Many of you have asked me to "copy" a recent a Facebook post I wrote this weekend about Dr. David Perlmutter's hot new book, "Grain Brain: The Surprising Truth about Wheat, Carbs, & Sugar - Your Brain's Silent Killers".
So here it is!
If you received this post via email/smartphone click here to get to the web site for all the links, videos & to leave a comment!
What's Up with the Grain Brain??
up with the latest "Low-Carb High-Fat" diet recommendations from
neurologist Dr. David Perlmutter?? Another doc recommending a high-fat,
low-carb, gluten-free, meat, egg, sat-fat, & high cholesterol diet
to "Save Your Brain". Really, Dr. Perlmutter? I don't think so.
The questions about Perlmutter's book all started with this provocative Psychology Today post: "Is Your Healthy Diet Killing You?"
I just answered one reader--& I'm posting my LONG RANTY-ish reply. Perlmutter will be on Dr. Oz on Monday, October 21st--so I'm sure everyone will be asking the same question.
Bottom Line: If you are already eating a high-nutrient dense plant-based diet low in saturated fats, sugar & refined carbs--Perlmutter's message is not for you! But, I'll give him some points! He's right about some things. Sugar. Refined carbs. Insulin spikes. Bad news for everyone's brain.
Look out! Everyone will likely be jumping onto this bandwagon (especially after Dr. Perlmutter appears on Dr. Oz) because it's a great excuse to load up on fats & meat. Bet his book is going to be a BIG BEST-SELLER. They always are. Everyone wants to hear that meat, fat, eggs, & dairy are good for them. They're not.
I happen to be eating a plant-based no-added oil diet PRIMARILY TO PROTECT MY BRAIN from the same fate as my parents: strokes & dementia. No thank you, Dr. P. on your meat, oil, eggs, coconut oil, cholesterol, & sat-fat recommendations!
But, look, Dr. Perlmutter's audience is the more than 99.44% of Americans who are ALREADY eating loads of meat, saturated fat, eggs & cholesterol---along with loads of sugar, refined carbs, & restaurant meals--& if they do choose a "whole grain" it's likely to be "whole wheat" (like a big fat bagel) which is the LEAST nutrient-dense of the grains--& Perlmutter is right - even "whole wheat" is high-glycemic. It's not like eating sugar--but, other grains are better.
Added to which, grains are best when they're eaten in their WHOLE INTACT form---not ground up into flour which gives a quick rise to the blood sugar. Eating whole wheat flour is not the same as eating WHEATBERRIES, for goodness sake!
CHOLESTEROL CONNECTION: As for his claim that we need cholesterol---well, our bodies make all the cholesterol we need without eating a speck of animal protein--as long as we aren't blocking that natural process by taking a statin - which inhibits HMG-coA Reductase, the enzyme in our body that makes cholesterol in our liver.
Perlmutter is right--we do NEED some cholesterol for our brains & for hormone production---which is one good reason to let our bodies make what we need, without having to disable our natural cholesterol production by taken a statin.
There's a balance of how much cholesterol we need. TOO MUCH IS BAD for our cardiovascular system--TOO LITTLE IS BAD FOR OUR BRAINS.
Problem is: no one knows exactly what that "just
right" amount is, according to Alzheimer expert Dr. Murali Doraiswamy.
Our brains also need GLUCOSE--from carbohydrates to function!! Ever notice how crabby people are when they're on a low-carb Atkin's style diet?
WHY PLANT-BASED ROCKS! For those of us on a nutrient-dense plant-based diet--we are already getting all the anti-inflammatory high-fiber benefits we need from a diet extraordinarily high in vegetables & fruit. We don't need what Dr. Perlmutter is "serving up" with his anti-grain, high fat, high animal protein diet.
THE CANCER & ATHEROSCLEROSIS CONNECTION OF A HIGH ANIMAL PROTEIN DIET: Is Perlmutter also forgetting about the "cancer connection" (especially prostate cancer) that goes along with a high-animal protein diet? Here's a good summary explaining the recent research (scroll down to "Red Meat Associated with Many Different Cancers") . The most recent study on the subject can be found in:
Di Maso, M. et al "Red meat and cancer risk in a network of case–control studies focusing on cooking practices," Annals of Oncology, : Published online on Oct. 11, 2013. https://www.ncbi.nlm.nih.gov/pubmed/24121119
TMAO: And if you need more convincing--look at the recent research from Dr. Stanley Hazen of the Cleveland Clinic N Engl J Med & Nature Medicine 2013 Read/listen to Dr. Hazen's Science Friday interview explaining the meat/TMAO/cholesterol/atherosclerosis connection. Turns out, a diet high in meat (carnitine) & eggs (choline) causes the gut bacteria of meat/egg eaters to produce a gas known as TMAO which promotes atherosclerosis in the presence of cholesterol.
