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:


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Leave a comment ?

3,322 Comments.

  1. Paul, I am reading the PHD book right now, and stopped in my tracks when you wrote to not take fish oil supplements. I take a DHA one daily, as I cannot eat seafood at all. (Long traumatic childhood story reasons, not allergies.) I have tried many times to put this all behind me, but I quite literally gag on seafood. In therapy I came to accept that it is just part of my life to not eat it.

    So, what to do? I need those Omega 3s! We eat Omega 3 eggs (or local pastured), and I supplement. Ideas?

    Thank you so much. I finally feel like me again after two months of following this plan and my autoimmune inflammation is q.u.i.e.t. YEAH!

    Jacqueline

    • Hi Jacqueline,

      Well, if you can’t eat seafood, then you should get omega-3s elsewhere. I’d suggest refrigerated liquid cod liver oil as a possibility. Also you could get some plant omega-3.

      Congratulations on your improvements!

    • By reducing w-6 (omega-6) PUFA’s, you substantially reduce your need for w-3 PUFA’s – as less competition exists for the conversion of the parent w-3 (linolenic acid) into EPA and DHA. W-3 acids are not exclusively found in marine sources – but also in grass fed terrestrial sources. DON’T TRIM THE FAT. Lean animal’s fat is mostly outside the meat. Pasture fed hen’s eggs also contain w-3’s. Wizard biochemists estimate the ‘need’ for w-3 to be 1/10 the amount of the recommended 3 grams per day, which makes .3 grams per day. EASILY obtained from good terrestrial sources. But you MUST limit PUFA’s. Get it?

  2. Can you eat chia seeds on the PHD?

  3. Hassan Hassan

    Paul,
    I would like to dearly thank you for your effort, website, book and research.
    I am reading the PHD book right now following the PDF recommendation trying to reverse the joint movement sounds, specially in my knees. Is there any special food concerns or exercise limitations?
    I am teaching Tai Chi here in Ajax, Canada which my put some light stress on the legs joints. Any recommendations.

    Thanks.

  4. Hello Paul,
    I come from India where a traditional diet is rice wheat & legumes. I can’t eat eggs and meats because I have IBS. My question was: How do I add fat to my diet? Use Ghee or butter and continue eating rice & lentils? We soak the lentils overnight. Pls advice as I am trying to get 50% calories from fats.

    • I’m also Paul. Not that Paul.

      When my old mother was suffering from some undefined colonic problem – IBS? Gastroenterititis? – and she was forced to undgo another colonoscopy, all these doctors could come up with was eat more fiber.

      Eventually I asked her if she would be willing to try a “low bulk” diet, which came to me via “The Fiber Menace.”

      “Anything! I can’t live like this!” I did so, three days later she was “cured.”

      Eggs and meats will mostly likely cure you. They are your friends, not you enemies.

    • I’m also Paul. Not that Paul.

      When my old mother was suffering from some undefined colonic problem – IBS? Gastroenterititis? – and she was forced to undgo another colonoscopy, all these doctors could come up with was eat more fiber.

      Eventually I asked her if she would be willing to try a “low bulk” diet, which came to me via “The Fiber Menace.”

      “Anything! I can’t live like this!” I did so, three days later she was “cured.”

      Eggs and meats will mostly likely cure you. They are your friends, not your enemies.

    • By experience, Joy, meat and eggs are the foods that help IBS not hurt you. Follow the PHD and you will feel better, I can almost promise! Get rid of the wheat and legumes (especially the wheat!) and embrace this diet. I think you will feel fantastic!

      • Hi Liz, eggs make me sick. I am sensitive to protein I think. Even chicken & fish is hard on my stomach. I digest lentils better. Still sorting it all out. Thanks for your suggestion

        • Maybe Paul will give suggestions. Maybe the yolks only ? Perhaps its the egg white that bother you. PHD suggests 3 egg yolks per day. They are so nutritious. Yes, and the wheat is so tough on the gut. I’m not being preachy, just trying to help. Good luck!

          • Hey Liz, no you’re not being preachy at all I really appreciate your reply! I tried egg yolk and it still caused me problems. I’ll try to get my protein from fish & whey protein powder. Even eating fish regularly makes me sick. Lentils used to make me sick, I think I am sensitive to protein. I recovered a a bit after taking Primal Ultra Defense probiotic formula. The high fat diet as Paul suggests, while on it one should get cholesterol levels checked every 3 months and carefully monitor the ldl to hdl ratio.

    • If digesting egg yolks and even a bit of fish is difficulty perhaps you could try building your digestive system in line with the suggestions in GAPS diet. A lot of broth and some home made fermented food – as well as high quality probiotic supplements . Google GAPS to find out more. Almost all healing diets require you to give up the lentils and gluten at least for a while. Also might find following low FODMAP diet helpful in relieving symptoms. Good luck.

      • Got it Maryam. I developed ibs after I took antibiotics for chronic bronchitis and aspirin & aleve for backache in 2006. I was only 23. Couldn’t eat properly for the next 3 years. Cymbalta helped my ibs but after gallbladder removal in 2010 I was bed ridden again for 3 years with chronic nausea and unable to eat anything except toast. Then I found primal ultra defense probiotic and it made a lot of differense. Got the GAPS diet and their recommendations on their website. Will implement. Thanks for your guidance

        • Joy, you may have low stomach acid, which would cause your inability to digest proteins and IBS. This is very common, especially if one has been on antacid medication or taken lots of antibiotics. There is a book called, “Stomach Acid is Good for You” by JOnathan Wright. I recommend you look into this to help you digest protein.

          • Thanks Ashley. I have been taking Prilosec twice a day for acid reflux for 7 years. Will stop. Thanks for the book name. Will buy it

  5. Question: During intermittent fasting, PHD recommends coffee as one of the liquids that can be consumed.

    I notice that Dr. Mercola has a whole article stating that coffee should be avoided: http://articles.mercola.com/sites/articles/archive/2010/01/30/if-you-drink-coffee-make-sure-it-is-organic.aspx

    However, it is easy to find multiple studies that conflict with the statements in his article…except for the cortisol issue.

    I believe the benefits of coffee (multiple studies demonstrate that mod-high intake is inversely related to risk of CHD, many cancers, and DMII) outweigh the cortisol issue, but I would like some input other than my “opinion.” I can’t reconcile his argument that increased cortisol is associated with fat gain, with studies that find moderate to high coffee intake is inversely associated with DMII.

    Can anyone weigh in? Thanks!

    • Personally, I wouldn’t be concerned about the cortisol issue. Everything seems to raise cortisol levels. It’s a red herring, IMO. People eat more when they are stressed, then are surprised that they’ve gained weight and blame is on hormones. Thus we end up just losing our sense of personal responsibility. There are very few articles that Dr. Mercola writes that I trust at all.

      • I concur, Joanne. But I have people swearing that coffee is gonna kill you based on a 2009 article on his site, who also ignore another on his site from 2011 saying it’s good for you. They are also pulling from someones 1981 study (seriously…1981???) that linked coffee and pancreatic cancer. A link that has been disproved multiple times since. I think folks just marry themselves to some lies and will not be dissuaded. That said, I’m about to stomp on some toes. While I realize that there can be issues w/high cortisol levels, I also trust that our bodies, for the most part, are hardwired to adapt to changing conditions. Rant over.

  6. BTW, just bought my THIRD copy of your book–for my BFF–the smartest nurse I’ve ever met! Thank you, thank you, thank you for writing this!

  7. Really enjoying the diet so far! I’m overweight and want to lose weight. Will eating the starches from sweet potatoes and potato starch inhibit weight loss at all? I’ve been warned against going without the carbs as this can raise insulin levels. Thoughts?

    • Pls check out this video on youtube https://www.youtube.com/watch?v=bjTmdvFH3gQ 100 people in Canada ate a high protein high fat diet for a year and lost weight and reduced their blood pressure and diabetes medication. For weight loss short term no carb diet is ok. In the experiment they ate cauliflowers to get some carbs from plant food.

      • Um….that’s been known for at least 80 years. See https://en.wikipedia.org/wiki/Vilhjalmur_Stefansson

        He was an arctic explorer and found out that a meat only diet was just fine.

        Back in civilization, he and a friend ate nothing but meat for a year, were monitored by lab tests, and of course, all was well.

        Personally, I’ve found a meat only diet lacking in satiety and I eat too much. My weight goes up.

        Damn.

