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 ?

3,945 Comments.

  1. Please help. Confused about fructose. On page 83 on Carbs says “Fructose intake should be below 25 grams (100 calories per day” then on page 102 talking about combining starchy and sugary plants
    it says 1 pound of sugary plants equals three bananas or three large peaches. The question I have is if you eat 3 peaches you have taken in more than 100 calories in fructose. Is the diet suggesting eating more than 100 calories a day in fructose to reach the 1 pound of sugary plant food. Can someone clarify this for me? Thx.

  2. Is everything weighed after cooking if it is cooked?

    • If you can put together a set of plant foods (consisting of lower sugar fruits and vegetables) that bring you to 5000 mg of potassium, you’ll be doing fine.

  3. Hi Paul,

    I am getting around 450mg of Magnesium daily on average.
    200 of them from green leafy vegetables (kale, spinach, collards)
    200 of them from Potato + beef.
    50 of them from Fruits

    Should I be getting the 200mg supplement daily dose?

  4. I shall speak for myself, as I do not wish to create a stir or to persuade anyone of anything. However, your question touches on an issue which I do wish were addressed in a more serious manner. Namely, what are the recommendations for a young person, in good health, who gets a good amount of exercise, has a healthy appetite, who doesn’t necessary weigh very much (i.e., is about 120-150 pounds) and who eats roughly the Perfect Health Diet food plate?

    The Perfect Health Diet is, at a rhetorical level, geared for sick people, or for people who started out on a nutrient poor diet, or for people who were on some crazy version of the paleo diet (indicative of a complete lack of judgment), or for people who have not embraced Christianity and who are still working within a Cartesian-Platonic (non-Aristotelian, non-Wittgensteinian) paradigm.—In a properly Aristotelian and Wittgensteinian paradigm there is simply no room whatsoever for the dichotomy between atheism and theism, both positions being conceptually incoherent. There is also no room, conceptually, for this new and bogus paleo-religious-cult that involves a worship and slavish adherence to the “blueprint” of “our” “Designer” called “Natural Selection”. The conceptual foundations of biology and psychology—again because of a lack of familiarity with and appreciation of the great works of Aristotle, Wittgenstein and Kant—have not been properly understood. Even the very notion of a “Diet” qua “diatia” (as a regimen people are supposed to follow on the basis of some external norm (whether it is God or the “natural blueprint”) is rendered conceptually incoherent within Kant’s philosophy, in light of the Kantian notion of personhood. (See what is Enlightenment? and Religion within the bounds of Reason Alone).

    I, however, have never had health problems in my life; throughout my life I always ate a good diet, and after adopting, four years ago, the Perfect Health Diet, I have not once gotten the common cold or anything else. The anatomical structures of my body have become increasingly robust, especially after the inclusion of pogo jumping. I still have chronic dandruff though, which is frustrating.

    But I do have serious questions about supplementation, questions which I still have not been able to adequately resolve despite my 3 years of continuous self-experimentation. Is supplementation a good idea? What if I just took the supplements (all of them), one day a week? For example, is it good idea to take gram doses of vitamin C everyday? What long term effects might that have? Will it interfere with the health benefits of exercise? Do I need magnesium? I find that when I take magnesium consistently, even at a dose of 100 mg, it has an almost laxative like effect after about a week. Should I be taking lithium orotate every single day? I find it makes me a bit sluggish. Do I need silicon? Why should I be taking mega-doses of B vitamins, or mega-doses of anything else for that matter? Why does 1000 mg of K2 make me feel like I’ve been drugged? Why would I possibly need to take 4000 IU of vitamin D a day and risk kidney stones? Etc, etc, etc. — These are questions are extremely frustrating. Now, I realize that it’s my own responsibility to handle what does and doesn’t work for me, but, I do want to say that supplements are something of a PANDORA’s BOX, especially for someone who craves understanding and perfection.

    If we take seriously the history of Western Philosophy, then the concept of a “diet” is actually seen to be conceptually incoherent. Conceptually speaking, all we can hope to learn from the Perfect Health “Diet” is that there should be an amendment to the USDA RDAs for micro (e.g., the need for K2) and macronutrients (e.g. concerning the role of saturated fat). (There should also be amendments to public health advice regarding circadian rhythms.) —For, the USDA recommendations take place within the conceptual framework of our constitutional democracy (which is grounded in Kantian and Aristotelian thinking) and this framework takes seriously the Kantian concept of a person and the Greek concept of a human being, qua Rational animal—both concepts being incompatible with the merely biological concept of a human being that is associated with the legitimate, but uncultured, science of “evolutionary psychology”.

    • A diet is defined as the rules of proper conduct of a person in relation to food. Now, are these rules to be understood as Kantian hypothetical imperatives or Kantian categorical ones?

      The paleo-diet, at least, understands them as Katianian categorical imperatives. For, the paleo-diet regards them as deriving from the Plan of our Designer, namely, the Plan of our Nature-Historical God, the Natural Selector, a Plan which has been divined by the paleo-Apostle.

      By contrast, a pure medical diet, for the sick and diseased, understands the rules as only hypothetical imperatives: in other words, they have a merely hypothetical form in relation to some practical goal—namely, if one wants to achieve such and such an outcome, then one must follow such and such rules.

      There is no such thing, however, as categorical imperatives dictating rules of proper conduct of persons in relation to food. This is because the only source of such rules would be—pace what some vegetarians might say—external to the realm of personhood (ethical Reason) itself, i.e., the source would have to be the old testament God or some more recent biologistic-paleo-God.—And such a notion, i.e., the notion of an external authority that transcends the authority of the realm of personhood in relation to persons is incoherent.

      The set of USDA RDAs, by contrast, is not a diet in either sense. Namely, it is not a diet of categorical imperatives (based on some religious or quasi-religious principle) nor is it a medical diet of hypothetical imperatives. For, the USDA RDAs do not constitute a set of rules for persons at all. And they are not aimed at any outcome, unless normalcy is regarded as an “outcome”. Rather, they are nothing more than a mere set of rough suggestions based on hypotheses regarding the requirements of the normal functioning of the physiological structures that underpin the normal exercise and possession of the faculties of people, across different age groups.

      • Now, there is a sense in which ancestral foods are the foods our bodies are designed to handle. However, this sense of “design”, which is borrowed from the concept of “intrinsic design” in Aristotelian “natural history”—a concept, which has no connection to the theory of evolution—is not sufficient to ground a categorical imperative. For, although we may harm our health, if we do not mind the intrinsic design of our bodies or if we do not use our bodies in accordance with their intrinsic design, we are not thereby offending any “Designer” (whether this “designer” is understood literally or only symbolically).

        Farewell, Paul. I hope these modest conceptual remarks have been stimulating.

        With love and admiration,

        Euthyphro

        • Hi Euthyphro,

          Dandruff is usually due to the fungi Malassezia. Try a zinc containing shampoo and maybe take a bit more of the immune-supporting foods and supplements (liver, spinach, oysters, seafood, sunshine/D). Maybe put some probiotic bacteria on your skin and touch others to share skin bacteria.

