Getting the Answers

Last month, you may have seen a post on my Facebook page about an interview I had done with Medscape. A few weeks later, the interview was made available to the general public on WebMD. The main focus of the interview was to allow me to explain how and why gluten and carbohydrates represent such a powerful threat to the human brain.

Now that the article has had a chance to disseminate across the internet, I’ve seen a flood of comments from medical practitioners, industry experts, and interested individuals, asking questions, providing anecdotal evidence, offering support, and much, much more. So, I wanted to take an opportunity to acknowledge some of these comments, offer thanks, and provide some answers. (All comments sourced from the posting on Medscape).

From Craig Petersen:

…I would be interested to see how the author works out the math, regarding the suggested daily carbohydrate intake of 60 grams, while conceiving an actual healthy diet that provides an adequate intake of calories…Just to translate 60 grams of carbohydrate in real terms, that number would be achieved with 1/2 cup of legumes, a slice of white bread, and a serving of fruit. This would leave no room for any other sources of carbohydrate like vegetables, potatoes, rice, cereal, corn, any refined sugars at all, milk, yogurt, cheese, or even nuts which contain relatively modest amounts of carbohydrate. Assuming a relatively high protein intake of 100 grams, which will need to come primarily from eggs and animal flesh, a modest 2000 calorie diet on this regimen would need to contain 1360 calories of fat, comprising 68% of total dietary calories…

Craig’s question is one many of you have asked: how do I build a nutritionally sound diet, and what is the proper ratio of fats to protein to carbs? As I’ve pointed out before on this blog, that ratio is about 65:25:10. The concern about including white bread, refined sugars, cereal, and other such grains are not really concerns at all, as these grain-based foods are basically off limits on the Grain Brain program.

From James Kantor:

Dr. Perlmutter, what do you feel was the purpose of fruit and other carbs in nature to man and other mammals?

James asks a great, and rarely considered question about the role of fruit. Fruit derives its calories basically from carbohydrate. That said, despite the recommendation that is so frequently espoused that we consume 4 to 6 servings of fruit daily, this represents a major challenge to human physiology and clearly isn’t healthful.

Fruit served a life-supportive role for our Paleolithic ancestors. As fruit became ripe in the late summer, its starch would change to sugar. That prompted our ancestors to eat fruit, consume sugar, stimulate insulin production and therefore create and store fat. This is the mechanism that allowed us to survive through the winter, a time of caloric scarcity.

From Paul Lebow:

Dr. Perlmutter claims that grass-fed beef is good, grain-fed, bad. Would be interested if this is backed by peer-review studies…

I’ve referred to this study to support the idea that grain-fed and grass-fed meats act quite differently in terms of their health potential and risks.

Finally, from Dr. Donna Canney:

This fits with some of my own observations of which patients have hyperinflammatory syndromes, fatigue, and loss of cognitive function. Appreciate his specific recommendations for monitoring the effects of lifestyle changes. Patients definitely feel better with appropriate diet and exercise, but they really respond better to having a number, such as A1C or fasting insulin, as a concrete demonstration of their progress. Works for cholesterol and blood pressure; why not for inflammatory damage? Perhaps we could incorporate an annual cognitive function test along with annual labs.

I couldn’t agree more. Our cognitive function is as important an aspect of our health as any, so why aren’t we keeping track of it like we would any other aspect of our health? We can only identify improvement or regression if we utilize a benchmark as is described.

Again, these are just some of the many comments I received on this article. I want to thank everyone for contributing to the conversation, and hope to continue it here on my site.