Grain Brain with Dr. David Perlmutter
15 Dec 2025 · 35 min
JJ Virgin talks with neurologist Dr. David Perlmutter about how diet affects brain health and neurological conditions. Perlmutter discusses environmental toxins, his book Grain Brain, and the connection between what you eat and how your brain works.
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Sweet Ray Ban Meta Glasses Available at Ray Ban stores and other authorized retailers. Welcome to the JJ Virgin Lifestyle show with celebrity nutrition expert, Fitness hall of Famer and four time New York Times best selling author JJ Virgin. JJ is a warrior mom whose knowledge and expertise have helped change hundreds of thousands of lives with over 3.5 million podcast downloads and appearances on Dr. Phil, Dr. Oz, the Today Show, Rachael Ray.
Larry King Love Whoa whoa whoa. This show is about you, not about me. I want to help you find practical, real world ways to dial in your health and mindset so you can finally lose that weight and feel strong and energized. Stop settling for less than your personal best. It's time to find out how to look and feel better than ever. And I'll be right here with you the whole way. Welcome to the show. I have such a treat for you today. I have just possibly one of the nicest human beings on the planet as well as one of the most brilliant I have with me Today my buddy Dr. David Perlmutter. I first met this guy at a medical conference in the gym and he is just something else. I just adore him and I'm actually was shocked. I thought I'd had him on the show a few times. So I will have him back because when you hear this interview today, you're gonna want way more of what he's got to offer. And one thing you'll want to do is get the show notes@jjvirgin.com forward/grainbrain. He has a great gift for you in his Keto guide. Download and also link right to his book. He's got the next new revised edition of Grain Brain and it's this was a massive runaway hit. Gosh, over a million copies out already. And now he just revised it, added new recipes, new research, everything else. You want to have this book even if you had the other book? I have the other book too. I got this one too. You're going to want to have it. So let me tell you a little bit about my buddy, Dr. Pearl Mutter. He is by the way. He's my go to guy. Anything comes up brain wise, I tell text him what's going on. He can tell me in an instant he's like, oh that's blah blah blah. Like you got to be kidding me. He is super brilliant. He's a board certified neurologist, four times New York Times best selling author and he also serves on the board of directors and he's a fellow of the American College of Nutrition. He got his MD from the University of Miami School of Medicine where he was awarded the Leonard G. Roundtree Research Award. Hey, little side note, I actually was doing my grad degree there. I took a year off and went to University of Miami to study sports medicine and I loved studying there. I was in the school of Medicine and that's where I did cadaver dissection. So it brought back memories seeing that he serves as a member of the editorial board for the Journal of Alzheimer's Disease and has published extensively in peer reviewed scientific journals including the Archives of Neurology, Neurosurgery and the Journal of Applied Nutrition. He is also a frequent lecturer at symposia sponsored by institutions such as World bank and imf, Columbia University, Scripps Institute, New York University, Harvard and serves as the associate professor at the University of Miami Miller School of Medicine. Lots going on and I see him all the time. He's always lecturing at all of the top functional and integrative medical conferences, whereas I generally get to see him and hang out. He's done an amazing job with Grain Brain. It's been published in 34 languages. Number one New York Times best selling book. He has some super cool books coming up, one he's been working on with his son as well. So we'll bring him back for those. I want to get right into this interview because it's just so juicy. But before I do I have to do a shout out. Oh, I love this so much when I get to shout out one of our listeners who leaves a review and these mean everything to us. So Chrissa 73 left rocks, five stars. JJ has educated herself relentlessly. She healed her son's TBI and is teaching countless individuals how to live a healthier, happier life. Listen, and by the way, Dr. Perlmutters, I, I actually used David's information to finally get my son Grant, who had a severe traumatic brain injury as a lot of you know, and nearly died and he's now 110%. But I finally got him pushed over the edge to get his butt back to exercising with the information that I got from Dr. David Perlmutter. All right, Dr. David Perlmutter, welcome to the show. I cannot believe it took me this long to have you on.
