Skip to content

Information for patients, their families and helpers

Diet: Which foods to eat?

This page contains information on various common types of foods, along with examples of which foods to eat and which to avoid, based on the level of phytanic acid they contain. (See the previous page, Phytanic acid in foods, for an explanation of how we categorise foods into three groups according to level of risk.)

The food types we have looked at are:

Savoury foods: Meat; Meat products; Fish; Vegetarian meat substitutes; Stock cubes and savoury flavourings; Soups

Dairy products: cheese; desserts; milks & creams; eggs

Cereals: breakfast cereals; pasta; pudding cereals; flours & breads; biscuits & cakes

Fruit and vegetables

Nuts

Oils & fats:spreads

Beverages

Alcohol

Confectionery, sweets and snacks: sweets, chocolate, crisps

Meat

Phytanic acid is found in foods obtained from animals which live mainly on green plants e.g. cows, sheep and goats.

Low risk

pig meat products:

  • pork;
  • pig's liver;
  • pig's kidney;
  • pig fat;
  • luncheon meat;
  • ham;
  • bacon

chicken

  • chicken liver

duck

turkey

Medium risk

rabbit

High risk

cow products:

  • beef;
  • calf's liver;
  • beefburgers;
  • beef liver;
  • beef kidney

sheep products:

  • lamb;
  • lamb's liver;
  • lamb's kidney;
  • lamb's heart;
  • mutton

venison

goose meat

  • goose fat;
  • goose liver

Back to list of food types

Meat products

Check the list of ingredients very carefully. Suitable ingredients include: pork, cured pork, pork fat, chicken fat, vegetable fats and oils, hydrogenated vegetable fats, whey solids.

Low risk

chicken pate

pork pate

pork sausages

pork and turkey sausages

Medium risk

High risk

Back to list of food types

Fish

All fish contain phytanic acid in the fat. The more fat in the fish, the more phytanic acid, so shellfish (e.g. prawns, crab) will contain the least; white fish (e.g. cod, haddock) will be medium; and fatty fish (e.g. salmon - including smoked salmon -and herrings) contain the most.
If you eat white fish such as cod, coley, haddock avoid the skin and have only small portions - i.e. 100g (4oz) or less. Never take fish oil medicines e.g. cod liver oil capsules.
Convenience foods such as fish pastes and fish in sauce are best avoided.

Low risk

Medium risk

white fish - without skin

  • e.g. cod, coley, haddock

crab meat

prawns

smoked haddock

tuna in water

High risk

fish oils

  • e.g. Maxepa, cod liver oil, halibut oil

herring

mackerel (fresh or tinned)

plaice

salmon (fresh, tinned or smoked)

sardines (fresh or tinned)

fish-in-sauce ready meals

Back to list of food types

Vegetarian meat substitutes

Plain Quorn and soya products can be used freely in your own recipes.

They are also available in many convenience foods including pies, curries, ratatouille, stir fries etc. Many are suitable for your use but beware of some sauces which may contain high-risk ingredients.

Low risk

soya products:

  • textured vegetable protein (TVP);
  • tofu

Quorn (mycoprotein)

Medium risk

High risk

Back to list of food types

Stock cubes and savoury flavourings

Low risk

Bisto

chicken stock cubes

Marmite

vegetable stock cubes

curry paste

curry powder

spices

Medium risk

High risk

beef stock cubes

Bovril

Back to list of food types

Soups

Low risk

chicken noodle soup

Medium risk

High risk

cream soups

Back to list of food types

Dairy products

The fats in milk from cows, sheep and goats all contain phytanic acid so great care must be taken with dairy products.

Even products labelled 'low fat' (e.g. half-fat cottage cheese and yoghurt) can contain phytanic acid.

So look for:

e.g. skimmed milk; very low fat fromage frais; very low fat yoghurt (1% fat).

Back to list of food types

Dairy products: cheese

All traditional cheeses, processed cheese and cheese spreads contain phytanic acid and should never be eaten. Even lower fat or fat-reduced cheese should be avoided.

Artificial cheeses can now be bought which are made from soya and vegetable oil. Other brands can be found in Health Food Stores. This type of cheese is the only one recommended.

The Vegan Society's Animal Free Shopper includes information on alternatives to cheese and other dairy products which are free from all dairy and animal fats. (Order from the Vegan Society's website or phone 0845 4588244.) (Adult Refsum's disease patients also need to check that they are nut free.)

