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 ?

3,841 Comments.

  1. I read the Perfect Health Diet book and was unsure on the number of eggs recommended. In some places it stressed 3 egg yolks per day but in other places it seemed that not always 3 eggs a day. Please elaborate on egg yolk intake, thanks.

  2. Sorry never mind I see you have listed 3 egg yolks daily under supplement recommendations.

  3. I was wondering – for safe starches is it a pound of precooked weight? So for rice 2oz dried is a serving. Is that what I’m basing the weight on? Also – is jasmine rice considered a safe starch? Or is it just strictly plain white rice?

  4. A friend of mine who started doing the diet in December noticed that she started getting regular migraines a few months after starting the diet, whereas she’d never had migraines before (she’s 33 yrs. old, though they do run in her family). She now has migraines after virtually every meal. When she went back to eating badly (gluten, etc.) during one week, the migraines went away. I know this is contrary to the usual experience of people on the diet (since usually migraines and other neurological symptoms can get better on a more ketogenic diet). Could it be toxins that have accumulated over the years being released? Is there anything you’d recommend she do additionally to try to address the problem?

    • Hi Alex,

      I’d suspect it’s some sort of amine sensitivity (histamine, tyramine) – if she increased protein or fermented foods she would get more of those and they induce headaches in sensitive people. It is dependent on gut flora and it indicates she has to reshape her gut flora, as the flora she has is generating high doses of toxins and/or creating gut permeability. I would recommend supplementing vitamin A, D, zinc, and iodine and vitamin C and eating collagen-rich soups and stews, plus probiotics.

      • Thanks for your detailed response, Paul. You are incredibly generous with your time in responding to reader questions, and I’m sure I speak on behalf of many people other than myself in saying that we really appreciate it.

        • If one looks on the database of medical journal articles, pubmed.com, you can pull up a couple of hundred articles for magnesium as a treatment for migraines or headaches (look under both search terms), as well as correlations between low magnesium and those ailments. I know Paul doesn’t recommend exceeding the DV for magnesium supplements, but many do find it helpful to do so, for a variety of ailments (Dr. Eades notes somewhere that if he could only prescribe one supplement, magnesium would be it, as its effects are so extensive and deficiency is so widespread).

      • Paul I have just found your comment and it describes me exactly. I have an imbalance of gut flora due to treating an Ameoba called Dientameoba Fragilis. I have been struggling with gut recovery for three years and have trouble taking probiotics as they also seem to give me headaches/migraines, worst of all is Mutaflor, but i continue to take them for short periods as Im sure they are my road to recovery.
        I will look into which foods are high in Collagen, I’m guessing red meat stews etc.
        Thankyou
        Suzanne.

  5. Love the Perfect Health Diet and the kindness that you and Shou-Ching share with all of us on our life journey.. Have a friend who started on a product called I6 gold with insitol, 4 years ago for stage 4 ovarian cancer..She has been in remission since starting, taking 16 capsules per day… When i researched this, it has rice bran and other things that we do not eat in PHD… Have you heard of this substance?

    • Hi Rene,

      You are referring to IP6 or phytate which is a mineral chelator, it reduces levels of iron and other minerals. There is some evidence that this can help against cancer, by removing nutrient excesses that promote tumor growth. Of course you have to be careful not to become malnourished either, as mineral deficiencies lead to DNA instability and promote cancer growth. I am not expert in exactly what protocol is best supported for this supplement in cancer patients.

    • Not to do with cancer – This is what I’ve read about IP6….According to the International Journal Cardiology, IP6 can “potentially remove calcium deposits from arteries.” [International Journal Cardiology 33: 191-9, 1991] and the Anticancer Research writes “IP6 has been shown to significantly lower cholesterol in animals fed a cholesterol-enriched diet.” [Anticancer Research 19:3699-702, 1999]. This promising research shows the positive effects IP6 can have on individuals with high cholesterol.
      While the proper dosages will vary from person to person, taking 2000 mg of oral IP6 rice bran extract on an empty stomach with water once a day for 30 days once a year seems to have shown beneficial results. In addition, because of its chelating effects, this procedure is thought to clean out the liver of excess iron as well.

