconut oil, avocado, nuts, etc. But without the beef, I would never get enough saturated fat in my diet.

    • So I should focus on trying to eat more beef? This has to be grass fed beef right? as I believe common beef which is sold in supermarkets have been fed a number of medications which turns the saturated fat into unhealthy saturated fat. I eat eggs but not everyday, and also I’ve always thought that the saturated fat in cheese is unhealthy? please correct me if Im wrong. Thanks for the quick replies by the way!

      • I’m obviously not Paul, but here are the basics if you have not read the book. First, look at the “apple” graphic at the top of this page – http://perfecthealthdiet.com/the-diet/ and the description below it. That explains the program in a brief format.

        To make it even simpler, you should eat… every day… the following:

        1) 3 egg yolks (I eat 3 whole eggs, but Paul recommends the yolks only.) I buy pastured organic eggs.

        2) 11 – 16 ounces of animal protein. Look in the red section of the “apple” graphic for suggestions – beef, lamb, chicken, etc.

        3) 12 – 16 ounces of “sweet plants.” This category includes fruits, carrots and beets.

        4) 12 – 16 ounces of “safe starches.” These include regular potatoes, sweet potatoes, winter squash and white rice (the rice gets weighed after cooking.) This is where you get the “fuel” for energy.

        5) 12 – 16 ounces of other vegetables. Eat a wide variety. This includes salad-type vegetables: lettuce, tomato, green pepper, cucumber, mushrooms and other veggies like broccoli, cauliflower, brussels sprouts, green beans, etc.

        5) 2 – 4 TB of additional fat – I use butter, coconut oil and eat avocados.

        You need to eat all of that every day. Even though the “apple” graphic shows 16 ounces of some of the plant categories, I put 12 – 16 ounces in my summary because as an average height female, I can’t eat and don’t want to eat as much as a 6’3″ man would. So I eat 12 ounces of safe starches and 12 ounces of sweet plants each day and 12 ounces of other vegetables And I eat about 8 ounces of animal protein.. mostly beef… some chicken and some shellfish.
        I am lactose intolerant, so I don’t eat any dairy, but dairy is included in the “pleasure” food category in the top part of the “apple” graphic as an occasional food.

        As to “grass fed” beef, that is good to eat, but not absolutely required. It is too expensive for my budget so I get my beef at Whole Foods which has a higher quality of “regular” beef than the typical supermarket. So it’s a middle of the road choice and fits my budget.

        Hope that helps. You really need to study the “apple” graphic on this website. I have it posted on my kitchen cabinet. When I started, I weighed things to be sure that I was getting the right amounts of everything, but I no longer weigh my food because I now have a good idea of how much food I need to be on target.

      • what about marrow from bones. Isn’t that a healthy form of saturated fat?
        I sometimes use lard for frying on occasion.

      • You should re-read the book. It covers your questions. Beef is not the only meat out there. Grass fed is better but do what you can.

  20. I have a question regarding the following quote from the newsletter: “The most healthful macronutrient mix is about 30% carb 15% protein 55% fat, with over 90% of the fats saturated or monounsaturated.” Would this apply for each individual meal or for the total daily food intake? I can easily figure for the day but is it necessary to balance each meal?
    I would really appreciate any answer.

    • Bree,
      The aim is to achieve these %’s as best you can over the longer term.
      So over the day, or even over the week

      • Thanks Darrin – can you tell me where I can find that information? is it in the book? or just on the website?
        Thanks again

      • just to clarify my comment a bit,
        you should aim to get close-ish to those %’s over the day…
        but no need to stress* on trying to hit them exactly, the %’s will tend to average out over a few days.

        *stress is not good for you 🙂

      • “can you tell me where I can find that information? is it in the book? or just on the website?”

        i’ll get back to you on this Bree with something; a ref, link or more info

  21. Dear Drs. Jaminet , Thank you so much for your book and for all of your help that you give to all. I have bought many copies of your book to give to friends. I am a 52 year old very active mom and I have transitioned to the Phd diet from two plus years on a very low carb diet. Over the last several months I have been following your book and your supplement list on the website. I actually did quite well on the VLC diet in terms of energy and sleep and control of migraines but had dryness issues and developed some fungal infections and found your website and your analysis of data compelling . I have experienced many improvements since trying to follow your advice including dramatically healthier gums and a big reduction in tartar buildup and a bit less circumference on the belly. I have some challenges too and could use some help.
    I tend now to get a racing heart after eating safe starches (drinking more water tends to help that) and I have stiffness and soreness especially in my hands and feet and neck after sitting and upon waking in the morning. I had this before I started VLC. Last week I ran out of safe starch and went a couple days without thinking about it, back to my old way of eating no starch at all and my soreness went away.
    Any advice as to what is going on and are there any adjustments I should make?
    Thank you!!!!

    • Carole,

      I agree… try using sweet potatoes and winter squash as your safe starches and eliminate regular potatoes and rice.

      I have had some of the same issues as you are having – particularly the racing heart – and eliminating the regular potatoes and rice has helped a lot. It could, as Ellen said, that you are sensitive to nightshades (potatoes, tomatoes, peppers, eggplant) or it could be that the white potatoes and white rice just turn to sugar in the body faster that sweet potatoes or squash. Please note that sweet potatoes are not nightshades…..so if nightshades are the problem, you can still eat sweet potatoes….

