- Aging -

Overcoming Grain Brain

Overcoming-Grain-Brain

A renowned functional-medicine neurologist says we are suffering an epidemic of neurological illnesses. And the best cure may be at the end of our forks.

Several years ago my family’s beloved terrier, Teako, began losing his fur, so my wife and I took him to the veterinarian. The first question the vet asked was simply, “What are you feeding your dog?” I was struck by this question. After all, it’s fairly unusual for a doctor to ask an ailing human patient, “What are you eating?”

Most people might be taken aback by such an inquiry. They expect queries about their medications and symptoms, not their dietary choices. And, yet, as I explained in my previous book, Grain Brain, what we eat is the most important decision we make every day in terms of health and our ability to resist and combat disease.

I believe that the standard American diet, which is high in carbohydrates and low in fat, is at the root of many of the modern scourges linked to the brain, including chronic headaches, insomnia, anxiety, depression, epilepsy, movement disorders, schizophrenia, attention deficit hyperactivity disorder (ADHD), Parkinson’s, and Alzheimer’s.

The idea that our brains are sensitive to what we eat has been quietly circulating in our most prestigious medical literature recently. While it’s common knowledge now that “heart smart” diets can help support the cardiovascular system, we are just starting to learn that what we put in our mouths can similarly affect our brains’ health — for better or worse.

Recently, the New England Journal of Medicine published a study showing that the costs for dementia care in 2010 were estimated to be as high as $200 billion, far outpacing expenses related to heart disease and cancer. By some estimates, 2.7 million Alzheimer’s patients in America today might not have developed this disease if only they had learned that food matters.

Inflammation: The Silent Killer

As a practicing neurologist, I’ve dealt with a wide array of brain disorders for more than 30 years. Unfortunately, I work in a medical system that’s still trying to treat patients with strong drugs rather than by focusing on disease prevention. In today’s world, we’re told that we can live our lives however we like, and then, if our health is affected, we just turn to our doctors to provide us with “magic pills.”

These drugs focus squarely on symptoms (in addition to altering the natural chemistry of the body and causing many side effects). They basically treat the smoke while ignoring the fire — in this case, inflammation.

Researchers have known for some time that the essence of all degenerative conditions, including brain disorders, is inflammation. In other words, the inflammatory process that’s involved in the degeneration of your arthritic knee or your coronary arteries is the same one that leads to the deterioration of the human brain. But until now, scientists didn’t know what triggered that inflammation.

To me and many of my forward-thinking colleagues, it has become clear that gluten (a protein found in wheat, barley, and rye) and a high-carbohydrate diet are among the most prominent stimulators of brain-based inflammation.

It has become clear that gluten (a protein found in wheat, barley, and rye) and a high-carbohydrate diet are among the most prominent stimulators of brain-based inflammation.

Digestive disorders and food allergies are relatively easy to spot because symptoms such as gas, bloating, pain, constipation, and diarrhea emerge relatively quickly. But the brain is a more complex organ. It could be enduring assaults at a molecular level without your feeling it. Unless you’re nursing a headache or managing an obvious neurological problem, it can be difficult to know what’s going on in your brain until it’s too late.

The upside is that our food choices can directly affect inflammation. And when you consider inflammation’s role in cancer, type 2 diabetes, heart disease, obesity, and virtually every other chronic condition common in Western cultures, the implications of what you eat are nothing short of life changing.

In my previous book, Grain Brain, I explain how excessive grain intake can negatively affect many aspects of both mental and physical health.

In my new book, The Grain Brain Cookbook, I give you the road map and the recipes to show you how to control your destiny through diet — even if you were born with a genetic tendency to develop a neurological challenge.

The Blood-Sugar Connection

If you live to be 85 years old, and you do nothing to change your risk for brain disease today, you have a 50/50 chance of developing Alzheimer’s disease. That’s a mere flip of a coin. If you have a family history of Alzheimer’s, your risk is dramatically increased. And if you’re a type 2 diabetic, your liability doubles.

