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 ?

3,153 Comments.

  1. Public Service Announcement: The PUFA content of Trader Joe’s sunflower seed oil is a factor of 10 higher than indicated on the nutrition facts label.

    So it is NOT suitable for PHD — contrary to what several commenters have assumed on basis of the faulty nutrition facts label (see for example http://perfecthealthdiet.com/2012/12/toward-a-happy-phd-in-the-mainstream-new-year/#comment-123526, item #7).

    Trader Joe’s tells me they’re planning on changing suppliers, to a low-PUFA (“high-oleic”) variety of sunflower oil; it should take 6–12 months to make the switch. I’ll post back here once that switch is completed with more details.

    Best,
    -Eric

  2. Hi Paul, I eat about an ounce of dark chocolate just about daily. It’s my one indulgence and brings me great pleasure. I’m not at all overweight. I just read that my favorite bar of dark chocolate (among others) was found to contain lead and cadmium. Should I worry about this?

  3. Paul, in your book you mention Homocysteine only few times. Whats your opinion about Homocysteine test results? Should we worry about its values? Should we even consider this test?

  4. Paul, do you think this will bring hope to all those people who suffer from undiagnosed brain infections?
    http://hopkinsinhealth.jhu.edu/community/featured-research/diagnosing-brain-infections-with-genome-sequencing

    • Hi Jorge,

      Yes, I’m very glad they are working on it. The downside is that progress will be very slow because they seem to rely on brain tissue specimens and those are rarely available.

      Best, Paul

  5. It is very confusing, annoying, upsetting and just makes me sad really, that there is still such a controversy and disagreements between doctors and scientists over what a good diet to avoid heart disease is. The main areas of vehement disagreement seem to be over meat, eggs, saturated fats.

    What is your response to people like dr. Fuhrman? He says: “Saturated fats have not been shown to be safe and healthy, and foods rich in saturated fat should be minimized: less meat, butter and cheese in favor of more beans, intact whole grains, vegetables, and nuts and seeds”
    http://www.drfuhrman.com/library/were-we-wrong-about-saturated-fat.aspx

    He is not the only one – others like greger, ornish, mcdougall, Esselstyn say similar things – meat, saturated fat, eggs and cholesterol are all bad and should be replaced with beans, nuts, seeds and more vegetables.

    • There’s a book out there called the Perfect Health Diet that lays out what they think is the best diet based on current science. Have you read it?

      • ralph, here is the thing and I sympathise with your frustration. There is NO PERFECT DIET. I love Paul’s book and think it is certainly one of the best books out there for overall guidance and detail. And Paul is totally awesome and available too! It’s just that every person is so individual.

        Take joints: you can find evidence that more grain, no grain, more meat, no meat, no nightshade, yes! nightshades! go on do vegan etc… but, yeah FAT! all work for some folks. Why? Too many reasons to list here. You need to find your way and comfort zone in your own journey. You can go too far and get depressed and then the beer and pizza diet will work.

        Sorry not meaning to be a pain I have been every place on my journey, at times riding on rollerskates and spinning a nice side of grass-fed meat above my head. Keep going, keep reading, but make sure you don’t get too disheartened.

    • The thing about those people you mention is that some of them place their vegetarian or vegan advocacy before everything, and that of course includes historical and scientific evidence. McDougall wouldn’t even let you eat nuts, maybe an avocado here and there if you feel naughty. He would disregard the fact that the people from the Blue Zones eat and highly value animal products, even if they indeed consume large ammounts of starch in the form of legumes and grains. Don’t pay attention to his jokes about eating a little piece of turkey on Thanksgiving -you know he ain’t doing that.

      You can always derive your own synthesis. For instance, Paul no longer recommends adding oils if you consume fat (and you should) from whole sources. Think that many in the ancestral community still proclaim that supplementing with oils is a good thing. He has somehow relaxed his possition towards properly prepared legumes, although he doesn’t recommend consuming them on the basis that people will simply buy the processed stuff. And if anything, PHD is pretty much plant based.

    • Dr. Michael Greger today on NutritionFacts.org. eggs increase oxidized LDL. Wish Paul would comment. Here is the text:
      Maria Fernandez has received nearly a half million dollars from the egg industry and writes papers like “Rethinking dietary cholesterol.” She admits that eggs can raise LDL cholesterol, bad cholesterol, but argues that HDL, so-called “good cholesterol,” also rises, thereby maintaining the ratio of bad to good. To support this assertion, she cites one study that she performed with Egg Board money that involved 42 people.

      If we look at a meta-analysis, a measure of the balance of evidence, the rise in bad is much more than the rise in good with increasing cholesterol intake. The analysis of 17 different studies showed that dietary cholesterol increases the ratio of total to HDL cholesterol, suggesting that the favorable rise in HDL fails to compensate for the adverse rise in total and LDL cholesterol. Therefore, increased intake of dietary cholesterol from eggs may indeed raise the risk of coronary heart disease.

      The Egg Board responded (as seen in my video, Does Cholesterol Size Matter?) by saying that the increased heart disease risk associated with eating eggs needs to be put in perspective relative to other risk factors, arguing that it’s worse to be overweight than it is to eat eggs, to which the authors of the meta-analysis replied, “Be that as it may, many people do not find it a major hardship to cut back on egg intake, whereas most people find it impossible to lose weight permanently.”

      Fine, Fernandez admitted, eggs increase LDL, but she claims that the increase is in large LDL, arguing that large, fluffy LDL particles are not as bad as small, dense particles. Indeed, large LDL only raises heart disease risk of women by 44%, instead of 63% for small LDL. Light large buoyant LDL still significantly increases our risk of dying from our #1 killer. The difference is similar for men: large LDL only increases risk of heart attack or death by 31%, instead of 44%. As the latest review on the subject concluded, LDL cholesterol has “clearly been established as a causal agent in atherosclerosis … Regardless of size, LDL particles are atherogenic.” Yet Egg Board researcher, Fernandez, wrote that the formation of larger LDL from eggs is considered protective against heart disease, relative to small LDL. That’s like saying getting stabbed with a knife is protective–relative to getting shot!

      Health practitioners should bear in mind, she writes, that “restricting dietary cholesterol puts a burden on egg intake” and leads to the avoidance of a food that contains dietary components like carotenoids and choline. She wrote this in 2012, before the landmark 2013 study showing that choline from eggs appears to increase the risk of stroke, heart attack, and death, so she can be excused for that. But what about the carotenoids in eggs, like lutein and zeaxanthin, which are so important for protecting vision and reducing cholesterol oxidation? As I explored previously, the amounts of these phytonutrients in eggs are miniscule. One spoonful of spinach contains as much as nine eggs. Comparing the predictable effects on eye health of organic free-range eggs versus corn and spinach, the effect of eggs is tiny.

      What about the effects of eggs on cholesterol oxidation? We’ve known for decades that LDL cholesterol is bad, but oxidized LDL is even worse. Therefore, according to Fernandez, since eggs have trace amounts of antioxidants, eggs may prevent cholesterol oxidation. But the science shows the exact opposite. Consumption of eggs increases the susceptibility of LDL cholesterol to oxidation. The researchers found that not only does eating eggs raise LDL levels, but also increases LDL oxidizability, in addition to the oxidizability of our entire bloodstream. This was published 18 years ago, yet Fernandez still tries to insinuate that eggs would reduce oxidation.

