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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Hey Chris. I also posted another comment just before the one you put up.
I’m just wondering if you got it.
Maybe you think it was too harsh.
Heh, maybe.
I couldn’t find an e-mail link to send you this, so . . .
Oh, and even the Inuit got plenty of carbs.
Ever heard of the “Inuit Paradox”?
https://discovermagazine.com/2004/oct/inuit-paradox#.UypZBM5_RK9
It’s estimated that they get over 100 carbs.
Other cultures, that are supposedly just meat eaters, also get plenty of carbs. They eat roots, along with growing certain vegetables.
Tribes in Africa often trade with other tribes for vegetables.
(Man cannot live by bread alone.
Man cannot live by meat alone.)
It’s not reported as such because of the low-carb nut jobs out there.
Now if you’ll excuse me, I’m off to have a big bowl of alfredo and garlic pasta and garlic bread, which brings my total carb intake to around 200.
I’m going to have a Snickers bar for dessert.
Maybe even two.
Gee, I hope I don’t die in my sleep.
In most if not nearly all cases, carbs aren’t the problem–stupid people are.
And, personally, I think Perlmutter and Gary Taubes are a little bit of a quack.
They have ZERO common sense.
Hello Chris.
I want to thank you for that great article.
As a health writer and researcher for the health industry, I know exactly where you are coming from.
Also, kudos for having the patience for putting up with a lot of the dumb posts here.
There are some real whoopers here.
“Carbohydrates are not essential.”
Tell that to runners, weightlifters, and especially college students who put their brain through the paces.
The more the brain is used, the more carbs are needed. There are times when the body cannot convert enough and fast enough.
“But think of each blood sugar spike as similar to, say, a single puff of cigarette smoke. The danger is lifetime cumulative exposure. The more exposure to high blood sugar over a lifetime, the higher your risk for so many health problems.”
Wow. Really?
Um, the human body is a pretty remarkable piece of engineering. It can handle simple carbs now and then. It can handle a Big Mac and greasy fries now and then (hell, it can handle it every day). It can handle a candy bar now and then.
And ya know what–it can even handle a single puff of cigarette smoke.
“…fruit can spike as much as ‘healthy whole grain’ bread.”
Um, whole gran bread does not spike to unhealthy levels. It is released slowly, like oats.
And, raising insulin level is not a bad thing. It is a normal bodily function.
Wow. *shakes head in disbelief*
Then there are soooooo many people making claims of feeling so much better. They can now sleep better. Their inflammation has gone down. They take fewer meds. . . .
Yeah, what is probably really going on is that they are taking better care of their health overall. They are eating better in general. They are exercising. They stopped eating so much of the simple carbs (junk food). . . .
But, of course, there are those rare exceptions. There are a slim few who can’t handle carbs.
For practically everyone, complex carbs don’t put on the weight and create health issues. Not being active enough and eating too much is what does it.
Duh.
There are, who knows how many millions of people out there who eat up to and over half of their calories from carbs, and they are doing juuuuuuuust fine.
Just because a very small percentage can’t handle carbs, for whatever, reason doesn’t make them bad.
As for insulin spiking…uh, again, that’s a normal bodily function.
Leave it to some doctors, and a lot of foolish people in general who equates “spike” and “sugar” as bad.
Bad carbs are–bad.
Such drama queens.
I lost thirty pounds in about four months, and I usually had two cups of oatmeal, two cups of beans or pasta, and some bread and meat at night.
Piece of cake. I just watched my calorie intake and outake, and became more active.
Wow, rocket science.
Oatmeal is loaded with nutrients and fiber.
Steel cut is great!
A big ol’ bowl, along with a cup of milk can keep you full for up to four hours–if not longer.
The same as eggs and a couple of pieces of meat.
AND, the oats have fewer calories, along with being three times cheaper!
I also saw a few doozie comments about bananas.
Oh, those bad bananas, huh? *rolls eyes*
Bananas contain the amino acids tryptophan which help your body to produce Serotine and vitamin B6 which helps to regulate your mood.
Carbs, in genearal does that.
Bananas also contain Dopamine, which also regulates moods and the ability to concentrate, and emotional ability.
Banana, along with beans, oatmeal, AND meat are great when dieting.
For those of you who are confused–just use your common sense.
Eat right (eating the wrong foods is OK if you don’t over do it), be more active–and have a happier outlook on life (being depressed, sad and angry is just as bad as simple carbs for many people).
Perry wrote:
There are some real whoopers here.
“Carbohydrates are not essential.”
—
I was referring to the definition of what an “Essential Nutrient” is. It’s does not indicate if you like to use the nutrient for whatever purpose you may have in mind ( athletic performance for example).
An essential nutrient provides your body with something it needs but can not make on it’s own. You MUST consume it to get it.
Carbohydrates are not essential. The amount of sugar your body must have to function properly can be made by the liver in sufficient quantities. Therefore, you don’t have to eat a single carb to have optimal health, you will be missing nothing “essential”.
