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Do Carbs Kill Your Brain?


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carbs brain fog, carbs and the brain
Could the carbs in that banana be contributing to brain fog? iStock.com/IgorDutina

Recently, I’ve been hearing from many patients who have read Dr. Perlmutter’s new book, Grain Brain, and are now concerned about their carb intake. In his book, Dr. Perlmutter suggests that dietary carbohydrates cause high blood sugar, inflammation, and other effects that lead to a “toxic brain,” which can then develop into neurological conditions such as Alzheimer’s, Parkinson’s, depression, and others. Based on this line of causality, he recommends that everyone consume a very low carb diet (<60g per day) in order to prevent neurological disease.

First of all, I’d like to point out that very low carb (VLC) and ketogenic diets can be effective therapeutic tools for treating many neurological disorders. I touched on this briefly a while back in my podcast with Emily Deans, and initial studies on low-carb diets and mental health have shown promise. (1, 2, 3, 4) Because Dr. Perlmutter is a neurologist, it makes sense that he would be a proponent of low-carb diets for his patients based on these therapeutic effects.

Does eating carbs destroy your brain and lead to neurological disease?

However, recommending a low-carb diet as an intervention for sick people is very different from promoting it as a preventative measure for the entire population, which is what Dr. Perlmutter does in Grain Brain. His approach would be somewhat akin to recommending that everyone go on the Autoimmune Protocol to prevent autoimmune disease, which would be unnecessarily restrictive and unhelpful. It’s important to realize that just because a low-carb diet can help treat neurological disorders, doesn’t mean the carbs caused the disorder in the first place. While I don’t argue with the idea that refined and processed carbs like flour and sugar contribute to modern disease, there’s no evidence to suggest that unrefined, whole-food carbohydrates do. In fact, there are three compelling reasons why this is not the case.

#1 – We Evolved Eating Whole-Food Carbohydrates

The first reason it doesn’t make sense that carbohydrates cause neurological disorders is that we’ve been eating carbs for a very long time, and we’re well adapted to digesting and metabolizing them. For instance, fruit has been part of the human diet for longer than we’ve been recognizably human, and while starch hasn’t been part of the human diet for quite as long, it’s clear that we’ve evolved mechanisms to digest and utilize it efficiently.

Compared with most primates, humans have many more copies of the gene AMY1, which is essential for breaking down starches. (5) This gene is unusual in that the number of copies varies greatly between populations, with more copies present in populations that consume more starch. This indicates that starch played a significant role in our evolution, and some scientists have even argued that consumption of starch was partially responsible for the increase in our brain size.

In addition to possessing the ability to break down complex carbohydrates, our bodies require glucose to function properly and maintain homeostasis. The fact that humans can produce glucose from protein is often used as an argument that we don’t need to eat glucose, but rather than viewing this as evidence that that glucose isn’t important, we might view it as evidence that glucose is so metabolically essential that we evolved a mechanism to produce it even when it’s absent from the diet.

#2 – There Are Many Traditional Cultures with High Carb Intake and Low or Nonexistent Rates of Neurological Disease

If carbohydrates cause neurological disorders, one would expect to see high rates of dementia and similar diseases in populations where carbs constitute a significant portion of the diet. But as it turns out, many of the cultures that maintain the lowest rates of neurological and other inflammatory disease rely heavily on carbohydrate-dense dietary staples. For example, the Hadza of north-central Tanzania and the Kuna of Panama obtain a high percentage of their total calories from foods that are high in natural sugars, such as fruit, starchy tubers and honey, yet they are remarkably lean, fit and free of modern disease. (6, 7)

Other examples include the Kitava in the Pacific Islands, Tukisenta in the Papa New Guinea Highlands, and the Okinawans in Japan. The Kitavan diet is 69% carb, with a high reliance on starchy tubers such as yams, and sugary tropical fruits such as banana and papaya. (8) The Okinawan diet is even more carb-heavy at 85% carbohydrate, mostly from sweet potato. (9) Finally, the Tukisenta diet is astonishingly high in carbohydrate at over 90%. (10) All of these cultures are fit and lean with practically non-existent rates of neurological disorders and other modern chronic disease. (11)

#3 – Modern Research Does Not Support the Notion That ‘Safe’ Carbs Are Harmful

The claim that carbohydrates from whole-food sources cause neurological disorders is not supported by anthropological evidence. In addition, modern studies on the health effects of carb-dense foods such as fruit also fail to support Perlmutter’s hypothesis. In fact, studies overall suggest that eating whole, fresh fruit may actually decrease the risk of health issues such as obesity and diabetes, and that limiting fruit intake has no effect on blood sugar, weight loss or waist circumference. (12, 13)

As you may know if you’ve been following my website, there is plenty of modern research demonstrating that diets rich in refined and processed carbohydrates are harmful. However, this is not due to carb content alone, and there’s no evidence that whole-food carbs have the same effect. When an author or expert recommends excluding or severely limiting one of three macronutrients that humans consume, the evidence demonstrating harm should be strong—not only because of the inconvenience of following such a restricted diet, but because extreme diets (ketogenic or VLC diets in this case) are not always harmless. In my practice I’ve seen many patients who’ve worsened on long-term VLC diets, including those with adrenal issues and poor thyroid function. Long-term VLC diets can also lead to imbalances in gut bacteria due to a lack of prebiotic fiber, which can result in digestive issues.

As I’ve always maintained, you need to find out what works for you and tailor your diet to your specific health goals, rather than follow a canned approach. This is exactly what I’ll teach you to do in my book, Your Personal Paleo Code (published in paperback as The Paleo Cure in December 2014), which is coming out at the end of December.

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  1. i think alzheimers is in the top 5 causes of death in the us. so not everyone is going to get it from eating a high carb diet. but the ones who will get it are really looking at the cause to figure out prevention. i think a high carb diet is a likely cause.

    • Again, there’s no evidence that its carbohydrates, per se. That’s the point of this article. If you have evidence that actually supports this idea, I’d love to see it.

      • Chis, Dr. Perlmutter affirms that he wrote his book in response to 252 professional, peer reviewed studies that were published in well regarded scientific journals, which substantiate his thesis. Yet you say those same studies don’t exist. You just state that, as you did here, without any other qualifying comments. Why don’t you get in touch with Dr. Perlmutter, find out which studies he’s incorporated, and then write a followup article that substantiates your as yet unsubstantiated accusation? I and many others would love to see what you come up with.

        • Or maybe Chris could read the book and then point out which supporting evidence he feels that Dr. Perlmutter is misrepresenting.

          I’m rereading parts of the book now, and Dr. Perlmutter focuses on insulin resistance resulting in high levels of circulating insulin and high blood sugars as what actually damages the brain. If we could ask him the question, I bet he would say if someone knew based on testing that they were highly insulin sensitive and therefore had excellent control of blood sugars despite eating Paleo carbs, then they could perhaps eat more without raising their risk of neurodegeneration.

          I think his recommendation of below 60 grams of carbs is meant as a general recommendation, assuming that not everyone follows their insulin level regularly (I can’t even get that test from my doctor).

          One thing that I haven’t seen mentioned yet on this thread is Dr. Perlmutter’s point that the brain may be experiencing inflammation and undergoing damage without one being aware of it at all. There are no pain sensors in the brain, which means that we do not feel inflammation in the brain. So for all the people that are just “listening to their body”, they might want to get their fasting insulin tested to be certain that they are not insulin resistant.

          Or yeah, I guess they could just take Chris’s word for it that there is no evidence that Paleo carbs cause any problem whatsoever, and gorge on sweet potatoes as long as they feel good doing it!

          • Actually, perhaps we all should know what our glucose levels are before and after meals, and adjust carbs accordingly. I believe Chris has said that, and Dr. Perlmutter would probably agree. I’m not sure there is such an enormous gulf between them.

  2. To each his own. But I’ve followed Dr. Perlmutter’s recommendations and feel / function 100% better. Due to worsening hypoglycemia, I’ve been on a low-carb, no sugar, no caffeine, no alcohol diet since the 1970s, and that helped a lot. However, since reading Dr. Perlmutter’s book and further restricting my diet by eliminating, as much as possible, gluten, dairy products, etc. I’ve gotten my old life back. Haven’t felt this good since 1969. Sometimes you just need to go with what works. .

    • Tom,

      I’m happy to hear a very-low carb diet has helped you. But of course that doesn’t mean it will help everyone, or that it’s even required to avoid Alzheimer’s and other neurological conditions.

      It’s also important to consider where people are coming from when they switch to a diet like this. If you were eating a standard American diet, and then switch to a low-carb, grain-free, caffeine-free, alcohol-free diet, how do you know what provided the benefit? Could you have received the same benefit by simply eliminating grains, dairy, legumes, caffeine and alcohol and not going low-carb?

      This is similar to stories I hear from people who’ve recently switched to a vegetarian diet and feel much better than when they were on a standard American diet. Of course! They’ve eliminated processed and refined crap and are now eating whole foods. The question is how will they feel after a few months or years on the vegetarian approach.

      • I say my diet is “low carb” but do enjoy abundant carbs in the form of salad greens, avocados, onions, tomatoes, broccoli, cauliflower and other low glycemic veggies. I know a particular food isn’t right for me if it causes sleep disturbance or otherwise makes me feel yucky. I seem to have a compass in my gut that points me in the right direction.

      • Chris,

        You need to re-read Tom’s comment. He already was on a low-carb diet, but only recently elimated guten and dairy products and said that he felt better after doing that. It doesn’t sound like he’s been on a standard American diet since the 70s.

      • Chris, you very correctly point out that Tom’s post is just one person’s positive experience with a low carb diet which may not be extrapolated to the general population, but I don’t see you making the same argument when others report problems like increased TSH or hair falling out because they went low carb. These are samples of one and there’s no information about possible confounding factors.

        I’m entering my third year of low carb. I still have all my hair. And my TSH did go high at one point, but when I tracked my nutrients around that time I saw that because of hunger suppression I was consuming well under 1000 calories a day. No big surprise that my thyroid was trying to down-regulate the metabolism to avoid starvation. When I increased my calories while still staying under 30 grams net carbs/day, my TSH went right back to normal ranges. It had to do with calories, not carbs.

      • To Chris Kresser
        It’s also important to consider where people are coming from when they switch to a diet like this. If you were eating a standard American diet, and then switch to a low-carb, grain-free, caffeine-free, alcohol-free diet, how do you know what provided the benefit? Could you have received the same benefit by simply eliminating grains, dairy, legumes, caffeine and alcohol and not going low-carb?
        if you cut out all those foods, what would you suggest we eat, in their place, for energy?

    • Hey Ginny, you’re off to a good start! Add some white rice and white potatoes to each meal and you’ll be off to the races. Chris is a big fan of Paul Jaminet’s Perfect health diet which includes 100-150 grams carbs from starches per day and doesn’t count carbs from veggies.

