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The Two Fundamentals of a Brain Healthy Diet

Last week I had the opportunity to participate in a Google Hangout discussing dietary recommendations in response to a case presentation of an elderly woman who was beginning to experience decline in cognitive function.

Basically, the case was selected as she was experiencing mild cognitive impairment (MCI), generally thought to be a harbinger of future Alzheimer’s disease.

Alzheimer’s disease, far and away the most common form of dementia, now affects some 5.4 million Americans, representing the third leading cause of death in our country. This number is predicted to double in just the next 15 years! Moreover, women are disproportionately at risk, representing 65% of Alzheimer’s cases. In fact, a woman’s risk of developing Alzheimer’s disease now exceeds her risk of developing breast cancer. The annual cost for caring for Alzheimer’s patients exceeds $200 billion, and this is a disease for which we currently have no meaningful treatment.

While we know that there is certainly a role for genetics in determining who is at risk for this disease, there is obviously much more to the story. If it were solely a gene-related issue, we wouldn’t be seeing a sudden explosion in new cases, as is now occurring.

As you will see in the video, I went into great depth in terms of the importance of adopting a low-carbohydrate, higher-fat diet as an intervention designed to help preserve functionality in this patient’s brain.

Researchers at the Mayo Clinic, publishing in the Journal of Alzheimer’s Disease, reported the results of their study in which they explored the role of diet as it relates to dementia risk. They followed a group of over 2,000 elderly individuals for close to 4 years and carefully monitored their diets with respect to consumption of protein, fat and carbohydrate. The subjects also underwent mental evaluations every 15 months to determine if they were developing any issues related to dementia.

The results of the study were impressive by any measure. The risk of dementia in those at the higher end of the scale in terms of carbohydrate consumption increased by close to 90%. Those whose calories came more from fat were found to have a reduced risk of becoming demented by around 44%. Higher protein consumption was also associated with reduced dementia risk, by around 21%.

In the discussion section of the report the authors call attention to other studies that relate these dietary parameters to brain health and function. They summarize research describing how reducing carbohydrate consumption is associated with reduced risk of mental decline. In addition, they point out results from the National Health and Nutrition Examination Survey revealing that a diet with a high percentage of fat is associated with better processing speed, learning and memory while lower processing speed was associated with a diet that favored higher carbohydrate foods. This information is important because beyond looking at risk for developing dementia, it relates diet to moment-to-moment brain function, and this clearly has merit as it relates to the patient in this discussion.

You will note at the end of this interview that I was strongly in favor of recommending dietary restriction of carbohydrate, while boosting dietary fat as a preventive measure for everyone who is at risk for Alzheimer’s disease. When you consider that the risk for this disease is 50/50 at age 85 years, clearly we are all at risk.

Can someone please pass the olive oil?

  • billslo

    Dr. Sabad said there’s little evidence for LCHF
    helping, then goes on to recommend a Mediterranean
    diet. There’s no consistent definition of a Med
    diet, let alone any evidence for its effectiveness.

    • Lynn Dell

      He said there’s little evidence for a LCHF helping Alzheimer’s, but that there is some evidence for it helping other neurological conditions, which is his rationale for recommending LCHF during when demetia starts to surface. That makes sense.

      The controversy was over pre-symptomatic/symptomatic phases of the disease and differing opinions on the diet for each. The other doctor said if there are no symptoms of dementia, that the types of fats in the Mediterranean diet provide adequate nourishment, being good fat. I’m guessing Alessio Fasano would agree with him on this point. Dr. Perlmutter does not agree – claiming the disease can be progressing years before symptoms start, thus a ketogenic diet is preferred all along, which makes sense to me. Dr. Perlmutter’s rationale was the evidence that even slight elevations in blood sugar raise dementia risks down the road, so the goal is to keep blood sugars on the low end of normal through a ketogenic diet as a preventive measure.

      The fact that the left brain is more susceptible to Alzheimer’s is fascinating. Never heard that before. Thanks, Dr. Perlmutter, for posting this.

      • Yvonne Forsman

        That doc needs to read upon gluten and all info coming out from the office of Dr Tom O’Bryan, one of the gluten experts of our time. No human can digest gluten, and never did. Meditterranean diet is garbage b/c it is based on grains. End of discussion.

