Alcohol and the keto diet: 7 things you need to know

7 things you need to know about
alcohol and the keto diet

Clay started the keto diet in 2014 because he wanted to lose weight. And it worked. He took 70 lbs (32 kg) off his 6’1′ (185 cm) frame in six months. During that time he drank alcohol every day — straight vodka, or vodka mixed with diet coke, often until he blacked out. Still, the weight came off. He actually liked the fact that the ketogenic diet lowered his alcohol tolerance: he’d get drunk faster.

About six months into his keto journey, however, Clay knew alcohol was causing too much havoc in his life, harming his health and hurting people he loved. He had to stop drinking.

“I realized the way I ate and the way I consumed alcohol were very similar. Once I started I couldn’t stop. It was hard for me to do anything in moderation,” says Clay, 28, who is in the military.

He has been sober now for 2.5 years and on the keto diet for three years (except for 8 weeks in boot camp). He feels wonderful, both because of his diet and his sobriety. He is a lean, muscular 185 lbs (84 kg) and feels fit, strong and clear-headed. He enjoys working out regularly. The cravings for both his trigger foods and for alcohol are gone. He sees the two as being very closely related. And he will not risk, ever, bringing up those cravings again.

“A few potato chips from time-to-time might not kick me out of ketosis, but it could very well awaken the cravings in me… so that saves me from taking the first bite. And I stay away from alcohol entirely. It is not worth taking a single sip, knowing where my mind goes when I drink.”

Alcohol consumption and the keto diet is a hot topic. Many people who want to shed pounds come to ketogenic eating and are delighted that, unlike almost all diets, alcohol is not strictly forbidden when going low carb/high fat. While it may slow weight loss for many people and lower tolerance, the occasional glass of dry white or red wine, champagne, or even distilled liquor is okay — as long as it has no sugar.1

In fact, back in 1964 a slim bestseller called The Drinking Man’s Diet, by Robert Cameron, was one of the first to tout a low-carb diet as a way, in that Mad Men era, to have one’s steak and martini, too. Cut out the sugar and carbs, Cameron said, and moderate alcohol was not a problem.

But is that true for everyone? Well, not exactly. The relationship between sugar, carbs and alcohol, and the caveats around smart consumption when on the ketogenic diet, alas, are not as simple and straightforward as Cameron’s 1960s advice.

For this post, we researched the medical literature and sought the input of an array of experts about alcohol and the low-carb/ketogenic diet. Here are 7 essential points to know:

1. Moderation is key

For those who have healthy livers, not much weight to lose, and no trouble stopping at one drink (for women) or two (for men), the occasional imbibing of a low-carb alcoholic drink is not going to hurt you and may even help with cardiovascular health and joie de vivre.

Dr. Aseem Malholtra, in his new bestselling book The Pioppi Diet, notes that a glass of wine at dinner among friends and family while eating a low-sugar, no-processed food, Mediterranean diet is part of the recipe for longevity and good health enjoyed by the people living in the Italian village of Pioppi.

Swedish diabetes researcher and medical specialist Dr. Fredrik Nyström, head of internal medicine at Linköping University, has studied dietary intake in various populations and has the same advice for generally healthy people: a daily glass of wine, combined with a low-carb diet, is good for heart health.

Nyström notes that alcohol is actually the fourth macronutrient, after protein, fats and carbohydrates and that in many studies of dietary consumption its intake is often overlooked. In Mediterranean countries like Greece and Italy, alcohol makes up about 10 % of the caloric intake and contributes to the touted benefits of the Mediterranean diet, Nyström says. “Alcohol is found to lower blood pressure and to acutely lower blood glucose. These effects are very well proven. It tends to increase healthy HDL cholesterol and it lowered LDL cholesterol in one of the studies I conducted.”2

Drinking alcohol, however, can slow weight loss for some. Dr. Sarah Hallberg advises her patients, who are trying to lose weight and/or reverse diabetes, to have a maximum 1 glass of wine for women and 2 for men, and not every day. “If they experience any weight stall, I recommend they stop the alcohol completely,” says Hallberg.