      She acknowledges receiving funding from the American Egg Board, and then claims she has no conflicts of interest.

      This is why a site like NutritionFacts.org can be so useful, because even when a paper is published in the peer-reviewed medical literature, it can misrepresent the science. But who has time to check the primary sources? I do!

  6. Wow. In a perfect world: Live in a big city, have a “healthy” income so you can afford these special foods and a personal assistant to find, fetch and fix all the meals and snacks for you. I’m just looking for a way to get off processed sugar, eat healthier and still feel satisfied -It’s become a real problem for me. How depressing. Happy for all who can do even a fraction of these money, resource and time consuming solutions.

    • Sheli – I am 70 yrs old, retired and live in a modest budget, but I do it.

      I do it by keeping things simple. No sugar, no wheat, no processed food.

      What do I eat?

      Meat, poultry and fish/shellfish – simple grilled or baked. A couple of eggs a day – fried or scramble.

      A baked Russet or sweet potato with some butter.

      Steamed vegetables or a mixed salad with a little salad dressing.

      A piece of fruit for dessert.

      It’s frugal, simple and doesn’t take a lot of time.

      It’s the way people used to eat when I was growing up in the 1940s and 1950s. Meat, potatoes, vegetables and fruit. Real natural unprocessed food. Simply cooked.

      And… I’m saving a lot of money on food.

      Try it !!! It really is easy. And.. I feel great….

    • and…

      3 meals a day.

      Protein
      Safe starch (potato, winter squash or white rice)
      Vegetables

      at every meal.

      Fruit – once or twice a day as dessert.

      That’s it. Very very very easy.

      No fancy ingredients. No expensive ingredients. No time consuming recipes.

  7. Does IF intervene with any strenght and muscle gains obtained from weightlifting?

  8. Amazing, always appreciate your quick response.
    Regards.

  9. I have asked this question before in other sites as well and thus far have never got an answer. Here it is: According to the Pritikin Program, The McDougall Program and Dr. Caldwell Esselstyn, author of Prevent and Reverse Heart Disease, all claim that their method of a low fat (10%) diet will stop the progression of heart disease, and in many cases the reversal of it. Are the claims true of these well respected doctors? Question: Can the same be said of the Perfect Health Diet? Will the LCHF eating methods or PHD stop the progression of heart disease or even its reversal?

    • Yes, it seems that a well designed very low fat plan has great health benefits. McDougall is Vegan so B12 supplement is necessary and his no oil rule is absolute. Not even a drop of olive oil. Pritikin is low calorie. These are great for those who can follow the plan.

      Oddly enough there are now several other diet plans with a completely different approach that also claim to reverse diabetes, heart disease, kidney disease and autoimmune disease and these claims have been backed by doctors (both MD and PhdDs). A few examples are 1) Intermittent Fasting – Dr. Jason Fund – Obesity Code 2) The Wahls Protocol – Dr. Terry Wahls who cured her MS. 3) The Paleo Approach: Reverse Autoimmune Disease and Heal Your body by Dr. Sarah Ballantyne. Perfect Health Diet fits in with this group.

      There are other books in same line which don’t make specific health claims beyond promise of weight loss. New Atkins is an example.

      What all these plans have in common:
      1) Plant based
      2) No sugar, refined flours, processed foods
      3) Eat until full (except Pritikin)

      Conclusion: There’s lots of choice so just pick one that appeals BUT follow the fine print of each plan. The devil is in the details.

  10. Hello Paul:
    I would like to know how much carb calories should a 19 year-old guy (6 feet tall), who lifts three times (bodyweight, and not so intensely by the way) and sprints weekly (one sprinting session) consume? I know 400 carb calories aren’t enough, but if I choose to eat more I end up eating something like 200 gr (I know that doesn’t sound like a lot, but I also read that carbs shouldn’t be eaten to taste, but rather a little bit less), so I would like to know what’s your opinion on this? The same happens with protein, but I end up eating LOTS of protein (~170 gr/day), and I know this isn’t healthy…

    Thanks a lot in advance!

  11. Hi Paul-
    Several stores in my area are selling potato chips made from either 100% coconut oil, avocado oil or olive oil. Would these be approved (in moderation) or does the high cooking temperatures of the healthy oils (deep fried) make them unacceptable? The only other ingredient added is sea salt. Thanks!

    • Sometimes a treat is in order, and while I rarely purchase or consume pre-packaged food, the coconut oil cooked chips offer a nice diversion. I don’t eat them daily, but if we’re going on a car trip or will be in a place where we can’t cook, or I just want to feel like a “normal” person, I will enjoy some. Try Jackson’s Honest – I think they are the healthiest and best tasting among all of the brands.

  12. TR, I’m always looking for some variety. I don’t like the ones in olive oil, but haven’t seen coconut or avocado anywhere. What are the brands and are they tasty?

    • Hi erp-
      They are very good and hoping they are ok to eat. Boulder Canyon is the brand. King Soopers (Denver area) and Walmart.

    • I’ve seen trafo brand

    • Hi erp, have you tried Jackson’s Honest? They’re incredible!!! They make potato, blue heirloom potato, sweet potato, corn and heirloom blue corn — all made with only coconut oil and sea salt only. They make a few flavored potato (BBQ) and corn (Salsa Fresca) that have other junk in them, but I avoid those. Almost all of their ingredients are organic too. I buy mine at Whole Foods and a few high end super markets in my area. But you can also buy some of them on Vitacost or order them by the case direct from Jackson’s Honest. My husband is not paleo, and he LOVES them. Enjoy!

      • Thanks. I’ll try Whole Foods.

        • I don’t know where you live, but on the SF Peninsula Whole Foods has them, and I’m pretty sure that they carry them in Seattle. If they don’t have them at your WF, then ask them to bring them in. The corn chips have been harder to find (I don’t eat corn regularly, but occasionally I do) but one specialty store started carrying them right after I ordered a case direct from Jackson’s (a few families shared them with us). Nice thing about all of their corn and potatoes is they are organic/non-GMO and the blues are heirloom varieties.

  13. Does White rice and white potatoes cause inflammation in the body?Do starches feed candida?I’ve had this bad post nasal drip for years and haven’t been able to pinpoint the cause.

    • Hi frankie,

      From (http://perfecthealthdiet.com/2011/10/jimmy-moore%E2%80%99s-seminar-on-%E2%80%9Csafe-starches%E2%80%9D-my-reply/):

      “Dietary carbs can feed Candida in the gut, but they also feed competing probiotic bacteria and promote intestinal barrier integrity and immune function, and thus their effect on the gut flora is complex. More importantly, ketosis promotes systemic invasion by Candida and glucose is needed for the immune defense to Candida, so a moderate carb intake is helpful to the defense against systemic Candida. As Candida is an effective intracellular pathogen that can flourish systemically, this is a very important consideration. No one with a Candida infection should eat a ketogenic diet… consult our ‘Results’ page for a few cases in which fungal infections were exacerbated on very low-carb diets and cured on our diet.”

