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Grain Brain by Dr. David Perlmutter

Can Gluten Cause Alzheimer's or Dementia? Grain Brain Says It Can

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Updated July 03, 2014

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Can gluten grains cause Alzheimer's disease or dementia?

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Back in the mid-1980s, a non-profit group ran a successful — and memorable — anti-narcotics public service campaign entitled "This Is Your Brain on Drugs," showing eggs frying in a hot pan. Grain Brain, the latest book from neurologist and author Dr. David Perlmutter, makes much the same point, but substitutes grain for drugs: This Is Your Brain on Grains.

According to Dr. Perlmutter, grains — particularly wheat and the other gluten grains — are largely responsible for the growing epidemic of Alzheimer's disease. He also blames grains for a multitude of other neurological disorders, ranging from attention deficit-hyperactivity disorder to migraines and even Parkinson's disease.

Of course, those of us with celiac disease or non-celiac gluten sensitivity already are familiar with many of these links. But Grain Brain maintains that gluten grains (along with sugar and other grains) aren't good for anybody, even if the person doesn't seem to have a reaction to them.

The book reminds me of Wheat Belly, by Dr. William Davis, which contains a similar indictment of gluten grains, but from a cardiovascular perspective instead of from Grain Brain's neurological perspective. I wound up liking Grain Brain, but I think it suffers from a couple of leaps of faith which really haven't been borne out (yet) by medical research.

Wheat: Bad for Your Brain

The U.S., along with many other nations, is facing an epidemic of diabetes and Alzheimer's disease. The two conditions are strongly linked: those with diabetes have a two-fold risk of Alzheimer's disease. And increasing consumption of simple carbohydrates — sugar and especially wheat — is causing insulin resistance, which predisposes individuals to both conditions, Dr. Perlmutter says.

"What we're beginning to understand is that insulin resistance, as it relates to Alzheimer's disease, sparks the formation of those infamous plaques that are present in diseased brains," he says. Ultimately, he argues that both Alzheimer's and diabetes "spring from foods that force the body to develop biological pathways leading to dysfunction."

And what are those foods? Sugar and most especially wheat, he says.

Americans consume an average of 133 pounds of wheat each year, and it's affecting our brain health — not just for those who have been diagnosed with a gluten-related condition, but for everyone, he says.

"There is little doubt that one of the largest and most wide-reaching events in the ultimate decline of brain health in modern society has been the introduction of wheat grain into the human diet," Dr. Perlmutter writes, noting that what we now call "wheat" bears little resemblance to the ancient forms of wheat consumed by Neolithic humans.

According to Dr. Perlmutter, "gluten sensitivity represents one of the greatest and most under-recognized health threats to humanity."

So Gluten's A Threat. Now What?

So what can we do about this problem?

The book is divided into three parts: an overview of foods and their effects on the brain, a more comprehensive discussion of the science behind the health habits Dr. Perlmutter is promoting, and a detailed month-long program, with menus and recipes, to implement those health habits.

Dr. Perlmutter has strong credentials — he's both a board-certified neurologist and a fellow of the American College of Nutrition (the only doctor in the country with both of those credentials, he says). And he makes a persuasive case, especially if you already believe that grains aren't the health food they're made out to be.

I also agree with him that there's evidence showing gluten (or perhaps other components in wheat — the research isn't clear at this point) can cause multiple neurological problems, including headaches, depression, and ADHD.

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However, he reaches the same conclusion about gluten and dementia ... and I just don't believe the evidence is strong enough to state unequivocally that gluten/wheat cause dementia. I think they very well may cause it or contribute to it (and I admit the case Dr. Perlmutter presents is persuasive), but medical science hasn't yet proven those links.

It honestly didn't help make his argument that Dr. Perlmutter both exaggerated and underestimated the incidence of celiac disease (pretty well proven to be 1 in 133 in the U.S. right now). In his chapter The Sticky Protein: Gluten's Role in Brain Inflammation (It's Not Just About Your Belly), he wrote: "Although many experts estimate that 1 in every 200 people has celiac disease, this is a conservative calculation; the number is probably closer to 1 in 30, since so many people remain undiagnosed."

But he's wrong here: the 1 in 133 figure already counts those who aren't yet diagnosed, and I don't know of any expert who believes the incidence of celiac disease is as high as 1 in 30 (gluten sensitivity is a different issue, as estimates of those affected are much higher). This is a relatively minor point, but it's important to get the details right in a book that's based on research.

The Bottom Line

Don't get me wrong: I liked Grain Brain, and I suspect some or even many of Dr. Perlmutter's conclusions eventually will be borne out by future medical research.

For example, there is tantalizing new evidence showing that even slightly elevated blood sugar levels — regardless of whether you have diabetes — may contribute to dementia or Alzheimer's disease. Other medical authorities (including Dr. Davis of Wheat Belly fame) have independently fingered gluten grains for spiking blood sugar levels.

So Dr. Perlmutter's theories are quite plausible ... they're just not yet proven. Nonetheless, since I'm already pretty much following his prescription for a healthy brain (no gluten grains, obviously, and very limited grains overall), I may actually be helping to lower my risk of dementia and Alzheimer's disease. I don't know that I'd change my entire diet based on this book, but I'm comfortable with how it fits into the way I already eat.

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