Both Dr. Jason Fung and Dr. Ted Naiman discourage any alcohol use among patients in their care who are still trying to lose weight, reverse diabetes or heal a fatty liver (see point 5). “I find alcohol is not conducive to steady weight loss,” said Fung.

Keto expert Maria Emmerich notes that the reason alcohol slows weight loss is not because of its calories, but because it stops the body’s ability to utilize fat stores for energy. Fat metabolism is reduced by 73% after only two low-carb alcoholic beverages, she says.3

The takeaway: small amounts of low-carb alcohol are fine, but if your weight loss stalls or you still have issues of metabolic health, consider abstaining, at least for now.

2. Moderate drinkers: fundamentally different?

Many studies have shown that alcohol consumption when graphed against mortality risk is a J-shaped curve. Abstainers have slightly higher mortality risks than moderate drinkers and heavy drinkers have the highest risks of all. (Debate has raged whether the teetotalers group includes former heavy drinkers now abstaining, hence the worse result.)4

Gary Taubes, in a discussion hosted by the New York Times says he is suspicious of these sorts of epidemiologic findings: “The question I always had about these studies was whether or not people who drink alcohol in moderation are just different than the teetotalers, who drink none, and the binge drinkers, who drink to excess. Maybe by looking at a glass or two of alcohol a day you’re selecting out for people who live their entire lives in moderation, people capable of living well without excess.”5

Nora Gedgaudas, author of Primal Body Primal Mind notes that those who drink heavily, especially alcoholics who cannot control their drinking, have problems with blood-sugar regulation relating to severe carbohydrate addiction. They are seeking fast sources of sugar to the brain, of which alcohol provides the fastest source. She likens it to throwing gasoline on a fire.6

The takeaway: Be honest with yourself. Can you easily stop at one or two drinks max? If you can’t, our experts say be very cautious with alcohol and consider abstaining. Naiman notes that at higher levels of consumption, alcohol is highly toxic to multiple organ systems, and linked to hypertension, gout, nerve damage, cancers and cognitive decline.

3. Can’t easily stop? It’s your brain chemistry

Many people who have trouble moderating their eating or drinking often beat themselves up. Rattenbury describes his feelings of self-hatred for his once uncontrolled eating and drinking. But as Diet Doctor sugar-addiction expert Bitten Jonsson stresses, the inability to quell cravings and moderate one’s consumption — whether high carb foods or alcohol — has nothing to do with will power and everything to do with the altered biochemistry of the brain.7

“The brain chemistry that drives the addict to seek pleasure beyond the point of satiety is similar, whether the user favours Jack Daniels or Jack-in-the-Box,” says Dr. Vera Tanman, author of Food Junkies, a book that Jonsson recommends for all sugar addicts.

Dr. Robert Lustig agrees and notes that neuroscience and addiction research shows that the brain’s dopamine (reward system) pathway is the same whether it is sugar, alcohol, nicotine, cocaine, porn, gambling… whatever. “All hedonic (pleasure-causing) substances and all hedonic behaviors work through the exact same dopamine pathway. All of them,” says Lustig, the best-selling author, anti-sugar advocate and pediatric endocrinologist. In his latest book The Hacking of the American Mind, Lustig describes how big businesses, like the sugar industry, beer companies, processed food manufacturers — even social media apps and smart phones — knowingly exploit this dopamine pathway to drive profits and to keep us coming back for more, despite detriments to our health and wellness.

Even if you are able to successfully stop one addiction, addiction transfer, also called addiction-interaction disorder, is a well known phenomenon. Jonsson notes that many sugar addicts can become alcoholics. Likewise, alcoholics who quit drinking often turn to sugar in an attempt to control cravings. Studies show that patients undergoing bariatric surgery, who can no longer overeat, have a 20 % higher rate of post operative problems with alcohol dependence.8

“When you are addicted to one substance and find yourself abstaining, your dopamine’s modus operandi is to find a substitute trigger,” said Lustig.

The takeaway: if you are doing the low-carb keto diet to help deal with a disordered or addictive relationship to carbs or sugar, addiction transfer to alcohol may occur. Our experts recommend abstaining.