          • Dear Paul,

            Thank you for the thoughtful recommendations. I am happy to report that the zinc pyrithione dandruff shampoo seems to have cured my problem. I used the product three times, three days in a row, and, ever since, I’ve been dandruff-free. (It’s been three weeks now.) This is the first time I’ve been free of this problem since high school. The other shampoos I tried in the past never worked.

            Yours,

            Euthyphro

          • Hi Paul,

            If you are curious, here are my lipid and vitamin D results. I’ve been eating the Prefect Health Diet food plate for the last four years, but I eat macronutrients according to instinct. I get vitamin D mainly from sunlight; this test was taken in April.

            Total cholesterol: 243
            Triglyerides: 61
            HDL: 75
            LDL calc: 156
            VLDL calc: 12

            Vitamin D: 30.4

          • The lipids are good. Vitamin D is low.

          • Thanks. I’m hoping the D will climb back up during the warmer months.

  5. So, I recently had blood work that showed I have high levels of Vitamin B of all things. Apparently this is unusual. I’ve been eating about 12 ounces of animal protein per day, and also a multi-vitamin which contains B (I take half the dose, 3 pills). It’s true, I’ve been looking at my turkey at lunch and feeling sort of ill, not hungry at all – very weird for me, a formerly obese person.

    I believe now that I increased my protein and fat – and am reaping benefits: no more hair loss or bruising – my deranged digestion can’t metabolize it. I stopped the multi, and I guess I should decrease my protein intake. But, I don’t want to go too low.

    Next up is serious attending to low stomach acid and SIBO. I wonder if my chronic UTIs are related to this? Everything is connected.

    I also recently began upping my starchy vegetables as you recommend. This is new for me, and I sense it is the right thing. I’m about to buy the book – actually several copies for family and friends. I sense yours are the best dietary guidelines.

    • @Debbie

      Some people have a decreased ability to take Folic Acid (which is in most vitamins) to the next step in metabolic breakdown which causes build up of B9 Folic Acid. If that is the B vitamin that is high there is a blood test to check to see if you have the genetic mutation for this called MTHFR. Or you could just switch to a vitamin with the useable version of B9 5-MTHYL. You might want to get the test anyway since the MTHFR snp does more that just buildup folic acid in your blood. But I agree with you that getting your gut in order will help all the problems you mentioned. Also, for your SIBO you might want to check out Dr. BG at AnimalPharm. She has a terrific protocol for gut health and getting rid of SIBO. Good luck.

      • Thanks, Sally for this information about a B9 genetic mutation. I’m going to mention this to my doctor.

        I have seen Dr. BG’s protocol, and started it, but I don’t know… I think I’m more bloated than ever – or maybe the same. What a mess.

        Thanks so much for your response. I love this site and this diet is definitely a great base for me. Thank you!

        • Feel free to advise further!

          • You may also want to look at ‘Cooling Inflammation’. He has a lot information on biofilms and how the matrix that holds bad bacteria and yeast together is very tough to eradicate. He gives a lot of suggestions. But one thing to keep in mind, is that once you gut becomes disordered, even the healthy things that people take to maintain or regain health, may not work for others. For example fermented vegetables are quite tricky for people who have the MTHFR mutation (due to ammonia) AND an out of whack gut biome. If you can find an Functional Medicine doctor or an Integrative Nutritionist to work with who can do the testing and make the necessary recommendations. Whatever you do start slow and add things one at a time so you know what is causing the problems. If your folic acid is high due to this mutation try Dr. Ben Lynch’s site MTHFR.net and Stirling Hill’s MTHFRSupport.com. Stirling answers a lot of questions on Facebook. Unfortunately, the sites will address the mutation but not necessarily your SIBO issues. Also, if you take probiotics and have SIBO be careful as to what species are in the product. From what I’ve read Bacteria in the SI are Lacto/Bifo kind. One last thing, at ‘Free The Animal’ there is quite a lot body of work regarding resistant starch. There is some speculation that RS can help get rid of SIBO. Best regards.

          • Thanks again, Sally. It turns out it is B12 that’s high. So, I’m going to cut back on protein first. I’ve seen the sites you’ve mentioned, and I’m starting to work with a functional medicine physician – so I’m beginning my journey. Thanks!

          • Debbie,
            Apparently (and similar to B9/Folate as discussed above),
            a person’s B12 *blood* test can be high, but that doesn’t necessarily mean that her/his body has enough B12 in a form that it can absorb and utilize.
            Just like B9 has an artificial version that is in most supplements and most “fortified” foods: folic acid (instead of the more natural form, which is methylfolate),
            B12 also has an artificial version that is in most supplements: cyanocobalamin (instead of the more natural forms, which are methylcobalamin, hydroxocobalamin, and adenosylcobalamin).
            Just like with B9, people who have various MTHFR genetic variants can have problems with B12 (not getting enough, not being able to metabolize well the artificial kind).
            I don’t eat much meat at all, and even at times when I am not supplementing B12 in any way, my B12 blood test is always very high — much higher, many hundreds of units higher, than the maximum level of the laboratory’s “normal” range.
            All my (ordinary/blase) GP doctor could tell me about it was “stop taking B12 supplements” and I said, “But I haven’t been taking any” and she shrugged and that was the end of it.
            I then found a few studies (this was probably in about 2015) indicating that having a very high B12 reading, without a good reason for it, statistically seems to be indicative that within the next year, the chances are high that the person will be diagnosed with cancer.
            Also, not processing B12 and/or B9 well can have a relationship with some types of anemia.
            And, as mentioned earlier, people with some MTHFR genetic variants might need to get a much higher amount of B12 than the RDA, even receiving regular injections, to help them with certain health issues (such as chronic fatigue/ME).
            There are MTHFR forums out there where some commenters report having very high B12 blood test results, but they still take a MTHFR-level of B12 supplementation anyway (which can be 500 mcg, or often 1000 mcg, and even up to 5000 mcg or more), of one or more of the forms of B12 that are easier for MTHFR folks to assimilate (usually it’s methylcobalamin, sometimes hydroxocobalamin, rarely adenyslcobalamin).
            So even though typical GPs may not care much about B12, it can be an important thing in some circumstances.
            It is my understanding that for the methylation cycle to work properly, one needs both B9 and B12, so you might not want to take one without the other in a supplement form (or in a “fortified” food).
            One good forum for information on B12 and B9 is “phoenixrising.me”.

  6. Hi there! I received my copy of PHD a few days ago and am very excited to get started, BEFORE I get through the whole book (which will take a while). I am getting a bit frustrated because I cannot figure out what my proportions should be. I can probably swing eating 1/2 lb of protein(meat), but then how much green do I need to eat? And what else? I am not able to figure out what MY perfect diet would be based on what I can consume. I have never been a big meat eater…which probably explains my poor eating habits and weight issues. I have scoured the index and contents and cannot locate the section that tells you how to tweak based on that. I do not want to over or under eat things. I feel like the different sections cover too many variations and I can’t figure out which parts to use for myself that would be accurate. I think of myself as relatively intelligent, but I feel really silly right now because everyone else seems to get it except me! PLEASE HELP. Thanks!

    • Simone,
      I can’t tell you how. BUT I can tell you you don’t have to feel silly! I’m so much better at almost anything than counting, quantifying, organizing data, setting goals, finding percentages.

      Someone recently mentioned a food log website called Fit Day, and I just now went to set up an account. It keeps track of the calories of whatever food you ate each day; it counts how many grams of carb, fat, and protein each food was.

