Book Review of Grain Brain: Extraordinary claim not backed up by evidence

A book review by Alice Friedemann of David Perlmutter’s (2013) Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar–Your Brain’s Silent Killers.

Update February 2014: Diabetes is usually triggered by eating too many sugary and high-fat foods that cause insulin to spike, desensitizing cells to its presence. As well as causing obesity, insulin resistance can also lead to cognitive problems such as memory loss and confusion. To investigate whether beta-amyloid might also be a cause of cognitive decline in type 2 diabetes, scientists fed 20 rats a high-fat diet to give them type 2 diabetes. These rats, and another 20 on a healthy diet, were then trained to associate a dark cage with an electric shock. Whenever the rats were returned to this dark cage, they froze in fear – measuring how long they stayed still is a standard way of inferring how good their memory is.  As expected, the diabetic rats had weaker memories than the healthy ones – they froze in the dark for less than half the time of their healthy counterparts. You can read all the details at NewScientist in Are Alzheimer’s and diabetes the same disease? 28 November 2013 by Jessica Griggs

Update December 2013: The Atlantic Monthly has just published an article about this book called “This Is Your Brain on Gluten” by James Hamblin. Below are some excerpts:

1) “In the Paleolithic Era, human life expectancy was around 30 years… humans did not live past their 50s. I wonder often why these are the times we cite as a standard of health. The paucity of old age should in itself explain why Alzheimer’s and cardiovascular disease were basically nonexistent”

2) Dr. David Katz is an epidemiologist who has published two editions of a nutrition textbook for healthcare professionals called Nutrition in Clinical Practice. Perlmutter estimates the Stone Age diet was 75% fat, a claim Dr. Katz finds “wildly preposterous. Anthropological research… suggests that in the age before cooking oil, humans ate mostly plants with a scattering of seeds and nuts. Virtually nothing in the natural world is that concentrated of a fat source, except maybe for the brain. Maybe if they just ate the brains of animals? They didn’t have oil. They only started adding oil to the diet after the Dawn of Agriculture. What the hell could they possibly have eaten that would be that fatty?'”

I have an excellent example of how absurd Perlmutter is to say our diet used to be 75% fat. In the amazing chronicle of Lewis and Clark Undaunted Courage: Meriwether Lewis, Thomas Jefferson, and the Opening of the American West, venison and elk meat was so lean (per 3.5 ounces: 4% fat, versus 35% fat in beef), that even though each expedition member ate up to 9 pounds of meat a day,…they were still hungry (p 165). Later in the book, Lewis remarks “that he didn’t care what kind of meat he got, whether elk or dog or horse or wolf, so long as it was fat”. Sacagawea brought the men some roots to eat which was a welcome addition to “the virtually all-meat diet…which if not complemented by other food might lead to scurvy, … the men of the expedition at various times did suffer from scurvy. It was an age in which almost nothing was known about a balanced diet.” A diet that sounds a lot like what Perlmutter is recommending!

3) Dr Katz goes on to say that Perlmutter’s “book is filled with a whole bunch of nonsense, that’s why it’s a bestseller. …That’s how you get on the bestseller list. You promise the moon and stars, you say everything you heard before was wrong, and you blame everything on one thing. You get a scapegoat; it’s classic. Atkins made a fortune with that formula. we now have Perlmutter saying it’s all grain. There’s either a scapegoat or a silver bullet in almost every bestselling diet book. The recurring formula is: Tell readers it’s not their fault. Blame an agency; typically the pharmaceutical industry or U.S. government, but also possibly the medical establishment. Offer a simple solution. Cite science and mainstream research when applicable; demonize it when it is not.

Dr. Katz gives Perlmutter too much credit for the few scientific citations he has — if he had read the papers cited (I read all of the original papers), he would have discovered that they do NOT support Perlmutter’s claims about whole grains and dementia (which is what my review below focuses on since it would take a book to refute every piece of nonsense — See #10 below).

4) Perlmutter’s advice is POTENTIALLY LETHAL. Hamblin asks: “What is the worst that can come of avoiding gluten and limiting carbs? That depends entirely on what you replace those calories with. I read the book with an eye for the most dangerous claim. What stuck out to me was Perlmutter’s case for cholesterol. He basically says that we can’t have too much. Beyond that, Perlmutter says that cholesterol-lowering statin medicines like Lipitor, which are prescribed for a quarter of Americans over 40, should actually be vehemently avoided. Cholesterol is necessary for the brain in high levels, he says, and lowering it is contributing to dementia. Dr. Katz replies: “..can we totally ignore both dietary cholesterol and LDL? Absolutely not…Ignoring LDL could absolutely result in heart attacks and strokes”. Katz acknowledges that dietary cholesterol may be an innocuous part of an overall healthy diet. “The problem is that people are going to get their dietary cholesterol from things other than fish and eggs; they’re going to get it from meats and dairies. The problem with diets like that is if you eat more of A, you’re probably going to eat less of B. So people who are eating more meat and dairy and high-fat, high-cholesterol foods are eating fewer plants–they’re not eating beans; they’re not eating lentils. So yes, I think it’s entirely confabulated and contrived, and potentially dangerous on the level of lethal.”

