Tips on going carb free, from Grain Brain author David Perlmutter

Neurologist and New York Times bestselling author on the effects of gluten and carbohydrates on brain and heart health
By Jessica Galang
Whole wheat bread Photo by Roberto Caruso

It isn’t difficult to see that low-fat foods are all the rage in any diet — just take a trip to the grocery store and see the hundreds of food labels boasting “low-fat” on their labels. But what if a doctor told you to that a high-fat, high-protein and low-carb diet can help prevent Alzheimer’s disease — and that whole grain sandwich you’re eating isn’t as good for you as you think?

Dr. David Perlmutter is a neurologist and Fellow of the American College of Nutrition whose New York Times bestseller, Grain Brain, challenges the way we think about brain and body health. After 18 years of research and practicing in the field of neurology, he believes that the gluten, carbs and sugar we’re eating in our modern diets is raising our blood sugar and putting us at risk of diabetes and brain disorders. Chatelaine sat down with Dr. Perlmutter to find out what inspired his book, the science behind it, and tips on starting the Grain Brain diet.

What inspired you to look at the connection between gluten and neurodegenerative disorders?

As a neurologist, I’ve been very frustrated because what we’re really doing is trying to come up with symptom management - there’s really no treatment for things like Alzheimer’s or Parkinson’s. So I began exploring what researchers are looking at in terms of causality and a lot of them have been looking at gluten and carbs.

Why are carbs connected to neurodegenerative disorders?

Carbs raise your blood sugar and raising your blood sugar is devastating for memory and the structure of the brain. Carbs and sugars inflame pathways to the brain, and we’ve known for decades that Alzheimer’s is brain inflammation. The more carbs you eat the higher your blood sugar. It’s really that simple.


So can someone just shop in the gluten-free aisle and be okay?

Gluten is found in wheat, barley and rye. But beyond wheat, there are also non-gluten containing foods that have a devastating amount of carbs. I’m certainly not advocating for spending any time in the gluten-free aisle of your grocery store because gluten-free cakes, cookies, pasta and bread are still terrible sources of carbs.

In your book, you say that we’re going in the wrong direction by demonizing high cholesterol, and you’ve found that cholesterol is actually good for you. What makes you say this?

Cholesterol in itself is a very healthy thing for the brain, heart and the immune system. LDL, or low-density lipoprotein, has gained a moniker for being a ‘bad cholesterol’. But LDL isn’t any form of cholesterol; it’s not a fat, it’s a protein. So to call it bad or good is meaningless.

What it serves to do in human physiology is to carry cholesterol throughout the body where it’s desperately needed – including the brain –where it’s critically important for brain function. And research has shown that the risk of dementia is highest in those with lowest cholesterol.


So why the bad rep?

LDL can become a problem when it becomes oxidized, which is damaging. The higher your blood sugar, the more LDL becomes oxidized and the more damaging it becomes for the body and heart.

You also say that we should be embracing high-fat diets. 

For 99.9 per cent of our time on this planet, we’ve eaten a high-fat diet. If you eat a low-fat diet you will inevitably bump up your carb consumption, which is the cornerstone of brain disease. The fact is that the balance of cholesterol, HDL and LDL in your body is really enhanced by consuming good fat. Not trans fat.

What does breakfast, lunch and dinner look like for you?


If I choose to eat breakfast, generally I will have several eggs with kale or spinach, mushrooms, goat cheese and everything is drenched in olive oil. I love olive oil.

Normally for lunch I have steamed mixed vegetables, mixed greens, and fish. For dinner I may have salmon several times a week, grass fed beef about once a week and chicken about once or twice a week. I’m big on kale salads with lunch and dinner. Sometimes on weekends I might have an omelette for dinner with spinach and goat’s cheese.

What are your top 10 favourite supplements?

There’s seven: alpha-lipoic acid, coconut oil, DHA, probiotics, resveratrol, turmeric and Vitamin D3. But DHA is especially important because it’s an important building block for the membranes surrounding brain cells, particularly the synapses that lie at the heart of efficient brain function. 

Should we also be including fruit in our diet?


I think that a piece of fruit a day is okay. But the notion of recommending six to eight servings of fruit a day is pounding your body with fructose and glucose, and that is devastating for your health. We’re all told to start our day with a 12 oz glass of fruit juice. But there’s 36g of carbs in a glass of orange juice – that’s nine teaspoons of sugar. It’s basically the same as drinking a can of coke.

