Frequently Asked Questions

Migraine headaches represent a serious health issue in America today, and the statistics are staggering. Everyone seems to be searching for an answer on how to stop these painful episodes, bot solutions are few and far between. One step I encourage patients to take, however, is to look at their consumption of magnesium, a vital nutrient. Magnesium is involved in hundreds of cellular functions that are very relevant to the discussion of how to prevent and manage migraine headaches. When magnesium levels are low there are significant changes in the release of brain chemicals, called neurotransmitters, that play a pivotal role in the frequency and severity of migraine headaches. In addition, low magnesium levels lead to an increase in the production and release of a chemical called substance P (the “P” stands for pain) which is thought to activate sensory fibers for pain. You can learn more about the relationship between migraines and magnesium in my blog post on the subject.

We have treated a variety of movement disorders quite successfully with the Grain Brain diet, including restless leg syndrome. My first experience in virtually curing this disorder with a dramatically low carb diet was around 22 years ago. I actually still remember the patient’s name.

I am currently treating several children who carry a diagnosis of Tourette’s syndrome who have seen remarkable improvements by going gluten-free. I should note that this is happening without the use of potentially dangerous medications.

As a matter of fact, I’ve recently published a paper on this topic (which is available here on this site). We often find significant improvement in patients with Crohn’s disease who go gluten free.

Atrial fibrillation is often a manifestation of coronary artery disease. The best diet to reduce coronary artery disease risk is a diet that dramatically restricts carbohydrates while providing lots of healthful fats.

I would discuss with your healthcare practitioner the idea of resuming the diet, but adding in 100-200 mg of vitamin B6 daily.

We have not seen a single instance of gout arising after our patients adopt the Grain Brain diet.

Generally, yes. You’ll just want to be sure the capsule material is gluten free.

The changes I made in Grain Brain have taken into account factors such as cost and availability. There are at least a dozen supplements that I favor and could have been included. This time, I really wanted to focus on food.

Turmeric (Curcuma longa) a member of the ginger family, is the subject of intense scientific research evaluating it’s anti-inflammatory and antioxidant activities. It is the seasoning that gives curry powder its yellow color and has been used for thousands of years in Chinese and Indian medicine as a natural remedy for a variety of ailments. Curcumin, the active compound found in turmeric, has beneficial effects for a variety of diseases and conditions. And it is curcumin that gives turmeric its anti-inflammatory and antioxidant activity. In a recent report in the American Journal of Epidemiology, researchers investigated the association between curry consumption level and cognitive function in elderly Asians. Those who consumed curry “occasionally” and “often or very often” had significantly better scores on specific tests designed to measure cognitive function than did subjects who “never or rarely” consumed curry. The results of this study are not surprising given the strong association of Alzheimer’s and other forms of dementia with inflammation and the powerful anti-inflammatory properties of curcumin.. But the relationship of turmeric to brain health, and specifically to Alzheimer’s, goes much deeper. One of the important elements of Alzheimer’s disease is the finding of elevated amounts of a specific damaging protein in the brains of Alzheimer’s sufferers, amyloid protein. Indeed, amyloid is considered one of the hallmarks of this disease. New research published in the Journal of Neuroscience Research has shown that curcumin actually inhibits the formation of amyloid protein. So promising were these findings that the author of the study concluded that curcumin “could be a key molecule for the development of therapeutics for Alzheimer’s disease.”

Yes, there is no problem taking any of my recommended supplements while pregnant or breastfeeding. However, be sure to consult your OB/GYN.

Pterostilbene, a related stilbenoid, may indeed be more potent than resveratrol. However it is generally quite a bit more expensive and much less widely available – considerations that I made when making the recommendations in Grain Brain.

This medication may have significant effects on the brain as a consequence of its role in depleting nutrients by inhibiting their absorption. This link will provide additional information:  https://www.naturalnews.com/DrugWatch_Cholestyramine.html

While inflammation is certainly a troubling consequence of diabetes, perhaps an even more sinister consequence is a dramatic increase in the production of damaging free radicals, a situation called oxidative stress. This damages protein, fat, mitochondria, and even our DNA. So I guess one could consider naming it Sugar Inflammation Oxidative Stress Syndrome, but let’s just stay with diabetes for now.

Gluten-free diets are clearly more effective from a physical performance perspective for those who have documented sensitivity. Overall however, consider that most gluten products are high carb and should therefore be avoided for long-term health.

