One of my favorite activities on Saturday mornings is opening up the Wall Street Journal to see what editorial writer Peggy Noonan has to say. In my opinion, she is one of the most insightful and thoughtful writers in the world concerning politics and current events. This past Saturday, I was a bit shocked to see Peggy once again commenting on President Trump’s brain for the third time in the past year. In the past, I’ve rarely seen her repeat topics in this manner. I suspect that like everyone else, she can’t figure out what the heck is wrong with Trump’s brain. Peggy, I have good news for you. I know precisely the reason why his brain is going into the toilet.
To understand my perspective, you will need a little background information. As many of my readers know, I am a Family Physician with a long-standing interest in the connection between diet and brain function. It started 30 years ago in the small northern Minnesota town named Chisholm, where I had my primary care practice. At the beginning of the obesity epidemic, I decided to measure the body composition of all my patients because the scientific definition of obesity is excess body fat. Weight and BMI tell you nothing about what is inside your body. I also had a keen interest in Neuroscience, so I always paid close attention to my patient’s brain function.
A New Disease Model
After taking thousands of body composition readings, I noticed something quite strange. There seemed to be a strong correlation between numerous brain dysfunction symptoms and excessive body fat regardless of someone’s size or weight. I also noticed that the brain dysfunction symptoms seemed to precede the changes in body composition. In these patients, when it came to fat storage, their brain seemed to call the shots. I also noticed that the lead symptom of this brain dysfunction seemed to be excessive hunger combined with intense cravings for sweet and starchy food. These patients would also develop a bevy of brain dysfunction symptoms that overlap with common brain disorders, and as these symptoms progressed, their brain function would become significantly impaired, interfering with their ability to function in virtually all settings.
About 15 years ago, I stumbled across a paper published in the journal JAMA Psychiatry written by James Hudson and Harrison Pope, two prominent Harvard Psychiatrists. They proposed that 14 common brain disorders were part of the same disease process which they called Affective Spectrum Disorder (ASD). These conditions included major depressive disorder (MDD), attention-deficit/hyperactivity disorder, bulimia nervosa, cataplexy, dysthymic disorder, fibromyalgia, generalized anxiety disorder, irritable bowel syndrome, migraine, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, premenstrual dysphoric disorder, and social phobia. Despite their impeccable credentials, their concept was far too radical for the medical and scientific communities, so it never made it out of academic medicine. They also never discovered the primary trigger of ASD.
I came to a similar conclusion monitoring the body composition and brain dysfunction symptoms on thousands of my patients. After careful observation and study, I concluded that at least 20 common disorders were part of the same disease process and I found that the primary trigger of this disease is long term exposure to highly processed food loaded with excessive fructose mainly from added sugars, excessive high glycemic carbohydrates especially from grains and excessive omega 6 fatty acids mostly from vegetable oils. I decided to change the name of this disease to Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. Over decades I learned how to diagnose this common disease accurately, and I found that it was completely reversible with proper management and compliance on the part of the patient.
I eventually identified 22 symptoms of CARB syndrome that over time, can significantly impair brain function. Early in the disease, people can often overcome their brain dysfunction with extra effort, but once they cross a certain threshold, things rapidly fall apart. Patients develop “labelitis” when diagnosed with a multitude of traditional brain disorders. They also accumulate a long list of treatments that are either ineffective or tend to make them worse over time.
I also find it fascinating what the top Neuroscientists in the world came up with over 15 years after Hudson and Pope published their remarkable papers. All the top Neuroscientists in the world got together several years ago and formed an organization called The BrainSTORM Consortium. Their goal is to figure out how the brain works. We know a lot about what the brain does, but we know almost nothing about how the brain performs these complex tasks. Last year they published their first paper in the journal Science. They concluded that most neurological disorders are not closely connected, whereas many psychiatric disorders appear to share some common pathology. They listed ten diseases that include all those listed by Hudson and Pope. When the academic world (Hudson and Pope, BrainSTORM Consortium) come up with a thesis similar to one developed from the clinical empirical world (CARB syndrome), it almost always suggests that they are on the verge of a remarkable new discovery.
