What's Behind 'Grain Brain': Are Gluten and Carbs Wrecking Our Brains and Our Health?
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Celiac disease is widely known to cause digestive problems. That’s just the tip of the iceberg, according to the book Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar--Your Brain's Silent Killers, by David Perlmutter. The intestinal difficulties associated with celiac disease are caused by an immunological response triggered by gluten, similar to an allergic reaction but less violent. This response, which leads to inflammation in the gut, can happen elsewhere in the body, too. Inflammation is at the root of many diseases and complications, including, Perlmutter argues, brain decay. Gluten can lead to inflammation in the brain, which Perlmutter believes leads to conditions like dementia and Alzheimer’s.
A practicing neurologist, Dr. Perlmutter’s experiences with patients, along with medical research he’s studied, have led him to piece together a theory behind brain degeneration that’s based on a foundation of gluten and high blood sugar. He also argues for the importance of cholesterol to maintaining brain health, and makes a compelling case that cholesterol-lowering statin drugs are bad for the brain.
Grain Brain frequently veers from the brain to other parts of the body that Perlmutter says are damaged by gluten and carbohydrates and of the general dangers of fat avoidance. You may have heard some of these ideas elsewhere; Perlmutter is clearly aligned with the likes of Robert Lustig, a pediatrician who writes of the ills of sugar, and Gary Taubes, one of the first to demolish the idea that dietary fat and cholesterol are responsible for heart disease.
What Perlmutter brings to the table is the idea that gluten teams up with high blood sugar to wreck the brain. The presence of high blood sugar, he explains, causes a reaction throughout the body called glycation, which he describes as “the biological process whereby glucose, proteins, and certain fats become tangled together, causing tissues and cells to become stiff and inflexible, including those in the brain.”
In the brain, he explains, "sugar molecules and brain proteins combine to create deadly new structures that contribute more than any other factor to the degeneration of the brain and its functioning…this is made worse when powerful antigens [a substance that triggers an immunological response] like gluten accelerate the damage. "
Glycation can’t be entirely avoided, but high blood sugar, as found in diabetics, he writes, exacerbates it. Where blood sugar is high, the brain (and other bodily structures) is constantly bathed in a glycating sugar bath. Recent studies show that having diabetes doubles one’s risk of contracting Alzheimer’s disease, he points out. The growing understanding of the connection between the two diseases has prompted some researchers to suggest that Alzheimer’s be re-labeled “Type-3 Diabetes.”
“The origin of brain disease is primarily dietary,” he concludes, and not hereditary, as is most commonly assumed. Gluten, by triggering the immune system, causes inflammation in the brain, which encourages the brain’s glycation by sugar circulating in the blood.
Perlmutter also presents evidence that some gluten breakdown products are in an endorphin-like class of molecules called exorphins, which are addictive.
We’ve known since the late 1970s that gluten breaks down in the stomach to become a mix of polypeptides that can cross the blood-brain barrier. Once they gain entry, they can then bind to the brain’s morphine receptor to produce a sensorial high. This is the same receptor to which opiate drugs bind, creating their pleasurable, albeit addicting, effect.
This addictive quality of gluten, he writes, can also lead to withdrawal symptoms among those who remove gluten from their diets.
There is a wide spectrum of gluten intolerance in the population, with celiac disease at the extreme end. Perlmutter recommends six markers you can have run on your own blood to determine your level of gluten intolerance. Along with these, not surprisingly, he also wants you to keep track of your fasting blood glucose and insulin levels.