Grain Brain – Take It With a Grain of Salt

During the last couple of decades Alzheimer’s disease and other types of dementia have become increasingly common. Today it is estimated that about 34 million people suffer from Alzheimer’s disease worldwide and the number is increasing rapidly.

It is expected that the number of individuals with Alzheimer’s disease will triple over the next forty years. Therefore, preventing or reducing the risk of this incurable disease is one of the biggest challenges facing modern healthcare.

15612550_mA couple of years ago a paper written by two US researchers on how reducing modifiable risk factors might cut the prevalence off Alzheimer’s disease was published in The Lancet Neurology.

The authors pointed out seven of the most important risk factors for Alzheimer’s disease: diabetes, midlife hypertension, midlife obesity, smoking, depression, cognitive inactivity or low educational attainment, and physical inactivity.

They  concluded that a 10—25% reduction in all seven risk factors could potentially prevent as many as 1.1—3·0 million cases of Alzheimer’s disease worldwide and 184.000—492.000 cases in the USA. Most importantly, the authors highlighted that to a certain degree, Alzheimer’s disease is a preventable disorder.

In his recently published book Grain Brain, renowned US neurologist David Perlmutter points out that for years the brain has been excluded from discussion about preventive medicine. He believes that lifestyle choices play a fundamental role in determining the brains destiny. Alzheimer’s disease, depression, Parkinson’s disease and ADHD are all preventable. Perlmutter believes that the fate of our brain is in the food we eat.

In the first chapter of Grain Brain you get a feeling of where Dr. Perlmutter is going. “Brain dysfunction starts in your daily bread, and I’m going to prove it”….. “Modern grains are slowly destroying your brain”….. ” I’m referring to all the grains that so many of us have embraced as being healthful – whole wheat, whole grain, multigrain, seven-grain, live grain, stone-ground and so on. Basically, I am calling what is arguably our most beloved dietary staple a terrorist group that bullies our most precious organ, the brain”….. ” I will demonstrate how fruit and other carbohydrates could be health hazards with far-reaching consequences”….. This isn’t science fiction; it’s now documented fact”….. “This is not just another diet book or generic how-to guide to all things preventitive health. This is a game changer.”

Although it is admirable when experts deliver such a simple and clear message, this is also where we should get suspicious. Biologic science is very rarely so black and white.

Perlmutter writes: “This book is about those lifestyle changes you can make today to keep your brain healthy, vibrant, and sharp, while dramatically reducing your risk for debilitating brain disease in the future”.

Is this a sales rep talking or a medical doctor? Either way, I’m quite amazed by Dr. Perlmutter’s conviction and persuasiveness.

Sorry, but before I go further I have to tell you about a psychological phenomenon called cognitive dissonance. I believe it deserves a mention here because I think it often seriously affects how we interpret scientific data and how we present them, or decide not to present them, to other people.

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Cognitive Dissonance

In December, almost sixty years ago, Dorothy Martin (alias Marian Keech) and her followers believed they would be celebrating christmas far away from planet earth. Keech claimed to have received a message from a planet named Clarion revealing that the world would end in a great flood before dawn on December 21, 1954. Her group of believers, located in Michigan, had taken strong behavioral steps to prepare for this moment. They had left jobs, college, and spouses, and had given away money and possessions to prepare for their departure on a flying saucer which was to rescue the group of true believers.

Cognitive dissonance is the distressing mental state that people feel when they “find themselves doing things that don’t fit with what they know, or having opinions that do not fit with other opinions they hold.” This produces a feeling of discomfort leading to an alteration in one of the attitudes, beliefs or behaviors to reduce the discomfort and restore balance. You can imagine the stress imposed on Marian Keech and her group when they realized that they were not going to be rescued by a flying saucer, and the second shock when realizing that Apocalypse was not imminent.

Later, psychologist Leon Festinger wrote his famous book “When Prophecy Fails: A Social and Psychological Study of a Modern Group That Predicted the Destruction of the World“. Festinger and his associates had read an interesting item in their local newspaper headlined “Prophecy from planet Clarion call to city: flee that flood.” They recruited a team of observers, joined Marian Keech’s group, and watched it from within. The story and the psychological reaction of the group members lead to the definition of the term “cognitive dissonance”.

Ok, I know what you’re thinking. Now the Doc’s gone completely mad. Telling a sixty year old story about UFO’s and Armageddon. Then trying to explain a psychological phenomenon he knows nothing about.

So, I’ll try to get back on track. One of the biggest problems with many books being written about health issues is information bias. If I have a belief or a point to make, I’m already biased. That’s quite obvious isn’t it? However, if I understand and respect scientific methods, I will present data that support may view as well as data that don’t support it. That’s honest. If I can’t make my point by doing this, I probably don’t have a case.

However many books on medical issues are written by individuals who tend to seek out information confirming their point of view and reject information on the contrary. This may be done on purpose, but it may also be done “unwillingly” to reduce the discomfort of cognitive dissonance. Okay, there you have the connection with the UFO’s.

