FOCUS ON:

ADDICTION
DAVID PERLMUTTER, MD
TABLE OF CONTENTS

From The Desk of Dr. Perlmutter 3

Articles
Inflammation Today Means Brain Shrinkage Tomorrow 4
Reduce Inflammation to Protect Your Brain 6
Diet and Depression: A Better Plan for Mental Health? 7
These Bugs May Improve Your Mood 8
 icrobial Diversity – Comparing The Richness
M 9
Of Gut Microbiota
Gut Bacteria Change Your Brain 10
Gut Inflammation Affects the Brain 11
About The Grain Brain Whole Life Plan 13

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FROM THE DESK OF
DR. PERLMUTTER
A Note Before Reading
Addiction is a misunderstood subject that straddles the
line between biology and psychology. Is addictive behavior
simply an inborn mental hurdle? Not exactly.

Nutrition and lifestyle play a vital role in all aspects of

our health, both physical and mental. And situated at the
intersection of all health concerns is the microbiome. There
is plenty of scientific research to prove that these trillions of
bacteria in your gut help your immune system function. But
gut bacterial diversity is of evergreen concern, particularly
when it comes to brain health. Boosting gut bacteria is a
scientifically-proven method of reducing inflammation,
making it an effective treatment for Alzheimer’s, depression,
migraines, epilepsy, and many other illnesses.

When you’ve finished reading, please do visit my website and

discover even more. I’ll continue to scour medical journals for
the latest research, and help you understand what that means
for your health.

In good health,

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 Inflammation Today Means
Brain Shrinkage Tomorrow

As I have emphasized over the past decade, artificial sweeteners, and acid-blocking
the fundamental mechanism that underlies medications, pave the way for increasing
neurodegenerative conditions, including inflammation. This threatens your long-term
Alzheimer’s disease, Parkinson’s disease, healthy by raising your risk of virtually all
multiple sclerosis, and other issues (think those chronic degenerative conditions you
diabetes, coronary artery disease, and even don’t want to get.
cancer), is the process of inflammation.
It doesn’t make sense to wait until you’re
We’ve got to do everything we can in
having an issue with one of these diseases
terms of our lifestyle choices to bring
to begin a program designed to
inflammation under control.
reduce inflammation. This
Dietary choices like
notion was powerfully
choosing to limit sugar
supported in a recent
and carbohydrates,
study published in the
avoiding gluten,
journal Neurology.
eliminating
In this report,
vegetable oils (corn
researchers from
oil, sunflower oil),
multiple institutions
increasing intake of
endeavored to
healthful fats (olive oil,
determine if
avocado oil, nuts and seeds),
inflammation in
and favoring fiber-rich foods,
midlife would have any
are all fundamental building
consequences for the
blocks of a lifestyle that helps to reduce
brain later in life.
the risk for excess inflammation.
They studied a group of 1,633
We know that there is a higher level of
participants (with an average age
the chemicals that mediate inflammation
of 53) by looking at their blood levels
in the blood of individuals with higher
for various markers of inflammation. These
blood sugar, caused by many of the poor
five inflammatory markers were compiled
choices outlined above. Again, higher
into what was called the “inflammatory
blood sugar correlates with higher levels of
composite score.”
inflammation.
After 24 years, the participants underwent
Degree of inflammation is, to a significant
a special brain scan to measure the size
degree, determined by the health and
of various areas of the brain. The study
diversity of gut bacteria. So issues that
revealed a marked correlation between
threaten gut bacterial diversity, like stress,

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midlife elevation of inflammatory markers
and reduction in size of key brain areas
including the hippocampus, the brain’s
memory center. The relationship between
these inflammatory markers and shrinkage
of the brain later in life was modified by age
and race in that younger participants, as
well as Caucasian participants, with higher
levels of inflammation markers in midlife
were more likely to show reduced brain
volumes during the follow-up.
The authors concluded:
“Our prospective findings
provide evidence for what
may be an early contributory
role of systemic inflammation
in neurodegeneration
and cognitive aging.” The
important take-home message
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here is in line with John
Kennedy’s statement: ‘The
time to fix the roof is when the
sun is shining.’
That means that we should be doing
everything we can to reduce inflammation
TODAY, long before some chronic
degenerative condition manifests. In this
study there was a clear correlation between
elevation of markers of inflammation
and risk for shrinkage of the brain, and
who wants that? This is what preventive
medicine is all about. It’s about doing the
right things today to pave the way for a
healthier tomorrow.
 Reduce Inflammation to
Protect Your Brain

