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Book Review: Grain Brain – by David Perlmutter, MD


Perlmutter, a neurologist in Naples, Florida claims that inflammation is the cause of many neurogenerative diseases and disorders such as dementia, diabetes, depression, ADHD, irritable bowel, and Alzheimer’s. The solution according to Perlmutter is to eliminate gluten, follow a low-carb diet and feed your brain a diet that’s high in fat. Fat, he claims will provide the nourishment that the brain needs. The diet involves restricting carbohydrates to 30 to 40 grams a day, followed by a maintenance phase of 60 grams of carbs.

Like most dietitians, I find this advice to be unsubstantiated at this time. Much of the evidence cited in the book is anecdotal and based on testimonials as well as the author’s own experience with his patients. The overpromise of health benefits from his diet plan raises another red flag. Plus, science tells us that carbs (more specifically glucose, and not fat) are the preferred fuel for our brain.

The author’s recommendation to increase our intake of fat to 80% of our daily calories warrants discussion. It’s a far cry from Health Canada’s fat recommendations of 20-35% of our daily calories. While it’s true that we could all stand to increase our consumption of healthy monounsaturated fats and omega-3 fats from foods such as fish, avocados and olive oil, it’s not advisable at this point to increase our intake of saturated fats because of their negative effect on heart health. What we also know is that swapping saturated fat for polyunsaturated and monounsaturated fats is beneficial to our heart health.

Perlmutter does make some recommendations with which I whole-heartedly agree. For one thing, he recommends that we exercise more and more regularly (he recommends at least 30 minutes, five times a week). Secondly, he advises that we work on getting restful, routine sleep seven days a week. The bottom line though is that Grain Brain is a low-carb diet. Instead of cutting out carbs, my advice is to choose smart carbs like whole grains, vegetables and fruit as part of a balanced diet.

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