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Category: Grain Brain


Grain Brain Math

I’ve seen many question come in from athletes who find it difficult to thrive on the 60 grams of carbs/day that the Grain Brain diet suggests. These individuals feel they aren’t able to perform at an optimal level, and have asked if it would be possible to stretch the upper bound of allowable carbohydrate intake to accommodate for their active lifestyle. I’d like to address this question, and similar ones, in this post, so that all may benefit from the answer.

Simply put: it’s not unreasonable to increase the intake if you lead an active lifestyle. Pushing your daily allowance to 90 or 100 grams of carbs/day is certainly acceptable. However, these 90 grams should be part of a balanced diet that takes in 60-70% of its calories from fat, with the remaining 20-30% coming from protein, and 10-20% from carbs. If you’re trying to figure out how many grams of protein that comes out to, you’re looking at 0.8 – 1.2 grams of protein per kilogram of bodyweight.

  • Michael Kovacs

    These guys should also be reading “The Art and Science of Low Carbohydrate Living” and it’s addendum for the athlete, “The Art and Science of Low Carbohydrate Performance” by Drs. Stephen Phinney and Jeff Volek. Also they could check out Peter Attia’s website : eatingacedemy.com

    • Darag Rennie

      Michael, great suggestions. Peter Attia’s website link is misspelt though so will take people to the wrong page. Here it is: http://www.eatingacademy.com He’s doing some great work with Gary Taubes http://www.nusi.org

  • Jan in KW

    Thanks for this post Dr. Perlmutter, especially a definitive protein consumption formula…..looks like I’m in a healthy range of carbs/fats/protein.

    • David Perlmutter

      That’s great to hear Jan. Glad this post was able to help you figure that out!

  • erin b

    Thank you for breaking this down, it helps a great deal.

    • David Perlmutter

      Happy to help Erin. Like I said, I see questions on this topic frequently, so I thought it would be helpful to just share the info with all!

      • Victoria Murphy

        Thank you, I am getting a better understanding of how it all works on a practical level. I am so enjoying my food now and my stress levels have dropped also.
        Kind Regards, Victoria Murphy

  • Victoria Murphy

    Hi Doctor, based on these percentages is this correct: a 55kg woman should consume 143g of fats, 55g of protein and 22g of carbs (vegetables) a day? If this is correct, that is 10 tablespoons of fat, how is this consumed?
    Kind Regards, Victoria Murphy

    • Jan in KW

      I’m sure Dr. Perlmutter will have a more refined answer but I get my healthy fats via avocados, pastured butter, bulletproof coffee, pastured meat, raw cheese, coconut oil, olive oil, eggs, and nuts…..it adds up!

      • Victoria Murphy

        Thank you Jan, I now see how it all works, would you mind sharing an example of your daily food intake? I have got the recipe for bulletproof coffee, just have to get some raw butter and mct oil. I now realise I was eating too many carbs. Victoria

        • Jan in KW

          I’m more than happy to share this with you…..keep in mind that my husband and I are retired so it’s just the two of us and we’ve been transitioning to this WOE since January of 2013….both feel terrific, no meds and very active.

          I drink a glass of lemon water upon waking…..followed by 1/2 cup of regular coffee. Later on, I drink a cup of bulletproof coffee with 2 TABS of coconut oil (I started with 1 tsp. and increased over time). Since I do a 1 1/2 hour yoga class every morning, I don’t want food in my digestive track, so I drink a glass of bone broth (I make it myself via Sally Fallon at Weston Price) before class. My first meal is brunch (around 11:30 to 12) .yesterday we had a spinach/cheese omelet , pastured bacon and 1/2 avocado…..with a few tabs. of fermented veggies that I also make myself. Last night for dinner we had pastured steaks with a side of veggies w/butter. Today for brunch, it’s burgers on a bed of lettuce, baked avocados, sliced tomatoes….tonight, eggplant parm with meat sauce and side salad.

          For snacks we have nuts/ olives/raw cheese…..I keep all kinds of deviled eggs prepared in the fridge….it’s been an easy transition to this dietary strategy and inspires my creativity in the kitchen!