  6. ❓ I’m trying to use the journal at MyFitnessPal.com to track my PHD to help me get the hang of it. My problem is that they want to use calories and percentages of daily calories and I have no idea how to set that up… any help??
    I have the print and spoken versions of the book but haven’t gotten my head around all the data yet, but I’m working on it.

  7. Is pure stevia allowed on the PHD?

  8. Just starting the PHD for hashi’s and poor sleep going on for years. For now, it seems that IF is too difficult for me…What do you suggest I have for breakfast?
    Is coconut milk with berries in a shake ok?

    • Also, its ont very clear to me in the book how much fat I should get everyday… 2 tablespoons of CO a day? Seems pretty far from 50% of my total daily calorie intake… Would you help me on that please? Thank you!!

      • Don’t forget that if you are eating fatty meats, which you should, you get a lot of fat there. Then You can add 2 to 4 tablespoons of fat for cooking or sauces, etc. also some in salad dressings.

    • See page 398 for some other ideas. Personally I would say experiment and see what makes you feel the best. Some do well with protein and fat, saving the carbs for later in the day, but your plan for coconut milk and berries might work best for you. You will just have to play around with it.

  9. Hi Paul, what do you think about having whole milk daily? i like it for breakfast, i have no problem with it.

    Thanks

  10. This is Jiayi from UCLA. Find your Ph.D website 😀

  11. Hi,

    Can Paul or someone tell me which fish has very low no Omega 3? When I google this all I get is fish high in Omega 3 😕

    Thanks,
    Colin

  12. Hello Paul i would really appreciate your help and attention 🙂
    I read many nutrition articles (+10 a week) and I am an information junkie… I have just skimmed over your work – and I have ordered the book online.

    My question – I am a elite althete – currently training around 7 hours a day (tennis) and I’m not sure how this would affect the diet plan! Should I just increase total caloric intake? Will this be correctly scaled due to my vigorous excercise routine?
    Also I am skeptical about the fasting period – would this affect my capacity to train and/ or recover if done on an off day…

    I would love to converse with you but if these questions are answered in the book I’m sorry – I feel the need to know now! 😛

    Thank you so much! Josiah

  13. Does Organic oatmeal still contain toxins?
    I eat oatmeal for breakfast to avoid eating bread and peanut and cereals and I thought that was healthy.

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  15. I’m just curious about the white rice. I thought brown rice would be a much better alternative since white rice doesn’t have any fiber and basically not much nutrition. I personally don’t care for the flavor of white rice and love brown rice.

    • Try Cuban yellow rice. Hard to stop eating it, it’s so good!

      The color and most of the taste comes from saffron. At one time, hard to find outside of Florida, where I grew up. My parents used to send the ex and myself care package of yellow rice and black beans.

      Now both tend to be available everywhere.

  16. In the book Paul you say some people have extra copies of the amylase gene and this suggests they may be able to tolerate more carbs. I read elsewhere that some people secrete more saliva than others (and as a result have healthier teeth) and have a tendency to wipe the corner of the mouth to clear the saliva. My question is, could saliva at the corner of the mouth be taken as a sign of increased ability to handle carbs/glucose?

  17. Allergic to milk products, wheat, corn, soy, yeast and can’t drink wine. Small rural town, no access to quality seafoods would frozen farm grown talapia and salmon and flounder do?

    Have IC which was recently made worse with egg white powder, blueberry and banana shakes for breakfast. Please discuss ICystitis and PHD.

    What kind of bones do I ask for at local grassfed meat market?

  18. Paul,

    What modifications to diet would you recommend for someone who is ApoE 4/4?

    Thanks,
    Jordan

  19. Hi Paul,
    For grains, you do not mention rye. My husband and I have eaten a low gluten/wheat diet for many years. We have been eating a whole grain rye bread from time to time. It has no flour. Did you skip rye on your list because it is ok?? Thanks for the answer.

