Brain Maker - critical summary review

Just like many other books that have “brain” in their titles, David Perlmutter’s “Brain Maker” (written with the help of Kristin Loberg) is about the anatomy, the performance, and the health of your brain. Unlike most of them, though, it is about the health of your stomach as well. 

Really: it seems that while you were doing your everyday chores – you know, making the bed and buying the groceries – teams of tireless white-coated scientists discovered a connection between the things that are on your plate daily and the health of your brain. The content of “Brain Maker,” however, allows us to radicalize this finding substantially: if you care enough about your diet, the book claims, you might be able to prevent some debilitating and on-the-rise brain diseases!

Before we proceed to our summary, a necessary word of caution (to which we’ll get back in our “Final Notes” once again): even though Perlmutter is a doctor, mainstream science is critical of the claims he makes in both “Grain Brain” and “Brain Maker,” and there aren’t many peer-reviewed studies that back his belief in dietary changes preventing brain diseases such as depression, autism, or Alzheimer’s. 

With that out of the way, it’s time we moved on to Perlmutter’s arguments!

Your microbiome: more than just a hundred trillion tiny friends 

There’s a big difference between an average American and an average inhabitant of the Greek island of Ikaria. According to one prominent study, the latter is nearly four times more likely to reach 90, often in better health and mentally sharper. Moreover, an average Ikarian rarely experiences things such as depression, cancers or cardiovascular diseases – the three most vicious killers marching through the Western world, and, by some margin, the three most critical health challenges in the U.S.

According to David Perlmutter, all of these problems can be attributed to our unhealthy diets,  and they represent only some of the health issues, all of which have as the root the improper development of the human microbiome – something which he says has “a commanding role in health and brain function throughout life” and describes “as vital to one’s well-being as oxygen and water.”

“Perhaps there’s no better word for the microorganisms that live in your intestines and help with digestion than superheroes,” informs us Perlmutter from the outset. Even though there are at least 10,000 distinct species of them, his study’s main focus is bacteria, not the least because bacteria make up the majority of our gut microbes: collected together, the bacteria in our gut weigh about the same weight as our brains: 3-4 pounds. Moreover, “it’s the bacteria that are your body’s key players in collaborating with your physiology – especially your neurology.”

Even though kindly disregarded by your biology teacher and reduced to a footnote by your schoolbook, these hundred trillion friends of yours have their own ecosystem inside your body. And its proper functioning is so important, and its contributions so numerous, that it can easily be considered a separate organ as vital to your health as your own heart, lungs, liver, and brain.

Your gut’s bugs: your second liver, your second brain, your second immune system

According to some of the latest findings, our “gut’s bugs” – the intestinal flora that lives inside your intestinal walls – play a vital role in numerous processes rarely connected to them in the past. Among other things:

They aid in digestion and the absorption of nutrients.

They create “a physical barrier against potential invaders such as bad bacteria (pathogenic flora), harmful viruses, and injurious parasites.” 

They act as “a detoxification machine,” serving as the first line of defense against many toxins found in your food. For this reason, they are sometimes referred to as “a second liver.” Rightfully so, writes Perlmutter, because “when you decrease the good bacteria in your gut, you increase the workload of your liver.”

They influence the immune system’s response. It’s even more than that – your gut is your biggest immune system organ, representing 70 to 80% of your total immune system. “If the events that take place in the gut weren’t so critical to life,” notes Perlmutter aptly, “then the majority of your immune system wouldn’t have to be there to guard and protect it.”

They produce important enzymes, substances, and brain chemicals, including vitamins and neurotransmitters. You may be surprised to learn, but an estimated 80 to 90% of the amount of serotonin in your body is manufactured by the nerve cells in your gut! And it isn’t just that: the neurons in your gut are so innumerable that some scientists call the totality of them the body’s “second brain.”

They help you handle stress (unsurprisingly by now, the flora affects your endocrine – hormonal – system) and assist you in getting a good night’s sleep.

Finally, they help control the body’s inflammatory pathways, which in turn affect risk for virtually all manner of chronic diseases.

Your intestinal flora makes you fat: the surprising link between your gut’s bacteria and obesity

Now, most of your bacterial microbiome – 90% – consists of two types of bacteria: Firmicutes and Bacteroidetes. Firmicutes are equipped with more enzymes to digest complex carbohydrates and are much more efficient at extracting energy (i.e., calories) from food. Therefore, Perlmutter jokingly describes them as “notorious ‘fat-loving’ bacteria.” Bacteroidetes, on the other hand, lack this capacity. Instead, they specialize in “breaking down bulky plant starches and fibers into shorter fatty acid molecules that the body can use for energy.”

Now, if Firmicutes extract calories from food and Bacteroides don’t, the more of the former you have in your gut, the greater the likelihood that you’ll get fat. At least, in theory, the logic is sound. The strange thing is that a recent Harvard study proved that it is much the same in practice as well.

By comparing the microbiome of children from Africa with that of children from Europe, they discovered that the “Western” microbiome lacks diversity and has significantly more Firmicutes than Bacteroidetes; it is quite the opposite in African children. Incomparably opposite, in fact: the ratio is almost reversed, with African children having about 65% Bacteroidetes in their microbiome, and European children having a percentage as large, but of Firmicutes.

This may explain why obesity is so common in the Western world and virtually non-existent in Africa. And so many scientists took heed of this study that the Firmicutes to Bacteroidetes (or F/B) ratio is now looked upon as an “obesity biomarker.”