      Best,
      -Eric

    • @frankie…I finally found out my sinus problems were caused by potato chips. I would eat a tiny bag at my break during work and it took me forever to figure out what what was making my nose run all the time. I am not allergic to potato chips either.

    • After quite a while of experimentation, I discovered that my sinus problems/post-nasal drip were caused by dairy. No dairy = no sinus problems…. none 🙂

  14. Could this be a food histamine issue?Is PND always almost a fungal issue?

    • What is PND?

      • post nasal drip

      • @ Cheryl PND is post nasal drip

        • I have a nasal polyp and was constantly trying to figure out what was causing inflammation in my sinus cavities. I never really had post nasal drip just a runny nose and a lot of sinus pain. And I read that chronic sinusitis was fungal but I have no idea why potato chips bothered me yet I can eat potatoes I cook myself. I get migraines from chocolate which I thought was histamine related.

  15. Hello, I was wondering if you would behave a sale on your book any time soon. I missed the November sale by a few days and have been waiting for another sale. Thank you for your tme!

  16. Hi,

    I’m halfway through the book, and wondering where tomatoes fit in.

    Tomatoes being a fruit do they count toward the sweet plant pound per day, or being only 48 calories per pound do they fall in with the vegetable pound per day (with onions, roots, green leafy vegetables etc.)?

    I’m sorry if you’ve addressed this elsewhere, but I’ve been looking and haven’t been able to find the answer.

    Thank you for all your hard work and dedication! This is amazing, life changing stuff!

    • Hi Jake, they are a fruit. The Jaminets discuss them as a sweet non-starchy plant or fruit. As a practical matter, I usually factor them into my sweet count, along with berries, bananas, etc. However, personally, I almost always eat 1 tomato per day (regardless of whether or not I’ve met 1 lb of sweet from other sources) because they are a top source of lycopine and of course potassium.
      When the Jaminets talk about non-starchy vegetables, I believe that they loosely mean the crunchy ones and all greens. (There is also some cross-over of semi-starchy or semi-sweet root veggies like carrots, parsnips, turnips, beets, sunchokes etc, between crunchy vs starchy; but unless I’m eating a big serving of one of the starchier ones in lieu of a starch, then I tend to ignore the starchy aspect of them.)

  17. My annual physical showed elevated creatinine and hemoglobin A1C, so I did a follow-up to retest, and the results are still elevated. Here they are:
    CREATININE 1.47 mg/dL (good range: 0.76 – 1.27 mg/dL)
    HEMOGLOBIN A1C 5.9% (good range: 4.8 – 5.6%; Pre-diabetes: 5.7 – 6.4; Diabetes: >6.4)

    I don’t know whether or not I should be concerned. I am 41 years old, not at all obese or even overweight, have good muscle tone, am generally healthy, eat a diet that’s generally close to the Perfect Health Diet on most days (gluten maybe once a month or so, low-moderate carb on most days, low sugar, low veg. oil, high sat. fat, many vegetables, protein largely from grass-fed kefir, wild caught seafood, grass-fed collagen, whey and beef) and am very active (two or three days per week of brief intense cardio, one heavy weight day (Body by Science) and many days of competitive sports. I also supplement with creatine one or two times per week. I’ve read that lots of athletics together with high protein and creatine supplementation can elevate creatinine. I’ve also read that ketosis might be associated with high creatinine. I have none of the symptoms associated with pre-diabetes or kidney dysfunction, so not sure if I should be concerned, how I should follow up or what, if anything, I need to do about these results. Any ideas would be appreciated.

    • Creatine can increase creatinine, but usually just as a by product of metabolism of the creatine. It’s not indicitive of kidney injury. If you weren’t taking creatine it would be an issue to look into.

  18. Heidi – Can’t find your link from your comment. What company / product are you complaining about? If it is Garcinia Cambogia,or something else, go through your credit card people. They may be able to help you by registering a dispute with the company. They (TD VISA) were very helpful for me and I got $700+ back.

  19. This question is aimed squarely at Paul. I hope you can respond……..

    I’m an overweight (but not too much) 45yr old male from the UK. I’ve got a cholesterol level of 9.4. I also have very raised blood pressure.
    I’ve been having investigations including running ECG’s etc and am due a CT scan in a couple of weeks to check my heart condition out.
    I’m already getting the lifestyle info from GP’s : Go on Statins, Reduce your fat intake, cut down the salt etc etc………..
    I’ve never believed in this sort of advice but now I’m looking at the possibility of heart disease, I’m having a wobble about what’s correct nutritionally 🙁
    I’m doing the book at the moment (just started) but wondered what you’d say to someone in my position. Cheers, Rich

    • Hi Rich,

      I would say implement our diet & lifestyle, and related natural remedies, ASAP, beginning with healing the gut (e.g. vitamin A / liver, vitamin D / sunshine, vitamin C, taurine, glycine, intermittent fasting, circadian rhythm entrainment, iodine, 3 egg yolks per day, 3 tbsp vinegar per day, lemon/lime juice, green leafy vegetables).

      Statins are on option you should think over. They may reduce your risk of a heart attack in the short term. After you have implemented natural lifestyle improvements you should see if you can get off them. Do not let your LDL cholesterol go below 130 mg/dl = 3.36 mmol/L while on statins.

      Best, Paul

      • Hey Paul, Thank-you so much for taking the time to reply, that’s really cool of you and very much appreciated.

        I’m doing the fasting, eating ‘clean’ but I’m going to be 100% honest and say that the book can be a hard read at times ! ! I don’t know if you’ve considered it, but I really thing a Dummies version of the PHD would be an absolute bonus to anyone who’s already bought the book. I’m sure alot of people have said the same or if they haven’t, they’ll be agreeing with this comment.

        Anyway, I’ll keep to the fasting. On breakfast days, I’ll have three eggs (whole) and a banana. I’m mainly eating chicken for lunch (I’m a plasterer by trade and I grab it hot from the supermarket for convenience). I’m getting plenty of organic butter into my food and also taking a teaspoon of coconut oil straight off the spoon every day. I’m drinking lots of water and eating alot more veg than I usually do. Dinner is generally a tuna steak or some chicken with veg but I’ll start mixing those meats up.

        I’m going to look at supplements now and also see what Circadian Rhythm Entrainment means ! !

        Thanks again for the reply, I truly appreciate your time.

  20. I have a question for Paul regarding the intermittent fasting. You indicate that we should fast 16 hours, eat all meals with eight hours, and that in the 16 hour period we can eat coconut oil. My questions are:

    * Can you describe what specifically triggers autophagy and why coconut oil does not affect this? Is the requirement for the cell to start autophogy that it run out of *both* glucose *and* protein?

    * If we eat coconut oil should this be done only near the end of the 16 hour period, when we get up in the morning for example? If you eat coconut oil early in the fast won’t that delay the exhaustion of glycogen from the liver?

    • Autophagy is triggered by shortage of macronutrients or specific shortages of protein or carbohydrate; or by innate immunity after detection of bacteria or viruses inside the cell. Coconut oil does affect autophagy by removing the low-calorie trigger for autophagy, but because longer fats don’t enter the brain and ketones are an autophagy trigger, they don’t prevent neuronal autophagy. Yes, I think it’s best to take coconut oil only at the end of the fast, so that you are ending the fast for most of the body but continuing it for the brain. I would say wait until hour 15.

