《谷物大脑》书评

歪理邪说

原始链接：http://www.amazon.com/gp/customer-reviews/R7YAG1F73O4W8摘录如下：This review is from: Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar--Your Brain's Silent Killers (Hardcover)Update(s):February 2014: Because your brain has a lot of fat, Perlmutter wants you to eat more cholesterol and fat. But that's how you get diabetes, which may lead to Alzheimer's! A recent study that induced diabetes in rats by giving them a high fat diet showed that the diabetic rats had weaker memories than the healthy ones (read all the details in the the article: "Are Alzheimer's and diabetes the same disease?" 28 November 2013 by Jessica Griggs. NewScientist)December 2013: The Atlantic Monthly has just published an article about this book called "This Is Your Brain on Gluten" by James Hamblin. Below are some excerpts:1) "In the Paleolithic Era, human life expectancy was around 30 years... humans did not live past their 50s. I wonder often why these are the times we cite as a standard of health. The paucity of old age should in itself explain why Alzheimer's and cardiovascular disease were basically nonexistent"2) Dr. David Katz is an epidemiologist who has published two editions of a nutrition textbook for healthcare professionals called Nutrition in Clinical Practice. Perlmutter estimates the Stone Age diet was 75% fat, a claim Dr. Katz finds "wildly preposterous. Anthropological research... suggests that in the age before cooking oil, humans ate mostly plants with a scattering of seeds and nuts. Virtually nothing in the natural world is that concentrated of a fat source, except maybe for the brain. Maybe if they just ate the brains of animals? They didn't have oil. They only started adding oil to the diet after the Dawn of Agriculture. What the hell could they possibly have eaten that would be that fatty?'"I have an excellent example of how absurd Perlmutter is to say our diet used to be 75% fat. In the amazing chronicle of Lewis and Clark Undaunted Courage: Meriwether Lewis, Thomas Jefferson, and the Opening of the American West, venison and elk meat was so lean (per 3.5 ounces: 4% fat, versus 35% fat in beef), that even though each expedition member ate up to 9 pounds of meat a day,...they were still hungry (p 165). Later in the book, Lewis remarks "that he didn't care what kind of meat he got, whether elk or dog or horse or wolf, so long as it was fat". Sacagawea brought the men some roots to eat which was a welcome addition to "the virtually all-meat diet...which if not complemented by other food might lead to scurvy, ... the men of the expedition at various times did suffer from scurvy. It was an age in which almost nothing was known about a balanced diet." A diet that sounds a lot like what Perlmutter is recommending!3) Dr Katz goes on to say that Perlmutter's "book is filled with a whole bunch of nonsense, that's why it's a bestseller. ...That's how you get on the bestseller list. You promise the moon and stars, you say everything you heard before was wrong, and you blame everything on one thing. You get a scapegoat; it's classic. Atkins made a fortune with that formula. we now have Perlmutter saying it's all grain. There's either a scapegoat or a silver bullet in almost every bestselling diet book. The recurring formula is: Tell readers it's not their fault. Blame an agency; typically the pharmaceutical industry or U.S. government, but also possibly the medical establishment. Offer a simple solution. Cite science and mainstream research when applicable; demonize it when it is not.Dr. Katz gives Perlmutter too much credit for the few scientific citations he has -- if he had read the papers cited (I read all of the original papers), he would have discovered that they do NOT support Perlmutter's claims about whole grains and dementia (which is what my review below focuses on since it would take a book to refute every piece of nonsense -- See #10 below).4) Perlmutter's advice is POTENTIALLY LETHAL. Hamblin asks: "What is the worst that can come of avoiding gluten and limiting carbs? That depends entirely on what you replace those calories with. I read the book with an eye for the most dangerous claim. What stuck out to me was Perlmutter's case for cholesterol. He basically says that we can't have too much. Beyond that, Perlmutter says that cholesterol-lowering statin medicines like Lipitor, which are prescribed for a quarter of Americans over 40, should actually be vehemently avoided. Cholesterol is necessary for the brain in high levels, he says, and lowering it is contributing to dementia. Dr. Katz replies: "..can we totally ignore both dietary cholesterol and LDL? Absolutely not...Ignoring LDL could absolutely result in heart attacks and strokes". Katz acknowledges that dietary cholesterol may be an innocuous part of an overall healthy diet. "The problem is that people are going to get their dietary cholesterol from things other than fish and eggs; they're going to get it from meats and dairies. The problem with diets like that is if you eat more of A, you're probably going to eat less of B. So people who are eating more meat and dairy and high-fat, high-cholesterol foods are eating fewer plants--they're not eating beans; they're not eating lentils. So yes, I think it's entirely confabulated and contrived, and potentially dangerous on the level of lethal."5) "We do not have reason to believe that gluten is bad for most people. It does cause reactive symptoms in some people. Peanuts can kill some people, but that does not mean they are bad for everyone. Diets consistently shown to have good long-term health outcomes---both mental and physical--include whole grains and fruits, and are not nearly as high in fat as what Perlmutter proposes. I hope people don't give up on nutrition science, because there is a sense that no one agrees on anything. An outlier comes shouting along every year with a new diet bent on changing our entire perspective, and it's all the talk. That can leave us with a sense that no one is to be believed. When a person [like Perlmutter] advocates radical change on the order of eliminating one of the three main food groups from our diets, the burden of proof should be enormous. Everything you know is not wrong."----------------------------And now here is my review:The blurb for this book reads: "carbs are destroying your brain. And not just unhealthy carbs, but even healthy ones like WHOLE GRAINS can cause dementia, ADHD, anxiety, chronic headaches, depression, and much more".Wow! This is such an incredible claim, and there is not one shred of evidence in the book to back it up. Here are some of the reasons why:#1: Mediterranean & DASH diets both recommend whole grainsThese diets have lots of carbohydrates and LOWER dementia, blood pressure, cancer, strokes, heart attacks, and so on.People eating a Mediterranean diet are among the longest-lived on earth and they've been studied for decades. Italy has the 4th longest lifespan in the world!U.S. News and World report has a fantastic overview and details of the best diets (and worst). The DASH and Mediterranean diets were considered to be the best diets by experts across many fields There were 22 experts - mainly physicians and professors of food science and nutrition, who evaluated and ranked a variety of diet plans based on: how easy to follow, ability to produce short and long-term weight loss, nutritional completeness, safety, and prevent diabetes and heart disease. The Paleo diet came in dead last.----------------------------------------#2 If whole grains or carbohydrates caused any of these maladies, it would be headline news on Time magazine, medical journals, the New York Times, and TV news.But it isn't.