Category: Grain Brain

Anti-Alzheimer's Trio: Avocado, Grass-fed Beef, Avocados

The Anti-Alzheimer’s Trio

During an appearance on the Dr. Oz show two ago, I was asked to highlight what I would consider to be the three items we should all be working into our diets more frequently to help support better brain health. Not knowing how popular it would later become, I outlined my “Anti-Alzheimer’s Trio,”  three foods high in “brain-healthy” fat including:

  • Grass-fed beef
  • Avocados
  • Coconut Oil

These items are all low in carbs and high in fat, helping to reduce some of that brain-bullying inflammation the root cause of so many ailments. Specifically, coconut oil is known as a rich source of beta-HBA, is one of our brain’s “superfuels.”

You may want to know why I highlight grass-fed beef instead of all beef, and the reason is simple: cows that are fed grains instead of grass have meat that becomes higher in inflammation producing omega-6 fats than their grass-fed counterparts. In addition, the corn and grain fed to cattle is overwhelmingly genetically modified, and this introduces worrisome proteins into non grass fed meat. It may sometimes be a bit more expensive, but it’s smarter to buy grass-fed when you can. Also, keep in mind that a vegetarian diet is perfectly consistent with our program. There is absolutely no requirement to eat any animal products whatsoever. What matters most is to be sure your food choices are low in carbohydrate and supply plenty of brain-healthy, heart-healthy fat.

For more information, order your copy of Grain Brain today and join Dr. Perlmutter’s email list.

  • Jan in KW

    I love your trio….and fortunately we have a bumper crop of avocados this year!

    • David Perlmutter

      I love the trio too! Hope you’ll enjoy those avocados!

  • Arorsa

    “There is” …. not “their is”

  • dmiller3194

    Yes. This. Although I can’t help but be annoyed at the very mention of Dr. Oz. Oh well… Good stuff…

    • David Perlmutter


  • erin b

    Oh what a leap of faith I am looking at.
    So many years of avoiding fats, high caloric counts in these type of foods.
    I see it and read it, and am trying so hard to believe it.
    It has always been beaten into our heads; low fat, no fat, no red meat and egg yokes are bad, and absolutely no oils. It is still being taught and talked about. Many doctors push low fat, that it is a must.
    You say in your book not to count calories, even at first? There is no guideline, no calorie counting, really?
    Stay true to the plan, follow the math and all will be fine. Weight will come off and health will get better or even return…could it be that easy?

    • David Perlmutter

      So there you go. Keep up posted Erin.

    • Karen Ferguson

      Leap of faith…you are soooo right. I couldn’t think, foggy thinking, depressed and overweight, big time. I thought I was doing good enough NOT to go on anti-depressants and I’m grateful I didn’t!! But my diet!! Ack!! I now attribute it to sugar/flour. If I relapse a bit, I just get back on the program and do it!!
      Sometimes its not easy, but eating right , hands down, beats junk/processed food. Don’t fall for the “moderation” promotion either. Propaganda. Sugar sets up a craving for more sugar [and flour which turns into sugar]. That’s miserably.
      The Doc is right…just give it up.
      BRAVO to you!! You won’t be sorry.

    • Allison

      In just 3 months of this protocol, my husband lost 40 lbs, is no longer type 2 diabetic, has great triglyceride #’s & has changed his LDL cholesterol from dense, dangerous pattern B to the healthy, buoyant pattern A. What I love is that I have the before & after detailed test results to prove it. I understand the leap of faith. I used to be a fat phobic “healthy” whole grain person too!

      • David Perlmutter

        Wonderful to hear of your husband’s healthful results!

        • Allison

          Thanks so much for commenting, Dr. Perlmutter! We owe it all to you and additional Paleo oriented experts. M.D.’s sharing this expertise is critical for skeptical people to even consider that conventional ‘wisdom’ has been misguided. My husband and I both have extra copies of your book to lend to friends & people at work. Keep the great info coming!!- Allison

  • Guest

    I recently took an Organix profile lab test. I came out with “high ethylmalonate”… the doctor says this means I have trouble metabolizing fatty acids. Would the high fat diet be ok? On a side note, I also have Parkinson’s

    • David Perlmutter

      I typically recommend a very low carb high fat diet to our Parkinson’s patients

      • anagirl

        yes, but even for someone who has a problem metabolizing fats?

  • Carrie Gordon

    I just got back my cholesterol levels and my total has gone up 24 overall to 241, in one years time. LDL has gone up, triglycerides are low and HDL are above range. I have been eating coconut oil, eggs, all the ” good fats” you promote in your book. Should I be concerned about this 1 year jump up in levels, or should I be rejoicing? Please tell me, they tell me to stop with saturated fat, which is only the coconut oil and red palm oil. I use evoo, walnut, sesame, avocado. I’m a follower of the plan!

    • David Perlmutter

      You might consider asking your doctor to check your A1c as well as OXIDIZED LDL as both have an important bearing on heart and brain health. It will also give you a metric as to how well you are on the low carb scale.

      • Kelly

        Aren’t avocados high in omega six fats?

      • Michelle

        So is non-hydrogenated palm oil acceptable?