      • It is as foolish to recommend a blanket amount of certain carbs to people as it is to recommend a blanket restriction…..
        This is a complicated question and there is considerable genetic and individual variation. Sure, read the views of experts, but in the end, you have to try stuff, see how it affects your body and tweak until you stay feeling good. It is important to recognise your limits.

        I could not balance my blood sugar, make my brain work well and be free of sugar craving and actually stay on a paleo diet without slipping until I cut out all sugary fruits and starches for several months and worked on my gut health a LOT. Now I can eat some small amounts of rice or sweet potato here and there and feel good afterwards and still maintain my nutritive instincts, but still not loads of it every meal. Green stringy veggies I eat in copious amounts however.

        My indigenous ancestors lived for centuries mostly on fish, turtle, seasonal berries and highly treated acorns. Possibly relevant to think about your family history, no?

        I know a lot of people thrive eating the way Jaminet recommends, but it is too much carbohydrate for for my physiology.

        But if you have been eating low carb for more than a month and feel tired and crave potatoes, by all means try eating some.

        Chris is of course absolutely correct that there is no evidence of tubers or rice giving people Alzheimer’s…

        • Alison, your post is completely correct in my view. Far too many blanket statements out there. I say, eat whole foods, but eat the whole foods you tolerate well, while making sure to get adequate amounts of essential micronutrients. I think that’s about as specific as I’d feel comfortable stating to a large group (which would make me a terrible addition to the government’s MyPlate committee).

  3. “he that is good with a hammer tends to think everything is a nail” -abraham maslow

  4. I haven’t read the book, but it would seem eliminating grains, which could even be processed or GMO, is a whole different thing than eliminating carbs from whole foods, such as fruit.

    • I’m so confused. I’ve soaked my already fogged out brain (low thyroid, taking levothyroxine) over this past week in a plethora of diet/disease info available on the net.

      I think, but not sure just yet, that Chris’s views on this site make the best sense. I just made out my shopping list based on Dr. Cordain’s (sp?) version of Paleo. Now it seems I need to start over again!!! Help! I’ve missed the past 4 weeks of work so please suggest low budget advice to help me get started. Time’s a-wasting!


      • Ginny,

        >> fogged out brain (low thyroid, taking levothyroxine)
        You might want to ask for Armour thyroid (or another brand of NDT natural dessicated thyroid) if you’re having brain fog with Levothyroxine. Or at the very least, ask your dr to check your free-T3 level, then maybe start a little Cytomel (T3) along with the Levothyroxine (T4). Many of us can’t convert the T4 to T3 easily.

        I’ve taken various thyroid meds for about 18 years, and think NDT helps me to have a clearer brain. stopthethyroidmadness.com has good thyroid info and explains more.

        Good luck! I hope the brain fog evaporates soon.


        • Just an aside: My husband suffered from brain fog and other thyroid issues, and his MD was unable to regulate his thyroid until his thyroid medication was compounded by a local compounding pharmacy. The reason: he was sensitive to or allergic to whatever they use as fillers in his thyroid medication. And he did try Armour thyroid, Cytomel, and Levothyroxine among other commercial thyroid products. Hope this helps.

  5. Hi Chris

    I read the book and have been self-experimenting with a keto diet for almost 3 months now. I feel good…not drastically different. The one thing I was surprised to find was that I could go for a 50 mile bike ride with virtually no carbs in my diet and only macadamia nuts and water during exercise. No bonking.

    My diet is relatively high in good fats, not too high in protein and then I have a big green salad once a day, and may supplement with a few raspberries, some daikon, poblano, and always some sauerkraut/kimchi. I’ve been testing my ketones using a blood meter. I’ve been surprised to find low ketone readings…usually no higher than 0.5 mmol/L. My body comp. has improved slightly. I’m 6’4″, 190# and approximately 11% body fat. Since going keto my home scale says I’m down 2 lbs and -2% BF.

    I also read The Art and Science of Low Carbohydrate Performance (Phinney/Volek) for a perspective on fueling exercise while low carb. Their recommendation was a long-term carb consumption of something higher than Dr. P – ~100g-120g/day.

    Just some points from an n=1 experiment.


  6. Don’t you think that Vitamin D status affects your ability to consume carbs? It would make sense that those living in the tropics could live on high carb diets, whilst those of us further north or south would only eat them in the summer – which would have been when they were available to us. I bet none of the high carb populations were from the far North for example.

    • According to Dr Price’s work, the isolated Swiss lived mainly on a diet of rye bread with pastured butter and raw cow’s milk. I’m not sure of the macro nutrient ratios, but I am certain that the amount of carbs in the milk and bread would put them far out of the VLC range.

  7. Chris, how many of these cultures eat such high carbs year round? Do they take a break from carbs during the year to clean the AGEs out of their system? I’ve wondered if a difference between traditional cultures and ours has to do with us having access to carbs year round. Thanks.

    • There is some seasonal variation, but the Kitavans and Tukisenta live in a fairly tropical environment where the availability of carbohydrates would be year-round.

      • Dr. Seneff has mentioned a few times in her talk today at the Weston Price conference that cholesterol sulfate is required to deal with the AGEs caused by high blood sugar. Cholesterol sulfate is produced by sun exposure. I wonder if tropical people are protected from AGE damage due to their year round sun exposure? Just a thought.

    • I come from Cameroon, more specifically from a tribe whose staple is carb (corn/maize, root tubers) all year round. We grow corn twice a year. I also know one or two tribes whose staple is very closed to ours mainly corn/maize all year round. At least as far as I know there are not many neurological issues among individuals.

  8. I have the book at home but haven’t read it yet. However, I’m a big fan if the low carb diet. It is against conventional wisdom though and while I agree with your point that everyone should find what works for them however I do believe that a blanket LCHF diet would generally leave the average person heslthier than a blanket LFHC diet

    • I’d agree that the average carbohydrate intake of 300–400 grams per day in the U.S. is too high for most people, especially when they are sedentary.

  9. Great article Chris! I am reading the book now and all the research supports avoiding excess carbs, spikes in blood sugar, and diet and other lifestyle factors leading to silent, chronic inflammation. There is research to support benefits for all for ketones for the brain but intermittent fasting would accomplish that. So yes, I would say he jumps to a very big and possibly dangerous conclusion and once again, people will follow the advice of an expert and 3 months from now, find they aren’t doing so well. People need to use their common sense and listen to their bodies. I have heard him lecture a year ago and he was right on target talking about omega 3s, gluten, inflammation, benefits of intermittent fasting. He does love to engage in dialog – a wheat farmer wrote him a letter and he published it and his response on his website. So perhaps send him a link to your blog. Would love to hear his response. He does have a degree in Nutrition as well.

  10. Chris – I’d like to add #4 – Decreasing carbohydrates to <60g per day in turn can decrease available fermentable substrates for the gut flora. Which can lead too gut dysbiosis and other harmful changes in gut flora resulting problems in the brain.

    Many foods that are "higher" in carbohydrate foods are also "higher" in fermentable substrate that is beneficial for the gut flora. I'm not saying that a VLC diet has to be lacking in this area but that it is a struggle to obtain that same amount of substrate that a person would naturally eat on a non-carbohydrate restricted diet and therefore many people will fall short in this area.

    New research is coming out each month on the link between a healthy gut flora and a healthy brain.
    Here's a couple good summaries of where things are at:

    • I mentioned this at the end of point #3 “Long-term VLC diets can also lead to imbalances in gut bacteria due to a lack of prebiotic fiber, which can result in digestive issues.”

      But I agree, it’s important enough that it should have been its own point.

      • Chris, what do you think about the emerging connection between immunity and microbiome? Those at Free the Animal seem to be reversing their constipation and cold body temperature which started with their VLC diet through resistant starch supplementation. I’m not sure if this actually raises FT3/T3, but that seems quite conceivable given this new link. Also, your FBG seems to improve due to resistant starch. But seriously, the most startling connection seems to be between gut flora and autoimmune diseases like RA. For example, this just came out last week:

        “It’s been suspected for years and years, both in humans and in the animal model, that the development of autoimmune diseases like arthritis is dependent on the gut microbiota,” says immunologist Diane Mathis of Harvard Medical School in Boston. Now, she says, those suspicions are beginning to be confirmed in humans. “It’s a very striking finding.”


        Is it possible that VLC/ketogenic diets could lead to autoimmunity by leading to an imbalance and the resurgence of the wrong kind? One can’t help but wonder because of the significant leukopenic effect I see in these low carbers (most are ok at 4s but some fall into the 2’s immediately upon cutting carbs).

      • Can’t one be in ketosis but still get plenty of fiber by choosing where you get your carbs, I.e. Vegetables? 10 Brussels sprouts have 15 grams of carbs and 5 grams of fiber. 2 cups of cooked cabbage gives you 28 grams of carbs and 10 fiber. One cup of carrots gives 12 grams of carbs and 4 grams of fiber. This would give you more fiber than the average America but you would probably remain In Ketosis.

        • Yes, you can. I sometimes go under 50 grams of carbs for periods of time, and my fiber intake definitely increases as a result. For me, when I am not restricting carbs, all of those high-fiber, low-carb vegetables are not appealing, but when you restrict carbs under 50 all of a sudden you start really enjoying brussel sprouts, broccoli, etc.

          • Mary! Totally agree!!!!! It’s amazing how DELICIOUS a plate of cabbage “noodles” and a huge green salad becomes when I have dropped grains. Greens not grains. 🙂

      • Chris, creating the illusion that somehow Dr. Perlmutter is against vegetables with his recommendations really is doing his work a disservice. I agree with you that prebiotic fiber is essential for our health and specifically our brain and immune health because our gut flora convert these to short chain fatty acids. Since Dr. Perlmutter’s recommendations encompass eating from 10 up to 50 servings, and beyond, daily of fibrous vegetables, I would have liked to have seen a more responsible disclaimer by you before you wrote this important section on #3. You create the illusion that Dr. Perlmutter’s recommendation will lead to fiber deficiencies. To the contrary. And to suggest otherwise, Chris, is professionally irresponsible.

        • Having read the book and been very impressed by it, I have to say I agree with Kurt. And, forgive me for being so blunt Chris, but your having given such short shrift to something as compelling as Grain Brain does not exactly recommend your upcoming book as an essential addition to anyone’s library…

          • Mary and Kurt, just think for a second about the explosion of alarmist diets that have emerged from behind every rock in the past twenty years. Do you notice a pattern?? The diet we have ALWAYS known to be healthiest, which includes fruit and whole grains, always prevails, and the fad falls by the wayside. Every. Single. Time. To believe in something that is just another one of those theory diets when we have thousands of years of tried and true nutrition is just a little silly. People are constantly trying to vilify foods that have already been proven essential to a healthy diet time and time again. Perhaps they want to blame good wholesome foods so they can pretend that what has truly caused our spike in diabetes, obesity and heart disease is from processed, refined sugar and other junk isn’t being consumed by anyone. Kurt, you keep insulting Chris didn’t read the book- I did. I’m a physician as well. It’s baseless and not a solid theory. Sorry. My opinion won’t change.