  21. Hey Paul,

    I hope you and your family are well. Since I came off my IVIG 14 mos ago I have been doing great, until now. I don’t make certain serotypes for E. COLI bc of my primary immunodeficiency and I developed a UTI with an antibacterial resistant e. Coli. The antibiotics I have used so far I have not been able to clear it. What would you recommend to optimize PHD. I am not having fungal issues, so ketogenic? Up my MCT OIL? Cut fructose out for now? Any supplements that might help? I am not sure which way to go here.

    Thanks,
    Amy

    • I would support antimicrobial peptides with vitamin A and D, use probiotics (AO+Mist, yogurt) on the urinary tract outlet to provide competing bacteria, and look into what pH of urine is best for eliminating E coli, then achieving that with alkalinizing or acidifying nutrition.

  22. Great, I will do all of that! Thank you!

  23. It seems to me there is an important idea here with fasting that is never directly addressed. There is a trend in research now show that many bacterial and viral pathogens are good at turning off the innate immune system. This allows them to become long term parasites in the body, and over time they accumulate and create a significant disease burden on health. Controversial researcher Trevor Marshall has the theory that many of these pathogens turn off the vitamin D receptor, which is critical for innate immune response in the cell.

    Wouldn’t fasting’s ability to promote the cell eating these organisms as food bypass the innate immune response entirely? If yes, then fasting might be the *only* way to control populations of these more pathological organisms that disable innate immune response. That seems like a HUGE idea that should be made clearer, maybe even devote a presentation to it.

    Perhaps the original condition of humans involved constant periods of starvation, so fasting may be a critical of our evolutionary response to pathogens.

  24. Can anyone answer me this question please ?

    I’m finding the fasting really easy. I have a meal at about 6 / 700pm and am happy not to eat again until 11.00am the next morning.

    Is this OK to do everyday, and will it speed things up for me (weight loss etc) or is it best to eat one day, fast the next……….

    Look forward to some advice here. I’ve been doing this nearly 2 weeks now and I’m losing some weight and feeling better already.
    Cheers Guys, Rich

    • Yes, you should fast every day.

      Best, Paul

      • Thanks very much for that Paul. I’m actually enjoying the fasting and I very much appreciate you taking the time to answer questions on here. That’s more or less unheard of with most authors.

        I do have just 1 other question……
        I’ve started following the book with weight loss being one of my main motivators. When I’ve done other online Paleo based weight loss plans, a ‘Cheat Meal’ has always been included once or twice in a 30 day programme. The science being that it shocks your metabolism back into working faster. I’ve always done well on these plans and wondered if a ‘Cheat Meal’ would be a good idea for someone primarily aiming to shed a bit of timber. What are your views on this ? Cheers, Rich

        • I don’t think it’s desirable on PHD. Those other diets are too low-carb and “cheat meals” bring them back towards normal. PHD is already optimized, we believe, so cheating will be detrimental. Which is not to say that you may not have other good reasons to cheat occasionally, e.g. eating birthday cake at a party. It’s just not good to do more than you need to, or to build it in.

  25. I am so sorry to post this, but I fear the entire foundation of the PHD is incorrect:

    On the other hand, when we eat fat along with carbohydrate, this “results in lower blood glucose levels and significantly higher insulin levels compared with those following carbohydrate ingestion alone.”
    http://www.mendosa.com/blog/?p=3667

    It’s insulin spikes and circulating insulin levels that wreak metabolic havoc, NOT elevated blood glucose. Elevated blood glucose is a symptom of metabolic derangement and insulin resistance, not the cause. Eating fat + protein with carbs INCREASES circulating insulin levels, it does not lower them. Thus, the PHD is a recipe for further insulin resistance. Sorry to write this. I love Paul and support his research, but it’s too late. Science will always win in the end.

    • It seems to me that opinions change on an almost weekly basis as far as health and diet go.
      I feel great eating this way and have also lost weight which can only be a good thing. And the south sea health references must say something about the validity of this plan ?

    • What matters is the entire insulin response curve, not the peak point.

      Your point is entirely academic, since there is no handheld meter for insulin measurement, and as a practical matter even endocrinologists are not ordering insulin time series for their patients (I agree they should though).

      Your point is also not quite correct, because research shows the insulin spike with fat is more associated with dairy fats than other types. I found in my own testing on myself that certain types of dairy fats have profound effects on my cholesterol and glucose response. Other fats like coconut oil do not. There is tremendous variability in individuals and for types of fats, and there is no way to extract that variability from studies on populations.

      What works for me to correct this issue is to eat my carbs in the form of certain types of fruit – like blueberries – that only contain monosaccharides. By whatever mechanism, I get a short-lived glucose response and then I quickly go back to normal. With complex carbs I get a 4 to 6 hour rise in glucose that I cannot control.

      I feel that individuals need to test things things on their own biology, and sadly very few people do that in a robust way, so they never learn their genetic variance.

      • “Your point is also not quite correct, because research shows the insulin spike with fat is more associated with dairy fats than other types. ”

        That’s because saturated fat + animal protein induce insulin resistance. Dairy = generally high in saturated fat + animal protein.

        Monounsaturated fats have been less implicated in insulin resistance. But the jury is still out. High-carb low-fat diets reverse insulin resistance.

    • (a different) Eric

      Hi Eric,

      Elevated blood sugar can be problematic by itself, c.f. https://en.wikipedia.org/wiki/Glycation#Endogenous.

      For healthy (non-diabetic) individuals, what evidence do we have that insulin response is more significant than the glycation resulting from blood sugar levels?

      I think it is telling that our evolved food reward system favors combining macronutrients.

      Best,
      -Eric

      P.S.: PHD was was not constructed with the goal of minimizing blood glucose, so why do you term that “the entire foundation of the PHD”? Eating different macronutrients in the same meal is only one of the many recommendations PHD makes.

    • Hi Eric,

      Nonsense. Insulin is benign. It serves a coordinating function, and its postprandial elevation is only transient. PHD is a recipe for insulin sensitivity.

      Best, Paul

  26. P One,

    I agree that individuals need to test things on themselves. But there are so many variables….it can be overwhelming to track them all. And most of us are not of a scientific frame of mind.

    I Would love to have more information on how you figured out that coconut oil did not effect you the way dairy fats do. What exactly was your testing method, routine, time period?

    • Elliebelly, for cholesterol I used NMR Lipoprofile to test number of LDL particles, as my proxy for “bad cholesterol”. I went on a diet that consisted of large amounts of dairy cream and the LDL-P went skyrocketing right through red zone of the scale. I removed the cream, substituted coconut milk, and over the next six months LDL-P corrected to low normal range, gradually. My doctor cooperated in helping me to order that test every two months for a year.

      For glucose, I use a glucometer before meal and every hour after meal. I discovered the kind of carbs that minimize my glucose response by repeating that in controlled experiments repeatedly. For me complex carbs and starches result in 4 to 6 hour high glucose. Carbs with monosaccharides and no starch resulted in quickly controlled glucose levels.

      I am just starting the PHD intermittent fasting and am quite excited about that. So far I like it and I am very intrigued with the autophagy idea.

