Late in 2013 a new book hit the market talking about the impact of carbohydrates on brain function. The book Grain Brain, was written by one of the most famous neurologists in the world, David Perlmutter, MD. As a brilliant board certified Neurologist and Nutritionist, for the past decade Dr. Perlmutter has been on the cutting edge of brain science – and usually a decade ahead of his peers.
Two year ago I listened to a lecture of his on Celiac disease and the impact of gluten on brain health, so I felt I already understood the point he would make in his book, I didn’t need to read it. Last month, however, one of my clients, a retired physician, gave me a copy and made me promise I would read it. I was blown away by what he had to say. No wonder it’s now a New York Time Best Seller. In this book he sets the record strait on several of the biggest myths in mainstream medicine.
Consider the following quotes regarding one of the heretofore most malevolent villains in all of medical practice and prime time commercials – cholesterol.
“Cholesterol is a critical brain nutrient essential for the function of neurons, and it plays a fundamental role as a building block of the cell membrane. It acts as an antioxidant and a precursor to important brain-supporting elements like vitamin D, as well as the steroid-related hormones (e.g., sex hormones such as testosterone and estrogen). Most important, cholesterol is looked upon as an essential fuel for the neurons. Neurons themselves are unable to generate significant cholesterol; instead, they rely on delivery of cholesterol from the bloodstream via a specific carrier protein. Interestingly, this carrier protein, LDL, has been given the derogatory title of “bad cholesterol.” In reality, LDL is not a cholesterol molecule at all, good or bad. It’s a low-density lipoprotein (hence its acronym), and there is absolutely nothing bad about it. The fundamental role of LDL in the brain, again, is to capture life-giving cholesterol and transport it to the neuron, where it performs critically important functions.
And now we have the evidence in the scientific literature to prove that when cholesterol levels are low, the brain simply doesn’t work well; individuals with low cholesterol are at much greater risk for dementia and other neurological problems. We need to change our attitudes about cholesterol and even LDL; they are our friends, not foes.” (pg 41)
But what about cholesterol and coronary artery disease? Is here such a thing as dangerously high cholesterol? Perlmutter responds by noting:
“Cholesterol is at most a minor player in coronary heart disease and represents an extremely poor predictor of heart attack risk. Over half of all patients hospitalized with a heart attack have cholesterol levels in the “normal” range. The idea that aggressively lowering cholesterol levels will somehow magically and dramatically reduce heart attack risk has now been fully and categorically refuted. The most important modifiable risk factors related to heart attack risk include smoking, excess alcohol consumption, lack of aerobic exercise, overweight, and a diet high in carbohydrates.”
Ok so that’s a pretty radical claim. What evidence does he present to back that up? You may be thinking – Well that must be pretty shallow evidence right? Wrong! Consider this. (I know you are going to want to share this with colleagues, friends and family who will likely be skeptical, so I’m quoting liberally and including a significant amount of evidence for you to share.)
