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Researchers at National Institutes of Health found that people with alcohol use disorder who ate a ketogenic diet showed lower brain responses to alcohol cues.
They also reported less desire to drink than patients on a standard diet. The study published in Frontiers in Nutrition adds to a growing body of work suggesting that what the brain burns for fuel may influence the strength of a person’s alcohol cravings.
The trial had 33 adults participating a three-week inpatient alcohol detoxification program at the NIH. Nineteen were assigned to a ketogenic diet while fourteen followed a standard American diet matched for calories.
Both groups received usual treatment including medication for withdrawal symptoms when needed.
Measuring Craving in the Brain
The research team led by Corinde Wiers, Peter Manza, and NIDA director Nora Volkow, used functional MRI scans to watch how participants’ brains responded to pictures of alcohol, food and neutral images once a week during treatment.
They compared those brain patterns against what they call a “craving signature” in the brain. This is a pattern of activity detected in the entire brain in earlier research to predict drug and food craving across substances.
The study tested the brain’s response to both alcohol and food cues. It showed that participants on keto had a lower craving response when shown alcohol cues than when shown food cues.
The two groups also differed in self-reported “wanting” when they viewed alcohol images. The wanting scores declined in the ketogenic group, while staying flat in the standard diet group.
Ketone levels rose sharply in the ketogenic group and stayed in the nutritional ketosis range.
Across both groups pooled together higher ketone levels tracked with lower craving signature scores.
Why Ketones Might Matter for Alcohol Craving
The theory involves how a brain that’s accustomed to heavy drinking handles energy. Brain chemistry shifts when you’re drinking alcohol. Instead of running on glucose as normal, the brain becomes saturated with a metabolite of alcohol called acetate.
In people who drink heavily that abnormal brain chemistry can become a pattern. And so when you abstain from alcohol, those acetate levels crash.
Researchers suspect that may be part of the reason why people have such discomfort and craving during withdrawal.
Ketone bodies are similar in structure to acetate. Supplying them through diet may smooth the transition away from alcohol. It may also ease the energy shock that hits when drinking stops.
Ketone supplements have dampened alcohol responses in both rats and human volunteers in early experiments.
What This Study Does Not Tell Us
The researchers are direct about the limits, which is that it’s a small sample of 33 people, because the design required three weeks of inpatient hospitalization and strict diet compliance.
The first MRI scan happened about four days after admission after the ketogenic group had already entered mild ketosis. That means there is no true before-and-after brain baseline to compare.
Craving scores did not differ between groups until the third week, even though brain and blood differences appeared in the first.
There is also a practical warning hidden in the findings, which is that detoxing from alcohol can be dangerous and seizures are a real risk.
Anyone with a severe alcohol use disorder should never attempt withdrawal with or without a special diet, or without medical supervision. The trial participants were in an inpatient unit with daily monitoring from doctors.
The study is also not a reason to overhaul your eating plan on your own, because the diet used in the trial was a strict 4 to 1 ratio of fat to combined carbohydrate and protein. It was prepared and weighed by a metabolic kitchen. It was a clinical intervention and not a lifestyle tweak.
Where This Fits for People Rethinking Drinking
For someone in early sobriety, the interesting takeaway is that alcohol craving has a physical basis that treatment can focus on.
Medications like naltrexone, acamprosate and disulfiram already work on that basis and fewer than 4 percent of people with alcohol use disorder receive an FDA-approved medication for it.
Researchers want to also explore nutrition as a means of supporting recovery.
If you are cutting back or quitting drinking alcohol, the fundamentals still do the heavy lifting. Meetings, support and tracked habits carry more evidence behind them than any diet.
The Sober App helps you log cravings and our guides explain what alcohol withdrawal involves and when it’s a medical issue.
Finding Support for Alcohol Use Disorder
Search Sober.com’s directory to find AA meetings in your city including online and beginners meeting. If you or someone you love needs treatment now call
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Nikki Wisher is an Atlanta-based content writer with more than a decade of experience. She specializes in creating content related to health and wellness. She also enjoys creating content in many other areas, like photography, beauty, and marketing. Her passion project is her inclusive running blog, forallrunners.com.
View ProfileEric Owens is a writer and editor with a bachelor degree in Philosophy, which has helped him with presenting complex information in a simple way that all audiences can understand. He specializes in the mental health and addiction recovery space. He’s also passionate about the environment and has extensive experience in creating content related to sustainability issues
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