  8. You say no sugar what are we supposed to eat sugarless chocolate and fruit! 😯

    • Anything with added sugar better avoid it. The authors recommended limiting your fruit sugar (fructose) intake to 25 grams per day. Internet sites have list of fruits and their sugar content.

    • There are plenty of chocolates that have no sugar. He’s not saying to grab a Hershey’s bar but a unsweetened dark chocolate bar probably no less than 75% cacao it’s bitter but I think it’s an acquired taste (tastes earthy after a while)

  9. Have you read the book?

  10. Very nicely balanced diet, Paul. But, remember, we are ALL taking risks with our dietary decisions. Tremendous uncertainty exists about human nutrition. Scientists are still unraveling how cells work – and how nutrients affect them.

    Far too little is currently known.

  11. There’s a new study out suggesting a plant-based diet is preferable for cancer/longevity:
    http://www.npr.org/b…meat-study-says

    I’m sure this will make the rounds just as previous studies have as yet another triumph for the plant-based approach to the world. Once again, I don’t see any indication that there was an effort to de-couple red meat consumption from the other poor lifestyle choices that often accompany it, though, interestingly, the study did find that older people benefit from higher protein consumption.

  12. Hello Paul,
    Since the PHD suggests eating 0.5-1.0 lb. of protein daily, can you help me understand this new research about animal protein? Or is this study flawed in some ways? Thanks.

    http://www.scientificamerican.com/article/diet-high-in-meat-proteins-raises-cancer-risk-for-middle-aged-people/?print=true

    Diet High in Meat Proteins Raises Cancer Risk for Middle-Aged People. For people aged 50 to 65, a high-protein diet increased the risk of cancer fourfold, comparable to the risk associated with smoking

    Mar 4, 2014 |By Bahar Gholipour and LiveScience |
    image of two raw steaks on a grill

    People who eat a high-protein diet during middle age are more likely to die of cancer than those who eat less protein, a new study finds.

    However, for people older than 65, a moderate protein intake may actually be beneficial, and protect against frailty, the researchers said.

    The researchers looked at more than 6,000 people ages 50 and older, and followed them for 18 years. They found that people ages 50 to 65 who ate a diet rich in animal proteins during middle age were more than four times as likely to die of cancer during the study period than those who ate a low-protein diet, according to the study published today (March 4) in the journal Cell Metabolism.

    “Popular diets in many cases have high proteins and low sugars. They may make you lose some weight, but that’s not a good diet to increase life span,” said study researcher Valter Longo, professor of biology at the University of Southern California (USC) and director of the USC Longevity Institute.

    The risks of a high-protein diet are even comparable to smoking, the researchers said. People who smoke are four times more likely to die of cancer compared with nonsmokers, Longo said.

    “Of course we cannot be sure of the reasons, but we have a pretty good idea, based on this study and also previous studies, as to why this is happening,” Longo said.

    The study also found that middle-age people who ate foods rich in animal proteins — including meat, milk and cheese — were 75 percent more likely to die of any cause than those who ate a low-protein diet within the study period. [5 Diets That Fight Diseases]

    The researchers defined a “high-protein” diet as deriving at least 20 percent of daily calories from protein, a “moderate” protein diet as deriving 10 to 19 percent of calories from protein, and a “low-protein” diet as less than 10 percent of calories from protein.

    However, what’s bad for people at one age may be healthy at another. In the study, people older than 65 were less likely to die of cancer or other causes if they consumed more protein.

    “So, not all people benefit from low protein. Older people actually seem to benefit from moderate intake of protein,” Longo said. Having enough protein in the diet may be important for older people to maintain a healthy weight and protect against frailty, the researchers said.

    The link between high-protein intake and risk of cancer almost vanished when the researchers considered participants whose protein mainly came from plants, such as beans.

    This may be because proteins in plants have a different composition, and don’t stimulate growth hormones as efficiently as meat proteins, Longo said.

    The study suggests that the Mediterranean diet, which is low in animal protein and high in carbohydrates, may be best for extending life span, Longo said.

    The researchers said they recommend eating about 0.8 grams of protein per kilogram of body weight every day in middle age. For example, a 130-pound person should eat about 45 to 50 grams of protein a day, with a preference for plant proteins, the researchers said.

    To investigate why there may be a link between protein consumption and cancer, the researchers looked at mice that were injected with mouse skin cancer cells. They showed that a high amount of protein in the mouse diet promoted the tumor’s survival and growth by increasing the levels of a growth hormone, called IGF-1.

    The researchers also measured the levels of IGF-1 for 2,000 people, randomly selected among those in their study, and found that for every 10 nanograms per milliliter increase in IGF-1, those on a high-protein diet were 9 percent more likely to die of cancer than those on a low-protein diet.

    “When you have a lot of protein, these growth factors go up, and we’ve shown that they help normal cells become cancer-like cells, and then they help the cells grow,” Longo said.

    • Often there are important factors at play that would lead to very different outcomes. For example in this study, when you look at it in detail, you find it’s actually conducted on mice not people. Now if mice live longer eating what we regard mice to eat in the natural environment, i.e. A carbohydrate rich diet, probably in the form of grains etc (although we don’t know what form these macro nutrients take). Is that a surprise, not really. Give them more protein or fat (we know not all macro nutrients are the same, no mention of what type of fat and protein here) and they die quicker. Well mice aren’t humans and certainly don’t have the same physiology as humans or dietary requirements. The assumption that we are identical to mice in our nutritional needs and the ways our bodies work is a huge one, and not one I trust in. Also, the reporting following these studies acan be extremely one-sided sometimes, sensationalistic or intentionally scaremongering, which is worth noting.

      Essentially I enjoy eating real food, that comes from organic sources in a way that agrees with our ancestral roots. I see this as natural to me. I also feel a connection to the philosophy of Charles Eisenstein and like his view that we should listen to our bodies, trust our desires and urges and use our body’s natural diving rod to sense what we need and what nourishment we most yearn for at that moment. What experience does it yield before, during and after and do we feel good eating it.

      This gives me all the insight I need and a news article on a questionable study falls woefully short of changing my current view of healthy food, but could unfortunately confuse and/or sway others less informed, or with less time to analyse the finer details here.

      • It says some tests were done on mice, but others on people

        “The researchers also measured the levels of IGF-1 for 2,000 people, randomly selected among those in their study, and found that for every 10 nanograms per milliliter increase in IGF-1, those on a high-protein diet were 9 percent more likely to die of cancer than those on a low-protein diet.”

  13. I read that article in my local newspaper. But it doesn’t say anything about how scientific the study was.

  14. PHD recommends eating quite a lot of animal products. I don’t want to eat that much meat actually. Please don’t try to convince me of the opposite now – i would rather appreciate advice how to eat less meat and more plant-food but stay as close to PHD as possible. I am not trying to be vegan here – I just want to reduce animal products to about 50% or so of what PHD recommends.

    some ideas I have:
    1.eat some legumes but make it safe (soaking, sprouting etc.)
    2.Don’t cut back on omega3(supplement fish oil)
    3.eat more fatty plant food like you would do on PHD:coconuts, avocado, some macadamia nuts, olives.
    4. I DONT cut back on organ meats, bones, animal fat for cooking. I eat mutton&beef sometimes chicken rarely pork.

    Do you have any other ideas? I understand I am not a gorilla or a cow…I was wondering if eating more fermented foods could somehow do the same for me what is happening in these animals’ guts?

  15. Hi Paul,

    I am a bit reluctant to use a lot of acidic products as I have arhritis and my body tends to be acidic.
    When you recommend lemon or vinegar together with carbohydrates, I wonder if fermented vegetables will provide enough acidity and replace effectively lemon or vinegar?
    Marie

  16. Paul,
    What are your thoughts on einkorn or emmer wheat? Thanks.

    • Whole Paycheck used to carry a frozen einkorn bread which ranks as one of the best breads I’ve ever tasted. Then French Meadows stopped making it…….of course!

      I have a modest wheat sensitivity. I can eat a sandwich just fine, but I can’t be eating lots of wheat every day. Then I get chronic body pain. And I do like the diet variety of bread in modest amounts, the ability to make sandwiches. Right now I’m meeting that desire with Genius brand Glutino bread. It’s excellent, but nothing has that wheat taste or toasted smell like wheat.

      A friend has a nearby cafe where she serves up creative, fresh foods. Lots of local produce. She has had gluten free breads available for a long time, but I talked her into trying out einkorn. So, I’ve ordered the flour and we’re going to try it out.