5) “We do not have reason to believe that gluten is bad for most people. It does cause reactive symptoms in some people. Peanuts can kill some people, but that does not mean they are bad for everyone. Diets consistently shown to have good long-term health outcomes—both mental and physical–include whole grains and fruits, and are not nearly as high in fat as what Perlmutter proposes. I hope people don’t give up on nutrition science, because there is a sense that no one agrees on anything. An outlier comes shouting along every year with a new diet bent on changing our entire perspective, and it’s all the talk. That can leave us with a sense that no one is to be believed. When a person [like Perlmutter] advocates radical change on the order of eliminating one of the three main food groups from our diets, the burden of proof should be enormous. Everything you know is not wrong.”

At the New York Times, this book was the #1 best seller in the Dining list and #9 in the Advice, How-To & Miscellaneous list in November 2013.

Dr. Oz endorses this book on the front cover with the blurb “An innovative approach to our most fragile organ” and on the back cover he says “Dr. Perlmutter is an absolute leader in the use of alternative and conventional approaches in the treatment of neurological disorders. I have referred patients to him with wonderful results”.

Dr. Perlmutter was practically unknown until Dr. Oz discovered him.  He is touted as a “board certified neurologist”.

One of the few references I could find to his past was his presentation of “Mitochondrial Therapy – A Powerful Approach to Brain Functional Enhancement” at the 17th Annual World Congress on Anti-Aging and Regenerative Medicine in  2009. This presentation explored “the body of science validating the use of specific oral supplements targeting mitochondrial functional preservation and enhancement including coenzyme Q10, acetyl L-carnitine, and N-acetyl cysteine and intravenous therapy with glutathione”.

Whole grains cause dementia?

The title “Grain Brain. The Surprising Truth About Wheat, Carbs, and Sugar – Your Brain’s Silent Killers”, and front cover blurb “carbs are destroying your brain. And not just unhealthy carbs, but even healthy ones like WHOLE GRAINS can cause dementia, ADHD, anxiety, chronic headaches, depression, and much more”  lead you to expect new scientific discoveries have found a connection between eating whole grains and all sorts of other major diseases.

Wow! This is such an incredible claim.  And there is not one shred of evidence in the book to back it up.

#1 If whole grains caused dementia etc., it would be headline news in medical journals, the New York Times, and TV news.  

But it isn’t.

#2  Perlmutter provides no evidence to support his idea. None.

Perlmutter hasn’t published peer-reviewed papers about anything –not in his field of neurology our outside of his field in nutrition.

To prove his point, he often cites what he calls a Mayo clinic paper in Grain Brain, TV, radio, and internet articles. He says that “Relative Intake of Macronutrients Impacts Risk of Mild Cognitive Impairment or dementia”, shows people favoring carbohydrates in their diet had an 89% increased risk of developing dementia. But those who ate the most fat had a 36% reduction in risk.

Not true.  In this study:

  • No one developed dementia.
  • Mild Cognitive Impairment (MCI) is a controversial diagnosis. It just means someone has mild problems with language, thinking, memory and judgment. Many physicians think these are normal symptoms of aging.  MCI often goes away.  Most people diagnosed with MCI do not go on to develop dementia or Alzheimer’s.
  • The words “whole grain” or “whole wheat” do not appear in this study.  No effort was made to distinguish healthy whole grains from refined carbohydrates.
  • This was an observational study.  It can only show a correlation between two things, not cause-and-effect.  There could be other factors in the participants’ lives that explain the results.
  • The subjects self-reported their dietary intake. Its well-known people aren’t good at this.

There are only 7 peer-reviewed references in Grain Brain that have anything to do with both carbohydrates and dementia.  Not one of these papers mentions whole grains or whole wheat. Two of the papers apply only to the 1% of the population with Celiac Disease.  Five of these 7 papers apply only to people with celiac disease or gluten sensitivities (at most 6 to7% of the U.S. population).

Perlmutter says that because 70% of our brains are fat, we should be getting 50-60% of our calories from fat.  That’s more than twice what the Mayo Clinic and every other expert says.  They all recommend 20-35% of total daily calories from fat, 45-65% of your daily calories from carbohydrates, and 10-35% of calories from protein (Zeratsky, Mayo Clinic Staff, U.S. Dept of Health and Human Services).

Goodbye nutrition, hello cardiology.

I know people are really angry that sugar and white flour may be as bad as fat, but that doesn’t mean going to the other extreme and eating so much fat you’ll get a heart attack.

Perlmutter cites studies to show fat prevents dementia, but if you actually read these studies (free and available online), it backfires.  He advises not eating much fruit, yet the conclusion of one of the papers “Dietary Patterns and Risk of Dementia: The Three-city Cohort Study” concluded “Frequent consumption of fruits and vegetables, fish, and omega-3 rich oils may decrease the risk of dementia and Alzheimer disease”.

At his website he cites “Evidence-Based Guideline of the German Nutrition Society: Carbohydrate Intake and Prevention of Nutrition-Related Diseases”.  Oops again. Perlmutter spends a lot of time trying to show that carbohydrates (and therefore whole grains) lead to diabetes, which leads to dementia), but this paper says the opposite: “a high dietary fibre intake, mainly from whole-grain products, reduces the risk of obesity, type 2 diabetes, cardiovascular disease and colorectal cancer”.

