Could gluten and carbohydrates be at the root of diseases like Alzheimer’s, ADHD, anxiety, and depression? Dr. David Perlmutter believes so. New York Nutritionist Jen Medina of Brown & Medina Nutrition provides her response below.
The Paleo Diet, the Dukan diet, Weight Watchers, Atkins, gluten-free, low-fat, low carb, sugar free… It seems like every 5 minutes there is some new fad or dire warning about what kind of food can save your life or ruin it. So many women grab on to each new fad in the desperate hope that this is the answer to their weight and body image woes. Problem is, if these diets work, why does a new one emerge only months later – every single time? Perhaps diets aren’t the answer? Maybe they don’t even work…
But before we look at the question of whether diets work, let’s examine the latest claim on the nutritional front:

Image courtesy of “yingyo”; freedigitalphotos.net
Dr. Perlmutter’s number 1 bestselling book is titled Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar – Your Brain’s Silent Killers, and it not-so-subtly suggests that the typical American high-carb, low-healthy-fat diet is to blame for many neurological diseases like Alzheimer’s, ADHD, anxiety, depression, epilepsy, and headaches.
James Hamblin, M.D., senior editor for The Atlantic, interviewed Dr. Perlmutter about his book – as well as several dissenters to his claims – in an article which you can read here.
Dr. Perlmutter posits that because grains (including the whole grain and gluten-free variety) have higher glycemic indexes, they cause the blood sugar to rise, which can be detrimental to one’s brain. He describes the current American diet as 60% carbs, 20% protein and 20% fat – when in fact it should be 75% fat, 20% protein, and 5% carbs. (The fats should be healthy fats like olive oil, avocado, nuts, and wild fish.)
So who is this Dr. Perlmutter, anyway? He’s a well-known and well-respected board-certified neurologist in Naples, Florida. He’s also a fellow of the American College of Nutrition.
Dr. David Katz, founding director of the Yale University Prevention research center – while he respects Dr. Perlmutter as an intelligent and innovative neurologist and appreciates the work he has done in the field of neurodegenerative diseases – believes “so much of [Dr. P’s] book is a whole bunch of nonsense.” He went on to say, “Now, he’s absolutely right that we eat too much sugar and white bread. The rest of the story, though, is one just completely made up to support a hypothesis. And that’s not a good way to do science.”
Dr. Katz went on to say that how you get on the bestseller list is this: “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’ve got Rob Lustig saying it’s all fructose; we’ve got T. Colin Campbell
saying it’s all animal food; we now have Perlmutter saying it’s all grain. There’s either a scapegoat or a silver bullet in almost every bestselling diet book.”Nutritionist Jen Medina’s Response to Grain Brain
Registered Dietician Jen Medina of Brown & Medina Nutrition here in New York City also takes issue with Dr. Perlmutter’s controversial nutrition book. She had this to say:
So many of our clients are phobic as a result of this type of dogmatism. Dr. Perlmutter appears to take some of the research out of context. One of the studies he cites has only 13 subjects. I believe they all had Celiac disease and they had a greater risk of Alzheimer’s from gluten. That’s hardly evidence that gluten is a risk for the general public.
For centuries, every culture around the globe has consumed one form of complex carb or another as a staple in their diets long before the increase in rates of metabolic syndrome and Alzheimer’s. Potatoes and bread for many European countries, breadfruit in the South Pacific, rice and noodles in Asia, just to name a few. In the article, Dr. Hamblin mentions tribes and cultures around the globe whose diets consist of at least 60% carbs, with little evidence of these neurological diseases.
As for low carb diets helping people with seizures, I do work with epileptics and still put them on a low carb diet. But it’s not about the gluten – it’s about getting their bodies into a heightened state of ketosis. The ketones may be what stops the seizures.
Dr. Perlmutter’s no-grain diet is not a safe one and has all sorts of risks involved.“
At IntrinPsych Woman, we are devoted to healthy living, in all its forms. Proper nutrition can certainly be medicinal, both physically and mentally. But the bottom line is this: while low-carb diets can certainly be beneficial for some people, we agree with Jen Medina (and several other experts cited in the article), that such blanket statements that no one should consume more than 50-80 grams of carbohydrates per day or that gluten and grains are definitively linked to Alzheimer’s and other diseases, is inaccurate and unfair.
Everybody (and every “body”) is unique and different, and therefore nutrition must be approached on an individual basis.