      There is a large amount of anecdotal evidence that those with wheat sensitivity – not celiac! – eat einkorn without any issue at all. The amino acid profiles (which is what makes gluten) of einkorn are very different than modern wheat, especially that of the “dwarf mutant wheat” dominant in the last half century.

      Einkorn is probably the original, natural wheat. It has two sets of chromosomes, IIRC. Spelt doubles that, and modern wheat has eight. All IIRC. So, it’s quite plausible that einkorn is safe for everyone except celiacs and who knows, possibly even for them. As always, “The dose makes the poison.”

      Those are my thoughts and experiences. Yours, or Paul’s mileage may vary.

  17. Hi, Paul has a post about cereal grain like this two.
    using Google I reach it.
    but the principles are simple: There is not enough scientific research about the safety of this starches.

    • I saw that post, I think it was back from 2010. It referenced Dr. Davis and Wheat Belly. Since that was from 4 years ago, I was wondering if there is any new information on einkorn and emmer wheat, since PHD states do not eat grains or cereals.

  18. In the orac list there is one plant at the top first, that smashes the other in the antioxidant load. It is the sumac bran. I think this is where all the anti nutrients are, anyway it’s an interesting ranking. Chocolate is by far superior to red wine. Spices are absolutely awesome in the ranking, thyme, clove, are at the top positions.
    Regards

  19. Good evening Paul,

    I just picked up a copy of the book and I am 1/3 of the way through but skimmed the remaining chapters for now. My wife and I started the Paleo 30 day challenge about a week ago. Albeit she has a lot of autoimmune diseases, I chose to support her by doing the Paleo challenge with her. I had many questions and reservations, but she found your book and thought it would be a better fit for me personally.

    I do not see a so called “30 day” challenge like a Paleo diet would, eliminating many foods and slowly introducing them afterwards to see how your body reacts. I do not think I have any gluten allergies, I am not lactose intolerant, nor do I have any major health issues. Do you not recommend any kind of “30 day” fast or challenge? Do you prefer being on the PHD and then just doing the intermittent fasting you describe vs. a 30 day plan?

    Thoughts? Thank you to you and your wife for taking the time to research and educate everyone about this great lifestyle change that I look forward to being a part of!

    • I too was curious about a 30 day plan like Teal. I’ve read about it a lot in Paleo books. Anyone have any thoughts on it?

      • I’ve just recently gotten Kresser’s book “Paleo Code” where he suggests the strict paleo 30 day reset, and I want to try it. I have been following PHD – not 100% yet – for the past 4 months. I’ve lost about 18 pounds. Now for the last month or so I’ve been stuck because I’ve been cheating a little bit almost daily. Sugar craving is the prime reason for that. Yet I have not regained any weight. Not losing it either but thank God I haven’t re-gained any.

        I never before thought I was gluten or lactose intolerant but after removing/reducing it from my diet, I clearly see that I am.

        I’ve been off Prevacid for several months with gradual lessening of heartburn and reflux. Some days, no heartburn at all. To be honest, quitting that drug has been the best thing that I have done next to the diet. I digest much better and quicker now.

        • So, JT to further answer your question about the 30 day reset, I am gearing up for it. I like dairy even though it doesn’t like me, and I’m almost IN LOVE with my new honey raspberry vinaigrette dressing. I could almost eat that stuff by the spoonful. So not having it at all for 4 weeks and then slowly adding very stingy amounts of it kinda upsets me, no lie. OTOH nothing ventured nothing gained. Doing the PHD for the past 4 months has prepared me for such a venture, because I have seen such positive results already. And it will certainly be worthwhile finding out which foods I have to eliminate from my diet. I hope to improve my digestion and eliminate the heartburn entirely and heal my esophagus ,which has already improved, and I hope to sleep better at night.

          I’m under so much stress from not having a full-time job and then having to accept 2 16hour weekend shifts every weekend to get by plus keeping my elderly mom who has Parkinsons with little help from my family who live nearby and could help but just won’t. I really need my health. PHD is very complex and overwhelming. I still have yet to incorporate all the recommendations, but I’m getting there slowly and surely.

          • If you find it complex and overwhelming, I think you’re approaching it wrong. When I started PHD I didn’t worry about amounts – I just dropped vegetable oils, sugar, and grains and started cooking more of my meals and using coconut oil, eating eggs regularly, and then added fermented foods. All the time I ate to taste – I didn’t worry about percentages much at all.

            I didn’t worry about supplements or some of the more specific details for about 6 months – I just got used to eating in a different way than I had been and felt so much better and dropped around 20 pounds without even trying. My reflux stopped almost immediately and lots of other things cleared up over time.

            After a while I incorporated intermittent fasting, which I love. I find it easy. When I don’t find it easy, I don’t do it, because I figure my body is telling me it wants or needs something.

            Good luck with your jobs and your mom. It’s really hard to keep an even keel with stuff like that in your life.

          • Thanks for the comments Ginny. I’m almost on week two of a paleo 30 day with no grain, dairy, sugars, PUFA’s and processed foods. It’s been tough but I do feel good each morning even when I don’t get a full nights sleep due to kids or work. I also don’t feel sluggish in the afternoon like I used too. I hope to add dairy and white rice after the 30 days and see what happens. I’ve been told by others to not stress over it like I did in the beginning. It’s been challenging but a much needed lifestyle change. Best of luck and to improved health to you and your mother!

          • Thanks JT and PeterC for your suggestions, comments and wishes! I didn’t see a “reply” button after your comments so I hope you both see this. And good luck to you JT on your final 2 weeks of the reset diet! Let me know how you do, please. I haven’t started yet but plan to within the next week or so. I hope to batten down the hatches on this diet and continue losing weight and getting better. I’ve already lost that “old person stiffness” upon standing after sitting for a while. Now I sit for a while and get up practically on the run! Not so before!! Before, I had to slowly get up and then oil my joints, and then hobble off slowly. YAY PHD!

  20. Hi Paul,

    Firstly, congratulations on writing such a comprehensive and measured take on nutrition, it’s been a very thought provoking read and I’ve implemented the main PHD precepts with good results: better blood sugar, calmer digestion, energy up.

    I’ve recently tried to implement some of the supplements recommended, however I’ve really struggled with incorporating iodine – my neck swells to the point of being quite uncomfortable. I was cautious in how I approached this, eating selenium-rich foods, and starting with an extremely low dose: 80microml liquid iodine drops. I then dropped this back to 40microml for several weeks to see if my body would adapt.

    The swelling was persistent though, so I’ve stopped supplementing for the time being. It’s a shame because I believe the iodine had some very positive effects as well – dry skin gone, alertness up, and a mild though persistent fungal foot infection cleared spontaneously.

    Have you any thoughts on this or suggestions on where to go from here – or has anyone else encountered this when supplementing?

    All the best from Oz 😀

    • Hi! have you tried adding iodine to your diet by eating small amounts of seaweed like Kombu or wakame, the sort you get from sushi. This food derived iodine may be more acceptable to your body.

    • Hi Chris,

      I would stay off the iodine for the moment and see a doctor to get a thorough thyroid evaluation done. When you are ready, re-introduce iodine at a very low dose (say, 40 mcg) and see what the effect is on thyroid hormones.

      Best, Paul

  21. Hi Paul,

    I cannot express my gratitude enough to you and Shou-Ching for this book and your ongoing generosity to heal the world. After only about four months on the diet, I have mostly healed my hypoglycemia, which I had for 25 years after a two-year stint as a vegan. My stamina has increased by about 25% and my overall well-being is dramatically better. I am telling everyone I know about your book!

    I have a co-worker and good friend who can barely eat anything due to two conditions — interstitial cystitis and gallbladder attacks. Her doctor has her eating greens, artichokes, low-fat meat and hardly anything else. She is allergic to wheat and dairy. She cannot eat fruit, fat (except coconut oil), spices or acid foods lest she have painful symptoms. White rice is problematic for her urinary tract. Is there any way she can try to incorporate The PHD with these issues?

    Thank you!