That doesn’t mean you cant choose to consume carbs for whatever benefit you want to assign to them.
I hope that helped.
You say the carbs are not essential, but what about the nutrients we normally get by eating them? Don’t b-complex come primarily from complex carbs? I am sure there are alot of vitamins/minerals and nutrients you are losing when you cut out “all carbs ” as bad.
I really think the culprit here is the toxins and GMO’s that are in the carbs. Its more of an environmental issue. Look at all the other cultures that don’t have this toxin load and still eat mostly carbs and are healthy and lean.
There is research to suggest diet alters gut flora BIG time, and those on a HFLC style diet experience significant changes here. Let’s just say most of the beneficial flora documented in healthy long living humans wastes away when these fad/restrictive diets are embraced. The best diet possible imo is to feed the good gut bugs and starve the bad ones. Certain restrictive diets do the opposite. It may takes years before it hits you but look out for IBS, IBD as your bowels become inflamed. I even suspect a state of ketosis will ultimately lead to IBD and various gut disorders. These people think they are very clever getting “energy” from fat, all the while their gut biomes are turning into a toxic wasteland.
I have been studying the widely varied and contradicting subject of diets, foods, gluten etc etc these past few years. All I can say if that every health problem large and small was resolved when I did a session with a kinesiologist which tested what foods were good or bad for ME. Not everyone else but what worked for my body. I stuck to the food exactly and lost weight so fast, 5kg in one week, cured a bacterial infection, stomach issues, skin problems and a host of other problems. I gained energy, clarity and peace of mind.
In current times, everyone feels they not only can, but should hold forth on just what it is that they believe with all the gusto, if not necessarily the panache, that they can! That is the direct opposite of our ancestors who just a few decades ago would have left the prognostications to “experts.” What has changed? Communication via all kinds of media, that’s what! And, that is exciting, elucidating, enlightening, and confusing as all get out! If your post- education was not a major in nutrition, chemistry, technology, or physics, chances are you are making decisions based on what you’ve read online, in magazines, or books by self-made experts; in addition your information may have been from friends and acquaintances, but rarely, from your family doctor. Now, experts can be, and have been proven wrong many times, but more importantly, who are the experts we should listen to? Is Dr. Perlmutter an expert with all kinds of valid research? That is question number one.
Two: Has any of the anecdotal evidence we’ve read in the responses to Chris been analyzed or validated by medical or scientific research? Come on folks, you’ve got to know how many variables there are when it comes to the human body! One cure does not a body of evidence make!
Three: If you believe something with all of your heart, does that mean you should ram it down everyone else’s throat?
Finally: There are still no definite answers that suit everyone’s actual health profile, but common sense dictates that one size does not fit all! What works for you may not work for your wife, friend, her boyfriend, or your son or daughter. We have to learn this lesson: everyone is different ; what works for you nutritionally is not necessarily someone else’s “fountain of youth” in the words of another so-called expert of yore who thought if he drank from an elusive fountain of water, he would find eternal youth.
As strange as that seems, we are in essence still stuck on that same old search. There is still no one answer, but we all realize that a healthy diet is part of it. So, if you can but give this all some time and distance, the future will tell us who had the best answers. In the meantime, could we all just give each other a gift of tolerance? Wait for the proof, question research that seems to good to be true, practice common sense balanced with a love of culture and the gathering for meals that makes our memories and family history so rich. This might in the long run be the best answer of all!
“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.”
Actually it’s looking like Perlmutter’s research is already out dated. The latest (within weeks) is showing ALS patients fared best on high calorie/high carb diets. A strong neuro protective effect. The researchers even optimistic high calorie/high carb could benefit additional brain disorders. If Perlmutter was so right this would not have even come close to what was discovered. If Perlmutter was right those ALS patients would have deteriorated big time, when they actually improved. Here’s hoping Perlmutter is not treating ALS patients. And another recent study showed in an animal model, those animals on a high carb diet bested all others in longevity by a high margin. This is enough evidence for me to warrant not removing entire food groups from diet. I believe a predominantly plant based mediterranean diet, coupled with very low to non-existent added sugar is the way to go. Plus adequate water, exercise, sleep and stress reduction 🙂
The title of the blogpost is: Do carbs kill your brain?
After reading almost all posts here, my conclusion would be: No, carbs don’t kill your brain, as long as you don’t take the kind and the amount of carbs YOUR system cannot handle.
What kind and what amount of carbs can your system truly handle, especially long term? (The same goes for fats, proteins and vegetables, I guess).
It is an individual quest for each one of us, isn’t it?
Any suggestions on how to go about this?
Carmen,
I have a suggestion. But, to start with, you are right that it depends on the kind and amount (quality and quantity) of carbs your body can handle and it is true with fat, proteins, fruits and vegetable, considering that there is no “One Size Fits All” anything, whether what and how we eat, lifestyle, etc. etc. – bioindividuality.