Alzheimer’s is a form of dementia and represents the most common cause of this affliction. Other forms of dementia relate to, for example, vascular conditions of the brain.

To a small degree, there is definitely an inherited risk for Alzheimer’s disease. The good news is that this risk can be reduced by specific lifestyle changes.

Here are the fundamental keys for reducing your risk of getting Alzheimer’s disease, a disease for which there is no treatment. First, dramatically reduce your carbohydrate consumption while increasing your consumption of “good” fats like fish, nuts, seeds, and olive oil. Second, get 15-20 minutes of aerobic exercise each day. This actually turns on the DNA in your genome that codes for the production of BDNF, basically the brain’s “growth hormone.” Third, make sure you’re consuming at least 1000mg daily of the omega-3 DHA. Research clearly links higher DHA levels with reduced risk, not only for Alzheimer’s disease, but for other forms of dementia as well.

The fundamental role of inflammation as a causative player in Alzheimer’s disease has incredible traction in the scientific community at the moment.

I think the key issue today in dealing with the epidemic of Alzheimer’s disease is what can be done to prevent this disease, a disease for which there is no cure. The evolving data is clear: a high carbohydrate diet leading to blood sugar elevations is a powerful pivot point in the genesis of the disease. So the answer as to whether the disease can be prevented or not is clearly a strong and resounding “yes.” Just take a look at this recent publication from the New England Journal of Medicine. We just have to broaden our educational pursuits as part of a public health effort to let people know that carbs are basically toxic to the brain.

A key player in vascular dementia is glycation (binding of sugar) to proteins. This process is reduced on the Grain Brain diet. Also important to monitor homocysteine, another risk factor which can be lowered in most people with B6, B12, and folate.

Becoming a diabetic will double your risk for Alzheimer’s disease, a disease for which there is no treatment. Elevated blood sugar attaches to proteins in the body and this process dramatically increases the production of both free radicals and chemicals involved in inflammation. Both of these are strongly involved in damaging the brain in Alzheimer’s as well as Parkinson’s and multiple sclerosis.

All carbohydrates ultimately activate insulin to some degree. It is difficult to get a clear understanding of what may actually constitute a “good” carb.

This is a common question, and it’s one I get quite often, especially as going grain-free and gluten-free becomes a more popular lifestyle choice. My answer is straightforward: yes, you can enjoy grains prepared in this fashion. However, you must be absolutely sure the grains you are consuming are gluten-free and that you are keeping a close eye on total carb consumption in your diet, both of these grains and generally.

Remember, a Grain Brain lifestyle is not just about eliminating gluten from the diet, but reducing your carbohydrate load as much as is possible. In fact, this is critical for your health! If we remove gluten but overconsume carbs, we will be doing no favors to our health or our body!

So again, if you want to consume soaked grains, my answer is this: yes, go ahead and do so at your leisure. But monitor yourself! You must always make sure the grains are gluten-free, and that you’re tracking your total carbohydrate consumption. I would suggest keeping a journal of daily carb consumption, or engaging in some sort of practice that presets your carb consumption the day before (like meal planning), or limits carbohydrate consumption to certain scenarios.

While the ancient grain Einkorn wheat has a dramatically lower level of gluten, it is still a source of gluten and, as such, may enhance inflammation. The best recommendation is to avoid it.

Even “organic” oats are often gluten contaminated so best avoided. Just take a look at this citation:

