Where are the Lowest Rates of Alzheimer’s in the World?

Alzheimer’s Disease Grain Brain or Meathead

The rates of dementia differ greatly around the world, from the lowest rates in Africa, India, and South Asia, to the highest rates in Western Europe and especially North America. Is it all just genetics? Well, the incidence of dementia and Alzheimer’s disease is significantly lower for Africans in Nigeria than for African Americans in Indianapolis, for example—up to five times lower.

Alzheimer’s rates of Japanese-Americans living in the U.S. are closer to that of Americans than to Japanese. When people move from their homeland to the United States, Alzheimer’s rates can increase dramatically. Therefore, when Africans or Asians live in the United States and adopt a Western diet, their increase in Alzheimer’s risk suggests that it’s not genetics.

Unfortunately, one doesn’t have to move to the West to adopt a Western diet. The prevalence of dementia in Japan has shot up over the last few decades. Mechanisms to explain this in Japan include increases in cholesterol, saturated fat, and iron from increases in the consumption of animal products. Traditional diets are generally weighted toward vegetable products such as grains and away from animal products. But since 1960, the diet in Japan has changed from a more traditional rice-based diet to one with a preponderance of meat. From 1961 to 2008, meat and animal fat increased considerably, whereas the rice supply dropped. The dietary factor most strongly associated with the rise in Alzheimer’s disease in Japan was the increased consumption of animal fat.

A similar analysis in China arrived at the same conclusion. As the authors of the Japan study (highlighted in the video, Alzheimer’s Disease: Grain Brain or Meathead?) note, on the basis of these findings, the rate of Alzheimer’s disease and dementia will “continue to rise unless dietary patterns change to those with less reliance on animal products.” This is consistent with data showing those who eat vegetarian appear two to three times less likely to become demented, and the longer one eats meat-free, the lower the associated risk of dementia.

Globally, the lowest validated rates of Alzheimer’s in the world are rural India, where they eat low meat, high grain, high bean, high carb diets. It’s possible that the apparent protective association between rice and Alzheimer’s is due to the fact that the drop of rice consumption was accompanied by a rise in meat consumption, but other population studies have found that dietary grains appear strongly protective in relation to Alzheimer’s disease. In other words, perhaps, don’t pass on the grain, but “pass the grain to spare the brain.”

A few previous videos on Alzheimer’s and maintaining cognitive function:

More on the consequences of carbophobia here:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of DeathMore Than an Apple a DayFrom Table to Able, and Food as Medicine.

Image Credit: Bob Peters / Flickr

  • vegan HOPEFUL

    Could the shift to omega 6 plant-fats (cakes, cookies, potato chips fried, french fries, candy bars, chocolate-based-fatty treats dense in sugar and fat combos also be just as much a causative factor?

    • Joseph Gonzales R.D.

      Perhaps if there are tons of trans fats (hydrogenated oil) in those foods, as trans fats are associated with increased Alzheimer’s risk.

      For more info on the essential fats like omega 3’s and 6’s, Dr. Greger mentions finding a good ratio and I discuss where to find a good dose of omega 3 here. Too many omega 6’s in the diet and be problematic and cause inflammation. These oils are heavily found in meat, cheese, and eggs, too.

      • mjs_28s

        Is there such a thing as too much Omega 3 to 6 ratio?

        I eat flax, nuts, and seeds and do not suppliment omega 3s. Cronometer.com often shows my Omega 3 to 6 ratio being way off of what it is supposed to be. Since I am not eating animal products and getting most of my fats from nuts and seeds I never worried about it….but should i?

        • Joseph Gonzales R.D.

          No need to worry. Sorry if I sounded an alarm I didn’t mean to. Dr. Greger always says that diet quality matters more than quantity. Sure, if all you ate were flaxseeds and walnuts maybe that would throw the ratio off, but I doubt that’s the case.

          The verdict is still out there whether or not those following a vegan diet need to supplement with DHA/EPA. Here are Dr. Greger’s Optimal Nutrition Recommendations.

        • Philip

          Considering that too much omega-6 is proinflammatory and can result in heart disease, cancer, arthritis, and other nasty stuff, I would definitely the ratio in the correct zone. See http://www.hablemosclaro.org/Repositorio/biblioteca/b_128_Relacion_omega_6_y_omega_3_importancia_%28ing%29.pdf After all, how much trouble is it to put a couple of tablespoons of flax seeds in your smoothie each day?