More details on cheese alternatives

Low risk

very low fat fromage frais (less than 1% fat)

cheese alternatives

Medium risk

half-fat cottage cheese

High risk

all cheeses

including:

  • cheese spreads;
  • cream cheese;
  • 'lower fat' cheese;
  • processed cheese;
  • goats' milk cheese;
  • sheeps' milk cheese;
  • Camembert;
  • Cheddar;
  • Stilton;
  • Danish Blue;

Back to list of food types

Dairy products: desserts

Low risk

very low fat yoghurt (1% fat)

non-dairy ice cream made from animal fats

  • e.g. Walls vanilla, Blue Ribbon

non-dairy ice cream made from soya

  • e.g. Berrydales

Bird's Angel Delight

Nestlé Tip Top topping

Medium risk

High risk

all dairy desserts

all dairy ice creams

Back to list of food types

Dairy products: milks & creams

Low risk

fully skimmed milk

skimmed milk powder

soya milk

supplements containing only vegetable oils

  • e.g. Fresubin, Ensure, Fortisip, Clinutren

Coffee Mate

Medium risk

semi-skimmed milk

High risk

condensed milk

double cream

evaporated milk

full fat milk

goats' milk

sheeps' milk

baby milks containing milk fat or fish oil

Back to list of food types

Dairy products: eggs

Low risk

hen's eggs

Medium risk

High risk

goose eggs (from geese fed on grass)

Back to list of food types

Cereals

Low risk

All cereals:

  • wheat;
  • oats;
  • rice;
  • maize;
  • sago;
  • tapioca;
  • corn

Medium risk

High risk

Back to list of food types

Cereal products: breakfast cereals

No phytanic acid was found in any breakfast cereal made from wheat, wheatbran, wheatgerm, oats, rice, maize: nor in rye crispbread, sago or tapioca. Work on the free phytol content is still in hand but the evidence so far indicates that there is no need to limit the intake of any cereal on this account.

Low risk

all breakfast cereals

  • e.g. Cornflakes, Rice Crispies, Special K, Weetabix, bran flakes, porridge, oats, wheat germ, wheat bran

Medium risk

High risk

Back to list of food types

Cereal products: pasta

Plain dried pasta that you cook with at home will be safe. If you are eating ready meals made with pasta or pasta dishes in restaurants you must check the ingredients of the sauces.

More on eating out and convenience foods.

Low risk

plain pasta

Medium risk

High risk

some pasta sauce ingredients

  • e.g. cheese, cream

some pasta fillings

  • e.g. beef, cheese

Back to list of food types

Cereal products: pudding cereals

Low risk

all pudding cereals

  • e.g. cornflour, rice, sago, tapioca

Medium risk

High risk

check other ingredients

  • e.g. avoid rice pudding made with milk or cream

Back to list of food types

Cereal products: flours & breads

Low risk

bread (including wholemeal bread)

  • unless it contains animal fats

white flour

wholemeal flour

rye crispbread

Medium risk

High risk

brioche

croissants

Back to list of food types

Cereal products: biscuits & cakes

Most biscuits and cakes are made using butter or animal fats, and should be avoided.

The Vegan Society's Animal Free Shopper includes a list of biscuits and cakes which are free from all dairy and animal fats. (Order from the Vegan Society's website or phone 0845 4588244.)

The Vegan Society website also provides recipes for animal-free cakes which you can make for yourself.

Low risk

biscuits and cakes made without dairy fats, animal fats or nuts

biscuits and cakes which are both suitable for vegans and also nut free

Medium risk

High risk

biscuits and cakes containing butter or animal fats (or nuts)

Back to list of food types

Fruit and vegetables

No phytanic acid was found in a selection of fruit and vegetables and none in any vegetable oil. Previous studies have shown there to be little danger from free phytol. In view of the protective effect of fruit and vegetables in maintaining general good health you are recommended to take average amounts (2-3 servings vegetables, 2-3 servings fruit) of a variety of fruits and vegetables every day.

There is a possible exception in the case of spinach and dried fruit, due to the high levels of phytol they contain - these might be a problem if eaten in quantity.