Research published in the Journal 1 and elsewhere2 strongly suggests that persons with celiac disease can consume moderate amounts of uncontaminated oats. Nonetheless, celiac disease organizations in the United States continue to advise against the consumption of oats because of concern that commercial oat products may be contaminated with wheat, barley, or rye during harvesting, transporting, milling, and processing.2 However, little information is available on the contamination of oat products in the United States. Here I report an assessment of selected brands of oats for gluten contamination. Twelve containers of rolled or steel-cut oats, representing four different lots of each of three brands, were purchased in Massachusetts between October 2003 and March 2004. The three brands were Quaker (Chicago), selected because it is a popular brand of oatmeal in the United States; Country Choice (Eden Prairie, Minn.), because it is certified to be organic; and McCann’s (Odlum Group, Naas, Ireland), because it is processed in an oats-only facility. Containers were sent unopened to an independent laboratory (Food Allergy Research and Resource Program, Lincoln, Nebr.) for analysis. Samples of oats were homogenized and analyzed in duplicate, according to instructions from the manufacturer (R-Biopharm, Darmstadt, Germany). The Ridascreen Gliadin sandwich enzyme-linked immunosorbent assay (ELISA), recently validated by the Working Group on Prolamin Analysis and Toxicity, was used for the analysis.3 This ELISA uses R5, a monoclonal antibody, that is equally sensitive to the prolamins of wheat, barley, and rye and that is insensitive to the prolamins of corn, rice, and oats.4 Internal controls for this assay include six gliadin standards of known concentration. The limit of gluten detection is 3 ppm. For this assessment, oat samples were considered gluten-free if they contained 20 ppm or less of gluten, in accordance with the current Codex limit for naturally gluten-free foods.5 The results of the analysis are presented in Table 1. On the basis of the mean gluten level in the two extractions, 3 of the 12 oat samples contained gluten levels of less than 20 ppm. The other nine samples had gluten levels that ranged from 23 to 1807 ppm. All three brands of oats had gluten levels above 20 ppm in at least two of the four samples tested. Ranges according to brand were as follows: McCann’s, below the limit of detection to 725 ppm; Country Choice, below the limit of detection to 210 ppm; and Quaker, 338 to 1807 ppm.

While we definitely require protein and fat, the human requirement for dietary carbohydrate is none, none whatsoever.

Bad idea on two counts. First, bread has a very high glycemic index, even whole grain bread. So it presents a big risk as it relates to the damaging effects of sugar. Second, your average lab test for gluten sensitivity is often going to miss the diagnosis.

It’s been estimated that more than 50% of adult Americans don’t consume sufficient foods high in magnesium to get the required daily amount (300mg for women, 400mg for men) of this critically important mineral. I urge you to consider adding these magnesium-rich foods to your daily menu:

• Almonds are nutrient-dense and full of healthy fats and protein. Just one ounce of almonds contains 80mg of magnesium!
• Spinach is packed with magnesium, providing 157mg in a single cup! Additionally, this leafy green has many other vitamins and minerals that help optimize magnesium absorption.
• Pumpkin seeds contain a whopping 184mg of magnesium in just ¼ cup!
• Avocados contain 58mg of magnesium in a single fruit, plus more potassium than bananas!
• Cultured yogurt contains 30mg of magnesium per cup and is a superb source of protein. Omega-­3 fatty acids, vitamins, minerals and probiotics, which are all also found in yogurt, make this one nutrient-rich, gut-­healthy snack.

The type of animal products consumed today represent a significant risk to health. Almost all red meat, for example, is GMO grain-fed and thus poses a significant health concern. I believe that limited amounts of grass-fed, organically raised red meats, as well as pasture-raised fowl, offer up good choices for general and brain health. The studies demonstrating higher levels of specific minerals in the Alzheimer’s brain may well represent effect as opposed to cause. Meaning that the Alzheimer’s brain may lack mechanisms for balancing various minerals.

The Grain Brain and Atkins diets are similar in that both diets emphasize higher fat consumption while minimizing carbohydrates. It is the specifics of fat type where difference exist in comparing the two programs. For example, Atkins diets can be high in fatty, grain-fed meats which are high in inflammatory Omega-6 fats. Often, the grains used to fatten cattle are worrisome as they are GMO derived.  In Grain Brain we advocate the consumption of meat, fowl, and fish, provided that it is grass-fed, free range, or wild caught.  This provides a favorable fatty acid ratio (high in Omega-3 fat).  However meat consumption is not necessary.  The most important thing is that most of your calories come from high quality fat sources such as organic extra-virgin olive oil, coconut oil, avocados, etc., while consuming ample amounts of above ground vegetables, and substantially limiting consumption of carbohydrates.

I do not believe there is much of a direct effect of salt on memory and cognition. However, the relationship to hypertension is clear, and hypertension is damaging to the brain.

Agave is a very big concern and should be strictly avoided. It contains as much as 70% fructose which is highly glycating. If you must use a sweetener, I favor stevia.

Dr. Campbell’s excellent book is critical of statistics related to health issues in populations eating meat. Understandably, there are problems with eating meat because by and large the meat people are eating these days represents a dangerous food. I agree with absolutely avoiding the type of meat that people consumed in his studies. These are meats from grain-fed animals, which are most commonly genetically modified. In addition, these are cattle who have been treated with antibiotics and who knows what else.