Everyone is familiar with inflammation. understanding, since anti-inflammatory

When a joint is inflamed with arthritis, drugs are often used to treat this disorder.
it swells, gets red, becomes painful, and On the other hand, it seems a bit more
becomes less functional. Inflammation may of a stretch to connect the process
also occur in areas that are less obvious of inflammation with such diseases as
such as in the coronary arteries. In fact, Parkinson’s and Alzheimer’s. And yet, this
inflammation as a process is a cornerstone process, inflammation, is a cornerstone
mechanism for the narrowing of the mechanism related to progressive
coronary arteries that typifies coronary destruction that occurs in the brain as we
artery disease. Inflammation is also a big age, as well as Alzheimer’s disease.
player as relates to the disability that stems
By and large, as we age, the levels of
from diabetes, And there’s even a strong
inflammatory chemicals within the body
correlation between inflammation as a
increase. And it is specifically these
mechanism, and cancer.
inflammatory chemicals that are
The past several books that I both correlated with the rate at
have published have which the brain degenerates,
focused on the as well as the degree of
important role of cognitive impairment that we
inflammation may experience during the
as relates to aging process. In this report,
the brain. published in the journal
Making the Therapeutic Advances
connection, in Chronic Disease, Yale
for example, researchers described in great
between detail the mechanisms relating
inflammation inflammation to progressive
and a disease damage in the brain as well
like multiple as what happens to the brain’s
sclerosis, performance during this
it certainly process. In addition they
something many speculate as
people don’t to
have much of
a problem

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how this understanding of brain
degeneration might relate to further
Diet and
therapeutic interventions.

What we do understand today is at least

Depression: A
one very important mechanism that relates
lifestyle choices to inflammation and
Better Plan for
therefore to brain inflammation specifically,
and cognitive decline. Much research has Mental Health?
focused on the important role of elevated
blood sugar as it relates to this process.
Simply stated, even mild elevations of
blood sugar over time increase the ability Could the food we consume impact our risk
of blood sugar to bind to proteins, in a for mood disorders and depression?
process called glycation. When a protein
It’s a fascinating question, and one we
becomes glycated, again as a consequence
should absolutely be exploring further.
of persistent blood sugar elevation, it
Today, I want to look at a study from the
dramatically increases the production in
journal Psychiatry Research, which looks at
the body of inflammatory chemicals, and as
the relationship between dietary patterns
such is directly relates to brain decline.
and depression.
So the focus of this report really brings
For more on how lifestyle choices affect
to our attention the fundamental role of
your mental health, visit our Focus page.
inflammation in brain degeneration. That
said, one of the most critical lifestyle
changes you can make today to reduce
inflammation is to make dietary changes
that reduce blood sugar, leading to
reduction of glycation, which will pave the
way for better brain health, functionality
and resistance to age-related decline. Click here
to watch
full video

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 These Bugs May
Improve Your Mood
You’ve heard of the term probiotics, and
likely prebiotics as well, but now we are
hearing about “psychobiotics.” These have
been defined as:
living organisms that, when
ingested in adequate amounts,
produces a health benefit
in patients suffering from
psychiatric illness.
That’s a pretty impressive new term, and
claim for that matter. But the reason
that scientists have developed this
terminology is because new research
clearly demonstrates that certain
probiotic organisms have a
dramatic effect on regulating
mood.
In recent double-blind, placebo-
controlled, randomized trials,
it has been demonstrated that
people taking a combination
of two fairly common probiotic
bacteria, including lactobacillus
helveticus and bifidobacterium longum,
had a dramatic reduction in their level of
psychological stress as compared to people
given a placebo. In addition, researchers
demonstrated that the level of cortisol,
the so-called “stress hormone”, was much
lower in those receiving these probiotics as
opposed to those who received placebo.
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We know that certain probiotic bacteria
have an effect on the level of various
neurotransmitters that can affect mood,
like serotonin and dopamine. In addition,
inflammation is a cornerstone of depression
and current research clearly identifies the
stability of the bowel lining as a regulator
of inflammation, throughout the body. This
stability is regulated to a significant degree
by the level of good bacteria living within
the intestines.
These are just two proposed mechanisms
whereby specific probiotic bacteria can
affect mood.
That said, well beyond just the idea of
intervening with probiotic supplements as
an attempt to help with mood, an important
take-home message from this research
should be that we should do everything
we can to preserve and protect our gut
a bacteria today by reassessing our food
and medication choices, as well as various
other lifestyle factors like sleep, stress,
and exercise. It makes sense that if we
compromise the levels of these and other
probiotic bacterial species within us, it may
well pave the way for debilitating mood
disorders.
 Microbial Diversity – Comparing
The Richness Of Gut Microbiota

