As a practicing physician, I have spent decades studying the nutritional literature trying to figure out how I should advise my patients when it comes to a healthy diet. Vegan or Paleo? Atkins or Ornish? Low-fat or ketogenic? The options are as endless as their associated health claims. It’s like trying to figure out which religion to follow. Every nutritional guru lives in their own castle, defending their position against those of their rivals and sometimes the battles can get bloody.
Over the years I have carefully studied each and every one of these approaches. I have looked at the scientific literature and I have looked at the patients who follow each approach. I have talked to the academic researchers and the clinicians who advise their patients to follow a specific diet. I have also carefully looked at my patient’s brain function because there is emerging evidence that what you eat can influence how well your brain works.
The Diet-Brain Connection
It is now clear that the incidence of many common brain disorders like ADHD, depression, obsessive-compulsive disorder, anxiety disorders, eating disorders, bipolar disorder, post-traumatic stress disorder, fibromyalgia and similar conditions are increasing at an epidemic rate. Many common metabolic disorders such as insulin resistance, obesity and type II diabetes are also increasing in incidence. Many studies have shown that these metabolic disorders and brain disorders are co-morbid. That suggests that they may be somehow connected.
Over a decade ago, Hudson and Pope from Harvard proposed that many of these common brain disorders are driven by a shared pathology. They called this disorder Affective Spectrum Disorder. Because they never identified the underlying pathology or environmental triggers of the condition and didn’t tie it to metabolic problems, their concept never made it out of academic medicine. I believe that is about to change.
The Toxic Triad
After years of clinical experience I am convinced that we have a deadly trio of toxic elements in our modern diet. Let’s start with excessive fructose. Most people consume large amounts of this simple sugar in the form of sucrose or high fructose corn syrup. These sugars are now added to virtually all processed foods. My friend Richard Johnson has done much of the research demonstrating the adverse metabolic affects of excessive fructose. Robert Lustig, a pediatric Endocrinologist from California, has led the charge when it comes to labeling sugar as a chronic toxin and I tend to agree with him. His recent book “Fat Chance” tells the tale. Excessive fructose seems to be the driving force behind insulin resistance where your cells need more insulin to allow glucose to enter into the cells. Excessive fructose is converted into triglycerides in your liver, causing a condition called fatty infiltration of the liver, the first step in insulin resistance. The majority of adults in this country now have too much fat in their liver.
Once you have insulin resistance from consuming too much fructose and you consume high glycemic carbohydrates, especially from grains, you end up with magnified glucose spikes in your blood. Because your neurons don’t have an insulin gate, these glucose spikes also occur in every nerve cell in your body and too much glucose can be toxic to these cells. High levels of glucose interfere with mitochondrial function, the small energy producing factories located in all cells. Too much glucose can also lead to glycation of proteins and fats, interfering with their normal functioning in your body.These glucose spikes also seem to cause the cells to dump out too many neurotransmitters like dopamine, norepinephrine and serotonin. This likely explains the temporary good feeling you experience after eating that glazed donut. Unfortunately this eventually leads to a situation where the neurons are depleted of neurotransmitters and this can lead to a long list of brain dysfunction symptoms.
The nerve cell membranes also play a critical role in neuron function. Cell membranes are made of a combination of lipids and proteins called phospholipids. In order to have healthy neuron membranes, you need to consume about equal amounts of the essential omega 6 and omega 3 fatty acids. Our modern diet is loaded with omega 6 fatty acids and lacks omega 3 fatty acids. Excessive omega 6 fatty acids tend to promote inflammation and a situation where your nerve cell membranes don’t function as intended. Barry Sears outlines this process in his latest book “Toxic Fat”. The simplest approach to this problem is to measure your omega 3 index. The ideal omega 6 to omega 3 ratio is 1.5-3. Many adults probably need around 2,400 of combined DHA and EPA daily.
Our Diet Has Spawned a New Disease
Thus when you consume processed foods loaded with excessive fructose, grain-based high glycemic carbohydrates and excessive omega 6 fatty acids, both your metabolism and brain take a hit. I believe this is what Hudson and Pope were seeing with their Affective Spectrum Disorder concept. Now that we understand the connection between this disorder and diet, we have renamed it Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. David Perlmutter in his new book “Grain Brain” proposes that our diet of processed food can increase the risk of brain disorders like Alzheimer’s disease, Parkinson’s disease, autism and similar disorders and I agree with him. The CARB syndrome concept takes it to the next level and proposes that this type of food is triggering a new disease that didn’t exist before we changed our diet.