        • Lynn Dell

          I did not see enough of this doctor to be dissing him the way as has been going on in this discussion. To wit, what I would need to know more of is what he would recommend in the pre symptomatic phases of diseases when there starts to be hyperinsulinemia, then higher fasting blood glucose, and systemic markers for inflammation, A1C, small particle LDL, etc. If he is not concerned until fasting glucose rises above 126, has a knee jerk eflex to prescribe statins and so forth, I would agree that that is not good medicine.

          • Yvonne Forsman

            I agree w Dr Perlmutter, disagree w the other doc, b/c of gluten in the Mediterranean diet.

          • Lynn Dell

            Grain Brain allows gluten free grains, and your first point was about gluten, not grains in general. There are a LOT of Mediterranean diet sites that are gluten free and use gluten free grains. In Grain Brain, these grains are allowed in strict moderation, and less are allowed in Grain Brain than on the Mediterranean diet. The Mediterranean diet does not demand that gluten containing grains be consumed, only that whole grains occupy a higher percentage than in Grain Brain. Both diets demand that only healthful fats and good vegetables be eaten, and not too much red meat, and red wine is allowed, also olive oil. Lots of polyphenols in both diets. But that’s just a wind-up.

            The reason I am inclined to respond to these points is to leave open the possibility of barking up the wrong tree and missing the important point that both diets are very gut friendly diets. And when you zoom out to look at the larger picture, there are many rural cultures, some Dr. Perlmutter has mentioned, that have very diverse microbiomes, no autism or ADHD in children and yet they consume grains and starchy tuners etc. as staples in their diet. In fact, that picture Dr. Perlmutter posted from Burkina Fossa was of a woman kneading bread of some kind. And this was, after all, a discussion on neurological disorders and diet. The people in Burkina Fossa, and in many blue zones consume grains higher than Grain Brain and don’t have the neurological problems we have in the USA and elsewhere. So I’m not sure the real problem is the grains in the Mediterranean diet to the exclusion of all else that diet offers.

            When I consider all these things, I just do not have it in me to severely disagree with the other doctor. I would need to know what lab values he considers problematic enough to severely restrict carbs, what kinds of meds he dishes out, etc.. It just takes stepping back from the YouTube discussion above and musing on the boat
            load of information we have been blessed with here and elsewhere. And I guess some of it comes from some things I read from Dr. Fasano.

          • Yvonne Forsman

            You mention Dr Alessio Fasano, MD. In the global gluten summit organized by Dr Tom O’Bryan in 2013, Dr Fasano said that science now acknowledges that no human can digest gluten, and no human ever could. I have read about a 5.300 yrs old mummy, which was diagnosed with today’s scientific tools with atherosclerosis, now known caused by gluten. There 300 health problems caused by gluten. According to Dr Perlmutter, different body parts take different time to break down, it takes the brain 30 yrs, and if I had known that 30 yrs ago, I would not have dementia today. Too late now! I don’t know about the ppl living in the mentioned pristine environments on our planet today and not having any health problems caused by gluten, but just a few hrs ago I read an article by Dr Mercola which said that we are all getting increasingly sick, majority of the global population has f-i-v-e diseases, only 4% of all ppl are healthy (of 7 B ppl). In the US we produce eighty thousand tons chemicals every yr. I wonder where does it all go? It is in the soil, in food, in water, in air, in our urine, even in breast milk and babies are born with 200 toxins in the umbilical cord, unless their mom detoxed 6 months prior to conception. Maybe in this day and time, b/c of the total environmental load, we should all try to eat grain free and organic. Unfortunately, 80% of food in the grocery store contains glyphosate. Sorry if I am repeating myself. I have learned a lot from Dr Perlmutter, Dr O’Bryan, and also Dr Peter Osborne who advocates a-g-a-i-n-s-t pseudo grains in the so called gluten free commercial products, b/c the products are free from w-h-e-a-t gluten but contain gluten in the flours they are made of! There are thirty thousand gluten proteins out there, wheat gluten is only one of them. Often patients who live on the gluten free commercial products don’t get better! Of this very reason I have cut out a-l-l grains, except occasional quinoa. I am aware of the fact that many health care professionals think that a little poison won’t kill you, but I just don’t prefer poison at all. You are right, I probably mentioned gluten, not grains, at first. There are two problems regarding Alzheimer’s. First, gluten is no good for overall health, it destroys the intestinal villi which then leads to holes in the intestinal wall and proteins escape and end up in the brain where they should not be, second, grains have complex carbs which break down to sugar, the enemy of the brain. So I meant both, both gluten and grains/sugars should be cut out of the diet for anybody who in 30 yrs from now wants to have clear thoughts. Obviously not me. Young ppl believe they are indestructible, but at my age (60), plagued with several diseases, you realize how fragile our health actually is! And nature too! It takes nature almost a thousand years to build perfect soil for us to grow nutritious foods, but it takes only one application of Roundup/glyphosate to destroy it. Not only has the large scale mono agriculture destroyed perfect soil worldwide and thus our ability to nourish ourselves, we are also facing a global drinking water shortage, and on top of that, we are no longer in a global warming phase, according to 114 NOAA stations all across the US, measuring temps during the last 10 yrs, we are now in a global cooling period. This is explained by the sun’s cycles, now in a cycle of declining magnetic filed, which results in more frequent earthquakes and volcanos, as we have noticed, and also lower temps. The Russians say that the retired NASA scientist John L Casey is downplaying the severity of the future 200 yrs of global starvation. So in perspective of these severe global problems, what is a grain of wheat gluten, right? Not much if you can still remember things, but a hole lot if you no longer can.

