Begin Reading Table of Contents Newsletters Copyright Page In accordance with the U.S. Copyright Act of 1976, the scanning, uploading, and electronic sharing of any part of this book without the permission of the publisher is unlawful piracy and theft of the author’s intellectual property. If you would like to use material from the book (other than for review purposes), prior written permission must be obtained by contacting the publisher at [email protected]. Thank you for your support of the author’s rights. To my father, who at age ninety-six begins each day by getting dressed to see his patients—despite having retired more than a quarter century ago. Your brain… weighs three pounds and has one hundred thousand miles of blood vessels. contains more connections than there are stars in the Milky Way. is the fattest organ in your body. could be suffering this very minute without your having a clue. Introduction Against the Grain 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. —NEI JING, 2ND CENTURY BC IF YOU COULD ASK YOUR GRANDPARENTS or great-grandparents what people died from when they were growing up, you’d likely hear the words “old age.” Or you might learn the story of someone who got a nasty germ and passed away prematurely from tuberculosis, cholera, or dysentery. What you won’t hear are things like diabetes, cancer, heart disease, and dementia. Since the mid-twentieth century, we’ve had to attribute someone’s immediate cause of death to a single disease rather than use the term “old age” on a death certificate. Today, those single diseases tend to be the kind that go on and on in a chronic, degenerating state and involve multiple complications and symptoms that accumulate over time. Which is why eighty-and ninety-year-olds don’t usually die from a specific ailment. Like an old house in ongoing disrepair, the materials weather and rust, the plumbing and electrical falter, and the walls begin to crack from tiny fissures you cannot see. Throughout the home’s natural decline, you do the needed maintenance wherever necessary. But it will never be like new unless you tear the structure down and start over again. Each attempt at patching and fixing buys you more time, but eventually the areas in desperate need of a total remodel or complete replacement are everywhere. And, as with all things in life, the human body simply wears out. An enfeebling illness sets in and slowly progresses at an excruciating pace until the body finally goes kaput. This is especially true when it comes to brain disorders, including the most dreaded of them all: Alzheimer’s disease. It’s a modern medical bogeyman that’s never far from the headlines. If there is one health worry that seems to eclipse all others as people get older, it’s falling prey to Alzheimer’s or some other form of dementia that leaves you unable to think, reason, and remember. Research shows how deep this angst runs. In 2011, a study conducted by Harris Interactive for the MetLife Foundation showed that 31 percent of people fear dementia more 1 than death or cancer. And this fear doesn’t just affect older people. There are plenty of perpetual myths about the basket of brain-degenerating maladies that includes Alzheimer’s: It’s in the genes, it’s inevitable with age, and it’s a given if you live into your eighties and beyond. Not so fast. I’m here to tell you that the fate of your brain is not in your genes. It’s not inevitable. And if you’re someone who suffers from another type of brain disorder, such as chronic headaches, depression, epilepsy, or extreme moodiness, the culprit may not be encoded in your DNA. It’s in the food you eat. Yes, you read that right: Brain dysfunction starts in your daily bread, and I’m going to prove it. I’ll state it again because I realize it sounds absurd: Modern grains are silently destroying your brain. By “modern,” I’m not just referring to the refined white flours, pastas, and rice that have already been demonized by the anti-obesity folks; I’m referring to all the grains that so many of us have embraced as being healthful—whole wheat, whole grain, multigrain, seven- grain, live grain, stone-ground, and so on. Basically, I am calling what is arguably our most beloved dietary staple a terrorist group that bullies our most precious organ, the brain. I will demonstrate how fruit and other carbohydrates could be health hazards with far-reaching consequences that not only will wreak physical havoc on your brain, but also will accelerate your body’s aging process from the inside out. This isn’t science fiction; it’s now documented fact. It is my objective in writing Grain Brain to provide information that is sound and based on evolutionary, modern scientific and physiological perspectives. This book goes outside the box of the layman’s accepted dogma—and away from vested corporate interests. It proposes a new way of understanding the root cause of brain disease and offers a promising message of hope: Brain disease can be largely prevented through the choices you make in life. So if you haven’t figured it out by now, I’ll be crystal clear: This is not just another diet book or generic how-to guide to all things preventive health. This is a game-changer. Every day we hear about something new in our various wars against chronic disease, particularly with regard to illnesses that are predominantly avoidable through lifestyle habits. You’d have to be living under a rock not to know that we are getting fatter and fatter every year despite all the information sold to us about how to stay slim and trim. You’d also be hard-pressed to find someone about how to stay slim and trim. You’d also be hard-pressed to find someone who doesn’t know about our soaring rates of type 2 diabetes. Or the fact that heart disease is our number one killer, trailed closely by cancer. Eat your vegetables. Brush your teeth. Sweat once in a while. Get plenty of rest. Don’t smoke. Laugh more. There are certain tenets to health that are pretty commonsensical and that we all know we should practice routinely. But somehow, when it comes to preserving our brain’s health and mental faculties, we tend to think it’s not really up to us—that somehow it’s our destiny to develop brain disorders during our prime and grow senile in our elder years, or that we’ll escape such a fate through the luck of good genes or medical breakthroughs. Certainly, we would probably do well to stay mentally engaged after retirement, complete crossword puzzles, keep reading, and go to museums. And it’s not like there’s a blatantly obvious, direct correlation between brain dysfunctions and specific lifestyle choices as there is between, say, smoking two packs of cigarettes a day and getting lung cancer, or gorging on French fries and becoming obese. Like I said, we have a habit of categorizing brain ailments separately from the other afflictions we attribute to bad habits. I’m going to change this perception by showing you the relationship between how you live and your risk