By Dr. Mercola

Alzheimer's disease has become nothing short  of epidemic in the US. Could it be that some commonly eaten foods are the  primary culprit? According to neurologist Dr. David Perlmutter, author of the  book Grain Brain, your diet has major implications for your Alzheimer's  risk.

Grain  Brain has been on the New York Times Best Seller  list for six months now, which is unusual for a health book. He has also been  on a few PBS specials. Dr. Perlmutter is also the editor-in-chief of a brand  new Harvard-based journal called Brain  and Gut, slated to come out next year.

    He came to the conclusion that brain  dysfunction is rooted in a flawed diet, particularly our modern-day high-grain diet,  after scouring the medical literature looking for clues to the underlying cause.

    He'd grown weary of treating his patients'  symptoms, and wanted to get to the bottom of the problem. As it turns out, the  scientific literature is actually replete with information telling us that, yes,  diet plays a crucial role in brain function. He says:

"What we've crystallized it down to now, in essence, is  that diets that are high in sugar and carbohydrates, and similarly diets that  are low in fat, are devastating to the brain.

When you have a diet that has carbohydrates in it, you  are paving the way for Alzheimer's disease. I want to be super clear about  that. Dietary carbohydrates lead to Alzheimer's disease.It's a pretty profound statement, but it's empowering  nonetheless when we realize that we control our diet. We control our choices,  whether to favor fat or carbohydrates."

High-Carb Diets Associated with 89 Percent Increased Risk for  Dementia

    As just one example, he cites research from  the Mayo Clinic, published in the Journal  of Alzheimer's Disease, which found that diets rich in carbohydrates are  associated with an 89 percent increased risk for dementia. Meanwhile, high-fat  diets are associated with a 44 percent reduced risk.

    Clearly, with Alzheimer's disease now hot in  the tracks behind heart disease and cancer as one of the top three killers in  the US, we really need to pay attention to such findings.

"[T]here is absolutely no treatment for Alzheimer's  disease. And yet, according to Dr. Deborah Barnes, publishing in the journal Lancet Neurology, more than half the cases of Alzheimer's  disease today – 54 percent – could have been prevented had people gotten this  information," he says.

    Fortunately, even if you're already having "senior  moments," you can turn back the clock, as it were. You can regenerate cells in  your brain's memory center. This occurs through a process called neurogenesis.

    According to Dr. Perlmutter, the evidence  clearly shows that high-carb diets and elevation of blood sugar is directly  related to shrinkage of your brain's memory center. And when your  hippocampus—your memory center—shrinks, your memory declines.

"That is the harbinger for Alzheimer's disease," Dr. Perlmutter says. "It's the first place you look on a brain  scan. But here is why we're having this conversation today: (1) it is  preventable and (2) more importantly, it's reversible."

 

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Saturated Fats Are a Critical Part  of a Heart- and Brain-Healthy Diet

    Like myself, Dr.  Perlmutter has been talking about the benefits of saturated fat for a long time.  Conversely, for well over half a century, the media and a majority of health  care officials have warned that saturated fats are bad for your health and lead  to a host of negative consequences, including high cholesterol, obesity, and  heart disease.

    There's little  doubt that this wholly inappropriate fat phobia has had a lot to do with our  burgeoning Alzheimer's epidemic. Fortunately, the importance of these healthy  fats is starting to become more widely recognized.

    The study concluded  that current evidence does NOT support guidelines that encourage low  consumption of saturated fat for heart health. Saturated fats, which have the  longest history of being (wrongfully) demonized, were in fact found to have NO  adverse effect on heart disease risk.

"We've been led down the wrong road," Dr. Perlmutter says. "[Saturated] fat is your friend. You  desperately need fat. You desperately need to have good cholesterol in your  body. That war on cholesterol is a perversion of the science that was even used  to tell us we should stop eating foods with cholesterol...

We know quite well that in elderly individuals, for example, those in the highest level of blood cholesterol have about a 70 percent risk reduction for becoming demented. These are the things that are good for the heart. They're good for the immune system. Cholesterol is the precursor of vitamin D, progesterone, estrogen, testosterone, and cortisol...This is probably one of the reasons why statin drugs are  so damaging. You lower cholesterol, and you set the stage for things that are  very, very worrisome."