    Amy

  22. Hi Paul. Again, thanks for all you do for us. How about wild rice. It is not really rice. But I don’t think it is a grain either, but really is a grass seed. Safe to eat? Also , how about pink rice, and black rice?
    Thanks, Terry

  23. I am so very interested in trying this plan. My husband and I are both in our early-mid 30’s and both already have various medical problems. We desperately desire to be healthy. I would love if you could post somewhere what a typical breakfast, lunch and dinner would look like. That would be super helpful! Do you recommend buying a food scale? Is that how we would figure out how many lbs of meat we are eating? Does each meal need to contain each healthy element? Thank you! Jen

    • A food scale is a good idea. What are your health problems? For breakfast you can eat eggs cooked in butter, salad mix, some nuts, and wild blueberries & strawberries. Pls share more on your health problems. I have been researching a lot about diet & nutrition and might be able to give you some advice

      • Thank you for responding. As far as health issues my husband was diagnosed with gout a few years ago and struggles with flare ups. He and I are both about 40-50 lbs overweight. I have terrible anxiety and wake up every night, several times a night. I also have sleep apnea. I have never had it diagnosed but know that I have it as it wakes me up. I feel tired most of the time and have terrible red dry eyes. Partly due to living in dry Colorado but I also wear hard contacts. Also I have TERRIBLE reflux. After most meals I regurgitate food back up. It’s horrible to say the least. I also have had life long constipation. We also have two children ages 5 and 9. My 9 year old daughter has struggled with constipation for years too. The docs told her to take miralax every day. We did it for a while but I hate giving her daily meds to help her do something that her body should naturally be doing on its own. Again, thank you for responding!

        • Thanks for the information. Are you also on any acid suppressing drugs like Prilosec? And any blood pressure medications? What is your diet like? Your family needs a good probiotic. Go to http://www.amazon.com and look up Primal Defense Ultra Probiotic. Get one bottle. Begin here. You will see a turnaround in your health

        • If you have insurance get yourself and your daughter tested for food allergy. Start by eliminating wheat. It is damaging the gut. I believe you a had a gut flora imbalance your whole life and as kids get their gut bacteria from their mothers you daughter is having constipation issues as well. First step: Get the Primal Defense Ultra

        • There is a small study back around 2008 or so, Eric Westman MD from Duke, showing rather astonishing results for reflux disease with a very low carb diet. My experience was that my reflux and snoring vanished within two weeks of going on low carbs. Might be worth trying the low carb version of PHD (or any other low carb high nutrient diet for that matter.) If you do low carb you will automatically do no wheat! I personally followed the New Atkins for a New You approach, which despite all the propaganda is virtually the same as Paleo/PHD if you actually read the book.

          I also live in colorado and yes, it is dry here in the winter especially.

          Jim
          paleopathologist.com

  24. Re: 1 # safe starches/day – cooked or uncooked? I can’t imagine eating a pound of dry rice cooked. Potatoes probably wouldn’t absorb nearly as much water. How much is a # of cooked rice? Thanks, Jim

  25. Does taking 4 tablespoons of resistant starch before bed still fit the 16/8 model of eating? Since RS has little effect on the stomach and small intestine, you would still be in a fasting state? Or is the fasting state stopped at that point?

  26. “If I have a book that thinks for me, a pastor who acts as my conscience, a physician who prescribes my diet, and so on–then I have no need to exert myself. I have no need to think, if only I can pay; others will take care of that disagreeable business for me.” (Kant, “What is Enlightenment”)

    The realm of the dietary, no matter how scientifically based it may be—and the Perfect Health Diet is, in this respect, in a league of its own—will invariably be connected to the religious, in the sense of something tribal and ritualistic, in the sense of what has supreme importance for someone, and in the sense of something one feels compelled to practice; and, to this extent, diet, from the standpoint of existentialist thought, at least, will always be a temptation to “bad faith”, i.e., a form of self-deception, in which one is under the illusion, an illusion that we are wont to embrace, that one is not in fact faced with reality—the reality that I am my responsibility. The self-deception allows me wishfully to believe that I can avoid facing my autonomy via the less than honest idea that I AM this or that or via the idea that such and such JUST IS so important.

    • I think the idea is that we have a tendency to avoid and hide from the choices we know we should make as rational and self-respecting moral beings, by representing things as though the decision has already been made by some external factor or by deceiving ourselves into believing that the decision never comes into view at all.

      For this reason, “being an adherent of a diet” is, from a Kantian standpoint, not lawful behavior for rational, self-respecting, moral beings. And, in being a propagator of a diet, one runs the risk of failing to properly reflect one’s recognition of the inherent dignity of human beings.

      From a Kantian standpoint, there is probably nothing particularly untoward about making probabilistic risk/benefit predications regarding the impact of food, micronutrients and exercise on health at a cellular level. But even this must be done with an appreciation of how human nature will quickly twist this into something tribal, in which one is then able to pretend that one is not a free, self-respecting, moral individual, who always, and at this very moment, has the power to do what one knows to be the right thing.

      The ethics of this blog seems to be essentially utilitarian, but Kant always had the deepest understanding of the contours of the moral.

    • The activity of providing nutritional recommendations combines biology and applied biology (i.e., medicine). But because it is an applied science, it invariably comes within the arena of the ethical. The ethical consists of the principles of relating to oneself as a person and to others as persons.

      The concepts that underpin the ethical are concepts that are actually not possible to make sense of within the preferred conceptual framework associated with evolutionary psychology, a framework which is both conceptually confused and impoverished.

      In the present age, the ethical is also frequently confused with the religious. Relating to oneself as a person and to others as persons cannot be equated with relating to God as God’s subject and to “the others” as potential converts and sinners. And these two realms (i.e., the ethical and the religious) needn’t even be compatible, as Kierkegaard notes. This matters because, within the symbolism of the paleo sphere, at least, it is natural to regard the Natural Selector as the God to whom one is beholden (and the paleo “guru” as the Apostle who has divined the Designer’s plan for us) and then to regard the SAD folks as sinners who have not embraced their Natural Designer and haven’t yet reflected their commitment to their Designer in their “diatia”.

      The combination of the conceptual blindness to the ethical that results from both of these sources, i.e., the negative conceptual influence of evolutionary psychology combined with the religious compulsion to serve, as a religious subject, the Designer of Nature, and to convert others to the same mindset—where this is then mistakenly misinterpreted as an ethical obligation— leads to a degenerate state of affairs, culturally speaking, in which the ethical arena is, at a conceptual level, unrecognizable.

    • A human being is a rational animal. A person is what has a moral conscience. The only persons are humans.

      The idea of “the religious”, i.e., the idea of authority outside the sphere of the ethical (the sphere of personhood), is illusory. Diet is a category within the religious. Therefore, there is no such thing as a diet.

  27. Although we are human beings, i.e., animals with a distinctive range of capacities, such as reason and voluntary action—capacities which evolved in the course of human evolution—we are also persons, i.e., beings who possess inherent worth in virtue of our responsibility to and for ourselves as serious individuals.

    “Diet” appeals to the natural instinct to try to wish away this responsibility by losing oneself in what Kierkegaard calls “the crowd”, which is a mere phantasm, but which has a blinding power nonetheless.

  28. Hello Paul,

    Is blackstrap or molasses a good source of carb ?
    It would be a rich nutrient source,(Iron, Copper,etc…) but I don’t know how to consider it as you don’t mention it…
    Thanks so much for your help and your advised answer.
    Best,

    July

    • I can’t find any kind of answer on PHD site about molasses/blackstrap.. if someone can help..? 🙄

      • It appears to have roughly the same ratio of fructose to glucose as sugar. When assessing sweeteners, the ratio is the issue that PHD cares about. They favor non-naturally occurring industrial sweeteners with a high to low glucose:fructose ratio such as rice syrup. Or course, I think they would say that if you had to choose between molasses and white sugar as a food, you would choose molasses which is high in many nutrients including potassium.

        The only sweetener I use is raw honey (which has the same ratio as molasses).

        I somehow doubt that eating honey, on rare occasions, is particularly toxic in the absence of PUFA.

        Would I use molasses if I was into baking? Yes. And I would feel no guilt about it at all.

    • Why would you want to pummel your body with sucrose? Why not just drink sugar water? The minerals and any other “benefits” of molasses should be in your real foods. Molasses is not a food! I do find it an essential ingredient in Kansas City style BBQ sauce, but that’s the only situation it’s good for.

  29. Hi There,
    Just one question. I am allergic to eggs. Can you give me some good suggestions for breakfast? Thank you.

    • Debbie – are you sure you’re allergic to the egg yolks? I’m pretty sure Paul has mentioned this at least once in response to another reader’s query. I believe he said that it’s quite likely that some people who are allergic to eggs are only actually allergic to the whites. The yolk is, in any case, the healthier part of the egg which is why he usually talks in terms of eating a certain number of egg yolks per day whether one eats the whole egg or not. Can you test just the yolk?