Both medical writers and their readers suffer from cognitive dissonance. The reader usually prefers to read books or articles that support or confirm his own beliefs. Keep in mind though, that cognitive dissonance is not a disease. It’s quite normal indeed.

Remember the story about the Fox and the Grapes. It’s a classic example of cognitive dissonance. In the story, a fox sees some high-hanging grapes and wishes to eat them. When the fox is unable to think of a way to reach them, he decides that the grapes are probably not worth eating, with the justification the grapes probably are not ripe or that they are sour.

Dietary Habits and Brain Health

Let’s get back to the grains and the brain. Dr Perlmutter provides historical and scientific evidence indicating that a diet rich in carbohydrates may damage our brains. Consequently, a diet rich in fat, and low in carbohydrates will protect our brain.

In a radio interview following the publication of his book he said: “It turns out that humans have never eaten grain. In 99.9 percent of our time walking this earth we have never eaten grain. What is wrong with wheat barley and rye is that it contains this very powerful protein called gluten”…. “Grain brain was written based upon my review of about 250 peer reviewed scientific journals with specific articles dealing with gluten issue”….. “We’ve never in 99.9 percent of our time on this planet eaten carbohydrates. They weren´t available”.

How about fruit? Dr. Perlmutter must know that our ancestors were not only “hunters”, they were “gatherers” as well. The “gatherers” found their food in what came out of the ground. They ate carbohydrates and proteins in the form of fruit and vegetables. So, apparently his historical argument doesn’t hold.

A number of studies have shown that a Mediterranean type diet has favorable effects when it comes to cardiovascular prevention. Actually, Dr. Perlmutter mentions the Mediterranean Diet once in his book: “In March 2013, the New England Journal of medicine published a large landmark study showing that people age fifty-five to eighty-five who ate a Mediterranean diet were at lower risk of heart disease and stroke by as much as 30 percent – than those on a typical low fat diet. The results were so profound that scientists halted the study early because the low-fat diet proved to damaging for the people eating lots of commercially baked goods rather than sources of healthy fats. The Mediterranean diet is famous for being rich in olive oil, nuts, beans, fruits and vegetables, and even wine with meals. Although it does allow room for grains, it’s very similar to my dietary protocol. In fact if you modify the traditional Mediterranean diet by removing all gluten-containing foods and limiting sugary foods and non-gluten carbs, you have yourself the perfect grain-brain-free diet.”

Okay, if this isn’t cognitive dissonance I must have completely misunderstood the term. The Mediterranean diet contains whole grains, including gluten, and lots of fruit. These are exactly the things Dr. Perlmutter wants us to skip to protect our brains. But still, he believes it’s very similar to his dietary protocol. Doesn’t make sense to me. Anyway, why should someone switch from a Mediterranean style diet which is supported by a lot of scientific evidence to a grain-free Perlmutter type diet that is based on limited evidence.

A recipe for a best selling health book
Click on the picture for another Grain Brain review: “A Recipe For a Best Selling Health Book”

We don’t have to look further than the most recent issue of the American Journal of Clinical Nutrition to find a paper contradicting Dr. Perlmutter’s claims. The study addresses the associations between The DASH diet and Mediterranean-style dietary patterns and age-related cognitive change in a prospective, population-based study. Higher levels of accordance with both the DASH and Mediterranean dietary patterns were associated with consistently higher levels of cognitive function in elderly men and women over an eleven year period. Whole grains and nuts and legumes were positively associated with higher cognitive functions.

Don’t misunderstand me though. I’m not saying that Grain Brain is necessarily a bad book, although personally I had huge problems with it. It touches on a number of important issues relating to obesity, diabetes, brain disease and heart disease, and there certainly are some good healthy tips on nutrition and lifestyle in general. However, in my opinion, it is too biased to be taken seriously. I would have preferred if Dr. Perlmutter had addressed his issues in a more balanced manner. In my opinion “Grain Brain” should definitively be taken with a grain of salt.

Remember that Alzheimer’s disease has many risk factors, some are known and some are unknown. Maybe a grain-free high fat diet according to Dr. Perlmutter is more likely to prevent Alzheimer’s disease than a Mediterranean type diet or a typical “heart healthy diet” low in fats. However, until a scientific study comparing these diets has been performed, we don’t have they answer. Until then, nobody can claim to know what’s right or wrong.

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bill
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bill

“…Mediterranean style diet which is supported by a lot of scientific evidence…”

Sure… Lots… …and remember all those
‘golden waves of grain’ surrounding
the Med? Just which country had those?

You just go right ahead and eat your grains.
Many of us out here have found great benefits
to excluding them from our diets.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Bill. This is exactly the issue. Everybody has to find their own way when it comes to dietary choices. Many people eat grains and fruits and feel great. Others feel better by skipping the grains. I’m fine with that. Never said that skipping grains is bad. Never said I eat them either. Let’s not get emotional about it though 🙂

Kevin
Guest
Kevin

Then what the hell are you saying? Do you eat grains? I like to know how the doc leads his personal eating habits so I can determine his immediate personal bias. Sounds like someone that does not want to change his or anyone else’s eating habits no matter what emerging science and technology are telling us.