    • Hi Carole,

      First thing, I would have your doctor check your thyroid status. Depending on what they find, you may need to adjust iodine intake (eg stop it if you are hyperthyroid). Also I would tend carefully to electrolytes, magnesium, potassium, salt, calcium. You may have some adrenal issues affecting electrolyte regulation.

      I would keep eating some starch while you track this down.

      Best, Paul

  22. Carole,

    You might try PHD without potatoes and other nightshades and see if they are the problem. What safe starches do you usually eat? How do yoy pepare them?

  23. Paul,

    I have a thyroid question, more curious for an explanation since you understand physiology so much better, and I know you and Shou-Chin have touched on it. I had a thyroid ablation. As I told you I am doing great and off IVIG I take a mix of T4 and natural T3, but I noticed my heart rate was high 5 hours after I would take it. So my doctor raised my T4 and dropped my T3 to 6.75 mcg from 10mcg.

    Almost immediately, I dropped 6 lbs. My legs starting aching, but my heart rate has normalized. So a couple positives and a negative. I would think that reducing T3 would cause me to GAIN. T3 is so profound, I am not the only one stumped by it, so it seems the entire medical community are at odds.

    Thanks,
    Amy

    • Hi Amy,

      Hyperthyroidism can lead to weight gain just like hypothyroidism. See eg http://www.endocrineweb.com/community/hyperthyroidism/1244-hyperthyroid-weight-gain. Weight gain is a coordination issue and hyperthyroidism may be just as discoordinating as hypothyroidism.

      Muscle aches are a symptom of hypothyroidism but they are typically exacerbated by electrolyte deficiencies. Try getting more potassium, magnesium, and maybe calcium or salt.

      Best, Paul

      • Thanks Paul, Since I was young I have been hospitalized for dehydration for unknown reasons, so that makes an immense amount of sense.

        As a side note, you used to recommend Selenium, when you removed it from your supplement page, I stopped taking it. I have to say, when I was taking the selenium in the morning with my thyroid meds, I felt really good. Do you think it is okay to take 100mcg of Selenium per day? I take iodine.

        Thank you again,
        Amy

        • Hi Amy,

          I think that’s a bit much but you could take it a few days a week. Experiment a little to see how much you need to get that feeling. It will probably vary with your thyroid hormone dose.

  24. Sounds good. I went from taking too much to too little. I will definitely feel it out and hopefully can achieve that without overdosing on it… Haha.

    Enjoy your holidays!

    Thanks again!
    Amy

  25. I am really confused to the amount of fat to eat per day. The only information given is 50-60% of daily calories. So if I eat 600 calories of carbs and 500 calories of protein, would my fat intake be 50% of 1100 calories which equals 550 calories of fat per day?

    • No, we would expect more like 600 carb calories 300 protein calories 1000 fat calories. Eating fatty cuts of meat will give you 600 fat calories in the meat; add two egg yolks and two tablespoons fat will add almost 400, and the plant foods will have a small amount of fat.

      • Thank you for such a quick response! Your book says to eat more protein if I need to lose weight, somewhere between 300-600 calories. Is this correct?

        • 300-600 calories are all safe intakes of protein, but I don’t think it’s necessary to eat at the high end of the protein range to lose weight. 300 calories per day would be a more normal protein intake.

  26. Thank you very much. I am looking forward to starting the diet.

  27. B1 in 28th percentile of range. Dr (Cardio) advised supplement three times per week (already taking once per week). 500 mcg.

    Later, B1 in 32nd percentile. Dr advised supplement daily.

    More than PHD advises. Any concerns?

    • Yes. You shouldn’t need so much B1 and 28th percentile (I assume this means 28% of people have lower B1 levels) is close enough to median levels that it is likely to be normal for you. B1 is a nutrient for microbes as well as humans so I don’t like to make the dramatic elevations in levels that follow supplementation to become too frequent.

  28. what about hemp seeds (hulled) often called hemp hearts by Manitoba Harvest. good omega ratio and high in protein. are these ok to eat?

  29. I loved the book, and I’m loving the foods! I am still working on the liver, fermented foods, and bone broth, but I will get there. Could collagen powder sub for bone broth and apple cider vinegar sub for fermented foods? Or at least fill some of the void during crazy weeks?

  30. Wow, you’ve just described my diet almost perfectly. I eat 65% kcal from fat, 20 from carbs and 15 from protein. I wonder do you stay in ketisis on this diet, cause I (a working-out woman) stay in mild ketosis on this proportions. My diet is a result of tweacking the ketogenic diet I was on, which was too much stress on my body (post work out ketosis was insane).

  31. I just read your book. What a masterpiece. Great work. You guys rock!!!
    I do have a question. Is rapeseed oil ok? If not can you explain why? It seems to have little Poly saturated fats.(only 2.7g per 10g spoon)

    • Hi Bart,

      That’s still 27% which is a lot.

