This is how you make better decisions, according to a neurologist

When we habitually fail to reject every single impulse that comes our way the pleasure they give us begins to depreciate.

This is easily translated to physical health. Routinely saying yes to that third bag of what-have-you’s will cause you to gain weight and in turn develop cellular and cardiovascular diseases.

“We know that sleep is important, we know which foods not to eat. The problem is action. We have to hack our decision-making process,” Dr. David Perlmutter said in a recent interview with

Since the age of 19, the neurologist has been promoting a holistic appreciation of healthy living. His latest publication, “Brain Wash: Detox Your Mind for Clearer Thinking, Deeper Relationships, and Lasting Happiness”, which was co-authored by his son, Austin Perlmutter, MD, is no exception. The book locates the key to a productive life in the distinction between the mind and the brain.

“Contemporary life provides us with infinite opportunities. We can eat whatever we want, whenever we want. We can immerse ourselves in the vast, enticing world of digital media. But living in this 24/7 hyper-reality comes at a steep cost: left unchecked, it poses serious risks to our physical and mental health, relationships, and even the ability to control our thoughts. How you think and feel—and in turn experience and respond to the world around you—is highly influenced by the health of your gut. And that is a direct reflection of your food choices,”  he wrote in reference to the objective of his new book.

Saying nothing of the physical correlation between a poor diet and the health of our prefrontal cortex,  every good decision begins with the willpower to reject a bad one.

Inflammation and impulses: The route to reward

Physiologically speaking, the brain is composed of millions of chemical conversations and patterns woven by nerves and synapses.

Being the most complex organ in the human body, its functions are numerous as are the consequences in the event that it becomes compromised.

In Perlmutter’s estimation, the most effective way to prevent chronic degenerative illnesses is concurrently the most effective way to correct a cycle of poor habits.

Rewiring the brain via lifestyle choices and diet yields neurological and existential changes alike. The western diet has long since been linked to a surplus of inflammatory mediators.

Inflammation, which can occur due to injury or infection, causes chemicals from white blood cells to secrete into our bloodstream and tissue in order to help fight potentially harmful agents. This is a necessary part of the immunization process—under very specific circumstances.

When we consume processed foods low-grade inflammation persists longer than it should, increasing our risk for developing clinical depression, diabetes, cardiovascular disease, nonalcoholic fatty liver disease, obesity, and several autoimmune disorders.

“The process of inflammation, be it from a lack of sleep, poor food choices, or not exercising, locks us into functioning from the amygdala and keeps us from the prefrontal cortex, the brain’s decision-making center,” explains Perlmutter.

Over time inflammation wounds our diverse gut community, surges physiological abnormalities and complicates activities of the prefrontal cortex, an area of the brain that allows us to properly survey the consequences of our actions.

Together these indulges produce a wide array of preventable diseases. In a society so well equipped with dietary guidelines and clinical resources impulse control seems to be the  most persistent contributor to our crippling morbidity statistics.

Perlmutter unpacks the mutualistic benefits of impulse control in the third chapter of the new book. Simply put, when we do things that are rewarding our body releases a chemical called dopamine. It is not yet known if dopamine is directly responsible for euphoric feelings or if it merely acts as stimuli for us to engage in activities that activate pleasure zones. In any case, a diminishing return effect has been observed by many medical professionals. 

It’s a fight against nature and commerce. An adaptational sweet tooth developed in mammals that intuitively understood that a sugary fruit indicated that it had achieved its highest level of nutritional content; that it was ripe. Animals with a sweet tooth survived much longer than those that did not.

Today, that acumen has regressed into an industry intent on abusing this preference at the expense of an abbreviated first-world lifespan. It is up to us then to parse the technological influences that mean us harm from the ones that are of utility.

Like Perlmutter correctly points out, there are areas of the brain that benefit from continued social interaction, but there are also toxic ways to go about doing so. 

Only pseudo-science blames commerce all on its own. A hard-wired addiction to instant gratification also has a huge role to play. Making room in your diet for fruits, vegetables, foods rich with omega-3 fatty acids, whole grains, lean protein, healthful fats, and spices is a good way to reduce an excess of low-grade inflammation.

“Inflammation, which is central to our most pervasive degenerative diseases, like heart disease, diabetes, Alzheimer’s disease, and even cancer, also directly compromises our ability to make good decisions,” Perlmutter writes. “Said differently, we see the goal, optimal health, awaiting us on the other side of the lake, but when we start paddling to get there we discover our boat is full of holes and taking on water. No matter how much we read about the rowing technique or the body of water we’re trying to cross, it can’t help us when the vessel that’s supposed to carry us there is compromised.”