          • erin b

            I appreciate this as well and thank you. Amazing menu and health program. Love it!

          • Victoria Murphy

            Thank you so much Jan, very generous of you to guide me on this new path. It has made the transition so much easier also with Dr Perlmutter’s mathematical equation based on 1g of protein per kg of ideal body weight, so your daily diet consists of approx. 25% protein, 60% fats and 15% carbs. I now realise I was eating too much. I have Sally’s book to collect this weekend and am waiting on Dr Perlmutter’s to arrive. I am also enjoying new recipes with no grain no sugar, the food is delicious. I also read and listened to Dr Natasha Campbell-McBride, she is in agreement with Dr. Perlmutter, all very interesting. Enjoy! Kind Regards, Victoria

          • Nancy

            Very Good! Do mind explaining WOE and bulletproof coffee? I like Sally Fallon, too.

          • Jan in KW

            Bulletproof coffee: adding coconut oil or pastured butter or MCT oil (medium-chain-triglycerides) to one cup of coffee….you may also add coconut milk, stevia, cinnamon if you’d like…..I mix mine in a small ninja and have found it’s a great vehicle for adding healthy fats to my diet…..start small. WOE = way of eating 😉

          • Kathleen Higgins

            Jan, Thanks for sharing your menu. I like your coffee idea. Do you have any ideas for ways I can overcome my cravings for sweets. I’ve been following the Grain Brain way of eating for 2 weeks to the letter. But I dream of ice cream and pie.

          • Jan in KW

            Hi Kathleen,
            I think one of the hardest components of this way-of-eating is to wrap your head around the fact that healthy fats are healthy because for the past thirty-plus years we’ve been told to eat low-fat. When I began incrementally increasing my fats, my cravings were gone….not only that, but I was rarely hungry…..fats are satiating. My only advice is to go slow….I started out much too high and had some stomach issues, so I cut back and then incrementally increased them. This is a wonderful journey we’re on thanks to Dr. Perlmutter and Dr. Davis!

          • Kathleen Higgins

            Thank you for your reply. It is a big help to know that the cravings will ease as my body comes to appreciate the fat it is getting instead of carbs. Also, I’m glad you told me about your stomach issues as now I know I’m not the only one.
            I’m excited about the cookbook that Dr. Perlmutter will be publishing next year. It’s so nice to get new ideas which is why I appreciate your coconut oil in your coffee suggestion. I couldn’t standing cooking my eggs in it and I got tired of eating it off a teaspoon.
            Thanks again,

          • Pierre

            Cook your eggs in butter on LOW heat, which is how you should cook eggs anyway.

          • Pierre

            Interesting, cuz my stomach issues cleared up with eating more fat. Whenever I cheated and got carbs in my stomach issues would come back. And I agree with everyone that eating fat is satiating and wards off hunger and cravings.

      • Nancy

        What is bulletproof coffee?

        • allison chapman

          You can look it up on-line, but organic butter from a grass-fed cow placed on organic coffee. It’s not bad…I like coconut oil so I use that now…I think you can put raw eggs in your coffee too…but you need to add them carefully or they will cook…I think there is a post I found about it in Mark’s Daily Apple…love bullet proof coffee. But usually just have a teaspoon full of coconut oil before having a green veggie smoothie every morning. It is easy to eat a lot of fat, and filling too. Best wishes.

    • terri

      I cook my three eggs for breakfast in about 40g of grassfed butter yum. Plenty of olive oil on my salad. I eat all the fat on my lamb chops or steak cooked in butter. Eat berries with double cream. too easy!

      • David Perlmutter

        Sounds like a delicious start to the day. Just be careful with the cream.

        • Lydia Deven

          Why should one “be careful with cream”?

          • Catalin

            because it is dairy, and also too much fat may cause you to gain wt. (over 60 to 70%) that is my guess

          • Robert B Millar

            Use whipping cream, mine is 36% fat. Just don’t any sweeteners.

  • Heather in TX

    Dr. Perlmutter, I had my gallbladder removed 10 years ago (now know that was a mistake). I want to eat this type of diet, (which really seems to be the same as Paleo) and have been doing about 70% of the time the last several years. My problem, however, is that I do not do well with too much fat now that I don’t have my gallbladder. Any recommendations for people like me?