Grain Brain represents my interpretation of the most leading edge science related to the roles of nutrition and other lifestyle factors in brain health, functionality, and resistance to disease. This dedicated review of current science, coupled with my day to day experience in applying this information in clinical practice dealing with a vast array of neurological conditions as well as my personal interactions with leading scientists, clinicians and researchers  from around the world have provided the resource base for writing Grain Brain. As I have been involved in exploring and reporting on the powerful role of nutrition in the brain health arena over the past twenty years I have witnessed an ongoing evolution in the nutritional science toward better and better refinement of the core messages. And this is why the fundamental tenets of my message have evolved as well. Dietary recommendations found in my previous books including, The Better Brain Book, Raise a Smarter Child by Kindergarten, and Power Up Your Brain – The Neuroscience of Enlightenment  were based on the very best information available to me at the time. Clearly, the recommendations found in Grain Brain differ somewhat from my previous works as nutritional science continues to refine our understanding of what truly represents the very best recommendations for human nutrition.

Maltodextrin is a processed starch made from things like corn, rice, potato or wheat. So it may contain gluten and is therefore best avoided. Aspartame may specifically change the sensitivity of the brain to hormones that regulate appetite. Higher aspartame consumption is associated with a dramatic increased risk for obesity and even diabetes, even though it is sugar free.

Actually, in this extensive study published in the Journal of The American Medical Association, higher fat consumption was associated with decreased risk of breast cancer, with those consuming higher carbs having a 15% increased breast cancer risk. Similar, but less profound results, were found with reference to colon cancer, showing a slightly decreased risk in those consuming the higher levels of fat. With respect to prostate cancer, being fat is clearly a risk (generally caused by a high carb diet) but no association is found with fat consumption – again as recently described in JAMA.

The science supporting coconut or MCT oil is sound, especially when coupled to a low carbohydrate diet. The mechanism centers on the therapeutic effect of the ketones on brain function. Here is an excellent reference. I cannot indicate that I have specifically evaluated coconut, in and of itself, as it is part of our rather extensive protocol in the treatment of Alzheimer’s disease.

Avocados are loaded with fat, and that’s why they are such a terrific food for maintaining health.

For snacking: nuts, cheeses, and carrots. For drinking: there’s only one option…water.

Without question, what will have the highest impact from a dietary perspective is a radical reduction in carbohydrate consumption.

Olive oil, like all plant oils, contains no cholesterol.

Unfortunately, the Standard American Diet (SAD) is not one that is optimized for brain function. Because it is rich in unhealthy fats and carbohydrates, this diet deprives your brain of the nutrients it needs for optimal functioning. Instead, you MUST be eating a diet that gives the brain everything it needs to work at peak performance. The brain thrives on a fat-rich low-carbohydrate diet, which unfortunately, is relatively uncommon in human populations today. Thus, these should be the hallmarks of your diet. Get rid of things like bagels for breakfast, and instead enjoy half-an-avocado or some eggs. For more ideas on how to eat for brain health, try visiting the Eat section of my website. Of note is our listing of gluten-free, low-carb recipes, which are just the thing you need to bring rich food into your diet and lifestyle. If you want to learn more about why this dietary plan makes for the optimal lifestyle for brain health, then I suggest browsing the Focus page on my website dedicated to a gluten-free study. There, we have many videos, blog posts, and studies that highlight the benefits of going gluten-free. So remember, if your goal is to eat to optimize brain health, then you need to push the carbs away from the table, along with unhealthy fats too, welcome back healthy fats (like avocado, nuts and seeds, and fish), and keep as far away from gluten-rich, processed foods as possible! Here’s to eating for your brain, and a lifetime of health.

This is an excellent question as there is great variability in what truly constitutes “free range.” Often, this simply means that the chickens will have access to going outside, but they may not. And, as you point out, they may still be fed with grains like GMO corn. Eggs from truly “free-range” chickens are not “fed” anything.  The best name to look for would be “pasture raised” as these chickens seem to spend the most time eating their natural food.  I agree that eating eggs from chickens fed grains poses a concern.

By and large the recommendation to avoid meat makes good sense because by and large the meat that is so widely consumed is indeed dangerous for our health. So, the data that these individuals used to make their recommendations is sound. That said, seeking out organically raised, grass-fed beef offers wonderful health advantages. Keep in mind again, that this is not the type of meat consumption that generates the data used by those advocating a low fat or vegetarian type diet.