      For breakfast ideas – anything you can eat for other meals can also be eaten for breakfast. Some people prefer to eat more protein and fats at breakfast, leaving most of their carbs for later meals. My husband and I love a breakfast of avocado, cheese and olives; sometimes, if I am hungrier or just want the carbs, I’ll butter a slice of toasted GF bread and mash the avocado on it, top with cheese, sometimes slice hard boiled egg, and maybe thin slice of onion – terrific, with or without the egg.

      • Hi Hillary,
        Thank you for your response. I was tested allergic to eggs. When I try eggs, I usually get an upset stomach and a massive sinus headache, out sick for about 2 days.
        I am currently experiences alot of food sensitivities with tomatoes, onions and advocados. So they are off the menu for now.
        Fortunately I can eat all the dairy I want. 🙂

        • Eat yogurt, berries, and nuts for breakfast.

          • Funny, you were thinking the same thing at the same moment. On the yogurt, I would make sure you buy full fat, organic. I have tried a few and Stonyfield is my favorite. If you opt for low fat, it usually has added sugar and/or other sweeteners.

    • full fat yogurt, raw almonds, raw cashews, pumpkin seeds, banana, blueberries

      • David, I also LOVE Stony Field! I think it’s the best and creamiest of all the yogurts I’ve tried (and I’ve tried Greek). Glad you mentioned this.

        • I know, I tried every whole milk yogurt I could find, and StonyField was the winner. (I even tried one that claimed to be Bulgarian style yogurt) I had to go to Whole Foods and the organic grocers to find them. The regular grocery stores here only have the low fat versions, or worse, the vanilla flavored variety.

          • I agree, Stony Field is the best of the plain, full fat ‘regular’ yogurts. But Fage (pronounced Fayeh) is the best plain full fat Greek yogurt. Very smooth & creamy; incredible taste. Most stores have the lowfat varieties so the full fat is a bit tricky to find – Whole Foods usually has it as do some specialty grocery stores.

          • Here’s a plug for homemade yogurt. It is easy and the probiotics outdo storebought by some vast vast number.

            My machine is called Yogourment. It cost me around sixty bucks online; you can get it cheaper, but I paid extra for a glass canister instead of the plastic it comes with. I have made yogurt weekly for about 3 years.

            Instructions:

            1) Heat 2 quarts milk to 180 degrees.

            2) Pour into the glass container. Set cooling container of milk into a big bowl full of ice.

            3.a) When cool to 100 degrees F, mix 1/4 c cooled milk with 1/4 c commercial plain yogurt; return this inoculated yogurt-milk back into the milk.

            4) Place canister inside the Yogourmet machine. Add a cup of water to the machine (acts as water bath). Plug in and leave for several hours. (If you need the lactose all to be eaten, leave it 24 hours).

            If you want your yogurt thick, add this step:

            3.b) Before “cooking” the yogurt in Yogourment, refrigerate the canister of inoculated milk for 12 hours or more. Then continue as directed in step 4.

            IS SO GOOD. Try it with coconut milk and coconut and vanilla and walnuts and honey.

            st

          • perfect. don’t buy ready made yogurts. we in India still make our yogurts at home. this is the key to good health. NO PROCESSED FOODS

      • I like Mountain High yogurt. It is thick and creamy and has 10 grams of protein per serving. I buy the full-fat, plain at Woodman’s (in Wisconsin).

        • Thanks, I’ll look for that one. Another good one I forgot to mention is the Trader Joes brand whole milk yogurt.

  30. ‘Our over-consumption of processed food is what is driving much of the increasing burden of chronic disease currently plaguing the Western world.
    ‘Poor diet is responsible for more disease than physical inactivity, alcohol and smoking combined.
    ‘Furthermore, nutritional supplements have no proven benefit for the vast majority of people. It’s better for the body to gain essential nutrients from just eating real food.’

    Read more: http://www.dailymail.co.uk/health/article-2582867/Saturated-fat-DOESNT-cause-heart-disease-all.html#ixzz2wKmcL0J0

  31. All of the arguments in the Perfect Health Diet that are regarded as “evolutionary” are in fact purely physiological and physiological/natural-historical. They are arguments that could have been made without the concept of evolution at all. What is needed is not evolutionary theory but an understanding of the natural history of human beings, i.e., an understanding of the proper environment in which to assess the physiological functions of our body. In other words, all that is needed is a little bit of Aristotle, some natural history, and a lot of cellular biology, physiology, and bio-chemistry. Though Darwin’s theory is correct empirically, it tends to confuse things conceptually.

  32. For example, the notion of an “adaptation” in biology is conceptually confused.

    Physiology deals with the functions of the parts of organisms. We may not know how a part of an organism is meant to function unless we know the organism’s proper environment. Is a proper environment, the one the organism “evolved in”? No, a proper environment is the one that it lived in and is suited for.

    Evolution is the result of changes in the genes passed on in reproduction. Genes that increase the probability of their being passed on are more likely to be passed on! This mechanism explains the existence of the diversity of the species, but nothing else. Thinking about evolutionary history can be a clue to helping us figure out the anatomical functions that the parts of organisms have, but evolutionary history does not explain the fact of their having that functionality.

    Organisms are not “designed” by anything, and the parts of organisms are not “designed” by anything—they are not designed either by “God” which is an incoherent idea nor by “the designer of natural selection” which is pure metaphor. It is not the case that something can have a function only if it has been “designed”. The parts of organisms have intrinsic functionality, and thus require no designer for their intelligibility as functional. Functionality is fully intelligible within the context of the idea of an organism as a unified whole with parts that are identified within a system. Aristotle regarded living things and organisms as conceptually basic. There is nothing “as-if” about life or intrinsic functionality; and this property needn’t be explained away as the mere projection of our subjectivity.

    It is not the case that an organ’s function depends upon its being the result of evolution. Nor is it the case that an organ’s function is determined in light of its ability to promote reproduction or survival—unless of course it is a reproductive organ or a physiological survival mechanism, like autophagy.

    An adaptation is defined as “a part or aspect of an organism that has a functional role that came to be as a result of the mechanisms of evolution, and which increases the likelihood of reproductive potential.” But everything came to be due to the mechanisms of evolution. And the only thing that increases reproductive potential in any direct physiological sense are things having to do with the reproductive system.

    Reproduction and survival are not “purposes of an organism”. Organisms have no intrinsic purposes, although their parts do. However, there are goods which are defined for organisms, i.e., conditions which must be met if the organism is to count as flourishing in the normal way it is expected to as a member of a species. For humans this consists in the development of the capacity of Reason.

    Human beings are not minds or souls or brains or abstract computer programs that then happen to be connected to a “body” which we manipulate with the a remote control joystick in our heads. Human beings are rational animals. Animals are organisms and organisms have an anatomy which can be studied in physiology. Activities such as standing, walking and running have a nature defined by the way they are supposed to work within this anatomical system. There is also a natural, physiologically appropriate, diet for us. But this kind of normativity is not something is that “grounded” in evolution (whatever that would mean), but must be discerned by investigating our natural history and physiology.

    • u need to be banned

    • The intrinsic functionality of our organs is not “for the purpose of survival or reproduction”—unless, of course, we are dealing with a reproductive organ or innate survival mechanism, like the physiological changes in response to starvation; no, the functionality of our organs is just for the purpose of allowing us to do stuff; that is, they function to allow us to do stuff—but there is no greater purpose to it.

      The purpose of the eye is to allow for seeing; it’s function is seeing and it functions to allow for seeing. Having eyes or having eyes that work properly certainly help beings survive who are supposed to have eyes. But the eye’s purpose is neither survival nor reproduction; rather, it’s purpose is simply to afford seeing.

      • r u a psycho ?

        • You’ve reminded me of the following remark.

          “I am sitting with a philosopher in the garden; he says again and again “I know that that’s a tree”, pointing to a tree that is near us. Someone else arrives and hears this, and I tell him: “This fellow isn’t insane. We are only doing philosophy.” (On Certainty, 467, Wittgenstein)

          The “evolutionary” health movement is at the most basic level a re-discovery of the scientific and philosophical question “what is man?” And thus it is important for both scientists, philosophers and laymen who are interested in this field to possess conceptual clarity regarding the concepts of a human being, a person, a living organism, an animal, the distinction between the exercise of a capacity and its possession, the distinction between a capacity and its physiological substratum, the property of life, the varieties of final causality, the concept of “evolution by natural selection’, etc. Clarity regarding these concepts is not settled scientifically and yet a lack of clarity here invariably leads to less than clear conceptual frameworks for the presentation of meaningful scientific research and engenders mistaken understandings of the implications of this research.