    • allison chapman

      I had my gallbladder out 11 years ago and haven’t noticed a problem eating like this for the past 13 weeks. Down 26lbs though. Feel fine.

    • diane83

      I’m like Heather in TX. Gallbladder removed 27 years ago and I also don’t do well with certain kinds of fat. Since then my system has been very sensitive to certain foods, too.

    • Heidi

      Get GB in a bottle called Beta Plus by Biotics research. I have many clients on this supplement that have had their gb removed (before coming to me).

    • Sybil Strawser

      No gallbladder here also for 10 years now. I find I cannot eat fatty foods in restaurants. Always causes me problems…I imagine it’s the type of fat. No problems at all eating reasonable amounts when I cook at home using grassfed butter, olive oil, avocado oil, coconut oil and home rendered leaf lard.

  • Robin

    I am confused: What is the underlying cause of clogged arteries? Is it sugar from carbs or animal protein and fat? Does the sugar predispose the body to to these diseases once the fat and animal protein are incorporated into the diet? What about the recent research linking the meat/TMAO/cholesterol/atherosclerosis connection? What about the connection of cancer to a high animal protein diet? Are you saying if we eliminate the carbs sugar, wheat etc then it is safe to eat animal products?

    • Tom Boyer

      Not at all clear that dietary fat is the cause of clogged arteries, which is what we’ve been told for 50 years. It may be that arteries clog more from triglicerides — which are fatty materials generated by the body when you eat carbohydrates. High trigliceride levels correlate closely to heart attacks; by contrast, high cholesterol levels do not.

      In addition, as Dr. Perlmutter notes in his book, latest research indicates what really causes heart attacks isn’t clogged arteries but inflammation — and inflammation is certainly NOT caused by dietary fat but by consumption of carbohydrates.

      • will

        Hi Tom Dr Will from Australia
        inflamation and excessive fibrin and scar tissue as well as trigliceride build up is the main reason for blockages that why I use Hydrogen 7.2 recovery 9elemental magnesium magnesium carbonate and calcium 46mg) to seperate the red blood cells systemic enzymes in conjuction with good fats to eat away the fibrin and stop inflammation as well as grape fruit pectin to remove the hard LDLs rom the artery walls in cases that require urgency

        • Lee, RN

          Will, What, exactly, are you talking about? this sounds interesting, but I can’t google it coz I don’t know what I’m looking for. thank you!

          • Will

            HI lee RN
            after the ages of 24 to 27 the bodys enzyme production reduces to from a teaspoon to eyedopper levels we start to rely on the bodies own ability to assimilate and absorb its own enzyme source where as we can run through walls at 17 to 27 try to do ot at 37 0r 47 things dont go as planned recovery takes longer
            a we age generally with poor diet and junk food
            shrinkage of organs increase as we age because of the lack of enzymes that are active in the body
            fibrin scar tissue and debris as well as sludge in the blood require the following
            ( number 1) is oxygen ( number 2) is Enzymes ( number 3) is electrolytes (Number 4) is negatively ionized (Red Blood Cells)
            this is what is required to remove the excessive fibrin from the body Dr perlmutter is correct with his grain and carb theory however without systemic enzyme assistance and the other 3 protocols organ shrinkage and early aging are a reality
            the enzymes (systemic) do the major work eating up and ridding the excessive fibrin that is in the body and easy to see with microscopy as is Red Blood cells that are positively ionised (Stuck together) find it had to deliver ATP (cell food ) that feed the cells
            One of the major causes of arterial blockages is inflamation condensed LDL triglycerides (bad cholestorol)
            not mistaking fluffy or non condensed LDL which is good for the brain and harmless as is HDL cholestorol levels

            I use 6 capsules grapefruit pection
            4 capsules 3 times a day of excellzymes systemic enzymes
            lemon and garlic juice 50 mils a day
            3 squares 80% dark chocolate
            good fats avacado nuts seeds etc finally
            3 litres of anti oxidant ionised water with at least 8.5 ORP over 24 hours
            any ORP under 7 oxidises the cells
            7.2 recovery Hydrogen caps 4 daily to neg ionise the blood
            best regards Lee
            Will Bayley ND

          • DavidT

            Thank you.