4. An adaptive trait that helped, now harms

Our innate dopamine reward system, which says “this is good, I want more” was likely a highly functional trait for survival in our primate and hunter-gather days, but our stone-age genes have not adapted to the modern world.9

The evolutionary studies of why our brain biochemistry may spur some to overeat or drink to excess are fascinating and varied, but almost all have to do with the ancient need to spur over-consumption of high-calorie fruit and carbs in season in order to pack on the fat to live off of during lean seasons and food shortages.10

In 2014 researchers in Florida sequenced human and primate genomes and worked backward to find the common ancestor 10 million years ago that first began to efficiently metabolize ethanol (fruit alcohol) found in fermenting fruit lying on the forest floor. A genetic mutation was found that linked to a time when primates were coming down out of trees, the earth was cooling off, and food sources were changing. Primates who had the mutation could eat the fermenting fruit on the ground in the limited time it was available, metabolize the ethanol 40 times more successfully, get the extra calories and thrive. The researchers hypothesized that hominid brains then evolved to link its pleasure pathways to alcohol consumption because it was associated to finding and consuming a key high-calorie food source in season.11

The takeaway: some people find more self-acceptance — and a better ability to understand and control their cravings — by knowing about a once-helpful ancient trait, like over-consuming alcohol, that in modern times is a liability. As Lady Gaga sings in her anthem to self acceptance: “Rejoice and love yourself today; Cause baby you were born this way.” As you can’t change your biology, avoid the trigger — alcohol — and prevent the overconsumption.

5. Fatty liver? Lay off the booze until it heals

As a number of recent Diet Doctor posts have noted, non-alcoholic fatty liver disease (NAFLD) is a huge health epidemic, impacting increasing numbers world wide — including 65 million people in the US alone. It is largely caused by overconsumption of fructose and low-fat foods. Dr Evelyne Bourdua-Roy wrote about how common NAFLD is among the patients in her GP practice — but also how reversible it is on a low-carb, low-fructose, high-fat, no-alcohol diet.12

Lustig notes that fruit sugar — fructose — and alcohol, unlike glucose, go straight to the liver where they are metabolized almost exactly the same way. “Fructose is alcohol without the buzz,” says Lustig. Ethanol and fructose are metabolic cousins and both promote fatty liver, leading to eventual liver fibrosis, scarring and potentially cirrhosis, liver failure and even liver cancer.13

Higher rates of non-alcoholic fatty liver disease (NAFLD) are very common in people with diabetes, obesity, and polycystic ovarian syndrome. On a scan, a fatty liver looks exactly the same whether caused by chronic alcohol consumption or high-fructose intake in someone who has never touched a drink.14

The takeaway: Anyone with any fatty or fibrotic liver issues should avoid sugar, carbs and alcohol until the liver has healed. “If you have liver problems you should avoid alcohol under all circumstances,” says Lustig.

 

6. Lower tolerance, worse hangovers

Many people posting in forums and discussion groups about the ketogenic diet report that their alcohol tolerance is much lower, and their hangovers much worse on a low-carb diet. While there is not a lot of scientific research yet to explain why tolerance is lowered, one of theories is that when drinking alcohol the brain uses less glucose and more acetone for energy, one of the ketones. When you are already running on ketones, consuming no carbs, your only glucose is from gluconeogenesis.15

When you consume alcohol, the liver prioritizes ethanol metabolism over gluconeogenesis and the brain gets even less glucose and more acetone – fast tracking the impact. As well, a stomach full of carbs will slow down alcohol absorption, but many people eat much less on the keto diet. Be careful, you will become intoxicated at lower levels of alcohol consumption. Especially don’t drink and drive. (And note: even if you have not drunk very much, ketones in your breath may make you blow over in a breathalyzer, as some case reports have noted.)16

Worse hangovers are likely the result of dehydration, electrolyte imbalances and hypoglycemia. Carbs hold onto water where as the ketogenic diet increases urination and fluid loss. Alternate water between any alcoholic drinks and consider adding some salt and taking magnesium and potassium supplements.

Alcohol is known to lower blood glucose because the liver is busy metabolizing the ethanol and not making more glucose through gluconeogenesis.