      Maybe this will help us? It isn’t perfect. It seems slow and unwieldy to use. Also it doesn’t know a lot of foods. When I typed in “kefir” and “kombucha,” it said “food not found.” And when I typed in “potato”, it gave me a lot of superfluous choices like “fast food baked potato, loaded” and “Campbell’s chunky potato soup.” I could never convince it to count mine a homemade baked potato with butter and salt added. So I just picked plain potato, then logged in butter, then sour cream, then parsley.

      So we’re both relatively intelligent and don’t get it, but maybe you and I get some things our analytical friends are less into. And maybe there’s something better than FitDay if anyone wants to mention it.

      s.

      • hi St,

        another site similar to fitday, is
        cronometer.com

        just did a quick search for kefir & kobumcha, cronometer had both listed.
        so may be worth a look.

        (i use it myself & prefer it to fitday)

          • thanks i’ll look up cronometer.com!

          • Cronometer is way better. How did you set it up so that it will “believe” in your PHD goals?

            I told it I wanted to eat 25% protein, 20% carbs, 55% fat.

            Beyond that, I’m not sure how to customize it.

          • actually i just use cronometer as a ref tool…
            to find out info on foods, esp if i cannot find it on nutritiondata.com.
            or i need to enter a specific weight (which cannot be done on nutritiondata).
            or if i want to compare foods.

            There is one tweak that i have done (& recommend)…
            to make a bit more info visible;
            (using the web version), go to the ‘Profile’ tab, then find the ‘Nutritional Targets’ section, then make every Nutrient visible, there is a checkbox on the far right column under the heading ‘Visible’. repeat for each tab;
            general/vitamins/minerals/carbs/lipids/proteins

      • Lol! Me too 🙂 I was getting brain-fry what with %s, grams, calories of protein etc etc. I had recently found the app Carb Manager which seems v good but this cronometer.com sounds even better.Phew!

  7. Hi Paul,
    I have been following a paleo VLC diet for about 3 years now. At first I felt much better than before… all GERD symptoms disappeared, my joints stopped hurting, and I was stronger and had lots of energy. Then things started to go downhill. My reflux came back, energy bottomed out, and worst of all my knees became massively inflamed after a hiking trip 2 years ago and have never really healed, constantly swelling and becoming painful for no apparent reason. My other joints have gotten worse, too. I should add that I had Chemo and radiation for Hodgkins Lymphoma 20 years ago, and as a result am hypothyroid, taking L-thyroxine.

    I have been trying to ‘solve’ these issues on my own, as the doctors here in Germany are still in the dark ages regarding ancestral health, gut-brain-body axis, and the dangers of a SAD diet on health. I have recently moved towards PHD, having bought your book a few months back. I also recently cut out dairy and nightshades for a month, with some positive results, but recently went back to milk as I am making kefir and also like cream in my coffee without any negative change. Last week, however, out of the blue my knees swelled up worse than ever before, and have not gone down again. MRI’s showed no unusual damage or wear 2 years ago, and I tested negative for Lyme disease and for any Rheumatoid Arthritis blood markers. I am extremely frustrated that I can’t find a cause-effect, despite trying elimination diets, eating probiotics, supplements, bone broth, getting my thyroid levels checked and readjusted. I am now eating way more starchy carbs but find I am having a hard time eating the amount you suggest, given that potatoes are out. I immediately gained 5 lbs although I’m still not up to your suggested 3/4 lb a day.

    One final note: it turns out I have been supplementing WAY too much Vitamin D for that last few years in the hopes of bolstering my immune system (between 10,000-20,000 iU daily). My recent blood levels were 134 compared to the suggested 40. I have read that ODing on D can cause a build-up of calcium salts in the soft tissues. Can you shed some light on this, and whether I should up my Vit K past what you normally suggest to counterbalance? Any other things I could try to get rid of this crippling joint inflammation? I am generally an active person, and at 48 am too young to be immobilized by joint pain! Help!

    Thanks!
    Melissa

    • My brother is huge on vitamin D, My wife and I were taking 10 to 20 k per day.
      We both started to experience joint pain, particularly in our knees. I backed way off on D, but she did not. After a year she was nearly crippled, she had had both knees replaced several years earlier, now her right knee needed to be opened up again.
      The surgeon discovered bone growth all through the artificial join and into the surrounding soft tissue, it took several hours to scrape it all out. the growth did NOT show up on Xrays or a scan.
      She is cautiously taking D again but with K-2 to prevent this growth.
      John

      • Hi John,
        Wow. Thanks for the info. Very interested to hear about a case so similar to my own. I completely stopped taking Vit D 2 months ago , and am now taking a bigger dose of K-2 in the hopes of reversing the imbalance. The inflammation in my knees has finally calmed down a bit after 4 unexplainably bad weeks, but I have no idea if that’s due to the K-2, or just fluke. I also have no idea why they suddenly got exponentially worse, as directly before that, I had the first pain free exercise in over 2 years.

        I am also scheduled to get a full gut analysis done next week, and am going back to the knee doctor for further pictures and tests in a few weeks. Crazy that there was no evidence of any build up on your wife’s scans. Weird. My knees sound like pepper grinders when I bend them, so it wouldn’t surprise me to find unwanted growths in there! Question is, can I reverse it without letting some quack open me up… 😕

        • Hi Melissa,

          In addition to vitamin K2 which is good, vitamin A will also help you recover. Our normal recommendation is 1/4 lb liver per week plus carotenoid-rich plants like spinach, carrots, sweet potatoes, persimmons daily. But you might try a bit more A, say 1/2 lb liver per week (mostly chicken/duck/goose liver), temporarily during recovery.

          Also, get plenty of the extracellular matrix material (bones, joints, tendons) in soups and stews, and take extra vitamin C.

          • Thanks, Paul.

            I love liver, so my difficulty is limiting it to 1/2 lb per week, though it tends to be calf if liver and onions, or pork or wild boar if in liverwurst. I guess I’ll just have to bite the bullet and eat more foie gras 🙂 I already eat a lot of carrots, sweet potatoes, and some spinach, and have upped my bone broth production/consumption. I will up my Vitamin C now too.

            One new question for you: should I stop taking probiotics before they check out my gut flora? I have been taking them regularly for 4 months (Prescript assist, coconut Kefir, Kombucha, sauerkraut).

            Thanks again.

      • Did you have your blood level checked for Vitamin D when you were taking the large dose?

        • I was checked when they did my blood work to check my Thyroid levels after adjusting my Thyroxine dosage. My doctor suggested testing it because that might have explained some of my fatigue… I warned her in advance that I was going to be on the high side, which surprised her, but proved to be the case when the results came back. At that point I had already reduced from 20k to 10k a day, but from then on I stopped supplementing entirely. I’m getting more blood work done this week, so we’ll see if it’s come down over the last 3 months.