      I do wish there was a cost effective way to measure insulin and free fatty acids as I would really like to understand how my body reacts to fasting, to help further refine how long I fast. Doing that outside of a lab environment looks tough, so far.

      • Please tell me what is included in 1.complex carbs/starches and what are 2. carbs with monsacchardies and no starch (or is ‘no starch’ a 3rd category)?

  27. Thanks P, very helpful. So counterintuitive that the complex carbs were worse for you. But the study they did in Israel recently showed how much variation there is amongst us with regard to different types of carbs..

    • Elliebelly, that Israeli study from 2015 exactly agrees with results of my self experimentation from 2014. Simple monosaccharides like glucose created quick rise and fall of glucose, whereas starch-based meals or even disaccharides like sucrose elevated my glucose for much longer periods.

      One theory might be that people with impaired digestion like the enzymes in the gut to efficiently break down complex sugars, so those foods stay undigested in the gut for longer periods, and therefore continuously supply small additional inputs of glucose and fructose over time. That’s just my random hypothesis.

      At this point I must have made 1000 glucose readings on myself, and I think people should become intimately familiar with how their unique chemistry responds to food. I was surprised constantly.

      One of the things I really like about the PHD intermittent fasting is that fasting is one of the most effective ways to lower your fasting insulin levels. So you not only activate autophagy, but you also start to treat your prediabetes or type 2 diabetes as well. I have seen some advocates of intermittent fasting advocate for one day of normal meals followed by 24 hours of fasting. I think you could merge that approach with PHD and do one 16 hour fast, 8 hour feeding, followed by 24 hour fast. Then repeat cycle.

      I realize very few people want to get this involved in their health. I am only prediabetic, but if I were type 2 diabetic I would be all over this fasting idea because I am convinced that almost any type 2 diabetic can completely clear their condition by smart use of fasting and appropriate diet (based on individual testing) during the refeeding periods. I realize all of the testing is a hassle and is also time consuming (it can take months). But a lifetime taking insulin and 10 years off your lifespan because of diabetes is so much worse.

      • “Simple monosaccharides like glucose created quick rise and fall of glucose, whereas starch-based meals or even disaccharides like sucrose elevated my glucose for much longer periods.”

        Look into AMY1.

        Also dysbiosis –> reduced ability to break down starches.

        I’m guessing you were either: not vaginally delivered, not properly breastfed, fed solid foods before 6 months, or took full spectrum antibiotics (probably at a young age).

        Am I on the right track?

  28. Loving this daily fasting, 16 / 18hrs a day is easy. Its feeling normal after just 2 weeks.
    I’m looking at the book right now and wondering how many black, decaffeinated coffees I can have whilst fasting. Does anyone know ? If its a few then PHD is more than living up to its name so far 😎

  29. whats the deal with cows milk and cheese (I’m talking cheddar cheese)

    I’ve binned the milk totally but have been eating smallish amounts of my favourite cheddar. It’s just occurred to me that maybe I shouldn’t be eating it ! !

    Anyone enlighten me please ? Cheers x

    • Hi Rich, I love cheddar too (all high-to-full fat milk products). They are allowed on PHD under the heading “pleasure foods” (look at the stem of the apple diagram), so good news for us. So if dairy and lactose are desired and tolerated, then they suggest them as healthy pleasure foods, but not required.
      Because they don’t appear on the main part of the apple diagram, then generally concepts like this apply: in moderation, as a snack or dessert or condiment vs central part of the meal plan.
      Personally I use full fat milk, cream, kefir, yogurt, sour cream and various cheeses. If you try to eat all of the foods in recommended quantities in all of the categories on the main part of the apple diagram (the apple itself), along with the recommended supplemental foods, it would be hard to consume much volume in the way of dairy.
      I’ve also read posts by Paul indicating that his family often eats cheese and rice crackers while preparing dinner, and that he often has a glass of milk with honey at about 8pm as his dessert. (He also used to recommend cream with coffee during the fasting period; but now prefers a 0-to-low calorie fast, so he eliminated the cream (to promote autophagy).

      • …sorry…I said stem of the apple; I meant leaf.

        • Thanks Susan, much appreciated. I’ve said it before and I’ll say it again, someone needs to produce a dummies version of this plan. For someone like myself, I find the book too laden with science that I neither understand nor really care about. I just want to eat healthier, feel better and live a bit longer ! !
          Thanks for answering my question. Rich x x

          • I agree!

            As for Paul changing things as he goes along, this is a work in progress and it’s a testimony to his character that he’ll make changes as he learns more about things and risk criticism from those who don’t understand the amazing work that’s gone into this project.

            I for one, would not be a bit surprised if Paul’s group finds a the cause of and cure for cancer.

            😎

  30. Stuart Mather

    Hi all,
    Is more than a 16 hr fast harmful? My eating window is between 12am and 5pm – so an 19 hr fast. I’ve been eating like this for about a year. Mild hunger in the last hr of the fast. Some abdominal fat loss in the first few months. Compensatory lean gain. Only thing I depart from PHD with is a LOT of supplementary fermentable fibre ( got to keep those gut bugs well fed). I simply don’t find that many leeks or cooled potatoes palatable, and the baobab tree won’t fruit for another 6 years. So until then about 80- 90 g supplemental fermentable fibre (RS, inulin, gluccomannan, acacia gum, pectin etc)
    The combination of intermittent fasting , safe starches, and nutrient dense everything else with a butyrate producing furnace in my colon (from all the prebiotic fibre) seems to work a treat. Maybe it’s all that butyrate my microbiome is churning out that makes such a long daily fast effortless. Dunno.
    For that matter, what does Paul think of occasional even longer fasts (like 24 hr for instance) – as long as they’re not hunger stressed, of course.
    So is an 8 hr eating window ‘better’ than 5hr, and why?

    • Shorter feeding windows are only harmful if they lead to (a) undereating or (b) circadian rhythm disruption, i.e. if feeding is at the wrong times or if adherence to the fasting schedule deprives you of social interactions at meal times. Since social interactions are important for health and lunch and dinner are common occasions for interactions, it’s difficult to adhere to a short feeding window without sacrificing social interactions to some degree.

  31. Paul, with PHD i noticed that i stay very lean and it is difficult to gain any weight (muscle mass). I do exercise every day and I was always around 178 pounds and 9-10% fat. Now with PHD I am 158-160 and cannot regain what i lost. Is there any tweak i can make? Really with such a clean diet it is hard to eat 3000 calories diets. I probably average 1400-1600 calories a day. It seems like if you eat PHD you must stay lean unless you cheat.

    I don’t know if this matters but I do have Hashimotos and my antibodies are at 30TPO and 3 TGAb. That was few months ago before i took your advice and stopped eating mammal meats. I hope that next blood test will show none.

    • Hi Bart,

      It certainly should be possible to eat more calories than that. Try adding more carbs and fats. Eat dessert more often, even if dessert is potatoes, berries, egg yolks, and coconut milk.