People with food-induced brain dysfunction or CARB syndrome can develop up to 22 brain dysfunction symptoms that interfere with their ability to function. People with these symptoms are often misdiagnosed with traditional disorders like major depression or bipolar disorder but it’s easy to tell the difference. Years ago all depressed patients lost their appetite and lost weight. In recent decades many depressed patients have an increased appetite, cravings for sweet and starchy food and weight gain. In my opinion this is CARB syndrome, not true major depression. Years ago we only had one type of bipolar disorder associated with mania and psychosis. In recent years we have been seeing a lot of folks with hypomania and mood swings we no psychosis. They decided to call this condition bipolar II. In my opinion this is CARB syndrome, not a form of bipolar disorder If you have the CARB syndrome variety of depression or bipolar Ii, you don’t need drugs—you need to change your diet! CARB syndrome is creating a lot of confusion in the medical profession because the symptoms of CARB syndrome overlap with many traditional brain disorders but you don’t need to be confused once you understand the CARB syndrome concept.
Because the brain plays a key role in auto-regulating fat stores, people with CARB syndrome continue to store excessive body fat even as they lose lean body mass from dieting. Anorexia is a good example of this phenomenon—a skinny person with excessive body fat and a brain that isn’t working very well. Someone with anorexia doesn’t have well-defined muscles because their lean body mass is decreased and their muscles are covered with a layer of fat. They have the same cravings as every other person with CARB syndrome, so when they do eat they tend to eat sweet and starchy foods.
Three Simple Rules
Now let’s get back to the food fight. I agree that that most diets promoted by popular nutritional camps are likely to be healthier than the Standard American Diet (SAD). Because each of us has a different genetic makeup, we are also likely to respond to various dietary elements somewhat differently. In my experience of treating thousands of patients over the years, most people will benefit from three simple principles:
- Keep your fructose intake below 25 grams per day. That means virtually no sugar or HFCS.
- Drastically reduce or eliminate grain-based carbohydrates. Get your carbohydrates primarily from vegetables and some fruits.
- Measure your omega-index and increase your intake of foods with omega 3 fatty acids, decrease your intake of omega 6 fatty acids and if that doesn’t do the trick consider taking a high quality omega 3 supplement to get your ratio in a healthy range.
Now that wasn’t so hard. By following these three simple eating rules most of the time, you will be well on your way to a healthier metabolism and improved brain function.
This approach is fairly close to a Paleo-style diet and people who are already metabolically damaged might benefit from such a diet as outlined in Loren Cordain’s book “The Paleo Answer” or Robb Wolf’s book “The Paleo Solution”. Others with a different genetic background might have more leeway in their dietary choices so you can experiment somewhat and see what works best for you. You can start with Paleo to get your metabolism and brain back and line and then play with broadening your diet to see how you do. In my experience paying attention to your cravings for sweet and starchy foods is the best way to monitor how your food choices are affecting you. These cravings are the lead symptom of CARB syndrome. The incidence of CARB syndrome seems to be inversely proportional to the length of time a given race has been eating processed food, so racial background should also be considered.
A New Meaning for Fat Head
A ketogenic diet can also be a great way to get your metabolism and brain back in line. This type of diet pushes your body and brain to use ketones for energy rather than glucose. It was originally developed to treat seizures, but there is some evidence it may be useful for other brain disorders. David Perlmutter discusses this approach in his book “Grain Brain” and Jimmy Moore has been a big proponent of ketogenic diets for maintaining a healthy weight and improving brain function.
Throw in a Few Supplements
I have also found that certain safe supplements can be helpful for preventing or managing CARB syndrome. The amino acid L-glutamine taken on an empty stomach between meals can help to suppress those pesky cravings for sweet and starchy food. Taking saffron as a supplement can also be helpful in this regard. I also recommend supplements like Cinsulin and chromium picolinate that help to reduce those brain-frying glucose spikes. To replenish your brain neurotransmitters I recommend taking a precursor supplement like CARB-22. I also like a product called GlycemicPro that contains the enzyme transglucosidase, which converts starches to fiber in your own digestive tract. This substance has been shown to reduce glucose levels and alter gut bacteria in a beneficial way in a recent double-blind study.
I am also a fan of probiotics and fermented foods to maintain a healthy gut flora. There are basically three nodes at play when it comes to your metabolic and brain health. The first node is your central nervous system–the brain between your ears. The second node is your enteric nervous system that controls your stomach and intestines and the third node is your microbiome or gut flora. All three nodes are adversely affected by a diet of processed foods and when one node tanks it adversely affects the other nodes because of the two-way communication between the three nodes. Yes, it is a little complicated but the good news is that a healthy diet keeps all three nodes functioning as Mother Nature intended.
It’s time to stop the food fight. You don’t need a nutritional guru to tell you how to eat. Your goal should be to start eating in a way that protects both your metabolic health and brain function and I believe we now have the science to show us the way. The key is to reduce your consumption of processed food and added sugars, consume moderate amounts of high quality protein and increase your intake of healthy fats. Using the Paleo diet as a template is probably the easiest way to do so for many people, but as long as you follow the rules you can craft you own healthy eating plan and become your own “nutritional guru”.