NAPLES, FLA. — While connections between coronary heart disease and the diet have received considerable attention in recent years, Dr. David Perlmutter of Naples is hoping to draw interest in connections between nutrition and neurological disorders, including Alzheimer’s disease.

In an interview published in the winter 2013 edition of Advances in Mind-Body Medicine, Dr. Perlmutter said unlike the idea of a “heart healthy” diet, “brain and brain health have always remained distanced from consideration” in nutrition discussions.

“In fact, the brain is absolutely sensitive to those same influences that affect every part of the human physiology,” he said.

Dr. Perlmutter is a neurologist and fellow of the American College of Nutrition. He has a private medical practice in Naples. Dr. Perlmutter’s book on the subject, “Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar — Your Brain’s Silent Killers” will be published later this year by Little, Brown and Co.

The same two culprits are at play in the degeneration of the heart, the brain and “any part of our physiology” —free radicals and inflammation, he said. His research focuses principally on the latter factor, which he said has been widely recognized as a driving influence in coronary artery disease.

“Inflammation is the underpinning of all degenerative conditions, including diabetes and atherosclerosis and coronary heart disease,” he said. “What turns out is that the brain is just as susceptible, if not more susceptible, to inflammation than is the heart and other parts of the body. Disease like Alzheimer’s, multiple sclerosis and Parkinson’s are fundamentally and primarily caused by inflammation in the brain. The beauty of this understanding is that it opens the door to a wide variety of influences over wheat we have control, than can reduce inflammation and therefore can create a scenario where the risk of these diseases is reduced. If the disease is already present, then the rate of progression can be attacked.”

Among the brain health influences cited by Dr. Perlmutter is the macronutrient makeup of the diet. He enthusiastically advocates consumption of healthy fats suggesting the popular view of such products is negative.

“We live in a very fat-phobic society where everything is either low fat or no fat, as if that is supposed to impart some healthful property to food,” he said. “In reality, nothing could be worse.”

Dr. Perlmutter employs similar language in his assessment of the typical diet.

“When the majority of calories in the diet come from carbohydrates, that is the worst thing for physiology,” he said. “Carb calories are the worst thing for the brain, truly the worst thing for the endocrine system and absolutely the worst thing for the heart.”

He said such a carbohydrate-rich diet triggers a chain of events that dramatically increases the production of inflammatory chemicals as well as free radicals.

“The best diet focuses on good fats,” he said. “There are certainly plenty of bad fats out there — hydrogenated fats and trans fats — and I am surely not referring to them. Good fats from eating olive oil, avocadoes, nuts, seeds, fish, grass fed beef, goat cheese and fish oils are fundamentals for health, while carb-derived calories as one might get from things like bread, pasta, potatoes, below ground vegetables, fruit and fruit juices are really things that you want to do your very best to avoid for a brain-healthy diet.”

He said every assertion he makes is “supported by documentation and the perigree of literature.”

“The best diet is a high fat, low-glycemic index and low-carbohydrate,” Dr. Perlmutter said.

A cornerstone of Dr. Perlmutter’s thesis is the connection between type 2 diabetes and the risk of Alzheimer’s.

A scientific consensus appears to be building linking the two diseases. Still, an item on the subject posted by members of the Mayo Clinic staff also acknowledges doubts.

“Though not all research confirms the connection, many studies indicate that people with diabetes, especially type 2 diabetes, are at higher risk of eventually developing Alzheimer’s disease or other dementias,” according to Mayo.

By contrast, Dr. Perlmutter is unqualified in his view of the connection.

“This is a disease (Alzheimer’s) which you have a 50-50 risk of developing any way if you live to be 85,” he said, “When you’re diabetic, you double that risk.”

He went on to say developing type 2 diabetes “is a choice” and not a matter of genetics.

“It doesn’t just happen,” he said. “It’s a choice a person makes based on his or her diet. The more carbohydrates in your diet, the more likely you are to become diabetic, at which point you have created a scenario where you are more than likely going to become an Alzheimer’s patient. It’s a preventable disease.”

While the incidence of type 2 diabetes was estimated at 8.3% of the U.S. population (27% among senior citizens) in 2011 by the Department of Health and Human Services, Dr. Perlmutter in the interview cited “some statistics” indicating the risk of developing the disease over a lifetime is now 85%.

“It is a huge risk, in and of itself for the complication of diabetes,” he said. “But when you look at it in terms of what it is doing to Alzheimer’s risk, it is profound.”

While many authors are upbeat about prospective interest in the topic of their book, Dr. Perlmutter in the interview appeared particularly optimistic and pleased about prospective interest in “Grain Brain.”

“The response, even to the preliminary information that we are putting out about ‘Grain Brain’ has been global,” he said. “People are interested in this because the whole notion that gluten sensitivity might be something important if you are a professional tennis player or if you have gastrointestinal issues is interesting, but the fact of the matter is, the brain is a huge primary target. It’s a powerfully affected, primary target for gluten sensitivity. Inflammation is a key player and gluten sensitivity in humans is very, very important.”

Perlmutter backgrounder – no stranger to controversy

NAPLES, FLA. — A neurologist and fellow of the American College of Nutrition, David Perlmutter has a private medical practice in Naples, where his title is medical director of the Perlmutter Health Center and the Perlmutter Hyperbaric Center.

The center describes Dr. Perlmutter as “an internationally recognized leader in the use of hyperbaric oxygen in the treatment of neurological disorders,” but such treatment is not universally recognized as therapeutically beneficial.

Dr. Perlmutter’s background includes graduation from the University of Miami School of Medicine, where he did his residency training in neurology. He has been practicing neurology in Naples for 25 years. He is an adjunct instructor at the Institute for Functional Medicine in Gig Harbor, Wash.

Dr. Perlmutter has been directing the hyperbaric center for 14 years. The center employs hyperbaric oxygen therapy for the treatment of patients with a wide variety of neurological problems, including stroke survivors, vascular dementia, multiple sclerosis and cerebral palsy.

The therapy uses elevated air pressure to allow a patient’s lungs to gather up to three times more oxygen than would be possible breathing pure oxygen at normal air pressure. It is a well-established treatment for certain conditions, such as decompression sickness from scuba diving.

More controversial is the treatment of neurological conditions with the therapy.

For instance, health information provided by the Mayo Clinic said there is “insufficient scientific evidence to support claims that hyperbaric oxygen therapy can effectively treat” stroke patients — a group targeted by the Perlmutter Hyperbaric Center.

Even more controversial is the use of the therapy for multiple sclerosis.

A meta-analysis of 12 randomized studies published in CNS Neuroscience & Therapeutics and posted by (National Institutes of Health) concluded, “No plausible benefit of HBO(2)T (hyperbaric oxygen treatment) on the clinical course of multiple sclerosis was identified in this review.”