      Best, Paul

      • Thanks for the answer.
        I would like to also ask about iodinized salt.
        Should healthy people eat Himalayan salt without iodine and source the iodine mainly from food or supplements?
        I personally have early stage of hashimotos where antibodies are present but no symptoms and I scratch my head in regards if I should supplement iodine? My functional medicine doctor claims that supplementing iodine can harm me and is very dangerous and most of the functional community agrees but my gut feeling things that maybe iodine can actually help me a lot and improve my thyroid function. I was able to lower my tpo antibodies to 86 but I don’t know what to do with iodine.
        What do you think?

  32. Hi Paul, again much appreciation for the care you give to ALL of your blog followers! Loving the PHD diet myself (although I’m still overcoming my past indoctrination against saturated fats butter etc)

    I train and coach others and came across these two studies which caused me to perk up as I like to entertain the “cons” as well as the “pros” of any organized plan for eating.

    The first on long term exercise and energy sources..looks like here fats are losing.
    http://www.sciencedaily.com/releases/2015/12/151215094542.htm

    And the second study here:
    http://www.sciencedaily.com/releases/2015/12/151217130328.htm
    With this quote from the synopsis: about 3 paragraphs down…

    “Atherosclerosis, commonly known as hardening of the arteries, has been linked to the consumption of high amounts of nutrients such as choline and carnitine, which are abundant in foods such as meat, egg yolks, and high-fat dairy products. Gut microbes convert these nutrients into a compound called trimethylamine (TMA), which in turn is converted by host enzymes into a metabolite called trimethylamine N-oxide (TMAO), which accelerates atherosclerosis in animal models and is associated with an increased risk for heart disease in humans.”

    Would greatly appreciate your thoughts.
    Best,
    steve e

  33. Thanks for taking the time Paul, I will dig in to Chris’s article.
    Best,
    Steve e

  34. Hi Paul,

    PHD recommends fatty cuts of meat to provide 600 calories from fat per day. For someone who eats leaner cuts of beef/lamb/pork, or chicken or fish, what should replace the calories?

    More starches and added oils?

  35. Hi Paul
    I happily found your book after an excursion into very low carb left me quite ill. After just 8 weeks of VLC, my blood pressure destabilised and was shooting up and down making me feel very ill and I had elevated heart rate and extreme pressure headaches. My doctor checked me out and did complete blood tests and everything checked out ok except a slight raising of B12, which worried me a bit but I put down to having had liver that day as it wasn’t a fasting blood test.

    Over the past two weeks I have moved over to your much more gentle diet and I constantly refer to your book both on my kindle and the hard copy I ordered. However, there is one question I need answered that I haven’t found anywhere.

    It’s to do with the 30/15/55% split. But it seems that the 600 calories for carbs and 300 for protein seems to apply to everyone whether a 6 ft man of a 5ft female. Which is more important – the percentage or the minimum number of carb/protein calories?

    I have worked out on the MFP (my fitness pal) app that 150g carbs (600 calories = 4 cals per g) (30%), 72g of protein (15%) and 121g fat (55%) would be 1977 calories. Now I know that most days I burn much less than that. My fitbit tells me that most days I burn between 1500 to 1900 unless it’s a big exercise day. So eating almost 2000 calories a day is much more than I usually burn.

    I don’t want to put on weight by over eating. So, should I scale back each of these macros proportionately to keep the same percentage split and keep me under my calorie expenditure?

    Or do I keep the carbs/protein constant (as you suggest is the optimal intake) and adjust the fat up and down to hunger (in which case I lose the 30%/15/55 macro split.

    I don’t want to end up taking down my carbs too low in percentage because I find when I get down to 120g (480 calories of carbs) I get splitting headaches but if I up the carbs I end up eating over my expenditure or losing the percentage split.

    I’d be grateful for advice on any of this as I’m struggling to get myself back in balance.

    Many thanks
    Shuna

    • Hi Shuna,

      For protein: # grams of protein = 4.27 * (your weight in kilograms)^0.7 = 2.46 * (your weight in pounds)^0.7.

      (For a 60 kg individual eating a 2000 calorie diet, that works out to 15% of energy.)

      For carbs: I’m not sure what the scaling law should be; but the exponent is probably pretty small since brain mass scales like (body mass)^0.28 within primate species, and the brain is the major user of glucose in the body. So I’d eat 150g of carbs per day, unless Paul chimes in otherwise.

      Best,
      -Eric

    • Hi Shuna,

      Yes, the calorie numbers we quote are based on a 2000 calorie reference diet. Most women will eat a bit less, most men a bit more.

      Generally the proportions will work for both men and women, though women may benefit from bumping carbs and protein up slightly on a percentage basis.

      An easy guide is to make your food as delicious as possible. Usually the optimal proportions will also be the most delicious.

      Best, Paul

  36. What is the best proportion of meat to carb early in day vs. late in day?

    I do follow PHD in terms of a total day/week’s diet, but I don’t (can’t) do IF and my dinners tend to be the most protein heavy meal due to habit and lifestyle. I usually eat 3 eggs at lunch and the rest is green veggie, and modest carb (potato, sweet potato or squash). The bulk of my protein is at dinner, usually around 5-6 oz meat (measured raw) and it varies daily b/w salmon, poultry, red meat and pork. I cut excess fat before cooking, except for poultry skin which I remove after cooking. I usually have a PHD sized starch with dinner, along with plenty of green and crunchy veg. So I’m trying to evaluate how much more protein should be shifted toward earlier in the day and possibly carbs later.