“Any suggestions on how to go about this?” Yes the best is to work with a holistic health and wellness coach who will start by meeting you where you are with regards to what and how you eat, the lifestyle you live, your physical, mental and spiritual state, and support and guide you step by step as you make sustainable changes steadily but surely.
I have been doing this with my clients and have had successful results. The key to such succes depends on the client’s committment to the program.
Philomina, you said: “The key to such succes depends on the client’s commitment to the program.”
I would add: ” it also depends on the openness of mind of the coach. Since most health consultants I know of are heading in one specific direction which is usually their own preferred diet. Like vegan, Ayurveda, Paleo, etc.”
I would need a coach who’s willing to inquire with me what is right for me, unbiased.
Any ideas for what I can do myself, without coaches?
Trial and Error is the name of the game. If you eat something that makes you feel bad or makes you gain or lose weight that you don’t want to gain or lose, don’t eat it. Pro-biotics and digestive enzymes are also a great help once you’ve eliminated foods that aren’t right for you. Aloha!
Trial and error, yes, the obvious. Yet I was hoping for something less time-consuming. A shortcut maybe.
I am new to all this and just happened to stumble upon this thread. Turns out that the blogger Chris himself, has written a book on this very subject: about customising your (Paleo) diet.
I’ll have a look at it in “amazon”.
“it also depends on the openness of mind of the coach. Since most health consultants I know of are heading in one specific direction which is usually their own preferred diet. Like vegan, Ayurveda, Paleo, etc.”
Yes I agree with your addition. I was talking about the type of coaches you have alluted to – opened minded coaches who listen very carefully to the clients and work with them as appropriate. A true Certified Holistic Health and Wellness Coach would do just that. I am one and that is exactly what I do. With regards to “Any ideas for what I can do myself, without coaches?” I need to visit with you listen and understand where you are at the moment with regards to Food, Nutrition and Lifestyle, in order to tell you what I think. If you are interested, you can send me a private e-mail and we go from there.
In response to Carmen, Perlmutter is most concerned about gluten, sugar and grains. The diet he recommends is not zero carb so implicitly even Perlmutter is suggesting there is a level at which carbs are not going to cause problems.
The Atkins organization in my opinion is the most scientifically mainstream of all the low-carb variants. And Atkins has, from Robert Atkins 40 years ago, always supported the idea that everybody has a different tolerance for carbohydrates.
How do you find out if you’re exceeding your body’s tolerance? Easy. Just watch the scale. If you are putting on weight, you’re clearly getting too many carbs, which are raising your blood sugar, provoking an insulin response, and the presence of insulin puts your fat cells into storage mode. (And by the way the insulin hypothesis is well established science and was developed in the early 20th century — before Atkins was even born).
Interesting and simple. “Just watch the scale!” 🙂
I like that!
Btw: how would I know when I’m getting too little carbs?
Technically, there is no such thing as too few carbs in the human diet. Carbohydrate is not an essential nutrient. In other words, whatever carbs can contribute is already being made by our own body. We dont have to have an outside source for something we lack. They are not “essential”
You can certainly add carbs to give you quick energy or they may be cheap and convenient sources of calories for you but no one has to eat a single carbohydrate in order to achieve the best possible health.
I thought that this statement is one of the points that are subject to contradicting opinions and research.
It is not my intention to start the debate above all over again. I hope it doesn’t, it’s lengthy enough already.
Just looking for some ideas to customise my diet to my individual needs. Suppose there is an individual case where someone, for whatever reason, does need carbs. Who knows… Then how would you know what is the right amount and right kind of carbs for you?
Learn to count carbs rather than calories. Keep them to 100 grams per day at first and then go lower if you want to. Or start low at 20 -30 grams and then slowly go higher. Once you gain weight you know that your body is now storing them as fat. But you do not need to worry about not getting enough carbs as I said before.
People have differing tolerance for carbs, which means the point at which they gain weight or have negative health effects vary. But that is different from worrying about not getting enough.
Worry about the other end, and observed when you are getting too many
( weight gain) and then cut back.
https://www.medicalnewstoday.com/articles/273273.php
Commenting on the findings, Dr. Wills says:
“Although the sample size was small, we are optimistic about these results, because they are consistent with previous studies in ALS mouse models that showed that hypercaloric diets improve survival.
Not only could this type of nutritional intervention be a novel way to treat and slow down the progression of ALS, it might also be useful in other neurological diseases.”
But the researchers say these findings should be “interpreted with caution,” noting that larger studies are needed to determine the association between high-carbohydrate/high-calorie diets and ALS disease progression.
In an editorial linked to the study, Dr. Ammar Al-Chalabi, of King’s College London in the UK, says that although he will not be changing his diet advice to patients based on these findings, he is keen to see what results come from larger trials.
concerning the study from your link, one commenter said:
“Jason Cholewa, Ph.D.
