Book Review: Grain Brain By David Perlmutter MD

Since its publication in 2013, Grain Brain by Dr. David Perlmutter has been making waves [1]. Written by a practicing neurologist and fellow of the American College of Nutrition, this book is a well-written and compelling read from a renowned doctor with a unique combination of credentials.

Grain Brain gives us a close and well-researched look at the history of food and illness, and the common denominators behind many diseases that have neurological roots. It challenges commonly held perceptions of what good food is. For many readers, it’s been a breath of fresh air.

That’s not to say it hasn’t polarised its audience. For those dedicated to the traditional food pyramid, it was heresy. To those who had researched the perils of the now out-of-favour Aitkins diet, this was a thinly-veiled back door to the same dietary system. However, for Paleo eaters and the nutritionally curious, along with Caeliacs and Non Caeliac Gluten Intolerance sufferers, this book was music to tired and frustrated ears.

The detractors had a field day with objections including assertions that some traditional cultures with high carb intakes had low instances of neurological disease, and multiple claims that grains do not increase inflammation.

Let’s be honest: there is much science on both sides of the fence. For every study asserting the harmlessness of wheat and other grains, there seems to be a contradictory study. One such work was Daulatzai’s study which says that “Non-celiac gluten sensitivity triggers gut dysbiosis, neuroinflammation, gut-brain axis dysfunction and vulnerability for dementia [2].”

We are also seeing evidence that gluten may compromise the blood-brain barrier, and that something called ‘Gluten Cross Reactivity’ may result in the body confusing other foods such as dairy for gluten and reacting in kind [3].

This is surely not an idea we can ignore.

In his book, Perlmutter presents a plethora of thought-provoking information that he deems scientifically sound and undeniably conclusive. They’re big ticket items too. You’ve not long plunged into the opening pages of Grain Brain when Perlmutter makes some big statements:

“Diabetes and brain disease are this country’s costliest and most pernicious diseases, yet they are largely preventable and uniquely tied together: Having diabetes doubles your risk for Alzheimer’s Disease. In fact, if there’s one thing this book clearly demonstrates, it’s that many of our illnesses that involve the brain share common denominators.“

The common denominators include gluten and inflammation, and the flow-on effects are many. Perlmutter lists Parkinson’s, ADHD, depression, epilepsy, and Alzheimer’s disease as just some of the possible repercussions. His assertion is that we are “increasingly challenging our physiology with ingredients for which we are not genetically prepared.” Gluten and starchy foods commonly ingested in the western diet are major concerns for Perlmutter, which he urges his readers to be informed about and empowered to act upon.

Grain Brain is a compelling read, designed to be equipping rather than fear-mongering. It urges a return to the way our evolutionary forerunners would have eaten: a diet rich in vegetables, meats, fish, and eggs.

As advocates of health, it pays to be informed of both sides of the argument when it comes to work like this. Grain Brain challenges the status quo, but is well worth the read.



[1] Perlmutter, D, (2013) “Grain Brain”

[2] Daulatzai, M, (2015), “Non-celax gluten sensitivity triggers gut dysbiosis, neuroinflammationm, gut-brain axis dysfunction and vulnerability for dementia,” CNS Neurol Disord Drug Targets. 2015;14(1):110-31. PMID: 25642988

[3] Cyrex labs, “Array 4 Gluten Associated Cross Reactive Foods and Food Sensitivity,” Http://


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