            What is your take on trimethylamine N-oxide (TMAO) and clogging of arteries? For example, what role might TMAO play Vs. inflamation condensed LDL triglycerides (bad cholestorol)? There were new reports in April 2013, based on research going back at least to 1962, indicating that when specific gut micro flora ingest red meat and eggs, the byproduct is TMAO, which leads to arterial clogging.

            Regards, DavidT

  • Tom Boyer

    There’s relatively little data on athletic performance, but In my own experience, when I’m in full ketosis (i.e. no carbs at all) I can ride my bike for much longer distance without getting tired. It’s actually quite amazing. It’s like how it feels after the warmup period when your second wind kicks in — in ketosis you start out in the 2nd wind and it never leaves you. People who work out should try it. Ketones (which come from burning fat, either dietary or your own stored fat) are not only good fuel for the brain, they’re good fuel for the body as well.

    This is a case where the latest science about metabolism hasn’t made its way down to athletes and trainers — who are still stuck in the old thinking that the human beings’ only fuel is glucose.

    Now, there is a question about whether the body does as well in sprint events. It’s possible ketone fuel is better for distance, but glucose will still be better for sprints. But anybody doing distance events — they should try no-carb, their performance may be better — a lot better.

    • Ben, UK

      I think most endurance athletes know that fat furning is fundamental and that fat accounts for the majority of fuel during a long event, adventure or whatever. However, to deprive yourself of additional carbohydrate by eating a meagre 100g (400cal) per day sounds ridiculous – you’d probably burn that off on your cycle to work. If I can store 3000cals of glycogen ahead of a 25km trail race, there is absolutely no question I will feel more powerful, more positive and be faster than if I was relying on fat alone. Have all pro-athletes that still eat massive quantities of carbs missed something? And try telling Chris Froome to eat only fat…

    • Pierre

      My energy soared thru the roof when I began eating fat, low carb. I felt like I could climb a mountain. The day I ate wild salmon, nuts, olive oil by the the spoon, eggs, cheese, more nuts, and a little fruit, and spinach with Greek Feta dressing, I just felt great, and did leaps and push up…and felt joked with my wife that I could have sex like a machine if she wanted, LOL…but it’s true energy is great on a healthy fat diet.

    • jackhb84

      Last fall I ran two marathons in full ketosis. During training I stayed around 20-25 net carbs per day. Only had electrolytes and water during race. Felt great with no bonking. I monitor my blood ketones with an inexpensive $20 ketone/glucose meter (Nova Max Plus) which I ordered via Amazon. I highly recommend reading “The Art and Science of Low Carbohydrate Performance” by Drs. Stephen Phinney and Jeff Volek.

  • Salsasue

    Eating the way Dr. Perlmutter prescribes has made me feel like I’m 21 again! No – I feel better than I did then! I have only been eating this way for 5 weeks and the brain fog, impaired memory, carb cravings, and fatigue is GONE!!!!! Thank you so much for bucking the system, Dr. Perlmutter! You are brave to contradict the “bad” science out there and those who promote it for economic reasons, etc. God bless you!

    • David Perlmutter

      That’s fantastic to hear, congrats on your good health. If you like, email me your story at Success@DrPerlmutter.com, so we can share it here on the website.

  • Jane

    I have just finished reading Brain Grain and am telling everyone about it! Have dieted for years mostly following weight watchers. Loose 20lbs gain it back and then some. Always yo yoing. I believe it’s the carb addiction. Dr. Perlmutter I started your program today and I am psyched. I do have a question however, while I have no symptoms, it turns out I have several gall stones. My Dr. Suggested speaking with a surgeon to have my gall bladder removed which I am reluctant to do. Is there anything that I could be doing on this plan to help dissolve the stones?

  • Jane

    Grain Brain hopefully the dyslexia leaves with the brain fog!

  • Kemahsabe

    Dr. Perlmutter; Can you comment on the new American Heart Assn cholesterol recommendations that are expected to double the use of statins? In “Grain Brain” you state, “And reviews of multiple large studies have routinely failed to find correlation between cholesterol levels and heart disease.” Apparently the AHA hasn’t seen these reviews?
    Where’s the disconnect between the two camps?