Take a deeper look at the raw data and some serious concerns are raised.
The original study this article was based upon had some serious methodological flaws.
Briefly:
A 24 hour dietary recall was used to classify subjects and then they were followed for 18 years. Is it possible their diets changed over that time?
Next, the work in humans was correlative and observational. It was not an intervention or controlled study. All we can conclude is there is a relationship.
Most importantly is the authors statistical analysis of the data and their interpretation. If we look at the raw data we see that the rate of cancer across the low, medium, and high protein groups was actually 9.8, 10.1, and 9.0%, respectively. There is no difference. However, the authors did some funky math to come up with this huge difference.
In mice, there was no difference in the rate of cancer growth between the vegan protein (soy) and the animal protein (casein); however, the authors claim there was a “non-significant trend” but they do not report the probability value. If we look at the graph, it is barely discernible and does not exceed the standard deviation.
Why then might the researchers make their conclusions off this lack of evidence? Its quite simple, the senior researcher, V. D. Luongo is the founder and has equity in L-Nutra, a Vegan Based Nutrition System. Luongo designed the study, obtained funding, and played a major role in the writing of the manuscript. This is a serious conflict of interest, and we should hold the publisher of the study, Cellular Metabolism, and their peer reviewers responsible for not identifying these issues. If you want to read more about it you can here at my objective critical analysis.”
Both of these studies are associative studies, and for a critique, read Tom Boyers’ response, and the comments to the study in your link (the far right tab).
I don’t have a problem with a diet high in carbs from time to time. Humans are omnivores, and are quite flexible in our dietary needs. What I find fascinating is the howls that go up when it is suggested one go low carb (60g or lower) although the human metabolism is perfectly suited to do so. In fact I went several weeks at 20g (atkins recommend 6 to 8 weeks before increasing your carb intake.) Its hard at first, but it can be done. Similarly, some people have trouble on a high protein diet at first, but over several weeks adapts to the higher protein levels.
I personally prefer protein and fats over sugar and starch, but i can derive them from non-animal sources, and have done in the past quite well. But being an omnivore, i must be flexible and eat what is available, whats in season, and what I can afford (if I am lucky, what I can hunt/forage). Acorn mush, anyone?
Good point, Nancy. That’s precisely why I chose Dr. Perlmutter to be my neurologist. He’s also a fellow of the American College of Nutrition…and a Linus Pauling Award winner among many other honors.
https://www.drperlmutter.com/about/bio/
Julie, that Linus Pauling Award is not the same one given by the American Chemical Society, which is indeed prestigious. Instead, it’s given by the Institute for Functional Medicine and is largely ceremonial. In 2013, they gave it to Alessandro Fasano, who, I’m sure, cringed, as he does not treat patients and is a researcher. In 2009, they gave it to Mark Hyman, another functional doc who used to be at Canyon Ranch. In 2010, it was Dean Ornish, yes Ornish!, who got the award. The commonality among all these awardees? They “stick it” to the medical establishment. They defy conventional medicine and the standard of care.
In 2011, they gave their “Lifetime Achievement Award” to Jeffrey Bland, the functional medicine guru for “exceptional creativity in … advancing principles of … functional medicine.” This is the same Jeffrey Bland that appears frequently in QuackWatch and is considered the godfather of functional medicine. Bland was charged in 1991 by the FTC for claiming that his diet causes weight loss by changing metabolism and induces fat loss through body heat, kind of like Cold Thermogenesis. He was charged again in 1995 for making false weight loss claims and had to make a settlement. On average, he gets cited either by the FTC or the FDA every 3 years.
https://www.quackwatch.com/04ConsumerEducation/bland.html
And get this: Bland is the founder of the IFM and he gave himself the “Lifetime Achievement Award!” — like the Grammy’s Lifetime Achievement Award given out by the Recording Academy.
But most importantly, the award is in memory of not Linus Pauling the chemist who won two Nobel Prize awards (1 in chemistry and 1 in peace). Rather, it’s named after Linus Pauling the chemist-turned-health guru who, in his 70s, became obsessed with Vitamin C and started pitching it as a cure-all for cancer and heart disease. He was uniformly criticized and his papers were thoroughly discredited. His obsession probably had something to do with his dementia and perhaps Perlmutter could have been helpful on this score. Pauling thought the Holy Grail was megadose Vitamin C; Perlmutter thinks its gluten/carb avoidance. Do you see the commonality? A simple, one-size-fits all solution to complex problems.
The Pauling Award is given to mavericks who happen to be pioneers, like Fassano, but also to the outcasts, eccentrics, oddballs, and crackpots of alternative and integrative medicine, who dot the landscape. They came up with the award to seek publicity and to promote a fraternity of like-minded practitioners who eschew standard medical procedures. You should give it as much credence as an award given by the Bigfoot Field Researchers Organization.