The Depression Conundrum
An example might be helpful. The Greeks were the first to describe major depression. To be diagnosed with this disorder, a person had to lose their appetite and lose weight. Without these parameters, you could not qualify for a diagnosis of major depression. It stayed this way for several thousand years until the 1950s when we first started to see some patients who appeared to be depressed, but they had an increased appetite and weight gain. This sudden occurrence of obesity coincided with the mass introduction of highly processed food in our diet. The “experts” who determine the criteria for mental illnesses and publish the Diagnostic and Statistical Manual of Mental Disorders (DSM) didn’t quite know what to do with this dilemma, so eventually they decided to include both parameters for major depression—increased and decreased appetite and weight loss and weight gain. In DSM V they call the weight loss type “melancholia” and the weight gain type “atypical depression”. Even a 7th-grade science student knows that if a parameter qualifies you for a diagnosis throughout the spectrum of the parameter, you must discard it because it can’t possibly help you to make a diagnosis. To me, it is clear that atypical depression is CARB syndrome, and it has nothing to do with traditional major depression. If you treat these people with high dose SSRI medications, the standard treatment for major depression, they get worse over time rather than better.
Several years ago, I wrote a previous post suggesting that Donald Trump has CARB syndrome. I can’t formally diagnose someone I haven’t personally treated, so I am merely speculating. You can decide if it seems to fit after learning about the 22 symptoms of CARB syndrome.
- Carbohydrate cravings. Carbohydrate cravings are the hallmark symptom of CARB syndrome, and you really can’t make a diagnosis of the disease without such cravings. These cravings are either for sweet food loaded with sugar or high fructose corn syrup or starchy foods, especially high glycemic starches like white flour, white rice, and potatoes. Whether you are consciously aware of these cravings or not, they will tend to drive your food choices. To me, it is clear that highly processed food is neurotoxic to the brain.
- Abnormal hunger drives. When your brain is functioning normally, you know when you are hungry, and you know when you are full or satiated. Your bodies’ nutritional needs are driven by your hunger drives. Much of this occurs at a subconscious level. When you develop CARB syndrome, your hunger drives become divorced from your bodies’ nutritional needs. You become hungry shortly after eating, and you don’t feel full after eating a reasonable amount of food. Hunger becomes your constant companion.
- Excessive physical and mental fatigue. One of the most common symptoms of CARB syndrome is excessive mental and physical fatigue. Your get up and go, got up and went. You wake up tired, and you end the day in a puddle of exhaustion. You don’t seem to have the mental energy to motivate yourself to do the things you need to do, and even if you do generate the mental motivation to move, your exhausted body doesn’t seem to want to go along with the plan.
- Difficulty concentrating and focusing. One of your brain’s essential functions is to concentrate and focus your thoughts in a way that allows you to effectively interact with your environment. When you lose the ability to concentrate and focus, it’s much more challenging to plan and carry out complex tasks. Your mind jumps from one random thought to another without apparent connections between the thoughts.
- Poor impulse control. One of your brain’s most important jobs is to control your impulses. As you move through your day, many of the things you think about saying or doing stay inside your head for good reason. If you expressed every thought that passes through your mind or acted on emotions without thinking, you would likely have few friends and your job prospects would be nil. It’s even possible you could end up in the slammer!
- Feelings of depression. If you have CARB syndrome, you will tend to have more down feelings than most people. Adverse everyday events are more likely to put you in a funk, and it’s much more challenging to maintain a sunny outlook on life. You tend to see the world through depression-tainted glasses.
- Excessive anxiety. Normal anxiety is a feeling of unease or discomfort based on some perceived threat in the environment. The anxiety associated with CARB syndrome isn’t normal because it isn’t a natural response to an environmental threat. This anxiety often appears for no reason, subjecting your body to the stressful “fight-or-flight” hormones that can trigger a full-blown panic attack.
- Excessive mood swings. People with normal brain function have some degree of emotional stability. They only get upset when the situation merits it. They somehow know when to feel happy, sad, anxious, or angry. Their moods almost always appropriately match the situation at hand. People with CARB syndrome often experience excessive mood swings, and they often emotionally overreact to everyday events. In a sense, their moods become disconnected from their environment.
- Insomnia. Melatonin is your natural sleep hormone that cycles with the amount of daylight. Because melatonin is derived from serotonin and when you have low levels of serotonin from CARB syndrome, your levels of melatonin will also be low, and you won’t be able to experience a restful night’s sleep. You may have difficulty falling asleep and staying asleep.
