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.)
Phytanic acid is found in foods obtained from animals which live mainly on green plants e.g. cows, sheep and goats.
pig meat products:
- pig's liver;
- pig's kidney;
- pig fat;
- luncheon meat;
- chicken liver
- calf's liver;
- beef liver;
- beef kidney
- lamb's liver;
- lamb's kidney;
- lamb's heart;
- goose fat;
- goose liver
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.
pork and turkey sausages
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.
white fish - without skin
- e.g. cod, coley, haddock
tuna in water
- e.g. Maxepa, cod liver oil, halibut oil
mackerel (fresh or tinned)
salmon (fresh, tinned or smoked)
sardines (fresh or tinned)
fish-in-sauce ready meals
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.
- textured vegetable protein (TVP);
Stock cubes and savoury flavourings
chicken stock cubes
vegetable stock cubes
beef stock cubes
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:
- Very Low Fat
- Virtually Fat Free
- Less Than 1% Fat
e.g. skimmed milk; very low fat fromage frais; very low fat yoghurt (1% fat).
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.)
very low fat fromage frais (less than 1% fat)
half-fat cottage cheese
- cheese spreads;
- cream cheese;
- 'lower fat' cheese;
- processed cheese;
- goats' milk cheese;
- sheeps' milk cheese;
- Danish Blue;
Dairy products: desserts
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
all dairy desserts
all dairy ice creams
Dairy products: milks & creams
fully skimmed milk
skimmed milk powder
supplements containing only vegetable oils
- e.g. Fresubin, Ensure, Fortisip, Clinutren
full fat milk
baby milks containing milk fat or fish oil
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.
all breakfast cereals
- e.g. Cornflakes, Rice Crispies, Special K, Weetabix, bran flakes, porridge, oats, wheat germ, wheat bran
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.
some pasta sauce ingredients
- e.g. cheese, cream
some pasta fillings
- e.g. beef, cheese
Cereal products: pudding cereals
all pudding cereals
- e.g. cornflour, rice, sago, tapioca
check other ingredients
- e.g. avoid rice pudding made with milk or cream
Cereal products: flours & breads
bread (including wholemeal bread)
- unless it contains animal fats
Cereal products: biscuits & cakes
Most biscuits and cakes are made using butter or animal fats, and should be avoided.
The Vegan Society website also provides recipes for animal-free cakes which you can make for yourself.
biscuits and cakes made without dairy fats, animal fats or nuts
biscuits and cakes which are both suitable for vegans and also nut free
biscuits and cakes containing butter or animal fats (or nuts)
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.
- 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
chips fried in beef dripping
roast potatoes cooked in animal fat
Contrary to previous results we found no phytanic acid in various nuts except walnuts and peanuts, which contain phytanic acid in the skins.
tahini (sesame paste)
- peanut butter
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.
- e.g. arachis (groundnut), corn, olive, rapeseed, safflower, sunflower
hydrogenated vegetable oils
Oils & fats: spreads
spreads and low fat spreads containing only vegetable and hydrogenated vegetable oils
spreads containing butter
- e.g. Clover
spreads containing animal fats
- e.g. Echo, Krona, Stork Special Blend
Neither tea nor coffee were found to contain any phytanic acid.
drinks with fully skimmed milk added
- (both ground & instant)
drinking chocolate (without milk fat)
drinks with semi skimmed milk added
drinks with cream and milk added
drinking chocolate (containing milk fat)
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.
small amounts of alcohol
excess alcohol consumption
Sweets containing no fat e.g. jellies, boiled sweets and liquorice, have no phytanic acid.
plain Turkish delight
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.
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
plain chocolate containing butterfat
Crisps cooked in vegetable oil are safe.
It would be sensible to avoid beef, cheese and onion, and prawn cracker flavours.
crisps cooked in vegetable oil
crisps cooked in beef fat
beef flavour crisps
cheese and onion flavour crisps
prawn cracker flavour crisps
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.
Page last updated 26 June 2006