          • There was a tiny bit of evidence that there bone growth going on in the joint. A VERY faint haze around the edges of the joint. The doctor and two different XRay techs disagreed that there way anything wrong in there, the doc voted to just open it up and look as she was unable to walk at that point.
            Not surprising that it grew quickly at the end, her’s did too, explained by the bone spurs the doctor found all around the rubbing surfaces of the joint. email me at jlahoreATcomcastDOTnet

  8. A new Austrian study suggests that vegetarian diets are less healthy than omnivorous diets:

    http://atlanta.cbslo…an-meat-eaters/

    The study also did a good job noting the lifestyle choices that make vegetarians appear to be more healthy in other studies that look merely at correlations between diet and health outcomes.

    • A highlight of the study, which is pretty significant, if true:
      Findings include that “[v]egetarians were twice as likely to have allergies, [have] a 50 percent increase in heart attacks and a 50 percent increase in incidences of cancer” and “suffer significantly more often from anxiety/depression.”

  9. What do you guys think of how in the “blue zones” of the world (areas where people have been recorded to live the longest) consumed a diet rich in plant foods (including legumes, tofu, lots of oils) with very little fat/animal products? Too many confounding factors to pin it on diet alone? The human body is much more complex than we give it credit for? And what about the studies done on the seventh day adventist church goers in California who had significantly less CVD, cancer, diabetes, etc as compared to the rest of the United States whom rarely if ever ate animal products?

    Also, look at this, http://www.nsca.com/uploadedfiles/nsca/inactive_content/program_books/ptc_2013_program_book/aragon.pdf

    I’m just a 21 year old guy (who is and has been perfectly healthy eating whatever except for just recently. I am currently recovering from unintended anorexia, caused by becoming obsessed with health and nutrition back in December and changing my diet to something that contained considerably less calories-I had eliminated bread, olive oil, and other starchy foods and was basically just eating fruits, veggies, and a little bit of meat, averaging a daily caloric intake of around 1400 calories a day)trying to figure things out nutritionally.

    I think the book is very convincing however I think it has raised more questions than answers after reading for evidence on the other side of the spectrum.

    • Blue zones are places that modernized late, so people ate a natural whole foods diet, cooked at home, got lots of exercise from traveling on foot, didn’t get exposed to TV or artificial light at night, etc. It has nothing to do with avoiding animal foods. Vegetarians always have worse health except in the 7th Day Adventist studies, and there it’s probably lifestyle not diet that helps. In fact the pescetarian adventists have the best health.

      • Hi Paul –
        I know there are other variables and this is subject to the post hoc ergo propter hoc fallacy however it is interesting that all 5 blue zones eat things such as legumes. If they are so bad, how are they overcoming it (all 5 zones)? Also why should one who is otherwise healthy, active, and whose diet is predominantly nutrient dense (~85% if energy intake) avoid any intake of cereal grains and HFCS? Where is the evidence that is demonstrating they are toxic when ingested in this context? Thank you.

  10. Bought and almost through the book, and just started adding back in safe starches. I started from a very low carb diet. I had stopped losing weight, but was feeling lovely. Now after just two days of adding in a little more starch and being careful about which fats i consume to reduce PUFA’s ,I’m exhausted and starving on more than 2000 calories. Why is my experience the opposite of what was expected?
    For background, I am obese, hypothyroid (medicated), and a celiac diagnosed 5 years ago and GF since.

    • Hi Dawn,

      Depending on your gut flora, you can have very different reactions to carbs and starches. It seems you have to alter your flora by supporting immune function and eating fermented foods.

      Best, Paul

      • I love ferments, but stopped drinking kombucha when i went low carb, fearing remaining fructose from the sugar. What are your thoughts on kombucha? Are specific ferments more beneficial than others?
        Thank you for your help.

  11. Trying to get the math regarding my attempt at PHD. Started using a tracking food diary website, cronometer.com today. Perturbed by how much excess carbs I’m eating. Also surprised how little meat I really eat — and this is as much as I can hold. If I ate more meat I’d be uncomfortable. In fact I have no room for much vegetables. But how can people eat more food than this?

    Do you think broad carbohydrate calculations are misleading because PHD looks at the starch component?

    For example, it says I am eating in excess of 200% of my stated carb goal. This is a typical day:

    1 c. yam
    3 eggs
    orange

    1 c. kefir

    3.5 oz. salmon croquette (made with almond meal)
    1 c. yam
    1 c. other vegetable

    banana
    rooibos chai + honey

    1 oz. dark chocolate

    raw carrot

    • Hi St,

      I’m puzzled by what your carb goal is. That’s certainly not an excessive amount of carbs.

      We don’t count calories from vegetables. You should never avoid vegetables because of a fear of calories.

      • from above comment by St here,
        http://perfecthealthdiet.com/the-diet/comment-page-9/#comment-418479

        St says,
        “I told it I wanted to eat 25% protein, 20% carbs, 55% fat”

      • When I plugged in the data at cronometer.com (because of my complete inability to analyze calories and percentages), the program said I was exceeding my carb goal (20% of total calories) by 200+%.

        (BTW, I don’t avoid vegetables because of fear of calories, but because I’m so full.)

        Maybe cronometer.com is counting carb calories that PHD would not count? They say I’m at 78% of my day’s carbs right now, after I’ve entered my breakfast and snacks:

        Eggs, 2 yolk/1white poached
        Potato, medium + parsley, mushroom, butter, vinegar
        Yogurt, whole + coconut milk, coconut, honey, walnuts
        Green tea
        Apple
        Kefir

        • I’m going to answer my own question to the best of my guess/knowledge in case another person has the same question:

          After I looked at the cronometer.com carb numbers, I decided to write down their number for starches and ignore their other numbers, then do my own math. I could easily not be understanding something, BUT it looks like that is where I get my PHD values. That way, I’m not counting the carbs in oranges, honey, carrots etc.

          Cronometer won’t let you set it to count only your starches. But I wrote them down and added up all the grams of proteins, starches, fats; then divided X grams of each macronutrient by the total grams of all three (protein + starch + fat) combined. I am hoping that’s the right formula to determine PHD values.

          • Basically, by doing the dreaded math this is what I’ve learned so far: I need to use more butter and cream, and really do the egg yolk thing (adding yolks and giving whites to my dog; for which she says, “Thank you Mr Jaminet,” since she is a mannerly dog).

  12. So I have started eating dark chocolate but all of the brands I can find have soy lecithin. Is this ok? If not where do I find dark chocolate with out it? Thank you

    • You can make your own dark chocolate. It’s easy, quick, the contents are always the best, and the cost is less than any factory made chocolate bar. The basic recipe is one cup of coconut oil and one cup of cocoa powder. If the coconut oil is solid heat it for 20 seconds in the microwave. Mix the oil and cocoa thoroughly (I use a fork, but you could use a spoon or a stick blender). Pour the mix into an ice cube tray and freeze. In half a hour the solid dark chocolate is ready. When you want a piece, remove a cube from the tray and let it sit for 10 minutes. The best cocoa is natural (not dutch processed, which is treated and that reduces the beneficial flavanoids). You can use Hershey’s or Nestle Toll House, which are available in most supermarkets for a couple of dollars – the price of one fancy dark chocolate bar. Or you can go for the more expensive fair trade, organic cocoa powders, some of which are even tastier. There’s additions you can make to the mix. Add a teaspoon of vanilla extract, which adds a sweet undertone. You can also add a sweetner if you find it’s too bitter. Look at the PHD Recommended Supplements for some good sweetners. Also you can mix in a quarter cup of shredded coconut or some crushed nuts, for a variation.