- Lack of proper sensory filtering. When your brain is working optimally, it filters out most signals from your sensory organs. You only see, hear, smell, and feel the touch of things that are relevant to your wellbeing, and the background static is filtered out. You tend to lose this sensory filtering when you have CARB syndrome, leaving you feeling uncomfortable in highly stimulating environments. You have difficulty concentrating on matters at hand because you are distracted by all this irrelevant incoming data. Excessive visual and auditory stimulation leaves you feeling extremely uncomfortable. At the disease progresses, you become uncomfortable in your own skin and avoid being touched even by those you love.
- Low self-esteem. It takes a healthy brain to maintain a healthy level of self-esteem or self-worth. If you have normal levels of self-esteem, you tend to have positive feelings about yourself, and despite any personal shortcomings, you vow to work on improving them without tearing yourself down. When you develop CARB syndrome, this positive sense of self starts to slowly fade away. You develop negative feelings about yourself even when you have done nothing to deserve such feelings. When you have low self-esteem, it’s much more challenging to interact with others positively, leaving you even more socially isolated. We know from recent research that narcissism often masks low self-esteem, and almost everyone seems to agree that Trump is a master narcissist.
- Low self-image. Self-image is similar to self-esteem but with subtle differences. Your self-image is what you experience when you look in the mirror, whereas self-esteem is a more internal sense. Your self-image is how you view your physical self. When your brain is working at intended, you like what you see when you look in the mirror regardless of any physical flaws. When you develop CARB syndrome, you slowly start to lose this positive self-image, and when you look in the mirror, you never seem to like or accept what you see because you only see the flaws. Because you don’t like what you see in the mirror, you assume that others recognize what you see—your weaknesses. A negative self-image pushes you to withdraw from social settings and other people, even those you care about, or you tend to compensate with narcissistic behavior.
- Loss of cognitive function. Your brain’s ability to cognate is its ability to think and perform more complex tasks based on abstract concepts. Using language, mathematics, and complex logical reasoning all depend on your brain’s ability to achieve higher cognitive functions. In a sense, being able to perform such complex cognitive tasks is what makes us human. When you develop CARB syndrome, your ability to perform these types of complex tasks becomes somewhat impaired. This change tends to be very subtle and occurs very slowly, so it’s not always readily apparent to you or others, but over time this change becomes more noticeable. Early in the disease, you can often compensate by merely working harder. Later as the disease progresses, even increased effort leaves you coming up short.
- Lack of empathy. To effectively empathize with others, you first need to put yourself in their shoes and see the world through their eyes. This process occurs naturally when your brain is functioning optimally. People sense your empathy for their situation, and this creates a bridge for closer and more meaningful relationships. Without empathy, human interaction tends to be more about differences and conflict rather than shared experiences. Empathy is the glue that binds our social fabric. When you have CARB syndrome, it becomes more challenging to see the world through the eyes of others. You become more self-centered and less concerned about the feelings and experiences of others, often leading to more social isolation and rebound narcissism.
- Chronic pain. Pain is your body’s way of telling you something is wrong in your immediate environment, something that is a direct threat to your safety and wellbeing. The pain fibers that feed your brain are always sending low-level signals that are filtered out by your brain, but when they want to alert you to actual environmental dangers, they will get your immediate attention. When you develop CARB syndrome, your brain slowly loses this filtering function, so some of these background pain signals start to get through. In a sense, you start feeling things that you aren’t supposed to feel.
- Short-term memory problems. Retaining memories is what allows you to learn from your experiences. Initially, new memories are stored in short-term memory, and later significant memories become cataloged in long-term memory. When you develop CARB syndrome, memories don’t stick so easily in short term memory, and they often fade away before they make it to long-term memory. Unlike true dementia, the memory problems associated with CARB syndrome tend to be mild and are entirely reversible with appropriate treatment.
- Internal restlessness and racing thoughts. When your brain is working as intended, it’s normal to experience a sense of natural calm when things are going well because you are in tune with your surroundings and your thoughts reflect what is going on around you. When you are fully integrated into your environment, this calmness is the natural outcome. When you develop CARB syndrome, this inner calm tends to fade slowly to be replaced with a feeling of internal restlessness where you feel the compulsion to keep moving. It becomes more challenging to sit in one place for any length of time, and you often resort to nervous habits like twirling your hair or tapping your leg. These “nervous habits” become almost second nature to you as the disease progresses. When you develop CARB syndrome, you race from thought to thought without logical connections between the ideas, leaving you with a “scatter-brained” feeling.
