This may sound like the kind of detox scheme dreamed up by an exclusive private rehabilitation center in Malibu: the promise that you can get addicted to the right combination of nutrients and macros.
But it can become a reality. Researchers are investigating the keto diet – the trendy eating regimen taken by the Internet’s wellness corner – as a possible tool for treating alcohol disorder.
A study released Friday in Scientific progress a ketogenic diet found in alcohol-dependent people and rats that apparently suppressed withdrawal symptoms. More research is needed before scientists can confidently recommend the diet as a way to treat alcohol abuse, but the signs are encouraging.
“It’s not a medication, it’s a diet. By using diet we can improve the results of a very devastating pathology, ‘says Nora Volkow, the senior author of the study. Reverse.
Volkow is the head of the Laboratory for Neuroimaging at the National Institute for Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH). Over the decades, she and her team have explored the benefits of a ketogenic diet for managing alcohol use disorder.
Here is the background – Based on previous work, Volkow and her team knew that the brain of an alcohol-dependent person uses less glucose for energy than a non-independent brain.
Instead, it relies more on acetate than fuel. It is a type of ketone body that is made when alcohol is metabolized. When alcohol withdrawal usually occurs, the relative lack of acetate (the energy source) leads to urge and withdrawal symptoms. Withdrawal can cause nausea, sweating, anxiety and even death.
The study team reasoned that with a ketogenic diet, the brain would have more ketone bodies to metabolize – mimicking the pattern established during alcohol dependence. They also assumed that there would be less of a withdrawal activity for the alcohol-dependent person. It can reduce symptoms and cravings.
What they did – For the study, researchers sampled a small sample of 33 alcohol-dependent people admitted to the hospital and placed 36 rats on ketogenic diets or standard diets.
The keto diets are high in fat and protein and low in carbohydrates. The human participants adhered to a keto diet or a ‘standard American’ diet for three weeks, while the rats ate a keto diet or standard rat diet for two months.
Thereafter, they observed the effects that the diets had on withdrawal and cravings in humans, and on the actual alcohol consumption on rats.
To evaluate their theory in humans, researchers once a week measured ketone bodies – including ketones and acetate in the participant’s blood and brain – as well as two markers of ‘neuro-inflammation’ using a technique similar to MRI scans. They also assessed withdrawal symptoms and the need for benzodiazepines, a medication often used to reduce severe alcohol withdrawal symptoms. They also showed the participants visual cues of alcohol and performed MRIs to measure the urge during the three weeks.
Researchers put the rats on the keto diet or standard rat diet for eight weeks and then put them all back on normal diets. After the diets, the scientists caused alcohol dependence in the rats by exposing them to alcohol vapor in the air over seven weeks and then measuring which group of rats administered more alcohol vapor to themselves with a lever they were trained to use. periods. They also measured blood glucose and ketone levels in the rats.
What they discovered – In the first week, people on the keto diet need significantly less benzodiazepines to relieve symptoms. They also passed lower in tests that assessed their “need” for alcohol after seeing visual cues.
Predictably, the keto diet group also had increased ketones, but they also had more glutamate and lower markers of inflammation in the brain.
In rats, they found that rats that participated in keto diets had less alcohol during the withdrawal period when they were allowed to self-administer it when the diet period was over and rats were dependent on alcohol and withdrawal periods. was on the standard diet.
‘You see the effect after they were on the ketogenic diet, so it has almost a protective effect, ”says Volkow.
Why it matters – Previous studies do suggest that ketogenic diets may play a role in reducing withdrawal symptoms due to alcohol dependence – but so far most of this research has been done on animals. For example, a study published in 2017 found that rats showed less “irritability” and “rigidity” during withdrawal during the keto diet.
However, a 2018 study, which did focus on people, found a decrease in cravings for alcohol among obese individuals on a low-calorie diet. This effect was only significant in men and not in the group.
This new study is the first to show that a ketogenic diet can facilitate the testing of alcohol withdrawal in humans. It has compelling consequences for the treatment of alcohol dependence, a notoriously destructive and complicated problem for the future.
“The risks associated with ketogenic diets are very minimal,” says Volkow. ‘I therefore predict that doctors will prescribe it, even if it is only one study. But they can say, ‘Well, what have we got to lose?’ ‘
What’s next – The researchers plan to further investigate this possible dietary intervention for alcohol dependence, including a study where participants take a ketone ester instead of starting a ketogenic diet. It can hypothetically increase their ketone bodies without complying with a new diet, in addition to the withdrawal of alcohol.
The finding that the study found that rats who completed the keto diet still craved less alcohol is an interesting question about the long-term effects of the diet on alcohol use.
The study team also wants to expand their research to more outpatient participants, in an effort to further evaluate the effectiveness of a keto diet on alcohol use disorder.
Summary: People with alcohol use disorder (AUD) show increased brain metabolism of acetate at the expense of glucose. We hypothesized that a shift in energy substrates during withdrawal may contribute to the severity of withdrawal and neurotoxicity in AUD and that a ketogenic diet (KD) may mitigate these effects. We found that inpatients with AUD who were randomized to receive KD (n = 19) required less benzodiazepines during the first week of detoxification, compared with those who received a standard American (SA) diet (n = 14). . Over a three-week treatment, KD compared with SA showed a lower response to dorsal anterior cingular cortex (dACC) versus alcohol indications and altered dACC bioenergetics (i.e., elevated ketones and glutamate and lower neuro-inflammatory markers). In a rat model of alcohol dependence, a history of KD has reduced alcohol consumption. We provide clinical and preclinical evidence for beneficial effects of KD on the management of alcohol withdrawal and the reduction of alcoholic beverages.