          • mjs_28s

            “After all, how much trouble is it to put a couple of tablespoons of flax seeds in your smoothie each day?”

            That is what I do. Getting in Omega 3’s is not the problem. Note that I eat flax, other seeds, and nuts everyday..

            I was specifically asking about the ratio of 3’s to 6’s that is always talked about since I get way more 3 to 6 ratio than what is typically recommended.

            Your answer is as if you didn’t even read my question since I was also not asking about too much omega 6.

            Again, the RATIO’s and is being heavy on the 3 a problem.

          • Tom Goff

            Interesting question. Of course, the concept of an “optimal” ratio itself clearly implies that too much omega 3 would not be good.
            There are certainly studies that suggest that high amounts of omega 3 (in absolute terms) can have adverse consequences :
            http://oregonstate.edu/ua/ncs/archives/2013/oct/excess-omega-3-fatty-acids-could-lead-negative-health-effects

            and that the optimal 6:3 ratio can vary between individuals and disease states.
            http://ebm.sagepub.com/content/233/6/674.abstract

            It would be useful to read the WHO/FAO expert panel report on fatty acids and human health. It suggests that a total intake of omega 3/6 PUFAs greater than 11% (of total calories) may cause dangerous levels of lipid peroxidation.
            http://foris.fao.org/preview/25553-0ece4cb94ac52f9a25af77ca5cfba7a8c.pdf

      • Tom Goff

        Some excellent links/references – thanks Joseph.

        • Joseph Gonzales R.D.

          Thanks for checking them out! Let me know if I missed something? Thanks!

  • VegGuy

    Yes, according to these studies. “Regular consumption of omega-6 rich oils not compensated by consumption of omega-3 rich oils or fish was associated with an increased risk of dementia (HR 2.12, 95% CI 1.30 to 3.46) among ApoE 4 noncarriers.” http://drperlmutter.com/wp-content/uploads/2013/07/12-Omega-6-offset-by-3.pdf

    “The Alzheimer’s Disease dietary pattern, FACTOR AD was characterized by a high intake of meat, butter, high-fat dairy products, eggs, and refined sugar.” http://www.mdpi.com/1660-4601/6/4/1335/htm

  • Shef

    My question is what is the life span o those in rural india. They aren’t living as long as westerners (by a lot!) so perhaps the chance of them getting Alzheimer’s is not even getting detected !

    • Joseph Gonzales R.D.

      I am not sure their exact lifespan, but Dr. Greger mentions “In rural Pennsylvania, the incidence rate of Alzheimer’s disease among seniors is 19. Nineteen people in a thousand over age 65 develop Alzheimer’s every year in rural Pennsylvania. In rural India, using the same diagnostic criteria, that same rate is 3, confirming they have among the lowest reported Alzheimer’s rates in the world. In rural India, using the same diagnostic criteria, that same rate is 3, confirming they have among the lowest reported Alzheimer’s rates in the world.” More can be found in this video Preventing Alzheimer’s with Turmeric, and From Table to Able: Combating Disabling Diseases with Food.

      • Kathy B

        Look for rates of the disease by age group or check to see if the study controlled for population life expectancy.

    • fencepost

      When you see life expectancy statistics, it is often life expectancy at birth. If there is high infant mortality or child mortality, then the life expectancy at birth can be much lower than ours. However, those societies can still have a lot of older people because their mortality rates after childhood can be comparable to ours.

  • Karen Lifshay

    Do you have any information about the new study showing that AD may also be related to fungus? I totally agree about the meathead information, but I have a vegetarian brother who has been struck at 54.

    • Joseph Gonzales R.D.

      Sorry to hear about your bro :( Let me look into the fungus and Alzheimer’s study can you post a link here? Thanks Karen.

      • Bean

        I was curious so Googled. Here’s the link: http://www.ncbi.nlm.nih.gov/pubmed/24452965

        • Bean

          Sorry, here’s the more recent research that Karen was probably referring to:
          http://www.nature.com/articles/srep15015

          • Karen Lifshay

            Yes, that is the link.

          • Joseph Gonzales R.D.