    • Allison

      Total cholesterol # is a pretty worthless # on its own (unless you have rare familial hypercholesterolemia). What matters here is is not even your total LDL #, but whether your LDL cholesterol is fluffy, large pattern A (Good)! or dense, small dangerous pattern B. Get tested for LDL pattern. Sense you have been following Grain Brain, I would be absolutely surprised if you have the bad pattern B. The “acceptable” LDL # total (By conventional medicine standards) has recently dropped. According to the new standards, my husband & I “should” both be on a statin. But, we both have the good, fluffy pattern A, So, we respectfully told our family practice that we would not be taking statin drugs. (Showing up at an appointment with cholesterol info from a M.D. like David Perlmutter or Stephen Sinatra arms you with info to back up your knowledge. Remember, most info. your M.D. relies on is provided by pharmaceutical companies, & not necessarily in your best interests to comply with.

    • Colette Houle

      Did you ever get answers re NRF2 question & others on Dr P’s discussion?

  • Anthony W

    I am vegetarian,have not eaten beef since 1976.
    What do you suggest for those of us who are against eating meat and animal products?

  • Ana Corton Migos

    if a person has “high ethylmalonate” and a problem metabolizing fatty acids – will following this diet pose a problem?

  • Rachael Reed

    I saw you on Fox news this morning. As a student pursuing neuropsychology, and the daughter of a mother suffering with AD, I would love to know more about your research that lead to this. Every generation on my mother’s side of my family as far back as I can remember, all had AD. Needless to say, that is a major focus of my interest.

    • David Perlmutter

      Rachael: Wishing you the best of luck with your studies. Take a look at the “Science” section of my website, it should have some helpful bits of research for you. http://www.drperlmutter.com/learn/studies/

    • David Perlmutter

      Rachel, this is an interest of mine both professionally and personally so I know where you are coming from. This is why I wrote Grain Brain. This information must reach the public awareness.

  • Sarah Rainbolt

    I’ve just started reading Grain Brain and am in the inflammation section at present. I have had MS 18 years or so and my husband and I are looking to follow what you say on becoming gluten free. Not being so concerned about cholesterol etc… I am seeing a Naturopath who has taken me completely off dairy already and I’m trying to find things I can get the same enjoyment from. It’s a struggle especially as I read how you suggest butter an ingredient I’ve long loved. I recently found Melt a butter alternative which we’ve come to really like an some soy based products to use in place of cream cheese and sour cream. I’m hoping to find more tasty recipes I can indulge in as I am such an eater that I’ve called myself a “Food Slut.” Perhaps your system will make me a Gluten Free Slut?…

    • David Perlmutter

      Not sure I’m comfortable with the nomenclature, but I’m all for gluten free.

  • Maureen

    Have any studies been done using this diet and people with MS?

  • Kay Greene

    My mother had Alzheimer’s so I am very interested in this diet. I also have severe osteoporosis and have been on 80% vegetable and fruit diet with 20% protein, and 4 Tbl coconut oil daily. How will this diet affect the osteoporosis?

    • David Perlmutter

      This is what we do for our patients, along with ensuring there is adequate vitamin D as measured inn the blood

      • Kay Greene

        Thank you for your reply. I currently take a vitamin D supplement. Are there other changes I should make?

  • Mary

    Am following the Grain Brain suggestions but am unclear as to whether popcorn popped in coconut oil with butter is an acceptable snack. Hope so I love it and its satifying after cutting out sweets.

    • erin b

      I wouldn’t eat it, corn is a grain in my book and to find corn that is not a GMO…hard, very hard to find. He has a recommended list of snacks.
      We need to do the work to get the benefits, read and know the plan for brain health. No food is worth my health or the people I love’s health, either.

      • guest

        There are 3 types of corn: Popcorn is nearly always non-GMO but it could have a lot of chemicals on it. Field corn, however, is fed to cattle or made into corn syrup and is mostly GMO with lots of chemicals. Sweet corn, the kind we boil, may have chemicals but is not GMO. Fairly much all corn will make animals and humans fat.

      • Jan Revers DeVries

        What about organic popcorn kernels popped in coconut oil?

        • Karen Ferguson

          Probably not. I said the same thing: what about “organic rye sourdough bread?” It’s a grain. it has 21 grams of Carbs in 1/8th of a cup. That’s 108 in a cup!!! Cowan, MD put me on 25 mg of Carbs! That’s one small orange. Cowan, MD was right!! That being said, see how you feel after eating it once a month.

    • Karen

      Corn turns to sugar in your blood. This would raise blood sugar and lead to fat and disease and brain shrinkage etc… I keep wanting to reach for the popcorn at night. Hard to find satisfying snacks. I hear ya, Mary.

  • Sue

    I recently finished Dr. T. Colin Campbell’s on-line course for Plant-Based Nutrition. This course has changed my perspective regarding animal consumption & animal products due to the scientific data included in the China Study. Does your book have evidence based science that shows Grass-fed beef will not give the same results as the studies I have seen in the China Study? Thank you kindly for your information.

    • erin b

      The China Study is flawed greatly, one example is the data presented was not exactly honest, with not listing all the countries looked at and only a select few. The full pictured would have changed the outcome greatly.

      I use to believe a lot from these sources as well, when I was a vegetarian. Until I got sick enough to research new science that is not bias, but truthful. Find a non bias resource with no hidden agendas.

      Then decide for yourself what you need to do.

      This plan can be adapted for a Ovo-lacto vegetarian.

      • Sue

        With all do respect Erin B, there were no hidden agendas with the China Study and we are talking about observational studies. There was more data in the research besides regional studies. Are you part of Dr. Permutter’s team? If so, can you answer my question? Is there evidence based data within the book? If not part of his team, maybe Dr. Permutter can answer. Thank you in advance.