Mark
Guest
Mark

Doc, one of the issues I experienced with the Paleo diet was a sharp increase in stressed kidney function. This was after six months of highly monitored and faithful adherence to the diet. Contrary to the claims of Taubes and others, LDL did not decrease significantly, though triglycerides did drop significantly. This was likely a function of the decrease in sugar intake. The significant strain on my kidneys was a bit of a scare and so I modified my diet back to a more balanced approach, though I have cut out refined carbs. I also don’t drink, which can contribute… Read more »

Julie K
Guest
Julie K

Thanks for your article. It made me realize I definitely experience cognitive dissonance. I am very much anti-grain and firmly believe cutting wheat and refined carbohydrates out of a diet can only improve overall mental and physical health. But I am happy to have a reminder to make to critically interpret and evaluate information presented on this and all other subjects. Thanks again for your helpful comments. Cheers!

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Julie. I respect your opinion. Many individuals feel better by skipping grains and carbs. Actually I’m generally in favor of that approach as you can see elsewhere on my website. In fact cognitive dissonance is very normal. But being aware of it, as you are, is important.

Robin Willcourt
Guest

The issue with finding the right diet is to look at the original diet. It is likely, but not certainly, to be the correct template for our modern foods to follow. By saying that some people can eat grains and fruits and seem to alrigbht, does not make them alright. I take that to mean that some people can cope better than others with grains and fruits but that is not an necessarily an optimal state of affairs. The truth is, we have to be able to explain why there are 400 million diabetics on the planet when based on… Read more »

Bob Johnston
Guest

Where is the like button? Excellent post from Robin Willcourt.

Cassie Bond
Guest

Hi Doc, Cognitive dissonance is happening all the time. A human being is cognitive dissonance. Humans keep thinking they are going to live forever and not get sick – this is patently cognitive dissonance. Well it must all be placebo effect with my husband when he began taking coconut oil, after getting more and more distressed and depressed about his memory lapses, he said it was like coming out of a fog. We decided to go full Paleo as we believed this would help the brain even more by providing even more ketones. When he lapsed on the diet at… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Hi Cassie. It’s great that you and your husband have found a dietary approach that has improved your health. I wish more people had the courage and discipline to try different options when it comes to diet. Although I have some problems with Perlmutter’s approach in his book, I have nothing against Paleo or carbohydrate restriction in general. Indeed if you look through my blog you can see that I’m certainly in favor of these approaches for the overweight/obese or those with metabolic syndrome. However, when reading books on health related issues I prefer a balanced, informative approach where I… Read more »

Raphi789
Guest
Raphi789

By your standard “until a scientific study comparing these diets has been performed, we don´t have they answer. Until then, nobody can really claim to know what´s right or wrong” – why even have a blog then?
Since when is “science” only “scientific studies”? That is a quite shallow view

Jaco Brand
Guest
Jaco Brand
Mie
Guest
Mie

Cassie, there simply isn’t any way of inspecting & examining oneself with the kind of accuracy and reliability that is required in scientific studies. In other words, the effects you mention could be due to placebo, coconut oil or a number of other factors.

Kevin
Guest
Kevin

Really Mie? Elimination and introduction one at a time over time isn’t close for a “study” on oneself? Hmm, seems when something is approved by studies, like SSRI’s for example, then a patient still must try it out to see if it affects them like others in the study or whether they need a different one even though the studies say one should be better for them than the rest. Thus the opposite can be true, that testing on yourself can be far better at determining effectiveness of many items for an individual.

Travis
Guest
Travis

Population studies are crap. They prove nothing. One of the biggest problems in nutrition is the slave-like devotion to epidemiological studies. Worse, these nutritional epidemiological studies are notorious for mis-reported self-reporting of diet. Anybody who has spent time looking into knows the mis-reporting is so bad, making any conclusions from them (even as hypotheses for randomized, controlled studies) is, well, impossible. My point is Perlmutter’s cognitive dissonance is very minor compared to the nutrition field as a whole. Do I think he got everything right? Of course not. This is very new science. But to fall back on the piss-poor… Read more »

bill
Guest
bill

That’s what I was trying to get across:

“…nobody can actually define this
miraculous Mediterranean diet”

…but it certainly didn’t/doesn’t contain
many grains.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

This is how the Mediterranean diet was defined in the ATTICA study and most other trials: “A diet rich in fruits, vegetables, legumes, whole grains, fish, nuts, and low-fat dairy products. Fat consumption is generally around 40 percent of total energy consumption, compared to ca. 70 percent in Perlmutter´s diet.

Raphi789
Guest
Raphi789

“rich” is a relativistic term as it is being compared to other diets that can be qualified as “lacking” (ex. DASH)…the whole grains in the Med. diet nowadays are NOT prepared traditionally and are eaten in much bigger quantities than they would’ve have even in the recent past

Mie
Guest
Mie

Raphi, repeating an irrelevant point over and over again doesn’t make it relevant.