#3 On the other hand, there is a lot of evidence showing that whole grains are really good for you

Thousands of peer-reviewed studies in scientific journals over many decades show whole grains can reduce heart disease and certain types of cancer, among other diseases..

The main cause of death in America and most of the world is heart disease. One of the few health claims the FDA allows is “Diets rich in whole grain foods and other plant foods, and low in saturated fat and cholesterol, may help reduce the risk of heart disease.” (FDA Health Claim).

The March 2008 issue of Consumer Reports says that eating whole grains is the #1 action you can take to improve your health (besides quitting smoking).

According to the World Health Organization Global Burden of disease 2010 study, the 16th leading cause of early death and disability is not eating enough whole grains (The Lancet).

In 2004 (Nutrition Research Reviews 2004), Dr. Joanne Slavin of the University of Minnesota published a comprehensive article that reviewed and compiled scores of recent studies on whole grains and health, to show how whole-grain intake is protective against cancer, cardiovascular disease, diabetes and obesity.

In 2010, the American Society for Nutrition brought researchers together to review the evidence of whole grain health benefits. Current scientific evidence shows that whole grains play an important role in lowering the risk of chronic diseases like coronary heart disease, diabetes, and cancer, and also contribute to body weight management and gastrointestinal health. The findings were published as a supplement to The Journal of Nutrition in 2011.

#4 The Mediterranean diet has lots of whole grains

People eating a Mediterranean diet are among the longest-lived on earth and they’ve been studied for decades. Italy has the 4th longest lifespan in the world!

These diets have lots of carbohydrates and lower dementia, heart attacks, blood pressure, cancer, and strokes.

U.S. News and World report has ranks diets from best to worst.  All of the top diets recommend whole grains ( Mediterranean diet, Mayo Clinic, DASH, and TLC).  Diets were ranked by 22 experts including many physicians and nutrition professors based on: how easy to follow, short and long-term weight loss, nutritional completeness, safety, and prevention of  diabetes and heart disease. The Paleo diet came in last, and Atkins was also very close to the bottom.  This is actually a Paleo book, and I don’t have time to debunk all the myths of this practically-a-religion-diet, but if you’re interested, I highly recommend Paleofantasy: What Evolution Really Tells Us about Sex, Diet, and How We Live.

#5 We already know what the causes of dementia and Alzheimer’s are from tens of thousands of studies. Whole grains have nothing to do with it.

The risks are: Being over 65, genetic (5%), female (women live longer), severe or repeated head trauma, lack of exercise, smoking, high blood pressure, high blood cholesterol, poorly controlled diabetes, not enough fruits & vegetables, lack of social engagement. You’re at lower risk the more education you have, a good job, have mentally challenging hobbies like reading or playing a musical instrument, and lots of social interactions.

#6 Grains are the basis of civilization. Over the past 10,000 we evolved to eat grain. So did dogs.

Our genetics have even changed to adapt to eating grains — those with ancestors from a farming region have up to 7 times as many amylase genes to digest starch as a hunter-gatherer gene (Perry, Hancock).  Cochran’s book The 10,000 Year Explosion: How Civilization Accelerated Human Evolution makes the case we evolved faster the past 10,000 years to adapt to agriculture than we did the previous 6 million years.
One of the top peer-reviewed science journals in the world, Science, has a 2013 article titled “Diet Shaped Dog Domestication”. DNA from wolves and dogs was compared and it was clear that dogs had evolved to digest starch 5 times better than wolves.


#7 Even before agriculture most people ate a lot of carbohydrates

In California, half the diet of most hunter-gatherer tribes was acorns. Tribes across America depended heavily on acorns, as well as tribes across the Eurasian continent. Acorns are 43% carbohydrate.
Bits of starch grains have been found on the grinding stones from 30,000 year old sites in Italy, Russia, and the Czech Republic, where our ancestors made flour from ground up plants, combined it with water and made a pita bread on stones heated in fires. Our ancestors were smart to grind roots so the flour could be stored or carried, since often game animals were seasonal and no meat was to be had many times of the year.

Eating carbohydrates could go back for millions of years. Fossil hominids had such sturdy premolar teeth it’s believed they were probably used to open seeds and chew starchy underground tubers and bulbs. Even Neanderthals ate starch, which we know from studying the plaque on their teeth.

Anthropologist Frank Marlowe studied the eating patterns of 478 groups around the globe. He found that no matter where you live, at least a third of your diet is going to come from plants (and in many places nearly all of your diet), so the idea our ancestors were mainly carnivorous is not true.

#8 Did Perlmutter single-handedly disprove decades of peer-reviewed studies about whole grains, the causes of dementia and Alzheimer’s, and that high fat diets do NOT lead to heart disease? 



#9 Testimonials are not proof. Only peer-reviewed science in top-tier journals counts

Testimonials are NOT SCIENCE –and Dr. Perlmutter MUST know this if he has an advanced degree. Only peer-reviewed science counts. Most of Perlmutter’s “proof” are the testimonials of his own patients.