How can someone just starting your diet approach it?

I say that half-measures only work halfway. Go low-carb, high fat and gluten free and within a couple of weeks you’ll feel like a new person. We’re addicted to carbs and it’s very difficult for some people to change but I encourage people to jump in with both feet. When you lose the weight and your mind is clearer it’s very reinforcing.

If you could sum up your book in a few sentences, what do you think the most important messages would be?

Number one: brain degeneration is preventable. We’ve got to extend our notions of preventive medicine to brain health and diet matters more than you can imagine. The foods people are generally eating these days are very detrimental to not only our brain health, but also our whole health. It increases our risk for inflammation, diabetes and weight gain.


If you want to try Dr. Perlmutter’s diet for yourself, we have a few recipes from the Grain Brain Cookbook to get you started.


Torta Rustica

3 tablespoons extra-virgin olive oil ½ cup grated onion 1 teaspoon minced garlic 2 cups cooked, chopped, well-drained spinach 1 cup sheep’s milk ricotta cheese ½ cup grated Pecorino Romano cheese Salt and pepper

Preheat the oven to 500F. Generously butter a 2-quart casserole and set aside.

Heat the olive oil in a small frying pan over medium heat. Add the onion and garlic and sauté just until softened, about 3 minutes. Remove from the heat and set aside.

Combine the spinach with the ricotta and Pecorino in a mixing bowl. Add the reserved onion mixture, season with salt and pepper to taste, and stir to blend completely. Scrape the mixture into the prepared casserole, smoothing the top with a spatula.


Transfer to the preheated oven and bake for 5 minutes; then, lower the heat to 350F and bake until completely set and golden brown around the edges, about 20 minutes more.

Remove from the oven and set aside for 5 minutes. Cut into six wedges and serve.


Thai Pork Lettuce Cups, gluten free from Grain Brain Photo, Stephen Pool.

Thai pork lettuce cups

1 tablespoon coconut oil 1 pound lean ground pork 2 tablespoons minced shallot 1 tablespoon minced garlic 2 tablespoons minced red onion 2 tablespoons minced fresh mint 1 tablespoon minced scallion 1 tablespoon minced fresh cilantro 1 tablespoon minced seeded hot red chili 1 tablespoon freshly squeezed lime juice 1 tablespoon Red Boat fish sauce 12 large Boston lettuce leaves 4 mint sprigs, for garnish

Heat the oil in a large frying pan over medium heat. Add the pork, shallot, garlic and fry, stirring frequently, until the pork is crumbly and cooked through, about 8 minutes.

Remove from the heat and scrape into a mixing bowl. Add the onion, mint, scallion, cilantro and chili, stirring to blend. Add the lime juice and fish sauce and blend well. Taste and, if necessary, season with salt.


Place 3 lettuce leaves in the centre of each of four luncheon plates. Mound an equal portion of the pork mixture into the centre of each. Garnish with a mint sprig and serve.


Salmon Roasted in Butter, gluten free from Grain Brain Photo, Stephen Pool.

Salmon roasted in butter and almonds

1 (1/2 pound) skin-on salmon filet Salt and pepper 6 tablespoons unsalted butter ¾ cup slivered almonds 1 tablespoon freshly squeezed lemon juice 2 tablespoons chopped fresh chives Cracked black pepper for optional garnish

Preheat oven to 500F.

Season the salmon with salt and pepper to taste. Set aside.

Place the butter and almonds in a small baking pan in the preheated oven. When the butter has melted, add the salmon, flesh-side down. Roast for 5 minutes; then, turn and continue to roast until the salmon is barely beginning to flake, about 3 minutes more (You can test by sticking the point of a small, sharp knife into the flesh to see if it flakes or easily comes apart.) Remove the pan from the oven and transfer the salmon to a serving platter. Stir the lemon juice and chives into the “sauce” in the pan and immediately pour over the salmon. Sprinkle with cracked black pepper, if desired, and serve.


Excerpted from the book THE GRAIN BRAIN COOKBOOK: More Than 150 Life-Changing Gluten-Free Recipes to Transform Your Health by David Perlmutter, MD. Copyright © 2014 by David Perlmutter, MD. Reprinted with permission of Little, Brown and Company/Hachette Book Group. All rights reserved.


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