Oh, jj, I'm delighted to be here.
It is. I, I figured this was like your 10th time on the show. I had no idea.
What can I say? I've had you on my show a couple times.
Well, you are one of my, not only are you one of my favorite doctor experts out there, you're also one of my favorite people.
Oh, my gosh.
And you're just, yeah, you're just an amazing human being and you're doing incredible, incredible work out there in the world. And I loved your first edition of Grain Brain. And now You've got your 5th anniversary revised edition of Grain Brain coming out. I just so excited about all this and I'd love to just back up a little bit and find out, like, how did you get in to all of this? Because this is very disruptive. David.
Well, I've been disruptive since childhood, that's for sure. Anyone who knows me from elementary school and what we used to call junior high, I think that's politically incorrect these days. But that said, I wasn't determined to be disruptive outwardly with respect to brain science, but it turns out that way. And I was very dissatisfied as a practicing neurologist because I didn't have really much to. I learned all the ropes, right. I did my neurology training, learned how to use medications, and I was very ineffective in really treating not just the diseases, but certainly had no concept in training with respect to preventing neurodegenerative conditions. What a concept. Even to this day, here we are, what, 32 years later and still the notion that our lifestyle choices play a role in determining the destiny of our brains doesn't get much spotlight. And that is despite the fact that our peer reviewed literature is absolutely full of these wonderful studies that demonstrate the role of exercise in enhancing the growth of new brain cells and reducing Alzheimer's risk, how a higher fat, lower carb diet is associated with lower risk of dementia, how inflammation sets the stage for inflammation 30 years down the line. So, you know, you see these types of studies and I began implementing these concepts in treating patients and really was very, very supported by the results I was seeing. But I want to do things that I will not necessarily see the results of. And that is unlike wanting to do a procedure where you immediately, the next day, see that that person is better because you did a heart transplant or whatever it may be. Preventive medicine doesn't pat you on the back that way because you may not be around to see the fact that, you know, a certain percentage of your patients in 10 to 20 years seem to have a lesser risk of some problem. So there's not that emotional remuneration that you might get from, you know, intervening in an acute way. But that said, I realized that I needed to do that. I really embraced the whole idea of preventive medicine. And over the years I've learned that, oddly enough, the brain seems to be most receptive to the lifestyle choices that we indicate to people are salubrious for them. More so than, you know, the tried and true heart smart diet, or women doing weight bearing exercises to improve their bone density or at least help them resist osteoporosis. The brain responds wonderfully. And now that we understand the fundamentals of what makes a good brain go bad, absolutely, we are able to develop language that allows people to take this level of understanding and create for themselves plans, lifestyle plans that can absolutely change the destiny of the health of their brains moving forward.
You know, it's crazy. I remember hearing that neurologists have one of the highest, like, dissatisfactions in their jobs because they feel like they can't make, you know, any changes.
It's true. It is absolutely a situation of diagnose and adios, meaning, you know, we make the diagnosis with all of our sophisticated testing, but once that happens, okay, let me see the next patient. There's nothing that you can do to really help in many situations. Interestingly, just last month, the Journal of the American Medical association published an incredible study. We've known for quite some time that the so called Alzheimer's drugs don't work. But this study that was authored by a Dr. Richard Kennedy, a meta analysis of 10 different studies involving more than 2,700 patients found that not only do the so called Alzheimer's drugs not work, but they actually are associated with a more rapid cognitive decline. Oh my gosh, that takes your breath away. These are drugs that are sold in the hundreds of millions of dollars worth, close to a billion dollars worth of these drugs annually in America. Not only do they not work, which would be reason enough not to have them available, but they actually worsen the very problem that you're trying to treat. And here it was put out by the American Medical Association. Did you see this in the New York Times? Did you see it on the evening news? No. And it just reinforces the idea of who really is controlling what people become aware of, when at the same time we're seeing wonderful research that shows, for example, that having a higher fat, lower carbohydrate diet is associated with a reduced risk of Developing Alzheimer's disease.