    • That an organ or appendage has this or that specific function is causally (but not conceptually) connected to evolutionary history; for, the theory of evolution predicts that the functions organs or appendages have will be well-suited to the environment in which they evolved.

      However, that an organ or appendage is something that has functionality as such—that is, that organs and appendages or parts of cells are functional sorts of things— is not conceptually connected to the theory of evolution whatsoever (nor is it conceptually connected to the metaphor of natural “selection” or “design” by natural “selection”, which, for the sake of conceptual clarity, are best dispensed with altogether). Rather, functionality is something that is intrinsic to the concept of biological life and to anatomical/physiological structure as such.

      Additionally, the fact that an organ or appendage has this or that specific function is constituted not by its evolutionary history, but by the role that the organ or appendage plays in its proper environment. And it’s proper environment is constituted by its natural historical environment (which again is a concept that has nothing to do with evolution).

      So, when Jaminet says that all mammals eat the same diet post-digestion, this wonderful observation has nothing to do with evolution and everything to do with straight physiology and natural history.

      • What the theory of evolution by natural selection explains is something empirical (as opposed to conceptual); what it explains is how it came to be that organisms came to be the organisms that they are, possessing the organs they do, organs which have such and such functions (the conceptual determination of which is determined by concepts that have nothing to do with evolution or design). It also predicts that the creatures will be reasonably operational in “their environment” relative to a very queer likelihood, namely, the likelihood of producing the somewhat abstract outcome of the reproduction of that species. However, the reproduction of a species is not an intentional or intrinsic goal of or for anything in the animal kingdom—-with the sole exception of an environmentalist, who happens to belong to the species homo sapiens, and whose life goal consists of the effort to preserve an endangered species; in such a case, the reproduction of a species is an intentional goal for this environmentalist.

        So the diet we ate in the environment in which we evolved should be operational in leading to the reproduction of our species as a whole. How could this idea possibly move a person to change their whole life?

  33. In case people haven’t heard the news, Sweden has essentially gone paleo:
    http://healthimpactnews.com/2013/sweden-becomes-first-western-nation-to-reject-low-fat-diet-dogma-in-favor-of-low-carb-high-fat-nutrition/

    Is the U.S. next? (As the article explains, given the power of the soy/corn/wheat lobbies, the answer is a resounding no, absolutely not.)

  34. I apologize if this has been posted already (didn’t see it), but a new study reported on in the NYTimes recently posits a theory that TMAO is a cause of heart disease, and carnitine in red meat gets converted to TMAO by certain gut bacteria that feed on carnitine (and so are present at higher levels in meat eaters), which leads to higher levels of TMAO in the blood, while TMAO, in turn, leads cholesterol to penetrate artery walls and prevents the body from excreting cholesterol, which, they then posit, leads to heart disease:
    http://www.nytimes.com/2013/04/08/health/study-points-to-new-culprit-in-heart-disease.html?pagewanted=all&_r=0

    Although this study in no way proves that TMAO is an actual cause, much less the cause, of heart disease, it is at the very least a little bit more interesting than those purely correlational studies that note some link between red meat and [insert horrific illness of your choice here] without factoring out other confounding factors such as other bad aspects of diet, lifestyle, etc. that usually go hand-in-hand with higher red meat consumption. In this study, instead, the researchers first noted that meat eaters had a much higher level of TMAO in their blood than vegans and then did an experiment where they gave meat eaters and vegans steak (I guess they weren’t very strict vegans, huh?), and they noticed that in the meat eaters, the level of TMAO soared in the blood immediately afterwards, which it didn’t do in vegans. Obviously, this doesn’t prove anything since it’s, again, possible that it’s not the meat that does the trick, but rather, the other bad lifestyle/diet choices of many meat eaters as compared to vegans, and I guess this study piggybacks on the controversial view that cholesterol in the arteries is a cause of heart disease, but at least they tested levels of TMAO in the blood immediately after red meat consumption so that this isn’t a PURELY correlational study.

  35. Hi Paul,

    I have some questions about my mom’s health. She is 88 yrs old and has Parkinsons disease (or Parkinsonism without the pill-rolling hand tremor, just generalized tremors.) She is 5’3” (due to osteo) and only weighs 88 pounds. Putting on weight has been a lifelong struggle for her, but until the past few years she has been over 100 pounds. Her best weight was 115.

    She lives with me, except for about 5 days every month when she goes to Hospice for respite care. So she is eating my diet with some modifications. I have seen her lose about 5 to 10 pounds since I started this diet and to be honest, I have panicked and let her eat some non PHD approved sweets and foods hoping to help her put weight back on.

    I’ve heard that those who have neurological disorders like PD need more fat in their diet and need to be in ketosis. But how can she gain weight on this diet and still treat the Parkinsons?

    At present, she is lying in bed with oxygen on. She complains she has no energy. She has an appt in two weeks to see a new internal medicine doctor who hopefully will agree to treat her. She has a DNR (do not resuscitate) order. I have found that some doctors interpret this to mean “Do Not Treat”. Her hospice doctors do treat her dehydration even though I have almost begged them to. Yet they will treat an infection, so go figure. I say why treat an infection if you are going to let someone go downhill because of dehydration?

    I’m really concerned about her losing weight and yet not feeling any better. Every day she has two eggs with bacon gravy for breakfast and a large helping of sweet potatoes with honey, and sometimes spinach. I usually give her a Boost chocolate drink to help her gain weight. Also she either drinks coffee or no sugar added grape juice. Usually soups for lunch, and for supper meat and vegetables, and she eats ice cream (Cookout restaurant) every day. She only takes Levothyroxine in the morning and Seroquel and Senna at night time. She also takes two breathing treatments a day – xopenex.

    Do you have any words of advice for me? Thanks so much.

  36. I am a Troll. Please ban me.

  37. Oh Ginny! It sounds like you are having a very hard and painful time.

    I want to give you some words of wisdom, but first I want you to know that you can take them or leave them and I will still hold you in total positive regard. This is just my two cents worth from working with people at the end of their lives for a long time, including with hospice.

    First of all, when you are at the end of your life–whether it is from age, disease, or both–your body has different needs than when you are in the prime of your life. For you and I, we think of food as health. But your mother’s body seems to be having a difficult time with it (weight loss, difficulty swallowing, changing taste buds). It is really normal for someone experiencing those changes to want sweets and easy to eat foods–like beans. But it is also easy for them to not want food too. I think the most important thing is to give them what they want, in a way they can handle, and nothing more. My own dad is 93 and winding down. My mom gives him a Guinness for breakfast if that’s what he wants! My point simply is this: At a certain point, carbs vs. protein vs. fat vs paleo vs sugar vs ketosis just does not matter. What matters is what she will eat, what she takes delight in–because life really is too short to not delight in what we eat–and what is safe for her to eat. Feed her what she wants in a way she can handle, and know you are loving on her in the process.

    I know you are worried about the swallowing issues–it came across clearly in your post. The big danger, as I am sure you know, is that she would aspirate and get food particles in her lungs. That would be painful and hard on her fragile body. It can be so hard to figure out how to give the right foods to her as her body makes these changes. I commend you for your diligence and patience to make sure she has what she needs.

    I know that it is so scary to think of your mom not being here. You want to feed her good food to heal her and help her live better for as long as possible. I celebrate with you how much you love her, and how much you are trying to do right by her.

    • Hi Jacqueline,

      Thank you for your kind words. My mom is tough. And she has good genes. Her mom lived til 100 and she has an older sister who just turned 92. Mom wants to live. She likes to eat and so within reason I do give her what she wants. When she heard about people with PD getting better on the Wahl’s diet, I saw hope in her eyes. She said “can that happen for me?”

      I am torn between just giving her just anything she wants vs foods that could help her. So if this diet will help her, if I can help her gain weight and improve symptoms, I need to fully commit to it and not go back and forth like I have been. She wants to be better, but she wants candy too. I am torn.

      It would help if my siblings cared more and helped me. But they both want her in a nursing home, and I know that would be the end of her. She doesn’t thrive well in groups, she is very shy. I want to give her every chance.