#10 Comparing whole grains to refined carbohydrates is like comparing wild Alaskan King Salmon to deep-fried Spam (sorry Hawaii)

If Perlmutter had read any nutrition textbooks, or even done a simple internet query, he would have quickly and easily discovered how healthy whole grains are.  How could he possibly say that whole grains are as bad as refined carbohydrates like white flour for your health?  He doesn’t have any evidence for that in his book or at his websites.

Whole grains are alive.  They’re seeds – full of all the nutrition a baby plant needs to grow. They’re like mini-vitamin pills, one of the densest sources of nutrition on the planet. Bread wasn’t called the staff of life for nothing.

White flour is unhealthy, nutritionally bankrupt, stripped of all fiber, most protein, vitamins and minerals.  Why isn’t that a crime?

White flour has had the bran and germ removed so it’s just a starch. It no longer behaves like flour, so up to 30 chemicals are added (many of them banned in Europe). White flour has no fiber, up to 88% of 21 vitamins and minerals are removed (they’re mostly in the missing bran & germ), all the essential healthy oils, phytochemicals, and most of the protein too.

David Kessler, former head of the FDA, writes in The End of Overeating: Taking Control of the Insatiable American Appetite that more than any other product, baked goods have more sugar, salt, and fat than other products to hide these sour, bitter chemical flavors.


#11     7 Billion people can’t be wrong!

4.6 Billion people get most of their calories from carbohydrates.  The other 2.4 Billion of us, the wealthiest third, get about half our calories from carbohydrates.

Meat, seafood, dairy products, fresh produce, and fruit are expensive.  They need refrigeration, which will only last as long as fossil fuels provide reliable electricity 24 x 7.   After that, all 7 billion of us will get most of our calories from grains and legumes (carbohydrates), just like we have for ages.

Civilization depends on grains and legumes because they can be stored for many years and outlast bad harvests.  As climate change makes growing food less reliable, we’ll be more dependent on grains than past civilizations were.

#12 Why are not just quacks, but a tiny number of legitimate nutrition professors attacking whole grains?

When you look into it, the only criticism a few actual experts make is that whole grains have a high glycemic index.  They are criticized by their colleagues, much as climate scientists dismiss climate change deniers, because they only have this one argument. They totally avoid mentioning that whole grains have fiber, protein, vitamins and minerals that don’t exist in white flour.  Instead, they say whole grains and white flour are equal because they both have a high glycemic index.

But that’s not true.  You don’t eat bread or cereal alone.  Sandwiches have butter, lettuce, tomatoes, ham; cereal has nuts, milk, and/or fruit. The additional ingredients, or any other food eaten with bread or cereal lowers the glycemic index.
I can’t prove it, but I suspect industrial food companies are funding scientists to speak out against whole grains.

Why?  The basis of processed food is cheap ingredients. Fat, sugar, salt and white flour are almost as cheap as water. Michael Moss writes about this in Salt Sugar Fat: How the Food Giants Hooked Us .  The multi-billion dollar food industry also hates whole grains because they have a shorter shelf-life than white flour.
So if there’s anyone who makes money off of attacking whole grains, it would be the processed food industry.

They’d do it by making lucrative engagements available to scientists who criticize whole grains by paying them a lot to speak at conferences and on TV and radio shows.

You can find many examples of how this is done in Bending Science: How Special Interests Corrupt Public Health Research and Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming

I also wonder who paid Amazon to give 19 Amazon Vine Reviewers free copies of Grain Brain a month before the book was published.  On the main amazon page for Grain Brain, the first three customer reviews are all by Amazon Vine reviewers (and they each gave the book five-stars).  The odds are really good that these early Amazon Vine reviews would stay at the top, where everyone  seeS them, because the “Most Helpful Customer Reviews” are shown first, and people are most likely to vote for the reviews at the top.  My review has been found helpful by 239 of 318 people and gotten 37 mostly angry comments that attack me with straw man and ad hominem fallacies, with a good measure of hostile vituperation. But so far, no comments have provided any peer-reviewed evidence.

#13 Perlmutter knows other factors are to blame

Most of Grain Brain is about getting exercise, sleep and other topics.   But not grains and brains.



It’s too much work to separate the wheat from the chaff in this book.

The only way to protect yourself from quacks is to know what we know and how we know it by reading books and articles based on peer-reviewed science.

There are a lot of good books at the library, or free information at medical websites like the Mayo Clinic, the U.S. Dept of Health and Human Services publication  Dietary Guidelines for Americans 2010, or nutrition textbooks like Nutrition for Health and Health Care that are based on evidence from peer-reviewed science.


FDA Health Claim §101.77   Health claims: fruits, vegetables, and grain products that contain fiber, particularly soluble fiber, and risk of coronary heart disease.

Hancock, A. M., et al. “Colloquium Paper: Human Adaptations to Diet, Subsistence, and Ecoregion are Due to Subtle Shifts in Allele Frequency,” Proceedings of the National Academy of Sciences 107:8924–8930 (2010).

Mayo Clinic staff. Healthy diet: do you follow dietary guidelines? Get the scoop on dietary guidelines for key nutrients, such as carbs, protein, fat, sugar, and salt.

Perry, G., et al. Diet and the evolution of human amylase gene copy number variation. Nature genetics 39 (2007).

The Lancet. Global Burden of Disease Study 2010.  December 2012.