            No worries. I saw this too in the related articles. I really appreciate your help finding the studies. To be continued..

        • Joseph Gonzales R.D.

          Thanks, Bean. Very interesting indeed. Let’s see what the good doctor has to say. I’ll get back to everyone here.

    • Wegan

      That is interesting. “Moreover, antifungal treatment in two patients diagnosed with AD reversed clinical symptoms” I wonder if the presence of the fungus is due to mercury or other metals in the brain.

      • Karen Lifshay

        Funny you should mention metals as my brother had lead, cadmium, and uranium poisoning and had chelation treatments prior to his AD diagnosis.

    • Joseph Gonzales R.D.

      Quick update: Dr. Greger has not really investigated this or knows much about the research on fungus and AD risks. I think there just needs more research in this area. Sorry we don’t know any more if that changes we’ll let you know.

  • Jason Huang

    Africa, India, and South Asia have also higher daily sunlight than in Western Europe and North America.
    It is the environment (and food).

    • Kathy B

      I think sunlight exposure and sleep hygiene are two factors that are not given enough attention by the medical establishment, perhaps because obtaining ideal sleep and spending enough time outdoors would reduce worker productivity (the corporate world controls everything). The sunlight exposure theory would also explain why people with darker pigmentation (i.e., Blacks and Hispanics in the more developed countries) have higher rates of AD.

  • Faith

    It’s the use of turmeric as well that keeps the rate of Alzheimer’s low in India. They put it in so many of their native dishes. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781139/

  • Jenell Mahoney

    Please connect this recommendation (“high grain, high bean, high carb diet”) with current recommendations for diabetes treatment…which involves controlling/limiting carbs. My husband is newly diagnosed…and while we have been mostly vegetarian for the past year, his sugar numbers have tipped him “over the line” into diabetes. I’m assuming the recommendations are actually for high levels of whole grains and beans…but what foods are the “high carbs” referring to?

    • Joseph Gonzales R.D.

      I think it’s the “refined” carbs that are problematic. Eating more whole grains and beans have been shown to lower blood sugar levels. Here is a great summary of diet and diabetes. I suggest reading this and watching the many videos on how to lower sugars and control the disease. From Dr. Barnard’s research, study participants received either a low-fat vegan diet or a typical diet for diabetes and found significant changes in weight loss and insulin levels. Dr. Greger presents the study in this video. Let me know if this helps or you need more information?

      Best wishes,
      Joseph

      • Jenell Mahoney

        Thanks! That was what I thought but never hurts to clarify.

    • Tom Goff

      I don’t think that the statement “current recommendations for diabetes treatment…which involves controlling/limiting carbs” is entirely correct. In fact, the CDC is quite clear that people with diabetes should:
      “Eat more fiber by eating more whole-grain foods. Whole grains can be found in:
      Breakfast cereals made with 100% whole grains.
      Oatmeal.
      Whole grain rice.
      Whole-wheat bread, bagels, pita bread, and tortillas.

      Eat a variety of fruits and vegetables every day. Choose fresh, frozen, canned, or dried fruit and 100% fruit juices most of the time. Eat plenty of veggies like these:
      Dark green veggies (e.g., broccoli, spinach, brussels sprouts).
      Orange veggies (e.g., carrots, sweet potatoes, pumpkin, winter squash).
      Beans and peas (e.g., black beans, garbanzo beans, kidney beans, pinto beans, split peas, lentils).”
      http://www.cdc.gov/diabetes/managing/eatright.html
      Personally, I think that Dr Greger’s and Dr Barnard’s dietary prescriptions here are much more consistent with this science based advice than “conventional” diabetes diet plans which appear to influenced by ideas about what patients are willing or not willing to eat.

      • Jenell Mahoney

        Thanks, Tom. I appreciate your comments very much.

      • Fred

        I believe canned fruit is a no-no due to the BPA content…fruits are acidic? Not to mention the syrup? Fruit juices have no fiber? Big dose of fructose?

        • Tom Goff

          I largely agree with you. However, those recommendations come from the CDC who presumably are targeting people whose previous experience of fruit may have been limited to Fruit Loops and Cherry Cola. In which case, these things would be an improvement – anything to get some real fruit into people’s diets perhaps?

