Renowned neurologist David Perlmutter, MD, blows the lid off a topic that’s been buried in medical literature for far too long: 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. Dr. Perlmutter explains what happens when the brain encounters common ingredients in your daily bread and fruit bowls, why your brain thrives on fat and cholesterol, and how you can spur the growth of new brain cells at any age. He offers an in-depth look at how we can take control of our “smart genes” through specific dietary choices and lifestyle habits, demonstrating how to remedy our most feared maladies without drugs. In Grain Brain, Dr. Perlmutter offers suggestions on how to fuel the brain properly with sound nutrition. These basic changes can help alleviate, or even reverse brain disease, eliminate brain fog symptoms, and improve memory and energy levels.
Check out this short video for more info.
It is so refreshing to read a book by a brilliant man who has done the research that aligns with our lifestyle. He is really onto something significant. He has clinical research to support his claims that carbs are killing us as a society. It's a NT Times best seller, #1 right now.
Dr. Perlmutter is very vocal about the destructive effects of grains and carbs on our brain. The frequency of mental disorders like, depression, ADHD, alzheimer's and other cognitive issues.
It seems the topic of calories comes up all the time. Everyone thinks that counting calories will cause weight loss. If you burn more than you take in, you'll lose weight. 3,500 Kcal = 1lb of fat, right? After all, you cannot argue with the first law of thermodynamics, right? Which basically states that you cannot destroy energy, conservation of energy is the law. Yes that is true, but maybe we need to have a quick physics lesson. The law states, "The law of conservation of energy states that the total energy of an isolated system is constant" So, is your body an isolated system? (See picture to the left) No, it is not. Also, is your body 100% efficient in turning your food energy into fuel? No, it is not. If your body does not use the fuel it goes out in the form of waste or is stored as fat. So the question is, what kind of calories are you consuming?
Here is an extreme example: Take 1 cup of olive oil and drink it. You'll be getting about 1920 Kcal worth of energy in the 224 grams of fats, 0g carbs. What will happen? Provided you don't vomit, most people know what will happen. You'll get diarrhea, why is that? Your body cannot use all of those calories with perfect efficiency so it dumps any excess. So our body is not an isolated system. Fat uptake is regulated by the pressure gradients and absorbed by the lymphatic system. So if your lipid levels are full, your intestines will let it pass. See Fig.1
Now, let's talk about carbs. These behave much differently because it uses a different metabolic system to harness the energy. If you were to drink 8 20oz bottles of cherry Coke, you'd have 2080 Kcal's via 560g of sugars. Provided you don't vomit or go into shock, what happens to these calories? Your body only needs 5g of sugar in your bloodstream at one time, anything above that destroys tissue. So your pancreas comes to the rescue and pushes the extra 555g of sugar into your fat stores with a rush of insulin. See fig. 2
So if your body gets a large dose of calories, it really depends on what kind they are. Generally speaking, carbs are digested quickly and turned to fuel then deposited into the bloodstream, depending on work being performed are converted into ATP with CO2 as a byproduct. The remaining glucose is transported into adipose tissue (body fat).
Fats are processed differently all together and enter the bloodstream as triglycerides where they are available for muscles to use for fuel as ATP. Any remaining fats that are not needed will not be stored, but eliminated via waste.
All exercise is not created equal. Sprinters use the creatine cycle, they don't tap fats or glycogen stored in the muscles and liver. Middle distance runners who are 2 through 120 minute efforts like 800m to 15,000m are tapping into glycogen stores almost exclusively.
Fig. 3 shows how your body uses the two main fuel systems as you work harder in your workouts. It's pretty fun to see this in action, when you're burning carbs, you produce more CO2, thus you have to breathe harder to eliminate the CO2 from your body. But when you're oxidizing fat, you produce quite a bit less CO2 and can improve your performance with less panting. You also don't feel the burn as quickly into a long steep climb as you would if you're burning carbs for fuel. There is a great article by Dr. Peter Attia on his journey to ketosis as measured in his performance. He proves pretty clearly that ketosis is a much better system for the endurance athlete.
I do not count calories to manage my weight, it seems to make no difference at all. Dr. Steve Phinney has been living in nutritional ketosis for 30 years, his weight has been stable during that time however, his calories can fluctuate from 2,000-6,000 per day.
Here is an example from MyFitnessPal app. It's great except for the assumption that my body is 100% efficient. Also, my lean body mass happens to be 137 lbs. So there might be a little something wrong with their calculation.