Axel, your well-written blog post has indeed brought out cognitive dissonance in many of the people commenting here. Good job. 🙂

Kevin
Guest
Kevin

And Mie, you top the list. Another lame comment, especially the “well-written” part. 🙂

Jen
Guest
Jen

Low-fat dairy is not consumed in the Mediterranean, and has only existed for a short time. It seems that biases (maybe unconscious) exist in everything, and the idea that low-fat dairy is part of a mediterranean diet seems like some sort of bias since we’ve had it drummed into us for so long that low-fat dairy is healthy. Heard of Greek yogurt? I mean real Greek yogurt, not the americanized versions with thickeners etc. Mediterranean dairy products such as cheese, yogurt and milk (from cows, goats, and sheep) are full fat! (also this is healthier, contrary to what we are… Read more »

Kevin
Guest
Kevin

And historically didn’t many of these studies involve cultures that exercised or moved around daily far more and thus a higher percentage of carbs was needed and were used quickly and entirely by their bodies as compared to our obese society that eats a larger percentage of carbs while being far more sedentary. And much of the shorter life expectancy of the past was due to the lack of antibiotics, medicines, and the technology we have today, not their diet (and additionally includes the huge infant mortality rate of the past that we do not have nearly as high today).… Read more »

Mie
Guest
Mie

Whenever a person dismisses a particular line of evidence or type of study outright by using cliches such as “we-don’t-know-nothing-because-of-misreporting”, alarm bells should go off. This is precisely the case with Travis’ post. Of course, it isn’t simply the case of misreporting (which, as Travis should have realized, itself has been studied and the effects can be quantified to some extent), but also the case of RCT evidence suggesting that Mediterranean diet is indeed healthy. Ever heard of Lyon Heart Study? PREDIMED? As for Mediterranean diet (as defined and studied) not being rich in grain produtcs … Please. Go read… Read more »

Kevin
Guest
Kevin

Mie, your comments are mostly lame and biased, like this “doc’s” blog. Glad he is not my doc. You two stay with the old data that created an obesity epidemic and I’ll side with the research that is emerging and making far more sense. Mie sounds like the doc who only believes what she thinks and never believes there could be people/patients more informed and intelligent. Remember, every profession has plenty of unintelligent people. And if Perlmutter is mostly correct then how embarrassing for so many of you that espoused the wrong information and put your patients in a worse… Read more »

Mark
Guest
Mark

Kevin, you’re just trolling now. If you don’t agree with the doctor, fine. You made your concerns known in your first comment. Now you’re just using ad hominem attacks (i.e., bullying) to support your ideas. Write your own blog if you’re so sure there’s a conspiracy of wheat eaters out there, but please quit bashing people who actually provide names of or links to studies that reasonable people can use to make an informed decision about their own lives and food choices. Believe it or not, it’s ok if not everybody agrees with you and Dr. Perlmutter.

Weave
Guest
Weave

I was gluten and dairy free for two years, trying to control chronic migraine which many suspect to involve inflammation. It did not help me in any quantifiable way. My migraines continue at the same rate/duration/ and intensity and the accompanying body aches and brain fog are unabated. Does that mean it doesn’t work for everyone? No. But, my experience leads me to question the vast claimed benefits of a gluten free diet.

Robin Willcourt
Guest

Great point Travis. The so-call Mediterranean Diet is an invention- a fantasy. I have asked many Italian and Greeks who lived on the islands and seaports just before and after WW2 what they ate and it is not the Mediterranean Diet! The real Mediterranean diet was mostly fish, more fish and some chicken and goat/sheep Small servings of a pasta came first and though bread was eaten, the total amount of grains was far less than in the “Mediterranean Diet” proffered by the USDA. I have over 80 people eating a “Leangains” type of pattern (see Martin Berkhan or Andy… Read more »

Kirk Bloomer
Guest

Isn’t all opinion basically cognitive dissonance anyway?

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Could be. Unless you are ready to look into every corner in search for the truth, not only seeking things you want to find on order to support your opinion, but everything else as well.

Kevin
Guest
Kevin

Listening to the “Doc’s” comments are like listening to those that say global warming is not happening and giving that less than 1% of scientists equal weight. Then you say we really don’t know for sure. The emerging science clearly points away from high carbs and gluten, so we’ll move forward while Doc and Mie remain in their past.

Janknitz
Guest
Janknitz

I see the same sort of cognitive dissonance when the meat, fish/seafood and animal fat in the Mediterranean, Okinawan, and Kitavan diets, and full fat dairy in the Mediterranean diet are ignored. Some people would have us believe that Mediterraneans rarely ate meat or fish, and the Okinawan and Kitavan diets are vegan, when they most certainly are not. Hungry people don’t keep pigs for pets (nor fowl, sheep, goats, or cattle)and people surrounded by the sea most certainly enjoy it’s bounty. In The Splendid Table podcast #519, host Lynne Rosetta Casper says there’s a “Clinker” in the theory that… Read more »

Raphi789
Guest
Raphi789

Living in the South of France (both at sea level & in the mountains) I second Janknitz’s opinion as regards the actual Mediterranean diet (not the theoretical one).
Simple thought experiment: if people eating a Mediterranean diet were forced to eliminate 1, 2 or 3 elements of their diet? Which would they choose? I doubt you’d hear “yes, please take my fish/meat/or raw dairy so that so I can keep grains and a little fruit”…

Mie
Guest
Mie

Answer to your simple though experiment:

It is meaningless in itself.