          • Mary, first of all, I’m a woman. Second of all, I’ve read THOUSANDS of articles, but put no stock in any of them if they’re not backed up with scientific proof in the form of legitimate medical studies. And third, if you believe everything you read, no matter how outrageous, just because “people with degrees” wrote it, you are going to have to believe millions of unproven, flat-out incorrect and conflicting theories. The person who wrote this article, and I, both have doctorates. Therefore, your argument makes no sense. And I have read the article. Where’s the proof and do you have a biochemistry background? If not, I don’t know how to explain to you it’s faults and I don’t know how you could be so adamant it has none,

        • Dr please get a clue.
          Read Grain Brain and pratice the knowledge thast Pearlmutter teaches you.
          You are way off base.

      • I agree that there seems to be confusion by many experts between use and interchangeability of “glucose” and “carbohydrate”. Perlmutter made it pretty clear that he was talking about glucose, and not non-digestible fibre. Your point is generally a good concern, Chris, but in raising it, you fail to anchor it trully in anything Perlmutter said. So it’s a bit like bullet shot off into the night – noise and impression but not particularly intended for a target.

  11. I’ve read Grain Brain. My family is affected by Alzheimer’s, and I am seriously afraid of this disease. Grain Brain was pretty powerful to me. I do think the book goes to a difficult extreme, but if his protocol does work, I would gladly do exactly what Dr. Perlmutter instructs. The problem is that I have no idea if it truly works for everyone, and works without other, negative consequences. As with everything regarding nutrition, there seems to be one smart person saying one thing, and another smart person saying another. Trying to make an informed decision about nutrition for me and my family has become nearly impossible. Thank you for your viewpoint on this important issue. I tend to trust your opinion above others, and am thankful for your blog and podcasts.

    • This is exactly the issue. I know Alzheimer’s is scary, but so far I haven’t seen any evidence that avoiding whole-food carbohydrates will prevent it, or that eating them causes it. Certainly we all agree that avoiding refined flour, sugar, and other processed carbs is preventative. But telling people to severely restrict whole-food carbs in order to prevent neurological disease isn’t supported by the current evidence.

      • So Chris, please clarify, are you saying that none of the supposedly compelling evidence Dr. Perlmutter presents in his book actually suggests, in your opinion, that total glucose load on the body over years and years may contribute to Alzheimer’s and other neurological disorders? Or is it that you have not come across such evidence elsewhere?

        • Mary, I suspect that Chris’s silence on your direct question is because he really has not reviewed the studies that Pearlmutter reviewed, and that Chris is not being forthright when he negatively says “there is no compelling evidence”. I see Chris as muddying the waters on this one, rather than offering clarity. I think his concern may be to reach out to his fan base to be seen to be saying “something, anything” rather than be silent on this significant book. All direct and forthright comments requesting clarity have been ignored by Chris, and it seems that the comments full of unqualified compliments for Chris are the ones that get comment from him. That’s very disappointing.

          • Actually, Kurt, I think Chris probably just doesn’t have time to respond to every query posted here. All of these people buying into the hype of ONE doctor’s opinion when there are hundreds of studies and thousands of years of nutrition proving the opposite is what I find disappointing. Chris isn’t an alarmist who is trying to start a trend, as he most likely knows the simple fact about food that has always been true- whole, non-refined food is what everyone should be eating, and fruits and veggies are necessary for good health. Accusing him of not researching is just childish.

            • Brittdoc – you are so right on target! I can’t imagine devoting all my time to answer accusatory comments rather than actual discussion.

    • My family is also affected by Alzheimer. I’ll admit that I haven’t yet read the book, but I did listen to a whole bunch of his interviews. It seems to me that the key here is how controlled is your blood sugar. If you have perfect blood sugars, maybe eating carbs isn’t such an issue. But if your blood sugar level is all over the place and your H1BC is high, there is indication that the carbs you are eating are damaging you.

  12. I think it’s important to remember that we should never be taking an axiomatic approach to dietary advice, whether it’s Perlmutter saying “Carbs are bad,” or Chris saying “Carbs are okay, most of the time.”

    The important thing is that we listen to our bodies. What does your qualitative sense of well-being and quantitative lab results say about your health? This is where the truth lies for us all individually.

    I know for myself personally, I feel that I thrive when I am in moderate ketosis all the time. Does this mean I think carbs are bad? No. Just listen to your body.

    • I agree…while I try and be very low carb and “Paleo”, I have to allow one day every 10 days or so for grains or else I become extremely sluggish and my digestion slows to a halt. Its finding that balance on an individual basis that is the “sweet spot”

    • I agree, Zach. I have followed a relatively low carb approach for the last several years with carbs well below 60 most days and do very well on that approach. One day or so most weeks, coinciding with high intensity training, I eats lots of white rice or sweet potatoes. Even when I don’t cycle the carbs in, I still feel good and perform consistently mentally and physically. On no occasion do I ever knowingly eat grains or grain-based products. Since making these changes, all of my health markers have improved along with body composition.

      “Carbs” to most people is not sweet potatoes, yams or white rice, but instead things like cookies, crackers, bread, french fries, etc. I think virtually everyone would be better off going low carb to avoid these items than eating these particular types of carbs.

      If one doesn’t have access to a kitchen and groceries, it’s very hard to consume safe, “whole food” carbs. When is the last time you saw a sweet potato, that wasn’t fried in some type of bad oil, on a menu? Even one of the relatively plain white rices at my local Whole Foods has sugar as one of the ingredients.

      I read the book and that it was excellent overall.

  13. Chris, I’m reading Grain Brain right now and it appears to me you’re misrepresenting what Perlmutter is saying. Not once has he suggested people eliminate carbohydrates from whole foods like vegetables and even totally from fruit. He targets grains generally, and wheat in particular. Hopefully this is just an oversight on your part (did you even read the book before you wrote this post?!?) and will be promptly corrected.

    • I have seen him suggest in several places that people should restrict carbohydrate intake to 60 grams a day, and that’s exactly how I represented his recommendation in the article.

      • Exactly. And after eating 50-60 grams of carbs a day for several months, I ended up with a depressed thyroid causing my energy level to plummet along with other effects. Increasing my carbs in the form of fruit and safe starches (AKA Perfect Health Diet – white rice, white potatoes, sweet potatoes, etc.) caused my energy to return and I feel so much better. Advocating such a low carb amount for the general population is a mistake, in my opinion. I know of several others who’ve had similar experiences, females in particular.

      • Chris, at 4 slices of bread-equivalence a day, 60 grams of digestable carbohydrate is hardly a draconian restriction. If someone told me that I should only have 4 slices of bread, or 1.5 cups of rice with my daily eating, I wouldn’t say they’re telling me carbs are toxic! 60 grams of carbs daily also equates to 3 cups of butternut squash, 7.5 cups of spaghetti squash, 14 cups of cabbage, or 7.5 cups of carrots – or 24 cups of boiled spinach. To sound a bit silly but not out of the ballpark, I would hardly say that a doctor who is telling me that optimally I should keep my carbohydrate intake to between 15 to 48 servings of vegetables a day (1/2 cup = 1 serving) is hardly telling me that vegetables and carbohydrates are bad for me. However, while it may be too low for some elements of the general population, that’s a far cry from criticizing someone for taking the tact that what’s good clinically can also be beneficial from a preventative perspective. It’s all about individual physiology and individual needs and health. What is good about the discussions openning up, is that all these knowledge pockets communicate better with each other. My big disappointment with Dr. Perlmutter’s book was that he didn’t address the issue of lectins in many foods, especially grains and legumes, and their role in autoimmune disorders, especially as can impact schizophrenia, bipolarity, multiple sclerosis, and a few others, since he is a neurologist. It’s not simply higher quantities of glucose that can be problematic. More research needs to be done on these.

        • I did not jump off a bridge either but I know I do not care to…
          I like a whole plant-based diet which includes properly prepared whole grains. If grains make you sick stop eating them. I am healthy eating steel-cut oats, quinoa and several other whole grains after I soak and ferment them.

      • You’re right Chris, he does state it that way. I often filter so many blogs and writings, given the importance of fibre in so many ways, that I assume people are talking about digestible carbs when they mention carb limits. But you’re right, that in the spirit of accuracy, these assumptions are my own and not the writer’s.

  14. I think his carb recommendations are 40 for 1 month and 60 after that? It’s low, but not atkins introduction or keto low. He concedes that occasional splurges are fine and there will be holidays and special events. The message I got from his book is more about overall health than super strict carb police. I really enjoyed reading it and it made me rethink my sushi dinners that were becoming way too frequent.

  15. Yes have read Grain Brain and also heard Dr P speak recently here in the Denver area. I believe his book reflects good clinic observation and a balanced reliance on current refereed journal articles and research. He is biased in his patient population and the extrapolation to the general public may be a stretch. However lets not throw his work under the bus either. If we as functional medicine practitioners can use this information and his extensive platform to get peoples attension then let’s use it. The message is stop consuming the most damaging carbs (hfcs, fake sugars and fats,gluten containing grains, processed dairy and rely on regionally grown in season fruits and veggies with good protein sources and good saturated fats. When you drill down this is his message. And I believe Chris it has been your message as well. Can’t wait to see you new book. Blessings Phillip

    • I am not throwing his work under the bus. As I said in the beginning of the article, there are absolutely situations where a VLC diet makes sense (and patients with existing neurological disease is one of them). But a diet that treats a particular condition isn’t necessarily required to prevent it.

      For example, low-carb diets can be helpful in the treatment of obesity, but contrary to some claims carbohydrates do not by themselves cause obesity. An autoimmune protocol which eliminates dairy, eggs and nightshades may help with existing autoimmune disease, but that doesn’t mean healthy people need to avoid these foods in order to prevent it.

      We have to be very careful about confusing causation and therapeutic effect.

      • Yes, thank you! We do have to be careful not to confuse therapeutic effect with causation. VLC has been on my radar since attending the Portland Regional WAPF conference in September and listening to Nora Gedgaudas speak. She mentioned Perlmutter several times. I think the sweeping recommendation that everyone benefits from a ketogenic diet is actually dangerous. I have spoken to many people and personally experienced adrenal and thyroid issues while on GAPS that went too low carb. As a nursing mother of three, I need carbs. So I appreciate you pointing out that many traditional cultures thrive on high carb diets. I also think VLC diets can be very unnecessarily restrictive and unrealistic long term-resulting in failure.
        I have read your posts for years, never commented. I appreciate your unbiased approach.