----------------------------------------#3 Grains have been the basis of civilization for over 10,000 years. We evolved to eat grain. So did dogs. Two-thirds of people on the planet depend on grains to get enough calories.Our genetics have even changed to adapt to this -- anyone with ancestors from a farming region has up to 7 times as many amylase genes to digest starch as a hunter-gatherer. Read The 10,000 Year Explosion: How Civilization Accelerated Human Evolution to learn more about how we evolved faster the past 10,000 years than the previous 6 million years to adapt to the new agricultural diet (and milk, etc).One of the top peer-reviewed science journals in the world, Science Magazine, has an article titled "Diet Shaped Dog Domestication" published 23 January 2013. DNA from wolves and dogs was obtained, and the most surprising difference between wolves and dogs was that dogs were highly evolved to digest starch, with 4 to 30 copies of the amylase gene, which breaks down starch in the intestine. Wolves only have 2 copies, which means amylase genes in dogs are 28 times as active than in wolves, making dogs 5 times better at digesting starch than wolves. The same is true of people - Europeans, Americans, Japanese and other cultures that eat a lot of grains have much higher numbers of copies of amylase genes than people who eat starch-poor diets like the Mbuti in Africa."We have adapted in a very similar way to the dramatic changes that happened when agriculture was developed," concluded evolutionary geneticist Erik at Uppsala University in Sweden."Axelsson thinks these results support the idea that wolves began to associate with humans who were beginning to settle down and farm. Waste dumps provided a ready source of food, albeit not meat, the usual diet. Thus early dogs that evolved more efficient starch digestion had an advantage".I thought a paleo diet made sense many years ago, and was both surprised and delighted to discover we'd evolved to eat grains and legumes in mere millenia. Grains and legumes are the basis of civilization and always will be, since grains don't need refrigeration and can last past several bad harvests. The Buddha said to avoid attachment, and this applies not just to things but ideas.----------------------------------------#4 Before agriculture, most cultures, even Native Americans, ate lots of carbohydrates.In California, half the diet of most hunter-gatherer tribes was acorns. Tribes across America depended heavily on acorns, as well as tribes across the Eurasian continent. Acorns are 43% carbohydrate. Whole wheat is 68% carbohydrate - but grains and lentils are only a quarter of the food plate, while Native Americans were depending on them for half of their diet. So it's 6 of one, half a dozen of the other.Bits of starch grains have been found on the grinding stones from 30,000 year old sites in Italy, Russia, and the Czech Republic, where our ancestors made flour from ground up plants, combined it with water and made a pita bread on stones heated in fires. Our ancestors were smart to grind roots so the flour could be stored or carried, since often game animals were seasonal and no meat was to be had many times of the year.Eating carbohydrates could go back for millions of years. Fossil hominids had such sturdy premolar teeth it's believed they were probably used to open seeds and chew starchy underground tubers and bulbs. Even Neanderthals ate starch, which we know from studying the plaque on their teeth.Anthropologist Frank Marlowe studied the eating patterns of 478 groups around the globe. He found that no matter where you live, at least a third of your diet is going to come from plants (and in many places nearly all of your diet), so the idea our ancestors were mainly carnivorous is not true.----------------------------------------#5 We already know what the causes of dementia and Alzheimer's are from tens of thousands of studies. Carbohydrates have nothing to do with it.The risks are: Being over 65, genetic (5%), female (women live longer), severe or repeated head trauma, lack of exercise, smoking, high blood pressure, high blood cholesterol, poorly controlled diabetes, not enough fruits & vegetables, lack of social engagementPeople at a lower risk have higher levels of formal education, a stimulating job, mentally challenging hobbies like reading or playing a musical instrument, and lots of social interactions.----------------------------------------#6 Thousands of studies over 50 years that show whole grains can reduce your risk of stroke by up to 36%, heart disease by up to 28%, and type 2 diabetes up to 30%The March 2008 issue of Consumer Reports says that eating whole grains is the #1 action you can take to improve your health (besides quitting smoking).According to the World Health Organization Global Burden of disease 2010 study, the 16th leading cause of early death and disability is not eating enough whole grains (The Lancet).Whole grains also appear to lessen or lower the risk of: Artery-narrowing plaque, Asthma, Atherosclerosis, Blood pressure, Cancer: Bladder, Breast, Colon, Esophagus, Gallbladder, Kidney, Liver, Larynx, Non-Hodgkin's lymphoma, Ovarian, Pancreatic, Prostate, Rectal, Stomach; C-reactive protein, lower LDL Cholesterol and triglycerides, Constipation, Diabetes, Diverticulitis, Gallstones, Gastrointestinal disorders, Gum disease, Hemorrhoids, Hypertension, Inflammatory diseases, Macular degeneration, Metabolic syndrome, Obesity, Varicose veins of the legs, Weight regulation (loss), lower BMI, and increase your life span (wholegraincouncil).In 2010, the American Society for Nutrition brought researchers together to review the evidence of whole grain health benefits. Current scientific evidence shows that whole grains play an important role in lowering the risk of chronic diseases like coronary heart disease, diabetes, and cancer, and also contribute to body weight management and gastrointestinal health. The findings were published as a supplement to The Journal of Nutrition in May 2011In 2004 (Nutrition Research Reviews, May 2004; Vol 17: 99-110), Dr. Joanne Slavin of the University of Minnesota published a comprehensive article that reviewed and compiled scores of recent studies on whole grains and health, to show how whole-grain intake is protective against cancer, cardiovascular disease, diabetes and obesity.The wholegrainscouncil has thousands of studies listed at their "health studies on whole grains" and "What are the health benefits" pages. If you think the wholegrainscouncil is a biased institution then you need to counter with peer-reviewed scientific evidence, not name-calling.----------------------------------------#7 Did Perlmutter single-handedly disprove decades of peer-reviewed studies in both medicine and nutrition?I can't find any reference(s) in his book to support his claims. Nor did the the New York Times, the 2 top scientific magazines Science and Nature, NBC, ABC, CBS, The Lancet, The New England Journal of Medicine, the Mayo Clinic, or any other medical or science journal.There are very few 2013 references. Many of those are non-science references (i.e. Dr. Oz, cookbook author Mark Bittman - my favorite cookbook author, but the citation is not a peer-reviewed study) and most of his scientific references that have anything to do with wheat are for people with celiac disease (1-2% of the population) or sensitive to gluten, at most 7% of people.----------------------------------------#8 the references that do exist only apply to the 1% with celiac disease or 5% with gluten intoleranceSo if there's a grain of truth to anything he's saying, it doesn't apply to those of us in the 90% majority. But I don't know if I can believe anything he's saying, and it's too much work to sort the wheat from the chaff.