    I’m not a good sleeper, and I’m still getting frequent headaches and they often start in the morning. I’ve done cortisol testing which shows a “normal” pattern, it doesn’t always feel this way, and I definitely have hormone imbalances (TSH is not optimal, and I have menopausal issues like facial and upper body overheating easily). I’m a 58 yo woman, 5’5″ and 118 lb.

    Any suggestions on how to better balance between lunch and dinner would be very helpful. And put in terms of ounces of meat and ounces of potatoes, etc, would be most understandable to me. Many thanks.

    • Why do you remove poultry skin?

      • Hi Peter,
        I don’t eat it because my understanding is that poultry fat is higher in Omega 6 vs. 3 (hopefully I didn’t misunderstand the Jaminets’ directive on this, but if I did, someone please correct me). But I do save the skin for making my chicken stock because it also contains beneficial matrix, but then I remove the poultry fat after chilling the stock. If I’m wrong on any of this, please correct me.
        Best,
        Susan

    • Hi Susan,

      It sounds like you may need more carbs, electrolytes, and water. Try adding more starches to lunch and dinner, moving the protein earlier, and snacking on vegetables with maybe a bit of salt at night and in the morning. A small tomato dipped in a few grains of salt would be perfect, plus some vinegar flavored water.

      To me, poor sleep, difficulty fasting, and morning headaches suggest dehydration and electrolyte loss, possibly due to hypothyroidism-associated adrenal insufficiency. You should see if you can get your hypothyroidism treated. Also, don’t undereat.

      Best, Paul

      • Thanks Paul! All of your suggestions make sense to me. According to my functional doctor I’m sub-clinically hypothyroid. I’ve noticed that FM’s are very reluctant to give thyroid meds unless your numbers are off the charts. My TSH was 4.5 at last testing.

        But regarding your last suggestion (don’t under eat):
        I actually feel like I eat a lot and if I eat more than about 1800 cals I will gain weight. I have a very robust appetite, so I eat tons of veggies to feel full without adding calories. Adding more lean protein earlier in the day like you suggested should help with that. I’ve pretty much cut out all chocolate and the like; semi-pleasure foods like nuts and cheese I do eat but less than 2oz per day each, usually. My added fats are very minimal at 2-4 T/day and that includes nutritious fats like avocado and sour cream. Almost all of my calories come from whole foods from the 4 groups on the PHD plate diagram, with with very little fatty meats and minimal added fat.

        • One thing that I have found is that because I have eliminated processed foods, I was not getting enough sodium. Most Americans get too much sodium, but that is because they eat so much processed food.

          So now I put 3/4 teaspoon in a salt shaker each morning and that’s how much salt I need to add in either cooking or sprinkled on my food.

          Making sure I get that salt in me and drinking 48 ounces of water every day has really helped me.

          In addition, of course, to following PHD.

          • SusanB and Paul (again),
            Thanks for the salt suggestions. I’m not anti-salt in moderation, and I do use sea salt in scant amounts. Here’s my dilemma: about 1.5 years ago (about 6 months into PHD) what used to be a scant number of spider veins began aggressively proliferating on my body, esp my legs, and I even started having peripheral leg throbs, numbness and RLS. I got an ultrasound determined that I needed ablations and phlebotomies between the knees and ankles, which I did. My mother had severe varicose veins, and my grandmother had them too. While mine developed later than theirs did (probably because I’ve never been pregnant), my veining has happened probably due to menopause (I’m 57 yo). Soooo….all that to say… that’s why I limit my salt to ultra-scant amounts. My understanding is that it’s not good to eat a lot of salt with varicose veins.
            All that said, I do prepare homemade sauerkrauts and ferments, and I go on the lower end of the salt range when I do.
            Re: Paul’s suggestion of eating some veggies with salt at night and in morning: maybe a 1-2T of fermented veggies would work for this?

            I’m certain that Paul is right about the electrolytes in general. This is weird, but I take 200mg of magnesium every night and eat tons of mag and potassium rich foods daily. But if I don’t eat a banana every day, I will get night leg cramps that wake me up. I’ve tested this dozens of times, and it’s definitely the banana. There’s something in a banana that prevents them for me. Anyone else experience this or know why?

          • Susan – I can’t speak to the varicose veins situation, other than to say at 70 yo I am getting them also. I think it’s a function of aging.

            But I wanted to comment further on a couple of things.

            I was getting irregular heartbeats that were frightening and headaches.

            I did some research and found out that dehydration was a major cause of irregular heartbeats.

            That’s when I upped my water consumption to 48 ounces per day – every day.

            I also read that low sodium was a contributing factor. As I said in my previous message, since starting Paleo/Primal and now PHD, I had eliminated all processed foods and, hence, was getting very very little sodium. As soon as I started adding 3/4 teaspoon of salt to my diet every day… and with the 48 ounces of water per day… the irregular heartbeat and headaches have totally disappeared. You NEED salt. I hope that you will re-think your current position on salt. It is a vital nutrient to keep the body functioning properly.

            I also take 200 mg of magnesium each day and that helps me sleep soundly.