      Best, Paul

  32. Stuart Mather

    Thanks for your response Paul,
    Point taken about the social interaction factor of short feeding windows. I love sitting down with people while they eat and they’ve become quite used to me not necessarily eating too. I’m increasingly aware that the emotional feedback from enjoying human company don’t have to involve ingesting calories, whether or not everyone is eating. Not feeling hungry outside my eating window helps of course. And hey, chefs spend their working lives surrounded by wonderful food and people consuming it with relish, without necessarily feeling the need to partake.
    What do you think about gut bugs producing oodles of super short chain fatty acids (which are then used as an energy substrate – in the colon of course- just like any other dietary fat producing energy much further up the G.I. ? Butyrate is considerably more saturated than any other dietary saturated fat. And modern food is woefully short in the fermentable fibre humans routinely consumed throughout their evolution
    Cattails anyone?
    Starch and fermentable fibre. We avoid them at our peril, don’t you think?

    On an unrelated topic, I’ve taken to wearing a pair of the cheap polarized yellow ‘nignt driving’ spectacles at night to filter out blue light and maximize circadian rhythm entrainment. What do you think of this approach to avoiding blue light after sunset?

    And thanks for making sense, Paul. I’m continually surprised by your ability to cut through the ubiquitous and unrelenting dietary nonsense out there, every time you speak.

  33. would be interested to hear what Paul has to say about this doctor’s article supposedly saying avoiding gluten is overdone.

    http://www.jpeds.com/article/S0022-3476%2816%2930062-2/fulltext

  34. Great work guys, I think this is the proper ‘balanced diet’ that we should be eating, but having said that I do have a question about white rice:
    Isn’t the insulin spike caused by a carb like rice dangerous and unhealthy? Can’t it lead to chronic diseases? Or are the toxins in other carbs like gluten the real cause of such things?

  35. Hi Paul,

    Reading your book now. Just lost my last 20 on a Keto low carb of max 25 carbs. SLOWLY want to get myself up to 80 so I’ve added Japanese sweet potato – just can’t do banana or white potatoes yet…too big a leap for me at this point. I see the merits of higher carbs now that I’m maintaining my weight loss. Transitioning from Paleo/Primal Keto to your plan is daunting for me and I’m afraid I’ll gain weight. I need to give myself guidelines – I work better logging into Fitday every day. I’m 5’2 118 67 years old (but trust me I don’t look of feel it) and I think my body fat is around 23%. I figure 1600 total calories including 80 carbs/110 fat and 67is protein is good for maintaining…one banana and more fruit will take that way too high for me right now. I suspect others had this transitional time too. Thanks for your amazing research – I take Ioral 6.5mgs 4 days a week 3 days off with 200mcg of selenium (the kind you nix in your book as recommended by my Iodne Workship FB group but other than a few supp diffs we are all on the same page I think. Are you guys getting a FB page? Be great to interact there especially for newbies like me. 🙂

    • Lynda – In my experience with PHD, I stay away from white potatoes and … instead… eat primarily sweet potatoes and winter squash as my safe starches. I find that white potatoes give me a “sugar spike.”

      For fruit, I only eat low fructose fruit and limit that to 6 ounces per day. I eat all types of berries, melons (particularly watermelon) and citrus fruits (oranges, grapefruit.)

      In the beginning, I weighed and measured everything. But… once you get used to the program, you will find that you don’t have to do that any more… and that’s the goal for me. Eat whole foods with the proper amount of safe starches, 8 – 10 ounces of protein plus 2 eggs, lots of vegetables and 6 ounces of fruit.

      For fats, I use butter and coconut oil.

      Once you get used to the planning/weighing/thinking about it….. you will find that it all comes easily and naturally. Listen to your body. Give it plenty of time to adjust to this new way of eating and… after you do get adjust… just listen to your body and you will find out which specific foods in each category work best for you. Good luck. It’s a great eating plan !!!

    • The PHD Facebook link is to the right or use this,
      https://www.facebook.com/groups/perfecthealthdiet/

    • The PHD Facebook link is to the right or use this,
      https://www.facebook.com/groups/perfecthealthdiet/

  36. Thanks Susan B – confirmation about white potatoes…didn’t go there. Now I will “re-gift them” LOL! I am quite used to planning, weighing so I am quite on board with adjusting my carbs and adding a bit more protein…now to enjoy some fruit…omg. Really looking forward to hanging here…timing is perfect! Thanks again.

    • Despite the name, “sweet” potatoes are less “sugary” than regular white potatoes…. a lot less.

      For me, the goal is to just eat whole foods and not count or weigh. I am just at the point where I think I can do that…..

    • Just as a general idea… I am 70 years old, in excellent health, 5’6″

      Each day, I eat as a total (split among 3 meals):

      8 ounces of protein (beef, chicken, shrimp, pork)

      2 eggs

      12 ounces of safe starch (sweet potatoes or white rice or winter squash)

      12 ounces of other vegetables

      a handful of lettuce

      6 ounces of fruit (berries, melon or citrus)

      2 TB of added fat (butter or coconut oil)

      a little bit of tomato or vinegar

      It works for me !!! I feel great…

    • ohhhh…. and make sure that you get enough salt.

      It is something that doesn’t get mentioned in the Paleo/Primal/PHD world and it needs to be.

      If you eliminate all or most processed foods, there is a danger that you will get too little sodium which is every bit as dangerous as too much sodium.

      I make sure that I get 3/4 of a teaspoon of salt every day…. sprinkled on food or used in cooking. Otherwise, I get an irregular heart beat.

      In addition, I also make sure to drink 32 to 48 ounces of water every day. Dehydration will also cause an irregular heartbeat.

    • I also don’t eat bananas. Just as bad as white potatoes for me.

      Potatoes (all kinds) have more potassium in them than bananas…….

      Okay…. I’m done…. that’s all the advice I have…. 🙂

  37. Yay Susan…thank you so much for your breakdown! Really helps. Jeez girl you are 70 – you don’t look it…(big smile) LOL! Love it that we are taking care of us…go baby boomer girls!

    I have been Paleo/Primal for 8 years and keto for almost a year. I get the salt/potassium drill believe me. I make sure to get 4600-4700mgs of potassium a day and I use a bit more salt than you at about 1.5 tsp. I use either Redmond’s Real Salt and or Selena Naturals Celtic. Thanks for the tip on Bananas…I know I can’t go there – also very spikey for me. My transition now is adding more carbs – I’m at 80ish with the sweet potatoe, beets and carrots and want to get to about 100. I eat more fat than you – about 112 grams a day (a tab of butter a tab of coconut oil and I make my own killer good mayo with lemon juice, dry mustard and lite olive oil – 2 tabs. I only eat 3-4 oz of meat or fish or fowl a day but I do eat beef and liver at least 3 times a week. I eat 3 eggs a day. I make what I call my “Daily Bowl” of chopped steamed veg, potato, beet, carrots, protein and eggs seasoned with salt and pepper and two tabs of mayo…I nibble every 2 hours and stop at 5. Don’t eat again until 5 the next morning…that idea works uite well for me…I am very energized. I drink 1/2 my weight in water so about two liters. I put two tabs of apple cider vinegar in my daily bowl. Once in a blue moon I have aged raw cheddar (I’m in Vermont – good stuff local made) but I don’t do much dairy. Grassfed yogurt plain with a bit of fruit might be cool. Do you do dairy?