    • Hi Jen,

      The Lindts dark chocolate 85% and 90% does not contain soy lecithin. It taste good too 🙂 You can buy it on Amazon.

  13. Lindt 90% dark is soy free. My favorite go to chocolate.

  14. I’m trying to lose weight and this is what I am eating. Would the % be consistent with PHD? My diet consists of 1 cup of rice per day, green veggie, meat, and nuts.

    Weight Maintainence 1437 kcal
    Your Target 1150 kcal
    Deficit 287 kcal

    1150 kcal Daily Calorie Intake
    100 g Carbohydrates (35%, 400 kcal)
    60 g Protein (21%, 240 kcal)
    57 g Fat (44%, 510 kcal)

  15. Day 4 of trying to understand the math of my diet; using cronometer.com to count and analyze calories. I am puzzled today about their numbers for my homemade mayonnaise. Maybe I just have the wrong idea about Omega3’s in coconut oil.

    This is my recipe:
    2 eggs
    2 Tbsp. lemon juice
    .5 tsp. each: dry mustard, salt, honey
    Mix well in food processor, then add in a very slow stream:
    1 1/4 c olive oil combined with 3/4 c coconut oil

    Their numbers say my recipe contains 2.16 g Omega-3 and 30.51 g of Omega-6. Do you think they are wrong?

  16. I love your book! I had been eating mostly vegetarian, but cheating occasionally. Paleo food is so much more satisfying! I work in the public schools in Japan and I’m wondering what to do this year. School lunches here, as far as I can tell, are mostly paleo approved, and I hate to be a picky eater since it’s generally frowned upon. So, should I…

    1) eat the same lunch as everyone else and make up the difference with other meals?
    2) modify it, only eat half the rice, skip the milk and packaged dessert, or…
    3) or make my own 100% paleo lunch

    I’m leaning toward #2 because I’m kinda lazy and because that huge plate of rice they serve makes me drowsy. >_<

  17. Hi, I hope you can help me. I have had very bad Gerd for years. P.P.Is didn’t help. I came across Dr. Robillard’s book ‘Fast Tract Digestion for Heartburn’ and decided to follow his low carb, low fermentation diet and I stopped taking the useless P.P.Is. It has been a total success. I no longer suffer from Gerds. However, since switching to this diet, I am getting a lot of arthritis pain in my hands. My knuckles are very swollen, red, painful and my hands are stiff during the night and in the morning. Before this diet I used to have occasional short periods of joint pain, now all the time. I stopped eating all grains a year ago as well as legumes, sugar and root vegetables. I eat a lot of above ground vegetables, eggs, dairy, nuts, meat, some fish and a small amount of fruit, usually berries. What could be causing the joint pain. I would appreciate your help. I am only 55. At the rate I am going I will have uselessly crippled hands in no time.

    • Hi Conny,

      Odds are you are just too low carb, and that has created a permeable gut and food sensitivities. The joint pain is likely due to immune reactions to food peptides and other compounds. It may also be that you are lacking in nutrients needed to maintain joints, including carbs.

      You need to add more carbohydrates. Try adding rice and potatoes back, plus more fruit. Eat bone and joint stock soups for collagen, supplement vitamin C, eat liver and egg yolks and spinach and seafood.

      • Hi Conny,

        I had hand joint stiffness for a long time, and I realized lately it’s gone away. I still have hip joint stiffness, though. But clearly something in my diet wasn’t right before, and now it is. In my case I think adding more fat and protein has helped me overall, in terms of energy, no more weird bruising, and no significant hair loss anymore. I do eat “safe starches” now, but this change occurred before adding more starch.

        I have gained some weight though, and I’m not sure where to cut back, since I already eat around 1,200 calories. I’m 58, 5′ 1″ and weigh now – yikes – 142. I still believe that doctor’s scale was broken. I should weigh 130 something, and still could lose 10 pounds.

        Also I now have recurrent urinary tract infections. It’s a process.

  18. Paul, I have a question regarding fats on the diet. I’ve ordered your book, but it hasn’t arrived yet – perhaps you address this in the book.

    I eat about a tablespoon or more – a glob – of coconut oil at dinner that I add to my bowl of food, which I enjoy mushing together into sort of a paste or, well, gruel. I’ve been told coconut oil is an extremely healthful food, that it even helps for weight loss. But I see you advise using fats “to taste.” I also feel since adding this coconut oil my mood, energy and some other things – see my above post – have improved. Am I eating too much coconut oil?

    Thanks!

  19. Hi there Paul.
    I too am having serious joint issues, particularly knees, after being too low carb for too long – see my post from April 6th for full details. I have been doing the things you advise for Connie and her arthritis problems for a while now… bone broth, adding more starch, Vit C, lots of eggs, seafood, liver. I have two questions though. First, how long does it normally take to reverse the joint pain issue? Should I expect weeks, months or years? Secondly, I was taking far too much Vit D for a few years, and as a result suspect I might have depleted all Vit K stores. I started supplementing Vit K two weeks ago. Do you recommend taking a greater amount of Vit K for a limited time to make up for the potential deficit?
    Thanks for your help!
    Melissa

  20. Similarly to those who have joint issues, I have had excruciating leg cramps, which are getting progressively worse. They begin when I get into bed at night and don’t let up until the morning. I’m exhausted. I’ve tried everything, from soap under the sheets to wine vinegar to quinine to magnesium cream to potassium supplements. The cramps actually started years ago but have gotten significantly worse since I’ve been on your diet, which I went on to get rid of my GERD. I’ve had my electrolytes checked and they’re fine. My doctors are stumped. What would you recommend?

    • have you had your iron levels checked…
      i wonder if your leg cramps are similar to restless legs syndrome (rls), apparently low iron can be a factor in rls.

      for more info google “restless legs syndrome” iron

      &/or start at the wiki http://en.wikipedia.org/wiki/Restless_legs_syndrome

    • On the off chance this will help (I get this excruciating pain in one or the other calf at times) — find the exact same spot on the other calf and press. If you find the spot (which does not hurt otherwise) that is very painful when you press / rub it, keep pressing until the pain subsides. This relieves the pain for me. e.g. left calf pain – press same spot on the right calf. It works like magic for me.

      • You should also look into essential oils! They are such a blessing in my life! I have always had “growing pains” in my legs. I am in my 30’s and unfortunately am no longer growing but still get terrible pains in my legs. I usually resort to motrin b/c the pain will get so bad. I placed my essential oil order a couple of moths ago with Young Living and b/c my order hit a certain dollar amount I received a free bottle of copiaba oil. I cannot tell you how well this works! I was having terrible pain one night and thought the oil was worth a try. I put several drops on and within 10 min the pain was completely gone. I was shocked!! Even motrin never fully takes the pain away. Quality does make a difference so really research it first. I also think copiaba might be a blood thinner so check with your doc first to make sure it is ok. Young Living is the brand I use and while their prices are higher the quality is outstanding.

  21. Just wondering as a lot of my issues began after I was diagnosed with gallstones– now I seem to have the start of arthritis and IBD– If I am having an inability to digest fat, what enzymes would be good for me to take? Also, what fat-soluble vitamins could I be lacking? I suspect K2 and recently starting supplementing.. I am low in D confirmed by a blood test– but wondering if I should supplement with anything else.. iron is also low and has been for years.