of developing an array of brain-related problems, some that can strike when you’re a toddler and others that get diagnosed at the other end of your life span. I believe that the shift in our diet that has occurred over the past century—from high-fat, low-carb to today’s low-fat, high-carb diet, fundamentally consisting of grains and other damaging carbohydrates—is the origin of many of our modern scourges linked to the brain, including chronic headaches, insomnia, anxiety, depression, epilepsy, movement disorders, schizophrenia, attention deficit hyperactivity disorder (ADHD), and those senior moments that quite likely herald serious cognitive decline and full-blown, irreversible, untreatable, and incurable brain disease. I’ll reveal to you the profound effect that grains could be having on your brain right now without your even sensing it. The idea that our brains are sensitive to what we eat has been quietly circulating in our most prestigious medical literature recently. This information begs to be known by the public, which is increasingly duped by an industry that sells foods commonly thought of as “nutritious.” It also has led doctors and scientists like me to question what we consider to be “healthy.” Are carbohydrates and processed polyunsaturated vegetable oils such as canola, corn, cottonseed, peanut, safflower, soybean, and sunflower to blame for our spiraling rates of cardiovascular disease, obesity, and dementia? Is a high–saturated fat and high-cholesterol diet actually good for the heart and brain? Can we really change our DNA with food despite the genes we’ve inherited? It’s fairly well known now that a small percentage of the population’s digestive systems are sensitive to gluten, the protein found in wheat, barley, and rye; but is it possible for virtually everyone’s brain to have a negative reaction to this ingredient? Questions like these really began to bother me a few years ago as damning research started to emerge while my patients got sicker. As a practicing neurologist who cares day in and day out for individuals searching for answers to debilitating brain conditions, as well as families struggling to cope with the loss of a loved one’s mental faculties, I’m compelled to get to the bottom of this. Perhaps it’s because I’m not just a board-certified neurologist but also a fellow of the American College of Nutrition—the only doctor in the country with both of these credentials. I’m also a founding member and fellow of the American Board of Integrative and Holistic Medicine. This enables me to have a unique perspective on the relationship between what we eat and how our brains function. This is not well understood by most people, including doctors who were educated years before this new science was established. It’s time we paid attention. It’s time someone like me came out from behind the microscope and the door to the clinical exam room and, frankly, blew the whistle. After all, the statistics are astounding. For starters, diabetes and brain disease are this country’s costliest and most pernicious diseases, yet they are largely preventable and are uniquely tied together: Having diabetes doubles your risk for Alzheimer’s disease. In fact, if there’s one thing this book clearly demonstrates, it’s that many of our illnesses that involve the brain share common denominators. Diabetes and dementia may not seem related at all, but I’m going to show you just how close every one of our potential brain dysfunctions is to conditions that we rarely attribute to the brain. I’m also going to draw surprising connections between vastly different brain disorders, such as Parkinson’s and a propensity to engage in violent behavior, that point to root causes of an array of afflictions that involve the brain. While it’s well established that processed foods and refined carbohydrates have contributed to our challenges with obesity and so-called food allergies, no one has explained the relationship between grains and other ingredients and brain health and, in the broader outlook, DNA. It’s pretty straightforward: Our genes determine not just how we process food but, more important, how we respond to the foods we eat. There is little doubt that one of the largest and most wide-reaching events in the ultimate decline of brain health in modern society has been the introduction of wheat grain into the human diet. While it’s true that our Neolithic ancestors consumed minuscule amounts of this grain, what we now call wheat bears little resemblance to the wild einkorn variety that our forebears consumed on rare occasions. With modern hybridization and gene-modifying technology, the 133 pounds of wheat that the average American consumes each year shares almost no genetic, structural, or chemical likeness to what hunter- gatherers might have stumbled upon. And therein lies the problem: We are increasingly challenging our physiology with ingredients for which we are not genetically prepared. For the record, this is not a book about celiac disease (a rare autoimmune disorder that involves gluten but only affects a small number of people). If you’re already thinking that this book isn’t for you because (1) you haven’t been diagnosed with any condition or disorder, or (2) you’re not sensitive to gluten as far as you know, I implore you to read on. This is about all of us. Gluten is what I call a “silent germ.” It can inflict lasting damage without your knowing it. Beyond calories, fat, protein, and micronutrients, we now understand that food is a powerful epigenetic modulator—meaning it can change our DNA for better or worse. Indeed, beyond simply serving as a source of calories, protein, and fat, food actually regulates the expression of many of our genes. And we have only just begun to understand the damaging consequences of wheat consumption from this perspective. Most of us believe that we can live our lives however we choose, and then when medical problems arise, we can turn to our doctors for a quick fix in the form of the latest and greatest pill. This convenient scenario fosters an illness- centered approach on the part of physicians as they play their role as the purveyors of pills. But this approach is tragically flawed on two counts. First, it is focused on illness, not wellness. Second, the treatments themselves are often fraught with dangerous consequences. As an example, a recent report in the prestigious Archives of Internal Medicine revealed that postmenopausal women who were put on statin drugs to lower their cholesterol had a nearly 48 percent increased risk of developing diabetes compared to those who weren’t given the 2 drug. This one example becomes even more critical when you consider that becoming diabetic doubles your risk for Alzheimer’s disease. These days, we are seeing an ever-increasing public awareness of the effects of lifestyle choices on health as well as disease risk. We often hear of the “heart smart” diet or recommendations to increase dietary fiber as a strategy to reduce