Did you ever walk into a room and totally blank on why you came in there in the first place? Lose your keys? While you’re not alone in these “senior moments,” the missing link that’s keep you from optimal brain function and power is lies somewhere you might not expect – in your gut.
New research demonstrates that the brain gut connection is not only ground-breaking, but it’s also exciting for the many who have memory and cognitive issues as well as those of us with family members who have suffered with diseases like Alzheimer’s and fear their fate could be our own. That means the way to stave off issues or possibly reverse early warning signs are more controllable than we’ve ever thought before.
I invited David Perlmutter, MD, author of the world-wide best seller Grain Brain and new book Brain Maker, to share his latest research and findings that could be key to getting back (or keeping) your healthy, well-functioning brain.
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Brain Gut Connection – Eating for a Healthy Brain with David Perlmutter, MD
Jennifer: Welcome back to the Gluten Free School podcast. I’m your host, Jennifer Fugo. Today, we are going to talk all about the relationship between your gut health and how that affects your brain.
Now, I know that we’ve talked before about brain issues and gut issues, but this conversation and this guest, which is incredibly special and I feel totally blessed to have him with me today, is someone who has a very unique perspective on all of these and his work is life changing in a worldwide perspective.
Now the reason is because Dr. Perlmutter has agreed to join me again to talk all about his new book. We’ll get to that in a second, but I want to want to give him a really wonderful introduction that he so rightfully deserves.
Now he is the author of seven books including the New York Times bestseller, Grain Brain: The Surprising Truth about Wheat, Carbs and Sugar, Your Brain’s Silent Killers, now published in 27 countries. His new book, Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain for Life, is now out on shelves.
This is actually Dr. Perlmutter’s second appearance on the Gluten Free School podcast. And if you’re not familiar with his incredible background, he’s a board certified neurologist and fellow of the American College of Nutrition. He has published extensively in peer reviewed scientific journals including archives in neurology, neurosurgery, and the Journal of Applied Nutrition.
He is a frequent lecturer at the symposia sponsored by prestigious medical institutions like Colombia, NYU and Harvard University. And because of how well-received Grain Brain was after its release, there’s a good chance you’ve seen Dr. Perlmutter on shows like 20/20, Larry King Live, CNN, Fox News, Fox and Friends, The Today Show, Oprah, The Doctor Oz Show and The CBS Early Show, just to name a few.
And now he’s back joining me again to talk about how the gut and the brain are linked.
Dr. Perlmutter, welcome back to the podcast!
Dr. David Perlmutter: Well, Jennifer, thank you for having me back. I’m sure we’re going to enjoy this!
Jennifer: Oh, I’m positive we will. I saw you speak recently at Natural Products Expo West in Anaheim, California and I was, again, blown away by the new information that you shared about this relationship between the gut and the brain.
So why don’t we start there. Let’s talk about how bacteria in your gut (nowhere near the brain) are actually sending messages to your brain or interacting with it in some way. Talk to us about that.
Dr. David Perlmutter: Well, I’ll be delighted. It’s well beyond the notion that the bacteria are, as you say, sending messages or talking to the brain. We now recognize that bacteria regulate a whole host of processes in the human body that have dramatic effects on the health and the brain’s ability to resist disease.
For example the corner stone of the regulation of the process of inflammation in the entire body from stem to stern is dictated by the health of the gut bacteria.
So the notion that the bacteria living in the gut, doing their thing and that they don’t really have an effect on anything else in the body… As if they live in Cleveland and your brain is in Chicago, well that just doesn’t hold water anymore.
We now recognize that, for example, this process of inflammation is what makes Alzheimer’s happen. It is the underlying mechanism of multiple sclerosis, of Parkinson’s, even autism. These are all fundamentally inflammatory disorders.
When you embrace the understanding that the bacteria (the hundred trillion bacteria that live within your gut) control the level of inflammation of your body, it really does pave the way for a whole new understanding of what we can do with reference to the gut in general and specifically how we care for our bacterial friends. In the long run, this is going to be a huge leverage point to maintain and even enhance brain health.
Jennifer: Well, for someone who is starting to notice memory issues or that they’re having a lot of mental fog… Anything where they’re like, “I just feel like my mind is not what it used to be.” Is it possible just from what you’ve said that perhaps they should turn their attention toward the health of their gut?