    • At one point, my holistic MD had me using a combination of Now Foods Super Enzymes and Thorne GI-Encaps. I stopped using the enzymes because it gave me a stomach ache, but still use the GI-Encaps. My digestion is better when I do.

      A few times after a heavy meal too near bedtime led to prolonged insomnia, I’ve gotten up and taken a couple of GI-Encaps with success.

  22. Thanks for your suggestion, Darrin, about having my iron levels checked. I’ll do that. But I’d just add three things. First, I definitely don’t have Restless Leg Syndrome; I have excruciating leg cramps extending from my toes to my knees. Also, I don’t have any other signs of anemia. Lastly, I’ve been eating a lot of red meat and other foods with iron. So it would surprise me if iron deficiency was the problem. I wonder if anyone else on this diet is suffering from leg cramps.

    • no probs Michelle, i just thought i’d throw it out there, since you mentioned that your doctors are stumped.

      if you do get your iron levels checked, make sure you get an iron panel if poss, i think there are about 4 or 5 tests, which includes ferritin.

      the only other thought i have on the cramp issue ( aka charley horse http://en.wikipedia.org/wiki/Charley_horse ), is that your diet may be lacking potassium (or out of balance/low compared with other electrolytes). & magnesium is another one i’ve seen mentioned.

  23. Hello Paul
    I’m looking for the best wheat free option.What are your thoughts on these ingredients for Ener-G brand hot dog buns?I’m looking for the best cheat I can.The hot dogs will be grassfed.Here’s the list: Ingredients: Filtered Water, Rice Flour, Tapioca Starch, High Oleic Safflower Oil, Pear Juice Concentrate, Bamboo Fiber, Yeast, Methylcellulose, Tapioca Syrup, Guar Gum, Organic Palm Fruit Oil, Salt, Orange Citrus Fiber, Calcium Phosphate ,Baking Powder (Glucono Delta Lactone, Calcium Carbonate & Magensium Carbonate). Enriched with Thiamin (Vitamin B1), Riboflavin Vitamin B2), Niacin, Iron, Folic Acid and Vitamin D.

  24. Hi, I have not already tyied any diet due to its kind of hard for me but I want to try your … mahsa from Iran

  25. whats wrong with beans, steel cut oatmeal .
    i am not overweight

  26. Hello Paul,
    How do you suggest we measure/weigh the protein content in the PHD program? Before or after cooking it or does it not matter?
    Thanks

  27. Hello,

    I discovered your site and the wealth of information available. Reading the book is needed now. Let an innocuous question: breakfast is not offered for pensions. However, in everyday life, what breakfast you advise? Thank you

    Ji (France)

  28. Paul,
    What is your take on this article, and have you reviewed any of the studies cited in the footnotes?

    https://www.drfuhrman.com/library/eggs_cancer.aspx

    Eggs May Promote Colon Cancer

  29. Joaquin Buitrago

    Dear Paul,

    I am sending you a couple question regarding your diet:

    When you eat Buckwheat on your diet, how do you prepare it or how do you soak it? And also do you mix it with fats, eggs or butter or only fruits or how do you eat it for better digestion and absorption of buckwheat ?

    2.Also I currently purchase rolled oats at whole food which are gluten free and wheat free, do you consume this kind of rolled oats ? Is it safe to eat them even though it saids wheat and gluten free? What is your input on this?

    3.Lastly, how many table spoon of fats do you recommend a day including coconut oil, olive oil and ghee which are the main fats I am currently using ? Do you recommend them for cooking only (taste) or do you think is better to eat them without cooking for better digestion and absorbtion?

  30. I am coming from a lchf, keto background so adding carbs is a little scary for me. My goal is fat loss. Currently I am 270 lbs at approx 35-40% bf at 6’6″ tall. I am excited though about eating fruits and starches again and I have adjusted my myfitnesspal account to reflect the 2000 cal 600/400/1000 (carb/protein/fat) of the PHD. My question is, should I eat carbs evenly at each meal or should i maintain a carb nite solution style eating method of staying low carb throughout the day and then eat the carbs at night?

  31. Hi. I am new to this diet and wanting to try it. How important is it that I measure out carbs, calories and nutrients? If I switch to the basic plan, following the diet outlined by the apple, is that enough to bring benefits? I could do with losing about 14lbs and this seems like a regime I could adopt long-term, but not if I have to analyse and record everything I eat. 😕

    • Hi Lesley,

      It’s not important to measure carbs, calories, and nutrients, and most people don’t do it, but it can be educational to do it for a few days. I don’t encourage making a habit of it, being too consciously controlling about food can lead to disordered eating, and it is a waste of time, it is better to listen to your body. Yes, follow the basic plan.

      Best, Paul

      • That’s brilliant, Paul – and thank you. I’ve got the book and I’m going to give it a go. Lesley

        • Hi Paul I’m having trouble tracking down the veggie guidelines in the appendix from your previous book. I have scoured the internet long and hard. Is there any way I can get them from you? (I appreciate that a veggie version of PHD wouldn’t be your top recommendation, but nevertheless I think it might be helpful to me right now.) Thanks. Lesley

    • You sound like me! But I have tried to buckle down and use one of the many online diet journals that tracks the numbers for you. When I did, I saw that my estimates were a little too far off track. I am now literally measuring food out with a measuring cup until I train my eye.

      Tracking showed me I was undershooting my fat quotient, and overshooting carbs.

      Darrin posted that he uses Cronometer so I started using that, but there are also other websites, including myfitnesspal and nutritiondata.com; someone else mentioned fitbit.com, but I couldn’t understand how to get started — it may be an app thing. (I’m low-tech.)

      • Like peas in a pod. 🙂 I’ve tried to write things down, record them on apps etc., but I know I’ll never stick to it. Paul has given me a perfect reply – but I might just experiment a bit and follow your lead. I don’t want to put on any more weight – so using statistics might help if I do.

  32. Hello Paul,
    Here’s another interesting review on the various diet plans. Thank you.

    http://www.annualreviews.org/doi/pdf/10.1146/annurev-publhealth-032013-182351

  33. Hi. I am using crono-meter (which I’m finding really helpful) and want to set the ratio of carbs:protein:fat so that I can check my daily uptake. I want to lose weight, so need to reduce the fat content of the PHD. Can anyone tell me what the fat ratio should be, please?

  34. Uh-oh. I am putting on weight. javascript:grin(‘:sad:’)
    Am attempting the weight-loss version of PHD but have already gained 3lbs – in a week. I am eating a lot more fat than I used to (before PHD I tended towards a low-fat, largely vegetarian diet), plus more carbs, and have concerns that this is going the wrong way. Have others experienced this – and is it just that the body needs to get used to this new way of eating? If so, how long might it take to settle down?

    Or do I just need to reduce the fat intake?

    Any advice/reassurance, please?

    • Hi Lesley,

      See Jacqueline’s post below. It’s not easy to advise without seeing what you were doing before, but if you were undereating before (and, if you increased carbs and fat, it sounds like you were) then a temporary weight gain is not unusual until your metabolism and your gut flora normalize.