  • Marie

    Dr permuter,
    Since i begin the diet, i have big creaving for carbs. I feel Ist like a drug all those carbs for all those years. I am sad. Please do you have something to help.


    • terri

      Eat lots more fat

  • Barbe

    Could this be the God designed diet? Thank you Dr. Perlmutter for giving us some radical information on how the government, AMA and food manufacturers and marketers have been deceiving us all for years and years. I have a full yearly medical exam scheduled for December and with my blood tests, I know that my Dr. will try to talk me into taking a statin. I’ll decline and the arguments will begin. I’m taking a copy of your book with me. This morning, after following your recommendations for only about 48 hours, I arose early, and commenced my morning routine. Except that it’s Sunday; that is not my ususal routine on the weekends. My husband even commented, “What’s going on and why are you out of bed before 10AM?” I look forward to further healing, elevated energy levels and enhanced wellbeing.

    • David Perlmutter

      Barbe: Thanks for sharing. I’m so glad to hear you’re already feeling healthier and empowered. Wishing you, and your husband, continued good health.

  • Ben, UK

    Hi, I’m very active and love the outdoors. I do a lot of cycling and running and I take part in competitive events. A couple of observations: Based on your recommended level of carbohydrate intake I’d probably be reduced to light jogging within 60 minutes, and on a day where I burn say 4000-5000 calories, easy when its cold, I would require ~300g of protein? (25% * 4500cal / 4cal/g = 281g) Is that right – over a kilo of nuts for a vege? I have read, from a variety of sources, that that level of protein consumption is quite unnecessary, and potentially harmful. Moreover I understand that burning protein is inefficient and loads the kidneys due to uric acid production. Feedback appreciated.

    Thanks, Ben

    • Steve Berthiaume

      I have recently eliminated all gluten/wheat/sugar from my diet, and have developed a kidney stone (calcium-oxalate). Obviously, a stone is a complex issue unattributable to a single cause, but I would like to see a response to the idea that low-carb diets contribute to kidney stones- other paleo sources seem to allow for more carbohydrate than what I interpret Grain Brain as recommending. Thanks for writing the book!

      • Montagu

        My husband had occasional kidney stone pain after changing his diet in a similar way, but the stones could have been formed in his kidney before changing his diet, and then went into the narrow tube where the stones cause blockage and pain. I increased his intake of unpasteurized organic apple cider vinegar. Basically it was added to coleslaw salad dressings eaten with our meals 2-3x/week (1/3 cup canned hi-fat coconut milk, 2-3 Tbsp vinegar, 1Tbsp olive oil, and add salt, pepper, turmeric, mustard and paprika to taste). Kidney stone pain went away completely after 3 months. I think it could have gone faster if he had more vinegar per day or week.

  • Buddy Driemann

    Nope…..I LIVED on VIRTUALLY NO CARBOHYDRATEs to get into the BEST condition of my life. Turkey, Chicken, London-Broil, Eggs, Green-Salad with Olive-oil & vinegar, and a “once-a-week” meal of low glycemic fruit. When you go into moderate ketosis (as you describe in your book) the body is then burning bodyfat for energy……..by far, a vast reservoir of energy that far exceeds a few hundred carbs your body can store in the form of glycogen. There is no “hitting the wall” ,…….. Your body has already jumped over the wall & is burning bodyfat. Another benefit to this; everyone knows it takes approx 20 minutes of steady exercise to begin burning bodyfat……..Not if you eat this way……from the very first moment you start any exercise, you are burning bodyfat…….I could literally train non-stop with fairly heavy weights, for a solid two hours, every day, 7 days a week when I trained for and won the NABBA Mr USA in 1994…….using a diet that is almost exactly as you recommend…

    • Norm

      Hi do you use a gluten-free unflavored protein whey isolate power? If so could you suggest some brands you like?