You know, you look at this, David, if that was, if that alone, that one statement there, if a drug did that. Imagine that.
Oh, yeah. I mean, this is, imagine whether, you.
Know, it would be everywhere. Right.
And this is from the Mayo Clinic, published in the Journal of Alzheimer's disease. Dr. Rosebud Roberts showed that those people who had a lower fat diet and had higher carbs had about an 83% increased risk of dementia, in contrast to those who had a higher fat diet whose risk was reduced by 46%. So, you know, you don't have to buy anything. You don't, you just have to change what you're eating. We gotta talk about exercise and sleep, et cetera. But even if you just change the, the Mac, the provision of your macronutrients, it's a major step in the right direction.
Yeah. And that's, I mean, we're talking Alzheimer's. It's just, just basic everyday living and how well you can think and the fact you don't walk back into the bedroom and go, what the heck did I come in here for? You know, it's like, can make a massive shift. I remember seeing a study that said if your fasting blood sugar is 90 or above, you have five times the likelihood of dementia. I mean, this is a lifestyle problem.
It is. It's so true. Even that relationship, the relationship of blood sugar and a marker of average blood Sugar Being the A1C, these are associated with dramatic increased risk for dementia even at levels below which diabetes is diagnosed. Even in the so called, oh, pre diabetic, your blood sugar's a little bit elevated, kinds of levels that these levels are already associated with an increased risk for dementia as well as brain shrinkage moving forward. It was an elegant study that was published in the New England Journal of medicine back in September 2012. And again, the blood sugar levels were levels where your doctor's gonna say, oh, you're not diabetic, everything's cool, keep doing what you're doing. Well, not so turns out that a blood sugar of 105, 110 already increases your risk for dementia.
Well, the cool news about all this stuff, again, like you already said, is it's not going to cost you anything. It's switching behaviors. And that's, I mean, granted that's a lot more difficult for people than taking a pill, but it also is going to have a much bigger impact. So you wrote the grain brain and I love this tagline of the surprising truth about wheat carbs and sugar. Your brain's silent killers. I'll tell you what was so interesting. When my son Grant was in the hospital, coming out of his coma with his traumatic brain injury, I was bringing coolers of food in for him. I was making smoothies in the hospital. People were shocked. I had to put a sign up, David, that said, no, ensure, no crystal light. They actually wanted to give him crystal light. They were like, what is he going to drink? I go, water. It's. It'll work great, you know, But I had to. They. They were, like, shocked that I was bringing in all this stuff, giving them extra, you know, all the fish oil and et cetera, and. And I was shocked that they weren't starting there. Like, it made no sense to me that they would want to give him sugar and carbohydrates, especially when his brain was so fragile. But when you talk about silent killers, let's expand on that, because that's a pretty dramatic, bold statement.