----------------------------------------#9 Testimonials are not proof. Only peer-reviewed science in top-tier journals countsMost of Perlmutter's "proof" are the testimonials of patients.Testimonials are NOT SCIENCE --and Dr. Perlmutter MUST know this if he has an advanced degree.Only double blind studies that can be repeated are valid evidence. Because people forget what they've eaten, or over/under estimate what they've eaten, the reports of people in scientific studies are the least reliable, and this isn't even a scientific study, it's his patients who probably like him or they'd go to another doctor.The most trustworthy studies look at the diets of millions of people across nations or large groups of people over decades. Many studies of national diet and thousands of people have shown many benefits from eating whole grains for decades.If you want to seriously debate the merits of this book, you need to counter with peer-reviewed science, not attack my character or invent something I wrote and then rebut an argument I never made.I feel like I disturbed a hornet's nest of True Believers, a religious Paleo diet cult. Hey, I'm not trying to take your bacon away -- believing in bacon makes more sense than believing any of the 3,000 plus Gods you can choose from across the various main and tribal religions.But as Eric Schlosser showed in Fast Food Nation: The Dark Side of the All-American Meal there are ethical and ecological repercussions to consider. So before you fry up that next pan of bacon, you might find that Raising a Stink: The Struggle over Factory Hog Farms in Nebraska (Our Sustainable Future) will give you food for thought.Bacon, eggs, and red meat do not lead to a long life. Quite the opposite: According to the World Health Organization's "Global Burden of Disease 2010″ study, American causes of early death and disability are: High total cholesterol #9, Diet high in processed meat #12, Diet high in red meat #32----------------------------------------#10 Perlmutter provides no evidence to support his idea. None.Perlmutter hasn't published peer-reviewed papers about anything -not in his field of neurology our outside of his field in nutrition.To prove his point, he often cites what he calls a Mayo clinic paper in Grain Brain, TV, radio, and internet articles. He says that "Relative Intake of Macronutrients Impacts Risk of Mild Cognitive Impairment or dementia", shows people favoring carbohydrates in their diet had an 89% increased risk of developing dementia. But those who ate the most fat had a 36% reduction in risk.Not true. In this study:1) No one developed dementia.2) Mild Cognitive Impairment (MCI) is a controversial diagnosis. It just means someone has mild problems with language, thinking, memory and judgment. Many physicians think these are normal symptoms of aging. MCI often goes away. Most people diagnosed with MCI do not go on to develop dementia or Alzheimer's.3) The words "whole grain" or "whole wheat" do not appear in this study. No effort was made to distinguish healthy whole grains from refined carbohydrates.4) This was an observational study. It can only show a correlation between two things, not cause-and-effect. There could be other factors in the participants' lives that explain the results.5) The subjects self-reported their dietary intake. Its well-known people aren't good at this.There are only 7 peer-reviewed references in Grain Brain that have anything to do with both carbohydrates and dementia. Not one of these papers mentions whole grains or whole wheat. Two of the papers apply only to the 1% of the population with Celiac Disease. Five of these 7 papers apply only to people with celiac disease or gluten sensitivities (at most 6 to7% of the U.S. population).Perlmutter says that because 70% of our brains are fat, we should be getting 50-60% of our calories from fat. That's more than twice what the Mayo Clinic and every other expert says. They all recommend 20-35% of total daily calories from fat, 45-65% of your daily calories from carbohydrates, and 10-35% of calories from protein (Zeratsky, Mayo Clinic Staff, U.S. Dept of Health and Human Services).Goodbye nutrition, hello cardiology.I know people are really angry that sugar and white flour may be as bad as fat, but that doesn't mean going to the other extreme and eating so much fat you'll get a heart attack.Perlmutter cites studies to show fat prevents dementia, but if you actually read these studies (free and available online), it backfires. He advises not eating much fruit, yet the conclusion of one of the papers "Dietary Patterns and Risk of Dementia: The Three-city Cohort Study" concluded "Frequent consumption of fruits and vegetables, fish, and omega-3 rich oils may decrease the risk of dementia and Alzheimer disease".At his website [...] he cites "Evidence-Based Guideline of the German Nutrition Society: Carbohydrate Intake and Prevention of Nutrition-Related Diseases". Oops again. Perlmutter spends a lot of time trying to show that carbohydrates (and therefore whole grains) lead to diabetes, which leads to dementia), but this paper says the opposite: "a high dietary fibre intake, mainly from whole-grain products, reduces the risk of obesity, type 2 diabetes, cardiovascular disease and colorectal cancer".--------------------------#11 What is Perlmutter's motivation?At amazon.com I have been accused of profiting somehow from my 1-star review of this book. This is called an "ad hominem" attack because it distracts people from my 11 criticisms by not addressing any of them. (By the way I don't work -- I'm retired, make no money from my book about home made whole grain & legume chips & crackers, and don't care if I ever do. I'm way too busy with other activities, such as volunteering to take 4th & 5th graders from the inner city on hikes at Audubon Canyon Ranch near Bolinas, blogging about nutrition and other food related topics at my website, etc. My grandfather was a nutrition professor at the University of Chicago so I've been interested in this topic for a long time. He died before he could publish his book about the extent to which a well-fed an army was likely to win a battle. Napoleon thought good food was essential and had first-rate bakers making high-quality bread for soldiers on the front-lines).So these strange attacks on me rather than my arguments and accusations that I was somehow doing this to make money brought up another argument I hadn't thought of, so I went back to this review to add what's below.In murder mysteries the killer is often found by discovering a motivation. Why would Perlmutter slam WHOLE GRAINS rather than white flour? And he's not the only one doing this, which makes me all the more suspicious that the industrial food companies are funding people who speak out against whole grains.Why would they do that?The basis of processed food is using unhealthy cheap ingredients. Fat, sugar, salt and white flour are almost as cheap as water. Read my review of Salt Sugar Fat: How the Food Giants Hooked Us at wholegrainalice.If there's anyone who makes money off of this, it would be the processed food industry, and they'd do it by sponsoring "experts" to slam whole grains so they can keep using cheap unhealthy white flour. There are many ways to do this, one would be making lucrative speaking engagements on TV, radio, and conferences available to Perlmutter and other "experts" who slam whole grains. The multi-billion dollar food industry has a very strong motive to fight whole grains because they're quite expensive compared to white flour, have a shorter shelf