U.S. Dept of Health and Human Services.  Dietary Guidelines for Americans 2010.

Zeratsky, K. to monitor how much fat I eat each day, which should I focus on—fat grams, calories, or percentages.


What the Whole Grains Council had to say about this book:

Celiac disease and gluten intolerance are real and serious issues. People with celiac disease (1-2% of the population) or non-celiac gluten intolerance (estimated at about 6% of the population) can indeed have medical issues not only with their digestive systems but with other organs including the brain, and these people will benefit from removing the four gluten grains – wheat, barley, rye and triticale – from their diets.

Even the 7-10% of people with a reaction to gluten, however, can continue to enjoy all the non-gluten grains: amaranth, buckwheat, corn, millet, oats (if certified as non-contaminated), quinoa, rice, sorghum, teff, and wild rice. The rest of the population can enjoy these ten grains along with the four gluten grains. Leading medical researchers in the area of gluten intolerance and celiac disease attest that there is no need for 90 percent or more of our population to avoid any grains.

Put simply, there is no evidence for the idea we should all avoid all grains. Perlmutter must realize this himself, since Grain Brain contradicts its main premise that all grains are injurious to brain health, and recommends eating, in moderation, “amaranth, buckwheat, rice (brown, white [sic], wild), millet, quinoa, sorghum, teff and [gluten-free] oats.”

In fact, evidence for the health benefits of whole grains is well-documented at the whole grains council website – and was touted by Grain Brain’s author in his earlier book The Better Brain which included foods like whole grain couscous, oatmeal, spelt pasta, and quinoa-stuffed peppers throughout its menu plans. In an interview promoting The Better Brain on CBN-TV, for instance, Perlmutter advocated replacing junk food with “real food such as unprocessed whole grains and fruits and vegetables.” He does not acknowledge or explain his flip-flop in Grain Brain, giving us no clue why he has now turned against what he previously acknowledged to be sound science.

While Grain Brain goes off the deep end in imagining that the very real health problems of the 7-10% of the population with gluten intolerance or celiac disease somehow extend to all of us, the book rightfully details many important components of good health that Oldways and the Whole Grains Council have long supported. These include the key roles of physical activity and sleep; the essential contribution of good fats; the value of the Mediterranean Diet (which Perlmutter cites as “very similar to my dietary protocol”); and the importance of avoiding inflammation and choosing carbohydrates with a low glycemic impact.

Our advice? Don’t let Grain Brain scare you away from appropriate-size portions of healthy forms of whole grains (yes, a whole grain cookie is still a cookie!). Enjoy a balanced diet including a delicious variety of real, whole foods, an approach followed in traditional diets backed up by proven science, like those championed by Oldways. What are the Health Benefits?

If you liked my review, vote you found it helpful at amazon



About Alice

I've milled and baked with whole grains for many years, because whole grains are delicious, and white flour is missing the nutrition that protects you from cancer, stroke, heart disease, diabetes and many other diseases. Plus it's a good emergency food.
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30 Responses to Book Review of Grain Brain: Extraordinary claim not backed up by evidence

  1. BP says:

    It’s very clear that either you did not read this book or you are painfully ignorant.

    • Alice says:

      I wrote my review hoping to get people to ask themselves “How can I tell what’s true from what’s false?” What is good evidence, what is bad evidence? There are so many wrong ideas in this book that it was impossible to mention and disprove all of them, so I chose just one claim: “whole grains cause dementia”. Then I looked at every single peer-reviewed citation in the book to see if it was about grains and dementia and backed up what was written in the book. At best he finds tenuous links between people with celiac disease and potential dementia — but nothing for the other 99% of us. If you care about not being tricked and your health potentially harmed and your money stolen by quacks, one of the best books I know of about evaluating evidence is “Know Your Chances: Understanding Health Statistics”.

      • BP says:

        I can’t say that I’m shocked that someone who runs a website called “” would vehemently attack a respected neurologist as a “quack” despite the extremely numerous and thorough studies cited in the book. Much of your reasoning is analogous to people citing the AMA’s promotion of cigarettes as healthy in the first half of the 20th century.

        It’s typically a best practice to read a book prior to writing a review. Your points clearly show that either you A) are making hollow and unfounded statements based off of an inaccurate summary you’ve read or B) an explicit attempt to misguide your readers to keep the wool firmly in place, over their eyes.

        • Jon says:

          Dear BP, you are clearly resorting to attacks against the person instead of his/her arguments.

          From what I’ve heard, it seems the author is confusing correlation with causation. Maybe it is he who doesn’t understand the science…

          Alice’s arguments were very logical, exactly what part did you oppose? Or maybe you didn’t even read her review… DID YOU, DOCTOR PERLMUTTER?!

          To be fair, he did refer in an interview to a study published in NEJM that states

          with a glucose level of 115 mg per deciliter (6.4 mmol per liter) as compared with 100 mg per deciliter (5.5 mmol per liter), the adjusted hazard ratio for dementia was 1.18 (95% confidence interval [CI], 1.04 to 1.33). Among participants with diabetes, higher average glucose levels were also related to an increased risk of dementia (P=0.002); with a glucose level of 190 mg per deciliter (10.5 mmol per liter) as compared with 160 mg per deciliter (8.9 mmol per liter), the adjusted hazard ratio was 1.40 (95% CI, 1.12 to 1.76).