      Focus on nourishment and circadian rhythm entrainment. I’ll have a free ebook coming out soon on weight loss and read that.

      • Dear Paul. What a kind soul you are to offer me more advice … or even bother replying. Thank you.

        I shall look out for your ebook and will swallow its contents whole (excuse the pun).

        I will see what can be done about my circadian rhythms, and hope that my body appreciates the new regime. I have invested in a number of supplements, and ditched the grains. I appreciate that I need to give it time to settle. Your reassurance, and Jacqueline’s, is helpful.

        Can I ask you something? Is the material on managing PHD for vegetarians, from the first edition of your book, available anywhere? I’d be interested to see it.

        Hope you enjoy the Total Fat Loss summit.

        Lesley

  35. Ashley,

    I gained 6 pounds the first month I did PHD and kept it on for three. Then one day it was just gone. I really believe it was because my body was nourished for the first time in a long time.

    In the book, they make the point that obesity is a result of malnourishment. I agree. My body put on weight after being very ill–part of which included a Celiac diagnosis. My bloodwork looked like someone starving, yet every month I was gaining. When I started PHD I could FEEL in my body my gut healing. Gluten free was enough to stop the weight gain, but not enough to actually heal me. PHD has done that. I went to the doctor this last week and she was AMAZED at how my numbers are all evening back out. Every. Single. One.

    When you want to lose weight, it is totally disheartening to gain some. I understand! But I would give your body at least three months to find its equilibrium, especially if you have been eating a low-fat/low-protein diet (vegetarian). (I was too, fyi.) That can seem scary, but your body has to heal before it can go forward.

    I have been eating 400-500 calories of carbs, 500 calories of protein (I have needed this do to my workout schedule.), and 800 calories of fat. I eat a bit more if I need it, and a bit less when I don’t. PHD–ultimately–is a great way to re-learn listening to your body. It does not feel crazy, or unsustainable, to me. It feels like health.

    Lastly, remember that your body is good. Tell her! Tell your body how much you love and appreciate her for carrying you through life even when she struggles to be her best. (And best does not equal thin, it equals fitness, vitality, peace, true beauty that we ALL possess!). Inner peace is gorgeous! In fact, I think a woman with a womanly body is more beautiful with inner peace than a skinny woman who hates herself and hates food any day of the week.

    To peace!

    • Hi jacqueline

      Thanks so much for the heartening advice. I am touched. So glad the diet has made such a difference to your life and to your health.

      Already my skin has improved, but alas my waistline and sleep patterns have not. It’s early days for me, so I will stick with it and see what happens.

      You’re right, it is scary to introduce more carbs and fat, and the detail of how many carbs/proteins/fat you eat is particularly helpful. I will persist -maybe I will env find that inner peace you speak of.

      To peace … and good health.

  36. Hi Paul,

    I was wondering if you could give me a little more information as to animal protein requirements. (I love the book, and am reading it slowly.) The diet says 8 – 16 ounces of protein is necessary. I’ve been underrating protein since losing my weight many years ago, and when I upped it to around 12 ounces a day stopped losing hair and no longer experienced bruising on the arms and legs. But, after awhile the sight of meat was making me sick – a very bizarre experience for me, as no food has ever caused a reaction like that. I love turkey and couldn’t swallow a bite. So, I’ve cut back on the animal protein – am getting bruises again – and the feeling persists. No problem with vegetables, or eggs – but any straight animal protein I’m almost forcing myself to eat. My B12 was way up when I was eating a lot of protein. I’m a little perplexed.

    Best,

    Debbie

  37. Hello Paul,
    If a stool test identifies yeast/candida, should one stop consuming all fermented foods and diary? Thanks.

    • No, but avoid yeast fermented foods and look for bacterially fermented (acidic) vegetables.

      • I have a PhD in mycology (fungus.) I’ve never really understood the rationale here; bread yeast is Saccharomyces cerevisiae, and Candida albicans is a completely different species. So why would eating one yeast feed another? Also why would the amount of sugar you eat make any difference to organisms that survive just fine on a variety of substrates? Doesn’t make sense to me. Now of course if you cut out sugars, there is a big variety of metabolic improvements that often occur (less insulin, better blood sugar control, better fat burning) and maybe THAT is why many people feel better on “yeast control” diets? (by the way eating bacterially fermented vegies does sound like good advice; I’ve seen many women get rid of antibiotic-related vaginal yeast infections by eating live culture yogurt.) But that’s probably because the bacteria take over the yeast and outcompete them, not because you are starving the yeast; my best guess anyway.

        • I’ve heard of cases of fungemia developing in people with systemic fungal infections who eat yeast. Although the yeast itself is not infectious, the addition of fungal cell wall components from dead yeast and/or immune modulation from the yeast and/or suppression of anti-fungal bacteria in the gut by the S. cerevisiae seems to be able to exacerbate existing fungal infections.

          The point about the diversity of substrates that fungi can utilize is one I often make, there is no reason to suppose that a very low carb diet is good against fungal infections and all the evidence is against it.

          Yes, bacteria are the main defense against fungi/yeast infections and the best therapy as a rule.

          • I would be very curious. The fungemia cases I’ve seen are almost all Candida albicans in highly immunsuppressed patients (cancer, HIV, etc.) Another rare one is Malassezia contaminating fat-containing IV fluids. Other than those fungemia is pretty darned rare, and I’ve worked in bone marrow transplant centers and cancer hospitals. Send me a case report if you like; since almost everyone in the US eats yeast containing foods (bread, beer, etc) it would be tricky to tease out cause and effect here.

          • The ones I’ve heard about have been in patients on combination antibiotic protocols for chronic infections.

            For instance, I believe this lady was diagnosed with fungemia after taking S. boulardii supplements while on long-term antibiotics: http://cpnhelp.org/tindimas_use#comment-57440, http://cpnhelp.org/help_what_do#comment-58245.

  38. Help, please. I’ve been following the diet (and reading the book) for a fortnight. I have gained 5lbs and find I have a lot of heartburn and reflux from eating extra fat/oils; I am also sleeping much worse than usual. A bit of background: I am a 62 year old woman, part-time Pilates teacher and pretty much full-time publisher. I am 5ft 10ins, and now weigh 192lbs. I am largely vegetarian, but eat tuna regularly and lots of eggs. Previous to the diet I ate pretty a fairly low-fat, low sugar diet, so I understand there might be a problem with weight gain due to changes in my diet. I am taking most of the supplements Paul suggests.
    The book recommends reducing fat if you want to lose weight, but if I do that won’t I be back on a standard low calorie diet?
    And if I take antacids for the heartburn/reflux, will that affect my gut flora – which needs time to adjust to the new regime? I don’t want to do something that might be counter-productive.
    I’ve been trying to hunt down a copy of the previous edition of the book, for the appendix on how a veggie might fulfill the diet. Any ideas where I could get hold of that?
    On the plus side, my skin feels softer and the dark areas under my inner eye are definitely lighter.
    I would really like this diet to work, but not sure how long I might need to give it?
    All advice gratefully received.
    Best wishes.
    Lesley

    • I can help with one of your questions, namely where to get the older version of the book. But I do hope Paul will see your larger question. I’m gaining too, and don’t have it in me just now to ask questions about it or analyze it. I started following PHD last year. I’m probably too guessy about the details and I don’t eat liver or enough fish and I’m probably doing various things wrong. I’m perimenopausal, and am using maca root for those symptoms. It helped my sleep. I also got tested for pathogens, and I’ve been treated successfully for parasites; am being treated now for a bacteria, but my doc says it is not an overgrowth. He may just not know. I’m not sure the testing I had done was the right kind, either.

