Brain Maker by Perlmutter & Loberg

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Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain—for Life
David Perlmutter, MD with Kristin Loberg
Little, Brown and Company 2015

Modern medicine has no cure for the major illnesses that plague both young and old today. Despite a barrage of pharmacological intervention, cures for Alzheimer’s disease, autism, depression, Parkinson’s disease, ADHD, multiple sclerosis (MS), migraines and others involving the brain and nervous system, remain elusive. Rates of diabetes, obesity and chronic diseases continue to rise. In his newest book, Brain Makers, world-renowned neurologist Dr. David Perlmutter shows us how the health of the brain and body are intertwined through the health of the microbiome, a community of bacteria made up of one hundred trillion microscopic creatures which share our body space, predominantly but not exclusively in the human gut. Perlmutter makes the case that research at the leading edge of medicine now acknowledges that the state of the microbiome is the key not only to physical health but to mental health as well.

In 2014 the United States National Institute of Mental Health spent one million dollars establishing a research program targeting the microbiome-brain connection. Out of this program, research is now emerging that clearly establishes the gut-brain connection.

The brain and gut communicate via the vagus nerve and the enteric (intestinal) nervous system, also called “the second brain.” The vagus nerve is the primary channel of information between the central nervous system and the intestinal nervous system, extending from the brain to the abdomen. The second brain and central nervous systems are created from the same fetal tissue and are connected via the vagus nerve. Scientists have found that the kinds of bacteria in the gut “directly affect the stimulation and function of the cells along the vagus nerve.” The second brain makes 80-90 percent of the body’s supply of the hormone serotonin, the feel-good chemical—much more than the brain produces. This may be the reason that dietary adjustments rather than antidepressant drugs are so effective in treating depression.

In a new study at the Ohio State University Center for Clinical and Translational Science published in May 2015, researchers determined that the microbiome of a toddler’s gut may influence temperament and behaviors. Scientists found correlations between these factors and the presence of specific types of intestinal bacteria in both girls and boys. They are trying to determine how and where chronic illnesses like obesity, asthma, allergies, and bowel diseases begin. Many new studies like this one are exploring the connection between the microbiome and chronic diseases of brain and body.

The central concept highlighted in this book, which is of special relevance to family doctors, pediatricians, parents and caregivers, is that early colonization by gut microflora may have lifelong and far-reaching effects, even outside of the intestinal tract, such as with the respiratory system or allergies, among others. According to Perlmutter, following nature’s way through vaginal delivery and breastfeeding sets the stage for the infant to receive the building blocks necessary to develop a strong immune system, which protects the fragile newborn from pathogens and potential infections from infancy all through life. However, the rates of Cesarean delivery in the U.S. have risen 48 percent since 1996 and today 32 percent of all babies are born via this surgery. Children born through Cesarean section (CS) will inherit only a limited number of bacteria strains—those found on the mother’s external skin—which differ completely from the diverse microbiota that children born vaginally receive from their mothers. Greater microbiome diversity is associated with better health. Even the oral microbiome (mouth and throat) is vastly different in CS babies, whose oral cavities are colonized by Slackia exigua, a periodontal pathogen not present in vaginally delivered babies.

In addition, CS carries risks for the child, such as depression due to anesthesia, fetal injury, increased likelihood of respiratory distress, and breastfeeding complications. Along with the increased rates of CS deliveries, rates of autoimmune diseases and allergies have reached epidemic proportions.

Perlmutter describes ways that the CS-delivered child can be inoculated with his mother’s microbiotic bacteria and how infants can be given probiotic supplements to successfully treat colic.

The breast milk of a well-nourished mother provides her infant with many precious nutritional substances to develop a healthy body and brain: immunological substances that protect against bacterial infections, hormones to regulate appetite and protect against obesity, and many others. The first milk, colostrum, contains substances that establish the basis for the human immune system. Babies fed infant formula receive none of these substances, but instead get artificial ingredients as determined by infant formula producers based on legal requirements.

Breastfeeding also teaches the microbiome tolerance and the budding immune system discrimination between food components, without which certain immune reactions such as eczema, allergies, and asthma might appear. Reactions or intolerance to food components can become a life-long problem leading to the development of other pathologies and gut disturbances.

Most infants are prescribed a number of antibiotics during the first year because of ear infections and other problems. These drugs can be a lifesaver in some instances but are used much too often in babies and infants. Babies today are not allowed to experience fevers which is nature’s way to help the developing immune system mature. Instead, fevers are knocked down with antibiotics and acetaminophen, a potent liver toxin which interferes with the production of glutathione, the body’s major defender. With the continued use of antibiotics damage to the microbiome shows up in a number of different ways both physically and mentally. Perlmutter uses recent studies to establish links between the damaged microbiome and multiple disorders including neurological, autoimmune, digestive, diabetes, obesity, allergies and other chronic diseases.