- Poor listening skills. You need a healthy brain to hear and process what others are saying to you, and then to respond appropriately. The ability to effectively listen requires a highly functioning brain. When you develop CARB syndrome, your ability to listen starts to diminish, and you don’t fully hear or comprehend what others are saying to you. You fail to effectively process communication from others, creating problems in interpersonal relationships. It also makes it more difficult for you to function in school and work environments, and you become more socially isolated.
- Obsessive-compulsive tendencies. Obsessions are repetitive thoughts that at some point, start to lose their value when they become too frequent or intrusive. Compulsions are repetitive behaviors that also become counter-productive if they become too frequent or intense. When you develop CARB syndrome, your ability to control obsessions and compulsions becomes impaired to the point where they interfere with your ability to function. You obsessively think about unimportant matters, and you repeat meaningless behaviors, leaving you little time for productive work.
- Intestinal symptoms. Your second brain is called the enteric nervous system. It controls the movement of food and waste through your stomach and intestines. When you develop CARB syndrome, your enteric nervous system starts to malfunction because like the brain between your ears, it is also adversely affected by magnified glucose spikes from consuming highly processed food. You may experience bloating, abdominal cramps, excessive flatus, and alternating diarrhea and constipation, qualifying you for a diagnosis of irritable bowel syndrome (IBS).
- Increased communication lag time (CLT). When somebody says something to you, it usually takes less than a second for you to listen and process this information. When you have processed and understood the message, you acknowledge it with a subtle change in facial expression, a head nod, or some other form of body language. This period of time that it takes to listen to and process a message is called the Communication Lag Time (CLT). You can’t respond to a message unless you understand what has been said, and this process generally takes less than a second. When you develop CARB syndrome, your ability to listen and process information slows down to the point where it takes you longer to process and respond to information from others. Your CLT starts to slowly increase to several seconds or more. The person speaking to you subconsciously senses this increase in CLT because it throws a monkey wrench into routine communications. The natural flow of communication is lost, along with much of the content of the message.
- Consciously thinking about food and eating. When your brain is working as intended, if you haven’t eaten for six to eight hours, it’s perfectly normal to consciously think about food and eating. Up until then, hunger drives tend to be subtle and subconscious. If you don’t respond to these subliminal cues to eat, your brain will ratchet things up a notch and push hunger into your conscious thoughts.
To make a diagnosis of CARB syndrome, a person must have many of the above symptoms, and they must also have excessive body fat (obesity) regardless of their size or weight. There are many thin people with CARB syndrome symptoms who have excessive body fat when you measure their body composition. Anorexia is a good example. Unless they are pre-terminal, all people with anorexia have excessive body fat. At some point, some of these people go from being a thin person with excessive fat to a big person with excessive fat. The geniuses at DSM decided to call these fat people with anorexia “atypical anorexia”.
A President with his Brain in the Toilet
To me, it is clear that Trump has a majority of the above 22 symptoms. As is the case with most diseases, not every patient will have all the symptoms of the disease, but over time they tend to accumulate more typical symptoms, and the symptoms gradually become more severe and disabling. That’s what has been happening to Trump. Peggy Noonan seems to agree by stating, “Everyone knows Donald Trump is a mental case, including I believe Donald Trump. Why else does he keep insisting he is ‘an extremely stable genius’?
It is also clear that Donald Trump has a lot of excess body fat. You don’t need to measure body composition when someone has such obvious visual obesity. He most likely qualifies as being morbidly obese. He readily admits that he loves fast food and gets by on very little sleep. That’s why he is up half the night tweeting like a psychotic songbird. Even though the CARB syndrome concept is new and somewhat radical, it is attracting the attention of many top researchers and clinicians like Robert Lustig, Richard Johnson, David Perlmutter, Tim Noakes, and many others. That is why I believe it’s time to move this concept into the public forum.
There is no question in my mind that Donald Trump has CARB syndrome, a potentially serious disease that can lead to markedly impaired brain function. This topic has nothing to do with politics. I voted for Trump because I viewed him as a highly intelligent person and successful businessman with the potential to be a truly great President. I hate to see all of this potential go down the drain because of untreated CARB syndrome, a completely treatable and reversible brain disorder.
The bad news is that unless somebody who understands this disease effectively treats Trump, he is doomed to get worse to the point where his impaired brain function could endanger the safety of our country and the world. If you have access to President Trump, please let him or those around him know that I am willing to treat him for free. That way, Peggy can finally get Trump’s brain out of her mind, and a lot of people will feel more comfortable about the direction and safety of our country.