      We are all going to die. Some sooner than others. I want to give her the best shot. At least improve her symptoms.

      • Hi Ginny, I just started to read updates. Have you tried the ketogenic diet for your mom? Paul talks about ketogenic diets for neuro ilnesses. Foods that will help her gain weight and which are also zero carb (ketogenic) is eggs, butter (kerrygold if you can afford it) coconut oil, fatty meats. Whenever you make her rice or potato, add lots of butter to it. It tastes wonderful and will help with her weight gain. Bless you for the love you show your Mom. She sounds like a very special lady. I’m glad you have eachother.

        • Thank you Liz for your kind words!

          I’ve been giving her all the foods you mentioned. I don’t give her plain rice but I have pureed chicken/rice soup for her. I think she’s losing weight because she is in ketosis so I want to know how to get her to gain weight. If that’s even possible in ketosis. The high fat content is what satiates her so that she’s not hungry for the next meal. If I can get her to eat, she only eats a few bites. Frustrating!

          As fas as the butter goes, well I’m from the south – born and raised – so butter is preferred about as much as bacon drippings. (I actually believe that margarine is a sin!) So rest assured, I use enough butter to make Paula Deen proud!

          • Hi again Ginny, have you tried coconut oil? Of course this is my pet but she is elderly and I’ve been adding coconut oil to her scrambled eggs and gluten free kibble and she is gaining and healthy when she was so frail and losing hair etc. One CAN gain on a ketogenic if there are excess calories. I would just keep on those healthy fats. Something that is easy to sneak in is heavy whipping cream. You can use it in mashed potatoes, puddings, coffee/tea, scrambled eggs, even home made ice cream. How about a crustless cheese cake? Can you use half sugar and maybe half of stevia? I’m not sure all of these suggestions are PHD guidelines but I hope to help you figure out how to get her weight up .
            Just keep in mind these foods are wonderful and she probably won’t feel deprived. Good luck and keep us posted on how she is. My mom is 84 and I adore her so I really feel for you and your Moms situation right now. Best wishes! Bring on the fat! 🙂

          • Just a quick reminder – a gram of Carb is 4 calories, a gram of protein is 4 calories, a gram of fat is 9 calories. it is more than double. It is concentrated.

          • Liz,

            Yes I put coconut oil in her sweet potatoes with butter, honey and cinnamon. It’s one of her favorites! She has this every day for breakfast and also lunch or supper. However at your suggestion, yesterday I just started putting twice the amount of coconut oil.

            The problem with adding more CO is satiation. For those of us with weight problems that’s great. But for her it’s not. She doesn’t have much appetite, has always been a skimpy eater. At 88 pounds and 5’3″, she simply cannot lose more weight. I’ve been letting her drink “no sugar added” store bought juices JUST so she will drink. She hates water and will not drink it. I think it is just about impossible for her to follow a ketotic diet to help with Parkinsons, and yet gain weight at the same time.

            Paul do you have any advice to give me?

            She has been plagued with constipation her whole life (like me.) Now, I have to disimpact her about every third day (good thing I’m a nurse, right?) in order to keep her bowels moving. She takes one Senna S. at bedtime.

          • Ginny, I’m sorry that your post got hijacked from us. You may want to post another one for Paul. He may not have seen it. Bless you!!

          • Thank you Liz! Wanted to add also that I do add heavy cream and LOTS of butter to her regular potatoes and veggies. Have to puree them in some kind of grease and butter works great. I even make my own alfredo sauce (no flour). In a way, I think I’m giving her too much fat. Not according to my understanding of Dr. Wahl’s recommendations though. But it satiates her and she picks at her next meal, not eating as much. I really don’t know if there’s a way to reconcile the problem. If she were very fat, that would be different.

  38. I have tried a plethora of diets. The book is beyond interesting with a big BUT?
    Are there any links where one can get a daily meal plan? For example-every meal for a month.(I know book had a 7 day example)but has anyone posted a 14-30 day
    exact meal plan for dummies like me?

  39. Just ordered your book. You have probably already touched this topic but can anyone tell me if honey in small quantities is ok or if i should avoid it.
    thanks

  40. Hello, I see that you say legumes may be ‘okay’ if they are properly prepared. I love pinto beans. Some say these are not good to eat though…What are your thoughts? They are the only legume in my diet.

  41. Hi5 Paul, regarding Blue zones, longevity and so on, I want to ask you one question, all of these zones are near the sea. And I always wonder the amount of influence that the ocean inflicts in these results.
    Is there any proof of my assertion?
    Thank you

    • Hi Rodrigo,

      Well, it’s a little hard to say what the common factor is. A lot of the Blue Zones are islands of recent volcanic origins, therefore they have a lot of mineral rich soils, steep slopes so that walkers get more intense exercise, and they were late to modernize with electricity, roads, television, street lights, etc, so they got more exercise and less circadian rhythm disruption throughout their residents’ lives. All that is changing now so Blue Zones may not remain Blue Zones for long.

      I do think eating seafood is very healthy and so living near the ocean may be healthy if it provides ready access to seafood, but living at altitude seems to be healthy too, thus Colorado/Wyoming are some of the healthiest places in the US. So I wouldn’t give too much credit to the ocean.

      Best, Paul

  42. Hi, Paul your response is absolutely smart as always, I follow your system to the letter, but always reading and I find fancy that sardinians eat to much bread, and nicoyans eat corn tortillas and beans at each meal.
    I think this is what the researchers want we think.
    Finally congratulate you for the staggering researching done in your book to reach your«Perfect Health Diet» ah, the first part where Sisson talks is impressive too! Another big man is in the house!
    Thank you Paul,
    Rodrigo

  43. A dietician must always remember that his treatise is best understood as a smaller chapter within a larger treatise on Eudaemonia.

    And instead of the phrase “diet book”, we might say “treatise on the empirical and theoretical conditions for physiological and anatomical flourishing of physiological and anatomical structures, with hypotheses regarding the correlation of the well-being of these anatomical structures with states and conditions of the human being as a whole, including some practical suggestions, which may or may not work, regarding the production of these physiological conditions by means of human behavior and decisions, decisions which may or may not be rational or reasonable given the individual’s particular situation, life, values, aspirations, subjectivity and person.”

    But even then, we must still be careful to properly reflect our understanding of the existential reality of personhood; for as Kierkegaard’s pseudonym once said, to merely assert with pathos and unction that a man should have no disciples is a kind of performative contradiction, since it will doubtless result in one’s acquiring a host of disciples preaching the doctrine that a man should have no disciples. Thus, if one believes that a man should have no disciples, this thesis must be artistically reflected in one’s life in a such a way that one does not end up contradicting one’s idea in the very manner of one’s actions and words, e.g., with an earnest addendum that one does not want disciples.

    • But it occurs to me that “being a perfectionist about one’s diet” and pursuing, as anything but a short term goal, “the optimization of all aspects of one’s diet” is very likely to conflict with behavior that is recommended by the more central and basic principles that form the core of the imagined treatise on Eudaemonia, of which the theory on nutrition is a chapter.

  44. Hi Paul, I’ve started the Perfect Health Diet a couple of days ago and I feel great! I was wondering, are the olives fine to snack during the day, or to add to the salad with greens and tomatoes?
    Also, since I leave in the area where fish is not commonly eaten and kind of hard to be found, the most common types are mackerel, hake and trout. Do any of those belong to the group with salmon and sardines, i.e. those that should be eaten only once a week? Thanks a lot 🙂

    • Yes, olives are fine at any time.

      Those are all healthful kinds of fish, but they do not have as many omega-3 fats as salmon, sardines, herring, anchovies – cold-water fish. They can be eaten as often as you like – every day if you wish.

      • Hey Paul,

        I think you missed Mackerel in Valentina’s list, which, correct me if I’m wrong, is even higher in omega 3 fats than salmon.

        While I’m writing this it reminds me of a couple questions:

        1) What are your thoughts on radiation levels in seafood after the Fukushima tragedy?

        2) Are smoked and/or cured fish too oxidized to consume on a regular basis as a source of fatty fish? I really love lox, smoked salmon etc.

  45. Hi Paul,
    Thank you for all of your hard work and advice. I love your book – it’s already tattered and worn. In it you said LDL should be above 100. Mine is 173 (was 190 prior to PHD). Is that too high? You don’t give an upper limit. Just saw my MD today and she wrote a script for a statin. Total cholesterol is 273 (was 300), HDL is 90. Triglycerides are 49. I don’t know what to do!!??