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＊飽和脂肪酸含有量一覧 

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Diabetes Doubles Your Risk of Alzheimer's

    Dr. Perlmutter cites a study published in the Archives of Internal Medicine, which  found that women who are given cholesterol-lowering statin medication have a 44  percent increased risk for becoming a type 2 diabetic. Diabetes, in turn, doubles  your risk for Alzheimer's disease.

    Our ancestral diet was very high in saturated  fats and virtually void of non-vegetable carbohydrates. Today, not only do we  eat tremendous amounts of carbohydrates, these carbs are refined and highly  processed. In the last decade, we've also shifted over to genetically  engineered grains and sugar (GMO sugar beets and corn).

    At present, you have close to a 50/50 chance  of developing Alzheimer's disease if you live to be 85 years old, according to  Dr. Perlmutter. His mission is to radically shift those odds, by giving people  like yourself the information you need to avoid being one of the unlucky ones  destined to die without your mental faculties intact.

Alzheimer's Is Directly Related to Elevated Blood Sugar Levels

    A study published in the New England Journal of Medicine in August 2013 demonstrates that  even mild elevation of blood sugar—a level of around 105 or 110—was already  dramatically associated with an elevated risk for becoming demented. Dr.  Perlmutter believes it's very important for physicians to become cognizant of  this link, and to stop downplaying the risks associated with even mildly  elevated blood sugar.

    If your fasting blood sugar is even mildly  elevated (over 95 mg/dl), it's time to address your diet to lower it. Dr.  Perlmutter makes a very important point here, noting that "normal" blood sugar really  should not be the same as the average. It should be the optimal or ideal level.  You do not want to be right smack in the middle "average" when the population  sample is severely diseased!

    So what is an ideal fasting blood sugar  level? Dr. Perlmutter suggests that anything over 92 or 93 is too high. He  believes the ideal fasting blood sugar level is around 70-85, with 95 as the  maximum. If you're fat adapted, there's no reason to shun even lower fasting  blood sugar levels. According to Dr. Perlmutter:

"It really depends on whether you have adapted your body  to burning fat. People who have been on a high-fat, low-carb diet are able to  tap into body fat as an energy resource. They've undergone a change called  keto-adaptation. It means they're burning fat and they can get by with much  lower blood sugar because they're burning fat and don't need to worry about  blood sugar as much.

This notion that your brain needs sugar is really old  news as well. Fat, specifically ketones, which your body produces by  metabolizing your fat, is now called a 'brain superfuel.' There is even a  pharmaceutical product; a medical food that you can write as a prescription,  which raises the level of ketones or fat in the bloodstream of patients, offered  up now as a treatment for Alzheimer's disease. Who knew? The point is the brain  loves to burn fat. That's what we have to shift it over to..."

Intermittent Fasting Can 'Reset'  Your Body to Burn Fat Again

    One of  the tools I've found particularly useful is intermittent  fasting, which can really help jumpstart your body into burning fat instead  of carbs as its primary fuel. In his book, Grain  Brain, Dr. Perlmutter also starts off the intervention section with a  period of fasting, which can be viewed as pressing the Reset button. He's  particularly aggressive about it in patients who are insulin/leptin  resistant. 

    I  typically recommend keeping your fasting insulin level below 3. The so-called  normal, however, is anywhere from 5-25 microU per mL. This despite the fact  that the upper edge of this "normal" clearly indicates you have a problem with  insulin resistance! Again, you do not want to be average here. You want your  insulin/leptin levels to be ideal or optimal for health and disease prevention.

"If somebody has an insulin level of 26, they are in deep  dudu. They need a lot of work. They need to fast. They need to drop the carbs.  They need to add back the good fat. They need to add in some anti-glycating  agents like benfotiamine and resveratrol. We need to hit these people  aggressively. This is what works. This is what reduces their risk of converting  to diabetes, and therefore has a huge role to play in protecting their brains," Dr.  Perlmutter says.

Eat the Right Types of Fat, and  Remember That Food Is Information

    The type of fat you eat naturally makes all  the difference in the world. Avoid all trans fats or hydrogenated fats that have  been modified in such a way to extend their longevity on the grocery store  shelf. This includes margarine, vegetable oils, and various butter-like  spreads. Sources of healthy fats to add to your diet  include:

Avocados	Butter made from raw,    grass-fed organic milk	Raw dairy	Organic pastured egg    yolks
Coconuts and coconut    oil (coconut    oil actually shows promise as an effective Alzheimer's treatment in and    of itself)	Unheated organic nut    oils	Raw nuts, such as pecans and    macadamia, which are low in protein and high in healthy fats	Grass-fed meats

 

"Let me make one other important point. Fat, protein, and  carbohydrates are the Big Three in terms of food. That said, we've got to  understand two things: (1) the human requirement for carbohydrates is zero. We  require no carbohydrates in the diet, unlike fat and protein. (2) Well beyond  the sources of calories that we take in, food is information. The foods that we  choose to consume are instructing our DNA in terms of its expression. This is  called epigenetics. How empowering is that?

