Too many carbs in our diet, says one expert, are spurring dementia and a national Alzheimer's crisis
By Gary Drevitch
Originally Posted On December 11, 2013
Gary Drevitch is senior Web editor for Next Avenue's Caregiving and Health & Well-Being channels. Follow Gary on Twitter @GaryDrevitch.
It's tempting to call David Perlmutter's dietary advice radical. The neurologist and president of the Perlmutter Health Center in Naples, Fla., believes all carbs, including highly touted whole grains, are devastating to our brains. He claims we must make major changes in our eating habits as a society to ward off terrifying increases in Alzheimer's disease and dementia rates.
And yet Perlmutter argues that his recommendations are not radical at all. In fact, he says, his suggested menu adheres more closely to the way mankind has eaten for most of human history.
Perlmutter's book is propelled by a growing body of research indicating that Alzheimer's disease may really be a third type of diabetes, a discovery that highlights the close relationship between lifestyle and dementia. It also reveals a potential opening to successfully warding off debilitating brain disease through dietary changes.
Grain Brain does delve deeply into the neurological effects of dietary sugar. "The food we eat goes beyond its macronutrients of carbohydrates, fat and protein," Perlmutter said in a recent interview with Next Avenue. "It's information. It interacts with and instructs our genome with every mouthful, changing genetic expression."
Human genes, he says, have evolved over thousands of years to accommodate a high-fat, low-carb diet. But today we feed our bodies almost the opposite, with seemingly major effects on our brains. A Mayo Clinic study published earlier this year in the Journal of Alzheimer's Disease found that people 70 and older with a high-carbohydrate diet face a risk of developing mild cognitive impairment 3.6 times higher than those who follow low-carb regimens. Those with the diets highest in sugar did not fare much better. However, subjects with the diets highest in fat were 42 percent less likely to face cognitive impairment than the participants whose diets were lowest in fat.
Further research published in the New England Journal of Medicine in August showed that people with even mildly elevated levels of blood sugar — too low to register as a Type 2 diabetes risk — still had a significantly higher risk of developing dementia.
Turning to Nutrition, Not Pills
This fall, the federal government committed $33.2 million to testing a drug designed to prevent Alzheimer's in healthy people with elevated risk factors for the disease, but "the idea of lifestyle modification for Alzheimer's has been with us for years," Perlmutter says, and it's cost-free.
The author hopes his book and other related media on the diet-dementia connection will inspire more people to change the way they eat. "Dementia is our most-feared illness, more than heart disease or cancer," Perlmutter says. "When you let Type 2 diabetics know they're doubling their risk for Alzheimer's disease, they suddenly open their eyes and take notice.
"People are getting to this place of understanding that their lifestyle choices actually do matter a whole lot," he says, "as opposed to this notion that you live your life come what may and hope for a pill."
As we learn more about the brain's ability to maintain or even gain strength as we age, Perlmutter believes, diet overhauls could become all the more valuable.
"Lifestyle changes can have profound effects later in life," he says. "I'm watching people who'd already started to forget why they walked into a room change and reverse this. We have this incredible ability to grow back new brain cells. The brain can regenerate itself, if we give it what it needs."
Change We Ought to Believe In
Changing minds, however, is an uphill climb. "The idea that grains are good for you seems to get so much play," he says. "But grains are categorically not good for you," not even whole grains.
"We like to think a whole-grain bagel and orange juice makes for the perfect breakfast," Perlmutter continues. "But that bagel has 400 calories, almost completely carbohydrates with gluten. And the hidden source of carbs in this picture is that 12-ounce glass of fresh-squeezed orange juice. It has nine full teaspoons of pure sugar, the same as a can of Coke. It's doing a service with Vitamin C, but you've already gotten 72 grams of carbs.
"It's time to relearn," he says. "You can have vegetables at breakfast – the world won't come to an end. You can have smoked salmon, free-range eggs with olive oil and organic goat cheese and you're ready for the day. And you're not having a high-carb breakfast that can cause you to bang on a vending machine at 10 a.m. because your blood sugar is plummeting and your brain isn't working."
But the change is worth making, he says, at any age.
"Nutrition matters," Perlmutter says. "The brain is more responsive to diet and lifestyle than any other part of the body and until now it's been virtually ignored. We load up on medications when our mood is off, we hope for an Alzheimer's disease pill when we get older. I submit that we need to take a step back and ask, 'Is this really how we want to treat ourselves?'"