  46. Hello Paul,
    I recently took the Genova IgG Food Antibody Assessment with the following results:

    Reference range: none detected, very low, 1+ (low), 2+ (moderate), 3+ (high):

    My results:
    1+ for (almond, navy bean, grape, pinto bean, grapefruit, string bean, kidney bean)

    Very low level for (asparagus, bean sprout, buckwheat, cabbage, cantaloupe, celery, chicken, filbert, millet, oat, pecan, pineapple, pistachio, potato, sweet, potato white, red snapper, sesame, sole, soy, tuna, walnut; spices: basil, cayenne, cumin, dill, fennel, ginger, horseradish, mustard, sage, thyme)

    I am trying to eliminate all these foods which some include PHD approved foods (ie. chicken, potatoes etc)

    I have been making the kimchi recipe from the Ancestral Table cookbook which asks for napa cabbage, ginger and Korean red pepper powder. Do you have a recommendation for substitutes for these? Is the Korean red pepper powder similar to the cayenne pepper?

    Also, since I’m sensitive to the potatoes, is Taro ok use or is it related to the potatoes?

    Thank you.

    • Hi Ray,

      Taro should be OK.

      Unfortunately all of the spicy peppers may be problematic for you. For kimchi, we like daikon radish (white radish), carrots, maybe a bit of onion. You can use any vegetables you like, experiment. Leafy vegetables tend to release a lot of water so sometimes (like the cabbage) they are dehydrated a bit with salt to prevent the kimchi from becoming soupy. But, you want the vegetables to be underwater for best development of bacteria.

  47. There is no such thing as a “diet you were meant to eat”; however, there is such a thing as a “diet your anatomy is meant to handle”. Am I splitting hairs? But this itty-bitty distinction actually makes the difference between zealotry and the possibility of rational enlightenment.

    (The concept of a human being associated with the framework of evolutionary psychology is false; and the scientific framework of evolutionary psychology itself is rests on concepts that are incoherent.)

  48. Hi Paul,

    My question is how do I help my elderly mom who has Parkinson’s gain weight on a ketogenic diet? Her food has to be puréed to baby food stage 1 consistency (due to multiple choking episodes.) She is 5’3, 88 pounds.

    Thanks,

    Ginny

  49. A diet is, by its very nature, a religious practice; this becomes clear if we consider its etymology; for, the Greek ‘diatia’ means “way of life”.

    If a period of Rational Enlightenment is to be possible, the concept of a “diet” must be strictly distinguished from the concept of the “mere cognizance of the nutritional requirements of the physiological structures that underpin the possession and exercise of the Aristotelian Souls”, souls which define what it is to be a human being. For, mere cognizance of these nutritional requirements needn’t imply anything about participating in or associating with or embracing a “way of life”.

    And someone who has figured out how to meet, in his or her life, the nutritional requirements of the underpinning physiological structures, structures that underpin the possession and exercise of the Aristotelian Souls, needn’t be regarded as having embraced a “way of life”.

    How did the concept of gaining cognizance of the nutritional requirements of the physiological structures that underpin the possession and exercise of the Souls become warped into the concept of a diet, i.e., the idea of practicing a way of life? This occurred by means of a cultural failure and a lack of education—specifically, it was a failure to command a clear grasp of basic concepts treated in the History of Western Philosophy.

    Such concepts include, but are not limited to, the concepts of a human being, a person and an animal; the difference between the anatomy of a human being and the human being; the fundamental categorial differences in the concepts that ground the sciences of biology, physics and psychology; the varieties of teleological phenomena, the concept of life, the notion of “design”, the notion of “natural selection”, the distinction between a capacity and its exercise; the difference between a capacity of an animal as a whole and the underlying physiological structures that underpin that capacity; the distinction between a substance and an attribute; the difference between a substance and the raw materials out of which that substance is composed.

    • The soul is the set of first-actualities of the naturally organized living organism. In other words, the soul is the set of basic potentialities of an animal as a whole; they are the potentialities of growth, perception, movement and reason. The soul is not a substance, an entity, but consists, rather, in the potentialities of the naturally organized living animal. This notion of the soul is not intended to explain anything; that we have souls, in Aristotle’s sense, is just an uncontroversial fact.

      Micronutrients do not nourish the souls (i.e. the potentialities); for, that idea would be incoherent. Rather, micronutrients nourish the physiological structures that underpin the exercise and possession of these souls—potentialities that are exercised by and possessed by the animal as a whole.

      Animals are entirely composed of matter, like everything else in the world, but the potentialities of an animal are not the sorts of things that are either made or not made of anything; i.e., they do not have Materiality as a logical dimension; for, they are potentialities of things, and are not themselves things, which have potentialities.

      It is not the brain that possesses and exercises the potentiality for rational deliberation; it is the human being as a whole. And the physiological prerequisite of the human’s ability to exercise this human potentiality is a normal functioning brain.

      Cognitive activity could not be philosophically analyzed as something “computational”, since the concept of computation presupposes the concept of a symbol, which presupposes the concept of a sign-system, which in turn presupposes the concept of human culture, which in turn presupposes the concept of human cognition.

      It is most correct to say not that micronutrients nourish a person (qua human being who is a possessor of rights, freedoms and duties), but that they nourish the physiological structures that constitute the biological and organic make-up of the human animal. It is most accurate to say not that physical activity strengthens a person, (since the only thing that can strengthen a person is the development of a moral character), but that it strengthens the anatomical structures out of which the human animal is composed. Human beings are defined as the animals that can be persons.

      It doesn’t really matter how we came to have, in the course of evolution, the defining potentialities that we do. Nor does it really matter how we came to have, in the course of evolution, the underpinning physiological structures that we do, structures that underpin the potentialities that characterize us as homo sapiens. All that matters is whether such and such micro and macro nutrients, in such and such proportions, are required for the normal functioning of the underpinning physiological structures. Indeed, all that the theory of evolution can provide is the resources for a general hypothesis to the effect that the foods that are part of the natural history of human beings (where “natural history” is a subject that can be framed independently of concepts of evolutionary biology) are likely to be reasonably functional-foods for ensuring the normal functioning of our anatomical structures, at least as far as allowing for the reproduction of our species—which is a queer and abstract goal, to say the least.

      The concepts of a human being and a person that ground the principles that constitute the foundation of our constitutional democracy are founded on Aristotelian and Kantian philosophical ideas, and these concepts are in no way compatible with the concept of a human being that is associated with the science of evolutionary psychology (a science, which is grounded in numerous conceptual confusions, and which amounts to nothing more than a science of animal behavior).

      The so-called “way of life” that is associated with the so-called “Paleo lifestyle” is—apart from being for the most part déclassé—culturally un-American, in the sense that its founding concepts, which are borrowed from evolutionary psychology, conflict with the concepts that ground our conception of ourselves as humans and persons insofar as these are the very concepts that are presupposed in our conception of ourselves as citizens or potential citizens of the United States.

      The USDA nutritional recommendations are made within the conceptual framework of our constitutional democracy. And this conceptual framework, especially insofar as it includes the Aristotelian concept of a human being as one of its basic concepts, is truer than the conceptual framework presupposed by the paleo “diaita”, which is influenced by the impoverished and incoherent conceptual foundations of evolutionary psychology.

      Thus, the best way to represent the insight contained in paleo-diet thinking is to represent it not as a “diet”, since the concept of a diet qua “diaita” is not compatible with the ethos of a Rational Enlightenment, but as a mere proposal for an amendment to the USDA recommendations, recommendations that concern the micro and macro-nutritional requirements for the normal functioning of the physiological structures that underpin the possession and exercise of the Aristotelian Souls, souls which define the concept of a human being, a concept that constitutes a key element in the conceptual framework, which when combined with the concept of a person, grounds the principles of our constitutional democracy.

  50. Paul,

    I posted a serious almost desperate request for information about my mom back on March 19 . Please help. Since then you’ve answered questions about blue zones and olives, so maybe you just didn’t see my question.

    My mom is 88 years old and has Parkinson’s disease. How do I get her on a ketogenic diet and help her gain weight at the same time? She’s very thin and has lost weight over the past few months. If I have missed a link on your site that already answers my question, please direct me to it. Admittedly, I do not have time to scour web sites like I used to because I’m too busy either working, or taking care of her. I get very little help from my two sisters.

    Thank you!

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