Many doctors are now actually referring to Alzheimer’s as “type 3 diabetes.” The idea that your risk for Alzheimer’s is tied to diabetes may seem inconceivable at first. But it makes sense when you consider the relationship between these two ailments.

Diabetes is characterized by elevated blood sugar. And elevated blood sugar is directly toxic to brain cells. In fact, in a recent report in the top journal Neurology, researchers found that higher blood-sugar levels translate directly to more aggressive brain shrinkage, specifically in areas that determine our cognitive and memory function.

There’s no question that your blood-sugar levels are a reflection of your consumption of carbohydrates and sugars. This knowledge is what informs every recipe in my book.

In order to achieve ideal blood-sugar levels, you need to cut back on many carbohydrates, especially plain sugar, foods that contain starches (such as breads, pastas, and potatoes), and the liquid sugar found in juices and sodas. (A 12-ounce glass of orange juice contains up to 10 teaspoons of sugar, about the same found in a can of cola.)

Fruit also represents a significant source of carbohydrates. It’s perfectly fine to have a handful of blueberries or an apple a day, but the four to six servings that are often recommended by “health experts” may wreak havoc with your body’s ability to process sugar.

Our goal is to keep total carbs at or below 60 to 80 grams per day.

Wondering what that looks like on your plate? You might start your day with a roasted-onion omelet with sun-dried-tomato-and-onion chutney. For lunch, you might enjoy a Greek salad with fresh veggies, olives, and homemade vinaigrette. And, for dinner, how about salmon roasted in butter; broccoli, mushrooms, and feta on the side; and a crunchy walnut-arugula salad?

Why Fat Can Make You Smart

If there’s one thing about my diet protocol that sets it apart from others, it’s that it derives a lot of flavors from fat. That’s right: fat. Along with a substantial reduction in carb consumption, the best thing you can do for your brain is to eat wonderful, healthful, life-sustaining fat.

Dietary fat, demonized over the last several decades, is actually a superfuel for the brain. A 2012 report from the Mayo Clinic published in the Journal of Alzheimer’s Disease showed that the risk of dementia was reduced by an astounding 44 percent in people eating a high-fat, low-carb diet. Those favoring the most carbs in their diet actually experienced an increased risk for dementia — by a whopping 89 percent.

Now, not all fats are created equal. You shouldn’t be eating any trans fats or cooking with highly processed, industrial vegetable oils.

Instead, embrace cooking with healthy oils and fats, such as extra-virgin olive oil, coconut oil, pastured butter, ghee, avocado oil, and walnut oil. And you can revel in eating whole foods with naturally occurring fats, such as grassfed beef, wild-caught fish, pastured eggs, nuts, and seeds.

For years, we’ve shied away from fat, including saturated fat, under the misguided idea that dietary fat leads to cardiovascular disease.

The truth is that we’ve been eating saturated fat for more than 2 million years. And the science is now showing that sugar and other carbs — not saturated fat — are the true culprits when it comes to heart disease.

In fact, the best lab test to determine your health status is not cholesterol levels; it’s hemoglobin A1c, a snapshot of your average blood-sugar level over the previous three months. The higher your A1c level — regardless of cholesterol — the higher your risk for brain disease.

Ditch the Gluten

You’re probably already somewhat familiar with the issues surrounding gluten and the trend in going gluten-free, as it’s made a lot of headlines in the past couple of years. [For background on gluten, check out “Gluten: The Whole Story“.] The reason it’s receiving so much attention now is because the science behind gluten-related inflammation is compelling.

To clarify, I’m not just talking about celiac disease, a relatively rare autoimmune disorder. I’m talking about a type of gluten sensitivity that may affect up to 30 percent of us and which has been linked to a variety of neurological problems beyond dementia, including movement disorders, epilepsy, ADHD, depression, migraines, nerve damage, and even schizophrenia.

As soon as the neurological community started to recognize inflammation as the root cause of a vast array of brain conditions, I began testing virtually every one of my patients for gluten sensitivity whether they were complaining of memory lapses or simple headaches. The results were eye-opening.