I make this point because our genome takes 50,000 to  70,000 years to make significant changes to adapt to new environments and adapt  to new foods. We are instructing our genome with this perverted information by  giving our genomes signals from high levels of processed foods and  carbohydrates. To me, job one is to get people to understand that you are affecting  your gene expression and giving it bad information. This is a cornerstone in  terms of almost every health malady that we are trying to deal with today," he says.

Exercise Promotes Neurogenesis

    Beyond its ability to burn calories and fat,  aerobic exercise is a powerful epigenetic player. It can help alter your gene  expression to code for things that will result in a longer and healthier life.  Exercise also reduces free radical production and inflammation, both of which  are drivers for chronic disease. More directly, exercise has been shown to turn  on a brain growth hormone called BDNF, which stands for "brain-derived  neurotrophic factor." BDNF codes for your brain's ability to both repair itself  and grow new brain cells. The latter occurs through a process known as neurogenesis.

    This is indeed new information. Back when Dr.  Perlmutter and I were in medical school, we were taught that once a brain cell  dies, that's it; there's no going back. This view has been completely  demolished by more recent research, which clearly demonstrates that your brain  can both regrow neurons and even rewire  itself to "work around" damaged areas. As for the type of exercise, Dr.  Perlmutter recommends high-intensity  interval training (HIIT), which provides you with the equivalent of two  hours-worth of conventional aerobic exercise in just 20 minutes.

Other Recommendations That Promote Brain Health

    Dr. Perlmutter's Grain Brain program also  includes a number of other recommendations, including but not limited to:

• Turmeric,  for its anti-inflammatory potential and ability to activate BDNF, the hormone  involved in brain health and neurogenesis.
• Monitoring  your vitamin D level. Dr. Perlmutter recommends maintaining an optimal  level of around 70-90 nanograms per milliliter (ng/ml) year-round.
• Optimizing  your gut health by reseeding your gut with beneficial bacteria (probiotics).  One recent study cited by Dr. Perlmutter correlates the risk for becoming an  Alzheimer's sufferer in various countries; countries that have a lot of  parasites in the gut as a marker of poor hygiene actually had the lowest risk  of Alzheimer's. Countries where there were no parasites in the gut or very few,  courtesy of superior hygiene, had a significantly higher risk of Alzheimer's.

"Who knew? Who knew that eating foods that have a little  dirt on them can be good, and that delivering our children through the birth  canal is so important for building their microbiome from day one? We've got a  lot to learn," he says.

    Equally important as  adding probiotics is avoiding antibiotics.  Non-breastfed babies are more prone to ear infections, which can easily set  them up for excessive antibiotic use—even though antibiotics  typically do not work for ear infections... So please, do your homework  before demanding antibiotics. Eating CAFO  meats will also provide you with traces of antibiotics in each bite. All  these antibiotics kill beneficial bacteria, and the resulting chronic poor gut  health can place your brain at significant risk.

• Measuring  your gluten sensitivity with a Cyrex [Array 3] test. Research suggests gluten  can play a damaging role by the changes it imparts on your microbiome, the  bacteria in your gut. But gluten can also wreak havoc with your neurological  health via the inflammation it causes. Non-celiac gluten sensitivity may  involve 30 to 40 percent of the population, Dr. Perlmutter says, and according  to work done at Harvard by Dr. Alessio Fasano, it may even affect every single  human being.

The reason for this  is because gluten, a protein found in wheat, barley, and rye, has significant  effects on your gut cells, which leads to the production of a chemical called  zonulin. Zonulin enhances inflammation and tends to make your gut porous and  leaky (i.e. leaky gut syndrome). But that's not all. Dr. Fasano discovered that  it can also make your blood-brain barrier leaky, allowing foreign proteins to  migrate into your brain, where they clearly do not belong.