        • erin b

          I am just a person trying to get healthy and expressed my opinion with all due respect to you as well.

          • erin b

            Dr. Eades and Dr. Mercola are two more, the list goes on and on. I am too busy enjoying my new found health to go do someone else’s research.
            When it came to my own health I investigated in all directions, and actually checked both sides of the argument. Hard to deny the facts.
            I am worth all the efforts that I made. I am so pleased with what I have learned here, results don’t lie.
            I can not thank professionals like Dr. Perlmutter enough, for stepping away from what is “popular” or “pushed” by agendas, but sticking with science and factual results. It is changing my life!

          • David Perlmutter

            Thanks for your support Erin. Not sure if you caught it, but I actually did a podcast with Dr. Mercola a few months ago. Take a listen: http://www.youtube.com/watch?v=ZABnzXpzRCc

          • erin b

            No I haven’t, but will! Thanks so much for the link.
            Loved you on the Gluten Summit!
            My life is changing and all for the better!

          • Karen

            I just enjoyed the Podcast. You mention that you cannot control the Alzheimer gene. Can you elaborate? Will lowering the fasting blood sugar still be effective if you have the gene?

          • Karen Ferguson

            I second that motion!!! Sally Fallon is a trooper too…from westonprice.org.

        • Steve

          If you want the science read Gary Taubes http://garytaubes.com/ who also looked at this and found the people were not totally honest in there reporting of results and study was flawed. You can also find more information on http://www.marksdailyapple.com as he also has very similar advice to David. The evidence against high carb diets and grains is growing daily.

          • Karen Ferguson

            Steve has nailed it in 2 little paragraphs.
            I like Perlmutter because he keeps it simple. Find someone you trust and can understand. I’m no scientist yet I know who I trust and who I can refer people to if asked.
            I love that fact that this Doc is a neurologist! I love the fact that he finally got fed up and started practicing another way! And, now he’s swimming “upstream” against the grain of the current beliefs…pharma drugs to treat the symptoms, not the problem. It’s not an easy road.
            I still don’t talk about it w/ some people trying raw food and I’m nobody and few care what I think. *chuckle* Hats off to DP!!! It’s a courageous act to be “out there” and go against the grain as a Doc.

        • Karen Ferguson

          You are right….perhaps…who knows…about hidden agendas? That’s why they are called “hidden” I supposed. But just because the China Study has no hidden agenda, doesn’t mean it isn’t flawed. IT’s easy to fall into its theories as those are the prevailing ones….but that doesn’t make it right either.
          Experiment for yourself. One size does not fit all, like I used to think.
          No, I am not part of the Doc’s circle…I’m just one person who has recovered from thinking I could be vegan/raw foodist and couldn’t. And, I thought it was my fault for a long, long time. whew..it’s a miracle I even tried to change..but I was so miserable I had to do something!!

    • Karen Ferguson

      Sue, i read that book, too. I’ve seen Campbell speak several times too. Nice chap! Let me say this: veganism is not for every one. Experiment. I tried to be raw vegan: my brain was foggy, I was hungry. I was overfed and undernourished: fat and starving. Hard to figure, eh?! All I can do is implore you to try Perlmutter’s plan: he’s swimming against the current. He’s going against the prevalent theories and I’m sure incurring
      the wrath of other MD’s. I think Dr. P would agree: MD doesn’t stand for medical deity!!!
      Try it and see for yourself. I recovered from depression and have my brain back without the fog. There are no contra-indications to this food plan, no side effects [except good ones] and nothing to fear. Honest.

  • Carol Anderson

    Hi Dr. Perlmutter I have a question about coconut oil. My internist said not to ingest it – use extra virgin olive oil instead. He said it’s a sham and isn’t good for the body. I have been taking about 2 – 3 tablespoons a day. I don’t have a gallbladder and thought coconut oil is easier to digest???

    • David Perlmutter

      I would say that you are well within your rights to ask your doctor to provide you the research that supports this statement. Look at the science.

  • jspenclj

    I have been taking lipitor and now atvoristatin for more than 10 years. Is it safe to stop taking this drug?

  • mdward

    My husband is a long term type 1 diabetic (since 1968). Of course, he is on insulin shots twice a day and they are based on eating carbs at each meal. Thence, the problem of cutting out carbs. His mother died of alzheimer’s and now his older sister has been diagnosed with the disease. After reading Grain Brain I am anxious to start on the diet, but am unsure how to accommodate my husband’s requirement for carbs. I wold definitely like to cut wheat completely out of his diet. Any suggestions would be appreciated. Thanks

  • Jeff l.

    Dr. Perlmutter, I have been taking statins (40mg Lipitor) for years, diagnosed with 60% blockage in one artery. My cholesterol used to get up to about 270 if memory serves. I just finished your book and want to try the diet. Do you think its safe to get off Lipitor? There’s no point asking my cardiologist. He’s a vegetarian from India and went ballistic when I brought up the Adkin’s diet years ago. Thanks, Jeff

    • Dave Ruoff

      I’m writing a book, myself. I think all side effects of drugs are very cancer causing or should I say all drugs with side effects are causing all of our major medical problems. I hoping to get Dr. Perlmutter permission to use some parts out of his book, GRAIN BRIAN. My medical problem was Spondilolisthesis, I’ve overcame this at 69. My core muscles came back and I’m still playing some golf. Please acknowlege because I’m just trying to help people.