    • Try a web search. Poof! There it is! Rye is one of the major gluten grains.

      And, BTW, all bread is made of flour. That’s a physcial trait, not a grain.

      • Oh, not really, pzo. Not necessary to grind the grain to make it into bread. Soaked, sprouted whole grain can make a very nice bread. Trader Joe’s has a store brand; then there’s a line called Food For Life that makes a couple of varieties of sprouted, flourless bread; and of course the soak-your-grain foodies make their own. Bread has many surprising unknown traits, then.

  20. Paul,

    I am trying to optimize the diet right now to get the best results. I have CVID and just started getting intravenous immunoglobulin last week. I’m a healthy weight (that’s about the only thing healthy, lol). I have a sinus infection and The doctors found two strains of bacteria in my nose called acinetobacter baumannii and stenotrophomonas maltophilia, which from my understanding are difficult to get rid of. I’m on prednisone right now and 750mg of Levaquin. I really want to knock this out of me so I don’t have to be on prolonged antibiotics. I am of course gluten free and follow the perfect health diet. I eat one tablespoon of coconut oil a day and sometimes added to food as cooking oil. In this case would you recommend increasing coconut oil, lowering carb intake and protein intake? Will that help the antibiotics effectiveness? I know some parasites and bacteria you can “starve”. I’m having a tough time getting out of this hole!

    Thanks,
    Amy

    • Hi Amy,

      Mainly I would emphasize good vitamin A status (eat 1/4 lb liver per week or alternatively 30,000 IU/week preformed A, plus lots of carotenoid rich plants), vitamin D, vitamin c, zinc, iodine; intermittent fasting; circadian rhythm entrainment. I think you should maintain PHD macronutrient proportions but some coconut milk in coffee while fasting would not be amiss.

      • Much appreciated Paul! My doctor’s are impressed how well I am relative to patients with the same diseases. I attribute much of it to my diet, and gave my doctor your book.

        I am going to institute your suggestions today.

        Thank you again!
        Amy

      • One more question, I take a multivitamin, should I take those vitamins in addition to? And do you think I should do the intermittent fasting on a long term basis. I’m eating duck liver right now and also made a variety of bone broths.

        Thanks again:)
        Amy

  21. I’ve been eating Paleo/Primal for almost 2 years and have done well. Still have a few extra pounds lurking around so I recently added some potatoes back into the diet. Worst decision for me, absolutely doesn’t work for my body – keeps me in the bathroom. I’m going back to limited starches and eat my carbs via salads and veggies.

    • Hi Sam,

      That indicates that very low carb dieting has created a gut dysbiosis. It would be a good idea to diversify your foods a bit and get a more diverse gut flora.

      • Hi, Paul,

        How would you recommend approaching diversifying foods to re-diversify gut flora if one is receiving such reactions as gas, frequent stools, abdominal pain, etc. when reintroducing things like potatoes or veggies?

        Any foods best to start re-diversifying with (if coming from LC/VLC?)

  22. Vegetable oils, in addition to being in many foods, are often found as ingredients in natural body care products. Sunflower oil, in particular, often makes appearances among the ingredients in such products (such as, for instance, some natural deodorants). In your view, Paul, does use of such products create the same hazards (to the same degree) as oral ingestion of vegetable oils?

  23. I recently consumed 5-9 dates.

    Though my diet is often (varying from slightly more than PHD to slightly less-than) safe starches (yam) and broths, meats/shellfish with limited veggies… (so not VLC) my reaction was quite surprisingly extreme.

    I experienced what I might assume is a “sugar rush” — very lots of energy, shakiness/”jittery”, and difficulty focusing. (followed by a bit of a headache, and still shaky/”jittery” but also some drained-feeling)

    Had never experienced this before. Ate some “fruits” today (on empty stomach) as an experiment, and part of brief forays into rediversifying my foods.