life, and are more trouble to predictably make "perfect" because whole wheat varies in protein and other content.But there are many other ways that corporations pay "experts" and also keep it a secret. The best book on this is Bending Science: How Special Interests Corrupt Public Health Research. Also see Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global WarmingBasically Perlmutter is making a claim that refutes thousands of studies of the health benefits of whole grains -- he deserves to be criticized just like those who deny climate change, evolution, or that tobacco causes cancer.Why didn't Perlmutter criticize white flour?White flour has had the bran and germ removed so it's just a starch. It no longer behaves like flour, so up to 30 chemicals are added (many of them banned in Europe -- see my article at wholegrainalice). White flour has no fiber, up to 88% of 21 vitamins and minerals are removed (they're mostly in the missing bran & germ), and all the essential healthy oils, and most of the protein too.David Kessler, former head of the FDA, writes in The End of Overeating: Taking Control of the Insatiable American Appetite that more than any other product, baked goods have more sugar, salt, and fat than other products to hide these sour, bitter chemical flavors.I can understand that the average person is totally confused by all the advice out there and wouldn't know that testimony counts for nothing, but Dr. Perlmutter knows he can't refute decades of studies showing the benefits of whole grains. Health claims for whole grains are one of the few claims allowed by the FDA. It's how two-thirds of people in the world get enough calories to survive.So to blame dementia etc., on wheat when he knows full well that other factors are mainly to blame, now why would he do that? Yet another way to make money off of this quack idea is obvious - to sell this book to gullible new age, Dr. Oz, Andrew Weil, gluten-free and Paleo diet followers.A third way to make money, in addition to corporate money and selling this book is that he's on the advisory board of the company that makes the Protandim pill he recommends taking.---------------------------------------------------#12 Perlmutter knows other factors are to blameAnd get this -- only a very small number of his citations are about grains, the title of this book. And only one chapter, the rest are about fats, statins, sleep, fasting, and other topics.ConclusionThe only way to protect yourself from bad ideas is to understand what bad versus good evidence is, develop critical thinking skills, and read about a topic. If you don't know what we know and how we know it, or have a basic understanding of nutrition, then you may fall prey to any quack that sounds good to you. Inoculate yourself by reading a nutrition textbook. My favorite by far (and I've looked through hundreds of textbooks at the University of California library) is Nutrition for Health and Health Care. Get it from a university library, or buy an older edition, the basics don't change much.One of the comments says that wheat has a gluten content 500 times what it was in the past which "disturbs the digestive tract by making it more permeable and "leaky" even in people who aren't gluten-sensitive". Another said they are "enriched" with chemical laden "nutrients" and it's not the same as it used to be. Another that mutagenesis has changed the wheat somehow. Prove these statements with peer-reviewed references, the more the better, and I'll change my mind.I noticed that the 3 Most Helpful Customer Reviews that appear on the main page, which few people would click past to reach this review, are written by Amazon Vine Reviewers. According to episode #492 of National Public Radio's "Planet Money", they receive the items reviewed for FREE. This would lead to positive reviews in two different ways -- the obvious one is that we are wired as human beings to be return gifts (that's why the Hare Krishna's liked to hand out flowers at the airport), and #2 the reviewers get to pick which items they want to review out of many -- so they're going to pick books that they might be interested in. I spent a good deal of time looking at the books and products these reviewers reviewed, and they tended to give nearly all four or five star reviews, and they write thousands of them, across thousands of not just books, but all the other products they get for free. I wonder if maybe Amazon is picking Vine reviewers by those that highly rate most products so they can sell more books (or whatever).Perlmutter also buys into the Paleo diet, which has been soundly shown to be a fantasy (see my book review of Paleofantasy: What Evolution Really Tells Us about Sex, Diet, and How We Live )Here's what the Whole Grains Council had to say about this book:Celiac disease and gluten intolerance are real and serious issues. People with celiac disease (1-2% of the population) or non-celiac gluten intolerance (estimated at about 6% of the population) can indeed have medical issues not only with their digestive systems but with other organs including the brain, and these people will benefit from removing the four gluten grains - wheat, barley, rye and triticale - from their diets.Even the 7-10% of people with a reaction to gluten, however, can continue to enjoy all the non-gluten grains: amaranth, buckwheat, corn, millet, oats (if certified as non-contaminated), quinoa, rice, sorghum, teff, and wild rice. The rest of the population can enjoy these ten grains along with the four gluten grains. Leading medical researchers in the area of gluten intolerance and celiac disease attest that there is no need for 90 percent or more of our population to avoid any grains.Put simply, there is no evidence for the idea we should all avoid all grains. Perlmutter must realize this himself, since Grain Brain contradicts its main premise that all grains are injurious to brain health, and recommends eating, in moderation, "amaranth, buckwheat, rice (brown, white [sic], wild), millet, quinoa, sorghum, teff and [gluten-free] oats."In fact, evidence for the health benefits of whole grains is well-documented at the whole grains council website - and was touted by Grain Brain's author in his earlier book The Better Brain which included foods like whole grain couscous, oatmeal, spelt pasta, and quinoa-stuffed peppers throughout its menu plans. In an interview promoting The Better Brain on CBN-TV, for instance, Perlmutter advocated replacing junk food with "real food such as unprocessed whole grains and fruits and vegetables." He does not acknowledge or explain his flip-flop in Grain Brain, giving us no clue why he has now turned against what he previously acknowledged to be sound science.While Grain Brain goes off the deep end in imagining that the very real health problems of the 7-10% of the population with gluten intolerance or celiac disease somehow extend to all of us, the book rightfully details many important components of good health that Oldways and the Whole Grains Council have long supported. These include the key roles of physical activity and sleep; the essential contribution of good fats; the value of the Mediterranean Diet (which Perlmutter cites as "very similar to my dietary protocol"); and the importance of avoiding inflammation and choosing carbohydrates with a low glycemic impact.Our advice? Don't let Grain Brain scare you away from appropriate-size portions of healthy forms of whole grains (yes, a whole grain cookie is still a cookie!). Enjoy a balanced diet including a delicious variety of real, whole foods, an approach followed in traditional diets backed up by proven science, like those championed by Oldways.

