When discussing celiac disease I mentioned that the book Grain Brain by Perlmutter advocated no gluten or whole grains for anyone, celiac or not. David Katz commented that this was ridiculous since the medical literature strongly confirms health benefits for whole grains. Because this book continues to be widely read and cited by low carb advocates I purchased a copy and read it. The following is the review I sent to Amazon:

I have rarely read a book that made me so angry.

It’s probably good to say who I am: a retired physician (diagnostic radiologist) whose retirement project has been studying nutrition and its effect on health for the past 15+ years.

The message of this book is that a low carbohydrate, high fat diet promotes brain and overall health primarily by keeping blood sugar and insulin low and controlling systemic inflammation. The diet advocated will help most people manage blood sugar and decrease inflammation for most who are eating a standard American diet (SAD).

Sugar and processed carbs are vilified; no argument since they are not healthy. But unrefined grains and whole plant food starches are given the same label. Interesting, since epidemiological studies uniformly find that large groups of people whose major calorie source is these foods live the longest and have the least chronic disease. The absolutely proven healthy diet is one that is exclusively or mainly whole plant foods including whole grains.

Since this diet avoids processed carbs and starches it will be calorie restricted for most people who will lose weight and have less inflammation. Perlmutter tells his readers that they can usually get their CRP (a commonly used lab test measuring inflammation) to less than 3 after a month or so. On a whole food plant based diet (WFPB) mine is 0.4 which is about par for people eating this way.

Many eating the Grain Brain diet will end up with high serum cholesterol but the author tells us that this is not only OK but good, citing some irrelevant references (too detailed a topic to cover in a review.)

Atherosclerosis, which causes most heart attacks and strokes, is barely covered, on one page mentioned as something everyone gets no matter what the diet. This is absurd which I’m sure the author must know. Many people do not get atherosclerosis- those who have eaten a WFPB diet their whole lives. Those who change to this diet reverse atherosclerosis. A WFPB is the only well-proven way to treat atherosclerosis, still the number one killer of Americans.

Cancer gets a few passing references. Since overweight people get more cancer the author assumes they will get less cancer in spite of many studies associating animal protein consumption, a mainstay of a Grain Brain diet, with more cancer.

The book does advocate eating non-starchy vegetables which is undoubtably a good idea but is unlikely to make up for the other bad advice.

It’s frightening to contemplate the number of people whose health has been damaged by this best selling book. I do understand that the author has made a lot of money from the book and other related projects: the American dream (nightmare) to create a very profitable business no matter the effect on health or societal welfare.