Kevin
Guest
Kevin

Just like your comment Mie, meaningless.

Mie
Guest
Mie

This “Some people would have us believe that Mediterraneans rarely ate meat or fish, and the Okinawan and Kitavan diets are vegan, when they most certainly are not. Hungry people don’t keep pigs for pets (nor fowl, sheep, goats, or cattle)and people surrounded by the sea most certainly enjoy it’s bounty.” and “Lard was the subsistence food for many, only wealthy Mediterraneans had the luxury to consume olive oil in quantities. The theoretical Mediterranean diet for health is not what true Mediterraneans traditionally ate.” this are excellent examples of people focusing on something meaningless when there’s an important message to… Read more »

Peggy Holloway
Guest

This is anecdotal, n=1 family, but in my extremely insulin-resistant family, eliminating most carbohydrates has resulted in reversal from a plethora health issues including ADHD, anxiety, insomnia, depression, eating disorders (bulimia and anorexia), chronic fatigue, obesity, and pre-diabetes (reactive hypo/hyper-glycemia). In my case, a ketogenic diet has proven to be nearly miraculous in improving my health and giving me phenomenal strength and energy along with keeping my weight at an optimal level while eating to satiety at every meal. I am nearly 61 and feel better than I did at 40 when I was eating “heathy whole grains” and restricting… Read more »

Kevin
Guest
Kevin

No comment from Mie telling you that you really didn’t experience these benefits?

Christopher Palmer
Guest
Christopher Palmer

When you the steps with the intent of arriving at destination that is no more than a few steps away the stance you’ll finish up with will be a function of which foot you led with. Can I suggest you give thought to whether you always begin from the same spot, and whether you may do better leading with the right, instead of always leading with the left? To help: The relationship with saturated fats in the diet and with lipoproteins in human physiology is one which is essentially adaptive. The numbers don’t matter, they’re ar merely the evidence of… Read more »

Doug Beard
Guest

I’ve spent quite a lot of time in Spain from the north to the south, particularly on the Costa del Sol ie on the Mediterranean, ate a lot of chorizo, Serrano ham, pork, chicken, beefsteak,fish and seafood, I can’t remember a damn thing that was whole grain, does paella count, there was white bread, ate tons of salad, but vegetables usually were the bottled vegetale mixta.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

I think we can find all kinds of diet in the Mediterranean countries. However, in terms of nutritional research the term “Mediterranean Diet” covers a certain definition. It is well outlined on the OLDWAYS website here.

lee
Guest
lee

Since when is corn part of the traditional Med diet? It’s on the Old ways list!

Cp
Guest

What? My family is from Leon and they eat a ton fuck of bread as well as carbs.

Doug Beard
Guest

I’ve read Oldways notion of a Mediterranean diet, it seems more of a wish list, a blend of smoke and mirrors to hide the enormous amounts of saturated fat in their everyday diet, from full fat hard cheeses, lardons in casseroles, lamb fat in stufado and moussaka and cured meats and sausages, chorizo, salami etc. Drinking wine in the sunshine, and considering manana to be not a contract, but merely not today. A combination of good real food, full of fat, good wine and good company in a warm climate with low stress, no wonder they are healthier!!

Superchunk
Guest
Superchunk

I agree that it sounds like Grain Brain may take a core kernel of truth and exaggerate it beyond its true relevance, which may be as much a reflection on the nature of marketing books as anything else, however there seems to be a lot of at least indirect evidence that wheat is a problem in general and likely not worth the risk of eating it. I looked at the AJCN study and it seems like a stretch for them to say that wheat in particular is actually protective. I don’t see how they could have isolated that as an… Read more »

Mie
Guest
Mie

“It’s also interesting that the evidence from Egyptian mummies is that they had very poor health similar to modern western diseases, and they apparently ate a diet that was heavily wheat-based. There is a good article on Dr. Eades blog about that.” Dr Eades and “good” don’t go together very well. 🙂 Anyway, when looking at archaeological evidence, you’d do well to bear in mind that e.g. rich Egyptians also exercised very little, ate more animal products and refined products than most of the population etc. etc. Therefore isolating wheat per se as the main source of problems is a… Read more »

David Harley
Guest

I’m not as educated as most of the people commenting here but have spent a lot of time doing ‘research’ into LCHF diets. The anti-carb movement seems to be moving about as slowly as the anti-tobacco movement did initially. However there does seem to be more and more evidence supporting the fact that carbs are unhealthy at best and possible even dangerous. The problem I see is that governments are going to be very reluctant to admit they were wrong and sadly the this will mean more deaths relating to obesity and diabetes. That is the saddest part for me.… Read more »

Mie
Guest
Mie

Of course David, you neglected to mention that the difference between anti-tobacco and anti-carb movements is that only the former is based on solid evidence.