            As to potassium, the daily recommendation is 4,700 mg per day. Most people are not getting even half of that. I sure wasn’t. I went to the nutritional database and made a chart of the foods I eat regularly and how much potassium they contain and I was shocked at how little potassium I was getting each day.

            So now I make sure to get enough…. and it isn’t easy… you really have to focus on potassium to understand what foods you need to eat and how much to get 4,700 mg per day.

            For instance, a baked potato has a lot more potassium than a banana.

            Here are some of the foods that I eat and their potassium count:

            In each case, unless otherwise noted, it is 1 ounce of the food = x mg of potassium.

            Baked potato 150 mg
            Sweet potato 133 mg
            White rice 0 mg
            Acorn squash 122 mg

            Beef 121 mg
            chicken 72
            Shrimp (cooked) 51 mg

            Eggs – 1 large = 75 mg

            Banana 100 mg
            Apple 30 mg
            Carrots – raw 90 mg
            Grapefruit 1/2 of a medium 166 mg

            Avocado 136 mg
            and so on…..

            Add it up and you will see that you really have to work at getting enough potassium.

            The easiest way is with potatoes. I eat a 12 ounce baked Russet potato or a 12 ounce baked sweet potato each day and that gives me about 1/3 of my daily potassium needs. Then I add on to that.

            Here’s a link to the nutritional database where you can calculate how much potassium you are getting daily..

            http://nutritiondata.self.com/

            Personally, however, even though potassium is very importatant, I think salt and water are even more important…. crucial in fact.

            Hope that helps !!!

          • SusanB, wow, thanks for all of that. It truly is enlightening. Maybe I need to supplement with potassium then, as I never have before. I do eat potatoes and sweet potatoes every day, but not enough to reach the amount you quoted. I’ve never eaten much processed foods and always been aware of sodium. But maybe too much so, as you say. (Still, there is something unique about that banana and leg cramps, which continues to stump me!)

            Dehydration — yes, I totally agree and I do drink 1-3 liters of water per day, usually 2. Sometimes I think it’s that I don’t drink it early enough in the day though. About half of that is mineral water, and I’m trending over to Gerolsteiner for that half.

            I agree with your comment about age, although lots of women in our age groups don’t have them. So it must be our genetics and epigenetics too.

            Your insights are extremely helpful, thank you!

          • Does the timing of the banana matter susan…
            I was just thinking it may be the carbs/sugars, if it was your last food for the day.

            But if a banana still helps you when eaten in the morning for instance…then it would seem like something else is going on

          • Hi Darrin, thanks for that…actually, I don’t think it matters when. Sometimes I eat it after dinner for “dessert” because I’ve forgotten to do so earlier. But most often I eat it around 3-5 pm or half in the morning and half in the afternoon. Regardless of when I eat it, I don’t get the cramps, but if I forget, then I do. I always do eat some carbs with dinner. But as Paul suggests, I’m going to bump them up.
            Thanks again!

  37. Just to re-emphasize…. the mg that I gave for potassium are for 1 ounce of that food.

    So a 10 ounce baked russet potato = 1500 mg of potassium. That gives me about 1/3 of my daily potassium requirement right there.

    I didn’t list all of the foods that I eat … so obviously I am getting potassium from other foods.

    But I do eat beef every day and 3 eggs and a large potato and some avocado and 1/2 a grapefruit and on and on it goes…. So now I get pretty close to the potassium I need.

    But a large baked potato (Russet of sweet) is a huge chunk of that. I love white rice and eat some several times a week, but it contains no potassium so I concentrate on a potato each day as the basis for my potassium intake….

    • Susan B: Thanks again! And oh, in that case, I’d say my potassium intake is relatively robust then. I eat about 10 oz of potato-sweet potato/day, 1 banana, 3 eggs, 1/2-1 c raspberries, and usually plenty of tomatoes (although now that they’re out of season, not so much, so I’ve begun using canned and organic imported this week). I LOVE LOVE LOVE potatoes and sweet potatoes (and winter squash!!!), so while I don’t eat as big a volume as I’d like, I don’t shy away from them either. I do think I’ll boost that potato and other safe starch number up to a full pound though, regardless of how much “sweet” like beets, parsnip, carrot, banana, tomato, berries, etc, that I eat — and I do eat most all of those in good quantities daily.

      Some of our health issues and our daily diets sound very similar, except for the salt quantity and supplements. Which salt are you using? I use Himalayan Pink, and Celtic mainly. So are you supplementing with potassium, and if so, what brand and how much? Also, which brand of magnesium do you take, and when do you take it? I’ve been taking Doctors Best (2 per day) but I’ve recently read on Suzy Cohen’s newsletter that Mag Threonate is superior. (Do you or anyone else agree with this?)
      Paul has also suggested that I split my dose b/w lunch and dinner, which I try to do, but I so often forget at lunch that I end up taking both after dinner.
      Thank God (and the Jaminets!) for this awesome PHD community!!!

      • Susan – I use a sea salt that I get at Whole Foods – I don’t remember the brand at the moment. I don’t supplement for potassium – I just make sure to eat plenty of potassium rich foods. For several weeks, I counted the potassium content of the food I was eating so that I could get a good idea of what and how much I needed to eat to get enough potassium. Now that I know, I don’t count any more…..