It’s important to remember that even though we see “M.D” after his name, doctors have VERY LITTLE, if any nutritional education in medical school. For that, you’d want a nurse and a nutritionist, not a doctor.
OK, one more post on nutritional epidemiology, because doing my taxes gave me a good example.
1) Socioeconomic status correlates very strongly with health outcomes and longevity.
2) Therefore, if you do the 1040 EZ tax form, you are more likely to be overweight, have diabetes, have heart problems, have cancer and live a significantly shorter life.
So let’s say I get the data for 100,000 Americans and find a significant correlation. (and let me note, when your N > 10,000, it is hard NOT to find significant correlation — that is the nature of statistics).
3) So now I’ve got my data, and I publish this in a journal and send out a press release. 1040EZ is bad for your health! 1040EZ makes you fat and takes 5 years off your life! If you want to avoid diabetes and live longer, USE THE LONG FORM!
It sounds ridiculous, right? So why do we accept that very same logic when it comes to “eating hot dogs kills you” or “people who eat tofu/kale/spinach/avocados live longer” or “kids who are breast-fed turn out smarter” or “people who eat organic rutabagas have better sex lives.” All these studies are pretty much doing the same thing — drawing causal conclusions from NON-DIRECTIONAL ASSOCIATIONS.
This kind of study is mostly worthless and people need to be aware of it speak up about it.
Thank goodness the New York Times did not pick up this crappy overhyped “protein kills” study.
But there is a great story in the Times today on breast feeding that everybody here should read.
As it turns out, all the “breast feeding is good for babies” research is based on the same worthless nutritional epidemiology type studies that like “people who eat hot dogs die earlier” or “people who eat kale are smarter.”
Some very good researcher found an effective way to control for socioeconomic effects — they identified sibling pairs where one kid was breast-fed and one kid was bottle fed. Surprise, surprise, raised by the same parents in the same household, as it turns out the outcomes for the two kids are the same.
Breastfeeding (like eating kale or tofu) is nothing more than a market of higher socioeconomic status. It is not a panacea nor does it make kids more intelligent. It’s just that moms who breastfeed are health conscious and well educated so their kids get all the advantages of that.
Enjoy:
https://well.blogs.nytimes.com/2014/03/04/is-breast-feeding-really-better/?hpw&rref=health
Dear Tom Boyer,
Although some interesting items did come out of that study, be aware that it also had some serious flaws. For example, one of the health outcomes they measured was Body Mass Index (BMI) years after weaning. In other words, the researchers found little difference in the BMI between the different siblings later on in life. I would ask: how is that striking news? The siblings would have been eaten relatively similar diets and potentially experienced similar weight gain. The study did not examine features such as gastrointestinal tract health (i.e., probiotic flora) and immune system strength (given the absence of colostrum in the bottle fed group). If you pay close attention to the comments made by the researchers, they appeared to have an agenda of making it more socially acceptable to bottle feed (they noted a strong pressure toward breastfeeding, and wanted to show this pressure was not warranted given the absence of clear benefits). Because of the particular health indices they chose, I’m not that surprised they did not find significant differences. I believe this paper, despite its drawbacks, is going to be used in a way that is not beneficial to newborns. Best wishes to you. (I realize this post is somewhat off topic, apologies to everyone but I wanted to politely respond to Tom.)
Arthur, the study isn’t saying that breast feeding isn’t of value.
What it’s saying is that we shouldn’t believe PREVIOUS studies that made outlandish claims in favor of breast based on non-causal correlations — i.e. the notorious “nutritional epidemiology.” It’s saying when you have a really good control variable (in this case, siblings who grew up in the same household) the correlation between breast feeding and health outcomes mostly disappears – poof!
Really, it’s obvious that breast feeding is a good thing. Assuming the mother is healthy and not drinking or taking drugs, breast feeding is the lowest-cost way of giving a baby a food that is designed exactly for them. You hardly need a study to prove that.
Where things go off the rails is when pro-breast-feeding researchers use non-causal associative data to argue that if you don’t breast feed, your kids will grow up unhealthy or with low IQ or bad breath or whatever.
The issue is of interest to me because I have three bottle-fed kids (because breast feeding was not possible for us), and all three turned out normal, healthy and bright.
My point in bringing the breast-feeding study into this thread was that it debunks the KIND OF RESEARCH that does such a disservice by drawing causal conclusions from non-causal data associations. I.e. the “protein kills” study that Beaker brought to our attention earlier.
When you see studies like that, you should know by now to say, well, that’s nice, and then forget about them because another study next year will come to the opposite conclusion.
When you have survey data large sample size and hundreds of variables, you basically have a cornucopia of non-causal correlations staring you in the face.
Which correlations you choose to publish and turn into headlines probably say more about your biases as a researcher than they do about what people should and shouldn’t eat.