Low risk

vegetables

  • e.g. green vegetables, root vegetables, mushrooms, onions, peas, peppers, tomatoes, tomato puree

vegetable stock cubes

  • e.g. vegetable Oxo

chips fried in vegetable fat

roast potatoes cooked in vegetable fat

fresh fruit

Medium risk

spinach

dried fruits

High risk

chips fried in beef dripping

roast potatoes cooked in animal fat

Back to list of food types

Nuts

Contrary to previous results we found no phytanic acid in various nuts except walnuts and peanuts, which contain phytanic acid in the skins.

Low risk

almonds

Brazil nuts

coconut

tahini (sesame paste)

Medium risk

peanuts

  • peanut butter

walnuts

High risk

Back to list of food types

Oils & fats

Butter fat, beef suet and fish oils are all rich sources of phytanic acid. Since they can be added to spreads and baking fats, great care must be taken in choosing both fats to use at home and also ready baked goods (e.g. biscuits and pastry goods).

Recent analysis found no phytanic acid in any vegetable oil or in a range of products containing vegetable and hydrogenated vegetable oils. Any product containing only these fats should be safe; some examples are given here. Soya oil is an exception - this may contain phytanic acid and therefore should be avoided.

Many fats supplied for catering contain animal fats (usually fish oils) so great care must be taken when eating away from home.

Some more advice on this appears in the section on eating out.

Low risk

vegetable oils

  • e.g. arachis (groundnut), corn, olive, rapeseed, safflower, sunflower

hydrogenated vegetable oils

lard

Medium risk

High risk

butter

suet

Back to list of food types

Oils & fats: spreads

Low risk

spreads and low fat spreads containing only vegetable and hydrogenated vegetable oils

Medium risk

High risk

butter

suet

spreads containing butter

  • e.g. Clover

spreads containing animal fats

  • e.g. Echo, Krona, Stork Special Blend

Back to list of food types

Beverages

Neither tea nor coffee were found to contain any phytanic acid.

Low risk

drinks with fully skimmed milk added

cocoa

coffee

  • (both ground & instant)

drinking chocolate (without milk fat)

tea

fizzy drinks

squashes

Medium risk

drinks with semi skimmed milk added

High risk

drinks with cream and milk added

drinking chocolate (containing milk fat)

latte

milkshake

Back to list of food types

Alcohol

Most alcoholic drinks are virtually fat free and contain no phytanic acid - except e.g. Bailey's Irish Cream.

However ALCOHOL IS A POISON and affects the nervous system.

Since adult Refsum's disease also affects the nervous system, alcohol should be kept to a minimum. National Guidelines give 21 units of alcohol per week for a man and 14 for a woman (1 unit = ½ pint beer, 1 glass of wine). You should aim for much less than this.

Low risk

Medium risk

small amounts of alcohol

High risk

excess alcohol consumption

Back to list of food types

Confectionery, sweets and snacks

Sweets

Sweets containing no fat e.g. jellies, boiled sweets and liquorice, have no phytanic acid.

Low risk

boiled sweets

fruit jellies

liquorice allsorts

marshmallow

plain Turkish delight

wine gums

Medium risk

High risk

Back to list of food types

Chocolate

Cocoa itself contains no phytanic acid. However, milk chocolate will contain milk fat and some plain chocolates contain butterfat. They should therefore be avoided. Look for plain chocolate with this sort of ingredient label: 'Cocoa mass, sugar, cocoa butter, low fat cocoa powder, lecithin'.

Chocolate containing soya instead of milk is OK (e.g. Plamil plain chocolate with soya).

Carob confectionery, if milk free, is acceptable.

Low risk

chocolate containing no milk or butterfat

  • e.g. plain continental from 'free from milk ranges'; Plamil plain chocolate with soya

carob confectinery (milk free)

  • e.g. Plamil raw sugar carob confectionery

Medium risk

High risk

milk chocolate

plain chocolate containing butterfat

Back to list of food types

Crisps

Crisps cooked in vegetable oil are safe.

It would be sensible to avoid beef, cheese and onion, and prawn cracker flavours.

Low risk

crisps cooked in vegetable oil

Medium risk

High risk

crisps cooked in beef fat

beef flavour crisps

cheese and onion flavour crisps

prawn cracker flavour crisps

Back to list of food types

More information

The rest of this section gives more specific information about cheese alternatives, eating out and convenience foods, taking extra care during illness, and lanolin in skin creams. It also introduces the phytanic acid calculator, for people who want to calculate the quantities of phytanic acid in their own food intake.

Back to 'Diet recommendations' homepage

Back to top of page  Back to main menu

Page last updated 26 June 2006