基因表达

基因表达(gene expression)是指细胞在生命过程中，把储存在DNA顺序中遗传信息经过转录和翻译，转变成具有生物活性的蛋白质分子。基因是生命体的规律，类似我们的世界遵循牛顿力学，基因和牛顿力学都是漫长时间进化的结果，就是无数哲学家科学家宗教追求的真理。因为我们生活在特定的时空中，无法脱离这些规律，所以只能遵循，违反的后果就是逆天而行。拉长时间轴，狩猎时代人类的饮食和农业时代以后的饮食对比是作者的中心思想。其实脱离人类生理结构谈论高脂肪和高碳水化合物的优劣没有意义，就像一只母青蛙绝对不会对林志玲产生性欲，你赖以生存的世界只是进化的结果，想在你的世界里活得顺风顺水就要清楚这个世界的进化由来。如果我们的生理结构是上百万年高脂肪高胆固醇狩猎生活的进化结果，那么碳水化合物饮食的合理性在哪里？狩猎历史塑造了人类基因，这个基因现在主宰着我们的生活，我们最好乖乖的顺着它，至于改变基因适应碳水化合物还是别做这个炮灰了。

我就想知道这样会不会太极端

看了梗概，我就是很好奇 作者说我们的祖先都是吃肉的，但是谷物这种也是很早的被发现的。难道这个就没有在基因么？难道猴子猩猩就不吃大米小麦碳水化合物了么。碳水化合物和糖的确要少吃 。不知道作者有没有研究过以碳水化合物为主的亚洲国家的人。总感觉这本书写的未免太以偏概全 太绝对，如果真的是过敏的话就算了 不用当圣旨版看待

营销的境界

看到的很认同的一篇书评http://www.theatlantic.com/health/archive/2013/12/this-is-your-brain-on-gluten/282550/?dt_platform=30a03ad59f9a83c7df4eca372291473f&dt_ref=da99f0d4269610ae&dt_dapp=0135e759cd902d35&from=timeline&isappinstalled=1翻译了两点结论如下"Now, he's absolutely right that we eat too much sugar and white bread. The rest of the story, though, is one just completely made up to support a hypothesis. And that's not a good way to do science.”关于糖和白面包的过度消费，他说得一点不错。而故事的其他部分，不过是为了支持一种说法而拼凑材料。这并不科学。"I also find it sad that because his book is filled with a whole bunch of nonsense, that's why it's a bestseller; that's why we' re talking."很遗憾，我觉得他的书里有很多无稽之谈，所以这本书会畅销，所以我们得谈谈。这本书在国内的流行可能部分源自于樊登读书会的推荐（见链接），对这些号称帮你读书的真得保持警惕了，哪儿有那么好的事儿啊！http://mp.weixin.qq.com/s?__biz=MzAwNTc3MzYzNw==&mid=2650883604&idx=1&sn=3ceb8ea9518ce5223e8acb5b65935b5f&scene=7#wechat_redirect补一条Amazon的评论Testimonials are NOT SCIENCE --and Dr. Perlmutter MUST know this if he has an advanced degree. 实证绝不能和科学划等号，作者拿到的高等学位肯定包括这一点Only double blind studies that can be repeated are valid evidence. Because people forget what they've eaten, or over/under estimate what they've eaten, the reports of people in scientific studies are the least reliable。只有可重复的双盲测试才能作为确证。人们会忘记他们吃过什么，可能高估或低估摄入量。科学研究中，受试者的描述是可信度最低的。