          • Lynn Dell

            Keep writing out what you are learning.

            I agree modern wheat is bad, and so is glyphosate, and so are oxidized fats, too many carbs besides modern wheat,, fluoride in water and the list goes on. And I agree with your point that, “Maybe in this day and time, b/c of the total environmental load, we should all try to eat grain free and organic.” In fact, I’ll add to your point. There are many people now letting their children play in dirt to help their microbiomes, but that dirt may be sterile and toxic. I agree it’s all around us.

            And the other cultures that eat grains – lots of them, and don’t get neurological diseases, some of these cultures are rife with infectious diseases.

            You are thinking and writing of all the factors that are destroying human health, yet, the one question still remains as to why many cultures in the world have grains as a staple In their diets and not hardly a lick of autism, ms, ADHD, dementia. Part of the answer must be the health of their respective intestines, which are shown to be better and more diverse than ours. They consume grains as a staple, yet have healthy guts, and neurological diseases are extremely rare. Why? That is what I am asking, in a nutshell.

            I mean this sincerely – if I wore a hat, it would be off to you in your valiant fight to regain health, and I wish and pray much success for you.

          • Yvonne Forsman

            Thank you for the compliment. Yes, it would be interesting to understand why healthy ppl are still healthy in this otherwise sick world. There are two reasons I can come up with, 1. they soak their grains, beans and nuts, to minimize the anti-nutrients (phytic acid), b/c according to Sally Fallon, soaking lowers the amount of the anti-nutrients, and 2. if they eat a lot of fermented foods (promotes good gut bacteria), that would help as well. But in theory, if a person has grains as their s-t-a-p-l-e, the gluten will cause harm, leading to disease. Roundup/glyphosate, which disrupts the microbiome, is pretty much all over the world. What areas of the world do you think have those healthy ppl?? I am really interested to find out, to understand this subject. Thank you.

          • Lynn Dell

            Dr. Perlmutter mentioned blue zones in Brain Maker, in addition to posting about the more diverse microbiomes of rural people groups, such as in Burkina Faso (which is NOT a blue zone – they have better gut bacteria and less neurological diseases, and their dietary composition is high in grains). Blue zones are characterized by longevity and a higher percentage of people living to over 100 years. It’s more than diet, but I found a link which examines the diets of the five so-called blue zones of the world: http://www.npr.org/sections/thesalt/2015/04/11/398325030/eating-to-break-100-longevity-diet-tips-from-the-blue-zones

          • Lynn Dell

            I feel the need to do a station identification for you. I can’t eat modern wheat, corn, rice, high fructose corn syrup, cooked potatoes, and a lot of fruit, being prediabetic. Aspartame hurts me, so I stay away from it. I’m not trying to justify me going back to eating those things on a regular basis. Now, regarding the link above, keep in mind they emphasize blue zone cultures are a lot more than diet. Stress is a real killer, as is social isolation, and lack of exercise. These cultures all have a strong sense of community and not the kind of stresses we put ourselves under, and they are physically active. It seems to me they get good sun exposure as well.