    • Hi Lynda – It sounds like you have everything under control !!! I do need to up my daily sodium and potassium. I get barely enough now – more would be beneficial. I could not exist on only 3 -4 ounces of meat/fish/fowl per day. I need 8 – 9 ounces which is what I eat. I have the eggs at one meal and then 4 – 4.5 ounces of meat/fish/fowl at each of my other two meals.

    • OOops… I hit a key and my reply was posted before I had finished.

      As to dairy – I used to eat it all the time, but in the past 5 years my body has revolted so now I don’t eat any. I miss my sharp white Vermont cheddar (I spent many many years in New England). I also miss cottage cheese and Greek yogurt…. sigh…

  38. Catching up on all the comments I am getting a sense of my dairy question. I really don’t eat it often enough to me a problem for me and already treat it as a “treat”. So much helpful info here. Appreciate it all very much. Now I know what to tweak total calorie-wise. On Keto I ate more fat to feel sated but adding sweet potatoes, beets and carrots is so sating I can cut back on the extra butter, coconut oil and mayo. Next up practicing adding an hour to my nightly 12 hour fast – one hour at a time is my motto. Thanks again – 🙂

    • I don’t do the fasting schedule. It did not work for me. Mark Sisson at Mark’s Daily Apple recently posted that women tend not to do as well with IF as men. I tried it, it didn’t work for me… at all.

      I eat 3 meals a day evenly spaced between about 9:00 a.m. and 6:00 p.m. So breakfast at 9:00, lunch at 1:30 and dinner at 5:30 or 6:00. I have eliminated all snacks…..

      We each have to figure out what works best for us. Good luck !!!

  39. Hey Susan – I hear you on the protein amount. My total daily protein is around 70 grams. I include eggs in that mix and whatever trace amounts there are in carbs and veg. I make a big daily bowl and wrap it in nori sheets fir my mini meals. I don’t eat a lot at one setting. My problem with two meals plus fasting in the past was over eating my dinner meal and really spiking myself – I invented a way to make my meals sustainable. Feel great eating this way. I think that’s why the smaller intake of meat works for me. It is all mixed up in my big bowl.

    I eat 4oz if grass fed beef liver 2 times a week. Grass fed beef 2 times. Week. Salmon and chicken divvy up the rest.

    Paul if you are reading this I am wondering if total protein is a correct calculation now that I am doing PHd or if I should up my meat fish chicken protein as well. It seems to me that my total calories would be too high. Lots of old info for me to let go of?

  40. Susan B…I wanted to mention how I keep my potassium up. I use LoSalt. 77% potassium. 1 tsp is 1800 mgs. With all the foods I eat I usually supp with 1/2-3/4 tsp. I don’t know if this is “allowed” but I hope so. I learned this trick in my Keto journeys. A great salty meal is one egg whisked with a fork in boiling bone broth or any broth, salt to tast, a handful of spinach – et voila Straccatella soup…:) Nice on the tummy.

    • Thanks. I’ll Google LoSalt. I have been tracking my sodium and potassium amounts for the past couple of weeks and I do need to increase both of them about 50%. Sometimes difficult to do with food alone.

      About protein…. if you look at the PHD “apple” graphic…. PHD/Paul recommend 1/2 pound to 1 pound of protein per day. I stay on the lower end of that, but never go below 1/2 a pound… and I don’t include eggs in that protein count.

  41. This is great! It seems that I am on the right track. I’ve also started to cut out as much bad sugar as possible, drink lots of milk and eat almost no cereal based grains in my own personal diet.

  42. Hi You All…well I did my weekly weigh in and I gained two pounds. Adjusting this week. I’m a little bummed but my carbs have been so low for so long it makes sense. I think adjusting my fat intake will get me back on track. It’s my first week after all, right?

    • It will take your body several weeks to adjust….. Just keep eating what the Perfect Health Diet program suggests…. and then after several weeks, you can adjust the quantities…

      while keeping the relative proportions of each category the same (very important)

      i.e. the PHD apple graphic is based on 2000 calories…. and I need about 1500 – 1600 calories a day.

      So I aim for about 3/4 of what each category says in the apple graphic.

      12 ounces of safe starches
      12 ounces of sweet plants/fruit
      12 ounces of other vegetables

      and about 8-10 ounces of protein.

      You need to eat the foods in all of the main categories…. just proportionally adjust the quantities to suit your needs.

      And…. give it some time… it will take a while for your body to adjust to the increase in carbs… and it will take a while for you to figure out the proper quantities that you need.

  43. Thanks Susan…this helps a lot…I know my maintenance calories are between around 1550 so this really helps me in my new process…:)

    • I’m still tweaking my quantities… all the while maintaining the proportions of the categories.

      I need to lose about 20 pounds, but I want to do it very slowly… like 1 pound per week…. so I am still tweaking my quantities.

      Fat is not the enemy… and I get fat in my protein (I eat a lot of beef). But I have seen Paul recommend that if one needs to lose weight, then keep “added” fats to 2 TB per day. “Added” fats being those that one cooks with (ie. I cook my fried eggs in 1/2 TB of butter) or gets in things like salad dressings.

      So I don’t worry about fat in my food…. just the added fat that I am going to restrict to 2 TB per day. Fat is important.

      So.. for me to lose the weight… I need to keep the added fat to 2TB per day and then adjust the main categories of food to the quantities that I need to lose 1 pound per week. I’m not there yet… but I’m continuing to tweak….

      What I put in my previous post is what I need to eat to maintain my weight…. which I have been doing with those quantities for several months.

  44. Great Susan…I’m in an odd place. I just lost my last 20 and have kept it off for 9 months eating a lot more fat, way less carbs and very moderate protein but I feel all dried out inside. I really resonate with the principals in PHD and I WILL figure it out LOL! I buy my meat/fowl from US Wellness – grassfed/finish and I eat pastured eggs and organic veg…now to figure out how to continue to maintain so this is all very appreciated! I do think 2tabs butter or my olive oil may PLUS avocado and any fatty meat/fish will be okay…we’ll see… I will report in…:)

    • I tried to be “perfect” at first, trying to eat everything in the apple daily. I did gain some weight at first, and I hadn’t been low carb before that. Even on PHD, in my experience, and as a 58 yo woman, calories DO matter. I am not fat phobic, but I eat added fat in moderation, and instead try to consume it through avocado, full fat dairy, nuts (all in moderation and meats (which I trim of excess fat).

      My advice is to eat within the guidelines but only to satiation, and as SusanB says, in the recommended proportions. I wouldn’t worry about weighing stuff. It’s stressful and unnecessary, and just meant as guidelines. I eat 3 eggs per day, but not quite as much meat at SusanB — usually more like 5-8 oz. I’m 5’5″ and my weight is relatively stable at ~118 lb.