It is. And I will say that's. That was five years ago, and, boy, did that raise some eyebrows. And. Which is good, because if you're not being a bit disruptive, there will be no progress. The ball won't move down the field. So you have to challenge the status quo. Status quo, Ronald Reagan said, was a Latin term for the mess we're in. And I think it's true. I mean, we cannot accept the status quo. So we challenge the carbohydrates, we challenge the sugar. And I think what we've learned over five years, which is now in the new book, is that, indeed, the literature, the research has been so supportive of that idea that blood sugar and increased insulin resistance are fundamental to the decline of the brain in the way that we then end up naming it Alzheimer's disease, affecting 40 million people around the world, costing this planet a trillion dollars annually, higher than the market value of Google or Apple. We have to look at it in that context, because as the Western diet spreads around the world, a diet that's profoundly higher in carbohydrate, lower in nutrient value, lower in healthful fat, we're seeing in lockstep increasing trends for both diabetes as well as, as you would expect, Alzheimer's disease. So it's crippling the brain function of the globe, and it's without a doubt strongly related to these dietary changes. So we went about to challenge this, not of carbohydrates and sugar being good for us five years ago, and as mentioned, it's been very supportive in terms of reviewing the literature. And, you know, even the gluten Story, I think, was, was considered way out there. I mean, we had William Davis's book Wheat Belly and Grain Brain coming out around the same time. And, and suddenly people, some people started to wonder about this dramatic change that occurred in the human diet just a few minutes ago in our history. In other words, the development of agriculture. Growing wheat and other grains happened just, just minutes ago. You know, what, 10, 12,000 years in the course of our 2 to 2.5 million years on the planet is a blink of the eye. But what we know, interestingly, was going on before we developed agriculture was throughout that period of 2 million years plus, the size of the human brain increased threefold. And it continued to increase until about, oddly enough, about 12,000 years ago, when then it plateaued. And actually since that time, our brains have shrunken by about 10%. So something dramatic happened that is causing the brain to shrink, that has led to increased loss of bone, poorer dentition. And the other thing we recognize in reference to our ancestors is there's been a dramatic change in the makeup of the gut bacteria as well. So I think there is truly a lot of validity in recognizing the so called tenets of the paleo movement. In other words, looking at the relationship between environment, including food, activity, sleep, et cetera, and gene expression, and recognizing that our human genome has not had any significant change in at least 70 to 100,000 years, long before we had agriculture, suddenly we send dramatically different signals to our genome by shifting from a diet higher in fat, much, much higher in dietary fiber, to a diet that is suddenly much higher in carbohydrates, much lower in dietary fiber. And now we're seeing the consequences of that.
Yeah, and then throw in some toxins.
We talked about in grain brain, the idea that, sure, we have celiac disease that affects about 1.4% of Americans, but we also have individuals who have non celiac gluten sensitivity. And we, you know, we were, I must say, highly criticized for even bringing up a topic like that. It's like saying chronic Lyme disease that everybody pushed back against, et cetera. So, but now, how validating for us that the Journal of the American Medical association in 2017 was completely supportive of what we had written about, and indeed, Harvard research headed by Dr. Alessio Fasano absolutely confirms the validity of this term, non celiac gluten sensitivity that can have manifestations that have nothing to do with the gut, that can involve the brain, the skin, the heart, the immune system. Were we wrong about anything back in 2005? I think perhaps You, I don't want to say wrong, but we could have pushed harder to make our case. And, you know, we did push pretty hard. But I think in moving forward, you know, I will say to your audience that, will our messaging be different five years from now? I think the answer is, hopefully it will be. And I'm hoping that your audience and in general people recognize that the mission here is to. Is to have a messaging that is dynamic, that changes with time as we continue to make progress and learn more information.
I love that you say that. I actually got. Got some flack about 10 years ago because I, you know, brought in some new information that was different than what I'd said in the past. And someone said, and I think Maybe it was 15 years ago is when I started to really increase fat and lower carbs and get gluten out. And someone said, but you used to do the opposite. And I go, but, you know, I'm reading all the research, you know, do you want me just to ignore that and just, like, take a stand and avoid everything that I hear out there? Like, we have to continue to look at the research and of course, look at the biochemistry. Because what I see out there and what you did with this is first you looked at neurology biochemistry and went, all right, what am I really seeing? Not what some of the studies are showing because they can be biased as to what they decide to look at, but what am I seeing out there and what's really working. I'm going to push on that and force some of these studies to come out because of what I'm seeing.
That's a really, really good point because somebody brought that up recently in another interview, and we talked about how now we're seeing research be responsive to public demand. And I think nowhere is that more evident than the research coming out from people like Dominic d' Agostino and Valter Longo on the whole notion of fasting, mimicking, or the ketogenic diet that they're recognizing there's a huge interest and popularity. And so the research is kind of filling in the blanks underneath it. And I think that's great. I think to have research be responsive to what the public is interested in is, you know, different than we're used to. I mean, it used to be the science would lead the way, the public would follow, but the public, I think, is becoming much more scrutinizing and discerning in terms of their interests.