          • Yvonne Forsman

            Sorry to hear about the diabetes. I know somebody who got rid of it by being on raw food diet for one year (he followed nutrition advice by Hippocrates Institute, West Palm Beach, FL, they have a website). I am grain free, not missing grains. I was a vegetarian, later a vegan, total of 15 years, that’s how I got sick, sadly. I still eat a lot of veggies, raw and cooked, and some animal protein (had to force myself to eat the protein in the beginning of switching the diet), but I must admit that making my own beef bone broth (Dr Mercola recipe) has helped with my mood, anxiety, paranoia, thanks to the amino acids (proteins) glycine and proline in the broth. I drink one cup every morning and it makes the world of difference, I no longer get upset by TV news, don’t get agitated or suicidal. But I wish I could be a vegan, it tastes better (to me). I ate a lot of soy protein and later was diagnosed with breast cancer. Apparently most breast cancers are so called hormone positive (soy has plant estrogen, my oncologist told me to stop eating it, I did). It’s not easy to stay healthy. *sigh* Good luck with the diabetes!

          • Yvonne Forsman

            I have googled prevalence of Alzheimer’s by country, and consumption of different foods high in carbs/sugars, such as sugar, wheat, rice, beans, potatoes and dairy, by country. I can see that Finland and Sweden both have a high dairy intake and high Alzheimer’s. Costa Rica (the Blue Zone) has a high sugar intake and high Alzheimer’s. US has a high wheat intake and high Alzh. Re Costa Rica, they eat a dish consisting of beans (soaked overnight, lowering the amount of anti-nutrients) and rice 3 times a day, with eggs for breakfast, with meat or fish for lunch and dinner, but they also serve it with sour cream (fermented dairy, good gut bacteria). Re the Blue Zone book, strangely the author does not mention The Valley of Longevity in Ecuador where ppl also grow very old, or Russia/Caucasus famous for kefir (fermented dairy) and longevity. I agree with you on longevity probably having many causes apart from nutrition. Here is the link to Alzheimer’s by country http://www.worldlifeexpectancy.com/cause-of-death/alzheimers-dementia/by-country/

          • Lynn Dell

            Yvonne, the blue zones are isolated regions within countries, and these countries may have high rates of dementia, just not within the blue zone. So it is an isolated group in Costa Rica, not the country as a whole that is being studied. Also, Loma Linda, CA is in the USA, and even though the USA has a very high rate of dementia, Loma Linda is a breathtakingly remarkable exception. Hence, the chart in the link you gave isn’t good when evaluating blue zones, for blue zonea exist as isolated groups and exceptions within their respective countries, and do not represent the country as a whole.

          • Yvonne Forsman

            Yes, I understand that. 🙂 Those are a few isolated paradise spots, not representative of the global population. And yes, the question remains: how come they live so long, and no doubt there is an intertwined number of causes for the lucky outcome. But in a global perspective, I think the website with the Alzheimer’s numbers is very interesting. As I was searching for correlation between Alzheimer’s and diet, I only found the dairy and sugar statistics speaking loudly, while numbers for other foods such as wheat, rice and potato (high in complex carbs which break down to sugar) were confusing… Low Alzheimer’s prevalence in top 3 countries with high consumption of these foods: Wheat: China, India, Russia, Rice: China, India, Indonesia, Potatoes: Belarus, Kyrgyzstan, Russia. So no doubt one would have to look at the whole picture of the diet in each country, and maybe somebody already has and there is a book written about it? Re the Mediterranean diet, mentioned earlier, according to google, it is based on whole grains and legumes (beans). I would not go back to eating grains, not only b/c of the sugar load, but also knowing that gluten leads to 300 health problems as outlined in this list by Cleo Libonati, RN and PhD:
            http://www.recognizingceliacdisease.com/21.html