转载：《谷物大脑》的真相

《谷物大脑》的真相2017-01-19 方舟子 方舟子　　人们把米饭、面食这些谷物食品叫做主食，因为它们是我们每餐都要吃，而且往往是吃得最多的一类食品。谷物主要是提供淀粉这类碳水化合物的。淀粉在消化道里消化成葡萄糖，被吸收到血液里。葡萄糖为我们人体提供了生命活动必须的能量。大脑监测到血液里的葡萄糖浓度足够高以后，知道有了足够的能量，就会让人产生吃饱了的感觉。所以吃主食最容易填饱肚子。在食物缺乏的年代，进餐的首要目的是获得足够的能量，谷物就成了最重要的食物，所以我们中国人才把进餐叫做吃饭。　　然而最近国内风行一本从美国引进的“健康”读物《谷物大脑》，却声称根据“进化理论、现代科学和生理学”，谷物以及水果和其他碳水化合物能对大脑造成永久的伤害，会导致阿尔茨海默症、慢性头痛、失眠、焦虑、抑郁、癫痫、运动障碍、精神分裂症、注意缺陷多动障碍等各种与大脑相关的疾病，而且还会加快身体的老化进程，人们关心的肥胖、关节炎、糖尿病和其他慢性病都跟这有关系。说得极其恐怖，然后“提供了一条光明的、充满希望的讯息”：吃极低的碳水化合物（每天不超过60克碳水化合物，也就是一份水果的量）、富含饱和脂肪酸和胆固醇的饮食是预防脑部疾病和慢性病的理想方案。　　该书声称这些观点“都以最受推崇的、最新的科学研究为基础”，“不仅仅令人大吃一惊，而且无可争辩地确凿无疑”。它的确令人大吃一惊，但是绝非无可争辩地确凿无疑。恰恰相反，它与主流医学界、权威科学机构的建议背道而驰。主流医学界推荐的均衡饮食方案中，谷物和水果都是主要的食物类群，每天来自碳水化合物的能量大约占了食物能量的一半。如果碳水化合物摄入得太少，身体得不到足够的能量，就要找新的能量来源。除了把氨基酸转化成葡萄糖，还会分解体内储存的脂肪作为能源。脂肪在分解过程中会产生一种物质叫做酮体。血液中如果酮体含量太高，就会出现酮体中毒的症状，会恶心、头疼，还会有口臭。这种口臭的味道不是因为口腔不卫生产生的，而是酮体的味道。葡萄糖是维持我们大脑正常运行最好的能源，大脑得不到足够的葡萄糖，被迫改从酮体获得能量，功能就会受影响。所以酮体中毒的一个表现就是人会变得很暴躁。这是大脑在提醒你，赶快给我葡萄糖吃。可见低碳水化合物饮食反而会对大脑功能造成伤害。膳食中的胆固醇是否会有害健康目前还有争议（参见方舟子《胆固醇被平反了吗？》），但是膳食中的饱和脂肪酸会增加心血管疾病的风险却没有争议。该书推荐的低碳水化合物、高饱和脂肪、高胆固醇的饮食，其实是极不健康、有害身体的。　　但是，主食如果吃得太多，获得的能量超出了生命活动消耗的能量，多余的能量转化成脂肪在体内储存起来，人就会逐渐变得肥胖。肥胖会带来一系列健康问题，比如增加了得心血管疾病、糖尿病的风险。即使获得的食物能量没有超出消耗的能量，人没有变肥胖，但是如果在饮食结构中主食占的份额太多，血糖浓度偏高，也会增加得糖尿病的风险。那么一天吃多少主食合适呢？这取决于性别、年龄、身体状况、活动程度。如果你是一个青年妇女，那么你一天需要的主食大概是750毫升，相当于6片面包，或者3小碗米饭。如果是小伙子，每天多250毫升，也就是1000毫升，相当于8片面包，或者4小碗米饭。当然，如果你运动量比较大，那就要多吃点。如果年纪大，那就要少吃点。此外还要注意，主食要尽量吃全谷的，每天吃的主食至少要有一半是全谷物。把谷粒的壳去掉以后剩下的完整种子，包括了谷皮、谷胚和胚乳这三部分的，就叫全谷物，比如糙米、黑米、红米、小米、燕麦、荞麦、全麦面粉、玉米面、爆米花都是属于全谷物。如果把谷皮和谷胚也去掉了，只剩下了胚乳，那就属于精制的谷物。精制的谷物就是我们平常说的白大米、白面粉，它把谷皮和谷胚都去掉了，剩下的胚乳基本上都只是碳水化合物了。而全谷物由于保留了谷皮和谷胚，除了碳水化合物之外，还有其他对我们身体很重要的营养素，包括B族的维生素、铁、锌、胡萝卜素、膳食纤维等等。而且吃全谷物的话人体对碳水化合物的消化和吸收就没有那么快，这样血糖就不会一下子升得很高，有助于预防糖尿病。　　然而该书却声称主流医学界的这些建议属于“外行人的教条”，涉及“企业的既得利益”，要人们摒弃。那么该书的作者是怎样一个内行人和超脱既得利益的高人呢？该书对作者戴维·珀尔马特（David Perlmutter）的介绍是“一名具有专科医师资格的执业神经科医生”、“在营养对神经病症的影响这个研究领域，珀尔马特博士是世界公认的权威”。很多读者相信他，就是被这些光环所迷惑，以为他们接受到的是一个世界公认的权威提供的科学信息，那么，挖一下这个作者的底细，是很有必要的。　　珀尔马特于1981年获得美国迈阿密大学医学院医学博士学位，之后在该校的医院做了几年住院医，于1987年获得行医执照后在佛罗里达州自办私人诊所行医。他的本行是神经外科，受的是神经外科手术训练，与营养学没有关系。在当了十几年神经科医生之后，自1996年起，他开始以“营养对神经病症的影响这个研究领域”的权威自居，发表演讲、文章、出书推销他对这个问题的独特观点。一个神经外科医生当然可以转行从事营养学研究，但是学术研究成果首先应该写成论文经同行评议后在学术期刊上发表。珀尔马特也知道这一学界常识，在其英文简介中介绍自己：“在世界医学文献中大量地发表学术成果，论文发表在《神经外科杂志》（The Journal of Neurosurgery）、《南方医学杂志》（The Southern Medical Journal）、《应用营养学杂志》（Journal of Applied Nutrition）和《神经学档案》（Archives of Neurology）。”他列举的这四种期刊中，《应用营养学杂志》是一本早已停刊、各个医学文献数据库都不收录的非正规期刊，而他发表在另外三种期刊上的论文，都是他在学生时代发表的神经外科论文，没有一篇属于“营养对神经病症的影响这个研究领域”。　　在珀尔马特的详细英文履历中，他列出了他发表过的全部24篇“期刊论文”，但是这其中有10篇是他当学生时发表的神经外科论文，8篇是发表在推销另类医学的非学术期刊上的介绍文章，2篇是访谈，1篇是给《美国医学杂志》的读者来信，两篇发表在学术资质可疑的期刊上（包括上述《应用营养学杂志》）。其获得行医执照之后唯一一篇正规的论文是2009年发表的通过注射谷胱甘肽治疗帕金森病的初步临床试验研究。这篇论文的发表背景是：珀尔马特一直在鼓吹通过注射谷胱甘肽治疗帕金森病，声称他的病人经过如此治疗后效果极佳，有效率达到80～90%，于是南佛罗里达大学神经学系研究人员与他合作做了初步的临床试验，发现没有效果。有趣的是，在这篇论文中珀尔马特是排在最后的最不重要的作者（不是通讯作者），然而珀尔马特在履历中却把自己的署名挪到第一，变成了最重要的第一作者。当然，他是不会告诉你这篇论文的结论是否定了他推销的疗法的，一直到去年他还在推销通过注射谷胱甘肽治疗帕金森病。　　由此可见，珀尔马特从来就没有在正规学术期刊上发表过任何“营养对神经病症的影响这个研究领域”的学术论文，他在这方面的资质和一个外行没有什么不同，他怎么就成了这个研究领域的“世界公认的权威”？不错，《谷物大脑》这本书在美国非常畅销，有不少非医学界的名人都相信、推崇它，但是这并不等于就让他成了“公认的权威”，否则中国自己的“养生大师”，例如张悟本，也出过极其畅销的书，也有过很多非医学界的名人推崇，是不是也成了“公认的权威”？　　珀尔马特抨击主流医学界受到“企业的既得利益”的影响，其实他本人推销的种种另类疗法、健康方案才带着巨大的商业利益。从2000年起，他陆续出版了几本“健康”类畅销书，同时配套推销相应的昂贵的独创疗法和各种保健产品，号称这些疗法、保健产品能够治疗、预防种种脑部疾病和其他疾病，疗效极其显著。可笑的是，他的这些畅销书的观点还互相矛盾。例如，他在2000年出的第一本畅销书《大脑复原.com》并不认为谷物是大脑的杀手，没有提倡要避免吃谷物，而是认为饱和脂肪酸、动物脂肪、胆固醇才是大脑的杀手，应该尽量避免，提倡最好的饮食是素食加鱼肉，这与《谷物大脑》所提倡的刚好相反。当然，我们应该允许他改变观点，问题是，在《大脑复原.com》和《谷物大脑》中，他都列举种种案例证明他的健康方案对预防、治疗脑部疾病效果极好，而这两种健康方案是截然相反的，那么你应该相信哪一种？　　珀尔马特和中国那些前赴后继、风靡一时的“养生大师”其实没有什么区别，都是在宣扬与主流医学界的建议格格不入的标新立异的另类健康观，都没有专业资质（更不要说是“公认的权威”），而且都有着商业利益。另类的观点当然未必就一定错，毕竟现在的主流观点有些也是从另类的观点演变来的。但是大部分另类的观点过去错、现在错、将来也还是错，特别是那些由没有专业资质的人提出的另类观点。如果有谁坚信自己的另类观点是正确的，那么首先应该是发表论文、出示证据争取获得学术界的认可，而不是急着向没有专业识别能力的大众推销，更不应该冒充是获得公认的专业观点。特别是在健康的问题上，更应该慎重，否则是把大众当成自己的另类观点的小白鼠。在健康的问题上去相信另类观点，实际上也就是把自己的身体拿来给“养生大师”们做试验品，不管这些“养生大师”是国产的，还是进口的。　　2016.9.3.（《科学世界》2016.10）