Dr. David Perlmutter: Well, I would say that it’s well beyond possible that they should. It is the fundamental. I published an op ed in the New York Times talking about the real fallacy of the idea of what is called this notion of the brain and the gut being separate parts. We realize now that everything works together.
Let us take a step back. I’m a neurologist, and as a neurologist, I deal with very, very challenging issues. 5.6 million Americans have Alzheimer’s. That’s a disease for which there is no treatment and a disease that is certainly not curable. It’s the same thing with issues like multiple sclerosis and autism. One in 40 births in America will end up being an autistic child. So that’s clearly how we would define something being epidemic.
But that said, now that we understand this powerful relationship, the focus of the most high level research at our most well-respected institutions around the world is finally, and for the first time opening up the possibility that yes, we can reverse not only these devastating conditions, but as we have already demonstrated and as I’ve written about it in the new book, Brain Maker, we can help the regular person who says, “I’ve been losing my keys lately, I can’t seem to remember the Wi-Fi passcode and sometimes I walk into a room and I forget why.” These are not simple things that we should write off as being just another marker of aging. These represent the beginning of problems down the road with respect to the brain.
I take the notion of senior moments very seriously with the patients I deal with. And that’s when the intervention becomes so profound.
So you hit the nail in the head. When I see a patient with moderate stage Alzheimer’s or in a wheel chair with multiple sclerosis, at that point there’s a lot of damage done and some of that is clearly irreversible.
But for individuals who are depressed and fatigued and are gaining weight and having sleep issues… Gosh, they are wonderful candidates for basically gut rehab- for putting the gut back in order so that we can sit back and watch what happens to all of those things I just mentioned once you pay attention to nurturing back to health the gut bacteria. They absolutely dictate the health of their host.
Jennifer: Talk to us for a moment a little bit more about gut bacteria. I know that everyone may be familiar with good guys and bad guys and yeast, but they might not understand that there’s actually a wide variety of different types of bacteria and how they then communicate with the brain.
Dr. David Perlmutter: We have really become a germophobic group of individuals in Western cultures. Ever since the Germ Theory in the work of Dr. Louis Pasteur, we’ve kind of pointed the finger at every bug that comes along as being ready to pounce upon us and cause misery.
Well, there is certainly very good reason for that and truthfully, as we move forward in time, with the emergence of what we call antibiotic resistant organisms, there are more and more bacterial threats.
Certainly many of your listeners are quite familiar with the term probiotic meaning “good for life.” These are bacteria that actually pave the way for wonderful health and do wonderful things within our physiology like regulate immunity, temper down inflammation, manufacture various vitamins, absorb certain nutrients, maintain the integrity of the gut wall, and produce neurotransmitters, the chemicals that allow the brain to function properly.
So we need to rephrase our sense of bacteria and indeed, as you said, recognize that most of the bacteria within us are doing a great thing in keeping us healthy, but certainly there are some pathogenic or bad bacteria living within you and me right this minute. There are seeds in your garden of weeds, but if the garden is healthy, the weeds won’t populate.
When we traumatize our gut bacteria by eating inappropriately, for example, or by loading up on antibiotics every time we have a sniffle and go to a walk-in clinic, we change the balance. We allow imbalance to occur, which is called dysbiosis. And when this happens, then the bad guys can overgrow and wreak havoc.
Now this doesn’t necessarily mean an overwhelming bacterial infection that gives you diarrhea and sends you to the hospital. We now understand that changes in the ratio of bad and good bacteria that are living within our bodies right this moment lead to things like obesity and diabetes and have now been correlated with even brain issues like Parkinson’s and even Autism.
Jennifer: You mentioned this whole idea of diabetes… that diabetes is somehow involved in the changes in gut bacteria. Diabetes is something that has struck my family quite significantly. I’ve lost a lot of relatives to diabetes and my father who’s a physician sees many diabetic patients. I’ve also had more and more clients who are insulin resistant and dealing with metabolic syndrome.
It is becoming a more pervasive problem that I feel we don’t realize the massive consequences – it’s not even about one little issue. Rather, with diabetes comes a whole host of problems.
Can you talk a little bit about how insulin resistance plays a role in all of these?
Dr. David Perlmutter: Well, of course, but let me just take a step back and recognize you brought a couple of very good points. Some people have diabetes, but some people only have metabolic syndrome or only have insulin resistance and they’re not fully diabetic yet. I think that right off the bat we must set the stage for this notion that being diabetic is not like being pregnant. Being pregnant, you either is or you ain’t.