Dear Tom,
I agree with a great deal of what you have written. Nutritional studies, without some type of grounding, are not as useful as many would claim. There needs to be a lens of some kind to view the studies through, a way of truthing the claims made by the researchers (such as comparisons against healthy populations that live free of chronic disease). It is clear that all of the contradictory information from dietary studies point to their near uselessness.
When it comes to breast milk, it is also clear we can point to a wide variety of factors that are not present in formula, especially when we look at the realm of the immune system. Bottle-fed babies acquire a completely different flora (just like those born to C-sections). If the researchers had chosen different indicators of health outcomes, they may have had different results. You note one benefit, that it is a low-cost way of feeding a child. Politely, I do not agree. If the mother is serious about nutrition, acquiring (for example) pastured animal products (rather than CAFO animals) is more costly. As is organically raised produce, etc. (for most people, because they do not wild collect or grow their own). And there are some differences in breast milk depending on the diet of the mothers (especially in regards to some fats, such as AA and DHA).
Please don’t take what I’m about to write the wrong way. I don’t mean it in a rude or degrading manner. You mention that your children are healthy. By what standards? Comparing against other American children, I would politely argue, is a poor standard. 1 in 3 born in the new millennium will develop diabetes in their lifetime. 1 in 9 have asthma. 1 in 50 are somewhere on the autism scale. 1 in 5 (while teenagers) will have suicidal thoughts. I’m hoping you get my point–I don’t consider these to be statistics to indicate a healthy young population. Equally as important, almost no children I witness develop straight, un-crowded teeth with broad palates such that their wisdom teeth emerge (a common trait in hunter-gatherer children whose parents consumed their traditional diet). Malocclusion has been demonstrated to be a nutritional deficiency. It is extremely common (to some degree) in Americans. As such, I don’t consider our population to be a good standard by which to measure the health of children. Again, I am making no claims that you are a bad parent, have failed to do everything you can for your children, etc. I am responding to a statement that I often read or hear: my children are healthy. My question is always: how was the health measured? I wonder if any Americans have ever seen truly healthy, well-formed children.
Thank you the discussion and best wishes to you and your family.
I’m not going to bother to explain this for the THIRD TIME in the same thread, but, no, epidemiology studies like this should NOT be used to advise people about what to eat because they have not established causal relationships — only correlations.
Example — in a dietary survey, the person who eats at McDonald’s every day might be the person who gets marked down as “high protein diet.” Is it the protein that leads to worse health outcomes — or is it the french fries and the coke that get eaten with the protein? Or is it the fact that the person who eats at McDonald’s is poor, doesn’t exercise, is overweight and doesn’t care about their health.
In fact studies like this are exactly why we have this research roller coaster of conflicting findings. Applying epidemiology statistics to nutrition, you can probably reach whatever conclusion you desire.
Please read this Beaker and then report back:
https://garytaubes.com/2012/03/science-pseudoscience-nutritional-epidemiology-and-meat/
Another new study indicates:
“Low-protein, high-carbohydrate diets are associated with the longest lifespans”
https://www.cell.com/cell-metabolism/fulltext/S1550-4131(14)00065-5
Perlmutter’s views are becoming increasingly unseated. I also recently posted another study showed high carb diet helped ALS patients and could show promise for brain health. Starting to worry about you folks on low carb.
This is a very interesting study. But before we declare victory and loot and plunder, some questions need to be asked.
What is the relevance of a diet of special kibble fed to transgenic lab mice (genetically engineered mice) to humans? In other words, for this study to have real meaning, the next step of the study would be to feed humans a similar diet (with our own special kibble). Oh we would have to find about 800 transgenic humans engineered for nutrition studies.
Was this study peer reviewed?
Mice, for their size, higher metabolism, etc. of course need a higher carb diet. Comparing omnivores of varying body size really doesn’t have much relevance, like how we try to learn genetics from a fruit fly. The survival strategies of a fruit fly is vastly different from homo sapiens.
I would much rather see a study using normal mice feed a diet that is closer to what a mouse would feed on in the wild.
Overall, this is yet another study using mice to try to figure out what humans should eat, and has incredibly little relevance to humans. A colossal waste of taxpayer money.
So in the end, this just tells us what might be good diet for a lab mouse. That’s about it.
Beaker, one thing you should be aware of, is that in the Pharmaceutical industry, many drugs do well in the early stages of trials, when only lab animal are being used. The vast majority fail when it comes to human testing. Why do you suppose that is? Why is the drug so amazing and shows so much promise on animal testing, only to fizzle when it moves to human trials? The obvious answer is that our physiologies differ enough from lab animals, that the chemistry simply doesn’t have the desired effect. So what works for a lab mouse, rat, dog, cat, pig, doesn’t necessarily work for humans.