Belly and brain on fire: the new science of inflammation

Obesity, unfortunately, can be considered a minor problem when compared to numerous debilitating brain diseases. According to Perlmutter, imbalances in your gut may be responsible for many of them – if not all. He admits that the evidence is still inconclusive, but turns his readers’ attention to a few studies that have alluded to a connection between problems in your gut-associated lymphoid tissue (GALT) – aka, your gut’s immune system – and problems in your brain.

In short, if your GALT is compromised and your gut isn’t protected from certain bacteria, somehow your brain might not be too. Even though most scientists still believe that the brain is securely protected by the semipermeable blood-brain barrier (BBB), “leaky gut” may lead to a “leaky brain,” i.e., brain inflammation may be preceded by gut inflammation.

And that may be a good thing, because, unfortunately, unlike other types of inflammation, brain inflammation is something that can’t be felt, due to the absence of pain receptors in your brain. So, you may be suffering silently from brain issues that might lead to serious diseases once you’re older, and not be aware of them for quite some time. However, if the gut-brain connection is found to be true, there may be hope on the horizon, i.e., we may actually be able to diagnose these problems on time in the future.

The story of Jason: autism, antibiotics, and your gut

According to Perlmutter, if a brain inflammation has occurred during childhood, this may disrupt the normal brain development process and result in attention deficit hyperactivity disorder. If nothing more, at least one study has found that many people with ADHD possess a particular configuration of gut bacteria that, interestingly enough, has been linked by other studies to a heightened inflammatory response.

For one 12-year-old kid named Jason, whose story is in “Brain Maker,” this brain inflammation may have been caused by multiple courses of antibiotics upsetting his gut microbiome during his earliest years. Because of them, when he was just 10, a stool analysis uncovered that his gut had almost no lactobacillus bacteria – a known protector of the body against potential invasions by pathogens.

Precisely because of this, a simple vitamin and probiotics treatment did wonders for Jason, since lactobacillus is most commonly found in foods such as yogurt! Believe it or not, his brain actually benefited from the improvement of his gut microbiome. And, who knows, we may hear even more stories such as this in the future – and all due to a new treatment called fecal microbial transplant that involves extracting bacteria from a healthy man’s stool and transplanting them to a patient’s colon. True, it sounds nasty, but many things that are good for your health sometimes are.

On a slightly related note: Jason’s example is one of many that illustrate how much the usage of antibiotics has gotten out of hand! As a result of the excessive and improper use of antibiotics, many bacteria have developed resistance to them, and because of this, we can’t fight some of the “bad bacteria” the way we used to. And this even though it is a known fact that food may sometimes be just enough!

Destroying and feeding your microbiome: the essentials

More importantly, antibiotics are bad for you because they make your “good microbiome” go bad and turn against you. The same holds true for many other substances, such as the contraception pill, nonsteroidal anti-inflammatory medications (such as Advil), environmental chemicals (pesticides and chlorine), and herbicide-laden genetically modified organism (GMO) foods. Most significantly, fructose and gluten – two staples of the Western diet – have pretty much the same effect and are the real cause for many diet-related diseases.

Fortunately, even if it is dysfunctional and underperforming, your microbiome can be rehabilitated. The six essential keys to restoring balance in your microbiome and sustaining it, in the long run, are the following:

Choose foods rich in probiotics, such as live-cultured yogurt, kefir, kombucha tea, tempeh, kimchi, sauerkraut, pickles, and pickled fruits and vegetables, cultured condiments, and even fermented meat, fish, and eggs.

Go low-carb, embrace high-quality fat. An ideal plate consists of a sizable portion of vegetables (two-thirds of your plate) and about 75 to 115g of protein (whole eggs, wild fish, grass-fed meat, fowl)

Enjoy wine, tea, coffee, and chocolate.

Choose foods rich in prebiotics, such as acacia gum, cooked onion, or some raw vegetables (chicory root, garlic, leek, Jerusalem artichoke, or dandelion greens). Aim for 12g daily.

Drink filtered water.

Fast every season.

Final Notes

If there’s one thing we don’t like in this world, it’s snake oil salespeople. Dr. David Perlmutter has received a couple of medical awards and has published articles in medical journals, so it’s safe to say that he is above this description. Moreover, “Brain Maker” has been deemed anything from “a game-changer” to “a lifesaver” by members of the scientific community, in addition to being called a “must-read” by William Davis, M.D., and author of “Wheat Belly.”

Unfortunately, this doesn’t tell the whole story. Some of the cases Perlmutter describes and many of the dramatic improvements he promises seem too miraculous to be believed, and have – justifiably so – raised many red flags. In fact, not a few neurologists and doctors claim that some of Perlmutter’s methods seem not just unorthodox, but unscientific as well.

Now, we are neither neurologists nor doctors, so we can’t really tell you how much of Perlmutter’s book is based on science, and how much on factoids or even blatant lies. Consequently, it is probably best to advise you something along these lines: do read “Brain Maker,” but read it with a lot of caution and at least a grain of skepticism.

12min Tip

There is nothing wrong with going to the doctor. However, it’s much better if, before resorting to that option, to have a backup plan. It’s not complicated, really: you need to exercise and sleep more, stay away from antibiotics and unclean water, and embrace low-carb high-quality fat diet. Also: drink a lot of yogurts: it’s perfect for your microbiome.