      • Mary mary

        What helped you overcome the spine issue? Is the vertebra back in place or it just doesn’t pain you anymore? I was also diagnosed with that same thing. I had gotten 2 shots to my spine to relieve the pain and inflammation.

    • Karen Ferguson

      hahah…Having been to India, vegetarianism is seemingly part of the spiritual path in that culture, so I’m not surprised. But you did make me chuckle. About 20 years ago, a normal CHO was 250 give or take. Let me say this bluntly: big pharma is in bed w/ our allopathic medicine [traditional medicine]. BPharma got the CHO numbers lowered. What did that do? Created a larger customer base for the product. ‘Nuff said. There are books on this topic.
      Bottom line: Graveline, MD wrote a book on statins. You may want to read it. There are solutions. Try not to stress, okay?! 🙂

      • I’ve been screaming this for years. In reducing the baselines for so many of our health markers, all we are doing is creating an artificially sick population, and a huge new revenue stream for Big Pharma and medicine in general. It’s making us feel that we are ‘bad’ by not following some arbitrary set of rules.

    • Frances Lilian Wellington

      Jeff, bottom line?…you are ‘in charge’ of your direction in health. As to which health practitioners you employ? …which one you prefer serves your best interests is your own choice. Do you have choices available to you?

      As a Kinesiologist, when my muscle testing indicates any dietary changes (small or significant) are beneficial for a client, we take care to make these changes in a time frame that suits the individual (some changes may me immediate, other’s may be over a longer period) so the person’s body can adapt. The specific adjustments (how much & how long for) is determined through muscle testing. I can test up any substance / nutrient / food sample to demonstrate to a client whether that particular substance is beneficial, neutral, or have an adverse reaction at that point of time of the test, as well as determine the time frame when the substance should be re-evaluated.

      I do not recommend a client adjust their medication, as this is not my role (it is the role of the prescribing practitioner, or other suitably qualified practitioner who you consult). Instead I would typically recommend the client have their medication requirements re-evaluated by their prescribing practitioner (or other suitably qualified practitioner) to determine whether the dose can be adjusted, whether the medication is still relevant.

      Whether you choose to follow any practitioners professional advice or recommendation is 100% your own responsibility. It’s your body, after all, so you are the one who has to weigh up the perceived risk in any choices you undertake. Frances Wellington – Kinesiologist.

  • Jeff l.

    Also, my hemoglobin Ac1 was 6 in my last test. Jeff

  • erin b

    Amazing foods, and choices. Be creative, plan ahead, and until you get it down pat, measure, weigh, record and count your numbers.
    My daughter(15) and I just had the best lunch.
    Flax veggie crackers(I made), topped with cream cheese(I made), slice of tomato, slice of avocado, slice of artichoke heart, alternated with a slice of cucumber. The veggies were pre-seasoned with a Sicilian spice blend(I made) and EVOO. 4 each and my heavens we are in love with this lunch.
    Who says you can’t eat vegetables on Grain Brain.
    Be selective and plan ahead.
    Coconut oil in the morning, with an eggs, spinach, mushroom and a bit of green onion. Light lunch including an avocado, so easy to work in. Dinner more vegetables or a salad and a great quality of meat or fish.
    It is so doable and I am reaping the benefits.
    Energy, clarity, sleep, exercising and wanting to exercise!
    My whole family is on board!
    Dr. Perlmutter.
    Listened to you on the Gluten Summit, a great talk!

  • Kay Greene

    What do you think about whey as a source of protein

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  • Kay Greene

    Are soybeans or whey allowed on grain brain diet

  • Scott

    Dr. Perlmutter,
    I enjoyed reading Grain Brain. I have lost about 15 pounds focusing on having a higher percentage of healthy fat in my diet and improving the quality of the carbs(gluten free whole foods) that I am consuming.
    I want to ask if you see a relationship between eating more fiber and brain health.

  • LadyJayTee

    I wish someone would show me a picture of a days worth of veggies comprising the proper number of carbs for per day consumption. I’m visual …I can look at a picture and know instantly, what to do with it and what size portions are the right amount. I think I’m not getting enough carbs & have been suffering severe heartburn with all the fat & protein, because I’m unable to be sure of the carb content & portion sizes of everything else.

    • Karen Ferguson

      I totally “get” you…because I feel the same way. Show me the amount on a plate!! I eat 12 oz of mixed veggies at lunch and 12 oz at dinner. I have a digital scale. I have to weigh it to “get enough.” That will change a little after I lose the weight I gained after falling off my food plan.

    • Susan

      Lady JT- Try some digestive enzymes, and they don’t have to be the most expensive kind either. 2-4 at mixed, complex meals, and with the last-meal-of-the day. Would smaller portions several times a day help? And I wouldn’t worry too much about counting your vegetable carbs as long as you don’t eat potatoes, carrots, yams, beets, parsnips. You will never over-carb on cucs, cabbage or cauliflower! Peas and beans, yeah, maybe. Smaller, more frequent snacks might be in order, too, without mixing too many food types at one meal. I find if the fat is good fat (olive oil, coconut, nut oil), I’m fine. It’s the greasy sausage that I will avoid.

  • Kathy Crockett

    Today is my first wheat-free day. I experimented with some recipes after reading the Grain Brain book. My goal is to reduce residual arthritis pain from inflammation and improve digestive health. Although active and in relative good health, I suffered for 9 months from sciatica pain from a muscle strain until an Osteopath diagnosed the cause.