    Any ideas as to what happened? Too many dates? Blood sugar spike/hyper insulin sensitivity?

    Should fruit be eaten in moderation for some, or not at all?

    It feels surprisingly terrible. 🙂 ..must be what high-sugar versions of Standard American Diet feel like.

    • See apple diagram above . fruits are pleasure food, meanings small amounts.

      Dried fruits are much higher in sugar than fresh fruits.
      Dates very high. Fruits should be eaten along with other foods, not by them selves.

      Everybody is different, you have to experiment for yourself. Perhaps some glucose testing.

      • Seamonger, i recently had a similar experience with dates. My wife looked it up and they have approx 18g carbohydrates per date. I assume this is in the form of fructose? This is quite an influx of sugar in a small period, to the tune of 100-160 g in that small quantity of dates. I think I had about 12. Won’t be doing that again any time soon.

    • Hi Seamonger
      I have had this too, I blamed Amines for a long while but in the end i really think its fructose.
      I have had a carbohydrate breath test for fructose intolerance and was positive ( although not as high a reading as my lactose intolerance reading that went through the roof.)
      Suzanne.

    • Hi Seamonger
      I have had this too, I blamed Amines for a long while but in the end i really think its fructose.
      I have had a carbohydrate breath test for fructose intolerance and was positive ( although not as high a reading as my lactose intolerance reading that went through the roof.) it does make you feel very ill.
      Suzanne.

  24. I have been on the phd for approx 8 weeks following my phisical in September 2013. My total cholesterol at that time was 256, LDL 177.6, HDL 39, Trigs at 196. My doctor wanted me to start Crestor. Afer 8 weeks, I weigh 15lbs less, my trigs are 146, HDL climbed to 51, but my LDL climbed to 196 and my total cholesterol climbed to 281. My doctor still recommends a ststin. It seems to me I am on the right track but I thought my total Cholesterol number would have dropped.

  25. The same thing happened to me on the PH diet. I’ve been reading about the ApoE4 gene (apparently about 25% people) that have trouble metabolizing fat (Dr. Suzanne Steinbaum’s Heart Book, pg 187). She says that people with this gene (ApoE 3/4, or especially 4/4)don’t break down LDL efficiently. There is a test for this gene (but hard to get it she says). She says that it is “imperative to be on a very low-fat diet, with less than 7 percent of your calories from saturated fat”. ApoE2 gene is associated with high TGs.I haven’t heard from Paul about this finding / theory / advice. Paul?? I’m wondering if this heterogeneity of genes in the population can account for some of the mixed findings on dietary fat and cardiovascular disease. I thought the Wiki summary of this “dietary fat and CVD” research was interesting

    • I would also like to hear Paul speak on the implications of the APOE 4 gene, as this is something which concerns me as well (APOE 3/4). This is the gene associated with Alzheimer’s, and that is also the one disease which is prevalent in my family tree. I have read both theories: that this gene requires a low fat diet, or that it actually is an adaption for those who would have needed to survive on high fat diets. I don’t remember how it was supposed to be helpful, but I believe there’s a discussion about this somewhere on Paleohacks. I’m inclined to go with the high-fat theory, as I find it doubtful that my ancestors would have been able to thrive in the cold Finnish winters if their genes were working against them and their environment to the degree suggested by the low-fat advocates.

      From my understanding, people with APOE 4 have a harder time detoxing their bodies, and need to be more careful about the food they eat and the products they use, etc. Thinking back to it, my family members who got Alzheimer’s were the ones who were also living in the middle of large polluted cities.

      Oh yeah, and you can get this test fairly easily actually. 23andme tests for this gene, along with many others. It was $99 when I took it, and probably still is.

      • @Donna and Dawn,

        This is a topic that intrigues me too! I am awaiting my 23andme results. To the extent the APOE4 issued has been discussed on various blogs, there is a lot of contradictory advice. I wonder if APOE4 accounts for why so many people have persistently high cholesterol on a paleo diet. My doctors have been trying to put me on statins for a while now (310 cholesterol after 2+ years of paleo). I refused but acknowledge that such a number is very worrisome. Trigs and HDL are good, but still … I don’t know what to do for now, except hedge my bets and eat a moderate-carb, moderate-fat diet that includes a lot of olive oil. Hopefully the science will move fast on this subject in the coming years.