  • Disa Lino

    Dear Dr. Perlmutter,
    Your book is amazing and I plan to follow it faithfully, I have also been a fan of Atkins for many years. My problem is my husband – he cannot get out of his head that eating eggs is bad. He has been on a statin for over ten years. his cholesterol is at 235 and his Doctor thinks he may have hypothyroidism and told him to eat a low fat diet. I got him off gluten, but how can I fight what his doctor is telling him? He is 55, has brain fog, memory loss and I think he naps/sleeps too much. I thank you for writing Grain Brain. I know for myself I have much more energy and generally feel better. Lisa

  • Halle Lu Ya

    Let’s talk about A1C levels – are carbs always the issue? If one eats a lot of protein, aren’t we putting too big a load on the kidneys? I’m very concerned about the egfr status of kidneys – egfr stands for erythrocyte glomerular filtration rate – basically how well one’s kidneys are functioning to filter blood, waste products, etc. Pre-diabetic – normal FBG – really eat few carbs – eat gluten free due to celiac and have a form of colitis that inhibits a high-fiber diet.

  • jan

    Dr. Perlmutter, I read your book Grain Brain. You wrote about a patient with cervical dystonia. I don’t eat grains for about a year, and have a low carb and sugar diet. What else can I do. I see the supplements and will try them. Do I need a specific amount of these supplements? What else can I do? Thanks, Jan

  • jan

    Dr. Perlmutter, Yes I did see the supplement list you pointed out and I also did read the supplement list in your book. I guess what I was asking is there anything more specific i should do for cervical dystonia? Thanks, Jan

  • Neil

    Hi Dr, I currently suffer from cervical dystonia which causes my neck muscles to spasm and consequently cause my head to “twitch” as though I have Parkinson’s. I take Botox shots every 3 months and a drug called clonazepam on a daily basis. Have any of your patients come to you with this and what do you recommend. I am concerned about the side effects of these drugs. Thanks for your help.

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  • Victor

    Dr.Perlmutter,I am a 12 years old boy and do competitive swimming about 13 and a half hours a week. My mom and I are thinking about pursuing this diet because i can not focus well at school or practice. I was wondering if the amount of food you have recommended for an athlete should be modified for my age.

  • Elizabeth

    I wish this was Simple! I’m ordering his book!

  • Stan

    I have started Dr. Perlmutter’s supplement regimen. What is the milligram equivalent on a daily basis for one teaspoon of cocoanut oil? Also, would a capsule supplement of cocoanut oil be a good substitute for cocoanut oil?
    Thank you.

  • Katelyn

    I’m going to try this. I’m 120 lbs and I shoot for the old school method of 120g protein, 150-200g carbs, and 25-35g fats per day. I’m an athlete (I do heavy weight training) and I feel like I’m functioning really well off of the diet I’m already doing. For anyone else out there who has switched to Dr Perlmutter’s advice, how has this impacted your workouts/body composition/ physique? I know healthy fats don’t make you fat, but at the same time, when I overdo my fats and everything else is on, I notice a gain in body fat. Thoughts? Also, are you concerned about not getting enough animal protein (ie complete proteins)?

    • janet

      I would like to respond to your question. I started a ketogenic lifestyle at 258 pounds and at the age of 48. the very first week being off all wheat and sugar, including fruit and high carb vegetables and starches and introducing leafy greens under 30 total grams, moderate protein 50-60 grams and fats like coco nut oil, avocado, butter, grass fed meats, bacon, good eggs at about 100g, my inflammation which caused the pain in my knees and joints decreased to the tune of 80%. I could at this point bend my left troubled knee up over the other which I haven’t done in years. I also was able to sleep well, think clearly, good bathroom experiences, felt energized and overall just felt good with so much energy that I didn’t know what to do with myself. this was all on week one. I am still a little stunned by all this and it has been 2.5 months and my left knee pain is down to only 5%. as an extra benefit I no longer have food cravings (and this is from the lady who ate oreos like the were going out of style and became h-angry without food for more than a few hours ) I eat in a small window of time, am so full and satisfied and as another generous bonus to this lifestyle, I have also lost 25 pounds. I will never return to a high carb diet as long as I live. I have never felt better in my life. I am satisfied with food, I don’t feel denied, I am settling into a routine and I have never felt freer. remember I could not go for more than a few hours without eating as a sugar burner. as a fat burner, you stay satisfied because you no longer have those insulin spikes. I never had this much energy in my life with so little food (compared to what and how frequently I was eating) and I have saved so much time.