          • Lynn Dell

            Thank you for your breakdown of the global map you provided, and for your research into it! I did not take the time to see how much of what kind of macronutrients were consumed. So many factors at play here – omega 3 to omega 6 ratios, how much food is cooked, how much meat is eaten, whether the microbiome can handle the meat, the consumption of raw above ground vegetables including prebiotic fibers, how much fiber and what kind, and fermented foods, how much exercise, how much sunlight, the quality of sleep, and much much more, all at play with genetic makeups that differ like snowflakes or fingerprints.

          • Yvonne Forsman

            Yes, it is a question with a complex answer, no doubt. The only thing we can be sure of is the fact that science does not understand the body completely, yet. I was reading about the latest research out of Virginia University, published June 1st 2015, about the brain, where somebody said he thought the body was mapped back in the fifties, but this new research shows we are still finding things we did not know (the brain is connected to the immune system through its own lymphatic system), and now all the books will have to be re-written. What I learned studying nutrition 35 yrs ago is totally wrong today! There was a funny joke on FB, can’t remember it right now, something about the past not being the same as the present. We are in a state of continuous progress!

  • Cheryl Hennessy

    thanks for sharing. i think the bigger hurdle is when patients are in a facility where they don’t have control over meals. appreciate any suggestion on such a transition please 🙂

    • Yvonne Forsman

      Dr Mark Hyman, M.D., active at the Cleveland Clinic, Center for Functional Medicine, says we all need to look at disease from a holistic perspective b/c organs are interconnected and gut microbiome and gut health is extremely important to the whole body functions. A new research out of Virginia Univ on June 1st, 2015, explained the brain has its own lymphatic system (not previously known) which is connected to the immune system! Ha! That screams how important it is to eat clean foods, free from chemicals destroying our immune system!!!! Nutritionists, dieticians, chefs, cooks, they all need to re-educate themselves. That’s a fact. I have seen online news about some hospitals growing their own o-r-g-a-n-ic produce. That’s one step in the right direction. But animal protein and dairy should also be organic! There was a post on FB where somebody said she found a bag of frozen veggies at Walmart where the label said 95% organic. It is like being 95% pregnant. Ppl laughed at it. It is about awareness of what foods protect our health and which ones hurt our health. “Moms Across America” organization works to spread food and health info to moms with children with mental diseases such as ADD, ADHD and ASD (autism), b/c these health symptoms can be helped by a “clean” diet. It is the same for dieticians responsible for meals at schools, they also need to be re-educated. There is no difference between sick children in a day care or a school, sick adults in hospitals or sick elderly in nursing homes, we are all humans, our bodies follow the same laws of nature, garbage in, garbage out! We all need to educate ourselves and implement changes promoting health. And this is also a political issue! EU/European countries prohibit sale of GMO foods while the US does not and we are getting increasingly sick b/c of that! WHO has declared the herbicide Roundup/Glyphosate carcinogenic. It also causes other diseases, destroys our immune system, leads to birth defects and infertility. 1 in 3 men and 1 in 2 women will be diagnosed with cancer during their life time! The US produces eighty thousand tons chemicals each year. Where does it all go? It is in our soil, food (80% of food in the grocery store), water, air, in our urine and even in breast milk. Babies are born with 200 toxins in the umbilical cord unless their mom detoxed 6 months prior to conception. Statistics predict that in 10 yrs from now 1 in 2 newborn will have autism. Most doctors still treat only symptoms, not causes of diseases, they only prescribe pills, but our body is not sick b/c of lack of Big Pharma pills!!! The whole society needs to rethink how we live, what we prioritize. We cannot pollute our environment and stay healthy, we are part of the environment! That’s like poisoning water in a fish aquarium and being surprised when all the fish died. Duh!!! It’s about education, about networking, about helping each other, about shifting perception from us vs them, b/c we are all in the same boat! Look at the political candidates running for the Oval Office, how many of them have any knowledge about the connection between environmental pollution, the food we eat and the diseases that plague us??? I know one candidate that declares support for the chemical industry and the GMOs!!! How blind, deaf and stupid can you be..??? And these are the ppl representing us, working on our behalf, protecting us! No, they don’t!!!