        • Interesting, would be very useful if Paul could comment.

        • Hi Thomas,

          Make sure you are eating enough carbs (30%) and getting daily iodine (225 mcg/day) plus have good zinc/copper balance (1/4 lb liver per week, dark chocolate if the liver is duck or goose or chicken, plus 100 mg zinc supplements or a dozen oysters). Plus spinach, sweet potatoes, carrots. The liver, iodine, and carbs are important for you, also vitamin D optimization and circadian rhythms.

      • I looked up reviews for 23andme on line. Some very positive – some extremely negative. Perhaps customer service has declined since the price lowered and they got very busy / overwhelemed with business?

  26. For the last two weeks, to speed weight loss, I have been trying a keto diet. Mostly fat, moderate protein, and very low carbohydrates. I wonder if this raised my TC and or LDL numbers. I am pleased with the weight loss and the higher HDL numbers and improved CHLO/HDL ratio, but I would still like to lower my total chol number.

  27. Hello Paul,

    Richard Nikoley recently presented a massive amount (35 research links) of the evidence of resistant starch usefulness.

    http://freetheanimal.com/2013/06/resistant-starch-now-we%E2%80%99re-getting-somewhere-part-2-35-links-to-research.html

    Do you think it would be a reasonable thing to do to have 3-4 tbsp of potato starch daily?

    Thank you,

    Vlad

    • Hi Vlad,

      If you have the right gut flora I don’t think it’s harmful and may be quite beneficial. If you have the wrong flora it may feed them and is a very high dose. If the wrong flora are protein-metabolizing bacteria then it may start helping immediately; if they are carb-metabolizing then you will have trouble. So I would start by eating whole potatoes, then try 1 tbsp potato starch, and slowly work up.

  28. @Vlad: May I suggest that you do your own research? When you do, you’ll probably be amazed at the many ways our little microflora do amazing things. They convert the RS, having passed through the small intestine, into short chain fatty acids.

    I have been dosing myself with 4 TBL potato starch and/or .5 cup pinto beans a day for several weeks now. My fasting blood glucose, traditionally about 95, was hitting 130 ten months ago. Panic! With RS, it’s been coming down and down and I’ve been happy seeing consistent 95-ish numbers.

    This AM it was 87. Never in my life, literally.

    Some people do report gastric issues, from low level pain to lots of fartage’. I suspect I had a pretty healthy variety of colonic bacteria because I experience none of these matters. Perhaps it’s because prior to the RS routine, I was eating gobs of yogurt, drinking buttermilk, and taking probiotic pills. So there was lots of variety just waiting for lots of starchy rations.

    Ny theory, understand. No proof, which is what Paul is so good at.

    • thanks a lot, great suggestion! What would be your thoughts on when to take the “PS drink”? Before meal? Or it can be taking with meal as long as the food is not too hot?

    • How do we know the RS bypasses the small intestine and won’t be contributing to SIBO as Paul said it might should the wrong flora be carb-feeding?

  29. Read Grain Brain (on Amazon). High cholesterol is not as bad as it seems. Statins can result in diabitis in 48% of women. Do current research.

  30. Hello Paul,

    thank you for being so kind to answer my questions!

    Here is another “burning” one 🙂

    In your book you say firm NO to legumes due to their anti-nutrient content. But I notice that lately some leaders of the paleo movement are easing on legumes. When properly prepared (soaking, etc) they are pretty impressive source of resistant starch and some nutrients. Do you still think that comparing to rice and potato beans are to toxic to eat regularly?

    Thank you,

    Vlad

  31. I really enjoyed reading your book on the Perfect health diet. You were right about eating wheat and wheat bread, recently it picked up media attention for its gluten content. They said it is probably safer to cut down on our dependence on wheat products for weight loss.