“In 1994, the Journal of the American Medical Association published a trial that compared older adults with high cholesterol (levels above 240 mg/dl) to those with normal levels (below 200 mg/dl).9 Over the course of four years, researchers at Yale University measured total cholesterol and high-density lipoprotein (HDL) in almost one thousand participants; they also tracked hospitalizations for heart attack and unstable angina and the rates of death from heart disease and from any other cause. No differences were found between the two groups. People with low total cholesterol had as many heart attacks and died just as frequently as those with high total cholesterol. And reviews of multiple large studies have routinely failed to find correlation between cholesterol levels and heart disease.10 Mounting research like this has prompted Dr. George Mann, a researcher with the Framingham Heart Study, to go on record stating:
The diet heart hypothesis that suggests that a high intake of fat or cholesterol causes heart disease has been repeatedly shown to be wrong, and yet, for complicated reasons of pride, profit, and prejudice, the hypothesis continues to be exploited by scientists, fund-raising enterprise, food companies, and even governmental agencies. The public is being deceived by the greatest health scam of the century.11
Nothing could be further from the truth than the myth that if we lower our cholesterol levels we might have a greater chance of living longer and healthier lives. In a recent report appearing in the prestigious medical journal the Lancet, researchers from the Netherlands studied 724 elderly individuals whose average age was eighty-nine years and followed them for ten years.12 What they found was truly extraordinary. During the study, 642 participants died. Each thirty-nine-point increase in total cholesterol corresponded to a 15 percent decrease in mortality risk. In the study, there was absolutely no difference in the risk of dying from coronary artery disease between the high-versus low-cholesterol groups, which is incredible when you consider the number of elderly folks who are taking powerful cholesterol-lowering drugs. Other common causes of death in the elderly were found to be dramatically associated with lower cholesterol. The authors reported: “Mortality from cancer and infection was significantly lower among the participants in the highest total cholesterol category than in the other categories, which largely explains the lower all-cause mortality in this category.” In other words, people with the highest total cholesterol were less likely to die from cancer and infections—common fatal illnesses in older folks — than those with the lowest cholesterol levels. In fact, when you compare the lowest-and highest-cholesterol groups, the risk of dying during the study was reduced by a breathtaking 48 percent in those who had the highest cholesterol. High cholesterol can extend longevity.” (pg 78-79)
In a French study of individuals with ALS (Lou Gehrig’s disease) it was shown that “those individuals with considerably higher cholesterol ratios lived, on average, one year longer than patients with lower levels, when compared with normal controls. As the authors stated: “Hyperlipidemia (high levels of cholesterol) is a significant prognostic factor for survival of patients with amyotrophic lateral sclerosis. This finding highlights the importance of nutritional intervention strategies on disease progression and claims our attention when treating these Patients with lipid lowering drugs.”
In 2010, the American Journal of Clinical Nutrition published an astonishing study that revealed the truth behind urban legends about fat, especially the saturated kind, and heart disease.14 The study was a retrospective evaluation of twenty-one previous medical reports involving more than 340,000 subjects followed from periods of five to twenty-three years. It concluded that “intake of saturated fat was not associated with an increased risk of coronary heart disease, stroke, or cardiovascular disease.” In comparing the lowest to the highest consumption of saturated fat, the actual risk for coronary heart disease was 19 percent lower in the group consuming the highest amount of saturated fat.
So why is fat consumption so important for our body and brain? Among other things he notes “Certain vitamins, notably A, D, E, and K, require fat to get absorbed properly in the body…, Because these vitamins do not dissolve in water, they can only be absorbed from your small intestine in combination with fat. Deficiencies due to incomplete absorption of these vitally important vitamins are always serious, and any such deficiency can be linked to brain illness, among many other conditions.” For example, “Without adequate vitamin A, your brain won’t develop properly; you will go blind and become exceptionally vulnerable to infections. [Without vitamin K we are more prone to macular degeneration] A lack of vitamin D is known to be associated with increased susceptibility to several chronic diseases, including schizophrenia, Alzheimer’s, Parkinson’s, depression, seasonal affective disorders, and a number of autoimmune diseases such as type 1 diabetes.”
So are there studies that support the value of high cholesterol for the brain? I bet by now you can guess the answer to that one. Perlmutter notes that: “In a recent report published by the National Institutes of Health, researchers compared memory function in elderly individuals to cholesterol levels. They found that the people who did not suffer from dementia had much better memory function if they had higher levels of cholesterol. The conclusion of the report crisply stated: “High cholesterol is associated with better memory function.” In the discussion that followed, the researchers indicated: “It is possible that individuals who survived beyond age eighty-five, especially those with high cholesterol, may be more robust.”6
In the fall of 2012, a report in the Journal of Alzheimer’s Disease published research from the Mayo Clinic revealing that older people who fill their plates with carbohydrates have nearly four times the risk of developing mild cognitive impairment (MCI), generally considered a precursor to Alzheimer’s disease…This particular study found that those whose diets were highest in healthy fats were 42 percent less likely to experience cognitive impairment.” (p. 72)
He notes a study in the Neatherlands which demonstrated that Parkinson’s is also associated with lower levels of cholesterol. In fact a more recent study in 2008 showed that people with the lowest LDL cholesterol (the so called bad cholesterol) had nearly a 350 percent higher risk for developing Parkinson’s disease.