      • Chris, I beg to differ with you on your interpretation of your contribution in this very interesting and well thought through article. You are throwing Dr. Perlmutter under the bus. I too have questions about the extent of glucose effect on the body, good and bad. Dr. Perlmutter wrote his book after carefully reviewing 252 studies specific to the topic. In this your article, you take the thesis that a “theme” of eating that may be therapeutic is not necessarily preventative. Yet you neither qualify nor substantiate your theory. It makes good emotional reading for those who want their nerves on this issue calmed, which seems to be your motivation on behalf of your readers, but while I see general vague references, I don’t see any hard science in what you have pointed to that would ground the tone of your critique of Dr. Perlmutter. I like your earlier writings on cortisol and the effects of glucose need and request, and the interplay of epinepherine. Yes, Dr. Perlmutter made some strong statements, and drew some strong conclusions. My guts tell me that there is substantiable critique of him out there, but I would like to see pointed science rather than emotionally flavoured arguments.

      • So, are you actually saying that people should not be trying to prevent Alzheimer’s by lowering carb counts based on the evidence he presents and his clinical experience? People should only lower carb counts once they are actually diagnosed with Alzheimer’s?

  16. I read Grain Brain but this is hitting home. My thyroid levels were on the high side of normal after following a low carb diet for a while. Very interesting.

  17. Great Stuff Chris! I think in general a low carbohydrate diet is good, but the very low carb diet may be too restrictive for long term success. There are simply too many good nutrients in fruits and vegetables that people need for good health.

    When most people think of carbs they think of breads and pastas. These are the carbs to remove for good health and they are the ones causing the “Grain Brain”. Most people today get all of their carbs from these sources, so lowering them will be beneficial. Too many people on VLC diets are not eating enough veggies (worrying about their carb content) and this is probably where they go wrong.

    I also think there is good value in cyclical ketogenic diets, with starches saved for 1-2 days per week post excerise. I don’t think you would see the same long term disadvatages while maintaining many of the benefits.

    • I agree that in the mainstream most people thing of breads and pastas when they think of carbs. However, the whole reason I wrote this article is that I’ve had several patients coming to me expressing concern that they are putting themselves at risk by eating more than 60 grams of carbs a day in the form of starchy plants and fruit. And I’ve received many questions via my website contact form along the same lines. That’s why I think it’s so important to be clear with these kinds of recommendations.

      • I hear ya. I read the book and I’ve been paleo/primal for a while… I thought, and commented on Mark’s forums, that the carb intake he advocates is extremely low. I’ve done ketosis before and it was fine but as a way of life I find it irritating and unnecessary. I’d hate to think about people stressing because they’re going over 60 grams of carbs…

      • Chris, 60 grams of digestible carbs is not very low. That’s equivalent to 4 slices of bread a day! My heavens, Chris. 4 slices of bread equivalent is not very low, nor a horrible deficiency. If I recall correctly (pulling from memory rather than checking their book) Drs. Jaminet and Jaminet in their recent book, Perfect Health Diet, establish carb toxicity levels above 150 grams, with optimal below that. Sometimes too much is made of select genetic populations that have evolved to eat one way or the other and, while informative of overall human diversity, that information is not necessarily valid for all human populations.

      • When I read your article, it did seem to start out to debunk Dr. Perlmutter, by characterizing his advice as a low carb diet. It then introduced points to rebut low carb diets. My understanding of Dr. Perlmutter’s recommendation is that he is not just a low carb advocate. He allows for 60 carbs in his diet, and the preference is that the carbs come not from whole grains such as wheat. The points in your article are about people subsisting on starchy roots, not whole grains. I would recommend a rewrite, because as it stands this reads like deliberate mischaracterization of Dr. Perlmutter’s position (who is also an MD) and a bait and switch. Perhaps a more accurate description of what Dr. Perlmutter actually recommends (with citations) and examples of healthy people with diets of 80% wheat in their diet.

      • Chris,
        Could you do something about the comments that are complete BS, or at least unsupported by any current and rational scientific research? Also, you should probably require people who write comments to at least state their qualifications. Too many people are writing as if they were doctors or researchers when they are not.
        Bob McConnell

        • We really dont want to listen exclusively to Doctor’s anymore or professional nutritionists or researchers… Fool me once shame on you, fool me twice, shame on me.

          Experts will cling to a dogma they are invested in long past the time they should have dropped it.

          Ordinary people taken as a collective whole have far more valuable information except that it is more defuse.

          The days when Doctor’s and Experts lead us down the road to soaring obesity rates and soaring rates of disease are ending.

          So sale
          I once had a candidate for Mayor knock on my door to get my vote. He told me his idea’s and then proudly proclaimed that he was a lawyer.. I stopped him in his tracks and told him I prefer not to vote for lawyers.
          He didnt know what to say.


    • There is no essential need in the human diet for carbohydrate, none at all. You can go your entire life and never eat a single fruit or plant or tuber and have optimal health and longevity. These foods may just be supplemental to our most natural diet. Plants really are not packed with as many nutrients as commonly believed especially coming from depleted soil. They do have good antioxidants and fiber but nothing all that special. If you eat too many sugary fruits and carb rich potatoes and such the like you will without doubt increase your insulin levels. Insulin should be kept as low as possible for optimal brain health, longevity and overall good health. High carb intake may shrink brain size and is glycating.

      • There is definitely a need for carbohydrates Mark. I was told to go on a no carb diet and saw very bad results as my body went into a severe stage of ketosis, followed by metabolic catabolism. Not to mention that (good carbohydrates) are a good source of energy. If zero carb diets were any good people would be still be raving over the Atkins diet not ranting about it!

        • Unless you are a type one diabetic you may have miss diagnosed yourself. People who are type one diabetic can’t make any insulin and can go into what is called “Ketoacidosis”, a very sever overload of ketones. That cant happen in a normally healthy person just by keeping your carbs low. Instead, you will change your metabolism and become adapted to burning fat for energy rather than sugar ( glucose). Both your brain and your body work more efficiently burning fat. Babies for example are naturally in ketosis if they breast feed right up until the moment their parents start feeding them carbs. Human breast milk is very high in saturated fat.

          Your body naturally produces all the glucose you will ever need and can store about 2,000 calories worth of it in your liver. You never need to eat a single carb. That is what an “essential” nutrient is, something we cant make on our own and need to eat. We can make all the glucose we need without out ever eating a single carb. Therefore, by definition carbs are not essential.

          I dont know you but if you got sick dropping your carb load there can be several reasons for that. After a lifetime of eating carbs/sugar people sometimes need to help their digestive system come back to life ( with pro biotics or fermented foods) so it can once again digest fat properly.

          • BreastmilK is actually a high carbohydrate food-40% carbs- mostly milk sugars that is what makes it sweet.
            I have been very sick by going too low carb- resulting in thyroid and adrenal issues. What works for one person doesn’t work for another. And even the same individual has varying carbohydrate needs at different points in their life. As a nursing mother of three, I need a moderate amount of carbs. My husband can go low. My kids needs change with their age. Listen to your body.

            • I appreciate your input. I Believe you are correct as we do change biologically in our nutritional needs any to tolerate complex or simple carbs or sugars depending on our health status, that is starting with digestive health then leading to mental health.

            • “Mature human milk contains 3%–5% fat, 0.8%–0.9% protein, 6.9%–7.2% carbohydrate calculated as lactose, and 0.2% mineral constituents expressed as ash. Its energy content is 60–75 kcal/100 ml. Protein content is markedly higher and carbohydrate content lower in colostrum than in mature milk. Fat content does not vary consistently during lactation but exhibits large diurnal variations and increases during the course of each nursing.” http://www.ncbi.nlm.nih.gov/pubmed/392766

              • You know that’s by weight right? I think Megan was referring to the percent of calories in milk that come from carbohydrate.

                Whole milk is around 30% carbohydrate, 20% protein, and 50% fat as a percentage of calories (see USDA data below)

                Nutrition Facts
                Milk, whole, 3.25% fat
                Amount Per 1 cup:
                Calories 148
                Total Fat 8 g
                Total Carbohydrate 12 g
                Protein 8 g

                • “Lactose is the primary carbohydrate found in human milk. It accounts for approximately 40% of the total calories provided by breast milk. Lactose helps to decrease the amount of unhealthy bacteria in the stomach, which improves the absorption of calcium, phosphorus, and magnesium. It helps to fight disease and promotes the growth of healthy bacteria in the stomach. ” http://americanpregnancy.org/firstyearoflife/whatsinbreastmilk.html

                  So actually Megan was probably referring to calories. Which of course means 60% of the calories are coming from fats and protein.

              • Breastmilk changes in macronutrient ratios depending on many factors, which include: baby’s age, time of day of nursing, nutritional status of mother, the fullness of the mother’s breast (fattier hindmilk clings to milk ducts and is not released to the end of a nursing), among others. On average lactose and oligosaccharides account for 37% of the total content.

                So, if we extend that to the adult population as Marc alludes to above… A 2,000 calorie diet, at 37% carbohydrate, would be 740 calories or 185g carbohydrate. This is more than three times what Dr Perlmutter is recommending.

                I just don’t believe that babies are in ketosis until they ingest their first solid food carbohydrate, like Marc states above. This is mininformation. And, I think every individual has to decide what carb level they feel best at. I think 60 grams is awfully low and unsustainable in the long term, because it can lead to major deficiencies. I’d hate to see the Paleo community go in this direction.

            • I tried the grain brain reduction in carbs for several weeks, felt lousy (headaches, fatigue, and bloated) I guess that can be expected. I will continue to watch my carb intake, but making something the forbidden fruit usually leads to disaster…craving it, and overeating it later on

          • Marc, you’re a good one to ask. What’s the story on VLC causing hair loss in some people? Read a good many accounts re Adkin’s diet. And not the hair loss that comes from rapid weight loss either. Seems there are people who report going on a VLC diet with no weight to lose and after a period their hair starts to thin.

          • The studies are not always about whole foods and that makes the results questionable.
            I eat raw garlic and onions but looking at only one chemical in garlic is not a scientific answer to what the whole food does to me.
            Grains have to be processed before cooking by at least soaking if not fermenting/sprouting followed by cooking. To look at the impact of eating whole unprocessed but cooked oatmeal is not going to result in what happens when I eat my oatmeal after soaking for 24 hours and fermenting it for another 24.
            Applying common sense by recognizing all the bad stuff in meat which is not the same as it was 100 years ago motivated me to a whole plant-based diet. I do not need any more studies to tell me I do not wish to eat farmed-fish or contaminated meat.

        • The ketogenic diet by Lyle McDonald, a great book but being in heavy ketosis can mess you up badly if done long term.. More damage then good

        • People who have felt bad trying low-carb diets are almost always feeling the effects of lower blood pressure and sometimes lower blood sugar. Both of those are good things but they can make you feel faint and queasy while your body adjusts.

          No one should try very low carb without some research — the “New Atkins” book is a really excellent and scientifically excellent starting point — edited by Eric Westman of Duke University Medical Center.