  • Ri

    “respectfully i dont agree” you are so tactful Dr Perlmutter! i love how you disagree respectfully :)-that doctor who was disagreeing with you was contradicting himself i agree with you and im loving reading Brain Maker and learning

  • Ri

    and you are glowing your skin looks great! do you recommend a line of skin products? thanks

  • Rebecca

    You have to just love Dr. Perlmutter. I love how clearly he always explains things.

  • Diane

    Great discussion! Thanks Dr Perlmutter.

  • Stephen

    Very interesting discussion/debate. Please try to do a little better with the sound quality.

    • David Perlmutter

      Thanks for that feedback Stephen. I don’t have control over that, but I’ll pass that feedback along.

  • HighlandHoney

    Where are your products sold since you no longer sell them from your website?

    • Annehedgpeth

      Please help with this problem. I was on your supplements and noticed a big difference.. I want to be able to continue.

  • Yvonne Forsman

    What a great discussion, thank you so much for posting this interview!!! I have read a lot about gluten/grains and I think I read that the problem with smelling is related to gluten, so cutting out all grains would be a must. I think quinoa is the only acceptable “grain” b/c it is actually not a grain. Mediterranean diet is based on grains, while Paleo is free from grains. Paleo diet style would be helpful, consisting of a lot of veggies, both cooked and raw salads, some animal protein, a lot of butter, coconut oil and olive oil, fermented veggies, fermented dairy = yogurt of kefir, kombucha tea (fermented drink), and one cup of homemade beef bone broth for breakfast daily (w added 1 tbsp org butter and 1 tbsp coconut oil) to heal the gut which is apparently damaged since the patient can’t smell food. Google Dr Mercola beef bone broth recipe (it has to be organic beef bones, b/c org chicken bone broth has not he same healing effect). This diet should be easy to follow as there are very many Paleo recipes online. Also organic foods are important as herbicides and pesticides (Roundup/Glyphosate) in foods cause diseases. Drinking filtered water is also important, to avoid health damaging metals such as aluminum and mercury which are the #1 enemy of the brain. Re the Mediterranean diet I agree w Dr Perlmutter. It is very high in carbs/grains. Btw gluten is a protein in grains that no human can digest. On top of that, grains contain phytic acid which inhibits absorption of minerals and enzyme, leading to depletion and diseases b/c there are several hundred chemical reactions in the body every day which need minerals, enzymes and vitamins.

  • Astrid Kelly

    Great discussion! I’m studying Naturopathic Nutrition and your books and conversations in you tube are of real help! Thank you Dr. Perlmutter.

    • David Perlmutter

      Glad to know you enjoyed this discussion Astrid.

  • Madeline

    Thanks so much Dr. I have been trying to clean up my diet in the past month and have read both of your books. At 66 years old, and a survivor of antidepressants and benzodiazepines (almost two years off of both, I have an interesting observation. I noticed that after two weeks off of gluten and most carbs, my sense of smell dramatically increased. I was worried that it might be a sign of dementia, as I still have some brain fog from withdrawal. Now I know that it’s a good sign. My depression is also improving. As a caregiver to my husband, who has mid stage dementia, I am also very interested in helping him. However, I think it is too late, since he is so very addicted to bread and jam, and I can’t talk him put of it. Madeline Winter

  • Joe Texan

    Dr. Perlmutter,
    I recently did a neuropsychological assessment of a boy and included a specific recommendation to read your book Grain Brain. His mother gave it to their naturopathatic doctor who just finished medical school. She was thrilled and sent me a copy of Brain Maker, which I had already read, but I didnt tell her that and just thanked her. She said you are her hero and the hero of all the students at her medical school. Kudos David. You are my hero also.

  • Lang

    At about 4 minutes into the above video you recommend about one liter of olive oil a week, which is a little over half a cup a day. I’m wondering whether that is correct? How many grams of fat daily do you think is the maximum a person should eat? Thanks

  • Roger Bradford

    I am an extreme cyclist 200 to 300 miles a week. I used to have a gatorade at our rest stops about every 25 miles. Can you suggest a commercial drink that I could safely drink. I carry water bottles on my bicycle.