Here is another important caution: for those doing the keto diet and intermittent fasting, a sudden episode of heavy binge drinking could even predispose some individuals to the dangerous situation of alcoholic ketoacidosis, in which ketones are very high in the blood, but unlike diabetic ketoacidosis, blood glucose is dangerously low. “Theoretically, there would be an increased risk of alcoholic ketoacidosis if binge drinking and fasting,” said Dr. Fung.17

The takeway: Be careful. Alcohol and its harms are much more potent on a ketogenic diet. See point 1: Moderation is key.

7. The keto diet can reduce alcohol cravings and may even help curb alcoholism

Many people, like Rattenbury, have found the keto diet, greatly helped reduce their cravings for both sugar and alcohol and reduced their urge and need to drink — likely because the diet evens out blood sugar fluctuations. Discussion threads on the popular social media site Reddit have many posts from people who found adopting the ketogenic diet helped them lower their consumption or even kick their alcohol addiction.18

“Once you get past the carb addiction and become a fat burner, your body has that other fuel (fat) that it can use instead of carbs and ethanol, and because it’s so satiating, both the carb and ethanol cravings subside, ” said “Rockithound” on the Reddit discussion.19

Film director Tom Naughton, who made the documentary Fat Head, says that when he was a vegetarian he craved alcohol and had trouble stopping once he started drinking. He lost the craving and desire to drink when he went on the low-carb/high-fat diet. “I thought I needed a 12-step program. Turns out I actually needed a medium-rare steak.”20

The ketogenic diet may even help alcoholics detox. The US National Institute on Alcohol Abuse and Alcoholism in Bethesda, Maryland is currently starting a new clinical trial to investigate the use of the ketogenic diet during detox for alcohol dependency. Principal investigator Corinde Wiers, PhD, notes that a number of studies and observations on brain energetics suggest that the ketogenic diet is a promising supplementary intervention for alcohol use disorders (AUD.)21

The NIAAA team is now recruiting 50 initial subjects, male and female, who are dependent on alcohol and want to stop drinking. These people will be admitted for an all-expenses paid residential treatment program for alcoholism for three weeks and randomized into the ketogenic diet (25 people) and the standard American diet (25) while undergoing otherwise normal detox therapy. Then after discharge, the patients will be followed for a year to assess drinking behaviour and relapses, if any.

“We will test if the ketogenic diet has an effect on withdrawal symptoms, craving, alcohol cue-induced brain reactivity and sleep quality,” says Wiers. If it does, then the ketogenic diet could become part of the arsenal of therapy for alcoholics who want to quit, she says.

The takeaway: the ketogenic diet could help you reduce your cravings for alcoholic drinks, or even help you quit altogether.

Conclusion

In short, drink moderately and stop if weight loss stalls. Be careful how alcohol triggers your own cravings for overconsumption. Watch out for lower tolerance and other harmful effects of mixing alcohol with keto (especially if you have fatty liver disease), and potentially note the positive impact on cravings on keto. Finally, of course, never drink and drive.

For Clay, he is happy that more people are talking about the ketogenic diet and alcohol. “I wish I had known about it earlier.”

What has been your experience with alcohol and the keto diet? Tell us in the comments below. And if you want to know more about what alcoholic drinks are low-carb or keto, check out our low-carb alcohol guide.


Anne Mullens

More

Top keto posts and guides

  1. A ketogenic diet for beginners
  2. 14-day keto diet plan
  3. Keto for beginners – new video course!

Top posts by Anne Mullens

  • Top 10 tips to lose weight on low carb or keto for women 40+
  • Keto snacks – the best and the worst
  • Trying to conceive? Try the better baby diet of beef, butter & bacon

Top keto videos

Comments

  1. Top 5 low-carb alcoholic drinks

  2. Annals of Medicine: Effects of moderate red wine consumption on liver fat and blood lipids: a prospective randomized study

  3. Maria Mind Body Health: Secrets to a healthy metabolism
    Full information: Secrets to a Healthy Metabolism by Maria Emmerich and Dr. William Davis

  4. Alcoholism: Clinical and Experimental Research: Alcohol consumption, heavy drinking, and mortality: rethinking the j-shaped curve

    The Medical Journal of Australia: J-curve revisited: cardiovascular benefits of moderate alcohol use cannot be dismissed

    International Journal of Cardiology: Alcohol and the heart: to abstain or not to abstain?

