Dr. David Perlmutter, a neurologist and fellow of the American College of Nutrition, recently released the fully revised edition of his incredibly successful book, "Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar — Your Brain's Silent Killers."
Having sold over 1 million copies, it has achieved a landmark rarely reached by books about natural medicine. Two fundamental points made in his book are that, a) sugar is toxic to the brain; and b) nonceliac gluten sensitivity is real. And, with this fifth edition, Perlmutter has been able to update the book with even more supporting scientific evidence.
Newer Evidence Fully Supports Lifestyle-Based Alzheimer's Prevention
As noted by Perlmutter, even though there's no conventional treatment for Alzheimer's, research shows this devastating degenerative neurological disease can be effectively prevented by lowering sugar exposure, increasing exercise and improving the quality of your sleep.
"The science is now completely lined up behind us, showing that our dietary choices are having a huge influence on the decay of the human brain … We're really hammering away at this profound relationship between even mild elevations of blood sugar and risk for dementia.
And certainly, the ideas that we put forward about becoming Type 2 diabetic and quadrupling your risk for Alzheimer's have been validated. The data that we did not have [five years ago] that we have now, with reference to what's causing diabetes, I think is really very intriguing, and is cause for us to take a step back and take a breath.
Because what we're now looking at is powerful data that connects statin use in both males and females with development of diabetes. In males, it's about a 41 percent increased risk of diabetes in statin users [and] … a 71 percent increased risk of developing diabetes in women who are put on a statin medication.
They become diabetic and their risk for Alzheimer's goes up dramatically — as much as three- or fourfold. Do I wish I would have had that information five years ago? Well, it wasn't published, so I didn't have it. But it's really hugely important that we, as physicians, try to practice under the notion of 'Above all, do no harm.'
We are making men and women diabetic and magnifying their risk for Alzheimer's and cardiovascular disease. I mean women have a three to four times increased risk of coronary artery disease if they become diabetic. For men, it's a two- to threefold increase, which is huge … That's new information.
The dietary information … now lines up [with] the idea that fat is actually good for us and that the real relationship that's damaging to us is our relationship with sugar and carbs.
That was our original message that was accepted by most, but certainly experienced a bit of pushback from mainstream medicine that wanted us to believe that we should all be low-fat and no-fat. We now know with great confirmation that [low-fat] is absolutely the wrong approach."
Ketogenic Diet and Intermittent Fasting Reverse Type 2 Diabetes
Among the studies published in more recent years that support diet-based disease prevention is Dr. Jason Fung's case series paper1,2 published in BMJ Case Reports, which details how fasting can be used as a therapeutic alternative for Type 2 diabetes. This exciting report actually made the front page of CNN online.3
Of the three patients, two did alternating-day 24-hour fasts, while one fasted for 24 hours three times a week over a period of several months. On fasting days, they were allowed to drink unlimited amounts of low-calorie fluids such as water, coffee, tea and bone broth, and to eat a low-calorie, low-carb dinner.
On nonfasting days, they were allowed both lunch and dinner, but all meals were low in sugar and refined carbohydrates throughout. (The complete manual of the fasting regimen used is described in Fung's book, "The Complete Guide to Fasting."4)
Two of the patients were able to discontinue all of their diabetes medications while the third was able to discontinue three of his four drugs. All three also lost between 10 and 18 percent of their body weight. All of these patients had been taking insulin for up to 20 years, yet were able to completely reverse their diabetes through this dietary change alone. Fung is not the only one who has demonstrated this.
"Dr. Sarah Hallberg of Virta Health published a report last year in a study of 100 individuals with Type 2 diabetes … Just putting them on a ketogenic diet reversed diabetes in many, and across the board, dramatically reduced their [need for] medications.
One class of drugs that's commonly used in Type 2 diabetics are sulfonylureas. In [Hallberg's] study, she was able to get 100 percent of the people taking sulfonylureas off of that class of medication. Who knew? Well, we suspected it. Many of us knew. I use that sort of rhetorically. But diet is key.
A ketogenic diet has also been implemented in individuals with early-stage cognitive decline and has been demonstrated to reverse their cognitive decline. Dr. Dale Bredesen certainly uses a higher fat ketogenic diet in his protocol for Alzheimer's disease. I think it really gets to the notion of why a diet that's higher in sugar, higher in carbs, is so detrimental for the brain.
I mean that was our contention with the original 'Grain Brain' five years ago. Mechanistically, when you have elevated blood sugar, you're doing a lot of things, one of which is to compromise the insulin receptor. [Your insulin receptors] become resistant to the effects of insulin. We now know that insulin is far more important than simply helping your body deal with blood sugar.
The insulin receptor has dramatic effects in terms of its activity in the brain … to keep our brain cells healthy. As we start to compromise the ability of our brain to be receptive to insulin, by virtue of our elevated blood sugar, we see the powerful relationship that that has now with developing dementia,"Perlmutter says.