          • Alice says:

            I’m not sure what the NEJM reference proves–how does glucose being somewhat associated with dementia have anything to do with whole wheat?

  2. David says:

    This is a pretty good book half way through and love it. A good addition to wheat belly. I have felt like crap and gained weight for years. I quit wheat by accident in August and lost 45# in 6-8 weeks. My girlfriend lost 35 and cut her sugers in half. My son has lost 10# he is 9. My mother lost her last 5 as she is 5’7″ 128. We all feel better no brain fog, headaches or IBS. Unless accidently wheated by something that should be wheat free. Then its 2-3 days of feeling like crap with bloating and 3-5# of weight gain. Eat wheat if you dare but noneof us willl again. Oh and global warming we just cracked the 3rd highest global sea ice extent in satellite record. If you start the Arctic from 1971 when it was at its lowest on record its hard to get excited. That is why the start the series in 1979.

    • Alice says:

      When you quit “wheat” you are quitting white flour, very few products have whole wheat in them because it’s too expensive. The only way you could have quit “whole wheat” is if you were baking your own bread and other whole wheat products from scratch at home. It is great that you quit white flour — I have no quarrel with that. White flour has no nutrition. No fiber. But you’re throwing the baby out with the bath water to give up on whole wheat and other whole grain carbohydrates.

      I’m making a scientific argument about truth and testable reality. Personal testaments are not legitimate arguments in the realm of science. And they’re not a good way to know if something is true or not — if that’s how you try to figure out who’s telling the truth then you are like a sailboat without a sail drifting about in the deep ocean. It’s hard to argue with the fact that the longest lived people on earth eat whole grains.

  3. Brandy says:

    Thank you Alice!
    First I will mention I have a Master’s Degree in Molecular Biology, which is only to say that I understand the scientific process involved in this type of research and discussion. I’ve read extensive reviews of the book, from both supporters and skeptics, and I greatly appreciate the points you make. Many people don’t understand that a lack of peer reviewed publications is a red flag (thanks for including your literature research), or the difference between a study that shows a correlation vs. cause and effect. I agree totally that the issue here should be with refined/processed ‘whole’ wheat and grains. Maybe one good thing to come of this book and the attention its getting would be for the FDA to reverse the slack definition they set for “whole grains” some time ago. Otherwise I think it’s an irresponsibly written book with no scientific references.

  4. Jay says:

    When I read the forgoing critical reports on Dr. Permutter’s book I found no references to genetic modification. I find it hard to believe that this criticism can be accepted at face value with out dealing with that issue. Are today’s whole grains the same as yesterday’s whole grains? Granted more study is needed on this but it should not be ignored as it is a possible harmful process affecting the nutritional value of whole grains.
    Likewise I find a lack of substantial reference to sugar especially its over abundance in our diet to be a serious omission further devaluing the critical reporting. Is it not true that over use of sugars especially some types (such a high fructose) are seriously harmful to our health.
    It is suggested that early peoples had little access to saturated fats. This is not wholly true. Many would have had access. Those by the sea would have had marine mamals rich in this type of fat. They and many others would have had various palm oils and birds eggs. All wild animals would have had this fat in varying quantities.
    The last concern I have relative to the criticism is to what extent are the critiques influenced one way or another by the grain indusrty or other 3rd parties adverse to his claims.
    On the positive side for the critical material the lack of peer reviewed work on his part does cause concern.

  5. @TheGirlPie says:

    Thank you, Alice, for your thorough and well-written review (which I first read on Amazon and traced you here from there.) You raised so many good points that the layman will bristle at, since (sadly) “well, it makes sense to me” seems to be all the science most people need or want. I’m guilty of it too, of course. But your POV on the subject (which most of your objectors ignore, miss-read, or can’t comprehend), was so clearly written that I realized how quick I am to hop to the latest idea that “seems true” — without thinking it all through from every angle as you have done for us.

    Thank you, Alice. I’ve bookmarked your other reviews and look forward to learning more from your good works. (And I’m sure I speak for the hundreds that find your review helpful but just haven’t taken the time to thank you personally.)

    Happy crackers to you —

  6. Galen Garrison says:

    Thorough and well-written critique. Thank you for investing the time.

