The
new book "Grain Brain" explains how numerous neurological afflictions
have a root cause of consuming too many carbs and too few healthy fats.
November 4, 2013
|
Imagine
being transported back to the Paleolithic era of early humans who lived
in caves and roamed the savannas tens of thousands of years ago.
Pretend, for a moment, that language is not a barrier and you can
communicate easily. You have the opportunity to tell them what the
future is like.
From a cross-legged perch on a dirt
floor in front of a warm fire, you start by describing the wonders of
our high-tech world, with its planes, trains, and automobiles, city
skyscrapers, computers, televisions, smart phones, and the information
highway that is the Internet. Humans have already traveled to the moon
and back. At some point, the conversation moves to other lifestyle
topics and what it’s like to really live in the twenty-first century.
You
dive into describing modern medicine with its stupendous array of drugs
to treat problems and combat diseases and germs. Serious threats to
survival are few and far between. Not many people need to worry about
crouching tigers, famine, and pestilence. You explain what it’s like to
shop at grocery stores and supermarkets, a totally foreign concept to
these individuals. Food is plentiful, and you mention things like
cheeseburgers, French fries, soda, pizza, bagels, bread, cinnamon rolls,
pancakes, waffles, scones, pasta, cake, chips, crackers, cereal, ice
cream, and candy. You can eat fruit all year long and access virtually
any kind of food at the touch of a button or short drive away. Water and
juice come in bottles for transportability.
Although
you try to avoid brand names, it’s hard to resist because they have
become such a part of life—Starbucks, Wonder Bread, Pepperidge Farm,
Pillsbury, Lucky Charms, Skittles, Domino’s, Subway, McDonald’s,
Gatorade, Haagen-Dazs, Cheerios, Yoplait, Cheez-It, Coke, Hershey’s, and
Budweiser. The list goes on.
They are in awe, barely
able to picture this future. Most of the features you chronicle are
unfathomable; they can’t even visualize a fast-food restaurant or bread
bar. The term “junk food” is impossible to put into words these people
understand. Before you can even begin to mention some of the milestones
that humans had to achieve over millennia, such as farming and herding,
and later food manufacturing, they ask about the challenges modern
people deal with. The obesity epidemic, which has gotten so much
attention in your media lately, comes first to mind.
This
isn’t an easy matter for their lean and toned bodies to grasp, and
neither is your account of the chronic illnesses that pervade—heart
disease, diabetes, depression, autoimmune disorders, cancer, and
dementia. These are totally unfamiliar to them, and they ask a lot of
questions. What is an “autoimmune disorder”? What causes “diabetes”?
What is “dementia”? At this point you’re speaking a different language.
In fact, as you give them a rundown of what kills most people in the
future, doing your best to define each condition, you are met with looks
of confusion and disbelief. You’ve painted a beautiful, exotic picture
of the future in these people’s minds, but then you tear it down with
causes of death that seem to be more frightening than dying from an
infection or being eaten by a predator higher up on the food chain. The
thought of living with a chronic condition that slowly and painfully
leads to death sounds awful. And when you try to convince them that
ongoing, degenerative disease is possibly the trade-off for potentially
living much longer than they do, your prehistoric ancestors don’t buy
it. And, soon enough, neither do you. Something seems wrong with this
picture.
As a species, we are genetically and
physiologically identical to these humans that lived before the dawn of
agriculture. And we are the product of an optimal design—shaped by
nature over thousands of generations. We may not call ourselves hunters
and gatherers any more, but our bodies certainly behave as such from a
biological perspective. In fact, genetically we are identical.
Now,
let’s say that during your time travel back to the present day, you
begin to ponder your experience with these ancestors. It’s easy to
marvel at how far we’ve come from a purely technological standpoint, but
it’s also a no brainer to consider the struggles that millions of your
contemporary comrades suffer needlessly. You may even feel overwhelmed
by the fact that preventable, non-communicable diseases account for more
deaths worldwide today than all other diseases combined. This is tough
to swallow. Indeed, we may be living longer than our ancient relatives,
but that doesn’t make up for the fact we could be living much
better—enjoying our lives sickness-free—especially during the second
half of life when the risk of illness rises. While it’s true that we are
living longer than previous generations, most of our gains are due to
improvements in infant mortality and child health. In other words, we’ve
gotten better at surviving the accidents and illnesses of childhood. We
haven’t, unfortunately, gotten better at preventing and combating
illnesses that strike us when we’re older. And while we can certainly
make a case for having much more effective treatments now for many
illnesses, that still doesn’t erase the fact that millions of people
suffer needlessly from conditions that could have been avoided. When we
applaud the average life expectancy in America today, we shouldn’t
forget about quality of life.