          If you have any kind of complex health issues you should try to involve your doctor — and if your doctor refuses to cooperate, and his/her reasons to say no don’t make sense to you, find another doctor.

          When you go low carb, the first thing that happens is you lose 4-6 pounds of fluid. There are two theories about that — one theory is that your body needs more fluid to digest carbs. The alternate, very intriguing theory, expounded by Perlmutter, is that the extra water weight is simply an inflammatory response to carbs, particularly to grains and sugars.

          In any case, when you lose that water weight, your blood pressure can go down quite dramatically and people feel lousy from hypotension and mild hypoglycemia. Fortunately there is an EXTREMELY easy cure for this — drink something salty, like chicken broth. It will stabilize your blood pressure while your body is making the adjustment to low carb. It works in nearly all cases where people are feeling bad on a low-carb diet.

          Often in a few weeks, as they lose water weight and then burn off a bunch of fat, people’s blood pressure stabilizes at a much lower level and they can come off their blood pressure meds, which is one nice benefit of low carb eating. Another really nice benefit which almost everybody experiences is that acid reflux simply disappears — often in a few days. So people who are basically permanent users of Prilosec or Zantac can come off them — which is really good because there is more and more concern about long term side effects from those drugs.

          The confusion between ketosis (fat burning) and ketoacidosis (a very serious condition suffered by diabetics in very late stages of the disease) I am not going to get into here, but any doctor who is still confused about that ought to turn into his/her medical license. Ketosis is safe for almost everybody, and virtually everybody does it to some degree every time they go 6-8 hours without food..

          • I love the way people determine that they know what is best for others and they tell you how you will respond to following a certain diet. I did fine with low carb at first, but as the months wore on, I felt TERRIBLE. I lost energy, had dry eyes and skin…my thyroid was withering and my metabolism was bottoming out. Increasing carbs IMPROVED my health tremendously. I know what works for MY body. We are all different. Don’t try to tell me what I need!

          • Tom Boyer, for the last time, you have zero evidence to back up your claim. Evidence would be controlled medical studies performed by a legitimate source, published in a respected medical journal. A guy with a theory is just that. It’s useless, especially when it goes against the thousands of published studies already done. Go on believing every alarmist headline you read. It will undoubtedly drive you crazy. I am not exiting gracefully out of this forum, as I am not going to waste another moment arguing against nonsense.

          • Why would I want to try a low-carb diet when I know how good greens, legumes, fruits and other vegetables are for me?
            Meat has protein and B12 but kale, watercress, broccoli, berries, garlic and onions have thousands of known good things in them and likely many more thousands yet unknown…

            • Richard, according to perlmutter, people should eat garlic, onions and broccoli – but avoid carbs coming from grains or pasta. A low carb diet allows you to eat up to 60g of carbs/day – and there’s room for a lot of broccoli here

      • You’re very incorrect in this, Marc. The body’s energy supply requires carbs to supply energy in cases of explosive energy need. Fats CANNOT supply explosive energy. Below 45% VOX2 MAX, fats are moreorless exclusively used to drive energy. Above 70% VOX2 MAX, it’s exclusively glucose primarily from glycogen. In between is a sliding variable scale. That’s why humans have between 300 – 700 grams of glycogen stored – for explosive energy. This regularly has to be maintained, so carbs are needed in an optimal world. Fats do fine for most of our energy needs, but not all.

        • Arguments that “explosive energy” can only come from a carbohydrate diet have been pretty well debunked. Look up the work of Jeff Volek and the scientifically rigorous blog of Dr. Peter Attia. Very low carb is actually a great regimen for people who exercise a lot (ask the LA Lakers whose training regimen is now low carb).

          Last time I read Attia, he was exploring the idea that carbs may provide a marginal benefit in sprint-type events. But for anything of distance/endurance, people seem to perform better, not worse, on VLC. The theory being that ketones are simply a better fuel than glucose and glycogen. The metaphor is that carbs are like burning paper, or maybe a marshmallow, and ketones are more like burning wood, or maybe lamp oil. Ketones provide a steadier and more efficient source of fuel.

          In my personal experience as a low-carb eater, I don’t get the “hit the wall/second wind” experience when I ride my bike. I just start out feeling like “second wind” and I don’t hit the wall at all. I don’t do long rides — maybe 20 miles — but my level of fatigue while riding is dramatically lower when I am limiting carbs.

          • Energy your whole focus? What about fighting cancer and clean arteries? I do not want to go through one day without lots of greens, beans, fruits and other vegetables joined together with raw garlic and onions!
            That kale is going to save my eyes when I am 80 lol

            • As I said in a previous comment, garlic, greens and such are allowed according to Perlmutter, and cereals and bread should be avoided

              • I do not advocate any grains, but I do advocate processed grains. There is a HUGE difference. People need to wake the hell up and stop comparing the two as equals. All my grains, breads, pastas are fermented a min 48hrs in sourdough cultures. All this harsh aspect of grains many complain about are GONE, pre-digested by the bacterial culture. Not only that but these processed grains have increased nutrients and virtually no phytates. To deny your body a food group because you are too lazy to prepare it properly is absurd. Perlmutter needs to fully investigate long fermented grains. I’m 41, 5-11 165lbs all muscle. Have had full cardio workup and bloods, doc puts me in top 3% of health. He even claimed “some of your numbers are that of a healthy 16yr old, keep it up”. I also intermittent fast 16hrs a day. You will improve all health markers by intermittent fasting far far more than by going grain free. So in summary, when people here discuss grains please make a distinction and call them “unprocessed grains”.

                • ” doc puts me in top 3% of health.”

                  Wow, and did he analyze your brain, too? Because that’s the main damaged organ according do Perlmutter. Actually, that’s what his book is about, the link between grains and neurocognitive distorders.

                  ” To deny your body a food group because you are too lazy to prepare it properly is absurd.”

                  Perlmutter makes very clear that “he human requirement for dietary carbohydrate is none, none whatsoever.”

                  And if you think Dr. Perlmutter didn’t do his research very well, I should tell you that he’s not the only respected doctor that warns us about the risks of grain. Previously to him, another famous MD was a guest to Dr. Oz, he told the audience that carbs are bad for you. Oz was clearly skeptycal about his statements, but later he had D. Perlmutter as a guest, he said the same things and Oz knew at that moment he was wrong all the time. You think all the researchers who think grains are bad for you forgot to take into account the differences between the grains?

                  PS: english is not my native language

                • I’ve never seen a single ‘anti-grain’ researcher mention long fermented sourdoughs or what happens to grain when it is processed properly. If they did that, how would they make any money and sell books or get on talk shows? I come from a family where most if not all of my relatives live past 87 and have phenomenal mental performance for their ages. No trace of parkinsons or alzheimers and I can assure you they eat grains and carbs. My grandmother is 93 years old, still drives and still works part time. She is like a 65yr old. I sat down and went over her diet (because, sure, I want to know her secret!). It turns out she skips breakfast everyday and has an early dinner. She has unknowingly been intermittent fasting for the last 40yrs. I’ll say it again, intermittent fasting will improve brain condition and health markers FAR more than any diet could. FAR FAR more. When in the fasted state the organism boosts and protects the brain in a variety of ways. Why? Because the organism wants you to be capable of finding food! It’s so simple. Eat a healthy varied diet but only 8hrs a day feed window. That is all that is required for optimal health -but it’s far from entertaining.. the people want their fad diets, diet gurus and diet bloggers so will be left in the dark about the real way to be healthful.

                • It seems like you don’t know what you’re talking about, you have no data to back up your statement.

                  Your mother is 93, and you found that she’s been fastening for 40 years but do you know any person who tried perlmutter’s recommended diet for such a long time to tell how long this person lived, and thus which diet is more efficient? I don’t think so.

                  Also, Dr. Perlmutter advocates fastening


      • Carbohydrates are so essential to the body that the body will produce them if the diet does not contain an adequate amount. That does not mean that low carb dieting is optimal. There are certain functions in the body that REQUIRE glucose. When I stayed under 100 carbs a day, my energy levels dropped, I was cold all the time and I just felt awful overall. Increasing carbs has resulted in many health improvements for me. No one can tell me my body doesn’t need carbs. It does. And I am a 52 year old female in generally good health.

        • From my experience, I have worked 10 hour shifts with complete ease while eating pretty much keeping below 60 g of carbs. I used to walk basically all day long and carry boxes weighing in some cases up to 50 pounds. I figured I walked on average 15-20 miles per day for 5 days a week, averaging about 75-100 miles per week. Most of the people I would ask them what they ate for breakfast that were the most likely to quit or take breaks or complain the loudest about all the walking required of the job often told me that they ate large breakfasts, juice, toast, cereal, fruits and maybe some eggs, but they usually never could keep up with the work, some were large and muscular, looking pretty fit, but complained regularly. I hardly ever felt tired nor winded by any of the work, I would usually eat at most 2-3 eggs with some bacon for breakfast. That was all. Recently I went off this diet and went from 165 to 225, not walking or exercising just eating carbs and whatever I felt like, When I did a low carb diet in 2006 I went from 250 to 165 over the course of 12 months, that enabled me to work that job. Anyways recently I have gone back on the diet dropped down to 195 from 225 (had inflammation, allergy problems with nasal polyposis, sedentary and carb consuming), now my allergies are clearing up no polyps issues, My reasons were not weight this time around though I did need to lose some, I just wanted to stop the inflammation. Now I can run 5k almost not breaking a sweat, not feeling tired afterwards, prior to cutting carbs running 5k was an ordeal, tiring and painful. Of course losing weight has helped, but while eating any carbs I wanted and exercising I was going nowhere, lifting weight and jogging, my weight would not budge nor would my polyps shrink, I cut wheat out and within the past 3 months my system has been relentlessly shedding the excess and the polyps have stayed put not to block my airway!

          • Good post, thank you Joe. It’s funny, the people most distainful of LCHF approach are invariably the people who know least about it — and usually have no desire to learn the facts. People who have firsthand or secondhand experience with it seem to range from mildly favorable to ecstatic.

            • I actually know a LOT about LCHF. And it DIDN’T work for me. Why do some people have such a hard time accepting that?!

              • And I also know of a LOT of people who have had negative experiences with LCHF over time. People who did it for months and then started experiencing symptoms of low thyroid/metabolism.

          • Good for you. However, that was not my experience. We are all different. What works for one, does not necessarily work for another. Low carb did NOT work for me.
            Also, I do not eat junk carbs. I eat potatoes, sweet potatoes and white rice (per the Perfect Health Diet) as my main sources of carbohydrate, along with 2-3 servings of fruit most days. My carbs come from real, whole foods, NOT processed crap. There is a HUGE difference in impact on health from real food or processed foods. Don’t blame carbs if you feel awful eating processed foods.

            • White rice is simply starch. Would you consider corn starch a “quality” carb? I don’t think one can seriously make a distinction between the two. Any chemists care to enlighten us?