      • janet

        oops I think I might have posted this under the wrong person. so sorry. 🙂

  • Yikes

    Is it ok to eat Steal Cut Oats
    and is it in normal to see your BP Drop eating this way?

    • David Perlmutter

      Yes, if you can be CERTAIN they are gluten-free. Cross-contamination is frequently a problem with oats. Keep in mind they are still a carb though, so be aware of that.

      • Yikes

        Thanks David! I think I will pass on the steal cut oats then as I really want to limit my carbs

  • Fernanda Basílio

    Hi Doc, as an engineer I know about math, but don’t know much about nutrition (trying to learn from you). I did an excel calculation sheet to preview the minimum number of calories based on your book’s and this article’s percentage of proteins and “calibrating” them with MyFitnessPal’s recomendations. What do you think about it? I know you say we shouldn’t count calories, but you say also we should eat less to live longer, so I think that having a minimum target might be somehow healthy.
    I’d like to send you the worksheet for you to unsderstand how it was calculated.

    Best regards,

    • David Perlmutter

      Tough to comment on this Fernanda. I don’t really look at calories, or the minimal daily requirement. I think it’s more important to focus on what you’re putting in your body. When you’re eating more proteins and fats, you’re less hungry, and you’ll eat less.

      • Fernanda Basílio

        Ok. Thank you so much for the answer and congratulations for your great work!

  • Jason S

    Dr. Perlmutter, would it be ok to just eat 1 meal a day and have all of your 60 grams of carbs in that meal?

    • David Perlmutter

      Everyone needs to find the diet plan that works for them and their body.

  • Rita Law

    Here’s another way of eating your coconut oil….scrape a raw almond (or raw walnut half) across the coconut oil in the jar and then eat the almond (or “glue” two walnut halves together). This works as long as the room temperature isn’t so warm that the oil is liquid.

  • sue

    I need some direction and clarification on some foods I can’t find some of the requirements in my normal supermarket. Grass fed tallow/organic pasture fed butter, grass fed meats, even raw nuts are processed with some of your no no’s, raw cheese?? I’ve been using cheddar , mozzarella, feta without checking out for the raw thing. how much is too much whipping cream? I drink 4 cups coffee and use a splash in each cup, too much? Secondary should I just get one of you supplement bundles and I’ll have all the right stuff?? Second question my husband had labs and is on Crestor and had to add another med because triglycerides 264, 8 out of ten lipoprotein particles and apolipoproteins are high and inflammation oxidation myeloperoxidase is 503 yikes. mind you he’s not on the diet because he’s on the road all day. happy for any input.

    • David Perlmutter

      Each of those bundles is indicated with what they include Sue!

      • sue

        great I will add what is not included, thanks. where to find tallow butter, grass fed meat, raw cheese. not typical fair at grocery stores.

  • Rosalie

    Hello Dr. Permutter, I recently purchased your Brain Change & cookbook last August 2014. Thank you for the awakening! . I eliminated all wheat breads & its by products & sugar only but really didn’t start your Gluten -free diet yet. I lost 15 lbs without even trying from September & October.
    ( Please bear with me as I explain my medication condition and wonder if I should continue the gluten free diet).

    FYI: I have two brothers who are diabetic. Older brother has other health problems – prostrate cancer, Parkinson’s disease.

    I have a hyperparathyroidism condition over 20 years and seen 3 endroconologists. At my recent visit to my endroconologolist was last July 2014 and I weighed at 183 lbs, A1C 6.2. My Calicum level has been 11.5 consistency. He mentioned kidney stones & wanted to do parathyodism removal surgery. We discussed this. No preventive measure taken and how to lower my calcium. No Diet either. This scared me that I am a borderline diabetic.

    Last August 2014, I had my annual physical. I had given both doctors a list of medications – BP Benicar, Metropolol Tartare, 325 mg asprirn, Crestor and a list of supplements which included Calicum 1000 mg & Vitamin D3 2000 IU.

