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Grain Brain

Book Review

Grain Brain
By David Perlmutter, MD, with Kristin Loberg
Little, Brown and Company (2013)
Reviewed by Marisa Moore, MBA, RDN, LD


From the press release: Perlmutter exposes the dangers of gluten and sugar on the brain and their role in everything from chronic headaches and insomnia to depression, epilepsy, ADHD and Alzheimer’s, including “healthy” carbs such as whole grains. He provides a four-week plan teaching what we should be eating in order to take back our brain health.

Synopsis of the Diet Plan

Grain Brain provides a four-week "protocol to brain freedom" that restricts carbohydrates to 30 to 40 grams a day with a maintenance level of 60 grams per day thereafter. The plan is designed to induce ketosis, as the author claims ketones are "far more effective fuel for the brain." The plan encourages adequate sleep, at least 30 minutes of exercise five times per week and a 24-hour water fast before starting the program. Additionally, the author prescribes a daily supplement regimen for life in the following doses:

  • 300 milligrams alpha-lipoic acid (ALA)
  • 1 teaspoon coconut oil
  • 1,000 milligrams docosahexaenoic acid (DHA)
  • 1 probiotics capsule (with 10 bioactive culture from 10 different strains) up to three times
  • 100 milligrams resveratrol, twice
  • 500 milligrams turmeric, twice
  • 5,000 IU vitamin D.

Nutritional Pros and Cons

Challenging long-standing beliefs about what makes a healthy diet, Grain Brain focuses on a diet where, not only are gluten and sugar containing foods eliminated, but “healthy carbohydrates” including whole-grain bread, beans and fruit are demonized and regarded as poison to the brain. Perlmutter exploits newer research that suggests a ketogenic diet (higher fat, very low-carbohydrate diet) is neuroprotective, yet he disregards the potential drawbacks of such an extreme diet regimen.

On the plus side, Grain Brain encourages fresh, whole foods including nuts, “above ground” vegetables, fish and heart-healthy fats which have been shown to be cardioprotective. Many recipes feature easily accessible foods, and the plan touts the power of movement and adequate sleep.

Perlmutter identifies carbohydrates as the cause of Alzheimer’s disease. He asserts that eliminating carbohydrates and replacing them with fat can not only prevent Alzheimer’s disease but also cure insomnia and depression. He goes on to say that this diet will eliminate cravings, physical and mental fatigue and boost mental performance.

In favor of this very low-carbohydrate diet, the author sets aside years of scientific evidence supporting the benefits of the vegetarian or Mediterranean diet for brain and heart health. Of note, Grain Brain combines the author’s anecdotal experience in the clinic and some scientific research.

Bottom Line

Grain Brain swings the diet pendulum in a familiar direction: eliminating carbohydrates. This plan is quite restrictive and would be difficult for the average person to master. The daily supplement regimen can also make it expensive to maintain.

More research is needed on the impact of ketogenic diets and other diet regimens on brain health. However, a key takeaway would be to cut back on excess carbohydrates and embrace heart-healthy fats such as avocado, nuts and olives without fear. Research suggests these fats boost heart and brain health.