    Journal of Studies on Alcohol and Drugs: Do “moderate” drinkers have reduced mortality risk? A systematic review and meta-analysis of alcohol consumption and all-cause mortality

  5. The New York Times: Gary Taubes responds

  6. Realistic recovery: Alcoholism and carb consumption

  7. No sweets of any kind, ever?

    “So addicted to carbs. Help!”

  8. Surgery for Obesity and Related Diseases: Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study

  9. The American Journal of Medicine: Stone agers in the fast lane: chronic degenerative diseases in evolutionary perspective

  10. American Journal of Physical Anthropology: Current views on hunter-gatherer nutrition and the evolution of the human diet

    Live Science: Drunken monkeys: Does alcoholism have an evolutionary basis?

  11. Proceedings of the National Academy of Sciences of the United States of America: Hominids adapted to metabolize ethanol long before human-directed fermentation

    Science: Ability to consume alcohol may have shaped primate evolution

  12. Medpage Today: Experts raise red flag over fatty liver disease

    How fat is your liver?

  13. Advances in Nutrition: Fructose: It’s “alcohol without the buzz”

  14. How fat is your liver?

    Journal of Gastroenterology and Hepatology: An association between non-alcoholic fatty liver disease and polycystic ovarian syndrome

    World Journal of Gastroenterology: Review of nonalcoholic fatty liver disease in women with polycystic ovary syndrome

  15. Reddit: WARNING: Keto REALLY DOES lower your alcohol tolerance! (embarrassing story inside)

    Neuropharmacology: Neurochemical and metabolic effects of acute and chronic alcohol in the human brain: Studies with positron emission tomography

  16. International Journal of Obesity: False-positive breath-alcohol test after a ketogenic dietı

  17. Journal of the Royal Society of Medicine: An obscuring cause of wide-anion-gap metabolic acidosis in alcoholic patient: an interesting case

    The British Medical Journal: Ketoacidosis is not always due to diabetes

  18. Reddit: Keto and alcoholism

    Reddit: Using keto/LCHF to defeat cravings for alcohol?

  19. Reddit: Keto and alcoholism

  20. Fat Head: Primal body, primal mind, primal tools

  21. Clinicaltrials.gov: Ketogenic diet (KD) in alcoholism

    Wiers list of studies and observations:
    1.Volkow ND, Wiers CE, Shokri-Kojori E, Tomasi D, Wang GJ, Baler R. Neurochemical and metabolic effects of acute and chronic alcohol in the human brain: Studies with positron emission tomography. Neuropharmacology 2017; 122: 175-188. 
    2.Volkow ND, Kim SW, Wang GJ, Alexoff D, Logan J, Muench L et al. Acute alcohol intoxication decreases glucose metabolism but increases acetate uptake in the human brain. NeuroImage 2013; 64: 277-283. 
    3. Jiang L, Gulanski BI, De Feyter HM, Weinzimer SA, Pittman B, Guidone E et al. Increased brain uptake and oxidation of acetate in heavy drinkers. The Journal of clinical investigation 2013; 123(4): 1605-1614.
    4. Wang J, Du H, Jiang L, Ma X, de Graaf RA, Behar KL et al. Oxidation of ethanol in the rat brain and effects associated with chronic ethanol exposure. Proceedings of the National Academy of Sciences of the United States of America 2013; 110(35): 14444-14449.
    5. Martin K, Jackson CF, Levy RG, Cooper PN. Ketogenic diet and other dietary treatments for epilepsy. The Cochrane database of systematic reviews 2016; 2: CD001903.
    6. Cervenka MC, Hocker S, Koenig M, Bar B, Henry-Barron B, Kossoff EH et al. Phase I/II multicenter ketogenic diet study for adult superrefractory status epilepticus. Neurology 2017; 88(10): 938-943.
    7. Derr RF, Draves K, Derr M. Abatement by acetate of an ethanol withdrawal syndrome. Life sciences 1981; 29(17): 1787-1790.