          As for the “fruits are acidic” comment, I don’t think seious scientists believe acid/alkaline diet theories are anything more than unscientific fads. In any case, most fruits and vegetables are regarded as “alkaline”.
          http://www.webmd.com/diet/a-z/alkaline-diets

  • k settle

    Still, when one looks at the nutritional profile of rural India, one comes up with this research: http://www.nature.com/ejcn/journal/v56/n11/full/1601457a.html
    I would imagine life expectancy is rather shortened as well. Maybe not the best comparison.

  • dancer80

    Unfortunately the healthy Japanese diet is in decline today. I spent part of this past summer in Japan (I also know the culture well and speak basic Japanese), and what surprised me this time was seeing more overweight youths. There is now even fashion magazine targeting young, overweight women.

    But the real dietary changes in Japan started around 1950s and 1960s, when nutrition classes (in Japan kids are taught nutrition in school) began espousing the merits of dairy, meat, and animal protein in general as being “genki” or healthy. In order to make room in their diet for meat, dairy, and Western refined foods such as white bread, traditional foods were edged out.

    Now it is very difficult to be a vegetarian or vegan in Japan because animal products are in everything, even in supposedly vegan/ vegetarian fares like veggie curry. Veggie curry likely made with chicken or pork stock for instance. Children get either school lunches which typically includes entree with meat AND carton of milk to wash it down. For kids who bring own bento lunches made by mom, it’s often just as bad because these homemade fares likely include processed meat (hot dogs, vienna sausages cut into cute shapes) or fried/ sauteed meats.

    The only feature of modern Japanese diet that has been able to, so far, stem the tide against obesity is the portion size. I would estimate serving size in Japan to be about 2/3 of what one would expect here in US. This is true for homemade, packaged, and restaurant meals. Traditional food consumption (rice, miso, tofu, soymilk, sweet potatoes, beans, sea vegetables) is waning but still higher when compared to other cultures affected by Western food influences.

    Also fruit can get quite expensive in Japan, definitely more expensive than vegetables. As a result in Japan the opposite is true compared to US, the Japanese eat more vegetables than fruits (when lumping veggies/ fruits as one group). Although meat and animal products are prevalent in prepared meals such as the popular grab and go lunches one finds everywhere in Japan, the amount is very little compared to similar meals in the US. For example, a bento might have 3-4 small pieces of fried chicken with veggies and rice, whereas here the fried chicken would be 2-3 times that amount and would be the centerpiece of the meal. A ham sandwich will have 2 slices of ham instead of a bulging mound, that’s another example.

    Young Japanese today also rely too much on processed foods made with unhealthy oils and refined flours. Western foods made by Japanese, for instance desserts and sweets, are generally less sweet (usually but not always) and portions are smaller. But people are increasingly eating refined foods as basis of their diet there, with unhealthy consequences.

    • Joseph Gonzales R.D.

      Nice post! Perhaps children and adults in Japan should take some tips from the traditional Okinawa diet?

    • TheHulk

      Unfortunately same pattern is happening in India. Youth is getting mesmerized by American food, culture and drinks, moving away from traditional food (as a result ditching traditional herbs like turmeric etc).

      • Fred

        The SAD sickness is spreading? Check obesity rates in Mexico after NAFTA? Wait till the TPP passes…..

  • SeedyCharacter

    I can’t remember where I found this article (perhaps here on NF.org!) but it features a small study where there was documented actual *reversal* of early AD symptoms. No surprise: the regimen that the study participants followed was quite similar to recommendations here on NF.org! http://www.impactaging.com/papers/v6/n9/pdf/100690.pdf

    • Fred
    • Fred

      https://en.wikipedia.org/wiki/Axona

      Same thing?

      http://www.swansonvitamins.com/now-foods-mct-oil-32-fl-oz-liquid

      My dog gets coconut oil….he started eating in the morning with a rounded tsp of coconut oil on top of his food. He also gets a cap of turmeric. Once dogs reach 7 or 8…they can go downhill like 50-60 yr old humans do? 8 x 7 dog years = 56?

      Was giving him 600 mg NAC…when this was stopped it was like deflating a balloon…replaced this with glucosamine. They are supposed to be incompatible….

