In this episode, we’re continuing our discussion with Dr. David Perlmutter on how the gut health impacts your brain health. It’s a really interesting discussion and you’ll sure learn a lot about the importance of your food choices in how your brain functions.
Now, if you have not listened to the first part, Grain Brain: How Gluten is Terrorizing Your Brain, be sure to check it out.
Donny Osmond: Hi, I'm Donny Osmond and welcome to The Brain Warrior's Way, hosted by my friends Daniel and Tana Amen. Now, in this podcast, you're going to learn that the war for your health is one between your ears. That's right. If you're ready to be sharper and have better memory, mood, energy, and focus, well then stay with us. Here are Daniel and Tana Amen.
Dr Daniel Amen: Well, welcome back everybody. We are here with our good friend, mentor, teacher, neurologist, four times New York Times bestselling author, Grain Brain, Brain Maker, his new book, The Grain Brain Whole Life Plan. He also has a cookbook which Tana and I are huge fans. So welcome back, David.
Dr David Perlmutter Delighted to be back with you guys.
Dr Daniel Amen: So in this episode, let's talk about Brain Maker. We'd started to talk about the gut-brain connection. Who would've thought in my psychiatric training at the Walter Reed Army Medical Center, not one lecture on the gut-brain connection. But the lining of the gut actually has some similarities to the blood-brain barrier, or the lining of the brain. And if one is troubled, it tends to be the other may become troubled. How did you get interested in this?
Dr David Perlmutter Well, like yourselves, I've been a bit of a disrupter, and [inaudible 00:01:37] satisfied with the status quo. Ronald Reagan told us that status quo is a Latin term for the mess we're in. Working in the neurosciences, it's a mess. 5.4 million Americans diagnosed with Alzheimer's, a number that's supposed to triple by the year 2030 and we have no treatment. We have no cure. I have been kind of led to believe that if you want to cure Alzheimer's or at least reduce it or MS or any neurologic condition, you should be looking at the brain.
Well, there weren't any answers there. And it turns out that we now have to take a step back and take a deep breath and realize that the origin of these diseases may well be in the gut, not in the brain. That's what motivated me to write this new book, Brain Maker, because it's all about the gut. It's all about what we learned from Dr. Hippocrates a few years back when he told us that all disease begins in the gut.
The reason that's so much more empowering is because we know that we can highly influence what goes on in the gut. Making the connection between our lifestyle choices and our brain and brain function and brain's destiny is a bit of a stretch for many people and frankly it was a stretch for me. But when you look at brain health and brain health destiny in terms rather through the lens of the gut, then suddenly you realize that indeed there is not just a connection, but more importantly and more empowering, there are leverage points. There are places where we can intervene to have profound impact and change a person's destiny.
As I mentioned earlier, in an earlier interview, the cardinal feature of all of our dreaded brain degenerative conditions is a mechanism called inflammation. Inflammation is regulated by things that go on in the gut. Most importantly, it is highly influenced by the adequacy or the patency of the gut lining that segregates things that are inside the gut from things that are then in the rest of the body.
And make no mistake about it. That's one cell lining thick. That's pretty, pretty narrow fence that segregates these two areas. And Dr. Amen, as you mentioned, the same situation is in the brain. We call it the blood-brain barrier.
It's very interesting to look at the research as of late that demonstrates that some of the same environmental issues that challenge the gut lining and lead to increased leakiness and therefore increased inflammation, do exactly the same at the level of the blood-brain barrier. We know that our gut bacteria play a very important role in regulating both the permeability of the gut lining and the permeability or lack thereof of the blood brain-barrier. So when we talk about the concern and the threat that having a leaky gut might present, let me tell you, a leaky brain is not necessarily going to be a party that you want to attend.
Unfortunately, these same factors are at play that regulate both of these. And what the research is telling us now is that a certain short-chain fatty acid by the name of butyrate, it comes from a Greek word that has to do with butter. That's where it came from. This is created by healthy gut bacteria. Butyrate tends to heal the gut lining and does exactly the same at the blood-brain barrier level. So we have got to do our very best to keep the gut bacteria diverse, and we've got to restrict things from our lifestyle choices that can threaten the diversity of our gut bacteria. The gut bacteria that we have is very sensitive primarily to our food choices.
So what I've just done is I've connected our food choices to the health and diversity of our gut bacteria, to their ability to make this chemical butyrate, that then will heal the gut lining and reduce this mechanism inflammation, which is the cornerstone of well beyond brain degenerative conditions, but degenerative conditions throughout the body, whether they involve the joints, skin, or the heart, or really anywhere.