  45. Hi Susn too…:) I hear you…calories matter. I’m one of those weird people that loves to measure, weigh and log my food. After a lifetime of NOT doing that I lost my last twenty last last year decided to bite the bullet and pay attention that way. I’ve been Paleo/Primal for almost 8 years so I get the not grain/bean/veg oil drill. Problem was I gained weight doing it and realized I needed do something more strict – enter KETO – 25-30 carbs and in four months I was 20 pounds less kind of effortlessly actually. Not sustainable unfortunately. I have maintained for 9 months now but I’m drying up inside. This last week was a little rocky and I gained two pounds but I know what I did…um…at too much? Yep LOL! I spent two hours today tweaking the plan to suit my macros and coming in at 1450 calories, 90gr fat, 68ish protein and about 85 carbs which is just HUGE to me but we’ll see how I do next week when I weigh myself. I should at worst maintain and at best lose a little…we’ll see…I’m pretty excited. I am lowering my added fat a lot for me anyway…just 2.5 ish tabs of butter and my mayo the rest is avocado, coconut milk for my coffee and fatty fish or beef on those days. We’ll see…thank you again…really appreciate your experience…both you Susans’…:)

    • Susan too always gives great advice and we often seem to tag team it !!! It may take a little while (a few months), but you’ll come up with a tweak on the quantities to work perfectly.

      Just remember that right now your body is adjusting to the increased carb intake, so it will take several weeks for your body to finish making the adjustment. After that, you’ll be able to confidently come up with the right quantities in each category.

    • SusanB is always so right on the money and very sweet too 😀
      If you see Jimmy Moore’s write up about what happened to him while attending the PHD retreat, it will ring true for you. If my memory serves me, he gained something like 15 lbs in 2 weeks there, whereas most people lose weight there. In addition to the physical and mental stresses that too low carb can cause, I think that it must to something to the way that the pancreas responds when you suddenly introduce more carbs. And like you said, it’s just not sustainable long term for overall good health.

      Also, do you own the PHD book? If not you should buy it or check it out at the library. In it, they provide excellent specific advice about how to modify the diet if you’re trying to lose weight. Aside from IF (which, similar to SusanB, absolutely does NOT work for me and causes all kinds of havoc, so I do agree with Sisson on it being less successful for women, in general), and the addition of acids to carbs, Paul suggests only 2 T total of added fat daily in the form of butter, oil or coconut milk and trimming excess fat from meat. For people trying to maintain, he suggests up to 4T. So fat reduction is still probably your answer to weight loss. I don’t know if you’re eating fruit, but other than certain berries and other low fructose varieties, you might want to reduce fruit a little too. Kudos on all that you’ve achieved thus far! Health improvement is an ongoing process for all of us!

      • Hi Susan,

        I’m pretty sure Jimmy lost weight while at the retreat. See http://perfecthealthdiet.com/2015/05/jimmy-moore-on-the-perfect-health-retreat/.

        Best, Paul

        • Hi Paul, I certainly don’t mean to disparage anyone, certainly not you or the retreat. But even that link says the same thing. Maybe I’m misunderstanding this post by him, or maybe it’s not the whole story?:

          Many have wondered what would happen to my weight if I truly gave these “safe starches” a go in my diet. Like I said earlier, I told Paul we would do his plan as prescribed just to see what would happen. And the results on the scale were pretty shocking after eating this way for just one week–I gained a whopping 13 pounds!

  46. Hey Susan Too!

    OMG on Jimmy Moore…scary. Yes I have the paper back and it’s also on my Kindle – I don’t mess around…:) I’m resonating with the plan. I already figured out about no fruit for now. Yes to 1/2 avo and 4oz chopped Beets, 4oz chopped carrot steamed with my 2 cups chopped broccoli and 1 cup chopped spinach. Only starch for now is Japanese sweet potato – one steamed chopped in my daily bowl. Yes on the leaner meat for now…I get it and you validate my direction. I do 1tsp butter and 1 tsp coconut oil in my coffee every morning with 2 tabs flax, a bit of cinn, salt and 1/2 tsp LoSalt…no really – whipped up in my hand blender. I usually fast from 5pm to 7am before I have that coffee but no other fasting for me for your same reasons messes with my system. 12-14 hours max. I actually did not want to lose anymore fat until I got on board here but I see I need to continue to watch it…I hope 70-80g of carbs will do me for now because that is huge to me still. This week I’m doing max 1450 cals, 90 fat, 75-80 carb, 70 protein…we’ll see how that goes. Crossing my fingers!

    Really appreciate being able to spill to you two Susan’s. Good kind nurturing advice. There is a very nurturing bunch on my Keto site and I’ll stick there and be a support and who knows get a good word in for PHD although most would freak out…sigh. The fear of gaining weight after losing it is big big stuff…big. Many there have lost over 100 pounds and are so proud. Hard to shift and trust being healthy first will pay off in weight loss. I understand their fear well…Thanks again…:)

    • Just to clarify, I don’t avoid somewhat fatty meats, I just trim the EXCESS fat. I eat 1 lb of wild salmon per week, I like to cook chicken with skin on and then remove and don’t eat it (I just think it tastes better cooked with skin on) , and most cuts of beef, lamb and pork, but I avoid the extremely fatty cuts like short ribs, and for the other cuts, I remove the outer layers of fat and large fatty deposits before cooking. Some marbling is fine.
      While I love braising, often the liquid is loaded to the gills with fat, so I typically refrigerate the liquid and pull off the layer of fat before consuming any of the liquid, like you would do for refrigerated chicken stock.
      These are just some of the things that just I do; not by any means saying it’s right for everyone!

  47. Paul – first – thanks to you both for all your research. My good friend Lynn at who works very closely with Breast Cancer Choices and Lynne Farrow/Iodine Workshop told me about you. She is on the PHD plan herself and loves it. That’s all I needed in the way of a referral…:) She’s been trying to get me to up my carbs for a long time. I’ve been a real bonehead about it. ANYWAY…very glad to hear about Jimmy Moore – WOW that he even attended…talk about a great “inflencer” for PHD.

    Maybe I’ll be the rare ex Keto person that manages her weight from the jump…that’s my plan…:)

  48. I’m baaack with a question – I have been maintaining a 20 pound weight loss eating about 110 grams of fat from butter, mayo with olive oil and the occasional avocado. Lower protein like 65 grams and of course ridiculously low carbs like 25 grams. NOW I need to reorganize my maintenance strategy and lower the extra fat considerably, up the carbs to at least 70 and up the protein a bit to maybe 80-90. If anyone is interested I’ve been tracking my macros in this calculator for a year. The link is: http://ketodietapp.com/Blog/page/KetoDiet-Buddy. I’m realizing that I need to keep from gaining weight but I am at a good weight was 118 last week now 120 this week since starting PHD…I’m fine with 120 – I just don’t want to go higher than that or lower than 118. I need a good infrastructure to work within…I can’t just eat everything in that lovely apple – the Susan’s have helped me there for sure but I’m short and kinda old (67) but moderately consistently active – more than most 35 year old’s I know…ANYWAY…it looks like I need to dive down to about 1250 overall calories while getting beets, carrots, sweet potato, greens, protein and hardly any fat – coconut milk in my coffe (no more than 1/2 cup a day) and 1 tab butter and 1 tab mayo a day…I can do it but I just want to make sure I’m getting the nutrients I need…I’m sure getting more than ever and my potassium is excellent at 4500mgs. I guess time will tell if I lose or gain doing this…I know be patient. On to the weekend…thanks for letting me vent…:)

  49. P.S. The thing with KETO is that the idea when you are in maintenance is to STOP losing your own fat stores and start upping outside fat about 200 calories…seems like the reverse is true here. I am lowering fat and upping carbs…it’s a little SCARY…:)

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