  7. Carrie says:

    Thank you, Alice, for your thoughtful exposé of Perlmutter’s book. I’m a physician in training with backgrounds in therapeutic plant-based nutrition and neuroscience, so admittedly I pored over the pages of “Grain Brain” with a skeptical eye. The claims made in the book went against almost everything I have learned over the past decade, yet I kept an open mind. Being the scientist that I am (I’m currently on research fellowship, and honing my lit review skills is my job), I took it upon myself to index every reference Perlmutter has listed to assess its validity and correspondence with his conclusions. I was outright shocked to find almost zero correspondence between the papers he has referenced and the theories that he pontificates upon as if they are well-established scientific fact. I couldn’t believe that anyone could get away with publishing outright lies (and in the name of science, no less) and make millions off of people’s gullibility and faith in doctors and scientists. It’s physicians like Perlmutter that make me ashamed to be joining the ranks of doctors in this country–doctors who are increasingly making a bad name for the physician community as a whole as they capitalize upon patients’ vulnerabilities and lack of education. Because after all, it is a certain degree of elite education that can teach one how to truly and earnestly pick apart a research publication, analyze its statistical analyses and methodology, and decide for oneself whether or not the study stands–it’s not as simple as reading an abstract or skipping to the concluding remarks, as so many unfortunately believe. Anyway, long story short, I am appreciative of your courage to take the time to reveal the truth, as I have had zero luck with contacting the publishing company to inform them of this considerable and abominable error. Perlmutter’s book is a stain on the reputation of physicians, and has enormous repercussions for a society grappling at the hands of chronic diseases of affluence–diseases which could very easily be remedied not with more protein, fats, and animal products as Perlmutter would have his readers believe, but with a whole-grains-inclusive, plant-based diet. I truly hope that many who have been wrongfully grain-brainwashed find themselves on your site and learn that not all books, nor physicians, can be trusted.

  8. Kathye Edwina Arrington says:

    Thank you for this information. I have to admit the when I saw Dr. Perlmutter on Dr. Oz. I was scared to death! I didn’t know what to eat at first. I lost 30 pounds in two weeks because I was to afraid to eat. Now I feel better that I can make better choices.

  9. Kmac says:

    I just can’t believe a review of an anti grain book, written by a pro grain website.

    • Alice says:

      One of my other interests in life is critical thinking skills, and I’m also a science writer. My opinion about grains is irrelevant. I have evidence in my review that what Perlmutter wrote is flat out wrong and even dangerous, and tried to show the reader how to do their own research the next time they encounter a book that throws all scientific evidence out the window. Perlmutter is very similar to Climate Change Deniers in ignoring evidence and making up his own.

  10. Jeanie says:

    Alice, thank you for your insightful review. I echo the sentiments expressed in the several previous replies that agree with you. At this moment I’ve just watched “BrainChange” with Dr. Perlmutter on Public Television. I was very interested in the program and amazed at the “facts” being presented. So amazed that I then did a search on his book and wound up here. I have a great respect for Public Television and the many informative and entertaining programs it provides. So I am horrified because I now think that they have almost been DUPED into presenting this mish-mash of theory and conjecture by someone who is a reasonably charismatic speaker with a slickly packaged product.
    I think they should pull the program from their line-up and I hope this point of view makes its way around the internet like wildfire. Thanks again for your candor and factual references! J.

  11. Janny says:

    I admit that I “ran” out and grabbed Perlmutter’s book after a friend of mine threw a pitch at me, telling me how he lost 18 pounds in the first three weeks from changing all his food choices to match what was in the Grain Brain book. I did not have to get far into that book to see the many red flags just a flyin in the wind! I am not interested in increasing my cholesterol to chase a healthy brain. What use is my brain if I’m six feet under as a result from eating high fat, high cholesterol foods?
    After I finish the book (and I will, for the sake of educating myself about deception tactics book writers use), I’ll take the road of Alice, and dig up some of my own research, then post my findings, with references.
    Thanks Alice, for what you are doing. I appreciate it.

  12. James says:

    I’ve changed my diet beginning in 2014 after reading his book and have lost 20 lbs. It’s not just the grains (ie. bread), but all the other crap in the U.S. diet that is basically sugar….and all the high fructose corn syrup that’s added to damn near everything we consume. Low carb, high fat and protein diet is what I’ll be on the rest of my life. Don’t be confused, you can still eat carbs and the worst ones too–but infrequently. Do your research and learn which carbs to eat. I feel better, sleep better and think better. ; ^ )

  13. Richard D. says:

    I’m in the 4th week of internalizing Perlmutter’s GRAIN BRAIN book. I first became aware of the entire gluten “iceberg” when I heard him on PBS. He is indeed an effective speaker. I do not know if he will prove to be correct as time passes. I watched my mother die from ALZ starting ~ 2007 and ending in January, 2012. The process of her death was terrifying to watch. That is the reason for my interest in Perlmutter… She was an ARDENT, COMMITTED, low-fat, high grain, vegetable oil advocate for ~ 30 years… yet she died from a wasting, degenerative disease that I personally find astounding in someone so committed to “healthy” eating of everything in “moderation” (her personal mantra). My dad was a victim of the nasty side effects of Lipitor 5 years earlier. Sooo, I’m willing to listen to the Perlmutters of this world when they skewer the monstrosities of Big Pharma and Big Food Processing, Big Marketing, Big Greed, and Big Corporations. I believe that beyond a reasonable size, all organizations exhibit bad tendencies. How do we judge the veracity of

    • Alice says:

      How to judge my review of Perlmutter’s book? EVIDENCE. PEER-REVIEWED. We KNOW what causes Alzheimers, I list the reasons in the review, which I don’t think you’ve read or you wouldn’t have written the above. Most of my book reviews skewer Big Food Processing, Big Greed, Big Corporations, another reason I don’t think you’ve read my review.