Once they stopped eating gluten, people who’d been plagued by chronic neurological disorders, from crushing migraines and epilepsy to relentless anxiety, were suddenly freed from their conditions.

So I began to evangelize to anyone who would listen — patients and colleagues alike — not only about the importance of a veggie-rich, low-glycemic, low-grain diet, but also about the importance of getting people who are gluten sensitive off of gluten. These are the most powerful interventions I have learned in my 30 years of practicing medicine.

At this point, you might be asking, Haven’t we always consumed wheat (and therefore gluten)? To many, bashing wheat is almost sacrilegious. After all, some of us pray with “Give us this day our daily bread.” But the wheat consumed in biblical times was not the same as wheat today, which is aggressively hybridized. Today’s wheat renders a product that our physiology cannot process. And when you challenge your body with foods that it cannot recognize, you’re creating the perfect storm to increase inflammation.

Making dietary changes, even small ones, can seem overwhelming at first. But, my hope is that the delicious, nutrient-dense, low-glycemic, high-fat, gluten-free recipes in my cookbook will make up for all that. (Of course, it’s good practice to check with your physician before beginning any new diet regimen.) A diet that emphasizes great nutrition and that eliminates gluten-containing grains is, in my humble opinion, the path to great health, longevity, and enjoyment.

Grain Brain Cookbook
Recipes for featured dishes adapted from The Grain Brain Cookbook. Copyright 2014 by David Perlmutter, MD. All rights reserved. No part of this adaptation may be reproduced or printed without permission in writing from the publisher. Reprinted by arrangement with Little, Brown and Company.


Coconut Bursts

Dark chocolate and toasted coconut come together to create the perfect gluten-free dessert. It also works as a super late-afternoon pick-me-up. You can use any toasted nut in place of the coconut, or combine nuts with the coconut if you like.

Coconut-Bursts

Makes about three dozen 

  • 8 oz. bittersweet chocolate (at least 70 percent cacao), chopped
  • 1 cup toasted coconut flakes

Line a baking sheet with waxed paper. Set aside. Place the chocolate in the top half of a double boiler set over boiling water. Heat, stirring frequently, for about five minutes or until the chocolate is almost melted. Remove from the heat and beat until completely melted. Add the coconut and stir to combine. Drop the mixture by the spoonful onto the waxed paper on the prepared baking sheet. Set aside to cool and firm up. When firm, serve immediately or store in an airtight container for up to two weeks.

Eggs Benedict With Zucchini Pancakes

Ditch the English muffin and place your ham, eggs, and hollandaise sauce atop crispy, delectable zucchini pancakes made with almond meal. Grain-free goodness!

Zucchini-Pancakes

 

Makes four servings

  • 1 tbs. white vinegar
  • 4 extra-large eggs, at room temperature
  • 4 slices Canadian bacon
  • 4 zucchini pancakes
  • 1 cup hollandaise sauce
  • 1 tbs. chopped fresh flat-leaf parsley

Preheat the oven to 275 degrees F. Heat about 3 inches of water in a large, shallow saucepan over medium heat until bubbles form around the edge. Add the vinegar. In another saucepan of similar size, heat 3 inches of water to 130 degrees F on a candy thermometer. Remove from the heat and cover to keep warm. Working quickly with one egg at a time, carefully break each egg into a small custard cup and then gently slide the egg from the cup into the barely simmering vinegar-water. When all of the eggs have been added, cook until the whites are just set but the yolks are still very loose, about 2 minutes. Using a slotted spoon, carefully lift the barely cooked eggs, one at a time, and place them into the 130 degrees F water. Cover and let rest for 15 minutes. You should, from time to time, check the temperature of the water. If it falls below 130 degrees F, slowly add enough boiling water to bring the temperature back up. Place the Canadian bacon in a large nonstick frying pan over medium-high heat. Fry, turning occasionally, until just lightly browned around the edges, about 4 minutes. Remove from the heat and place on a baking sheet in the preheated oven to keep warm if the eggs or pancakes aren’t done yet. Place a warm pancake in the center of each plate and top with a slice of Canadian bacon. Using a slotted spoon, lift the poached eggs, one at a time, from the water and pat gently with a clean kitchen towel to remove excess water. Place an egg on top of the bacon (if the edges of the eggs are a bit ragged, carefully trim them with a small knife or kitchen scissors). Spoon about 3 tablespoons of the hollandaise sauce on top of each egg, sprinkle with chopped parsley, and serve immediately.