        • Your body is not going to produce all that great stuff in watercress, kale and other fruits and vegetables….you are deceiving yourself!

      • Sure Marc, you can survive without carbs….for a shorter time than those who fill their diet with starchy plants and fruit. Where did you get this information from? You can survive on twinkies if you wanted to. And you would get I’ll more frequently, and be in general poorer health, just as you would if you cut out carbs completely. If you were familiar with biochemistry, you would know that this is a totally erroneous theory.

  18. I have read Grain Brain and came to the same conclusion you did, great as a therapy if you have serious problems.
    What I am wondering about is that I had my gallbladder removed 30 years ago, it has not been a problem for me, but I am concerned that eating a “high fat diet” my cause some problems in the long run.
    would love to hear your feedback on this

    thank you

    • Maybe consuming ox bile at meal times would be a work-around for the fact that you no longer have the reservoir to hold a back-log of bile in preparation for when you consume a meal and fatty acid and protein are detected.

      Without the gall bladder, the common bile duct is now draining bile via the sphincter of oddi but if the sphincter of oddi is normally closed off in the interdigestive phase, I’m not sure now the body copes with a build-up of bile in the common bile duct and how that affects the liver which actually produces the bile. Methinks I’ll have to hit the A&P sites some more…unless someone has the answer to that one for me. The sites have said that post-cholecystectomy the CBD drains the bile into the duodenum continuously but I’m not sure if that’s the case if the sphincter of oddi remains contracted in the interdigestive phase. Perhaps the pressure of not having a reservoir increases the flow of bile against the sphincter of oddi. I could ask the maestro of CBD surgery here in NZ (Saxon Connor).

  19. I just finished reading the book last week and “my” takeaway wasn’t that carbs cause neurological disorders, it was that gluten causes neurological disorders. And that too many carbs from sugar, fruit, etc. (mainly high insulin and high blood sugar) increases your chances of alzeimers and dementia.

    Love your blog by the way!!

    • There’s no evidence that too many carbs from fruit increase the risk of neurological disease. From sugar, yes, but not fruit or starchy plants like sweet potatoes (that I’m aware of, at least. I’d like to see any if it exists.)

      • What about the point that fruits and other plants were seasonal and now we have them all year round. Fruits have way more sugar content now. Did you read Grain Brain?

        • Even more important, fruit has been re engineered to be much sweeter and softer than it ever was in the wild. We are probably not well adapted to fruit this sweet. Ancient fruit was much smaller, far more fibrous and as much sour as it was sweet.
          I think we are adapted to eating some carbs because we are opportunists and can eat a wide variety of foods. That does not make carbs optimal as food, only possible to be eaten as food. More likely our ancestors remained in a nutritional keotgenic state for as long as meat, fish and eggs were abundantly available. Perhaps during hard times they could switch to glucose for energy and scrounge up plants tubers and fruits.

            • Dear Joel, the article that you provided a link to is very interesting. It should be pointed out that this paper presents a biased view on fruits (wild vs. cultivated) by examining a selection of fruits that fit the author’s thesis. I can list many, many more fruits that do follow the pattern of the wild version being smaller, and/or having more fiber (hence less sugar in the entire mass of fruit), and/or having a more bitter taste. Certainly these are generalizations and their are exceptions (as the author has focused on). His pie charts are misleading as he notes the carbohydrate content without noting that many of these carbohydrates do not contribute to sweetness. While it is good to be aware that stating wild fruits are smaller (or whatever) is not a hard and fast rule, generally speaking, those found in US grocery stores are larger, sweeter, with less beneficial phytochemicals, lower antioxidant content, less fiber, and less nutrition than their wild counterparts. Again, I do appreciate this link as it provides some nice exceptions. Best wishes.

          • I disagree. Wild tropical fruits are large and sweet, and our sweet tooth suggests that we naturally desire a certain amount of carbs in our diet. Nutritional ketosis let us survive in places where fruits and tubers were not year round, so it’s a great thing, but I don’t think we can say that modern fruit is a problem. I would say modern fruit is just mimicking tropical fruits. Refined sugar and grains, now, those are a problem…

        • What about those things? How does the fact that we can eat most types of fruit year round change the fact that fruit has NEVER been scientifically linked to Alzheimer’s or dementia? Don’t buy into the hysteria- the theories in this book, surrounding fruit especially, are 100% baseless. Have you read the thousands of articles/journals/studies proving fruit is essential to obtain many of our micronutrients? Telling anyone to cut down drastically on their fruit intake (unless it’s incredibly high to begin with) when they have no proof it will be beneficial is ridiculous. We should cut out one of the only three macros we need to live because one guy has a theory, starving ourselves of micronutrients along the way? And vegetables are largely carbs, too. So we should all revert back to the failed fad Atkins diet then? Load ourselves with protein and fat, and pretend we don’t need the vitamins and minerals that keep our bodies going? This book is a dangerous mistake, because far too many people will see “M.D.” After a name and believe every word that person has to say, regardless of its implications. I’m a physician. A brand new physician that doesn’t know the vast majority of what people think I should know (that goes for all new docs by the way- I’d like to think I’m not a total moron or a really crappy doctor). I’m smart enough to know that I will NEVER know everything my patients expect me to know. Please, people, don’t believe completely baseless claims just because the person stating them went to school for an extra four years after college. The fact that people put so much stock into this nonsense scares me to death.

          • So we shouldn’t necessarily listen to an M.D. (logical fallacy: appeal to authority), but yet we should listen to ” thousands of articles/journals/studies proving fruit is essential to obtain many of our micronutrients” which itself is an appeal to authority. Last I checked, Atkins is not a failed diet, and proves you know nothing about it. Atkins advocated eating lots of veggies and never said not to eat fruit.

            What failed was the popular misrepresentation of his diet, pushed by fast food corporations and his detractors.

            • There is no long term study on the Atkins diet that shows it can reverse disease as some other diets can.
              The longest study on Atkins was one year and the average weight loss was less than 5%. If your goal is to lose weight for one to three months you might do well on Atkins….

              • Hi Richard, Do not know where you get your information on Atkins. People that got on diet and kept on it lost alot of weight. I lost alot on it, I went from 215 to 176. I think that is more then your 5%. Everyone I knew who went on diet lost alot of weight. Please research more before you make uneducated comments.

          • Britt Doc Fruit, or Carbs, is not necessary to our survival, Protein and fat, yes but not carbohydrates. we can not make protein in the body, we need it to survive. we can not make all the fatty acids. We need fat. We can make glucose, we don’t need to ingest them. Will we thrive without carbs, that is an unanswered question, but a lot of evidence is pointing to maybe, yes.

            • Keep believing you do not need carbs, eat only beef, eggs and cheese and talk to me in twenty years.

          • If everyone had actually read the book, we would not be making such wild accusations about what Dr Perlmutter has to say.

      • I had a history of neurological problems, including epilepsy. Meds never worked and surgery in 2005 stopped my seizures. In 2009, I was no longer able to lift my arm. I went to many MDs, who suggested therapy or surgery. When I learned about histamine intolerance there was something called frozen shoulder caused by reactions to citrus fruit. I stopped all citrus consumption (2013) and my arm began working again within 3 weeks. No meds, no surgery, and PT never worked. Stopping eating oranges and tangerines did. I had started to cut out food with histamines in September 2012. I have not fainted since then (which is the first time I have gone more than a few months without fainting since 1970).

        • I have frozen shoulder. I almost never eat citrus, and I’ve never heard this ridiculous theory before. Sorry, this was a placebo and frozen shoulder heals after about a year on its own.

          • I have heard of this in relation to my mother. She was having pain in her joints and she cut out citrus and the pain went away. It has to do more with citrus picked green.

            Just because you never heard of it before doesn’t mean its ridiculous. Perhaps you should do some research before shooting off your mouth.

            • Had frozen shoulder twice, and have done tons of research. If you google this, one random site claims there is a connection.

              Pain in joints is not frozen shoulder, so I’ve never researched that. Perhaps you should consider they are different conditions before YOU shoot off your mouth.

              Have a great day!

        • I had frozen shoulder for years and bought a speed bag platform about five years ago. I stretch and use the speed bag for 30 minutes three times a week.
          I eat about six to ten servings of fruits along with the rest of my whole plant-based diet and have not had shoulder problems for years now…
          I am happy your shoulder problem is gone but I doubt it was ever due to the fruits you consumed.

      • Chris and others, I’d recommend that you read a very interesting take on fructose published earlier this year by Dr. Richard Johnson, The Fat Switch. Dr. Johnson is a renal expert teaching at the University of Colorado. Very interesting stuff on the effect of fructose.

      • Did you read the book Perfect Health Diet by Paul Jaminet? Their diet is a moderate carb, high healthy fat diet. They mentioned eating roughly 1 pound of safe starches such as potatoes, white rice, sweet potatoes and 1 pound of healthy sugar plants such as carrots, raspberries, bananas, beets. Also protein is eaten roughly at 0.5-1lb per day.

        Their diet tries to maximize nutrients and minimize toxins. So to reduce the quick rise in blood sugar they would use starchy carbs by boiling the potatoes, eat them with an acid such as vinegar, and a fat such as butter to blunt the spike in glucose response in the body.

        The healthy sugary plants should be optimized for high potassium and low fructose ratio. Fructose is shunted by the portal vein in the liver and can be problem above a 100 calories a day according to their book. Fructose can change blood lipid and cause other harmful problems. Fructose comes from two main sources fruit and high fructose corn syrup. In the case of most Americans the over dose of fructose is from the sweeteners used in the processed foods.

        I am just someone interested in learning and applying better health standards to myself and might not have translated Paul Jaminets idea correctly but it should be close enough for you to understand.

        Appreciate your information and keep up the good work.

      • Chris writes: “There’s no evidence that too many carbs from fruit increase the risk of neurological disease. From sugar, yes, but not fruit …”

        Thompson seedless grapes: 1 cup contains 23 grams of sugar, almost all of it in the form of fructose, which some people contend is the most toxic form of sugar.

        Banana — 1 medium size contains 28 grams of sugar — again mostly as fructose..

        One large orange — 17 grams of fructose.

        A 12-oz can of Sprite: 38 grams of sugar, either fructose or sucrose.

        How exactly could sugar in soda be harmful in myriad ways (which many people seem to accept) but sugar in fruit — which is EXACTLY THE SAME CHEMICAL COMPOUND — be harmless?

        Seems to me we are overdue for a reappraisal of the role fruit should play in our diet.

        I personally love fruit but we think of it as a dessert or a supporting ingredient. We do NOT think of it as health food. It is one step above cigarettes. I.e. we’ll enjoy an orange smoothie a few times a year as an indulgence. We’ll add a few tablespoons’ worth of mandarin orange to add a splash of sweetness to a salad.

        But given what we know about fructose and obesity, diabetes and pancreatic cancer, I can’t understand anybody recommending that people eat 4 or 5 servings of fruit a day. That just does not seem responsible to me.