      • Kathy B

        I would say that if a person is going downhill before the age of 60 or 65, barring some genetic issue, they have been making some serious mistakes in their lifestyle. An unhealthy lifestyle can start to catch up with you as early as late 30s. I suppose the same applies to animals. I have had many ferrets over the years and they don’t seem to experience a decline until about 6 years old (the equivalent of the 60s in human years). You see them slowing down and starting to experience chronic health problems after that age. Before then, they are as energetic as kittens.

  • Gary

    Delaying the onset of the disease by just five years, research studies show, could decrease Medicare spending by 50 percent. That’s an important point to consider, because economists forecast that unless something is done to cure or even slow the symptoms, the number of people with Alzheimer’s will rise to 16 million by 2050 and cost the U.S. economy $1.1 trillion. The portion covered by Medicare will balloon to $589 billion.

    Closer to home, the financial burden of caring for someone with Alzheimer’s can be devastating. According to a recent study by the Annals of Internal Medicine, the cost of caring for a person with Alzheimer’s in the last five years of life is $287,038.

    http://www.cnbc.com/2015/11/09/a-disease-on-track-to-bankrupt-medicare.html

    • Joseph Gonzales R.D.

      Sounds like we need to resuscitate medicare! Great point about medical costs. I may add that the burden and anxiety of dealing with a loved with Alzheimer’s disease also has its toll. My grandfather suffered from Alzheimer’s and I can recall as a child not quite understanding what was going on when grandpa couldn’t look me in the eye or recognize my face. It’s a scary disease and although we need more research we already know so much about dietary and lifestyle trends affecting the disease. I’m lucky to work for a doctor who gives us Straight Information about diet and disease.

  • David Johnson

    I still have the question, what are the AD rates among vegetarians vs vegans (at least long time vegans who do not supplement with DHA)? Anything known about that?

    • Joseph Gonzales R.D.

      Some data suggest meat eaters have twice the riskof becoming demented. I don’t think anyone supplemented with DHA. Fish is often touted for the omega-3s as you know. Dr. G. points out that the BMAA in fish may be a problem surrounding degenerative diseases. Also, there is an allele called APOE-4 (mentioned in the study you shared) and if folks have it their risk of Alzheimer’s go up, so that may factor into the equation, too.

    • Kathy B

      I read somewhere (I’m pretty sure it was a peer-reviewed meta-analysis of epi studies on diet) that the best health outcomes occurred in people who followed a pescatarian diet. Vegans didn’t fare much better than people who ate meat. Vegetarians did a little better than meat eaters. Vegetarians who removed dairy products from their diet did even better. This seems to suggest that we may need whatever is in fish or seafood and eggs, but not other animal products. Of course, many vegans in the West eat a lot of refined carbs to compensate for the lack of animal fats, which also might explain their poorer health outcomes. In addition, if you are vegan for ethical reasons, you have to be willing to take the health risk and find ways to compensate through supplements (B12 is critical).

      • David J

        >>Of course, many vegans in the West eat a lot of refined carbs to compensate for the lack of animal fats, which also might explain their poorer health outcomes.

        Right. I tend to discount epi studies of vegans for this reason.

        Interestngly, Dr. Fuhrman makes a number of comments about Seventh-Day Adventists in his recent book The End of Heart Disease (Dr. Fuhrman), where he points out that the longest lived subset were the vegans who regularly ate nuts. To quote:

        “The Adventist Health Study confirmed that nut consumption was one of the most dramatic features accounting for extended life span benefits, a variable producing a greater benefit than being a vegan. 59 In other words, vegans generally lived the longest, but only if they ate seeds and nuts regularly. Those vegans who did not eat nuts and seeds did not live as long as the intermittent meat eater (flexitarian) who ate them. Nuts alone account for a 5.6-year difference in life span in the Adventist Health Study data, meaning that people who did not regularly eat nuts and seeds lived shorter lives.”

        Nuts and seeds, of course, provide plenty of healthful fats, perhaps missing from many vegan diets.

  • Wilma Laura Wiggins

    I just finished reading a study that correlated sugar consumption with Alzheimer’s. I’m fairly sure those areas listed with low levels are also low in sugar consumption.