    My primary doc said to avoid sodas, to STOP the Calcium & Vitamin D3, and changed my aspirin to 2 tabs of 81 mg aspirin. He didn’t give me a diet how to lose weight. All prior endrocologists & my present one didn’t even say to STOP TAKING CALCIUM OR VITAIM D3.
    I decided then that I had to change my diet!!! At that time, I saw you on public TV regarding your Brain Change foods, purchased your books and started the gluten-free foods.
    Then I got very sick last October 15 to 18th, thinking I had the flu. I went to ER and was committed as a patient for an kidney infection and kidneys stones – 5 mm stone in left kidney and 2 mm right kidney.
    To bare you the details, I recently had two procedures & the 5 mm was passed.
    With Thanksgiving dinner, pies & other foods – I tried to eliminate my daughter’s homemade yeast rolls (made with enriched wheat flour). but I couldn’t resist. Now, I trying to get back to gluten free foods but hard to do.
    Next week, I will be seeing both doctors. I suspect my hyperparathryroism is the cause of the stones. Or my Diet?
    I have a lot of concerns regarding if I should continue the gluten-free foods and vitamin D. What would be your advise?

  • Billie Kruger

    How does the ketogenic diet affect fibrin and the clotting mechanism?

  • Dr. Perlmutter is ketosis safe and why? conventional wisdom considers it dangerous.

  • Scott Romack

    Dr. Perlmutter, please check out ‘carb backloading’. It seems like a really good system with many advantages.

  • Diana

    I just read the book grain Brain and started to follow the diet . I am having a hard time moving my bowels . Is there something I can be eating more of such as fruit or beans?

  • CCC

    What if I have multiple food allergies, what is there left to eat and feel satiated? I am allergic to the following:


  • Greg Killmaster

    I’m having a hard time getting any clarity about this, but when you’ve suggested we stay at 60g carbs or below daily, are you referring to net carbs or net carbs minus fiber?

    • David Perlmutter

      Total carbs.

      • Greg Killmaster

        Ok. So I’ll count both fiber and sugar carbs. Thanks for the clarification! Seems like using the actual sugar carbs could be more accurate unless I’m missing something. Thanks for your great work. I can say its made a huge change in my life!

      • Greg Killmaster

        thank you for this. Its a little confusing cause other Doctors use net Carbs. I believe when Dr. William Davis discusses this, he is referring to net carbs (total minus fiber)…

    • Greg Killmaster

      Hi Dr. Perlmutter,

      I asked this on another forum on your website. Sorry for the double post. You responded that we should count total carbs, fiber plus sugar… thank you!

  • Greg Killmaster

    Thanks for the clarification. It can get a little confusing cause other doctors use net carbs (total minus fiber) when referring to counting carbs. I believe Dr. William Davis refers to it this way. It seems to make more sense to me on account that it addresses actual carbs that have an affect. I’m probably missing something here though. Also, I think Dr. Davis suggests not eating more than between 13-16 carbs in one meal (again referring to net carbs), which is useful info.

  • Ed Miedema

    Dr Perlmutter, My wife and I have been following your diet for the last 2 two week. We have both been losing weight, but my wife who is a migraine sufferer is having more migraine than usual. This is very frustrating for her because it was suggested that your diet would help with migraines but it hasn’t so far. Do you have any suggestions.

  • Ami Addo

    Will this diet help correct the A1C levels? My GP told me I am pre-diabetic. My A1C in November was 6, and as of yesterday, it is 5.7. I have been following your diet, not to perfection, but nearly. In thee months I’ve dropped also 10 lbs, and my cholesterol went from 249 to 186. I am also much more active, running, weights, etc. I have limited my intake of red meats, and when I do it’s only grass fed beef. Other than that it’s free range chicken and wild caught fish. I would like to improve my A1C levels further.. Thank you.

  • SO

    Can anyone comment on low blood sugar and their experience. I am an athlete and for my profession do a lot of physical activity. I followed the diet and felt great, except I started to have heart palpitations, finding that I had low blood sugar levels. Adding carbs helped with the heart but I’ve gained weight and don’t feel as well. Thanks.

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