So this really becomes very humbling, at the same time, very, very empowering because now that we focus on what is it that threatens the diversity of the gut bacteria and beyond that, what can we do to reestablish this diversity, suddenly there is lots to do here and that's a really good feeling.
Tana Amen: So I have one question about the butyrate. So I had heard this a while back and I had cut out all dairy at one point, but then I started adding back in some ghee or grass-fed butter and small amounts, is a lot of people ask us that. What are your thoughts about that?
Dr David Perlmutter Oh, I think that ghee, which is clarified butter, has been recently described as having very powerful health properties. Recently means it was just 3000 years ago that the literature started to appear. So ghee has been talked about in Vedic texts as having profoundly positive health attributes, very salubrious thing to be consuming on multiple levels.
First of all, ghee is a fat source of fuel. We really want to power the body with fat as opposed to sugar and carbohydrates. But beyond that, ghee is a form of butter, and butter contains 4% to 6% butyrate. So not only do we rely on butyrate being produced by our gut bacteria as an important short-chain fatty acid, but understand that we can get butyrate in its raw form by consuming it. Anything from cows is going to contain ... Well, milk of cows has its ghee, it's going to contain a significant amount of butyrate. We really want to push that.
The next thing to consider is that when you are on what is called a ketogenic diet, and that means when you really have forced your body to burn fat as opposed to sugar and carbohydrates as a fuel, and you're in what we'd call ketosis, which isn't that hard to achieve, one of the main ketones that your body produces that powers your body is called Beta-hydroxybutyrate. Yet another source of butyrate.
So we have really three avenues that we can create this, where we can create butyrate from our gut bacteria by nurturing them, by consuming butyrate, by eating things like butter. Butter is back. And by restricting our carbohydrates and generally eating more healthful fats like extra virgin olive oil, coconut oil, nuts and seeds, pasteurized eggs, et cetera, wild fish. These sources of good fats while we restrict the carbs and sugar, push our bodies into ketosis and we are producing three ketones, acetate, acetoacetate, and Beta-hydroxybutyrate. Strictly by definition actually Beta-hydroxybutyrate isn't a ketone by its chemical analysis, but we'll leave that for another day.
That's it. These forms of butyrate serve as fuels for many of our body's cells. They also change our gene expression. They bind certain binding sites on our DNA and they are what we call, I don't mean to be too technical here, but histone deacetylase inhibitors, a fancy term that means that they can amplify our gene expression to reduce inflammation, to increase our ability to detoxify, and to increase our production of antioxidants. That's why. Go ahead.
Tana Amen: So if I could just really summarize that for people listening. So butyrate from butter or from doing a low carb, high fat ketogenic type of diet actually decreases inflammation.
Dr David Perlmutter Yes.
Tana Amen: In your body.
Dr David Perlmutter Right.
Tana Amen: And heals the gut.
Dr David Perlmutter Decreased inflammation.
Dr Daniel Amen: Let me, just okay this, because we often-
Dr David Perlmutter And the same time, we're powering your brain cells with fat and not sugar.
Tana Amen: Okay.
Dr Daniel Amen: Well, I think you know I have a-
Dr David Perlmutter [inaudible 00:10:08] much more efficiently you're creating less free radicals and it really is kind of the natural state that your brain wants to function on. We all grew up at a time that we were told, "Oh, your brain needs glucose, and so you better eat today a Snicker's bar before you take your SATs, feed your brain what it needs." And that's really, there's no science behind that. And we're really seeing a great research from people like Dr. Beach and others who are showing that the brain works much more efficiently when it's powered with fat. So we should be fat heads. It's a good way to be.
Dr Daniel Amen: One of the concerns I have with dairy is the hormones and the antibiotics that they feed the cows, along with how do you make cows fat? It's with grains. So grain fed. Is that too much of a concern or ...
Dr David Perlmutter No, not at all. I think you are 1000% dialed in on that comment. When you read books like The China Study by Dr. Campbell and people say, "Well, Dr. Perlmutter, what do you think of that? I mean, after all he's advocating no consumption of meat or dairy because of health risks." What do I think about it? I think he's exactly dialed in. I agree with him. That may surprise your listeners, why do I agree with him? Because I think that by and large, the meat and the dairy that are used by people and that really are part of the statistics that he used to come up with his conclusions are things that you've got to avoid.
I'm not saying go to the fast food and eat the burger or drink the milk that you get at the grocery store. That stuff's good point. That stuff is deadly for you. It threatens your microbiome, and as you correctly pointed out, as an effort to fatten up the cattle, they are given grain. They're finished with grain if they don't get that their whole lives, but more importantly, what they're given is an antibiotic or two.