While the statistics about celiac disease may be correct, as many as 30% of the population may be sensitive to gluten, without a specific involvement of the small intestine (celiac disease). This sensitivity can relate to any number of problems from dementia to ADHD, skin disorders, joint pain, neuropathy, headaches and even depression as we describe in Grain Brain.

No. For those without celiac disease, but who are gluten sensitive nevertheless, throwing out your cookware isn’t at all necessary.

While the statistics about celiac disease may be correct, as many as 30% of the population may be sensitive to gluten, without a specific involvement of the small intestine (celiac disease). And this sensitivity can relate to any number of problems from dementia to ADHD, skin disorders, joint pain, neuropathy, headaches and even depression.

It is likely that 100% of humans activate zonulin when exposed to gluten, and this increases gut permeability. This is thought to play an important role in autoimmunity.

There is no doubt that the number of people who are now clearly and significantly sensitive to gluten has increased dramatically in recent years. And there are several reasons why this is happening. First, the ability of the immune system to recognize friend or foe as far as proteins are concerned is fundamentally regulated by the balance of bacteria that reside within our intestines, our microbiome. With the overuse of antibiotics and other challenges including other medications like anti-inflammatories, and even chlorinated water, the regulation of our gut related immune system can be compromised, and this leads to inappropriate and excessive reactions to what might otherwise have represented a nonthreatening protein like gluten. So disturb the balance of bacteria in the gut, and next thing you know, you are at risk for gluten sensitivity. In addition, the hybridization of wheat has favored both genetic changes in the composition of gluten as well as greatly increasing the amount of gluten found in wheat-derived products (as well as barley and rye). These changes further overwhelm the immune system’s ability to respond in a normal fashion when exposed to these products.

The data to specifically answer this question is surprisingly sparse. While pharmaceuticals have been designed to affect GABAergic receptors and cross the blood-brain easily, free form GABA is another story. Inferential data revealed in “Oral intake of γ-aminobutyric acid affects mood…induced by mental tasks,” shows at least some changes in brain response to an oral challenge.

I posted an answer to this question over on IntegrativePractitioner. What follows are snippets from that article. For the whole article see: Making New Connections: The Gift of Neuroplasticity. The ability of the brain to change and reorganize itself and its function is called neuroplasticity. Neuroplasticity provides us with a brain that can adapt not only to changes inflicted by damage, but more importantly, allows adaptation to any and all experiences and changes we may encounter, freeing us from merely responding reflexively as a consequence of genetically determined hardwiring. Harvard Medical School’s Dr. Alvaro Pascual-Leone recently stated that neuroplasticity “… is an intrinsic property of the human brain and represents evolution’s invention to enable the nervous system to escape the restrictions of its own genome and thus adapt to environmental pressures, physiological changes, and experiences.” How does neuroplasticity come about? While the individual working unit of the brain is the single neuron, even simple tasks require the recruitment of vast numbers of interconnected neurons functioning as a unit or network devoted to accomplishing even the simplest activity. The neural network represents a specific unique pattern of connections of neurons that fire in a specified sequence that allows you to accomplish such tasks as snapping your fingers, or recalling the lyrics to Hey Jude. And neuroplasticity, the ability of the brain to adapt and change, is predicated on the modification of existing neural networks and the creation of new ones. Though the precise biochemical changes that take place when neurons connect to form these networks is quite complex, there is general agreement among researchers that BDNF (brain-derived neurotrophic factor), BDNF, creates the fertile ground for this union to take place, helping transform a mere embrace of two neurons into an eternal dance. Thus, BDNF is now looked upon as playing a pivotal role in neuroplasticity. Modifiable behaviors which upregulate BDNF transcription include physical exercise, the omega-3 fatty acid DHA, and caloric restrictions. But it takes more than simple repetition of a stimulation or activity to create the brain connections that lead to the formation of neural networks.

Carbonated water, although it does contain more sodium than flat water, is absolutely encouraged on the Grain Brain program. In fact, adding natural flavoring makes this even more refreshing and still adds no sugar.

The two most important tasks for anyone to help short-term memory are to increase aerobic exercise to at least 20 minutes daily. And second, make sure you’re getting at least 800-1000mg DHA in your diet each day (adults).

Quite simply, nutrition matters more than you could imagine. Time to hit the books and realize that food is our most important health ally.

We were taught that the brain couldn’t regenerate itself. Too bad it took so many years to overturn this misconception!