• Fecal  transplantation, in cases of severe neurological dysfunction where poor gut  flora appears to be a contributing factor. Your microbiome is critical for  multiple reasons, including regulating the set point of inflammation, producing  neurotransmitters like serotonin, and modulating systems associated with brain  function and brain health. This form of therapy is now the standard of care for  life-threatening C. difficile infections.

A Brain Healthy Diet Will Benefit All Neurological Disorders

    It's worth noting that a high-fat, low-carb  ketogenic diet is not just for the treatment of Alzheimer's and other forms of  dementia. It's the right diet for ALL brain-related disorders, including but  not limited to:

• Parkinson's  disease (according to Dr. Perlmutter, the rate at which a Parkinson's patient  will decline perfectly correlates with the elevation of their blood sugar)
• Migraines
• Seizure  disorders like epilepsy
• Autoimmune  disorders like multiple sclerosis (MS)
• Attention  deficit hyperactivity disorder (ADHD)

Core Ingredients of a Brain-Healthy Diet

    In terms of a brain-healthy diet, Dr.  Perlmutter emphasizes the importance of favoring above-ground colorful  vegetables, as these contain less starch, which your body breaks down into  simple sugars. Healthful options include kale, chard, collards, broccoli, and  spinach. These also contain plenty of healthy fiber—you really do not need  grains to meet your fiber requirement.

    Dr. Perlmutter also recommends cooking your  food as little as possible. The more food you can eat raw, the better, especially  as it relates to your microbiome. To this, I would add fermented vegetables, to  promote healthy bacteria in your gut, and sprouted  seeds, for a boost of nutrients that is hard to match. Sprouts are also  really easy to grow at home, which is an added boon for anyone seeking to  improve their nutrition for the least amount of money. As for animal protein:

"I think that if you choose to be a meat-eater, you  should be choosing meats that are grass-fed and that are organically raised.  There's no alchemy that happens when cattle are given genetically modified  grain, treated with antibiotics and hormones, and who knows what else. There's  no alchemy that happens to create this wonderful meat. You've got to be super  selective," he warns.

"Meat, by and large, is a dangerous food with the  exception, in my opinion, of those grass-fed products – wild fish as opposed to  farm-raised, antibiotic-treated Frankenfish, pasture-raised chicken, and  farm-raised or pasture-raised eggs as well. We look at foods in terms of how  they're going to treat us with respect to inflammation, and we know that, for  example, factory farm-raised eggs are about 14 times as high in omega-6 fatty  acids, the pro-inflammatory fatty acids, as compared to natural, pasture-raised,  free-range eggs."

Take Control of Your Brain Health—For Life

    In closing, Dr. Perlmutter quotes the Yellow  Emperor of 4th century B.C. who said: "Maintaining  order rather than correcting disorder is the ultimate principle of wisdom. To  cure disease after it has appeared is like digging a well when one feels  thirsty or forging weapons after the war has already begun." Your lifestyle  choices have a huge role to play in determining whether your brain will  maintain its function throughout your lifetime, or degenerate with age into a  potentially deadly neurological disease like Alzheimer's. Again, the key  lifestyle factors that will promote lifelong brain health are:

• Eating  a whole food, low- or no-carb, high-fat diet; ideally organic with a focus on  raw foods. Your main source of carbohydrates would be above-ground vegetables,  which are low in starch and high in beneficial fiber. Every effort should be  made to keep your fasting blood sugar level at or below 85, and your fasting  insulin level below 3. Avoiding carbohydrates (think processed foods, refined  sugars, processed fructose, and all grains) along with exercise are the right  tools for this.
• Intermittent  fasting can help "reset" your body, jumpstarting its ability to use fat as its  primary fuel.
• Maintaining  a healthy gut flora by regularly eating fermented foods (and/or a probiotic  supplement), and avoiding all medically unnecessary sources of antibiotics.  This includes antibiotic treatments for viral infections (which do not respond  to antibiotics) or minor infections that can be treated with other natural  alternatives, and eating animal products (meat, dairy, and eggs) raised in  confined animal feeding operations (CAFOs) as these are fed low doses of  antibiotics for growth-promoting purposes.
• Optimizing  your vitamin D levels, ideally through appropriate sun exposure or by using a safe  tanning bed. A vitamin  D3 supplement can be used if neither of those options is feasible. Just  remember that if you take supplemental vitamin D, you also increase your body's need for vitamin  K2.