His test to
measure TMAO as a predictor of the risk of death, heart attack &
stroke just made the list of the Cleveland Clinic's "Top 10 Medical
Innovations for 2014".
Watch the 1:34 minute video all about it, here
Read my Face Book post about the TMAO award here.
"The biomarker, called TMAO (for trimethylamine-N-oxide) is produced by the liver after bacteria in the intestines digest red meat and other animal products. In three clinical studies, TMAO has been a good predictor of heart disease risk—those with the highest levels of TMAO had risks of negative outcomes that were two to 2 ½ times higher than those with the lowest blood levels of the biomarker."
Hazen: "The gut bacteria of meat-eater's turns carnitine into a gas called TMA (& it smells like rotting fish), then our livers turn TMA into the artery-damaging metabolite called TMAO."
[I call TMAO "Too Much
TMAO is what CHANGES our metabolism of cholesterol. Hazen explains, "SO THIS PROCESS IS NOT INDEPENDENT OF CHOLESTEROL. It actually works through cholesterol. It changes how our body senses cholesterol and metabolizes cholesterol at the artery wall, in the liver and in the intestines. TMAO makes our cholesterol pro-atherogenic & accelerates atherosclerosis. Which helps to explain why some people with normal cholesterol levels still have atherosclerosis & heart disease.
In contrast, the longstanding vegetarian or vegans [in the study], and to be enrolled in [the] study, the subjects had to claim that they had had no animal or no meat product within the last year. So they were longstanding vegetarian or vegan. WHEN THEY INGESTED CARNITINE, THEY MADE VIRTURALLY NO TMAO."
Further, take a look at the illustration in the N Engl J Med of what arteries look like on a high-protein, low-carb diet. https://www.happyhealthylonglife.com/happy_healthy_long_life/2011/04/ornish.html
Smith, Steven R. MD. "Clinical Implications of Basic Research. A Look at the Low-Carbohydrate Diet." N Engl J Med 361(23):2286-88, December 23, 2009
ORNISH ON "WHEAT BELLY": When Dr. Dean Ornish recently visited my hospital he was asked about books like "Wheat Belly" which is the same premise as "Grain Brain".
His answer: "It's misguided. Refined
carbohydrates are bad. Whole grains are great--on so many levels!
There's a big difference between the two. It's always easy to demonize
ONE FOOD--but, the "whole picture" is far more complicated than that."
Ornish has 30 years of success in preventing & reversing heart disease & early prostate cancer (& now in increasing telomeres), all with a low-fat, plant-based diet, exercise, & stress management. My money's with him.
All that matters is what's happening inside of the the arteries.
The traditional intermediate risk-factors of cholesterol, weight-loss, blood pressure, HDL & LDL don't always tell the whole story--which is why promoters of the high-protein high-fat low-carbohydrate diets, like Atkins & Gary Taubes, think their (HPLC) diet works--while all along, unbeknownst to them, it promotes plaque & atherosclerosis.
If you're eating a diet that's high in animal protein, high in fat, and low in healthy carbs--your weight & lipid numbers might even be looking good--but your arteries are not!
The high-fat high-protein low-carbohydrate diets cannot produce the circulating endothelial progenitor cells (EPCs) that are needed to repair damaged blood vessel walls & improve endothelial function.
And the HPLC diet doubles the nonesterified fatty acids (NEFAs) which promote inflammation & atherosclerosis. If you think high-protein-low-carb is good--think again!
And it's all about what's going on inside of the arteries--not just the lipid numbers! A low-fat high-unrefined-carbohydrate diet increases those endothelial progenitator cells--and keeps the artery walls healthy, flexible, and atherosclerosis-resistant. Read more in the PNAS "Vascular effects of a low-carbohydrate high-protein diet"
Full disclosure: the graphic is from an animal model study.
--My paraphrasing of both Dr. Dean Ornish's comments on the graphic & Smith's N Engl J Med article--
OMEGA-3's: And yes, Dr. David Perlmutter recommends omega-3's. I couldn't agree more. But, we can get plenty from chia, flax, & algal omega-3 supplements - and when we lower our intake of corn-fed meat & fish, and cut out vegetable oils, we don't need those mega-doses of omega-3's.