  32. why white rice versus brown rice ?

  33. Hi Paul,

    Im glad I recently stumbled into your website and now reading your book. Some safe starch/ carb like white rice and potatoes allowed in PHD apeals to me.

    May I know is only WHITE potatoes allowed or coloured ones are fine too especially Yukon Gold. Your book sometimes mentioned “potatoes” only. I cant find the answer although I havent read all the comments. And can a type2 diabetic following PHD also eat some of the safe starch like rice & potatoes. Anyone who knows please advise too.

    Wonderful Thanksgiving to all!

    • Hi simony,

      Yes, all kinds of potatoes, sweet potatoes, and yams are allowed.

      Yes, diabetics should eat these foods too. You might find the optimal amount of carbs is slightly lower, but it should still be in the 20% to 30% range.

  34. Hurray! Thanks Paul.

    Best wishes!

  35. Hi, I’d been following a paleo type regimen (only walking as exercise) for about 2 years and recently read your book and so incorporated the safe starches. All other recommendations I was already following. This was about 4 weeks ago. I probably eat a bit less in quantity to that recommended by find what I do eat satisfying.
    One thing though – I’ve put on nearly 4 kg!
    I’ve been hypothyroid for sometime and only started treating with bio-identical bovine extract about the same time I started the PHD.
    Why have I put on SO MUCH weight! I thought the weight would be coming off big time.
    Maybe the PHD isn’t for me?? I guess one size doesn’t fit all?
    Rosalind

    • Hi Rosalind,

      Weight gain is an inflammatory process and it generally signifies bad gut microbes. The extra carbs support immunity so in the long run they should be beneficial, but in the short run they feed the microbes. You were probably starving them on a low-carb diet, reducing inflammation. However, that does nothing to nourish good bacteria, so you don’t replace them and can often make the problem more entrenched.

      The same infection that causes you to gain weight is probably responsible for the hypothyroidism.

      If you aren’t already, do intermittent fasting, promote gut immunity by getting lots of vitamin A (liver, sweet potatoes, carrots, spinach), vitamin D (sun or supplements), and vitamin C, and work on circadian rhythm entrainment. Take probiotics and eat fermented vegetables. Include zinc and iodine among your supplements.

      Best, Paul

      • Is eating fermenting vegetables for probiotics better than eating daily yogurt and kefir, homemade? Homemade yogurt has vastly more probiotics than storebought.

        My first experiments with fermenting vegetables discouraged me. Since it’s so easy for me to understand and to enjoy kefir and yogurt, I haven’t made time to learn and make a habit of fermenting vegetables.

  36. Please explain why it is important to avoid legumes? Would this include cashew nuts?

    • No, cashews are tree nuts, not legumes. Legumes are grassland plants that have been fed upon by grazing mammals for millions of years, thus they’ve evolved toxins that suppress mammalian digestion. Their saving grace is that many of these toxins can be destroyed by soaking and thorough cooking. However, most people are impatient cooks, so we recommend avoiding them.

      • Soaked and cooked lentils, yay or nay?

        In the past I seem to have done better on lentils than any other carb source, without the typical side-effects of other legumes.

        Type 2 diabetes runs in my family and potatoes cause my blood sugar to go crazy. I seem to tolerate smaller quantities of white rice, such as in sushi.

  37. Hi, I really this is diet is amazing.

    I’ve been on it for 4 weeks and I’ve been feeling great.

    However, in the book i wasn’t able to find the section on how many seeds or nuts I can consume. I typically consume 2 table spoons of raw sunflower, seasame or pumpkin seeds and two table spoons of raw almonds, Is that okay?

    • I cannot find an amount listed for nuts and seeds, although nuts is listed in the Pleasure Foods section of the diagram. I am assuming they must be raw, because if they are roasted, they may be cooked in oils: cottonseed, safflower, canola, etc.