  • Edward

    Has this diet actually stopped the progression of dementia for someone who already has moderate Alzheimer’s?

    • Karen Ferguson

      Organic coconut oil and AD have a great correlation. Punch it into Google and you’ll find a study maybe two now….

    • Karen

      Good question I want the answer to this one also?

  • Grandma

    My venture into brain health began with my grandson’s diagnosis of fragile X syndrome. He is currently three months old and is on a diet of 100% breast milk, so diet and supplementation is not an issue now. I’m wondering if you know of a connection between diet and exacerbation of frag x symptoms.

  • Maureen McGovern

    What can you tell me about Grain Brain and MD?

  • Nancy Eastin

    I am concerned. Since watching the Gluten summit I think I may have sporadic gluten ataxia. I have been gluten free (and all grains even rice} for over 2 years .I live in a small town in Northern Michigan. Should I look for a neurologist? Cyrax 4 Array? I am reading “Grain Brain.” Any suggestions would be helpful. My cholesterol is elevated for years, 350-450.

  • Diane

    Is organic, deodorized coconut oil as effective as regular organic?

    • Marc Turgeon


  • Charlotte

    I’ve tried repeatedly to take coconut oil but suffer severe nausea for hours afterwords. It doesn’t seem to help if I start out with a small amount and gradually increase over the next few days. After googling this problem I discovered that I am not alone. Do you have any suggestions?

    • Karen Ferguson

      What’s a small amount?? I put mine in hot tea. I know, it’s rather slippery….I wish I had an answer. I use it all over my body and it goes into the pores: I don’t know if that helps me or not. I keep trying though although the texture is rather hard to stomach.

  • doctor hamod

    what do you consider to be an excellent Blood Sugar level?

  • Susan

    I’ve been low carb for almost 2 months, no grains at all, in ketosis almost all the time but I’ve had what feel like “flu” headaches and I’ve been trying to get to the bottom of them. Any ideas? Yes, I drink enough water.

    • Ricecake

      Maybe it’s a healing crisis. Maybe you are detoxing too fast.

      • Susan

        definitely NOT detoxing. I was a very healthy eater before I dropped grains completely, and barely ate a slice a toast a day; whole grain, organic toast from bread I made myself for the past 20 some years. lots of organic and free range meat in my life and good fat, too. I never could eat lots of sugar, pop, fruit, juice. Even a commercially made muffin or a few grapes gave me a mental buzz and I couldn’t think straight. And I’ve needed to think straight through university, etc. So I’m hardly detoxing.

        • Frances Lilian Wellington

          Hi Susan. In the first few weeks of keto-adaption the kidneys switch from retaining salt to rapidly excreting it, along with any excess of retained fluid (water). Ridding excess salt and excess fluid retention is a good thing… up to a point. One needs to replace some of the ongoing salt excretion by adding just an average sprinkle of salt to suitable foods you eat. I have been in ketosis now for 16 months and I still add a sprinkle of salt once or twice a day where I can for this very reason. Adding salt also balances any light-headedness and dizzy symptoms. Expect the salt to take effect within 3-4 days. Frances Wellington (Kinesiologist).

          • Susan

            yes, certainly I noticed I suddenly had a lot of urine to get rid the first week in ketosis, and I did add a little salt to my diet. What I’m describing about having the flu was about 2 months in. I mostly got over it, and wonder now if my carbs got too low. What do you think The carbs I ate came from the nut or cabbage family. Eggs, cheeses, and meat have no carbs. So I might have been very low; what do you think? Also I do a good .5-1 hour work out most days. So maybe a small apple a day, along with not eating 2 hours before bed was all I needed? Can you relate.

          • Frances Lilian Wellington

            My thoughts?..I demonstrate to my clients an exercise that shows them they can rely upon their ‘gut’ instincts regarding nutritional choices…if you sense you would benefit by introducing/deleting (temporarily or longer term) something, follow this natural instinct. Your body will tell you what it needs to obtain all of it’s essential nutrients. Listen. Learn. Adapt. If you sense an apple… then that’s what is going to supply what you currently need. At times I have re-introduced this or that for as long as I felt my body will benefit, whilst still remaining in ketosis… at times I have created a ‘plateau’, other times I go “full steam”. Even at times when I have come out of ketosis, I know how to ‘switch’ myself again. Two things I’ll mention… if you have access to a kinesiologist, the trigger of the imbalance causing your headache can be readily identified and addressed. The cause may not be what you assume (it may not be nutritional). Pain that’s been around for more than six weeks usually has an underlying emotional component involved. On a personal note, I get ‘stuffy sinus’ and flu’ish feeling at times when I am not enjoying myself. My remedy is enjoyment. Enjoying food, enjoying everything I involve myself in.

  • Regina

    I get terrible gastric distress when I eat whole eggs. Is it okay to eat just the whites?

  • mom

    im a mother of 2 ADD girls and Im trying to get gluten out of our lives. i`ve seen exciting results like less anxious, more focused, more self confidence, better sleep and weight loss. I just have a question…about the supplements suggested on the book, are the amounts ok for children beteween 7 and 16?
    thank you

    • guest

      I went to a good health food store and they advised as to which vitamins would be the best for kids…..some of them I have them take it every other or third day…seems to be working…remember some extra vitamins and nutrients are better than none!

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  • Kmartin

    I was recently diagnosed with diabetes. My dr told me if I simply lose 20 lbs I shouldn’t have a problem with my blood sugar levels. How does this diet work with diabetics?

