Dementia: Is Gluten the Culprit? Bret S. Stetka, MD, David Perlmutter, MD January 21, 2014 Editors Note : In his new book Grain Brain: The Surprising Truth About Wheat, Carbs, and Sugar -- Your Brains Silent Killers, Dr. David Perlmutter, Associate Professor at the University of Miami School of Medicine, advocates that lifestyle modifications, starting with a high-fat, nearly carbohydrate-free diet, can prevent or greatly lower dementia risk and progression -- and hes armed with plenty of data to back up the claim. But detractors say the evidence isnt quite there. With Grain Brain about to hit its 15th straight week on the New York Times best-seller list (including a stint at the top spot) Medscape spoke with Dr. Perlmutter about his thoughts on the impact of carbohydrates and gluten on the brain. Medscape: For those unfamiliar with your ideas, can you summarize the thesis behind your new book and how you arrived at it? Dr. Perlmutter: Certainly. Im a board-certified neurologist and a fellow of the American College of Nutrition. Ive been very frustrated with neurology over the past 20 years, because were trained in residency and practice to basically treat symptoms of neurologic disorders. I found that not to be satisfying and thought it was important to delve into causality as opposed to just focus on treating the smoke and ignoring the fire. That said, with time we began seeing wonderful research citations that were drawing a link between risk for dementia, for example, and blood sugar levels appearing in our most well-respected journals. For example, a study published in Neurology in 2005[1] pointed a finger squarely at the most powerful metric being glycated hemoglobin. Even back then, it was becoming clearer that there was something going on with blood sugar correlating with rate of brain atrophy, specifically hippocampal atrophy, and cognitive decline. When you now retrospectively evaluate that study, you begin to appreciate that glycated hemoglobin is more than just a metric of average blood sugar, which is typically how its looked upon even today. Glycated hemoglobin is a glycated protein. This is a marker not just of average blood sugar, but more important, its a marker of the degree of glycation thats going on in human physiology -- a process that increases inflammation and dramatically increases the production of free radicals and oxidative stress. So the idea that even subtle elevations of sugar, which is a dietary lifestyle choice, are related to risk for brain degeneration really began to crystallize. This notion has gained traction and, I think, is profoundly supported by a couple of more recent studies. A study published in August 2013 in the New England Journal of Medicine (NEJM)[2] was very supportive, indicating that even subtle elevations of fasting blood sugar translates to dramatically increased risk for dementia. This was a prospective analysis that measured fasting blood sugar and followed 839 men and 1228 women for a mean of 6.8 years. Ill quote the conclusion: Our results suggest that higher glucose levels may be a risk factor for dementia, even among persons without diabetes. Why? These are levels of 105 and 110 mg/dL -- levels that most doctors are going to be satisfied with. However, according to the study, these numbers translated into a significantly increased risk for dementia in individuals who were not demented THIS ARTICLE IS OVER 6 PAGES LONG, I WILL SEND THE LINK TO MY NEXT POSTING
Posted on: Tue, 21 Jan 2014 20:57:04 +0000
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