When your blood sugar starts to elevate, you are already at risk for significant brain issues long before your fasting blood sugar reaches a 126, which is the cut-off for making the diagnosis of diabetes.
But that said, when we load up on carbs and load up on sugar, we actually change the complexion of the gut bacteria to one that favors a group of bacteria called the Firmicutes that paves the way for obesity, that is associated with diabetes, that leads to leakiness of the gut and therefore plays a role in inflammation.
Now, let me take this story a little further because it’s really interesting. And then we’ll get back to the impairment part.
In Amsterdam, there’s a Dr. Max Nieuwdorp. Dr. Nieuwdorp is a pioneer in understanding how the levels of various bacterial species in the gut affect things like our metabolism, how we handle sugar, how we extract calories from the food that we eat. He recognized that there is in fact a specific pattern of bacteria seen in type II diabetes. When you look at the bacteria in the gut in the type II diabetic, it’s different from people who are lean and from people who don’t have diabetes.
He demonstrated that he could reverse obesity in the laboratory animal by changing its gut bacteria without any change in the food he gave the laboratory animal. And then, he hypothesized that if he could change the gut bacteria in humans, perhaps that might change their parameters of diabetes.
And what Dr. Nieuwdorp did, which was really quite incredible! He took 250 patients and performed a double blinded study. Half the group received what’s called a fecal transplant. They received the fecal material, instilled into their colons from lean, healthy donors, whereas the other half received back their own fecal material. But the groups didn’t know who got what.
Lo and behold, the diabetics who received transplants of fecal material into their colons, which is really an aggressive way of changing the gut bacteria, had reversal of their diabetes.
Jennifer: Oh, my gosh! That’s amazing.
Dr. David Perlmutter: It is amazing. I heard Dr. Nieuwdorp present this information at a symposium at Harvard in September. I recently invited him to a microbiome symposium in Hollywood, Florida in October of 2015 that I’m hosting. He’s going to be one of our guest and he’ll follow-up on that data and let us know what happened with these individuals.
I’m certainly not suggesting that diabetics just yet undergo fecal transplantation, but what I am suggesting is that we now understand that changes in the gut bacteria pave the way for bad things to happen and that the standard American diet is a sure fire way of making those detrimental changes to the gut bacteria.
So, I think the follow-up question from you, let me help you with it and be, “Hey, Dr. Perlmutter, what kind of changes then would you recommend to put our gut bacteria back in shape?” “Ah, Jennifer, that was a great question. Thanks for asking me that.” I would say that, as I mentioned, we’ve got to get the sugars and carbs out of the diet.
And how incredible it is that just recently, a governmental advisory dietary committee here in America came out and said the big problem in the American diet is not fat, it’s the sugar and the carbs and the refined wheat products that give us issues and really instructed us to get back to eating foods with good fats and to not reject foods, like eggs, that contain cholesterol indicating there’s no relationship between the consumption of cholesterol rich foods and heart disease. Holy Toledo! This is revolutionary.
Jennifer: It really is.
Dr. David Perlmutter: Well, I was knocked off my chair when I read this information because it validates everything we talked about in Grain Brain and it validated everything that is now in Brain Maker.
And what is so exciting for me as a neurologist is this is paving the way for treatments based upon changing the gut bacteria that have already been seen to be helpful.
So let me get back to the idea, “What do we do?” Well, first of all, what can we do to preserve the gut bacteria, protect them? After all, those bacteria outnumber your cells 10 to 1. In your body, there are 10 times more bacteria than there are Jennifer cells. And that said it, you’re very proud of you 23,000 genes, but recognized, there are 5 million or more bacterial genes in your body meaning that 99% of the DNA in your body is bacterial, not Jennifer DNAs.
Jennifer: I actually wanted to ask you about this, which was one of the most surprising things (at least to me because I didn’t know this) that I saw on your presentation. Would you talk about the importance of genetic material in gut bacteria for our well-being and how important that is? I mean, I’ve never heard that before. Could you tell everybody a little bit about that?
Dr. David Perlmutter: Well, that’s why I wrote Brain Maker. What I would say to your listeners, if they want to get a taste of this book, if they just go to YouTube and put in Brain Maker trailer, we actually have a movie trailer about the book that is four minutes long, but really summarizes everything that we’re talking about.