  • Karen Ferguson

    Dr. Perlmutter actually answers questions on this forum?? Do you know how unusual that is?
    OMGoodness….amazing. I just saw you, Dr, on my local PBS station last night. I’ve learned from the Westonprice.org site all you are saying. But I never understood the gluten aspects…like exactly ‘what is it?’ Now I know.
    I went from trying to be a vegan/raw foodist [and overweight from flour and sugar] to changing EVERYTHING. I have my brain back…8 years later.
    Thank you for continuing the message and getting it out there!!!!

    • David Perlmutter

      Thanks for your support Karen! I try to answers as many questions as I can so that we can continue to build momentum around these ideas.

      • Karen Ferguson

        Anytime! Just tryin’ to keep it short. One point though that I seldom hear about: moderation in sugar and flour, imho, doesn’t often work. These “foods” create cravings [for more of these foods] and when I don’t have the craving, I’m thinking “when does a ‘normal’ person have it again?”

        I was 256 pounds when “nutritionist” said to me, “Karen, I think you can have cheesecake once a week.” I left her Stanford office and sat in my car where I had an epiphany. Why would I want to set up a craving, take longer to lose the weight and create an obsession? I went home & fired her via phone machine. I’ve gotten better ever since.
        Thanks. I needed to address that aspect so if another is feeling that way, they know it’s normal.

        i know I’m not the only one that experiences sugar/flour as addictive. I suspected later, after the fact, that there is a correlation of use to depression. And, then you confirmed that on your PBS special. Thank you..

  • willy3x

    I’ve been using organic coconut oil as a skin lotion for over a year in an attempt to reduce winters itch. It doesn’t seem to help a bit in that regard but it’s great for dry skin and scaly heels. Is there any chance any of it’s making its way into the blood stream through the skin and nourishing other parts of the body?

  • Steve Bergman

    It really makes sense to put the omega6:omega- ratios of different types of been into perspective with respect to total diet. And a few facts are worth noting.

    Firstly, so-called “grain-fed” beef is, in fact, mostly grass-fed. It’s only in the final weeks that grain is mixed into the cattle’s feed. The the vast majority of the time, they are on mostly forage (grass). It works out to about 85% forage, 15% grain.

    Secondly, if you look at the studies done over the decades, the measured n-6:n-3 ratios are all over the board for both grass and grain fed beef. There’s a huge amount of variability, and not as much difference between the 2 as many seem to assume.

    Thirdly, and perhaps most importantly, the absolute amounts of n-6 and n-3 in beef are are small in comparison to other omega sources. I recall these numbers from one study, standardized to a 4oz serving (raw):

    Grain-Fed: n-6=670mg, n-3=70mg
    Grass-Fed: n-6=480mg, n-3=100mg

    Is a difference of 190mg in n-6 and 30mg in n-3 important? For reference a 3oz serving of salmon will get you 20 times that amount of n-3. And a standard 2 tbsp serving of Ranch Dressing will get you 35 times the n-6. The tiny relative differences between grass and grain fed beef just don’t matter when taking in the context of a complete diet. And they certainly aren’t going to make the difference between the grain-brain plan working or not.

    If grass-fed beef is justifiably part of the anti-alzheimer’s trio, then so is grain-fed beef. It makes no sense to reject one based upon a trivial absolute difference in omega fatty acids.

  • Gloria

    I am planning to start a diet on January 2nd. I want to stick to it this time, not start Monday and be off Tuesday. Unlike many comments posted here, I do not like vegetables at all. I am latin and hardly ever eat vegetabes. I will try to incorporate some into the diet. I know I have to change my lifestyle but when you don’t like something it is hard to follow through long term. I am obese and am also looking at using a diet pill called Napsil. Is that contrary to the grain brain diet? I plan on going to buy your book today and reading it. Please let me know 1) if it not all plant based 2) How do I get grass fed meat? Where? 3) Is it ok to take Napsil while doing the grain brain diet. THank you!

  • Susan

    Excellent Breakfast idea for people in a rush in the morning. On Sunday, mix up a crustless quich: 6-8 eggs, whatever vegetables you like (spinach, onion, mushroom, peppers, celery) with whatever cheese you like (cottage, swiss, feta, Havarti, cheddar) and pour into a GLASS pie plate. Bake at 340 for 20-30 minutes. Every weekday morning, have a piece of egg pie for breakfast, no cooking, fewer dirty dishes than making an omelet. Fast protein on the go.

    • Karen

      Awesome! Thanks for the tip!

    • Susan

      Make sure the glass pie plate is greased with coconut oil.
      Certainly the secret to staying on this diet while working 8-10 hours outside of the home is prep time. Each weekend, I make low carb muffins (coconut-lemon-cranberry are a favorite), crustless quich, and pumpkin seed pancakes (to eat with nut butter each day, 10am coffee break), and cabbage soup (with lots of chicken, beef or ham-bone) and that adds some variety to the salads, meat and nuts. Everything does start to taste the same on ketosis so variety is important.

      • David Perlmutter

        Susan: Great point with regard to prep time. Tim Ferris’ work is all about batching activities: if you make all your meals at once, not only will you eat better, but you save time on both ends (prep/cleaning).

      • Cindy Robin

        Susan, why do you specify glass?

        • Susan

          Because if you leave food in a tin or Teflon pie plate for more than 24 hours, the metal reacts with the food and changes colour and taste. Glass doesn’t do this. I don’t have much silicon bake wear.