    • Greg Reser MD

      Jeff,

      I recommend reading The Art and Science of Low Carbohydrate Performance by Volek/Phinney. Good resource for endurance athletes to switch over to ketogenic diet. No more bonking!

    • Karl

      Gatorade is really bad. Water and lemon/lime and salt is much better

  • John

    Good conversation. I wish Dr Perlmutter would have noted the benefits of pro and prebiotics a bit more. I have been following Dr Perlmutter for seven years since my girlfriend was Dx with ALS. She is still alive enjoying life following a number of Dr Perlmutter’s protocols. I believe his six essential keys and supplements in Brain Maker is a game changer (using the doc’s verbiage)!

  • Deborah

    Thank you Dr. Perlmutter for sharing your knowledge. We need to know the importance of eating for health. More importantly is what to eat to live healthy lives. Thank you and get out there and help us all.

    • David Perlmutter

      Glad to know you enjoyed this discussion Deborah.

  • Deborah

    In 2006 I had a par thyroid gland removed, due to too much calcium in blood. 12/2011 after four days of feeling like I could not burp was told I was having a heart attack. They put in four stents and thankfully no heart damage. 05/2015 I was told I have trigeminal neuralgic and give gabapentn that has taken away that pain in my face. Back in Oct. 2012 the eye dr. told me my body was full of inflammation. I told my pc dr who was not concerned. I am wondering if these conditions are related to inflammation in body. What can I do to help myself. I am 90% gluten free, eat mostly fruits, vegs, salmon and really try to eat healthy. Thank you for all you are doing to educate the world.

    • Alice emery

      The diet changes you have made are good. Here is how to make it better, if you want to, decrease the fruits to a small amount. They have a lot of sugars. Stick with berries for small amounts of fruit. If you are eating salmon, eat the wild caught not farmed fish. Farmed fish do not have health benefits. Drop the artificial sweeteners, get used to not eating sweets. Think of sweets as harmful. Think “full” fats as they will make you feel full and satisfied. If you are not eating sweets (carbs) the fat won’t make you fat. I feel so much better without the carbs. Whenever I get a sweet tooth and eat something like donuts, I gain several pounds of water weight and feel crappy all day. We have several kinds of nuts and seeds to snack on. No food in the house that we don’t want to eat helps too.

      • David Perlmutter

        Much of this advice is in-line with a Grain Brain lifestyle.

        • Alice emery

          Yes that is what I was trying to promote! I love your work, and am cautiously encouraging everyone to take steps in that direction with their diets. Thank you for presenting these ideas and making them accessible to medical practitioners as well as the general public.

  • john doe

    Ive just got the book BRAIN MAKER,,, FREE as a PDF download,,, Thanks Dr Perlmutter 🙂 🙂

  • Epiphany Bakery

    Stay away from Aluminum

  • cheryl

    My father, that has dementia, refused to eat for two days in a hospital setting. I had him removed and sat with him through the night. In the morning, he appeared more lucid than I had seen him in over a year. He talked and shaved and discussed family members. I was amazed. I gave him an egg breakfast which he refused to eat. Worrying about him needing to eat, I resorted to feeding him his usual donuts and orange juice. It was no more than an hour when he was back into his full dementia state. He is in a memory care facility and I realize now that his temporary recovery was probably due to his fasting state which replicated a ketogenic state. . However, the staff has refused to put my father on a ketogenic diet because it may hurt his kidneys, they say. I wish I could find a home that will allow a proper ketogenic diet to help my dad. And….there are so many patients that may also benefit…why isn’t this type of diet the norm in homes with memory care patients? Dr. Perlmutter, have you ever heard of a memory care patient having this type of improvement? Could a patient, experience long term improvement with a ketogenic/fasting approach?

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  • Andrea

    The findng that higher protein levels in the diet is associated with less incidence of alzheimers is at odds with the finding that in many individuals increased meat consumption and therefore higher homocysteine levels increases the risk of alzheimer’s. We need to be careful not to make recommendations across the board….

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