So what is great for lab mouse chow, isn’t necessarily good for human consumption. But hey, if you are a scientist looking to publish, and the government is handing out cash…well…
You could be right Bruce. What are your thoughts on the ALS study and high carb benefiting those patients (and speculation could also benefit patients with other brain disorders), those were human subjects. I would like to see Chris comment on these two recent studies, that would be interesting. Also in the news today a study claiming animal protein is worse than smoking:
Highlights
High protein intake is linked to increased cancer, diabetes, and overall mortality
High IGF-1 levels increased the relationship between mortality and high protein
Higher protein consumption may be protective for older adults
Plant-derived proteins are associated with lower mortality than animal-derived proteins
https://www.cell.com/cell-metabolism/fulltext/S1550-4131%2814%2900062-X
Welcome to the never ending nutritional roller coaster ride..
Go ahead and worry about it if I eat low-carb. No skin off my nose. I’m fine. In fact it wasn’t until I was low carb that I:
1. Reduced my medication list down to 3 from over 10 medications including controlled.
2. Reduced my neurological events down to 1 or none per month from 4-6.
3. Reduced my medical expenses per month from $300+ per month to a more manageable $50.
5. Was able to return to the workforce and have a real life again.
Now tell me to eat carbs.
Man, nobody has a clue about anything. One guy tries to come up with a solution and people knock it down. But at the same time people complain that doctors just want to treat the symptoms and not the problem. So this guy throws out an idea and all hell breaks lose. FUNNY LOL
Screw it. Eating his way isn’t gonna hurt. All you can do is try it on yourself. If you forget its working, then you probably have Alzheimers, and at that point you don’t care. If you remember its working, well guess what.. it works.
I had NO health problems at all until I got my first gout attack at 29. We had 4 gigs outside in the hot memphis heat with no water and I had an injury to my foot.
The next few days, my foot swelled up like Obama’s failures. So, the idiot government doctors (military) told me, eat more grains and quit eating meat. I said ok. So, 5 years into this craziness. I have been diagnosed with depression, arthritis, Low T, and for the first time in my life I have brain fog. I can’t concentrate on anything and my mood swings are worse than my 16 YO daughter. Not to mention, for the first time in 15 years I didn’t make weight. I gained 20 pounds and I have a gout attack every 3 weeks or so. They are so frequent, that exercising is something i can only dream about.
I hate my life and can’t stand getting up in the morning knowing that i will be in pain. I hate it. With that said, I had NO problems at all until i started eating all that grain stuff and not eating ANY meat at all. Except Chicken
Well I’m starting his diet and ill see what happens.. My life couldn’t get any worse. As a military family we can’t afford to eat like rich paleo people and we probably never will. Pretty sad
Hi TheMac, I like your post!
Just wanted to tell you not to be discouraged because you can’t eat like Rich Paleo People. I can’t either, but it is possible to cut the grains and eat better without breaking the bank. Remember that going lower-carb Perlmutter style doesn’t have to mean loading up on grass-fed meat (like I can even find that where I am, much less afford it!). It doesn’t even mean that you have to increase your protein. My main animal source of protein is eggs, which are actually not that high in protein. The key to low-carb is actually increasing fat. My go-to sources are coconut (all types, including full-fat coconut milk), butter, avocadoes, nuts and olive oil/olives. You can even try hemp seeds (blended in soups and smoothies). And of course, how could I forget, coconut oil!
Well.. I hope Dr. Perlmutter’s has not recommended patients with ALS go low carb:
New study in the lancet phase2
“A high-carbohydrate, high-calorie diet could delay the progression of Amyotrophic Lateral Sclerosis (ALS), also known as motor neuron disease or Lou Gehrig’s disease, according to a phase 2 study published in The Lancet. ”
https://www.alphagalileo.org/ViewItem.aspx?ItemId=139395&CultureCode=en
ouch.
“Not only could this type of nutritional intervention be a novel way to treat and slow down the progression of ALS, it might also be useful in other neurological diseases.”
double ouch.
A couple of observations. First, if you read the book as only slamming cards, you missed the point. The major consideration is gluten and there is more than sufficient evidence in support of the damage of gluten on insulin receptors. Second, the mechanism of diabetes is well known and does relate to damaged insulin receptors. Third, there are several subtle points that seem to be missed. One such is the fact that a high percent of American are vitamin D deficient. Vitamin D is produced by the skin from exposure to the sun. Individuals who have more than enough exposure to the sun are also in the category. The pathway for this creation involves a derivative of cholesterol. Low cholesterol, low vitamin D regardless of the sun exposure. Dr. Levine of UT Southwestern Medical Center has verified in independent studies that lowering caloric intake (a point made in the book) and reducing insulin resistance increased life span in test organisms by as much as a factor of two. There is growing evidence from these same studies that these changes initiate autopathy whereby the body actively rids itself of not essential cells in a very healthy manner.