          • Cindy Robin

            Thanks. I think stainless would be okay,too. I don’t use aluminum or non-stick. Great ideas.

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  • Joy

    I have 3 brother-in-laws that have been diagnosed with Huntington’s. They told the family that their Dr’s told them there is no cure, or anything they can do to slow down the process. only one of them have presented signs, of this decease. will the grain brain work for them?

  • Anne

    Dr Perlmutter, Until reading Grain Brain I was consuming a Gluten Free-Vegan diet. I have embraced your diet to the level that I feel comfortable by consuming eggs, fish, and poultry, but I do not feel comfortable with incorporating mammal meats into my diet related to animal rights issues.
    My question to you is this. If our bodies are able to produce cholesterol, then why do we need to consume “dietary” cholesterol? And without mammal fats in my diet will I still get the same benefits?

  • sally norton

    Dr. Perlmutter, I just purchased your book last week but have not had a chance to read it. All my health stats are very good but I have suffered from osteoarthritis since my thirties.
    After three major surgeries to replace degenerative body parts, I seem to be facing a life of limited activity, prescription drugs, and an addled brain! Can your recommended diet and supplement regimen help improve my outlook?
    Thank you.

  • bonny

    He dr P. I had started on the grass fed beef and homemade raw milk yogurt about three months ago, My Cholesterol went up to 260 and HDL 100. I take NO meds never have taken any. I am 74 weight 124-126, I am doing very well Except ONe Huge problem. If I am back to my chronic constpition. What can I do to get stool back to normal? when I first started the diet I was using only yougurt now I am useing milk Kefir. Will Milk Kefir make me constipated???.
    Please help. thanks for all the info

  • Andrea

    Dr Perlmutter, I wonder how you feel about venison as opposed to grass-fed beef. Beef of any sort is quite costly and grass-fed beef is prohibitively expensive in these economically challenging times, but venison is free, or nearly so. Does it compare favorably to beef?

  • Vicki Munge Little

    Just ordered your book from Amazon. Should be here next week. I am very aware of the gluten-free, low carb, high fat diet. My husband has been diagnosed with Alzheimer’s. He is taking Namemda and Aricept. He is 69 and still works part time, plays golf. He is good shape except for his memory. Do you think this way of eating will help him–reverse it, keep him stabilize? Thank you for your help.

    • Anne

      If u read the many books on coconut oil by Bruce Fife he sd if not too far gone u can improve but u need him to consume 5-6 tablespoons per day. Spread on sprouted bread, in your tea, rub on body and in hair and can use cacao, dessicated coconut, coconut oil and gogi or whatever and its all doing good. Good luck. Anne PS I also make up water kefir, great for gut, digestion and food sensitivities. Helps lits health issues and so easy to do daily.

  • Brian Chaput

    Not a vegetarian but have been making my own black bean burgers, using grilled portobellos as the buns and guacamole as condiment. My binders are egg, tablespoon tomato paste & going to try flaxseed meal instead of bread crumbs.
    Haven’t read the book – but definitely going to, but just wanted to get some opinions on this. Thanks

  • Debbie

    I’ve been eating an avocado a day and am now concerned they are way too high in omega-6s. Also, those of us with high ApoB, but also high HDL, and everything else normal including calcium scan – should we in your opinion, eat a somewhat lower fat diet as some suggest?

  • Anne Shirley

    Is farro a gluten ?

    • Marc Turgeon


  • Thomas Baffuto

    How about using flaxseed for your DHA.
    Is that bad

  • daoleta

    Dr Perlmutter:
    I was raised in a rice eating surrounding and I can’t get off the habit. White rice. I feel very guilty, so had eaten oatmeals for a few years now for breakfast as my largest meal of the day so that I can eat “normally” when with friends and families meaning white rice and seafoods. I am 70 and my checkups are all OK. ̣(I am active,+ do light exercise daily). I want to be knowledgeable, current, nutritionally wise, but I don’t want to break the habit ̣of eating rice.

    Thank you for your “trio”…I had stayed away from coconuts, one of my favorites, now I will enjoy them weekly or more often.

    • David Perlmutter

      Glad to know you will add coconuts back into your diet! One note on rice: if it is a must-have, you can enjoy it in moderation, as it is a non-gluten grain. And be careful with oatmeal, must be sure it is gluten-free.

  • Ginger Matthews

    Is there anything I can do and take supplements to slow my genetic. Cerebral degeneration .?Thank you

  • Ginger Matthews

    Is there any supplement I should take to slow my. Genetic cerebellar degeneration. Stage 6 ? Thank you.

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  • Tami

    I have been eating all the good fats you promote for over 20 years and am quite healthy. Being an endurance age group athlete I train (workout) approximately 8 to 15 hours per week depending on the on and off season of racing. Obviously I need more carbs and protein in my diet too – what would you suggest for more carbs for me? I am female, 52 and 118lbs. I do mostly 1/2 marathons and triathlons so besides biking, swimming and running I do daily yoga and strength 2x per week.

    • David Perlmutter

      Great question Tami. For someone like yourself, I allow for 90-100grams of carbs/day.