  • Hello team of Dr. Geger,

    I just wondering if there is any study available which considering the idea, that a plant based diet can revers Alzheimer or Dementia? Or is the Patient already lost once they get the diagnose Alzheimer, is it to late then?
    At the time my knowledge about Alzheimer and Dementia is, that it starts as an inflammatory disease… is that right?

    • Joseph Gonzales R.D.

      Hi Steffen,

      Here is a great write-up on the disease. Check out the many links, especially on turmeric and other foods shown to help slow progression. I don’t think researchers know exactly what causes it. Inflammation may one of the main reasons, as some believe there’s this type of plaque (called beta amyloid) that can build up in the brain.

      There was an International Conference on diet and brain health exploring seven potential guidelines for preventing cognitive disorders. The guidelines are published in the Journal of Neurobiology and Aging.

      Let me know if some of these links help? Thanks, Steffen.

  • Regeneration USA

    We strongly believe in Turmeric/Curcumin to give your body a fighting chance. http://www.regenerationusa.net/turmeric-curcumin.html

  • Mark

    Let’s face it, the Western SAD is garbage and leads to many degenerative diseases. But the problem is NOT with meat – at least the right meat. We are omnivores, for one. As with most of these one-sided arguments, here again, we have yet another article which fails to elucidate the fact that there is light years difference between processed antibiotic and hormone-laden CAFO-raised meat, and organic, pastured, free-range, grass-fed and grass-finished meats which are nutrient are the most nutrient dense foods available.

    Also, strict plant-based vegan diets are simply unhealthy and lack important macro and micronutrients. Grains, in particular, processed grains, are pro-inflammatory, contain anti-nutrients rendering them worthless, and have been shown to be a cause of most degenerative diseases with few exceptions.

    Cholesterol, SFAs and iron are NOT the culprits. That is based on obsolete and outdated science and have all been debunked. Excess carbs and grains are the problem.

    The reason those traditional diet have served those races well and they stay lean is because their genes have adapted over centuries to consuming higher quantities of some grains, i.e. rice (particularly white rice, although highly glycemic, but is actually healthier than brown rice because it isdevoid of the phytic acid which blocks nutrient absorption). Those cultures are also eat other things in their diet to offset the insulin spike those carbs cause. In addition, they are not obese like most Americans are because they USE THEIR BODIES MORE in daily activities.

    This guy has it all backwards. Total nonsense.

    • Mark
    • Leonid Kalichkin

      > Grains, in particular, processed grains, are pro-inflammatory, contain anti-nutrients rendering them worthless, and have been shown to be a cause of most degenerative diseases with few exceptions.

      No.

      > Also, strict plant-based vegan diets are simply unhealthy and lack important macro and micronutrients.

      No.

      > The reason those traditional diet have served those races well and they stay lean is because their genes have adapted over centuries to consuming higher quantities of some grains

      Prove.

      > In addition, they are not obese like most Americans are because they USE THEIR BODIES MORE in daily activities.

      No.

    • Tom Goff

      I’m always amazed how people with views like you can state their opinions as absolute facts without ever once bothering to offer some evidence to support their statements. Frankly, the views expressed in your post are at best half truths and at worst they are – as you put it – total nonsense.
      No credible health authority anywhere in the world believes that the evidence supports the views expressed in your post. Don’t you ever find that a trifle disconcerting or a cause for re-examining your beliefs?

  • dk

    what do you think about taking Soil-based Organisms (probiotics – prebiotics) vs other store bought probiotics like a garden of life brand or jarrow or anything other non-SBO probiotic?

  • Tom Goff

    The Delphi Consensus study is a little old now. You probably ought to reference

    http://www.ncbi.nlm.nih.gov/pubmed/23305823

  • Sita Packer

    I am very confused about whole grains. I love organic brown rice, farro, etc., but I keep reading people like Dr. Bruce Hyman, who associates grains with diabetes. Also, my alternative doctor has shared research talking about “wheat belly” and how grains increase inflammation and blood sugar. As a vegetarian, this supposed research upsets and confuses me. I would love to hear an informed response, and I apologize that I don’t have the studies Hyman and my doc are referring to.

    Thanks, Sita

  • Don

    Am I wrong in thinking that diary consumption is quite high in rural India? That would argue against the animal protein theory of Alzheimer’s.