Well yes, their DNA influences the expression of your DNA and even beyond that. What’s recently been discovered is that we have now identified segments of bacterial DNA that have been inserted into the human genome. Wow! Not only are they creating metabolic products and chemicals that influence our gene expression, but they even inserted their DNA into ours for good reason. That’s the kind of interaction that has allowed us to survive for these two million years.
So let’s get back to what do you do, first of all, to protect your commensal organisms? We describe the bacteria as commensal, meaning they share the table with us, “they eat together…” “commensa.” Basically, they eat what you eat and they’re exposed to everything you’re exposed to.
I think step one would be to recognize that we are bombarding our microbiome, our bacteria that live within us who are so in love with us and caring for us, with antibiotics with such increasing frequency that it likely is playing role in so many of our health issues.
If you have the sniffles or a cough and you go to walk-in clinic, you’re almost guaranteed to walk out of there with a very broad spectrum, powerful antibiotic because if you don’t, you’re going to think that you didn’t get what you paid for. That’s what people want. “Doc, I need to get back to work. You need to give me something for my cold.”
Colds are viruses, but antibiotics are for bacteria. I often tell my patients that it’s like having your appendix taken out when your gallbladder is inflamed. It’s the wrong treatment.
I tell them, “Look, if you take an antibiotic when you have a cold, it will only last a week. But if you don’t take the antibiotic, it’s going to last seven full days.” It takes a little while to realize that that’s a joke. The point is there’s no difference and in fact you’re doing generally more harm than good when you take an antibiotic when you have a cold.
What you’ll read in Brain Maker is that now there’s a large body of scientific literature that says, “Hey, if you’ve got an artificial hip or an artificial knee, there’s no real advantage to taking an antibiotic every time you get your teeth cleaned because there’s been no demonstration of increased risk in the various articles that we cite in the book of having an infected knee joint or hip prosthesis by going to the dentist.” And yet most people are told that, that you’ve got to load up an antibiotics if you go to the dentist because, “Oh, something terrible happened. Maybe your children will be born naked or who knows what’s going to happen to you.”
But that said, we’ve really got to take a step back in terms of our overzealous use of antibiotics. Four-fifths of Americans take antibiotics every single year. So that’s a very scary proposition.
Jennifer: And the other point to make on top of that is not just that we are taking so many antibiotics, but the animals that we eat, if they are conventionally raised, are also exposed to a lot of antibiotics to which we are then coming into contact. This is like a huge problem such that now some of these antibiotics aren’t working anymore and thus developing very virulent strains of bacteria that we can’t manage.
Dr. David Perlmutter: You’re exactly right. In fact, 75% of the antibiotics that are used in America today are used on our cattle because it does two things. First of all, our cattle are, by and large, raised in environments that foster illnesses like infections. And beyond that, and more importantly, the use of antibiotics makes these animals fat.
As was recently described in a book called Missing Microbes, there’s a lot of science indicating that in fact the overuse of antibiotics may relate very strongly to childhood obesity. Well beyond the dietary changes in the fast food, when you bombard children’s gut bacteria with antibiotics, you do the same thing that you do in animals. You favor an environment of different bacteria that tend to extract more calories from food and therefore may lead to obesity.
This is a wonderful book by Dr. Martin Blaser of Columbia University called Missing Microbes. It’s a really interesting read.
Jennifer: Now, as far as this whole idea of eating fermented foods, I’m totally onboard with that. I love the idea and I’ve been experimenting with different forms of fermented foods for a long time. And I recently had Kirsten Shockley on recently who spoke about how to make your own fermented foods at home, but what are some of the things that you suggest people do with fermented foods? At your dinner table, how would you incorporate fermented food into a meal?
Dr. David Perlmutter: I don’t think it’s really that challenging. The more I’ve been eating fermented foods over the past couple of years, the more I’ve enjoyed them. And a kimchi, for example, fermented vegetables, Korean recipe is very easy thing to make. You can buy actually a kit online and you make a gallon or two at a time. It stays in your refrigerator for a month or two. And what that means to me is simply putting a serving of kimchi alongside the vegetables and whatever else I might be having with dinner or lunch, keeping things in refrigerator and just adding them in.
If you don’t want to make kimchi, that’s totally fine. Most grocery stores now carry kimchi and other fermented vegetables like sauerkraut, fermented pickles. Pickles are fermented by definition, so that was a bit redundant. But hey, many health food stores carry these foods. You buy them, you put them in your refrigerator and you just put a spoon in and add them to your meal.