  • Linda Corsetti

    Can you comment on the “Grass Fed Beef” in your Alzheimer’s trio? I am a vegetarian. What can the animal product be replaced with? Thank you, Linda

  • Lauri Lanter

    I am confused! I looked at the chart in the book “Grain Brain” showing the relationships of Omega-3’s to the Omega-6’s in the various oils, on pages 75-76, and according to the information in the book, why is sesame seed oil on Dr. Perlmutter’s list as a good oil to consume? Sesame seed oil has 42% -Omega-6 content to 0%Omega-3%? I know canola oil is not advocated on Dr. Perlmutter’s plan, yet on the surface, canola oil would seem better, given that the chart shows canola having Omega-6 content as 20% to 9% Omega-3 content. (still not great, I understand), but Dr. Perlmutter does not advocate canola. And yes, I see that flaxseed oil is wonderful, but I’m specifically referring to Dr. Perlmutter putting sesame oil on the list to consume.
    Also, why, Dr. Perlmutter, did you say a vegetarian diet can work on this program? You stated that animal products are not necessary, but number 1, how are you going to get adequate B12, that the body can absorb easily – as opposed to plant sources? I understand you can get some B12 with consuming eggs and cheese, but, number 2, those are animal products, without the Omega-3’s. So, for vegetarians who want to do the program, do they just take a Omega-3 supplement?
    I would love to do the program, as I am a diabetic, but I’m just a little mixed up. I have high cholesterol, high triglycerides and high LDL – a little frightening.

    • Bell

      Lauri, you wrote that you are a diabetic with high cholesterol/ high
      triglycerides/ high LDL, so I suggest that you consider Dr. Fuhrman’s
      plan. Dr. Fuhrman is another reputable physician who emphasizes the
      pivotal role of nutrition in health. He stresses that diabetes and
      heart disease (and even auto-immune disorders) can actually be reversed
      with proper nutrition. He was featured in two PBS special programs
      (titled “3 Steps To Incredible Health” and “The Immunity Solution.”)
      PBS repeats those programs periodically, so I recommend that you check
      your local TV station’s schedule (or get a DVD from a PBS station),
      because each of those programs were excellent — exceptionally helpful
      (even uplifting and inspiring). But you could also learn about his
      approach by going to his website http://www.DrFuhrman.com , and/ or by reading
      his “bestseller” books, such as “Eat to Live” and “The End Of Diabetes
      — The Eat to Live Plan to Prevent and Reverse Diabetes.” Also, I
      suggest that you look at the “success stories” section on his website, regarding people who started with circumstances (“risk factors”) like yours.
      There you will see some of the remarkable turnarounds that were
      highlighted in the programs that were broadcast on PBS. Best wishes.

  • Woodenbead

    I am confused about the O blood type diet which says no avocados & coconut… and then all the news of these 2 being so healing for all? Thanks

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  • Angela De los Santos

    I have a problem. I was diagnosed with Epilepsy and have gone to many doctors and was prescribed the same medication. Because of that, I started a “Medicine Outline” stating all Doctors, medications, and tests conducted. But now, my main problem is MEMORY-LOSS. From what my present doctors have said “The issue is that you have Epilepsy. So, the memory problems have to do with all the small brief seizures you have during the day. We think what’s happening is that you have some kind of reaction of your Immune System that’s attacking other parts of your body. Your Immune System is mistaking parts of you for something that’s foreign. Thinking that parts of you are foreign, bacteria and virus and attacking it.” Also, apart from that, I am now having headaches mostly on sides of my head, above my ears and by the side of my eyes. And because of the medication its basically sleep for most of the day. I try staying awake but these medicines have me tired and seeing double throughout most of the day. If you can Please help me. I have and still do search on things that can help me but nothing. Please and Thank You.

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  • Diane

    My husband and I are two weeks into being gluten free and I just finished reading the Grain book. .

    My husband is 72 and I am almost 69 years old. Loss of memory for both of us and loss of some (too many) cognitive skills for me feels pretty scary when there is nothing that you can do about it. After reading in the book about Dr Perlmutter’s MIDAS Study it has given me hope that the we will get our brains back. No more wheat and gluten for us if we can help it. Whoopee!!
    Thank God and you Dr Perlmutter for writing that book.

    • David Perlmutter

      Wonderful to hear of your health success and turnaround!

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  • Josh

    Why do you recommend grass-fed beef over wild salmon? Is there something better in beef for you that salmon does not have?

  • Tracey

    Hi – Are there recommendations for someone with pre-menopausal osteoporosis? (I have been prescribed HRT by many doctors, but it triggers severe depression.) Is there research linking the microbiome and osteoporosis? Thank you very much!

  • Rebecca T. Johnson

    can you please tell me why carrots & parsnips have to be eaten only moderately? I love both of these vegetables & sweet potatoes, rutabaga, etc.; are all of these vegetables too starchy (too high in glycemic number)?

  • Neayo Teklemichael

    my address for the free copy is as follow:
    626 Lincoln Ave apt #B
    Alameda, Ca. 94501

  • Lori Byrd

    I am confused about “grass fed” beef. I live in a rural area and have access to locally grown beef. However, the growers tell me that all beef is grass fed until they are about 700 pounds and then they are grain finished due to time it takes vs grass finished for cattle to get up to 1200 pounds when they are taken to sell. So is there truly any grass fed start to finish beef? They have told me it would take 18 months to finish cattle on grass versus 5 months to finish with grain. Do we still get health benefits if cows are grain finished?

  • Elaine Wilkes

    What is better for Alzheimer’s and dementia? MCT oil (Like Bulletproof Brain Octave) or coconut oil? I’m hearing the MCT oil is easier to absorb.

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  • Mary

    Dr Perlmutter say not to drink milk but Dr Mercola states it is alright to drink raw milk. Comments please?

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