    • largelytrue

      I think you are wrong depending on the time period under consideration, and you do need to consider the latency of the disease which probably makes the relevant time period decades prior when wealth was indeed low. Dairy consumption is an aspect of northern Indian diets but is not really going to be the foundation of a peasant diet produced with low-tech methods. Pulses and roti in northern India, like most other staples, have been the foundation of the diet for hundreds or thousands of years but like most humble staples, their historic proportion in the diet is often overlooked in favor of the more glamorous parts of the cuisine, even by the native culture.

      Greger’s citation doesn’t really talk about the local diet in detail so it seems that its attachment to the word ‘eat’ was a bit inappropriate. In the state of Haryana overall, milk availability per capita seems to be 660g currently, around 3 cups, but this information is almost a decade after the paper Greger is talking about which studies a cohort that was selected even earlier.

      Regardless, in the paper cited by Greger, Chandra cites another 1998 paper for some of his discussion on potential nutritional factors. Specifically the authors state:

      “…Another reason could be that even if the frequency of the epsilon4
      allele is similar, external factors such as cholesterol intake may
      modify the expression. The population under study in India has a low
      socioeconomic status with poor nutritional intake and the majority of
      these individuals are vegetarians. The mean cholesterol in the
      Ballabgarh male population where the study is being conducted, is 169.9
      mg% compared to 191.6 in New Delhi and 231.3 in Indian migrants to
      England [40] and 236.3 in Europeans [40] (table 1)”

      That is, at least comparatively speaking, it looks like this cohort was eating a much more plant based diet overall. Also, note that even 660g of milk per day is not actually that many grams of protein (maybe 20 or so), due to the high water content.

  • Linda Colvin

    I think people should read Grain Brain, about how hybridized wheat has become. Pass on the gluten grains, but include rice would be better advise!

    • jm

      “look at the produce section of your local supermarket. It’s TEEMING with variety! There are tomatoes and eggplants and potatoes and bell peppers and cayenne peppers and…hold up. Wait a second. What if I told you that all the plants I just listed are actually one plant. That they’re all hybridized versions of wild nightshade
      All varieties of lettuce come from one plant — wild lettuce, which is actually a narcotic.
      Broccoli, cauliflower, cabbage, kale, collard greens and brussels sprouts are all bred from wild mustard.
      Onions, garlic, scallions leeks and all other “alliums” are all hybrids of the wild onion and garlic plant.
      So in short: Virtually nothing we eat today is a wild plant. Everything has been bred by humans —for certain “desirable” traits like sweetness, taste and size.’
      http://www.wildmovement.com/global-domestication/

    • Leonid Kalichkin

      Is it based on scientific evidence?

    • Tom Goff

      Read it only for the entertainment value. Neither “Grainbrain” nor Perlmutter should be taken seriously. It’s worth reading this NYmag review:
      http://nymag.com/scienceofus/2015/06/problem-with-the-grain-brain-doctor.html

    • jm

      Without hybridizing we would not have some veges we have today.

      Broccoli is a result of careful breeding of cultivated leafy cole crops in the Northern Mediterranean in about the 6th century BC. Since the Roman Empire, broccoli has been considered a uniquely valuable food among Italians. Broccoli was brought to England from Antwerp in the mid-18th century by Peter Scheemakers.

      Like broccoli, cauliflower, and collards, kale is a descendant of the wild cabbage, a plant thought to have originated in Asia Minor and to have been brought to Europe around 600 B.C. by groups of Celtic wanderers.

  • Katja

    Are there any date on fat consumption in rural india? Most indian dishes are made with a lot of oil (especially for the tempering of spices). The extremely high incidence of diabetes in India could be partly attributed to the high fat (high oil) diet.

  • thaddeusbuttmunchmd

    Do NOT Count out Curry, either. Indians and Cambodians BOTH have Turmeric in their Cuisine and have Dramatically lower age-adjusted rates of the Disease. But, perhaps, there are Other Elephants in the room, such as the fact that they have low body mass indices or have more Vitamin D from Sunlight Exposure. There is also the “Hygiene Hypothesis.” Indian Food and Water is FILTHY next to the US and Europe. You WILL get Sick if you go there (ask me how I Know.) Being exposed to germs early is protective. Alzheimer Brains have Herpes Virus and fungi in the affected areas.