素食者黯然伤神，肉食者喜大普奔

之前对这本是很是期待，满心欢喜。哇，谷物大脑啊，这岂不是素食者的福音。看了之后才发现并非如此。再看看书封面，大脑里的各种谷物没错，但是，一把大叉叉打在上面。这真是晴天霹雳。这本书对素食者不友好，如果作者能多考虑素食的情况就好了。或许作者觉得就没必要素食吧。除此之外，运动、睡眠部分和一些医学机理部分讲得还不错。

亲测有效

看这本书之前，我看过《一生健康》，是同样的理念，并且我也亲自实验过了。目的是调节身体状况，带来的附加效果就是减肥。不想看前面絮絮叨叨的，就直接看第10章吧。后面的菜谱对于异国的我们来说没什么用。个人认为《一生健康》比《谷物大脑》讲的更直接明白，《谷物大脑》感觉废话好多，可能作者希望拐弯抹角通俗易懂，但其实还不如用专业名词来得直接了当的。书里面对"升糖指数"的概念讲的比较少，《一生健康》里说的比较清楚。嗯，然后是，如果全不吃蔬果的话，要另外补充钾片，好像这本书里没有说？后面都是粗略过一遍而已。打4分，是给书本核心。但是翻译…看得有点吃力。作者废话多多，不言简意赅也真是，凑字数麽？总之啊，就是：零麸质＋低碳水化合物＋优质脂肪＋优质蛋白质＋适量有氧运动＋足够睡眠＋足量水。对了，其实书尾译者的那段话里，也有总结出来。

有待进一步考证

实践了一段时间，不吃主食的感觉真是很难受，感觉口渴，口臭，而且脑部有被抽干的感觉，情绪低落，但是真的会瘦，我不知道这是短期反应还是真的对人不好，网上太多各式各样的理论了，不知该听谁的