We know that when you give animals, humans included antibiotics, you increase their fat production. A wonderful book by Dr. Malcolm ... I'll figure it anyway, called Missing Microbes. Martin Blaser at NYU. He quite squarely points the finger at antibiotics as being strongly related to the increasing incidence of pediatric and adolescent obesity.
Look, it happens in animals. It's been happening since the late 1950s. Change their microbiome, change their gut bacteria by giving them antibiotics, but they're going to get fat. Look around at our society right now. We're using antibiotics like candy, knowing that 70% of the antibiotics used in America go into production of the food that we eat.
Dr Daniel Amen: Correct.
Dr David Perlmutter And yet people are scratching their heads saying, "I can't understand why I'm still getting fat. I'm doing the best I can. I don't even drink soda anymore. I drink artificially flavored sweetened soda." Well, okay.
An amazing study was published about a month ago showing a dramatic increased risk of obesity in people who consume artificially sweetened beverages, squarely pointing the finger again at changes in the gut bacteria that are brought on by consuming this type of chemical.
Tana Amen: Wow.
Dr Daniel Amen: So let's just summarize and then we're going to continue with more podcasts with Dr. Perlmutter. If you want a healthy gut, you want a healthy brain so you have to have a healthy gut, what are three things to avoid and three things to do?
Dr David Perlmutter So when we talk about a healthy gut, we're talking about diversity of species. We want to have every piece of the orchestra playing its part so that we get a symphony.
That said, if you want to have a healthy gut, you've got to eat a good diversity of food, but it should be focused on the tenants of higher fat, lower carbs, and much higher levels of prebiotic fiber. Not just fiber, but a specific type of fiber to nurture the gut bacteria. It's called prebiotic fiber. Foods rich in prebiotic fiber include hickamo which is Mexican yam, a chicory root, a garlic, onions, leeks, and my favorite, dandelion greens and others, artichoke, asparagus, et cetera.
The other thing to recognize, some new research has demonstrated a strong correlation between diversity of gut bacteria and aerobic exercise. Who knew? So we've been popularizing aerobic exercise for years because of its effect in terms of growing new brain cells. Now we're seeing literature that demonstrates increased diversity of gut bacteria in people who engage in that activity. Now, that is a correlative study, means they show people who get a lot of exercise, have an increased diversity. It doesn't mean that aerobic exercise necessarily will improve your gut diversity. I think that it will.
Now, in terms of things to avoid, we sort of covered that already. A diet that is higher in sugar needs to be avoided. Artificial sweeteners are deadly towards the gut bacteria. Not getting aerobic exercise I think is very important. But I think beyond that, we really got to begin to see and embrace the notion that drugs really matter. Obviously antibiotics are devastating towards the gut bacteria. Some wonderful research out of Denmark shows that even one course of antibiotics increases a person's risks for type 2 diabetes based upon changes in the gut bacteria by 50%. And it's a dose related correlation. The more antibiotics you receive, the higher is your risk for type 2 diabetes.
Tana Amen: For people who have had to take antibiotics, what can they do? Just take some probiotic?
Dr David Perlmutter Well, I think, that's an excellent question. I do know that there's some significant improvement in the gut that can happen when people then get back on the program. However, any course of antibiotics changes the gut bacteria permanently. So this notion of deciding to go and have a Z pack or whatever you want to have because you have a cold needs to be rethought, because there are lifelong consequences of every exposure to antibiotics.
But I think that boosting your prebiotic fiber is key and it does allow regeneration of the good species that are ... with antibiotics might have been suppressed, but they're still there. They're still ready to help you. We just got to give them what they want. We say when a woman is pregnant that she's got to be careful now because she's eating for two. And I often say, look, every one of us is eating for 100 trillion. That's the number of microbes-
Tana Amen: That's interesting.
Dr David Perlmutter In the gut that are waiting for dinner.
Dr Daniel Amen: Your pets.
Dr David Perlmutter And what are you going to give them because they control your health destiny.
Tana Amen: Yeah. We tell our daughter that she needs to feed the pets in her gut because they're like protection dogs. You have to feed them because they protect you back.
Dr Daniel Amen: All right. We have to stop today.
Dr David Perlmutter Or we are their pet. Or we're their pet. They're taking care of us.
Tana Amen: Right, exactly.
Dr Daniel Amen: But we are going to continue with Dr. Perlmutter. Stay with us.
Donny Osmond: Thanks for listening to today's show, The Brain Warrior's Way. Why don't you head over to brainwarriorswaypodcast.com, that's brainwarriorsway.podcast.com where Daniel and Tana have a gift for you just for subscribing to the show. And when you post your review on iTunes, you'll be entered into a drawing where you can win a VIP visit to one of the Amen clinics. I'm Donny Osmond, and I invite you to step up your brain game by joining us in the next episode.