RENOWNED ALZHEIMER EXPERT, DR. MURALIY DORAISWAMY: Last week, I listened to one of the top Alzheimer specialists in the country, Dr. Murali Doraiswamy, on People's Pharmacy. He explained the connection of dementia & diabetes & the negative effects of a high fat, sugar, refined carb diet on the brain. He does NOT recommend coconut oil (its benefit is for people who's brains are so damaged, primarily from diabetes, that they can no long absorb glucose to function--("diabetes of the brain")--& he also happens to be a vegetarian. Just saying.
Dr. Murali Doraiswamy's interview: https://www.peoplespharmacy.com/2013/09/28/919-avoiding-alzheimers-disease/
GOOD GRAINS: Personally, I do agree with Dr. Joel Fuhrman---I don't avoid them, but neither do I go overboard with my intake of grains---not because they're unhealthy--but because other foods have more nutrients. Namely, vegetables, fruit & legumes. When it comes to potatoes (which I love) I choose sweet or purple potatoes over big fat starchy white potatoes.
Steel-cut oats ROCK--& similar to other complex carbs like barley & quinoa, they have both soluble & insoluble fiber, as do all the legumes (BEANS ROCK, TOO)--which feed the healthiest of gut bacteria--and they prevent insulin spiking, which is what harms the brain.
"Why is red meat harmful? Saturated fat, which can lead to cardiovascular disease, is really just the beginning of the story,” explains Harvard investigator, Frank Hu. Even though it is “difficult to pinpoint one compound or ingredient” as mechanistically linked to diabetes risk, three components of red meat—sodium, nitrites, and iron—are probably involved. Sodium is well known to increase blood pressure, but it also causes insulin resistance; nitrites and nitrates have also been shown to increase insulin resistance and to impair the function of the pancreatic beta cells. Iron, although an essential mineral, can cause beta-cell damage in individuals with hereditary hemochromatosis (a disorder in which the gastrointestinal tract absorbs too much iron), and heme iron—the readily absorbable type found in meat—at high levels can lead to oxidative stress (and cell damage) and systemic, chronic inflammation in some people."
Dr. Neal Barnard's "Power Foods for the Brain": I also refer you to Dr. Neal Barnard's recent book presenting the case for a plant-based diet to protect the brain: "Power Foods for the Brain". His case is the polar opposite to Dr. Perlmutter's. Watch a video of Barnard here
THE HIGH COST of MEAT IN $$$ (especially grass-fed) & to the ENVIRONMENT + THE SCARCITY OF TOXIN FREE WILD SALMON: Lastly, the grass-fed beef, cage-free eggs & poultry, & toxin-free wild salmon that Perlmutter glibly recommends doesn't come cheaply, doesn't exist in the quantities that can feed the majority of the population, & has an environmental price tag.
I'm sticking with my high-nutrient anti-inflammatory diet that minimizes sugar, refined carbs as much as possible--& keeping whole grains (except for oats, barley, quinoa, & sprouted flour-less breads) to a smaller portion of what I eat. Emphasis is on greens, all vegetables, legumes, lower sugar fruits like berries, citrus, grapes, apples, pears & stone fruits. And I include EXERCISE (aerobic & muscle-building strength-training) as one more defense against DIABETES--a significant contributor to dementia.
"Eat Your Way to Dementia," New Scientist, September 1-7, 2012
Final parting thoughts. Take a look at the illustration & text of "The Save Your Brain Diet" that minimizes FAT, SUGAR, & High-Glycemic Refined Carbs. It tell a different story from Dr. Perlmutter's!
The "Save Your Brain Diet"--cut the fat, the sugar, the high-glycemic refined carbs, & start exercising. You might want to read "Eat Your Way to Dementia" in the New Scientist Sept 1-7.
Bottom Line: Multiple ongoing studies not only link a high fat, high sugar, high glycemic diet to the insulin dysfunction in the brain that causes cognitive impairment & Alzheimer's, but researchers are starting to understand how this diet increases the damaging beta amyloid plaques that can lead to dementia. Exercise, along with diet, can play a preventive role--by decreasing blood sugar & keeping insulin levels at an even keel.
Read more about one of the top scientists mentioned in
the New Scientist, Suzanne Craft, PhD, "Could This Be the Alzheimer's/Dementia
Prevention Diet? It's the Ultimate Food Fight Face-Off - The VA Puget
Sound Study Shows How a Low Fat Low-Glycemic Diet Improves Markers for
Alzheimer's Disease in Just Four Weeks"