It might be one of the positives out there in, you know, having this big social network and the Internet is that piece of it is that we now have much more of a voice.
So I think it's great.
Yeah, it is really helpful and. But it still takes crusaders, disruptors like you to go out there. And especially I know you took a lot of flak and heat. So I just want to acknowledge that because, you know, when you come out with an idea and it's different from status quo, especially in the medical community, it's worse there than anywhere else, you know, so you've changed so many lives with that bravery.
I have an interesting experience that suddenly one morning I awakened to a frantic phone call from my publisher and my agent, literary agent, and they said, did you see the article that was published about you last night? I said, no, I didn't. And they said, well, take a look and then get back to us. We'll have a three way call. And there was a very long paper written in a. In a very popular venue. And it was basically how wrong Dr. Perlmutter is, what a terrible person he is. And he told us we should be low fat 18 years ago and now listen to what he says. And he did a study with glutathione and Parkinson's that didn't work. Parentheses from me to you. It worked very well, thank you very much. And so we got back on our conference call and they said, what are you going to do? How are you going to respond? What do you do now? I said three words. I said, God bless him, because this was the best he could do to launch a book at the time about how good gluten is for you. And I said, this is the best this guy can do. And you know, it was a wonderful teaching lesson for me because truthfully, when I first read the article, I was, I was most upset when he was derogatory towards my wife. My wife and I talked about it and we, you know, we forced a smile on our face and after which the smile becomes indelible and real affects your emotional centers that then recharacterize that smile and make it really valid and we move forward. So that's the way it is. Begin. I'll mention that it's very, very good for people like JJ Virgin and David Perlmutter and so many of our colleagues that people do challenge us and push back because that makes us study harder.
I was just going to say it makes us up our game. So, right.
Somebody says, well, you know, maybe this is the way it is. And you bet I'll find research and look at this to be sure the next Time somebody challenges me, I have a response to that. Well, actually GMO foods are good because they're going to feed the planet. Well, I happen to think otherwise, but I want to strengthen my position. So go back and do the research that would allow me to stand on firmer ground. When I combat that type of research, I love it.
So you have for everybody listening and I will put this in the show notes. We're going to have them@jjvirgin.com GrainBrain we will have a direct link to grab the book. You're going to want to get this book even if you have the book from before. I'm sitting here with this. I have the old book and now I have the new book too. You're going to want to have both for your library because you got all sorts of great new recipes and new info in here. It's awesome. You sold a million copies, more than that of the last one. This is just. You are making such a dent.
Well, I have to tell you, 34 languages and what that means for me is I get to travel the world where people speaking languages that I will never hope to understand. Have read the book. Hopefully it was translated well, I don't know. I'll never know. But it just, you know, if it's made a very small dent in the way people think, then I am. I'm very, very pleased by that.
Yes, it definitely seems to be making more than a small one. So you'll definitely want to grab the book. You're also gifting everyone your keto guide. You will be able to grab that as well. Again@jjvirgin.com GrainBrain I appreciate that so much and I appreciate you. Thank you so much for taking your time to hang with me today.
You know, I appreciate you. I. When I see your face, it just, it just lights me up from the very, very deepest part of my being. And I just want to say that, ah, thank you.
I just adore you and your wife. And I always, I must say, I always judge men by their wives. When I met Lisa. All right, this guy is even more awesome than I thought. So.
Oh my gosh. Thank you, jj.
Thank you so much. Now after the break, we'll be answering listeners questions. So stay with me.