两个月实验表明，要么笨，要么秃

作为怕死星人，最大的恐怖作品，不是什么《午夜凶铃》，《德州电锯杀人》，是健康读物，或者说医学书。尤其西医的。买过一本《家庭日常百科疾病大全》。本着小病可以不上医院的心思。因为一到医院就腿软。结果翻这本书，开启人生最恐怖的经历。翻到哪页，我就觉得自己得了哪页上的病。摔看地图找路，我不擅长。看医书找病，我行。发现自己这一特点后，我尽量少碰健康类读物。微信上老人转的N类食品要少碰。这样的文章也尽量不点击。可还是免不了会被恐怖袭击。最近的一次恐怖袭击就是这个美国教授的著作，听某知识脱口秀里听说的。以我听风就是雨，看一本医学百科就可以把自己看出N种病的前科，实在没有胆量实事求是的把这本书找出来，逻辑分析一下对方讲得是不是有道理。所以，我立马改食谱。并且要求家人，从今天起，谷物类食品就不要上我家餐桌了。有没有道理，我不管。保命第一。近几年的早饭都是自家烘培的面包蛋糕。起得晚，可以把早饭带到办公桌上吃。可是，美国教授说，吃谷物制品要变笨的。吃鸡蛋，尤其是蛋黄好。于是，一连一个月，天天早饭各种蛋。有卤蛋，有酱蛋，有厚烧蛋，有蛋羹。感谢世界各国都有鸡蛋这样的美食。网上蛋的做法层出不穷，我觉得，有生之年还是可以不断吃下去，吃不厌的。早饭解决了。中饭和晚饭，就少吃米饭，多吃菜。碰到双休日，比较麻烦。夏天，家人习惯冷面。偏偏知识脱口秀里说，各种面食，面条吃多了会导致生病——具体病的名称，请自己看书或百度。不想说。在自己做饭，大热天，好热；还是吃多了要得病的纠结恐惧中，想了一个折中办法。少吃点。如是，这场谷物恐惧症引起的餐饮改革持续了两个月。现在观察到的结果是，掉头发！在把面包当早餐主食的时候，头发掉得少。梳头也就一两根。洗头发的时候，也就几十根的量。这一个月，随便梳一下，可以掉过去半周的量。洗头发的时候，海藻一样一团团的脱线。关键是，其实这个结果，我是知道的。去年，人高马大的女友采用了法国的牛肉减肥大法。用了这个方法后，简直就不能跟她在一起愉快的吃饭。光 听她说吃饭的种种忌讳，我们这顿饭就过去了一半。比如，牛肉只能吃菲利牛排，拒绝一切碳水化合物。虽然在社交上，少了聚餐这一条，女友依然无悔。因为，效果显著啊。像脱皮一样褪去了两层肉。她的瘦，不是那种客气的敷衍，是一个月不见，让熟人惊悚的。在效果斐然，进入到巩固期后，女友出现了新问题，脱发。她是齐耳短发，浓密款。之前从来没有听说过有头发的困扰。那段时间，只要听说什么对头发好，她就买买买。尝试过的方子里有韩国 那个 昂贵的洗发水。德国那把神气的电动发梳。各种品牌的发膜，护法产品。饮食里，她能够吃的各种美发护发食品，是的，她依然还在坚持她的法国牛肉减肥大法，对头发好的，都没有拉下。护发行动的结果是：╮(╯_╰)╭倒是她的健身教练，看了她的食谱后，教练说，你这是食物摄取不均衡引起的脱发。就是碳水化合物吃太少了。真凶找到了。接下去就是她纠结，要么瘦，要么秃，这道选择题了。这故事没想到换了个版本，就发生在自己身上了。好吧，导致女友脱发的元凶，至少带给她身材健美的好处。我妈听我诉苦，说掉头发后，第一反应就是骂我一顿。她觉得最不可思议的是，去年，你不还说XXX“作”嘛。为了减肥，结果掉头发。结果，你还试。看到前面有陷阱了，还看到前面人掉到陷阱里了，结果，你自己跳了下去。这么愚，我妈无法接受。可是，她是为了减肥啊。我是为了不生病啊。不要变笨啊。能一样吗？虽然看起来，我们都掉了一个坑，可是，进坑爹理由是不一样的。所以，是不是出坑，让我再想想。目前的结果，证明身体的不同部位需要的营养不同。美国教授说的或许没有错。大量食用谷物，会让大脑变笨。但是，头发要想长得好，就是要谷物，要碳水化合物。那么，这道选择题就是，要么变笨，要么变秃。问题是，变笨这件事，在日常生活中不太明显。一周智商掉0.1的话，一时半刻也看不出来。而且，周围人也是大量食用谷物的。所以，估计他们的智商也在持续掉值。可是，掉头发就是非常直观的了。随便捋一下头发，就有好几根青丝逶迤而下的感觉，实在冲击心理承受值了。冬天的时尚圈人常常要面临残酷的选择。要么穿秋裤保暖，要么光大腿显美。有时尚女主编带队出国 时，会一一翻团员的旅行箱，看到秋裤就丢。在他们的世界里，要么光腿受冻而美，要么穿秋裤保暖而丑且丢碗饭。既要遵守医生的嘱咐，保护膝盖，又想在时尚圈里愉快地玩下去，很难。作为怕死星人，犹豫着，要不要停止实验，让面包和面条重新进入食谱呢？

远离麸质食物

美国畅销书，其中观点存在争议，不过身边有人亲证，对减肥非常有效。麸质的摄入会对大脑有损伤，减少大脑灰质，同时会大大提升糖尿病几率，而老年痴呆其实是三级糖尿病。多摄入高级脂肪，适量胆固醇，少量大米小米，拒绝含麸质食物。减脂还包括肝脏减脂，建议每年换季的时候辟谷1-3天，减轻肝脏负担。这本书对减肥，养生还是很有指导意义的。书中内容易懂，也易于实践。