Zucchini Pancakes

  • 3 large zucchinis
  • 1 extra-large egg white
  • 2 tbs. almond meal
  • 1 tsp. paprika
  • Salt and pepper
  • 3 tbs. clarified butter, ghee, or unsalted butter

Using either a hand-held grater or a food processor fitted with the shredding blade, shred the zucchini. Place the shredded zucchini in the center of a large, clean kitchen towel. Bring the sides up and twist hard to express all of the liquid. You may have to do this a few times to get all the liquid out; the drier the zucchini, the crisper the pancakes will be. Place the shredded, drained zucchini in a large mixing bowl. Add the egg white, almond meal, paprika, and salt and pepper to taste, tossing to blend in the seasonings. Heat the clarified butter in a large frying pan over medium heat. When very hot but not smoking, spoon in the zucchini mixture to make individual circles about 3-1/2 inches in diameter (you will need to do this in batches). Fry, turning once, until cooked through, golden brown, and crisp, about 5 minutes. Using a spatula, transfer to a double layer of paper towels to drain. If necessary, place on a baking sheet in a low oven to keep warm until ready to serve.

Easy Hollandaise Sauce

  • 3 large egg yolks, at room temperature
  • 1 tbs. freshly squeezed lemon juice, strained
  • 3/4 tsp. salt, or to taste
  • 1/2 tsp. tabasco sauce, or to taste
  • 1/2 cup clarified butter, melted

Bring a few inches of water to a boil in the bottom half of a double boiler set over high heat. Place the egg yolks, lemon juice, salt, and tabasco in a blender and process on medium speed for 45 seconds. With the blender running, add the hot clarified butter through the hole in the lid in a slow, steady stream and process until the mixture is very smooth and slightly thickened. Scrape the sauce from the blender into the top half of the double boiler and set it on the bottom half to keep warm until ready to use.

Thai Pork Lettuce Cups

This zesty mix makes a light and refreshing lunch that is a cinch to pull together. It can be served atop lettuce leaves, or wrapped inside them for a gluten-free spring-rolls presentation. Ground chicken, turkey, or lamb may be substituted for the pork. 

Thai-and-Lettuce

  • 1 tbs. coconut oil
  • 1 lb. lean ground pork
  • 2 tbs. minced shallot
  • 1 tbs. minced garlic
  • 2 tbs. minced red onion
  • 2 tbs. minced mint leaves
  • 1 tbs. minced scallion
  • 1 tbs. minced cilantro
  • 1 tbs. minced hot red chili, or to taste
  • 1 tbs. lime juice
  • 1 tbs. fish sauce
  • Salt to taste
  • 12 large Boston lettuce leaves
  • 4 mint sprigs for garnish

Heat the oil in a large frying pan over medium heat. Add the pork, shallots, and garlic, and sauté for about eight minutes or until the pork is crumbly and cooked through. Remove from the heat and scrape into a mixing bowl. Stir in the onion, mint, scallion, cilantro, chili, lime juice, and fish sauce. Taste and, if necessary, season with salt. Place three lettuce leaves in the center of each of four plates. Mound an equal portion of the pork mixture into the center. Garnish with a mint sprig and serve.

David Perlmutter, MD, FACN, ABIHM, is a neurologist who practices functional medicine and a fellow of the American College of Nutrition. He is the author of the New York Times No. 1 bestseller Grain Brain. His new book is The Grain Brain Cookbook: More Than 150 Life-Changing Gluten-Free Recipes to Transform Your Health.