  38. Paul – have you seen this article in yesterday’s Wall Street Journal (personal journal section)? “Short Fasts for weight loss vs traditinal diets”. This is the first time I’ve seen intermittent fasts mentioned in a main stream publication. The results they describe are very much in line with PHD philosophy.

    The article can be found at: http://online.wsj.com/news/articles/SB10001424052702304854804579234140222181848?mod=WSJ_hps_sections_health and remains free to non-subscribers for 7 days

  39. Hi Paul,

    I recently had my well water tested and was advised to install a reverse osmosis filtration system because the TDS (730ppm) was in excess of recommended safe levels (and there could be possible negative health effects). I suspect the quality of drinking water is an important consideration. I have the Scribner edition of your book (very well done!) but I don’t see a discussion on this topic of drinking water. What is your recommendation as to a good choice of healthful drinking water? Natural spring water, reverse osmosis purified water, natural mineral water with a high TDS content such as S.Pellegrino, distilled water, other?

    Thanks in advance!

    Sean

  40. Someone recommended this diet to me, but I am a vegetarian. I am a vegetarian by choice. Is there any realistic alternative to this diet that is just as good, but does not include eating meat?

    • Hi J,

      Since our diet is based on optimizing nutrition, it’s possible to have a vegetarian version. We discuss that briefly in the book. It is important to eat eggs and dairy, however. It would be best to eat fish too. But the general strategy of optimizing nutrition is the same, you just find plant sources of nutrients and supplement for the rest.

      • Thanks Paul. That points me in a good direction. I will have to check out the book.

      • Hi Paul,

        Glad I read through the comments! Have been vegetarian for over two years and was starting to experience increasing symptoms of acid reflux, abdominal pain, headaches and nausea. Got to the point of feeling constant nausea and having acid reflux each night, was unable to eat any breads (including sourdough and rice flour breads!) Testing for gluten and lactose intolerances by cutting out starches and dairy only made the problem worse. Finally a workmate gave me your book. I rigourously cut out soy, legumes, and polyunsaturated fats, ate safe starches with eggs, dairy and fish, and kept up with fermented foods, which I was already doing previously. It has been less than a week and I feel so much better! I plan to buy a copy of your book and slowly reintroduce ethical meats while continuing to implement a vegetarian version of the PHD. Any advice regarding supplements while I make this transition?

  41. Hi Paul,

    I love tree nuts and glad to see it laid out in PHD’s food plate albeit non core. Recently I came across numerous nutrition bloggers recommending to soak and dehydrate tree nuts even if raw and organic ( besides beans and seeds) before eating them to remove toxin which is not easy for me.

    Do you think it is necessary? I dont have any problems with digestion when I consume nuts from the shops although Im not sure whether longer term is my underlying health is being compromised.

    Thanks and have a great weekend?

  42. Hi Paul,
    I’m a 22 year old male athlete trying to build muscle and recently started the PHD to improve energy, mental focus, thyroid function, and stomach discomfort. I have been on a strict healthy diet for years, though it was high protein, high carb, and low fat.

    The high fat and oil consumption has made my stomach feel perpetually sick and bloated, making me dread each meal. I also feel mentally and physically miserable, to the point where my doctor and I think I’ve have the flu but tests came back negative. Is this normal? If I don’t improve soon I will have no choice but to go back to my old diet, I have used all of my sick days at work because of this.

    Also, I’m rather concerned about the PHD’s macronutrient recommendations. What athlete is the recommended 600 protein calories and 500 carb calories (+100/hr exercise) for? It seems very odd to recommend that to everyone, from a 100lb female gymnast to a 300lb male football player.

    • I’m not Paul and not an expert, but perhaps all the extra fat is overloading your liver?
      I also struggle with eating too much fat – I feel all tired and bloated after a meal containing too much coconut oil.

      I feel a bit better after scaling back the fat a bit, and reducing toxins in general.