        • Well, there is something fruit has that straight sugar doesn’t.. 100’s of chemical compounds and fibre that go with it. Those same compounds and fibre feed the gut biome which in turn does a lot of the processing of the fructose. It’s likely high “dead” sugar intake weakens or destroys the biome, causing a dysbiosis that makes further sugar intake detrimental. Future science will be based a great deal on the human microbiome.

        • Hi Tom,

          Looking at fruit as something to indulge in could be seen as one way of looking at things. Others may argue that it is much more than that.
          I would certainly not compare it to a cigarette.

          One mistake in your assumption is that fructose in fruit is the same as fructose that is chemically derived or from processing food. Yes, chemically, it looks the same, but it does not behave the same way.

          Have a look at this video:
          This guy makes the distinction between those two (although, he mostly speaks about the bad fructose)

          Also, if you look at scientific evidence, you can find that humans are physiologically build like frugivores.

          Two references:
          Have a look at the table http://jewishveg.com/schwartz/natural.html


          I hope you have an open mind.

          The healing I have seen once people switch to a fruit diet is just amazing.

          best regards,


        • Tom Boyer, you are very confused about sugar. I don’t want to get into the biochemistry, or the types of sugar that exist, but your notion that fruit and Sprite are the same regarding sugar and fructose being toxic (so not even remotely true nor does it make any kind of sense) is just incorrect. Refined sugar and the sugar that appears naturally in fruit are NOT THE SAME. not even close. Again, the complex biochemical explanation isn’t something I’ll get into, but refined sugar is the only type of sugar that MAY have some link to neuro disorders, but we don’t even know if that’s a factor in reality. Fruit is rich in micronutrients and to cut it out of your diet because one doctor theorizes it may cause neurological disease is ridiculous. You are doing yourself a huge disservice if you avoid fruit because you think it is remotely similar to refined sugar.

        • Yes, Tom Boyer, I’m extremely confident. Confident about my knowledge of biochemistry, in which I possess a college degree, and confident that you have jumped on the hype train and didn’t have the essential basic knowledge of biochemistry before you did so. To essentially say eating fruit and drinking Sprite or eating candy is the same thing is unbelievably foolish and the opposite has been proven so many times it’s ridiculous to believe otherwise. Your theory is just conveniently sidestepping the fact that fruit has fiber, which causes it’s sugar to absorb into the body slower. And “dont tell you about micronutrients”?! Um, that’s the whole point! So you’re saying the fact that fruit offers multiple micronutrients that are essential to healthy physiological function is not important when comparing it to processed sugar?? Huh? Let’s see… Fruits have super nutrients and phytochemicals that no one can argue benefit the body tremendously. Your Sprite example has nothing of value. You’re acting as though nutrients don’t matter, but the TRUTH is that they can change the way the sugar is processed in the body. I think you should read up on the well-established science that has proven beyond a doubt that you’re wrong and stop obsessing over new, unfounded studies. If you had the level of biochemical training I happen to have, you would know that what you’re saying it just completely false.

      • But these ‘safe’ carbohydrates you speak of, they get converted into sugar (glucose) and then enter the bloodstream. As the research shows, all glucose (including the glucose converted from fructose and fruits) when taken in doses over 60g in human testing cause inflammation in tissue. Namely brain tissue. I think you might want to actually read the book a few times before posting a response. Check the research at the back of the book, when you actually check it you’ll realise that this is irrefutable. The absolute main point to REMEMBER and fully consider now, is the delay in cause and effect between ingesting diets moderate or high in carbohydrates. No symptoms? No worries? Well no. Whether you realise it now or later on when it sinks in, if you continue with the carbs, the ‘EFFECT’ will definitely catch up to you and you will wish you had of sat up and read the research. -Do the research on inflammation studies

        • Danny, irrefutable?! Hardly. Food research such as this that is taken out of context is NOT the end-all-be-all. There have been so many erroneous food studies that claimed to “prove” one thing or another and were actually DISproven shortly thereafter, I can name about fifteen off the top of my head. Don’t believe everything you hear because “a study was done”. The bottom line is that fruit provides a huge percentage of multiple micronutrients we need to survive. To compare them in any way, including the effect of their sugars, to refined junk is preposterous. And to cut them out of your diet is doing yourself a huge disservice. Whole, unrefined food is good food. That’s the very simple underlying fact that people tend to forget in all of these trendy, alarmist food fads.

      • Just started reading the book with my wife, but to your statement shouldn’t someone i.e. type ii diabetic be concerned about any forms for sugar be it natural or not? If a diabetic should, then from reading what I have read, I can draw a correlation between giving my body too much (sugar, natural or not) before diagnosis thereby creating the sensitivity in the first place?

      • Okay, but if you eat too many starchy vegetables and sweet potato at one sitting, would that cause a blood sugar spike – in someone with metabolic derangement?

    • Yes, this blog post is focusing on fruit as the reason why the author’s arguments are somewhat faulty, but the book is more focused on gluten/whole grains.

  20. I have not read this book but I’ve heard and seen the buzz the last month or so.

    This reminds of the “debate” you participated in at AHS 2012 in Boston. I think your responses very much much the same to this. One of the things I’ve re-learned over the last few years, as with everything, there are two sides to everything in the nutrition debate. And both are compelling. Given that Perlmutter is in trenches with this kind of work, I’d be interested in his take on your post.

    In the end, as you said, “you need to find out what works for you and tailor your diet to your specific health goals, rather than follow a canned approach” is the best advise I’ve heard. One size doesn’t fit all.


      • I don’t think finding “What works for me” works for diseases like Alzheimer’s since it may take
        a long time to develop and I can’t really tell if I’m damaging my brain on a daily basis by eating
        my whole grains. I look to experts to guide me as far as what I should I and right now
        I’m only hearing contradictions when it comes to whole grains. (Most experts agree on
        highly refined carbs)

        • Mr. Keto, you will continue to see contradictions in research results and in recommendations due to the way we currently examine food. We perform micro-analyses of food, often out of context of real diets, extrapolating the results into a meal plan that has never been practiced on this planet before (meaning it is an experiment). Without grounding the results of dietary research, we get all kinds of crazy results (e.g., don’t eat any fat, red meat is bad for you, animal foods cause cancer–all of these statements are supported by research, though I would not consider it good research). For me, I view all dietary recommendations through the lens of long time use and exposure to people (meaning I often look to indigenous and traditional cultures to see what they consumed, how they processed the foods, what they combined foods with, etc., etc.). What I like about Chris Kresser’s approach is that he combines anthropological data with modern research (which I feel creates the most solid total argument). These groups (indigenous and traditional cultures) often had aspects of health we do not currently possess (which I will not get into now). As far as grains, they are very much maligned in most paleo circles. However, we can see that some cultures relied on grains as a staple and enjoyed excellent health (contradicting the statement that all grains should be avoided). So for me, the real question isn’t if we should or should not eat grains, the real question is what grains we should choose to eat and what dietary components combined with them to build an effective diet that maintained health and produced healthy, well formed children. I hope this can be of help. Best wishes to you.

          • Arthur Haines, that is BRILLIANT! Exactly the way I look at nutritional research, but without the eloquence you used. People need to realize that foods like whole grains have been a staple of so many diets for hundreds and hundreds of years, and blaming them fir a new or growing health phenomenon is utterly ridiculous. Not only that, but how does saying these types of foods are “deadly” (“wheat is murder”? Give me a break) square with the fact that other countries CURRENTLY eat diets rich in the same food and the occurrence of the same disease in question is so low it’s almost non existent. Some may claim it’s because of the way we process our grains (using the same example), but that’s not a valid argument- we import and export food to the point where almost no one is eating food solely from their country of residence. The hysteria-based trend diet -Atkins rings a bell and gluten-free is in the same boat in my eyes- is running rampant these days, and quite frankly, I don’t see myself ever buying into any of the hype. No one can ever tell me that a whole food that has been consumed for thousands of years is all of a sudden a toxic substance. It’s nonsense in large part, and if more people researched these alarmist trends, they would find that there is either NO research backing them up or research that isn’t properly conducted, or like Arthur said, completely taken out of context.

            • The point your all missing is the fact that we have NOT been eating like this for thousands of years. We are NOT eating the same grains that our ancestors ate thousands of years ago. The grains we eat today and have been eating for a long time now are all Genetically
              Modified and they have been over and over again to the point that our bodies can not accept them. Our bodies don’t know what to do with these GMO foods so they get stored here and there in our bodies and start to become deceased. All the animals are being forced to eat these GMO grains and we in turn eat the animals and we take them in again. These GMO foods are all around us and we keep consuming them in almost everything we eat. That is why deceases like diabetes, depression, dementia, Alzheimer’s and other deceases have escalated to frightening and alarming proportions. If I’m going to occasionally eat beef its going to be grass fed. If I’m going to have any carbs it’ll be from heirloom seeds that have been organically grown. If I’m going to have an egg , a glass of milk or a piece of cheese its NOT going to come from an animal that was stuffed with GMO grains and feeds that I know will eventually kill me. I’m 100% behind Dr.Perlmutter and have been
              practising his beliefs long before his book came out.

              • Gosh, with that plan, I bet you’ll LIVE FOREVER!

                Or, like all human beings, you will die anyway.

                • It’s not about living forever. It’s about living healthy and staying OUT of the nursing home. Being able go make decisions for oneself, not becoming a burden to society.

              • Do you even know what is in GM food? Didn’t think so. BTW, no GM wheat is grown or sold anywhere in the world.

              • Wow. That is simply not the way food works. You clearly have no idea what GMO means, or how each crop is modified. I encourage you to research how the digestive system actually works instead of taking your eating advice from a hyperbolic link bait blog somewhere. Making something resistant to disease does not store anything anywhere in your body the normal food wouldn’t. In fact, if they had a genetic therapy vaccine treatment for Alzheimer’s, people would line up around the world for it without a second thought. Its much more complicated than boiling it down to “GMO=BAD”.

              • I agree. I haven’t finished the book but what I’ve taken out of it so far is not that carbs are the enemy but the grains that have been processed beyond recognition throughout the years is the problem. He’s not promoting low carb as much as low grain because there is no longer any such thing as ‘whole’ grain unless you shop in the middle east.

              • GMO foods have been extensively studied by all leading health national health organizations and there is no evidence that they are unhealthful.
                The idea that “heirloom seeds” — which themselves are the product of generations of human hybridization — somehow produce healthier food is not supported in fact. There is just no reason to believe that using precise genetic techniques to alter plants is somehow more dangerous than using more primitive techniques to achieve the same end.
                The anti-GMO hysteria is based on a non-scientific belief that some things deemed “natural” are inherently better than those things deemed “unnatural”.