As I have been researching ways to improve my lipid profile, I started reading a bunch of research on Niacin (vitamin B-3). It comes in a few forms, some good, some not so much. The benefits are flat-out amazing! Niacin, also known as nicotinic acid and vitamin B3, is a water soluble, essential B vitamin which when given in high doses is effective in lowering low-density lipoprotein (LDL) cholesterol and raising high density lipoprotein (HDL) cholesterol. Which is better than statin drugs that lower all cholesterol, including the good stuff. There are 3 main forms of niacin, nicotinic acid, niacinamide and inositol hexanicotinate. The later is the extended release or sustained release that is not very safe. Niacinamide is the most common form because it does not trigger the flushing response, but is less effective for certain conditions. The best part is that niacin is cheap and pharmaceutical companies cannot patent it.
I want to do a fair and balanced report here, so I will do my best to show both sides, but frankly, I like niacin, in fact, I'm doing a niacin flush right now, my skin is starting to get red and warmer as I type.
So let's start with a recent study that headlines, "Niacin Therapy Shows No Benefits, Has Some Harmful Effects" it opens with this, "Mar. 11, 2013 — A highly anticipated study evaluating a combination of the vitamin niacin with the anti-flushing agent laropiprant finds the therapy provides no benefit to and may even be harmful for patients with vascular disease, according to research presented today at the American College of Cardiology's 62nd Annual Scientific Session. Detailed trial data is presented here for the first time."
Now, here comes the study, (I hope this serves as a lesson on how to read studies, because this one has some serious inconsistencies.) They did a good job at selection and randomization with placebo. See if you can spot the issues in isolating niacin's impact. Click the link to see an article that highlights the study details.
"The four-year study tested a combination of extended-release (ER) niacin with laropiprant in patients at risk for cardiovascular problems such as heart disease and stroke. The 25,673 patients in the study were randomized to receive ER niacin/laropiprant 2g/40mg or a placebo, and all received commonly prescribed LDL cholesterol-lowering medication simvastatin (with or without ezetimibe)."
OK, I hope you got this quiz right. They were all on statin drugs, they chose the extended release and had laropiprant to reduce the flushing effect that normally occurs with niacin. Let's take a look at their findings that they published for the world to see.
"The study did not meet the primary endpoint of reducing the chances of a major vascular event, defined as the composite of non-fatal heart attack or heart-related death, stroke, or need for angioplasty or bypass surgery. Patients receiving ER niacin/laropiprant had a similar number of major vascular events as patients receiving placebo (13.2 vs. 13.7 percent, p=0.29).
The study also found unexpected and significant excesses of bleeding (2.5 vs. 1.9 percent) and infections (8.0 vs. 6.6 percent) among the ER niacin/laropiprant patients. In addition, significantly higher numbers of patients receiving the study drug suffered serious known side effects including new onset diabetes (9.1 vs. 7.3 percent), diabetic complications (11.1 vs. 7.5 percent), gastrointestinal problems such as indigestion and diarrhea (4.8 vs. 3.8 percent), and skin issues including itching and rashes (0.7 vs. 0.4 percent)."
First, using extended release niacin has been proven to produce unacceptable side effects, primarily liver damage. "Significant hepatotoxicity is particularly common with high doses of sustained release niacin. In many cases, the injury becomes apparent after a dose increase or after switching from the regular crystalline to a sustained-release form."
Second, laropiprant has been recalled, "Merck & Co has said it is recalling Tredaptive cholesterol tablets in response to trial results that raised safety concerns and the recommendations of a European Medicines Agency safety panel." The US regulators rejected laropiprant for market release in 2008. So, why would you continue a study with a product that was rejected by the FDA?
Third, why were the subjects all on statin drugs? It seems that there are too many chemical interactions to have a reliable study. In order to study a single compound, you need to reduce the variables. Could the statin drugs inhibit the effects of niacin? We may never know.
In conclusion why have them on the least effective, most dangerous forms of niacin available? Why use laropiprant to prevent the niacin flush? Why select people who are on statins? So you can have the headlines that say niacin is harmful -- maybe?
Moving on to the benefits. One of the noted benefits is the anti-inflammatory effect on arthritis. In an excellent article, "Several researchers have reported excellent results in arthritic patients using niacinamide. While niacin opens up the blood vessels near the surface and causes a flushing sensation, niacinamide only opens up the deep blood vessels like those surrounding the joints.
In cases of moderate arthritis, outstanding results have been produced by taking 1,000 to 1,500 mg a day. In more severe cases, as much as 3,000 mg to 4,000 mg have been recommended."
For dealing with cholesterol, it raises the production of HDL and reduces triglycerides and LDL. The article continues, "One of the most effective and least expensive ways to lower blood lipids (cholesterol and triglycerides) is to take 1,000 to 3,000 mg of niacin a day.