55 comments

  1. Colin
    I initially had great success on low carb with occasional red wine. But I noticed weight gradually creeping up again when I went back to what I thought was "moderate" drinking 1, or 2, ..Ok 3 glasses per evening, and the occasional few pints of beer. There were also the associated bowls of peanuts and addictive pistachos of course. Stopping drink resulted in immediate weight loss again. So for my metabolism its a simple choice if I want to lose weight I can't drink, and if I want to maintain the loss I can drink very little.
    Reply: #53
  2. Nicole
    I'm going to admit that I am a massive wine lover! I love the taste! I didn't drink much or like getting drunk (small kids and early mornings had killed that need a long time ago) but I would drink a glass a night. I always said it was due the high stress job that made me want those weeknight glasses of wine to help me unwind. So when I left my high stress job and started a new job over a year ago, I took that opportunity to prove to myself that it was time to give the up the wine during the week because I was no longer in that stressful environment and I wanted to ensure I slept better (my new job had me waking up insanely early in the morning). As another experiment, people kept saying I wasn't losing weight because of the wine despite being keto for almost 2 years at that point. Months later and the results were that the lack of stress had made it easier to give up that wine but I never lost any weight (much to my disappointment). But here's the thing, I really missed wine! I continually craved it and couldn't wait for the weekend to have my glass of wine! It bugged me when I didn't get that treat on the weekend. I still wanted it!
    6 months ago I added fasting to my keto diet because nothing else was helping me lose weight. Don't get me wrong, up to that point I felt great eating keto but it wasn't until I added fasting that the weight came off. But the added side bonus to adding fasting and kicking my sugar addiction to the curb permanently is that my desire to drink also went away! Even initially when the weight was falling off, I still had my glass of wine on the weekends, but it didn't take long before I knew it, I had cut those out without even consciously trying to! I still loved wine, but I no longer crave it. Even when life ended up getting more hectic with different stresses, I don't turn to wine or food to cope with that stress! Its no longer a coping mechanism. I now only have it on special occasions and when I do, I don't over do it. I stop at one and don't feel deprived.
    So no, cutting alcohol didn't help me lose weight fasting did, but it definitely helped me in other ways and I can definitely see how a ketogenic/fasting regimen can help with addiction. Because once you heal your body, you don't want anything messing with that!
    Reply: #42
  3. Andrew
    Excellent article. I love the takeaways.
  4. Shana
    I don't drink much and only occassionally, but this answers the question of why my weight loss stalls sometimes. Thanks for the article. Abstinence it is until I hit my goal weight.
  5. bartolo
    In Letter of Corpulence William Banting, the father of low carb, gives his sample daily menu - which includes 4-5 glasses of wine plus a whiskey grog. Seems to me alcohol consumption impact on weight loss is highly individual.
  6. Annie Sullivan
    I noticed right away that alcohol was effecting me faster and differently and the next day it is apparent that my metabolism has changed. ...I wouldn't call the way I feel a "hangover "...it's quite different.
    Maybe because I grew up near the location of the first trading post in the US, I had to wonder if a keto diet is the reason First Nation people had the reputation for not being able to handle "fire water"! ?
  7. Experiences
    I have 2 observations.
    1. Stopping eating grains also stopped my cravings for alcohol (sadly, goes for most, and especially unfiltered, beers also). So no problems to have glass of wine or shot of rum in the evening, keeps easily in control now. Wild guess is that it has something to do with exorphines that grains metabolism generates.
    2. During keto initiation, the first 1-4 days, the tolerance for alcohol is very low. Very! But when the ketosis is on, tolerance is lower but no surprises to be expected. And without cravings you can stop drinking when so choosed.
  8. James H Stewart
    I am one of the Keto people who noticed that alcohol is 2-3+ times stronger. Took me a couple times to figure it out and accept I need to watch out. Also my breathalyzer shows a much higher level after just 1 drink.
  9. Colin
    All goood stuff, but the bottom line is people lie about their drinking. They lie and lie and lie even to themselves.
    So here's the bottom line. You want to lose weight? Simple! Stop drinking aclohol! Not a drop must pass your lips! Have one slice of toast and a coffee or tea for breakfast. Have half a sandwich for lunch have a bowl of vegetable soup or broth for dinner. Drink lots of water, tea or coffee in between. AND THAT'S IT!
    I've lost 9lbs this month and I follow this to the letter.