By destroying beneficial bacteria antibiotics can allow pathogens to grow. These harmful bacteria create toxins which dump into the bloodstream and pollute the brain. They interact with the immune system to cause release of inflammatory molecules and stress hormones. As it turns out, antibiotics encourage the growth of a very problematic microbe, Clostridium difficile, or C. diff. This species is dangerous to the host and produces extremely high levels of propionic acid (PPA), one of the three major short-chain fatty acids produced by bacteria. PPA, if released into the circulation, is toxic to the brain and causes leaky gut by weakening the cells of the intestinal lining, enters the blood stream and causes inflammation and oxidative stress. It also assaults the mitochondria, interferes with cellular communication, and wreaks havoc in the brain by depleting it of antioxidants, neurotransmitters and omega-3 fatty acids. Researchers have determined that PPA “plays a central role in autism” and that treatment with oral NAC (n-acetyl cysteine), omega-3 fatty acids, and L-carnitine caused improvements in autism symptoms.

Diet composition directly controls the numbers of bacteria in the microbiome. The bacteria in our body are divided basically into two families, Firmicutes and Bacteriodetes. A whole foods diet with plenty of organic fruits and vegetables encourages the growth of Bacteriodetes while the Firmicutes prosper under the standard American diet. When Bacteriodetes are low there is increased leaky gut.

Our microbiome is also at the front in the battle of the bulge. Experiments with obese individuals show that their microbiome is predominant with Firmicutes while lean individual have more Bacteriodetes. High fructose corn syrup, for example, feeds pathogens and creates a type of microbiome (“the Westernized microbiome”) that limits diversity and favors overgrowth of bacteria strains that fuel adipose cells.

In addition to a healthy diet that excludes sugars and refined carbohydrates and incorporates wise choices, the supplement Lactobacillus GG (LGG) given to mothers during pregnancy not only affected their own weight, but even that of their children up to age four, according to recent studies.

Scientists from the Netherlands have improved blood sugar levels in type 2 diabetics using fecal transplantation of good bacteria into those patients. No medication known to man is able to reverse diabetes or improve insulin sensitivity. Elevated and uncontrolled blood sugar levels have been established as a risk factor in brain degeneration and Alzheimer’s disease which is now being called “diabetes type 3.” Focus on improving the health of the microbiome shows the future of treatment for easing the health burden associated with these diseases.

A healthy microbiome can become “sick” through the use of antibiotics, oral contraceptives, dietary choices, chlorinated and fluoridated water, environmental toxins and others. But the good news is that it can be improved by re-establishing a healthy balance of microbes through improved diet and lifestyle choices.

Food choices are a major source of problems for the microbiome as the standard American diet is high in sugars and artificial sweeteners; processed foods; vegetables fats; GMOs (genetically modified foods subjected to heavy spraying with toxic chemicals); factory meats, poultry and dairy; and lack of traditionally fermented foods.

Brain Makers outlines a prescription for improving the microbiome through sample menus and recipes. Recommendations for healthy foods include beneficial fats such as coconut, grass-fed butter and tallow, ghee, and olive oil, as well as organic products, grass-fed meats, pastured chickens, eggs and other products, along with increasing the amount of naturally lacto-fermented products in the diet. Lacto-fermented does not necessarily mean that a dairy product is involved but usually lacto-fermented foods are prepared with whey from cow’s milk because it contains probiotic bacteria and is easily available. Dairy-free probiotic starter bacteria for preparing lactofermented foods are available and sauerkraut made with organic cabbage, for example, can be made traditionally without adding any probiotic materials, just a brine of salt and water.

The Perlmutter plan recommends frequent use of food sources of prebiotics, those “nondigestible food ingredients” such as leeks, garlic, onions, asparagus and others that beneficially affect the host by selectively nourishing and stimulating the growth of lactic-acid bacteria in the gut. In addition to diet and prebiotics, Perlmutter points out the probiotic supplements that are helpful in reseeding the microbiome. He recommends five core species that provide documented benefits to health: Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus brevis, Bifidobacterium lactis, and Bifidobacterium longum. These probiotic strains have shown brain benefits in reducing “leaky gut” (gut permeability); increasing BDNF (brain growth hormone); favorably controlling the microbiome balance; and reducing levels of LPS (lipopolysaccharide), an inflammatory molecule that is a risk factor for Alzheimer’s disease, autism, depression, inflammation and other disorders.

In Brain Maker, Perlmutter describes his successes in treating autistic children, patients with multiple sclerosis and others with his program of healthy diet, probiotic supplements, and lifestyle changes. His book outlines “six essential keys to boosting your brain by boosting your gut,” a guide to supplements, a seven-day meal plan to incorporate more probiotic foods into the diet, and delightful recipes including some old standards like kombucha, kefir and sauerkraut, with some new favorites like coconut water lemonade, blueberry mint preserves, and a wide range of others, complementing the lacto-fermented recipes found in the traditional cookbook favorite, Nourishing Traditions by Sally Fallon and Mary Enig, PhD.

To learn more I highly recommend this potentially life-changing book for all readers and give it a most enthusiastic thumbs up.

 

This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Fall 2015

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