Since I know folks on Facebook, on Twitter, and in my real-life neighborhood who have mentioned they read this book, I thought I’d pass along this review (not mine) from Amazon.com of Grain Brain:
Some important information, but lots of holes in this science, September 20, 2013
By Sandy & Richard (Maryland, USA)
I applaud Dr. David Perlmutter’s effort to help conquer Alzheimer’s and other neurologic disease, from autism to migraines, through the use of nutrition. Information abounds elsewhere on heart health and cancer nutrition, with little focus on diseases of the brain. Dr. Perlmutter also brings our attention to the potential dangers of taking daily pills and our nearly century-long experiment of abandoning real food for processed food. (Unfortunately, he advocates the use of pills that are supplements, which also should be unnecessary for those who have appropriate nutrition.)
The gist of Dr. Perlmutter’s recommendations is to eliminate sugars, gluten (wheat and barley), and processed foods, and to greatly limit whole carb foods like fruits and whole grains, and also potatoes, beans and lentils. He also advocates eating more fats from nuts, olive and coconut oil, and avocados, but also from beef, butter and cheese.
I compare his book to those of other “popular” doctors who make names for themselves writing books, appearing on TV, and treating prominent personalities, doctors like Caldwell Esselstyn from the Cleveland Clinic, Dean Ornish, Neal Barnard, Susan Blum, and T. Colin Campbell, a nutritional science professor and researcher. It is noteworthy that among them, Dr. Perlmutter is the only neurologist.
Eliminating sugars, refined wheat products and processed foods from the diet is agreed upon by all. Dr. Perlmutter’s assertions about gluten’s adverse effects on the brain are supported by Dr. Blum’s warnings about its association with autoimmune disease. While Dr. Esselstyn, who focuses on heart disease, argues that only small amounts of plant-based fats are required by the body, perhaps he could be convinced to concede a bit on this point, as he seems to have done with regard to people who are not already suffering from heart disease, although the proper amount of fats needed for good health remains in dispute.
But what remains most controversial are Dr. Perlmutter’s contentions that food products derived from animals are healthy, that saturated fats are necessary, that whole carbs are dangerous, and that high total cholesterol and LDLs are healthy. Some of the doctors listed above might concede that a little fish and the occasional egg in the diet may be beneficial (though some would not). One or two of these doctors might sign off on a piece of chicken a couple of times a week. One or two might be okay with limited amounts of dairy products (though Dr. Perlmutter too restricts milk, for reasons he does not explain well).
What I believe is unanimous among the doctors listed above, as well as cardiologists everywhere, if not oncologists, is that the excessive amounts of beef and eggs prescribed by Dr. Perlmutter, the three-times-a-day consumption of animal products, and the elimination of beans, legumes and most whole carbs, are a dangerous prescription for heart health and cancer prevention, if not also for brain health. And therein rest the holes in Dr. Perlmutter’s hypotheses. I list below some obvious ones.
Dr. Perlmutter overemphasizes our need to return to the diet of our hunter-gatherer “caveman” ancestors in order to stave off diseases like Alzheimer’s. Let’s return to the non-packaged diet of our grandparents. But to advocate the “caveman” (i.e., Paleo) diet is naïve. Members of today’s rare remaining hunter-gather societies who survive infant mortality and childhood disease live on average into their early 50’s. […] While it’s true that our increased life expectancy in the developed world may be nearly entirely attributed to the eradication of infectious disease with antibiotics and vaccines and certain other safety, hygiene, and medical advances, rather than to improvements in our diet, it is also true that “cavemen” did not live long enough to contract Alzheimer’s in their 70’s and 80’s. Returning to a caveman diet may argue well for accepting that human beings were simply designed to only live to their 30’s-50’s and does little to convince those of us who would like to live well into our 90’s.
Dr. Perlmutter points out that our caveman ancestors could eat fruit only when it was in season, not every day of the year (implying that we too should not eat it year round), but says nothing of the fact that in the same geographic locations they also would not have had green vegetables all year round (but does not advise us to abstain from greens, ever). He does not talk about the fact that caveman diets differed in different parts of the world. Some ate more plant foods than animal foods. Those who ate animal foods were not “hunting” primarily for cows but for deer, rabbits, duck, mountain goats, or whatever the locale offered. The Paleo argument borders on absurdity and does not support a diet based on cows.
Dr. Perlmutter points to the increased consumption of grains during the 20th century as a cause for declining health but ignores the exponential increase in the consumption of cheese and beef. […] Moreover, Dr. Perlmutter ignores the diets of modern societies with extraordinarily long life expectancies. For example, the staple in Okinawa, which enjoys one of the world’s longest life expectancies, is the sweet potato, which Dr. Perlmutter shuns. […]
The Mediterranean diet of residents in Ikaria, Greece is low in dairy and meat and emphasizes potatoes, beans and legumes. A recent study there revealed residents living 8 to 10 years longer than Americans and suffering only a quarter as much dementia. […] In the “Comments” section following this review, I have listed a number of other societies as examples, with links to the supporting data. The bottom line is that Dr. Perlmutter’s attack on potatoes, whole grains, beans and legumes is unfounded.