When I was in medical
school decades ago, my education revolved around diagnosing disease and
knowing how to treat or, in some cases, cure each disease with a drug or
other therapy. I learned how to understand symptoms and arrive at a
solution that matched those symptoms. A lot has changed since then,
because not only are we less likely to encounter easily treatable and
curable illnesses, but we’ve come to understand many of our modern,
chronic diseases through the lens of a common denominator: inflammation.
So, rather than spotting infectious diseases and addressing sicknesses
with known culprits, such as germs, viruses, or bacteria, today doctors
are faced with myriad conditions that don’t have clear-cut answers. I
can’t write a prescription to cure someone’s cancer, vanquish
inexplicable pain, instantly reverse diabetes, or restore a brain that’s
been washed away by Alzheimer’s disease. I can certainly try to mask or
lessen symptoms and manage the body’s reactions, but there’s a big
difference between treating an illness at its root and just keeping
symptoms at bay. Now that one of my own kids is in medical school, I see
how times have changed in teaching circles. Doctors in training are no
longer taught just how to diagnose and treat; they are equipped with
ways of thinking that help them to address today’s epidemics, many of
which are rooted in inflammatory pathways run amok.
Before
I get to the connection between inflammation and the brain, let’s
consider what I think is arguably one of the most monumental discoveries
of our era: the origin of brain disease is in many cases predominantly
dietary. Although several factors play into the genesis and progression
of brain disorders, to a large extent numerous neurological afflictions
often reflect the mistake of consuming too many carbs and too few
healthy fats. The best way to comprehend this truth is to consider the
most dreaded neurological ailment of all—Alzheimer’s—and view it within
the context of a type of diabetes triggered by diet alone. We all know
that poor diet can lead to obesity and diabetes, but a busted brain?
ALZHEIMER’S DISEASE—TYPE-3 DIABETES?
Flash
back to your moment with those hunters and gatherers. Their brains are
not too different from yours. Both have evolved to seek out foods high
in fat and sugar. After all, it’s a survival mechanism. The problem is
that your hunting efforts end quickly because you live in the age of
plenty, and you’re more likely to find processed fats and sugars. Your
cavemen counterparts are likely to spend a long time searching, only to
come across fat from animals and natural sugar from plants and berries
if the season is right. So while your brain might operate similarly,
your sources of nutrition are anything but. In fact, take a look at the
following graphic that depicts the main differences between our diet and
that of our forebears:
And what, exactly, does this
difference in dietary habits have to do with how well we age and whether
or not we suffer from a neurological disorder or disease?
Everything.
The
studies describing Alzheimer’s as a third type of diabetes began to
emerge in 2005,1 but the link between poor diet and Alzheimer’s has only
recently been brought to light with newer studies showing how this can
happen. These studies are both convincingly horrifying and empowering at
the same time. To think we can prevent Alzheimer’s just by changing the
food we eat is, well, astonishing. This has many implications for
preventing not just Alzheimer’s disease but all other brain disorders,
as you’ll soon discover in the upcoming chapters. But first, a brief
tour on what diabetes and the brain have in common.
Evolutionarily,
our bodies have designed a brilliant way to turn the fuel from food
into energy for our cells to use. For almost the entire existence of our
species, glucose—the body’s major source of energy for most cells—has
been scarce. This pushed us to develop ways to store glucose and convert
other things into it. The body can manufacture glucose from fat or
protein if necessary through a process called gluconeogenesis. But this
requires more energy than the conversion of starches and sugar into
glucose, which is a more straightforward reaction.
The
process by which our cells accept and utilize glucose is an elaborate
one. The cells don’t just suck up glucose passing by them in the
bloodstream. This vital sugar molecule has to be allowed into the cell
by the hormone insulin, which is produced by the pancreas. Insulin, as
you may already know, is one of the most important biological substances
for cellular metabolism. Its job is to ferry glucose from the
bloodstream into muscle, fat, and liver cells. Once there, it can be
used as fuel. Normal, healthy cells have a high sensitivity to insulin.