        The magnesium that I take is a Swanson brand that I get at swansonvitamins.com It’s called Albion Chelated Magnesium Glycinate.

        I try to remember to take one at lunch and one at dinner, but sometimes forget the one at lunch. If so, I just take one with dinner and don’t double up.

        • OK, thanks Susan B. After Christmas I’ll try calculating my potassium for a few days to make sure that I’m hitting the target. I never bothered doing this before since I follow the general PHD guidelines which take that into account and theoretically hit the target.

        • SusanB and Paul:
          Well guess what?…at your suggestion, about a month ago (after a string of frequent and debilitating migraines that often began in the morning) I began sprinkling more pinches of sea salt on my food (including my fruit and yogurt in the morning since I don’t do IF). And not one headache since I’ve begun doing that! I’ve even felt one brewing in the morning a couple of times, and then had my modest breakfast with salt sprinkle and it has vanished.
          I’m truly in disbelief. You would think that some doctor, somewhere along the line, would have suggested that. I was so fixated on magnesium and potassium and figured that the natural salt in food along with just a pinch or two during the course of the day and evening would be enough. But a few more pinches, and especially the one in the morning, seems to have made the big difference. I’ve been using Celtic Sea Salt. This, after decades of suffering. I’m going to knock on wood that the success will continue.
          THANK YOU!

          • Susan – I’m so glad to hear that it helped. As I have said before, I was having irregular heart beats and heart palpitations that had me very concerned, so I started doing some research. And I discovered how important sodium is to our health. We have been so inundated with warnings about getting too much sodium that it can be a problem for those of us following a Primal/Paleo/PHD way of eating…. BECAUSE…. when you eliminate all processed foods from your diet, you can very easily be getting too little sodium. And that was what was causing my irregular heart beat and heart palpitations. Now I put 3/4 of a teaspoon of salt in a salt shaker each morning and be sure to add that to my foods – either when cooking or on my food after it is cooked. I also make sure to drink at least 32 ounces of water each day. Since I started with the 3/4 teaspoon of salt daily and 32 ounces of water, I have never again had irregular heart beats or heart palpitations. Sodium content for our way of eating is something important that doesn’t get mentioned very often sadly…. The reason that most Americans get too much salt is because of all of the processed food that most Americans eat. Processed food has far too much sodium in it.

          • SusanB, now that I’ve been through this, I totally agree with you, especially for us conservative rule follower types who avoid “bad” things. I do eat non-conventional dairy, so I do consume some added sodium that way, but obviously not enough. I also make almost all of my own sauces, including tomato, BBQ, salad dressing, etc, and I rarely eat out, so unless I add salt, it’s miniscule. Of course my homemade kraut contains sea salt too, but consumed as a condiment, that isn’t a huge amount either.
            My mother was ill with high sodium in her early 80’s and was put on a strict no-sodium diet which she adhered to for 2 years, until suddenly one night she was rushed to the ER with stroke-like symptoms, and was on the verge of being administered a potentially fatal, but also potentially brain and life-saving drug in case of stroke. While the Doc was explaining this to me, her CBC results came back showing her sodium at around 99 which is extremely dangerous. (Luckily he’d concluded that while some of her symptoms were stroke-like, she was still responsive, so he wanted to rule out low sodium which can mimic stroke symptoms. Smart Doc!) So instead of the drug, they started a sodium drip stat, and within about 30 minutes her behavior and symptoms began normalizing.
            I guess this is a great example of the PHD guidance that both too much and too little of a critical nutrient can be dangerous/fatal, and that there is a perfect health sweet spot in between that we should aim for.
            BTW, her at-home diet was actually quite good prior to the high sodium, but they had begun going on a few cruises each year and they load food with salt. She actually began falling sick with high sodium symptoms while on one of those cruises.
            But I’d never have connected low sodium to my migraines if you hadn’t been so insistent in your commentary!
            So you eat the 3/4 tsp in addition to what’s in sauerkraut, and incidental in dairy and other foods? I haven’t been doing that; I’ve just been putting a pinch or two on my food at every meal in addition to using it modestly/conservatively in cooking.

          • Oh, I see that you use the 3/4 t for cooking too. It’s a little harder to measure daily consumption when you’re batch cooking, like I do, or making food at one meal that results in leftovers the next day. I’ll make a 2-3 qts of soup at a time (homemade stock as base, but with TONS of veggies, etc) for the week. Also I’m cooking for 2, so again, hard to measure for me without keeping a journal (trying not to obsess).
            Also, re: water — yes, I’ve been consuming tons of water daily for a few years now (though I never used to drink water!). In addition to coffee, soups, etc, I drink 1.5-3 qts water per day, depending on activity and temps.

          • Susan – I think I was well on my way to being in the same situation as your mother. My heart palpitations and irregular heartbeat were getting scary. I am so glad that I found information on the Internet that taught me that too little salt/sodium is every bit as bad as too much.

            I am cooking for 1 and I use almost no processed foods. I tend to cook very simple meals and I rarely cook in large batches so I don’t generally have leftovers.