Patients using 1,000 mg the first day, 2,000 mg the second day, and 3,000 mg each day thereafter have seen as much as a 25 percent reduction in cholesterol levels, and a 50 percent reduction in triglycerides. (Blood lipid reduction is the case where niacinamide is not as effective as niacin.)"
Another reference manual from Berkley Heart Labs concluded their study of Lp(a) (the lipoprotein(a) is one of the most dangerous blood markers for CHD) "Treatments for elevated Lp(a) levels have variably reported analyte-lowering benefits. Lifestyle modifications such as diet, weight loss, and exercise generally have little or no effect on Lp(a) levels. Compared to the well reported LDL-lowering effects of statins and bile acid sequestrants (resins), these drugs generally also have little, or no effect on Lp(a) levels. Based on the best available study data, Niacin is the most effective drug option to treat Lp(a) elevations."
This study in 2002 was conclusive though some, 21%, did not like the regimen due to the flushing response. Though it lowered their Lp(a) and improved their other lipid profiles, they did not stay with the treatment.
It's been known to help with:
Reversing heart disease
Senility, memory loss, depression, insomnia
Tinnitus, vertigo or hearing problems
Improved circulation in legs of diabetics
It's not a perfect vitamin. You need to be aware that there are side effects like irritated stomach lining or ulcers and gout flare-ups. Be sure to take niacin on a full stomach, right after a meal is best. Several sources recommend consulting your doctor prior to taking niacin, especially in high doses.
We've been taking straight niacin, 500mg as pictured above. My first dose which was about 1 hour after a meal, caused quite the rush of blood to the surface of my skin, it felt like a sunburn all over my face, neck and abdomen. It lasted about an hour and then subsided. Then the next morning dose I felt a small warming sensation, the evening dose had very little effect on me. Your body does adapt to the niacin once your levels come up. It takes about 2 days to reduce the effects, but they are not painful, some enjoy the warming feeling.
This is my second blood test after starting the low-carb/high-fat (LCHF) lifestyle over 2 years ago. In the past 3+ months, we've gone into ketosis. These numbers are pretty good, but I'll explain why in a minute.
The first test (pictured below) is the Atherotech VAP, which is an actual particle count, vs. the estimated LDL formula on a typical lipid panel. In case you did not know, the LDL is estimated using a formula created in 1974, so we're generally depending on a formula to estimate the "bad" cholesterol instead of measuring it directly. I chose this test in addition to my normal tests after reading the books, "Don't Die Early" and "The Great Cholesterol Myth." This shows size and type of particles measured directly. It is much more useful information to know the size and density of the cholesterol in your bloodstream. It also measures the other critical components like triglycerides and Lp(a).
For those with the gift of seeing the obvious, I have four results that show HIGH, so it must be alarming & bad, right?
First, lets look at the good & great stuff. My HDL (good) is 94 which is 19 points higher than last time. Any number higher than 45 in men is good; I'm more than double. My triglycerides are 48, which is very low, considering 150 is the level which causes concern; I'm less than 1/3 threshold. That low number is most likely due to my no-sugar, no-wheat, no-corn diet. But wait, I thought eating all that saturated fat makes a whole bunch of fat show up in your blood, right? Not if you're a fat-burning machine -- it gets consumed. Fat is dangerous when it is combined with wheat and sugars. (can you say doughnut?) because you're burning glucose, the fat is still floating around in your blood, then the sugar and wheat inflames your arteries creating lesions where the small dense LDL particles can lodge and start to build up into plaque.
So the total cholesterol of 233 is high, right? Well, people with cholesterol of 250 have heart attacks and so do people with 150. There is no direct correlation between high cholesterol and heart disease, in fact there is no correlation between high LDL and heart disease. A recent study of almost 140,000 patients admitted to the hospital for heart disease, almost half of them had LDL levels under 100 mg/dL. So the Lipoprotein(a) is the more serious one because that is the one that is sticky and collects on the arterial walls and promotes cardiac plaque. The issue is the definition of HIGH. Upon reading these results, I was a little scared that I was at 17 and the baseline is at 10. According to two sources, 30 mg/dL is considered elevated and one source said 20 mg/dL is to top of the normal range. Source 1 Track Your Plaque site and Source 2 NIH.gov. A quote from the prolipid.com site states this, "You may notice Lipoprotein(a) or Lp(a) on your medical chart. Lp(a) is a subtype of LDL, and individuals with high levels of Lp(a) or "very bad" LDL, appear to be at higher risk for heart disease. Researchers can't seem to agree on the exact level of "high" Lp(a), but most specialists consider a value of approximately 30 mg/dL (0.8 mmol/l) to be high."