Maybe this is the issue- differences in but flora allowing or disallowing digestion of carbohydrates.
https://mobile.nutraingredients.com/Research/UK-research-takes-aim-at-beneficial-bacteria-s-ability-to-break-down-carbs
Totally. With the rise of our chemical lifestyles and over use of antibiotics, plus lack of breastfeeding it’s no wonder brain disorders are becoming the norm -we’ve damaged our micro biome. I’m sure another “grain brain” book targeting gut biome as the key will be released soon and make the best seller list. I drink 2 cups a day of home made milk kefir and other cultured foods. Another possible cause of brain disorders would be the rise of looking at screens all day and night. This cuts out melatonin production leading to all manner of illness. I would like to see a study of those who turn screens off at 5pm every day and at night are in subdued lighting. I doubt you will see them developing brain disorders -but let’s just blame everything on grains.
To Beaker: I don’t know that everything can be blamed on grains, but probably a lot of things can.
We live in a country that is awash in cheap processed food made from corn, wheat, soybeans and sugar. Is it a coincidence that we live in a country where obesity, diabetes, cancer and Alzheimer’s are growing at almost unbelievable rates?
In 1960 when people unapologetically ate food fried in lard and bacon fat, the adult obesity rate was 17%. Today we’re headed for 40% even though we exercise far more than we did 50 years ago. Have we magically turned into a country of gluttons and sloths? No. It is the composition of our diet that has changed for the worse.
There are a lot of unknowns, but the evidence is strong that sugar and grain are not only part of the problem but probably the biggest part of the problem.
Denying that grains and sugar are a problem in the American diet strikes me as pretty similar to denying that the burning of fossil fuels could be contributing to climate change.
I can’t do much about climate change or the American diet on a macro level, but I can make choices to reduce my risks, and I encourage you to do the same.
Several of my doctors have suggested that I get The Grain Brain. So I downloaded it from Audible and find the information extemely helpful in my case. During the 80’s I went to Pritikin on the advise of a friend/doctor and followed the low fat high carb diet. I lost a lot of weight and thought I was doing the right diet. I told my Mother to follow the diet too and within a few years she started to lose her memory and ended up with dementia and we didnt know why it happened. She is the only one in our family to do so. And In my case I became borderline diabete with high blood pressure, required sleeping pills to sleep and recently treated for lymphoma. I thought at my age 66 it was normal. Since listening to The Grain Brain I tried eating a good fat and low carb diet and the results are; my blood pressure dropped to a normal range, my blood sugar is now normal without meds, I can sleep with out meds and all my allergies are gone. Needless to say I feel better, my eye sight, my hearing, my memory have all improved. I am not a guten intolerant I wasn’t eating the good fats and too much carbs.
I have told numerous friends and family about The Grain Brain and I think there is some valuable information about what we are eating.
I think we all know someone who has benefiitted by going guten free and some people that should give it a try.
I had a fellow worker that fought depression and went guten free and is doing fine now.
I have a relative that enjoys her guten rich diet and takes meds for mental and skin issues.
Good luck
Hi Steve,
So sorry to hear about your kidney troubles and confusion. I really don’t know that much about kidney problems, but I have experienced a lot of confusion about what to eat (join the club 😉
One comment I will make is that, from what I have read, a high protein diet is very bad news for someone with kidney trouble. I used to eat a high-meat low-carb diet but after a few years I started to feel really sick on that. I went completely vegan for like 10 days as a kind of experiment, and then I decided to eat just a large portion of roast chicken for lunch one day. I was so sick–I was nauseated all night long. It was when I started searching for the reasons why I would have felt so bad that I learned that some people’s kidneys can’t handle high-protein meals, and it causes the symptoms I experienced.
However, having to do a low protein diet definitely does not mean you can’t go low carb! People confuse low-carb/paleo with high protein. Some people do it that way, but it’s definitely not the way to go (particularly for you). You have to increase fat–fat that is not attached to a dense protein source like meat.
Also, you may want to cut back on the juicing. That can spike your blood glucose for sure. And you can restrict the whole-food starches (like squash, potatoes etc.) and ditch the grains (even whole grains) if you are worried about gaining weight.
Also, keep in mind that eggs and dairy are not really that high in protein. So I would think you could have those in limited amounts on a low protein diet.
In terms of getting dietary fat without too much protein, many people tend to cook vegetables in coconut oil or butter. Some of them also put butter or coconut oil in coffee. You can also make yummy blended soups with low-carb veggies and full-fat coconut milk or fresh coconut meat. When you do have cooked squash or sweet potato, don’t hold back on the butter. You can also do green smoothies (little or no fruit) with coconut oil, coconut milk or coconut meat and avocado. Hemp seeds are another kind of high-fat thing that people put in smoothies. When you have salads don’t skimp on the olive oil in the dressing, and put avocado in there too.
Also, I should point out that this thread is just a discussion gone wild due to the blog article. You should probably head over to Mark’s Daily Apple forum or to Robb Wolf’s forum (RobbWolf.com). There is also a forum called lowcarbfriends. In those places you can post a topic about low-carb paleo for people with reduced kidney function, and you will get lots and lots of help and advice!