            So my system of putting 3/4 teaspoon of salt in a salt shaker by my stove works really well for me. I know that I need to consume that 3/4 teaspoon of salt that day in a combination of adding it while cooking and sprinkling it on food that I am eating raw or sprinkling it on food that has finished cooking.

            If you are cooking for more than one person and/or making larger batches to eat at another time, that the solution is not as easy as my solution.

            I think if you just remind yourself that you need salt every day… and probably more than it sounds like you are getting… even now with your increase…. then you will most likely get enough.

            If one is not eating processed food, it would take a lot to be overdoing the salt intake…..

  38. Hello,
    In my country I have access to wild cough Cod and Salomon. Is it ok to eat Salomon once a week and cod 2 times a week? (1-1.5 fillet portions)
    I am not sure about content of omega 3 would be too much from above?

  39. Paul,

    I just broke my jaw, I have been telling you how great I have been doing! Two nights ago while grinding my teeth I broke my condyle bones my jaw. Very painful and unfortunate thing, since through the holidays it is soft foods and soups! They want me to get a bone density test, i went undiagnosed with hyperthyroidism for a very long time, it took 6 doctors. So I am concerned my bones may have been compromised. The doctor told me to take calcium, I eat so much cheese and green veggies, I feel like I get enough, plus I take vitamin D3 and my K2. Obviously I can not do resistance training in my jaw,. Should I up my bone broth? I am taking 2000mg of glycine at night as well.

    Any other suggestions?

    Merry Christmas! I hope you enjoy a wonderful holiday together, kids truly make everything seem more magical! My little girl is 6 yrs old… And we are relishing every minute!

    Amy

    • Hi Amy,

      Ouch! Amazing that hyperthyroidism was so hard to detect, TSH should be a regular test, it is so important.

      I think I would supplement some calcium. Look for a calcium-magnesium supplement that has about twice as much calcium as magnesium. It’s hard to be consistent with bone broth and the calcium content is uncertain. Excess calcium has extremely mild negative effects, so don’t worry about modest supplementation.

      Be sure to also get vitamin A (up to 10,000 IU/day), vitamin D, vitamin K2, boron, sulfur, glycine or extracellular matrix from food (chicken feet, ox hooves are good sources; also scallops/shellfish and any gelatiny stock), do intermittent fasting with daytime eating, and tend to circadian rhythms.

      Best, Paul

      • Yes, I bounced from doctor to doctor, they kept telling me my heart rate was normal. After I dropped 20 lbs, one doctor suggested I was anorexic…lol. I live in Jacksonville now near the Mayo clinic and my care has improved immensely.

        It is so interesting you mentioned vitamin A! I had my DNA done, and Just last week I found I have 2 gene mutations that severely limit my ability to convert vitamin A from plant sources to active Vitamin A. Many long term problems like poor eyesight at a young age, acne, poor immune response and now my jaw breaking can all lead back to this mutation. My family from many generations back came from the Orkney islands, where they ate a wide variety of seaweeds and made their own cod liver oil. Made me think perhaps that our bodies adapt and down regulate conversion and adapt to what was probably massive doses of vitamin A and D. Then as children emigrate and lose tradition and old world ways of eating, we are left severely deficient. Just a theory on my part that has most likely been very well explored.

        Just an interesting coincidence in your suggestion:)

        Thank you,
        Amy

    • Amy: A calcium-magnesium supplement to consider:
      Nature’s Way Alive! Calcium Bone Formula
      They recommend that you take 4 tablets/day, but of course you can take fewer if that’s what suits you.

      One tablet provides:
      250 mg calcium
      125 mg magnesium
      500 IU D3
      25 mcg K2-MK7
      and a teeny bit vit C & some other minerals

      Cheapest prices on amazon are ~$20 for 120 tablets. So: definitely more expensive than some Ca/Mg supplements (eg Costco), but I like the simplicity of just taking one type of tablet when I travel. At home, I’m currently taking 3/day and supplementing with additional D3 and K2 (Life Extension Super K with Advanced K2 Complex; it & D3 on amazon via Paul’s recommended supplements page, which I believe gets him a little compensation).

      I have osteoporosis myself (per DEXA scan, lumbar spine; hip still hanging in with osteopenia) and am hoping my next scan will at least show no further bone loss. Good luck to you!

  40. Make sure they check your parathyroid hormone.

  41. Paul,
    Does Perfect Diet allows being 80 or 90 percent perfect only? Especially people who are healthy, can they eat some bread, pizza or Italian pasta from time to time as a reward? (5-10 times a year)

  42. I tossed all of my nonstick pans awhile ago, but now I’m rethinking it and considering buying one. Before I spend the time on this, has anyone out there recently done this, and can you provide any information about the best and safest brands and models?

    All of my regular pans are Stainless Steel All-Clad and Le Creuset. I’ve only window shopped nonstick in All-Clad, Calphalon and Scanpan, but I haven’t researched them or any other brands/models yet.

    • I think the Green Pan ones are safe. Available on the Shopping Channels.