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Welcome back. This is the time where I answer a listener's question. Today's question came from Mary. Now I get a lot of questions around how I help my son heal from his massive traumatic brain injury where he was hit by a car, literally left for dead in the street and in the hospital for four and a half months. And it really took five years to help him bring his brain back. But I was devoted to helping him get to be 110%. Unfortunately, had people around me like Dave, Dr. David Perlmutter, Dr. Daniel Amen, Dr. Michael Lewis, Dr. Hila Cass, helping me make this massive goal dream come true. And so Mary asks, what were the top things that you did to help heal your son's brain? And here's what I'll tell you about this. Whether you've, if you've hit your head, you've hurt your brain, you know, We've got what Dr. Daniel Aman says it's like, you know, having an egg inside a hard shell here. You hit your head, sloshes, you hurt your brain. It does not need to be to the extent of what happened with Grant and all of the things that I did to help heal Grant's brain, help make all of us have better brains and, and help us slow down the impact of aging. So what you're going to read in grain brain are a lot of what I did for Grant, which was increase the fat, get rid of the sugar, lower the carbs, make sure he has clean protein. That was huge. Grant does not have gluten. He is gluten intolerant. And that does create some inflammation and a negative effect on the brain, which we can see within an hour of him eating it. So he is super aware. We've tied, helped him connect the dots between what he's eating and how he feels. So we keep sugar out, we keep gluten out. We have him eating a lot of good, healthy fats and taking a lot of fish oil. One of the first things that I did in the hospital was to start to increase his fish oil big time. He was taking 20 grams a day for months, and then we tapered him down to 10 and now he sits at 5 grams a day of fish oil. Plus he eats a lot of fish now. Beyond that, Dr. Daniel Amand had us get a ping pong table to help with coordination. We did hyperbaric oxygen treatments and stem cell treatments. But I'll tell you, the thing that we did that doesn't get talked about often, that I think is probably the most important thing is to help Grant feel connected, supported, part of a community and with a purpose. And I, I'm so concerned, and I was talking to David about this before we started taping. I'm so concerned with what is going on nowadays with social isolation, with the idea of these fake friends from all of our, you know, our Facebook and Instagram likes. I think more than ever, we need to take the time daily to connect with loved ones and connect deeply. Even if that's a short phone call, you know, to take time to hug, to release that oxytocin. But I made sure early on, I was with Grant every single day in the hospital. And if I had to go travel to do an interview, then my, his dad was there and we were there supporting him. So he knew that he was loved, that we cared. And then as we brought him back, we started working on finding, helping him find his place in the world, what he was going to be doing, what was, what was important. Because we all need a purpose, we all need a role, and we all need a community. So I want to underscore those because I think we don't talk about those as enough. They've. They've likened social isolation. Dr. Alyssa Rankin talks about this to smoking a half a pack of cigarettes a day. So it's definitely one we want to incorporate in. And as you're listening to this right now, after you stop listening to this, take a little time and connect with someone. Tell them you care. All right, I want to remind you again, grab Those show notes jjvirgin.com grainbrain and be sure to subscribe to the show so you don't miss the goodness like today's interview. All right, see you next time. That's all for this episode of the.
JJ Virgin Lifestyle show, which marks another step towards a healthier body and mind. Don't forget to rate, review and subscribe to the show, and we'll talk to you next week.
Foreigners. This is Anne Bogle, author, blogger, and creator of the podcast what Should I Read next? Since 2016, I've been helping readers bring more joy and delight into their reading lives. Every week, I take all things books and reading with a guest and guide them in discovering their Next Read. They share three books they love, one book they don't, and what they've been reading lately, and I recommend three titles they may enjoy reading. Next Guests have said our conversations are like therapy, troubleshooting issues that have plagued their reading lives for years, and possibly the rest of their lives as well. And, of course, recommending books that meet the moment. Whether they are looking for deep introspection to spur or encourage a life change, or a frothy page turner to help them escape the stresses of work, school, everything, you'll learn something about yourself as a reader, and you'll definitely walk away confident to choose your next read, with a whole list of new books and authors to try. So join us each Tuesday for what Should I Read Next? Subscribe now wherever you're listening to this podcast, and Visit our website whatshould I read next podcast.com to find out more.
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