But when cells are constantly exposed to high levels of insulin as a
result of a persistent intake of glucose (much of which is caused by an
overconsumption of hyperprocessed foods filled with refined sugars that
spike insulin levels beyond a healthy limit), our cells adapt by
reducing the number of receptors on their surfaces to respond to
insulin. In other words, our cells de-sensitize themselves to insulin,
rendering a condition called insulin resistance, which allows them to
ignore the insulin and fail to retrieve glucose from the blood. The
pancreas then responds by pumping out more insulin. So higher levels of
insulin become needed for sugar to go into the cells. This creates a
cyclical problem that eventually culminates in type-2 diabetes. People
with diabetes have high blood sugar because their body cannot transport
sugar into cells where it can be safely stored for energy. And this
sugar in the blood presents many problems—too many to mention. Like a
shard of glass, the toxic sugar inflicts a lot of damage, leading to
blindness, infections, nerve damage, heart disease, and yes, Alzheimer’s
as well. Throughout this chain of events, inflammation runs rampant in
the body.
To add insult to injury, I should also point
out that insulin can be viewed as an accomplice to the events that
unfold when blood sugar cannot be managed well. Unfortunately, insulin
doesn’t just escort glucose into our cells. It’s also an anabolic
hormone, meaning it stimulates growth, promotes fat formation and
retention, and is a pro-inflammatory hormone. When insulin levels are
high, other hormones can become adversely affected, either increased or
decreased due to insulin’s domineering presence. This, in turn, plunges
the body further into unhealthy patterns of chaos that cripple its
ability to recover its normal metabolism.
Genetics are
certainly involved in whether or not a person becomes diabetic, and
genetics can also determine at what point the body’s diabetes switch
gets turned on, once its cells can no longer tolerate the high blood
sugar. For the record, type-1 diabetes is a separate disease thought to
be an autoimmune disorder—accounting for only 5 percent of all cases.
People with type-1 diabetes make little or no insulin because their
immune system attacks and destroys the cells in the pancreas that
produce insulin, so daily injections of this important hormone are
needed to keep blood sugars balanced. Unlike type 2, which is usually
diagnosed in adults after their bodies have been abused by too much
glucose over time, type-1 diabetes is typically diagnosed in children
and adolescents. And unlike type 2, which is reversible through diet and
lifestyle changes, there is no cure for type 1. That said, it’s
important to keep in mind that even though genes strongly influence the
risk of developing type-1 diabetes, the environment can play a role,
too. It has long been known that type 1 results from both genetic and
environmental influences, but the rising incidence over the last several
decades has led some researchers to conclude that environmental factors
are increasingly involved in the development of type 1 and may be more
important than genetic predisposition.
What we’re
beginning to understand is that insulin resistance, as it relates to
Alzheimer’s disease, sparks the formation of those infamous plaques that
are present in diseased brains. These plaques are the build-up of an
odd protein that essentially hijacks the brain and takes the place of
normal brain cells. And the fact that we can associate low levels of
insulin with brain disease is why talk of “type-3 diabetes” is starting
to circulate among researchers. It’s all the more telling to note that
obese people are at a much greater risk of impaired brain function, and
that those with diabetes are at least twice as likely to develop
Alzheimer’s disease.
This statement is not meant to
imply that diabetes causes Alzheimer’s disease, only that they both
share the same origin. They both spring from foods that force the body
to develop biological pathways leading to dysfunction and, farther down
the road, illness. While it’s true that someone with diabetes and
another person with dementia may look and act differently, they have a
lot more in common than we previously thought.
In the
last decade, we’ve witnessed a parallel rise in the number of type-2
diabetes cases alongside obesity. Now, however, we’re starting to see a
pattern among those with dementia, too, as the rate of Alzheimer’s
disease increases in sync with type-2 diabetes. I don’t think this is an
arbitrary observation. It’s a reality we all have to face as we
shoulder the weight of soaring healthcare costs and an aging population.
New estimates indicate that Alzheimer’s will likely affect 100 million
people by 2050, a crippling number for our health care system that will
dwarf our obesity epidemic. The prevalence of type-2 diabetes, which
accounts for 90 to 95 percent of all diabetes cases in the US, has
tripled in the past forty years.
No wonder the U.S.
government is anxiously looking to researchers to improve the prognosis
and avert this catastrophe. And in the next forty years, more than 115
million new cases of Alzheimer’s are expected globally, costing us more
than $1 trillion dollars (in today’s dollars). According to the Centers
for Disease Control and Prevention, 18.8 million Americans were
diagnosed in 2010 with diabetes and another 7 million went undetected.
Between 1995 and 2010, the number of diagnosed cases of diabetes jumped
by 50 percent or more in 42 states, and by 100 percent or more in 18
states.
Excerpted from GRAIN BRAIN: The Surprising
Truth About Wheat, Carbs, and Sugar – Your Brain’s Silent Killers
Copyright © 2013 by Dr. David Perlmutter. All rights reserved. No part
of this excerpt may be reproduced or printed without permission in
writing from the publisher. Reprinted by arrangement with Little, Brown
and Company.
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