    • if you really want to be safe you could get carbon steel pan and learn how to cook with it.
      It requires little more skill and seasoning but it is safe.
      http://www.amazon.com/gp/product/B00462QP0C/ref=s9_dcbhz_bw_g79_i2_sh
      or cheaper
      http://www.webstaurantstore.com/vollrath-58920-carbon-steel-fry-pan-11-french-style/92258920.html

      • Hi Bart, thanks for that thought. I actually have one of those pans. I bought it originally for making French crepes decades ago. It’s interesting though, the description says 99% cast iron. I thought that Paul didn’t recommend cooking in cast iron (unless it’s enamel coated, like Le Creuset)?

        • From what i know iron accumulates in the body especially in men. I would go for the carbon steel version. No iron.

          • Bart, thanks. Ok, the link that you sent was for the iron one, but now I see the carbon steel, which I actually what I think that I have but haven’t considered using as a nonstick pan before. I’ll give it a shot! The Amazon reviews from knowledgeable cooks look compelling, so I may have to get one in the 12.5″ size. Thanks for this great recommendation, it definitely looks like a great option. Questions for you though: other than seasoning it both originally (and presumably after each “washing”) do you find that you need to use any oil or fat when cooking things like eggs or a rare grainless pancake? And how do you wash it — just scrubbing with hot water, or is dishwashing soap ok? (Of course, I’d never put it in the dishwasher). Thanks!

          • Carbon steel pan works perfect for meat, fish or even vegetables. I love it as it responds to heat in seconds but when it comes to eggs it is an animal and it requires proper technique. I personally use vollrath that I had to season myself but the seasoning comes off on different occasions. I don’t reseason it anymore but I just use it and let it season on its own. The key is to use enough oil. Butter works great and with perfect diet we are not afraid of butter. If you attempt eggs with no any type of fat the seasoning will go off. I try not to use any soup. I either use just towel or water and scrubber.

          • Well my All Clad SS frying pans work great with butter, ghee and oil too. And clean up is a breeze. But I make them sunny side up every day which is not messy at all when cooked on low. To do scrambled in SS may be a different story though since the fat is being moved around during cooking.

            This actually came up because I tried to make banana pancakes using a PaleOMG recipe on Christmas and she called for a nonstick pan. Instead I used my 14″ SS frying pan with ghee and I couldn’t keep the pancakes from burning. So I was thinking that the nonstick would have worked better. One person made them in the oven on parchment paper, so maybe that or a silpat would work too.

  43. Ellen, thanks for that link. Based on her guidelines, I shouldn’t use non-stick on my stovetop since mine is a high-output range top. Each burner is 15-30K BTUs.

  44. Hi Paul,
    Two brief questions if you don’t mind.

    – How (and when) do you incorporate coffee in your routine?
    – How to safely overeat (considering suboptimal caloric intake in the past)? I guess keeping the fat intake normal but increasing the carb intake..?

  45. hi Paul – I am enjoying your book and trying new things. I have a question on fasting – I have been trying it for about a week so far, not eating till about noon as dinner is over around 8pm. It is great for energy but I am having a problem adjusting my bathroom schedule as previously I would poop twice in the morning, once right after I get up and again right after eating breakfast around 9 or 10am, but now without eating something to stimulate the digestion process I feel like I need to go all morning but I can’t get it to happen? Any suggestions? thanks.

    • Ralph, I can’t find your reply to me about chocolate, so I’m replying to you here…
      Actually I buy 100% chocolate and have several great sources (including a local chocolate curator) with 85% +, very high quality chocolate, and several of them use only cacao, coconut sugar and sea salt. So far I haven’t found the need to make my own. For Christmas I made chèvre truffles using a cross between Enjoy Life dark chocolate chips and 100% specialty baking bars that yielded a net ~ 80% (the other ingredients were chèvre (fresh goat cheese), vanilla and sea salt). I rolled them in unsweetened Italian cocoa, so the % was even higher. They were crazy good.

  46. Paul,

    Is there a reason you suggest cold brewing green tea and then heating it before you drink as opposed to hot brewing? Is it more healthful?

    Bruce

  47. Should the measurements of starch and meat be raw or cooked form?

  48. I apologize if this has been covered before either here or in The Book but don’t recall seeing them specifically addressed….
    Split Peas:
    Following PHD, I rarely consume legumes, but occasionally I enjoy cooked garden peas, string beans and even more rarely, lentils (I buy them pre-sprouted). But has the safety of split peas (presumably soaked for 24 hours, then either slow-cooked or pressure cooked) been addressed with PHD? I haven’t consumed them for 2 years (rarely did prior to that either), but a friend recently made a delicious split pea soup in her Instant Pot. Since it’s soup season, I’m wondering if they’re OK for a rare change of pace. Thoughts/guidance?

    • Hi Susan,

      I think split peas are not the best legume: Lentils or mung beans, especially the hulled varieties (red lentils and yellow mung beans), would be safer; and immature legumes like garden peas or string beans would be the safest.

      However, split peas also aren’t the worst legume: True beans (black beans, kidney beans, etc) would probably be less safe; soybeans, fava beans, jack beans, and peanuts would be the least safe.

      Best,
      -Eric

      • Thanks Eric! Yes, Russ Crandall told me the same thing in response to one of his recipe posts and it’s also explained in Paleo Dork’s email today. So I made fresh garden pea soup instead of split pea as a result and it’s delicious.

Leave a Comment


NOTE - You can use these HTML tags and attributes:
<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>