      • Gary says:

        Brain Grain seems to follow Dr. William Davis’s book “Wheat Belly”. Can you comment on Dr. Davis’s recommendations. Does he site any acceptable peer-reviewed science in his book? My take from both books was that wheat raised blood sugar levels and that these evaluated blood sugar levels cause glycation? Is this a correct conclusion? If so, can the effects of this glycation process cause damage to the brain? What should a good peer review study look like and how long will it take for such studies to provide us with acceptable data? Finally, besides loosing weight, which I do not need to do, do you see any life threating harm in following these low carb plans while the peer-reviewed scientific data is collected?

        • Alice says:

          The peer-reviewed evidence to refute Perlmutter has been around for FIFTY YEARS. That’s why it’s so outrageous for him to make claims with no evidence to back them up whatsoever – I looked at every single one of his citations.

  14. Keith Akers says:

    Great review. You’ve saved me, and probably numerous other thinking people, the time and energy of wading through this sort of trash. The replies are also interesting; I’m also grateful to you for resisting the urge to hit the “delete” button and instead to take a few moments to point out the obvious.

  15. cindy says:

    My husband has multiple sclerosis. We went to the neurologist today and told him we had stopped the statins. My husband has been on them for over ten years, and he had an an attack that is attributed to MS. He is 64. I want his brain to be healthy and to strengthen his immune system. The neurologist asked me where I got my doctor degree. I should not have made such a drastic decision based on one person’s words in a book, but it sounded like it made so much sense. It scares me when I do not know who to believe, especially when my husband’s health is at stake. In the Grain Brain, it made such claims of statins causing damage by preventing fats from getting to the brain and how the brain needs fat. I believe maybe it is a lot of words written to confuse desperate people looking for answers, and/or a guide for healthy living and apparently it is only causing possibly more health problems for people willing to believe one person. I am sorry I jumped in and believed.

  16. Catherine Scott says:

    Recently there was an article published in The New York Times, saying that, in fact, low carb diets were the healthiest diets to follow and produced the greatest amount of weight loss, while lowering cholesterol, triglycerides, and ending the need for insulin. All bread products are sugar. Carbohydrates, from grains become sugar in our systems. It’s unfortunate, and speaking as one who loves bread and wheat…I also know it’s addictive. A very hard fact.
    It’s conclusive and indisputable.

  17. Lazlo Toth says:

    Alice, first off, I read your review during a prolonged negotiation in a windowless room on a beautiful day outside, during a period where I had no role in the negotiation. The following quote made me have to suppress laughter so people wouldn’t know I was reading something unrelated to the negotiations:

    “Even Neanderthals ate starch, which we know from studying the plaque on their teeth.”

    My thinking was “studying the plaque on our ancestors’ teeth – and I’m sitting here complaining to myself about MY job?”

    I loved the energy and passion and detail of your Amazon review. I loved the book equally. I don’t resent somebody being a forceful advocate of a position in a book and recognize that I need to be pretty skeptical.

    But I think there is room for your points AND his – this is a debate in an area where everybody’s knowledge advances by the hour.

    For what it’s worth – yes, Grain Brain and Wheat Belly both get carried away. But I love bread – especially the kind that is the worst for me – and these books helped me think of that kind of bread as essentially a toxin in many ways that my body didn’t need, got me to stop eating it, and actually got me to look more at whole grains – especially the older, unmodified forms – AND got me to make sure that when I ate them they didn’t form a disproportionate part of my diet. And that made me eat them more slowly, and enjoy them more. So the irony is that you are very skeptical about his claims but his book made me much more interested in looking at the types of grains you believe are so beneficial.

    I really DO think that white “enriched” flour of the type in middle-aisle grocery store products does a lot of harm in the quantities it is consumed and the manner in which people consume it. I actually think that you and Mr. Perlmutter both believe that. Beyond that, I think advocacy that occasionally crosses the line into adversity is healthy when it advances knowledge so I really admire his book and your response – I don’t know if that would strike you as possible or sensible but it does to me so I appreciate what you do too!

  18. Judy says:

    I wanted to love “Grain Brain” and “Wheat Belly” however when I followed the diet my blood pressure and cholesterol levels rose. I did not need to lose weight. I had 0 energy. I suffer from hypoglycemia and need starches and a “well balanced diet” to feel normal. I am so sorry to say I cannot endorse these books which I purchased and followed to T.

  19. Lukas says:

    Usually I never comment on blogs but your article is so convincing that I never stop myself to say something about it. You’re doing a great job,Keep it up. Thanks for the Book Review of Grain Brain: Extraordinary claim not backed entry, webmaster! For more information on preventing diabetes refer to Lukas(%URL%) website and derive more information benefit.

  20. Mateo Ramiro says:

    I agree that Pearlmutter’s book is bullshit but if a diet plan that features (almost) no carbs is not possible or highly dangerous how did nomadic pastoralists like the Mongols get along? And do you see nomadic pastoralism making a comeback after the age of oil?

    • Alice says:

      Please read my other post on paleo diets here:
      In the past, tribes ate whatever they could find in their area, and plants were far easier to come by than meat unreliably hunted. Read about Lewis & Clark’s expedition, they ate up to 12 pounds of meat a day and were still hungry and starving, because wild meat has little fat! The expedition’s favorite meat was beaver tail, which does have meat, and dogs, which the native americans raised for food as well as a burglar system (they bark if another tribe is about to launch a sneak attack), and perhaps to help them hunt as well.

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