Makes ya feel like going out and eating an egg, right? (Egg yolks are high in cholesterol as well as memory building choline.) Especially those from free range chickens or those fed a diet high in Omega3’s, like algae or flax.
This also helps explain why Dr. Shea’s UMass formula – Perceptiv, and Suncrest’s Memoryze are so helpful, as they contains Vitamin E, which protects fats from oxidation, L-carnitine that helps break them down for energy, and SAMe that helps convert them into neurotransmitters for memory.
What are other sources of good fats? Those from healthy cold water fish are among the best like wild caught salmon, tuna, mackerel, and sardines. Chicken, turkey and even beef may also contain healthy fats. (Eat red meat in moderation, however, as too much red meat, especially fried or grilled has also been linked to Alzheimer’s and cancer.) In the plant world coconuts, avocados, olives, and olive oil, most nuts and seeds like flaxseed or pumpkin seeds, as well as leafy greens contain healthy oils needed by the brain to succeed.
“In one study they found in those who never ate fish, the risk of dementia and Ahheimer’s disease during the four-year follow-up period was increased by 37 percent. In those individuals who consumed fish on a daily basis, risk for these diseases was reduced by 44 percent. Regular users of butter had no significant change in their risk for dementia or Alzheimer’s, but people who regularly consumed omega-3-rich oils, such as olive, flaxseed, and walnut oil, were 60 percent less likely to develop dementia than those who did not regularly consume such oils. The researchers also found that people who regularly ate omega-6-rich oils — typical in the American diet— but not omega-3-rich oils or fish — were twice as likely to develop dementia as people who didn’t eat Omega-6 oils – found in corn, canola, cottonseed, safflower, sesame, soybeans and sunflowers.”
By the way fried or hydrogenated fats are still terrible for your brain and body. That fact has not changed. And they are especially bad in the absence of good fats as the body will try to use any fat it finds to feed your brain cells. But these make for weak easily diseased and dysfunctional cells.
So how on earth did our medical community fall for and perpetuate such misinformation?
The authors of the above noted “retrospective” review went on to note: “’Our results suggested a publication bias, such that studies with significant associations [between cholesterol and heart disease] tended to be received more favorably for publication.’ What the authors are implying is that when other studies presented conclusions that were more familiar to the mainstream (i.e., fat causes heart disease), not to mention more attractive to BigPharma, they were more likely to get published. The truth is we thrive on saturated fats. In the words of Michael Gurr, PhD, author of Lipid Biochemistry: An Introduction, “Whatever causes coronary heart disease, it is not primarily a high intake of saturated fatty acids.”15 “(pg 80)
And what about statins Lipitor Zocor etc.? Needless to say he doesn’t have much use for these as they tend to create the very state that we are trying to avoid – diabetes, impaired neurotransmission, reduced energy production, depression and dementia.
So what should we be looking at in research?
“In a subsequent report from the American Journal of Clinical Nutrition, a panel of leading researchers in the field of nutrition from around the globe clearly stated: “At present there is no clear relation of saturated fatty acid intake to these outcomes [of obesity, cardiovascular disease, incidence of cancer and osteoporosis].” The researchers went on to say that research should be directed at “biological interactions between insulin resistance, reflected by obesity and physical inactivity, and carbohydrate quality and quantity.”16 “(pg 80)
So too many simple carbs, refined or modified wheat and sugars are still the villains and maybe worse than we previously thought, but at least my boiled eggs have now been eggsonerated! : ) Pass the word!
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