Addiction Disorders

Keto Diet Reduces Alcohol Withdrawal Symptoms

Heather R. Johnson
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A bunch of fresh ingredients for a sushi bowl with avocado, salmon, cucumber, seaweed, radish, and seeds.
According to the study, individuals with alcohol use disorder (AUD) show elevated brain metabolism of acetate at the expense of glucose. The study authors hypothesized that a shift in energy substrates during withdrawal may contribute to withdrawal severity and neurotoxicity in AUD and that a ketogenic diet may mitigate these effects.

A ketogenic diet (KD) (high fat, low carbohydrate, and protein) reduced alcohol cravings in people with alcohol use disorder. In alcohol-dependent rats, the KD diet reduced alcohol consumption. The study was published in Scientific Advances.

Chronic alcohol consumption is associated with cognitive deficits. Alcohol withdrawal in people with alcohol use disorder (AUD) can be life threatening. The symptoms often trigger people with AUD to relapse. The researchers wanted to explore targeting brain energetics as an intervention, as acute alcohol consumption decreases glucose metabolism in the brain and increases acetate metabolism. KDs increase ketone bodies that can be used as an alternative to glucose as an energy source.

The researchers studied 33 individuals with AUD during detoxification and randomized them into a KD (n=19, aged 39.3, 37% women) or a standard American diet (n=14, aged 44.2, 21% women) for 3 weeks. The researchers tested levels of brain ketones, amino acids, serum ketone and neuroinflammation markers weekly. Urine AcAc levels were measured daily.

Changes in urinary ketones were observed by day 3. Blood ketones became elevated in the KD group in week 1.

Within 2 days, the KD group required less benzodiazepines than the American diet group. The cumulative dose of benzodiazepines decreased by 39% in the KD group. The cumulative dose in the American diet group increased by 187%. Ratings of “wanting” also decreased in the KD group over time, but not in the American diet group.

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Limitations were a small sample size and the fact that the preclinical study was performed only on male rats.

The study “offers a potential new treatment for AUD that is diet-based,” the researchers concluded. “Moreover, the promising results obtained from the preclinical model of alcohol dependence that showed the successful reduction in alcohol intake 6 to 7 weeks after KD termination hint at the possibility that the KD might have long-lasting beneficial effects, which merits further clinical corroboration.”

Reference

Wiers CE, Vendruscolo LF, van der Veen JW, et al. Ketogenic diet reduces alcohol withdrawal symptoms in humans and alcohol intake in rodents. Sci Adv. 2021;7(15):eabf6780. doi:10.1126/sciadv.abf6780