I’ve yet to see evidence pointing out that whole grains or legumes or fruit etc. are dangerous.

Raphi789
Guest
Raphi789

You never will see evidence that they are dangerous. They are not. Our species is simply very poorly adapted to the large majority of grains, to a lesser but similar extent to legumes as well. What fruit are we talking about? How much? Seasonal berry consumption or bowls of apple, oranges and melon?

Mie
Guest
Mie

The argument of adaptation often comes out, but – yet again – without evidence. There’s nothing in epidemiological evidence or RCT data to suggest that.

But of course, if you happen to be an exception and can actually provide proof of this, I’d be happy to hear it.

Kevin
Guest
Kevin

Mie, you are a relic of the past. Good luck. 🙂

David Harley
Guest

Of course, but I’m sure the tobacco companies said the same at the time. In fact, didn’t doctors advertise cigarettes at one stage? (Which reminded me of statins but don’t get me started on that ) 😉

Mie
Guest
Mie

David, don’t worry. Judging from your squirming tactics, you’re obviously a “man of faith” and therefore I’m not under any false assumptions concerning the nature of your beliefs.

Kevin
Guest
Kevin

His beliefs have far more accuracy than most of the comments I have read from you Mie.

Kevin
Guest
Kevin

Fruit is dangerous? Typical Mie b.s. “Good” and Mie don’t go together very well either. Sugar is the culprit dummy, so you eat far less fruit with a higher sugar content. You miss his whole point Mie, but I’m not surprised after reading your other comments.

tobi
Guest
tobi

Doc Sigurdsson,
While I have my well-investigated dietary ideas and opinions, I know that ultimately, I could be right, I could be wrong.
More importantly, though, I’d like to compliment you on your patience and good humour in responding to comments. You are a model of courtesy and supportiveness. Thank you for that

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Tobi. Appreciate your kind words.

Tom Dolan
Guest
Tom Dolan

Some strategies work for everybody. Most do not. I don’t know which nutritional tribe I belong to but am increasingly aware of which foods do and do not agree with me, thanks to what I call a compass in my gut. Now 80 years old, I’ve been using trial and error to identify which foods contribute to well-being and which ones disturb sleep or otherwise make me feel unwell. First to go were high carbs, then caffeine, alcohol and grains. Most recently I’ve given up dairy products, though I long suspected they weren’t good for me. Even fruit had to… Read more »

Richard lowfat4ever
Guest
Richard lowfat4ever

Doc, the working hypothesis among Alzheimer scholars is that saturated animal fats have an important role. Moreover, you failed mention the (perhaps) most important risk factor for Alzheimer’s. Elevated blood cholesterol at midlife. Midlife serum cholesterol and increased risk of Alzheimer’s and vascular dementia three decades later. https://www.ncbi.nlm.nih.gov/pubmed/19648749 Too Much Saturated Fat Tied to Alzheimer’s Risk? https://www.webmd.com/alzheimers/news/20130617/saturated-fat-may-make-the-brain-vulnerable-to-alzheimers There are several exceptionally well studied populations that have extremely high carbohydrate intake and very low levels of chronic disease including Dementia & Alzheimer’s. The popular example may well be the people in Okinawa island. The longevity and heath of Japanese elderly made… Read more »

Hilary
Guest
Hilary

Some researchers are suggesting that sugar (rather than fat) may raise cholesterol levels (Mary Enig, Robert Lustig, Gary Taubes and others). I am no expert at all, but this all seems interesting…

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Remember that, according to Grain Brain, raising cholesterol is good.

Mie
Guest
Mie

One more indication that “Grain Brain” is pure s*it.

Just like 99% of that diet guru, alternative/integrative medicine, paleo etc. etc. nonsense out there.

You could do a blog post on that Axel. Think about it: what could be more important to an ordinary Joe than to learn to recognize pseudoscience from science?

Kevin
Guest
Kevin

Now the true Mie. Many good points backed by emerging science in Perlmutter’s book. The fact you call it this tells me no one here should be listening to anything said by Mie. I know, the globe isn’t warming either and playing football over a lifetime doesn’t lead to huge increases in dementia issues. Stay in the past Mie while the rest of us move forward.

Superchunk
Guest
Superchunk

Hilary, Several things for you.. – There are two podcasts with Dr. Permutter on Livinglavidalowcarb.com and on the one that is part of the ask-the-low-carb-experts series there was a question about half-way through where he explains his point on cholesterol. Neither he nor anyone else I am aware of in the cholesterol world thinks total cholesterol is itself meaningful, but total to HDL is a good predictor of issues, and the real problem is oxidized cholesterol (which I think is the same as small particle LDL but I am not sure.) Anyway, Dr. Perlmutter said that the truly bad cholesterol… Read more »

Mie
Guest
Mie

“he stresses that in his view, truly bad cholesterol of wildly high or low readings are markers for other root cause problems like insulin resistance, and if you fix those, then the cholesterol will resolve itself, but just fixing the cholesterol (such as via statins) doesn’t address the root cause issue.”