The VLDL at 13, and VLDL-3 being low is encouraging. These are the small, sticky guys who cause problems with your arteries.
The good news is, a simple solution for lowering my LDL is available. It's Niacin, or vitamin B3. 500mg per day, some sources up to 3g, are recommended to lower Lp(a) up to 20-30%. I may choose to increase my niacin and see what that does to my numbers next year.
More to come, next week I'll be getting my physical with more numbers...stay tuned.
This scenario seems to be a regular occurrence, I meet so many people who do not want to engage in learning about their bodies. It is amazing how people decide to be 'low-information' about their body while memorizing stats on cars, baseball players, movie stars or technology and yet choose not use that same capability to learn about what makes them sick or healthy.
I have pondered for quite a while about writing this commentary because I could not find a way to be positive or non-judgmental about the topic. I am completely fascinated about how seemingly simple things work in our bodies. It is natural to assume that others would think the same way as I do. Well, that is not true. I cannot get myself interested in golf no matter what I do, nor who attempts to influence me, I just don't enjoy it. Perhaps it is that the rules say you cannot tackle or steal, and where is the goalie anyway? Now it could be that I'm maxed-out on expensive hobbies by my wife. Woodworking, sailing, fly fishing, hunting, and cycling are all pretty expensive sports to say the least and golf would not help my marriage. My point is, I understand that some people prefer not to know about certain topics.
Our bodies are not hobbies, they are the magnificent machine that will enable us to do great things, change history, influence generations or perhaps save lives. I expect to have a huge affect on the world because I believe there is much to be done and I want to live a very long, productive life. Humanity is valuable and I see myself making great contributions in the years to come.
No matter the opinion, I cannot sit by and let the propaganda pumped out by the media guide my eating decisions. I cannot be a low-information citizen! I have to research the articles and news stories by reaching back to the source, then deciding the course of action. I am the one who has to live in my body and I want it to be an enjoyable experience.
Lynette and I decided not to outsource our health-care to the "really smart" people. Instead, we would rather take the personal responsibility to steward our temples and hire smart people to help us. Yes, there is a slight difference. I still go to doctors when needed, (2 times in 9 years), and when we want to have a good check-up. We just take personal responsibility for our health first.
If I follow the USDA guidelines, being the Plate or Food Pyramid, I may end up where the majority of our society is -- obese and looking more like a pyramid. If you think about it, everything that was pulled from the market was first approved by the FDA as safe. Fen-phen for weight loss, for example, was deemed safe, we now know too well now that it is not. I am opting out of the typical health care system because if I follow their guidelines, I could end up on high blood pressure medicine, statin drugs, injected with flu shots and downing sleep aids like Ambien. Then comes diabetes, so I can depend on insulin and the additional medications needed to deal with the side effects, and on it will go. In time, interventions like stints, pacemakers, angioplasties and bypasses will become part of my health care. In the end, I am dead and broke, my life cut short 20-30+ years. If you think I'm being extreme, read this. However, if I choose to live on purpose by evaluating information from a scientific basis, and take the time to learn the signals of my body, allowing it teach me how to care for it, I will live a longer and fuller life.
To me, sickness is what happens when people do not make the effort to educate themselves about their bodily systems, the beautiful balance and interdependence we live in moment to moment. It is truly a work of art. The ATP cycle is amazing beyond belief, it makes your next heartbeat, your next breath, facilitates digestive system processes and so much more. This power currency has a complete recycling system too. I found this to be startling. "The energy used by human cells requires the hydrolysis of 100 to 150 moles of ATP daily, which is around 50 to 75 kg. We have only 250g of ATP at any one time. A human will typically use up his or her body weight of ATP over the course of the day. This means that each ATP molecule is recycled 500 to 750 times during a single day. ATP cannot be stored, hence its consumption closely follows its synthesis." If you don't have ATP for 1 second, you are dead. When you learn how to maximize that one system, you begin to tap into the potential of the human body.
Please watch this video, just to expand your mind.
You are amazing! You are engineered with an adaptable immune system, fuel manufacturing system; producing the needed fuels to run every unique cell in your body. It is mind-blowing how versatile and forgiving our bodies are. We can give it bad foods and it will graciously accommodate our bad choices and provide energy for us to live.
Take time to learn the major systems of your body. Learn what the most efficient fuels producing the least amount of waste. Learn what feeds you and what feeds sickness and cancer. Learn to Live!
Tim & Lynette Jenné are learners first and foremost. We love to ask "why?" We question the status quo. We also love to research and find answers for ourselves. As parents of four adult children, we've learned a few things along the way that may be helpful to others. We love to live & eat clean, simple lives.