Dr. Perlmutter cites a study (Barberger-Gateau, et al.) that he claims supports the notion that people who don’t consume Omega-3 rich fish have a higher risk of dementia and Alzheimer’s. The study’s actual conclusion was that those who consumed Omega-6 oils without compensating with sufficient Omega-3 oils were at higher risk. In other words, as long as a person doesn’t consume inappropriate Omega-6 rich oils, s/he can be amply healthy without fish.
Dr. Perlmutter’s assertions about cholesterol are contested by much scientific literature in addition to many or all of the doctors listed above. Moreover, Dr. Perlmutter’s opinions are positively confusing for the casual reader. He acknowledges that high oxidized LDL’s are unhealthful but gives no advice on how to determine one’s oxidized LDL’s rather than the LDL levels as presented on common blood test reports. He believes that total cholesterol should be high, but triglycerides shouldn’t be. But nowhere does he give clear guidance on what ideal cholesterol levels would look like. He cites a 1994 article (Location 1230, Kindle) that demonstrates that the risk of heart attack with total cholesterol under 200 was as high as for total cholesterol over 240. In his book on heart disease, Dr. Esselstyn agrees that 200 is not safe but presents evidence instead to support the fact that total cholesterol should be even lower, 150 or less. And while improving diet before resorting to pills would always make good sense, doctors at Columbia University just this year reiterated the opinion that high LDL’s are dangerous, and they continue to believe that statins have saved lives. […]. The bottom line here is that the public needs a lot more guidance, untainted by the pharmaceutical industry. And Dr. Perlmutter should remember that before people worry about getting Alzheimer’s in their 70’s and 80’s, they must survive their 50’s and 60’s without heart disease and cancer. His discussions on cholesterol may have some validity, but they are are too confusing to be convincing. I found Dr. Esselstyn, who has brought heart patients back from the brink of death, to be a lot more convincing.
Dr. Perlmutter advises to eat grass-grazed beef, free-range chickens and wild-caught fish, ignoring the fact that most people can’t afford these products, and even if they could, the planet could not sustain a sufficient supply of them. Even the relatively affluent would be hard-pressed to be able to eat these products three times a day at home and in restaurants. They’re difficult to find, and he offers no alternatives in his menu plans. It is not clear whether he would favor factory-farmed beef over plant-based proteins like beans, or vice versa, when those are the choices.
Dr. Perlmutter ignores the research by T. Colin Campbell at Cornell University, which showed that the protein casein, found in dairy products including milk and cheese, promotes cancer growth. He also ignores Dr. Campbell’s extensive research in rural China during the 1980’s that revealed that a vegetable-based diet with very little animal products resulted in extremely low levels of heart disease and cancer (and total cholesterol in the 120-150 range, without dementia). A more recent study at Loma Linda University showed that vegetarian and vegan diets were protective against a large number of cancers. […]. Dr. Neal Barnard’s book Power Foods for the Brain presents ample evidence to support the benefit of a plant-based diet for brain health.
Finally, Dr. Perlmutter’s book does not include sufficient numbers of footnotes, and some of those that he does include reference websites without referencing specific pages, making it all but impossible to find his sources.
In summary, I believe that Dr. Perlmutter offers a lot of useful information, and some good advice. But he concludes his book by saying, “It’s hard to separate truth from fiction, and to know the difference between what’s healthful and harmful…” He’s right about that, and his book fails to end the confusion. I do believe that I learned some useful things from this book and have made slight changes to my diet (which, in my opinion, was already very healthful). But I can’t give the book more than two stars because Dr. Perlmutter’s opinions about eating so many cow and chicken products and saturated fats, and cutting out nearly all whole-food carbs, are too controversial to endorse. It seems that unless and until his theories are better proven, they are too potentially dangerous to follow.
It is noted that wherever you see “[…]” above, I had included links to the supporting documentation for the facts cited. Apparently, Amazon has bleeped out these links. I suggest that if you google the subject matter, you will find the supporting studies.”
So there you have it, my friends. This is not my review, but I urge you to consider it.
On New Year’s Day, 2014, I posted two WordPress blogs that I also posted on the Lisa Mason Official Website: Keep Fit, Keep Writing: A Roundtable with Authors Kevin J. Anderson, Lisa Mason, and Linda Nagata (Part 1: Move It!), discussing exercise,and Keep Fit, Keep Writing: A Roundtable with Kevin J. Anderson, Lisa Mason, and Linda Nagata (Part 2: Chow Down!), discussing diet. Now that you’re done with your taxes, check it out!