Too bad this isn’t the case. Or what kind of “root cause problems” do e.g. FH patients have?

Archie Robertson
Guest

“The Mediterranean diet contains a lot of whole grains”
I live in a country bordering the Mediterranean, with the second lowest rate of CHD in the world, and the diet here does NOT contain a lot of whole grains. The vast majority of grains eaten are refined to within an inch of their lives—and they do not constitute a large proportion of the total calorie intake.

As for Okinawa, the islanders’ nickname for their homeland is not “The Island of Whole Grains and Beans” but “The Island of Pork”. Enough said?

Mie
Guest
Mie

Yet another “anecdote warrior” surfaces.

I can’t hep but wonder what people like you hope to achieve with such displays of problems in reading comprehension.

Archie Robertson
Guest

Mie, your own comprehension is no broader than the pig wallow between your ears. When you learn how to participate in a civilised discussion, let us know.
But I’m sorry to have have had the temerity to question Axel’s wisdom…

Kevin
Guest
Kevin

Mie, you are lame. Hopefully you never get to treat any real patients. Thankfully all of your comments help “Doc” lose even more credibility.

cavenewtt
Guest
cavenewtt

“The dietary approach in this study was to switch the treated group to a Mediterranean style diet and to add supplementary alpha-linolenic acid in the form of an enriched margarine (free of trans-fats) thus increasing the n-3 content of the diet. This study, known as the “Lyon Diet Heart Study” underscores the importance of the n-3 essential fatty acids in connection with heart disease.”

So the Med diet was supplemented with something extra.

https://www.yourhealthbase.com/archives/engdec02.html

craig
Guest

I’m having a bit of cognitive dissonance right now. I went from Paleo to HFLC and my ldl’s went through the roof, i.e. 356! my ldl particles were 1650. that’s not good. many of my parameters were good, but not ldl’s, total cholesterol or PLAC test for vascular inflammation. Now I’m not sure what to do. I was eating between 1.5 to 3 lbs of animal flesh daily. perhaps that was too much. I clearly have to do something different, and i guess that means less fat and more healthy carbs? any suggestions?

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Craig. Some individuals on a low carb high fat diet respond with a dramatic increase in total cholesterol, LDL-C and LDL-P, in particular if high amounts of saturated fat is consumed. This is indeed not very uncommon. However, it is unknown why this occurs in some individuals but not others. We also don´t know what this means in terms of risk. However, the only way to improve the numbers is to reduce saturated fat consumption.

Kevin
Guest
Kevin

The ONLY way? Are you positive about that statement?

Jason
Guest
Jason

Some good points raised in the critique, but I question Doc’s fruit claim. In non-tropical latitudes, fruit is only available to hunter-gatherers for a very short period of time. What would the source of carbohydrates have been for the other 9-10 months of the year???

Kim
Guest

The comments here remind me of the discussions we used to have in my health statistics class in college, back in the day. Nothin’ like a healthy debate> lol…. I liked the book, not because I interpreted it as biblical law but because it prompted me to be more thoughtful in my eating habits. That’s all.

Tracy
Guest
Tracy

Okay, to start off pointing out that the author of the book claimed in an interview that: [99.9 percent of humans existence on earth was sustained sans carbohydrates] and then challenging the statement by reminding us readers that we ( humans) have consumed fruits and vegetables (since practically forever HELLO) is exactly why the book should be read with a “grain of salt”. There is so much human suffering in the world, And often people are quick to try the next great idea/ theory/concept, hoping for some relief. If practicing the suggestions given in the book “Grain Brain” enriched your… Read more »

Kevin
Guest
Kevin

I think your statements are incorrect. Please provide your links to all this public contradiction you allege. You keeping eating lots of carbs and gluten, and I’ll keep feeling way better without them.

Mark
Guest
Mark

Man’ you are a piece of work.

gayle63
Guest
gayle63

Coming a little late to the party here, but I just started reading The Grain Brain yesterday. I find it very interesting. Fortunately, I already have a really good diet that includes nuts, lots of veg, some fruit, and although I don’t eat meat or fish, I do eat eggs (we have our own spoiled hens in our backyard) and cheese on occasion. I agree with the Doc that we won’t know if the hypothesis of the Grain Brain is true unless there is a long-term study. It would have to involve many people over many years into their dotage… Read more »

Ryan
Guest
Ryan

Doc, I respect the fact that you are the only person I have found thus far to offer a scientifically presented counter-argument to ‘Grain Brain’. I appreciated your insights and professionalism. For my own take, I think it’s odd that while people are touting all these ‘original’ diets that existed before grains came into our every day lives, they ignore the higher mortality rates of the people who lived in those times. Can that mortality rate really be contributed only to the fact that modern medicine’s (which apparently is as worthless as our modern diets) impact on our lifespans? The… Read more »