      Through interlibrary loan, your local library can borrow the older version of the book from another library. I know you’re not in the States, but surely interlibrary loan is everywhere?

      God bless.

      • Hi St – and thank you for your further comments. When you’re body is out of kilter it’s difficult to know whether one is getting the right tests and finding the root cause – but sometimes you have to put your your faith somewhere and go with the flow.

        Re the veggie appendix, I do not believe the old edition was available in the UK, so the library loan isn’t going to be a possibility for me. Perhaps someone out there can assist?

        I hope this diet settles down soon. I can’t afford to put on 5lbs every fortnight!

        Thanks again.

  39. Some people just plain need to be lower carb than others. Genetic? Environmental? Buildup of metabolic damage? Who knows? The Atkins folks (there is probably more science on Atkins than any of the paleo approaches) have found that some people gain weight if they eat more than 30 gm/day of carbs, while other people do fine on 100 gm/day. While some branches of the paleo community do believe in the concept of “safe starch” there is a significant subset of the population who are HIGHLY sensitive to carbs and will skyrocket their insulin, which is a signal to store fat and gain weight. I personally do a lot better with pretty low carbs and tend to gain weight if I stray; maybe that describes you too, and a little experiment with less carbs might be worth a shot.

    • Thanks, Jim. That’s a good suggestion and one that I will definitely bear in mind. I have wondered if I might be carb sensitive. My belief is that when I mix carbs and fats it usually results in weight gain, and indigestion to boot. I had hoped that the ‘safe starches’ would work for me, but maybe some are safer than others – least for me.

      I am still hoping that the PHD will be the answer, or a large part of it.

      All the best.

      • Eric Westman MD did a small study 8 years ago or so showing that in several people with reflux disease (“indigestion”) that very low carb was helpful. (It was helpful to me and to my wife who said I lost my snoring habit within ten days of going LC.) Happy wife, happy life, they say.

  40. Good result all round, I say. Thanks for the tip.

    Lesley

  41. Perfect health diet!? Haha, okay maybe for the person who made this site. There is NO SUCH THING as a perfect diet for everyone. “Do not eat grains or legumes?” Try telling that to anyone in central or south america, they would most likely laugh at you. Whatever happened to listening to one’s self? Ayurvedic medicine has been preaching that for over 5,000 years. I’ll eat properly prepared bread, beans, etc. if I feel the need for it. Too much obsession nowadays will lead to more stress which will compromise the health (thyroid, hormones, immune system) even more. Drastic changes are horrendous too.

    • Daniel,

      I do agree with you, there is no one diet for everyone.
      In India, people eat mostly grains and legumes, centarians mostly plant based diet with grains and legumes too.
      Not only diet but lifestyle is important. Yes, stress about diet makes worse.

      Daniel, where are you from ?

      • Hi Maria. Sorry if my previous comment came off as a little rude. I’ve just been a little frustrated with the boom in diets there have been over the past decade. But, I believe Ray Peat is just trying to help people out, so it is a good thing. I’m from California, my grandparents were from Mexico and I find it interesting that they prepared legumes and nuts properly without having the research as to why it is better for consumption that way.

  42. Can you comment on kefir in the diet? You list dairy as a pleasure food, but I was wondering where you would put kefir on your “apple” chart, and if you would count a few cups towards ones daily protein needs? Thank you!

  43. Paul just been reading a interesting article by Ben Greenfield on his website about a multivitamin by ThorneFX Multi AM/PM
    its sounds good, have you an opinion ?
    before I spend my money
    thanks for all your hard work
    marcus

  44. I always thought that we should only cook with saturated fat, since polyunsaturated fats like vegetable oils and monounsaturated fats like olive oil oxidize with heat. However, this well-researched article suggests that olive oil doesn’t actually oxidize much or at all with reasonable amounts of heat:
    http://authoritynutrition.com/is-olive-oil-good-for-cooking

    I’d be curious to you have a view of this.

  45. Paul..I’ve been skimming your web site and it all seems pretty balanced. The only difference between my diet and your is that I avoid cooked foods when possible, as I find cooking to be a bit of a chemistry experiment with all sorts of mutant compounds created, most of which I’d rather avoid.

    The one thing that I would love to hear your take on is sleep foods….ie foods that are pro-sleep versus anti-sleep. Obviously healthy blood sugar levels is the number one factor, but beyond that do you find certain foods to be pro-sleep and others to be anti-sleep. Like for example, I find that tomatoes and potatoes tend to be anti-sleep. Also, rice or oats without sufficient fat also seems to bind with some pro-sleep compounds in the gut, etc. Do you have a perspective on that subject in general?

    Aloha, Mark

  46. Anyone ever notice what all diet gurus, diet teachers, and diet authors all have in common? None of them have ever supervised a single water fast, and most of them have hardly ever fasted themselves. Ever heard of a guy named Herbert Shelton? He supervised around 40,000 water fasts, give or take. That’s probably more than all the living dieticians, nutritionists, diet gurus, and medical doctors combined.

    I know it is hard for most people to believe, but there is a time where zero carbing and zero fatting and zero fibering and zero protein is the one thing that is needed most.

    Water fasting is a long lost skill/art that has become almost unheard of nowadays, and it is needed more now than ever before, especially for anyone suffering from any acute health issue or obesity. Fasting nowadays is seen as basically ‘absurd’ and ‘idiotic’ and ‘dangerous’, but maybe in 200 years when humans have evolved a bit more, it will make a comeback.

    • Paul definitely talks about fasting. You just have to keep reading all his articles and find time to hang out in the comments sections, and ultimately you piece together the rest of his extracurricular kind brilliance.

  47. How does the PHD work for a Type 1 diabetic?

    I’ve tried for years to figure out how to eat, and I’m so weary 😥 Low carb, high protein, some starch, no starch, no dairy, some dairy….help?
    Was on Dr Bernstein diet for a while, and it’s extreeeeme. Hard to follow. (IE.He hasn’t had an apple since 1970) I just want to have some normalcy 🙁

  48. I love this diet. However, I still have IBS issues. So for digestive/ food combining purposes, I wonder if it would be better to eat the safe starches away from the protein (meat) meals. Any thoughts on this?

  49. I love this diet, also. I’ve been on it for 6 months and it’s the easiest diet I’ve ever been on. I started it to help eliminate my acid reflux and chronic headaches. It worked remarkably well but just recently my headaches are back. I’m trying to follow the ketogenic version, hoping that it will get me back on track but it’s difficult to eliminate fruit and eat loads of coconut oil. I’ve always loved the taste of coconut but not so much anymore. Any other suggestions from fellow headache sufferers? Thanks so much!

  50. Great article on Agave being worse than HFCS. I believe the best thing in the article, however, is the table at the bottom showing the grams of Fructose per serving of most fruits!

    http://www.huffingtonpost.com/dr-mercola/agave-this-sweetener-is-f_b_537936.html

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