What a humbling notion it is to consider the areas. Moreover, the ratio of Firmicutes to
fact that 99% of the DNA contained within Bacteroidetes is strongly influenced by diet.
the human body is actually DNA that is
What these researchers looked at was the
associated with the bacteria that live within
effect of the ratios of these two groups of
us. When we consider how the human
bacteria in terms of how they influenced
genome has been so aggressively studied
human DNA. What they found was really
as representing the “holy grail” in terms of
quite remarkable. Higher levels of Firmicute
its role in determining our health destiny, to
activated human DNA pathways that are
get our arms around the notion that in fact
associated with detrimental changes in fat
almost all of the DNA in the human body
metabolism, increased production of fat,
is actually bacterial certainly changes our
and heightened levels of inflammation.
perception of who we are and what we are.
So the end result of this research reveals
And even more compelling is new research
that not only is most of the DNA in the
that indicates that even that 1% of the DNA
human body represented by bacteria,
in our bodies that we consider our own is
but that those bacteria themselves are
itself actually and powerfully influenced by
actually regulating our own DNA! Not only
the gut bacteria, our microbiome.
is this humbling information, but it should
In a new study, published in December be looked upon as opening the door to
2014, researchers attempted to unravel the powerful new therapeutic techniques based
finding that changes in the various groups upon interventions that will alter the ratios
of bacteria contained within the human of gut bacteria, and therefore change our
microbiome have an effect on metabolism. gene expression in a favorable way. And
It is known that the ratio of two very it’s these concepts that I explore in Brain
large groups of bacterial organisms, the Maker: The Power of Gut Microbes to Heal
Bacteroidetes group and the Firmicutes and Protect Your Brain–for Life.
group strongly relates to risk of things like
obesity, metabolism, insulin sensitivity,
and even inflammation. Those
individuals with higher
levels of Firmicutes
organisms, in
comparison to the
Bacteroidetes group, Click here
are more prone to to watch
problems in these full video

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 Gut Bacteria
Change
Your Brain

I’m very excited to bring you this research

study from my friend Dr. Emeran Mayer. It’s
a very intriguing report that demonstrates
not only how changes in the gut bacteria
correlate with irritable bowel syndrome,
but, in addition, how these changes in
the gut bacteria correlate with the size of
various brain areas.

In addition, the authors were able to

correlate how the changes observed in
the gut bacteria actually linked to early life
trauma. This seemingly connected the dots
between early life trauma and the observed
differences in brain morphology.

I understand this may sound complicated,

but hopefully the video will make this more
understandable.

Click here
to watch
full video

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 Gut Inflammation
Affects the Brain
The fundamental mechanism that underlies
such seemingly disparate issues as autism,
Alzheimer’s disease, Parkinson’s disease,
multiple sclerosis, and various other
neurodegenerative conditions, is the
process of inflammation. As you will note,
this has been a central theme in my recent
lectures, television programs, as well as
books, as this is what current science is
strongly supporting.
But it now looks as if this process,
inflammation, may actually begin in the
gut and subsequently affect the brain as a
downstream mechanism. In a submission
to the Journal of Neuroinflammation,
researchers at Cedars-Sinai Medical Center
in Los Angeles reported on a fascinating
experiment.
Using a laboratory mouse, they
administered a chemical, dextran sodium
sulfate (DSS), into the drinking water of
some of the animals. They then examined
the brains of these animals at various times
up to 26 days after the chemical was placed
in the water. DSS specifically causes gut
inflammation.
What the researchers discovered was,
in fact, quite profound. First, they
demonstrated dramatic evidence of gut
inflammation following exposure to DSS;
there was an increase in inflammatory cells
in the intestinal lining.
What was more compelling, however, is
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what went on in the brains of these animals.
The scientist found that there was first
an increase in the chemical mediators of
inflammation, IL-6 and IL-1 beta, followed
by activation of the brains inflammatory
cells called microglia.
Even more compelling was what they
found in the animals’ brain memory center.
This area of the brain, the hippocampus,
plays a role not only in memory but also
in regulation of mood. Normally, it is
fairly straightforward to demonstrate
persistent growth of new brain cells in the
hippocampus in the mouse brain (as it is in
humans). However, when inflammation in
the gut was brought on by administration
of DSS, there was a dramatic reduction in
the growth of new brain cells in the animals
in which inflammation had been induced.
Not only was there a reduction in
the growth of new brain cells, but in
addition there was a reduction in the the
differentiation of the brain stem cells into
fully functioning neurons.
The implications of this study are
breathtaking. Not only does it shed
important light on the explanation as to
why individuals with inflammatory bowel
disease are frequently compromised
with respect to cognitive function as
well as mood, but it further extends our
understanding of the pivotal role of gut
related issues, in this case inflammation, as
they relate to the brain.
It’s time that we begin looking in earnest
outside of the brain for clues to our most
pernicious brain maladies. By and large,
researchers have come up fairly empty-
handed when looking only at the brain in
terms of trying to explain mechanistically
what goes on in things like Alzheimer’s
disease and Parkinson’s disease.
I admit that this is an animal study and that
it is certainly inappropriate to extrapolate
too aggressively from the results.
Nonetheless, we are moving forward with
a new concept of brain health and disease,
and these researchers are to be praised for
bringing us this valuable information.

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 About The Grain Brain
Whole Life Plan
It’s time to turn advice into action. The Grain Brain Whole Life Plan is your practical,
comprehensive empowerment guide for achieving optimal health, preserving brain
vitality, losing weight and reducing your risk for chronic diseases. Dr. Perlmutter
leverages the leading edge of published science on nutrition and wellness, taking
the lessons of Grain Brain and Brain Maker to create a powerfully actionable plan for
optimizing health and achieving peak mental performance. The Grain Brain Whole
Life Plan – live happily ever after.

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