So I think that when you really get your arms around the health benefits of these fermented foods, you’re going to want to eat them more and more.
And likewise, adding in the prebiotics, the fiber rich prebiotic foods as I mentioned like Jicama. Jicama is Mexican yam. You can grate this and use it as a side dish. You can eat it raw, it can be cooked, it can be added to the vegetables that are being cooked, added to soup. It retains its prebiotic activity. There are various ways it can be flavored and spiced. It’s actually very beautiful looking dish on your plate.
But that said, onions, even when they’re raw. Garlic, add it to your meal. One of my favorites has become dandelion greens. You can sauté them with garlic and olive oil, a little salt.
And yeah, “Do they taste a little bit bitter?” Sure, they do. But I think pushing the flavor boundaries is a good thing.
Jennifer: It is!
Dr. David Perlmutter: I get behind the notion, “What makes you feel good about the foods that you eat?” Well, it can be attractive to you in terms of the flavor. But when you get some higher brain function going into the mix here too, instead of just catering to your pleasure center or lower brain area that says, “We love sweet, salt and fat”… when you get the higher brain center that say, “We love this food because it’s good for me“ dialed in, then eating becomes really a different experience. It becomes a lot more enjoyable and much more empowering. I think much more satisfying.
You really feel good about what you’re eating instead of it just being another meal. You feel like you’re really honoring the “let food be thy medicine” doctrine. That’s what’s happening in the world of nutrition as it relates to medicine, which unfortunately here in America is looked upon with almost derogation. People still don’t recognize what a powerful influence our diet has upon our health. Who knew? That was only published just recently by I think his name as Dr. Hippocrates.
The point is that I gave a lecture the day before yesterday to first year medical students at the University of Miami who are deeply entrenched in basic science right now – anatomy, physiology, pharmacology. And here I roll in there and give a two hour lecture showing peer reviewed science about the role of nutrition in human health and in disease prevention and it was great. I call them kids. They’re younger than my children, so definitely kids. They just loved it.
I know that after my lecture, they’re going to jump back in and then hit the books and learn more about how to treat illnesses with prescriptions. But if one percent of them got this message, that’s going to be huge. The word “doctor” doesn’t mean healer, it means teacher. So I’m getting back to a lot of that these days. That’s why I wrote this new book Brain Maker to give people the tools to empower them to not need doctors, not need me to just make these life changes in terms of modifiable factors, the most important which is the food we eat.
Jennifer, great kudos to you for doing the work that you do because the word that you spread through this forum, and the people that you have on whom you take the time to interview are just giving out life-changing information for people. So I honor you for that.
Jennifer: Awww, thank you. I’m really glad and I am so appreciative that you’ve been willing to return and not just spend time with me, but to share and disseminate this information and be so generous with it. You’re right… there really is only one of you and there’s a very limited number of physicians out there that are on this train of believing that if we get back to a more traditional diet in some respect, getting away from the refined carbs and grains, adding in actual healthy sources of fats and getting rid of our fat phobia, having really good fermented foods in or diet, we can actually begin to correct things. You’re helping inspire people to realize that the control is within their reach.
I think a lot of times with modern medicine, people feel like, “Well, if there’s no pill, I’m a lost cause.” But what you shared with us today goes to show that no one is really lost cause. That on some level, we all can find a way to some degree to take back control of our health and especially – oh, my gosh! Your brain is so important. Brain function is so important. I’m really grateful that you’re able to address this and bring this message to the public at large and it’s been so well received. So thank you so much for that and thank you for joining us today!
Dr. David Perlmutter: Oh, it’s absolutely been my pleasure. And again, great work that you’re doing. Any time you need me, just send me an email and I’ll be back.
Jennifer: Okay, will do. Well everybody, please stay in touch with Dr. Perlmutter. You can visit him on his wonderful website at DrPerlmutter.com. He’s on Facebook and on Twitter. I’ll put all the links below.
And remember, you’ve got to go get this brand new book, Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain for Life.
I’ll put links below to everything to make it really easy for you. I have to tell you, every single thing that I have read, everything that I’ve listened to by Dr. Perlmutter has been more than worth it. I’m urging you, this is the book. If you don’t get any other book from any other author that I’ve ever talked to, this is one to get.
Thank you so much for joining us, I hope you have a fantastic rest of your day and I look forward to seeing you the next time. Bye bye.
Dr. Perlmutter’s website – www.DrPerlmutter.com