Robin
Guest
Robin

You are right. Producing toxic alien grains is really cheap. That does NOT make them good. Forget the effects of grains on the body (elevated triglycerides, IBS, inflammation etc) but look at the environment. Massive swathes of land have been destroyed with the ecosystems shot to pieces in order to grow grains etc. This is a catastrophe. The real problem is US- There are far too many humans on the planet and we are destroying it to produce cheap useless polyscaccharides. The balance of animal to grass is what has made the world ecologically stable. We, humans, have blown it.… Read more »

Robin
Guest
Robin

Okay, forget Grain Brain. There is ample evidence that grains have not helped ONE bit, the onslaught of modern diseases. They HAVE kept people alive, though I think that the evidence strongly suggests a negative role in people’s health. It is no coincidence that the human race was physically worse off after the widespread introduction of grains, I onlay have to look outside my window to see the effects of the modern diet. It is appalling!

Nessa
Guest
Nessa

Thanks Axel, for braving your opinion. I listened to Perlmutter on tv. last night and noted the camera shots of adoring, admiring faces nodding and oh so ready to idolize this next great diet guru. Like you, I thought, “he must be selling something”… or “poor old guy, he just wants to be worshipped…”
There was not a mention of the genetics of Alzheimers, or the recognition that advancing age is a factor because we weren’t designed to outlive our fertility. And his proof was laughable. Such is science in America…

Axel F. Sigurdsson
Guest

Thanks for the encouragement Nessa. Appreciate your interest and your comment as well.

Richard
Guest

Go to love Paleomorons, always so sure of themselves. They’re the same type of people who in the 80’s admonished anyone who dared eat a fat filled, artery clogging avocado. Besides, don’t you guys know that paleo is so mid decade? All the coolest health nuts have moved onto something else. Look, If a low grain diet helped you in some way, great for you. But please don’t shove your dietary dogma down everyone else’s throats. The whole paleo idea is interesting, and no doubt useful in certain circumstances. But it was never close to anything paleolithic, that’s a pure… Read more »

Art Roberts
Guest
Art Roberts

After reading all these comments….. Almost every diet book I’ve ever looked at seems to have ‘scientific’ study references showing that it is the only correct diet. If you pay attention to health related TV and magazines, you could end up taking hundreds of supplemental pills every day. If you want to show that Paleo, or Adkins, or Mediterranean diets are bad, you can find studies that will support pretty much any diet you want to support. Time after time, I hear that caloric restrictive diets are the only answer, yet many of the textbooks used in Nutritional classes state… Read more »

Robin
Guest
Robin

It is clear that a disaster has occurred to all westernized consumers of food. So, eat what you feel like is not working. Scientists may be honest or not so many published studies may not be factual. This is confusing but one thing is certain, we are not eating correctly and that IS a fact.

Tara
Guest
Tara

I think it’s all a grand personal experiment. My husband and I thrive on different diets. I feel better with fewer carbs and little to no grains and he is the opposite. We mostly manage this by eating different portions of the same foods. But what we do have in commmon is our passion for quality. We choose pasture raised over grain fed animals, we choose organic over conventional produce. We have a tiny pantry for things in cans and boxes and have multiple fridges and freezers for real food. We cook our our own meals 98% of the time.

jack depalma
Guest
jack depalma

what do you’all think of confirmation bias…selecting those “facts” that confirm your beliefs as true and ignoring those details that maybe contradict your opinions. not cognitive or dissonant, just masquerading as (pseudo-) scientific. good health and good nutrition are both multi-determined and obviously over-discussed phenomenon today and far more complex than what I can know of using any science I know (BS Physics and MS General Science) and any available information as public/research statistical studies or the newspapers may generate and report. too much info (and money) from too many sources about too many diverse issues is going to complicate… Read more »

Brad Steinemann
Guest
Brad Steinemann

Well I have read high carb diet gurus Esselystyn,Cambell, Ornish and low carb gurus Atkins,Agatston,Perlmutter ect. Perlmutter says fruits are seasonal, this can be true in some areas but not in tropics and subtropics. For me, without a doubt low carb is better and results to prove it with having better energy and proper weight. The wheat argument saying the ancestors ate no wheat. Well in the Hebrew scriptures going back 4,000 years ago they made bread. “Take also unto thee wheat, and barley, and beans, and lentils and millet, and spelt and put them in one vessel…” Ezekiel 4:9… Read more »

Julie
Guest
Julie

Good point Brad! People tend to get so worked up arguing over which diet is truly the best and which “expert” is telling the truth. At the end of the day we are choosing to eat various diets in order to live long and feel good. I’m definitely of the mindset that low carb is a healthier choice than low fat/high carb, but I also pick and choose tips from various other diet theories and apply them to my life. If they work, I stick with them. If not, I chuck them. Thanks for your comments.

Mac McJunkin
Guest
Mac McJunkin

Eat food. Not too much. Mostly plants. Michael Pollan

robert
Guest
robert

thanks doc and everyone else for their insights and wisdom – helps for a better perspective of all sides-

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