This Is Your Brain on Gluten

A No. 1 bestseller by a respected physician argues that gluten and carbohydrates are at the root of Alzheimer's disease, anxiety, depression, and ADHD. What to make of the controversial theory?

“If you could make just three simple changes in your life to prevent, or even reverse, memory loss and other brain disorders, wouldn’t you?”

So asks Dr. David Perlmutter, in promotion of his PBS special Brain Change, coming soon to your regional affiliate. Three changes. Simple ones. Wouldn’t you?

The 90-minute special is a companion to Perlmutter’s blockbuster book on how gluten and carbs are destroying our brains. In November it became a New York Times number one bestseller. Since its September release, as Perlmutter told me, “It’s never not been on the bestseller list, frankly.”

“Is it still number one?” I asked. A pause over the phone as he checked. In modern interview style, we were both also on our computers.

“As of next week it’s number six ... darn.”

The book is Grain Brain: The surprising truth about wheat, carbs, and sugar; your brain's silent killers. It promises straightforward dietary solutions to prevent the illnesses we most hate and fear.

Why wouldn’t you make three simple changes?

* * *

“The question is, how far will you take the Paleo diet?” Perlmutter asked in a recent video on his YouTube channel. “Here we are at a Chinese grocery store in San Francisco—and this is part of the Paleo diet.”

He holds up a large frog.

“How far will you go?”

That is Perlmutter’s kind of joke. He is not joking when he says that carbohydrates, even the whole-grain carbs that many of us think of as the good ones, are the cause of almost every modern neurologic malady. That includes dementia, decreased libido, depression, chronic headaches, anxiety, epilepsy, and ADHD.

“It may seem draconian,” he says, “but the best recommendation I can make is to completely avoid grains.”

“Most grain foods, whether we’re talking about quinoa, amaranth, the very popular grains of the day, the reality is they still are associated with a carbohydrate surge. They have a fairly high glycemic index, meaning that after 90 to 120 minutes, your blood sugar is going to go up, and that is detrimental to the brain.”

Humans consume calories in the form of three macronutrients: carbohydrates, protein, and fat. Perlmutter describes the current U.S. diet as 60 percent carbs, 20 percent protein, and 20 percent fat. His ideal is close to that of the Paleo diet: 75 percent fat, 20 percent protein, and 5 percent carbs. He allows for up to 50 to 80 grams of carbs daily, which is about one serving of fruit. The heart of the diet is “good fats like olive oil, avocado, wild fish, organic nuts and nutrient-dense vegetables.”

* * *

David Perlmutter practices in Naples, Florida. He holds a medical doctorate from the University of Miami School of Medicine. He is both a board-certified neurologist and a fellow of the American College of Nutrition—the only person, he says, to have both credentials. He is the medical director of the Perlmutter Health Center and the Perlmutter Hyperbaric Center. His practice is endorsed by Mehmet Oz, “America’s Doctor” (Oprah-appointed), who says he has referred patients to Perlmutter “with wonderful results. He is on the cutting edge and can help change the way we practice medicine.”

Oz’s endorsement also wanders across the jacket of Grain Brain: “An innovative approach to our most fragile organ.”

In large letters at the top of his website, Perlmutter describes himself as an Empowering Neurologist. To my knowledge and his, this is another distinction unique to Perlmutter. This is presumably not to imply that neurologists without this qualifier are not empowering, but that in a specialty plagued by powerlessness in the face of many incurable and barely treatable diseases, he offers power.

In his 2013 book Do You Believe in Magic?, University of Pennsylvania pediatrician Paul Offit wrote about the idea that there is really no such thing as alternative medicine; there is only what is proven to work and what is not. His book meticulously debunks alternative medical myths with science. Offit recounts hundreds of years of history of physicians peddling hope: Max Gerson’s miracle cancer prevention diet in the 1980s, William Koch’s 1940 cancer-curing glycoxide, which turned out to simply be water, and Burzynski’s “urine cure.” (Dr. Stanislaw Burzynski claims to have discovered a unique peptide with anti-cancer properties, which he then, according to his website, “began extracting from human urine, since it was far easier to obtain large amounts of healthy human urine versus healthy human blood. Burzynski began setting up collection containers at state parks, religious institutions, and even prisons. Today, Burzynski synthesizes the chemicals to help your body naturally produce these peptides in his massive 46,000-square-foot manufacturing facility in Stafford, Texas”).

Offit’s book spent zero weeks at the top of the bestseller list.

Over the last 40 years, people have become addicted to gluten, Perlmutter’s narrative goes. In combination with carbs, gluten’s influence on our diets explains why we get dementia—and every other common neurologic problem. “Inflammation is the cornerstone of Alzheimer’s disease and Parkinson’s, multiple sclerosis — all of the neurodegenerative diseases are really predicated on inflammation. Who knew?”

“Who knew” is Perlmutter’s vocal tic. He says it where a celebrity diet guru might say “It’s just that simple.”

Publicists started to contact me about this book in August. I was reluctant. Wouldn’t you like to speak with Dr. Perlmutter about his new book? As the book spent week after week at the top of The New York Times bestseller list, it became clear that people cared about this idea.

Well, Perlmutter has been practicing medicine for decades and has seen all kinds of tragedy. He took the same Hippocratic Oath I did in medical school. I agreed that there was something to his basic tenet that “diet is fundamentally important in reducing the degeneration of the body, and particularly the brain.” But then he calls gluten “a modern poison” and earnestly, imploringly likens eating it to drinking gasoline. Okay, let’s talk.

* * *

“Why do you think this book has seen such an enormous response?” I ask. “It is now being published in 15 countries.”

“It’s not because of the marketing,” Perlmutter says, quickly. His speech is almost completely devoid of pauses. “I think it’s because of the empowerment. I think people are finally getting this message that’s so darn important for brain health. This is information that people have not gotten from the mainstream medical community. People say ‘what you’re promoting here is really outside the box. Is that your mission?’ I try to explain that, no, my mission is to make this inside the box. To make the box bigger. So that mainstream medical professionals will begin to discuss the importance of these factors. Because it’s already there. In the peer-reviewed literature. It’s been there for decades. There’s nothing proprietary about this. Every peer-reviewed article is available in the “Science” section of my website.”

In fact it is. There are full-text PDFs of articles from The New England Journal of Medicine, Neurology, and many other credible peer-reviewed sources—the sort that are typically behind paywalls. His site hosts what appears to be every journal article that might support his argument.

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James Hamblin, MD, is a senior editor at The AtlanticHe is the host of If Our Bodies Could Talk.


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