      • It certainly feels like overload, I always have that feeling. I would LOVE to scale back on the fat but I need the calories and can’t get them anywhere else. 🙁

        • How much fat are y’all eating? PHD is high fat by calories, not by amount. I don’t eat all that much fat – a bit for cooking and whatever comes along as part of whatever protein I’m eating. It isn’t supposed to be unnatural or overwhelming.

    • out of interest, where did you get those numbers from, when you wrote: “What athlete is the recommended 600 protein calories and 500 carb calories”

      • I found the athlete info from the book and Paul’s post about athlete nutrition:
        http://perfecthealthdiet.com/2010/10/perfect-health-diet-for-athletes/

        Also, I was considering making carbs 30% like you said because that was also mentioned in the book, but everywhere else in the book and on this website it says anything more than 500+100 carb calories is bad. So its hard to know which one to believe.

      • i believe Paul has become more ‘flexible/open’ to carbs since that ‘Athletes’ post was written (October 2010).

        So go by the ‘Athlete’ info in the book,
        ie.
        for carbs, pg91 start reading from heading “Summary: the body’s natural carb intake”.

        for protein, pg77 start reading from heading “Summary: the peak health range”.

        (your pg no’s may differ, i have Aus edition)

  43. Hi Paul. You are relatively negative on fructose in your book. I just wonder if there are studies showing harmful effects from eating natural foods containing fructose. I have not seen such studies. Even a few studies showed beneficial effects from natural honey (http://www.ncbi.nlm.nih.gov/pubmed/?term=15117561). Some of Staffan Lindeberg´s studies also underlines this fact. For example a study he did feeding pigs a paleo diet with 57% of energy as carbs (including a little starch from potatoes) and probably as much as 25% of energy as fructose showed many beneficial effects (which you cite in your book). Conversely we know that Suomo wrestlers are eating a very high starch+protein diet. Also fois gras is produced with similar high starch feeding. The livers end up 5-10 times bigger than normal with lots of saturated fats in it. In the end we should ask whether it is really better to consume 20 gram carbs in the form of white rice than say 1 banana. In Japan the «morning banana» diet was at one point very popular and people lost weight by eating only bananas for breakfast. Fructose intolerance seems less of an issue with natural honey, and frequently disappears when glucose intake (say starch) is higher than fructose in the meal. Natasha Campbell-McBride (Gaps diet) argues that fructose intolerance is a sign of suboptimal digestive function that can only be truly healed by abstaining from starch for a period of time. Gout appears to be related to a lack of alkaline minerals to neutralize the uric acid. Fruits will provide these minerals, but not honey. I have seen on urine therapy discussion groups that some end up with nasty symptoms (excess uric acid), but that these symptoms disappears with adequate fruits and vegetables in the diet. The urine then tastes «better».

    • Interestingly, a recent study suggested that overall fructose consumption in the US did not increase between 1970 and 2009. The 10% increase in calories was primarily from starch in grains, and fats. During this period obesity rates increased from 13% to 34%. http://www.nutritionj.com/content/12/1/130

      Now, it would be interesting to know how different starches affect weight and appetite, such as yams vs potatoes, white rice, whole grains etc.

  44. Hey Doctor,

    Can this diet help with leaky gut?

  45. This Harvard study reported on NPR is another one of those things all the anti-meat people are scoring points with. Researchers fed one group of people all meat and cheese, another group all vegetable and rice, and checked their gut microbes; then told the world once again that meat is bad for us:
    http://www.npr.org/blogs/thesalt/2013/12/10/250007042/chowing-down-on-meat-and-dairy-alters-gut-bacteria-a-lot-and-quickly

  46. Hi

    Is taking probiotic supplements allowed on the diet?

  47. Also, would anyone know where i can buy organic sago?

    I can’t find anywhere. Any good companies?

  48. Hi,

    Modified Citrus Pectin is amazing at removing heavy metals.

    Do you guys support it?

    • Hi Enrico,

      I don’t believe modified citrus pectin has been sufficiently well studied to justify having an opinion on it.

      Until there is more evidence, I would stick with natural pectin from fruits and vegetables.

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