Dr. David Perlmutter is an MD neurologist and fellow of the American College of Nutrition who has written prolifically: he knows a thing or two about the brain and nutrition. As such, I was very excited to read his book Grain Brain and learn more about the connection between our obsession with carbohydrates and our brain health. Personally, I know that I always have a foggy head after eating a carb heavy meal, and I wanted to know more about what is happening on a neurological level.
Dr. Perlmutter begins by explaining the human body’s need for fat as fuel for the brain and how our fat phobic culture has actually created a situation where rates of heart disease, dementia, and diabetes have continued to increase despite the best efforts of our physicians, the FDA, and the government’s insistence that lowering cholesterol is one of the healthiest things we can do for ourselves and our society. Many studies including the Framingham study (The National Heart, Lung, and Blood Institute; Boston University, 2013)– the basis for most of our current heart disease prevention recommendations – have shown a connection between low cholesterol and premature death as well as dementia (David Perlmutter, 2013, pp. 34-35). This shows us the importance of fats for brain function, but what about carbohydrates?
Carbohydrates have only recently become the main players in our diet in recent history. Prior to this, carbohydrates came in the form of roots, vegetables, seasonal fruits and berries, and small amounts of grain. Loaves of bread were time consuming to make, Twinkies and soda were non-existent, and if you have read about a sugaring off in a Little House book, you know that candy and sugar were only consumed on special occasions if at all. These days, in our western culture, one has access to all the blood sugar spiking carbohydrates they desire. This leads to wide swings in insulin and blood sugar levels, insulin resistance, and eventually diabetes. The risk of Alzheimer’s disease doubles after the diagnosis of type II diabetes (David Perlmutter, 2013, pp. 86-87). This link between diabetes and Alzheimer’s disease has led some neuroscientists to rename Alzheimers “Type 3 diabetes”.
The next focus of the book centers on gluten and the havoc it can create in the brain. In some patients with leaky gut, gluten is absorbed into the blood stream where it crosses the blood brain barrier and exerts an opiate-like effect on the brain – essentially drugging them. It has also been well documented that children with learning and behavioral disorders have a much higher incidence of gastrointestinal disorders than the general population. Dr. Perlmutter goes to far as to suggest that everyone should avoid gluten simply due to its effect on brain function, “[t]he removal of gluten form the diet and the adoption of a grain-brain-free way of life is often the surest ticket to relief for these brain ailments [common behavioral and psychological disorders] that plague millions, and this simple ‘prescription’ can often trump drug therapy.” (David Perlmutter, 2013, p. 150) Anyone familiar with seizure disorders will recognize that a ketogenic (fat burning) diet has been used to control seizure activity in children and adults for decades. The book goes on to showcase several cases studies where this prescription has worked to stabilize and remove the symptoms of depression, bipolar disorder, ADHD, and Autism Spectrum Disorder.
At the end of his book, Dr. Pearlmutter gives a great 4 week plan for helping the reader adjust to a new healthier lifestyle the removes inflammatory foods and adds in water and exercise. Additionally, he gives a list of recommended supplements for brain health and laboratory testing that should be done prior to making your changes and after completing the four week plan. Looking at the plan it is a bit reminiscent of the Atkins diet, but this plan does not bring you down to the lows of 20 grams of carbs per day, nor does it advocate eating deep fried meat wrapped cheese as individuals I know who were on the Atkins diet in the early 2000s were common to brag about eating.
One caveat I have about this book, is the focus on the promotion of ketosis. Yes, ketones are a product of the breakdown of fats, and the levels of ketones should be monitored – when ketosis occurs at high levels, it can be damaging to the kidneys and create unwanted side effects. In the case of diabetic ketoacidosis, ketosis can also be life-threatening. If you decide to experiment with the diet promoted by Grain Brain or any other low carbohydrate program, you should be aware of and watch for the side effects of ketosis: headache, dizziness, weakness, fatigue, and constipation (The Mayo Clinic, 2011). Before making any large changes in your diet or exercise level, it is important to consult with your doctor, have a screening physical exam, and have basic blood work run to rule out any underlying conditions that may be worsened by your efforts to improve your health.
Personally, I limit my consumption of grains and only eat sugar on special occasions as I feel much better when they are kept to a minimum. I do not however count my carbohydrates at this time. I fill my plate with vegetables, healthy fats, and quality proteins. I enjoy a daily piece of fruit, and I drink as much water as I can remember to. This is my current personal nutrition plan. What do you think? Are you considering giving the grain brain plan a try? Have you had success or with a grain-free diet? Have you felt worse on a low-carb diet? Please share your stories.
David Perlmutter, M. (2013). Grain Brain. New York: Little Brown.
The Mayo Clinic. (2011, October 11). weight loss. Retrieved from The Mayo Clinic: http://www.mayoclinic.com/health/low-carb-diet/nu00279/nsectiongroup=2
The National Heart, Lung, and Blood Institute; Boston University. (2013, November 20). Retrieved from Framingham Heart Study: http://www.framinghamheartstudy.org/