            • Here is the issue, people for thousands of years had the correct gut bacteria to properly digest those grains they were consuming. Other cultures around the world also still enjoy gut health. Modern day antibiotics, toxins, and stress can take a tole on our gut health and many people, myself included cannot properly digest grains in any form and this contributes to a bloated belly, digestive issues, joint pain and many other woes if I even consume white rice or gluten free oats. My husband on the other hand has no issue with them, and he also never had the months of antibiotics I was force fed on as a baby due to ear infections (milk allergy, I now know) We need to find out what our bodies need and follow suit. Just because a certain culture does great on grains does not mean modern day America can in the majority.

              • Melissa! I am exactly like you! I am now almost 60. I can’t eat any grains. I have a terrible time with all starches. Oats are bad! All rices are a nightmare. I break out in deadly skin rashes full of puss and oozing blood and syrupy fluid. This started in 1983 when I jumped in to the Macrobiotic Diet (Die! t) get it?) I thought the concept of 60% grains with a little vegees and seaweed was simple. After 2 weeks, I started breaking out in rashes all over my body. I will spare all of you the detail of the pain and misery. This went on for many years. Doctors told me it was a skin topical problem, so they sold me cremes and other junk. I finally got mad enough and went to Brookline, Mass. to find Dr. Michio Kushi, the founder and author of all the books I owned. When I arrived, I learned he said that smoking of tobacco was acceptable as long as it was clean. I smoked lots of cigars and they were “natural and expensive.” He said the rashes were a sign of detoxification and that I should hang in there. My youth was filled with Doctors. Ear infections, epilepsy, strep throat constantly, I drank milk as a youth too! Hernia at age 9. Fast forward. I really appreciate Dr. McDougall. He is the only one that seems to communicate and demonstrates the fact he cares. He is disturbed over the fact I cannot eat any starches he recommends. I can eat organic beans and other canned beans I get from Trader Joe’s. EVERY TIME I get soft and try again to eat a small amount of grains, sweet potato or white-organic or not, I break out on my hands, arms and legs and feet. My wife NEVER has a reaction like me. All bread is out by the way. I keep no meat in the house. No dairy. No eggs. No booze or beer or wine. No pot. No drugs by the pharma at all. I have retried fish, chicken and meat with no rash side effects. I simply had slower digestion because that is what meat does to us. I used to eat meat at least 3 times a day and was 100% stronger and more virile than I am now. Poor wife. I do not want colon, prostate, testicular, throat, brain and all the other locations to be hit with cancer. Duh! Now what do I do?

            • Guess you have never heard of GMO wheat, which if grown in this country has 10,000 times more gluten than wheat grown in other parts of the world, especially Europe. Yes, wheat from even a hundred years ago was very different from what we are eating today. We have so altered the grains that our bodies’ cells would struggle to utilize them as food.
              More than my love for grains, i so love feeling well and being healthy. We have found great ways to eat well without grains!

          • Britt Doc and Mr. Haines: I’m about 2/3 through Perlmutter’s book and I really appreciate his references to current research. I notice you don’t include any links to back up your assertions so for me right now it’s Perlmutter one / you guys zero.

            • Well, most of his “assertions” are common knowledge among people who know anything about nutrition. And citations are only as good as the science behind them.

        • They also all agree that you should buy their latest book.

          I am concerned about the armful of meds my wife just bought from Amazon as listed in Grain Brain. I see her buying and taking the OTC meds…thats’ the easy part….but how well do they work when she sits down to a bowl of tortilla chips afterwards?

        • Mr. Kayo, it is not clear to me which contradictions or experts you are addressing in your comment. What is clear is that many cultures have been healthy, both mentally and physically, by consuming primarily whole grains for many years. Those cultures provide better evidence for me than labs and till science can prove the allegations against grains I will continue to consume whole grains.

          • Have a look at the latest research on “Barleymax” a new type of barley preparation. All bowel and stool health markers greaty improved when subjects ate foods containing barleymax. Many of those markers indicate greater reduction of bowel/colon cancers as well. Sounds terrrrrible right?

            • Might be good stuff, need some research on it but one problem with it is the omega-6 to 3 is 25:1 which is way too high.

    • Sorry, you lost me at “we’ve been eating like this since before we were recognisably human”.

      • Really? You don’t actually fathom a time when “we’ were not yet recognizably human? Actually “we” as we know us, did not exist at the time he references. We did evolve though. So … do you also believe “we” have nothing to do with the melting of polar ice caps?

        • “So … do you also believe “we” have nothing to do with the melting of polar ice caps?” Why don’t you ask the researchers who were trapped in the Antarctic ice a few weeks ago…

        • Speaking of hysteria…the reason for polar ice melt has no place in this conversation beyond a recognition that the fear mongering surrounding it is quite similar in pattern and nature to that which undergirds narrow minded theses like Dr. Perlmutter’s. This (and perhaps this has always been) is an age of irritatingly frequent, near sighted dogmatic theories swallowed whole by a public which prefers pat answers to everything. But fundamental scientific and even moral issues seldom have a perfect story arc laid out such that they satisfy our desire for good guys and bad guys. The age of Facebook knowledge prevails and Americans slowly entrench thelmselves, less willing to view life through a unifying set of lenses.

          • Chris, 100% agree. Schools have successfully eradicated reason. People are only left with looking to the experts’ opinions. Most experts become experts by towing the line within the current paradigm. They speak out and they are discredited. And that is how we have remained sick and unhealthy in this country, by following those experts. And the cult of expertism rules all. Luckily, with the emergence of the internet, if you are willing to research and reason, the information is out there.
            And while I don’t agree with him on everything, I don’t think Kresser falls into the cult of experts group. I am speaking of those who come up through the conventional channels and the highly respected schools.

            • We live under the illusion of freedom of information. When in reality, it is very subtly controlled.

            • Academia is just as full of opinions as I am, but having a Dr in front of ones names lends credibility. And, hey, an education certainly is a valuable filter. However, the shifting currents of popular beliefs in intellectual circles is pretty sketchy. Once you have tailored analysis to fit your desired outcome, the game is over. As you say, the internet is a great aggregator or information, if only one has the logical tools and wisdom to wade through the tripe. If only I possessed the wisdom.

              • A few spelling issues with that one. And half thoughts. Sorry folks. I guess what I’m trying to get at is that intellectuals are very good at jumping on a popular bandwagon, often based on theory which is conflated with the outcome the academic desires to find.

          • Chris, no matter what I write I will never sound as smart or articulate as you, so I will just reply, “Yep.”

        • Sorry Andrea, there is no such thing as “evolution.” We were created human, even though we now hate our Creator. “Evolution” has been scientifically proven to be unfactual, from the Second Law of Thermodynamics (entropy), to irreducible complexity. Even the famous geological column supports Creation, not “evolution.” Until God created there was nothing to “evolve.” In fact, the idea of “evolution” was on such such shaky ground in the late 1800’s that Sir Julian Huxley had to declare it a scientific law – despite the facts. So much for scientific method! Perhaps we would know a little more about humanity and the universe if we approached it from the point of fact rather than fiction.

          • Now we’re really off topic. Rev. Ronald, there are no facts and no science for creation. As an evangelical Christian, I fully accept the overwhelming evidence of evolution and ascribe it, by faith, to God’s handiwork. I suggest that the only thing on shaky ground here is the notion that the Bible has anything to say about the science of modern nutrition. Please, sir, as a fellow human and a brother in Christ, may I recommend you subscribe to web blogs such as http://biologos.org — science and faith in harmony. Peace.

            • I completely agree that this has nothing to do with the article. So if you are irritated at this discussion being here then just don’t read it.

              “There are no facts and no science for creation.” Actually there are no facts and science for macro evolution either (nobody in their right mind would disagree with micro evolution which is observable). Scientific laws apply to events and phenomena that can be reproduced and verified. Macro evolution can not be observed, and cannot be verified scientifically. All we have is the similarities in DNA that can be analyzed. This however does not sceintifically prove evolution. If there is a God, He could have (and to me it makes sense that he would have) used the same framework for life (DNA) and then modified it to create different species. When it comes to the issue of creation or randomness, all we can do (since we weren’t there and we can’t reproduce it) is look at the evidence and make a decision. I don’t agree with your statement as if it takes blind faith to believe in creation. Almost all of science leads me to the conclusion that it is far too complex to have been random. For example, if you took the number of characters in the most basic DNA (the supposed first cell), it would roughly equal the same number of letters in 5,000 encyclopedia books. Simple probability shows that the time for this to randomly arrage would by far exceed the age of the universe. So rather than reach the very rational conclusion that a God created the universe, scientists developed a very irrational theory that there are billions of other universes, or that evolution started on another planet which then seeded the earth. Have fun trying to build up enough faith to believe that.

              • I am very curious how you reconcile evolution and Genesis. Since there were no “First humans”, but an evolution of a group of humans evolving over time, there was no adam and eve, no adam and even, no original sin, no original sin, no need for a savior. The whole idea of needing forgiveness is because of original sin. One would have to create some very interesting ideas not from scripture, to reconcile these in my opinon(Such as “adam and eve” being a symbol of humanity, etc. which has no biblical basis)

                • As a Theologian and student of philosophy and the sciences, I can say that there is substantial proof that this universe began c.13.7 billion years ago, as we count time. This universe is continuing to evolve at the speed of light. Genesis uses the known cosmology of its time. The two creation stories are in the genre of myth. They in no way speak of a creation ex-nihilo. “God” creates from something that exists already.Just as grains evolved in our diet.

              • I agree, it is actually a BOL (a barrel of Laughs) enjoying every word!

          • I’m sorry, Rev., but every unfolding discovery of biological science supports evolution. There is no such thing as a “fact” in science, by the way. There are theories that best support the evidence we have found. Any particular theory remains valid until the evidence disproves it. Every theory must undergo the scrutiny of “null hypothesis”. That is why scientific discovery will never end.

        • 1000 to 2000 years ago it is likely that it was warmer than today. How much human influence is melting the ice caps I do not know any more than you do…
          I do know that if people would change to a whole plant-based diet reducing animal production would have a larger impact than eliminating all modes of transportation not to mention the savings in water and land.

    • Read the book. I had diabetes 11 years ago and the hemotologist told me to quit eating carbs or I would die an early death because the body converts carbs to sugar. I quit all carbs and in three months no longer had diabetes. Dr. Perlmutter has brought together the enormous amount of research done over the past 15 years and backs up everything he says with research from places like the Mayo clinic, Johns Hopkins, Harvard medical, and cites articles in the leading journals of the world. We now know that carbs also cause Alzheimers, heart disease, Parkinsons, and lot of other nasty stuff. Go ahead and keep eating them if you want, but they will destroy your brain and body.

    • Not so much carbs are bad for us, but too many carbs are bad for some of us, especially fast acting carbs. The cemeteries would be filled to the brim if it were not for medical intervention, think about diabetes, in its many forms, if it were not for insulin injections,where else would they be, but in a grave.