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Can a Low Gluten Diet Reduce Risk of Dementia?

By Burg Simpson
March 2, 2014
4 min read

David Perlmutter, neurologist and associate professor at the University of Miami School of Medicine, argued in his new book: “Grain Brain: The surprising truth about wheat, carbs, and sugar – your brain’s silent killers,” that a high-fat, nearly carbohydrate-free diet can prevent or greatly lower the risk of dementia and its progression. Perlmutter takes a fresh look at past research on blood sugar and dementia and discusses the underlying connection.

The link between gluten and your brain
Perlmutter argued that high blood sugar caused by eating high levels of carbohydrates leads to an increased risk of dementia. He argued that this is caused by processed carbs and sugars as well as whole grains.

Carbohydrates, especially foods with gluten, elevate blood sugar, which stimulates inflammatory reactions in a number of people, not only persons with a gluten allergy. Science has already shown that this reaction can lead to bowel permeability or increased blood-brain barrier permeability. Perlmutter argued that this reaction also affects a person’s brain health.

Supporting research
Perlmutter used a study by researchers at the Medical University Graz, published in 2005 that looked at glycated hemoglobin and its relation to brain atrophy. Glycated hemoglobin is an indicator of not just blood sugar levels, but the overall presence of glycation in the body. Glycation increases inflammation and the production of free radicals and oxidative stress in the body.

A study by Crane, Walker, Hubbard and others supported by the National Institutes of Health, published in August 2013 in the New England Journal of Medicine, found subtle elevations of fasting blood sugar (the level of blood sugar after a person hasn’t eaten for eight hours) dramatically increased risk of dementia. Perlmutter quoted the study’s conclusion: “Our results suggest that higher glucose levels may be a risk factor for dementia, even among persons without diabetes.”

The Mayo Clinic published a study in the Journal of Alzheimer’s Disease in 2012 that found people who ate a high-carb diet increased their risk for mild cognitive impairment by 89 percent, compared to people who ate a high-fat diet, whose risk decreased by 44 percent.

The opposing view
Perminder Sachdev, co-director of the Center for Healthy Brain Ageing at the University of New South Wales, said a current study indicates that high blood sugar levels in the brain increase the risk of cognitive decline and brain shrinkage due to oxidative stress and inflammation, the Sydney Morning Herald reported.

Sachdev disagrees that there is a link between gluten and dementia. Maintaining a person’s glucose at low, healthy levels is necessary for increased brain health, not the avoidance of gluten.

“Some people need to avoid gluten because of [celiac] disease or gluten sensitivity, but there’s no strong evidence linking gluten to dementia,” he said, according to the Sydney Morning Herald.

What should you eat?
Perlmutter advocates maintaining a low blood sugar diet by eating a low carb and high fat menu. He suggests keeping daily carbohydrates to only 60-80 grams, adding healthy fats in the diet and avoiding modified, trans, and hydrogenated fats.

“We’re talking about specifically small amounts of grass-fed beef and wild fish.” said Perlmutter. “We’re moving the meat, chicken, and fish away from being the centerpiece of the meal to being the side dish, the garnish. Lots of above-ground leafy green vegetables, colorful vegetables, and welcoming back good fats, because that’s what the brain is desperate for.” according to MedScape.

Sachdev argued there is no foolproof plan to avoid dementia, but certain diets have been linked to a reduced risk such as the Mediterranean or traditional Japanese diets. He suggested choosing carbs wisely, eating plenty of fish and vegetables, olive oil and only small amounts of lean meat.

“Knowing that poor control of glucose can harm the brain means that doing all we can to keep glucose levels healthy with the right food and exercise gives us a better chance of avoiding dementia,” Sachdev says.

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