    Remember; NO ALCOHOL AT ALL of any kind !!!!!!!!! DON"T FOOL YOURSELF!

    Replies: #13, #16
  10. Thomas
    I have been diagnosed in london with fibrotic liver disease .last year I did LCHF and abstained from alcohol for three months .My weight reduced from 18 stone to 17 stone .I’m 6 feet tall .My fibroscan result improved from 18 to 14 .The liver consultant reccomended persevering with further total abstention from alcohol whereas my GP thinks that my fatty liver is not so much alcohol (because my consumption is regular but moderate )...he thinks it’s more to do with obesity ,rich food ...high fat ...and reccomended the Mediterranean diet based around vegetables ...he thinks if I could lose a few more kilos the fatty liver would disappear even if I continue to drink ....anyone out there agree ?
    Replies: #12, #14
  11. Marti Levy
    I used to drink a glass of wine every day. Being in ketosis essentially reduced my desire for alcohol!
  12. Chris317
    I agree, Thomas. My NAFLD was observed in an abdominal ultrasound. I have been eating LCHF/Keto since January this year. I have lost over 80 lbs and am nearing a healthy weight. I am fully convinced that when I have a repeat ultrasound in January that the NAFLD will be gone or greatly improved. I am not a big drinker (maybe consumed 1 or 2 glasses of wine a month if I was out with friends). My NAFLD was definitely caused by the high carb standard American diet.
  13. Kim
    Yep, some people who have a drinking problem may lie about how much they drink. So what? This is an excellent and informative article directed at the LCHF community meant to assist us in deciding whether or not to incorporate alcohol based on our unique circumstances. If you are a teetotaler, fine. Otherwise, it seems that you, your toast and 1/2 sandwiches and resulting weight loss landed on the wrong site.
  14. Jeri
    Your GP is probably right that continuing to lose weight will help your fatty liver, but do not get your diet advice from him if he is worried about the richness and fat content of your diet. You will need to eat eat rich foods in place of the sugar and carbs, as you have already done successfully in the past.
  15. Mary Beauchamp, RN
    Thanks for the great read! I am a nurse working with many patients with NAFLD. Are there any clinical studies on the effects of a Ketogenic diet for reversing this? It seems there is contraversy about this. I feel it is one of the best ways and your testimonials here are very compelling! Thank you for the shares! But is their proof? People like to see proof it seems!
  16. The
    Colin, why are you even commenting? Your diet is, unfortunately, carb-heavy and unsustainable. You are losing weight by starvation, and your liver is likely not getting healthier.
  17. Sunflower
    Great article. I agree with the information that you have to consume a whole lot less alcohol than before keto or you will be hammered and the next day hurts more than pre keto days.

    My experience has been that when I first went keto in the spring, I lost ALL appetite and cravings for alcohol. It was awesome. However, after about three months in ketosis, I seem to have found my appetite and cravings for alcohol have come back. I can usually manage my intake no problem, but rather than having a drink or two a couple times a week, I now find it's creeping up to be more like 5 times a week. Has anyone else had this experience and/or does anyone maybe understand why this may have happened? I have not changed my diet or macros and follow a classic keto program of <20g carbs (5%), 20% protein and 75% fat. Other than fat coffees, I IF on most days for at least 16-20 hours. I am lean and I don't do keto for weight loss, but, rather for therapeutic reasons and love how I feel.

  18. Skye
    Since going on this keto diet a bit more than 5 weeks ago, I have not lost my desire to drink (mostly red wine) at all. Haven't lost any weight, either, but I don't have that much to lose (and I lost 1 " around my waist). The biggest thing I notice, so far, is that I feel much better in the mornings. I am guessing this may be due to more Omega 3's and animal fats (coating the stomach and feeding the brain). I have cut down a bit on wine consumption, because I suspect it will help with weight loss eventually. But I feel great on the diet, and know I'll grow into changes "organically". I'm not in a real hurry - although I'll be thrilled when these extra 15 lbs. start to disappear. I'm not a huge sugar/carb eater, but I suspect the drinking has been quite a contributor to my weight gain...
  19. Henry
    I started on Keto weighing 285. I lost down to 222. I then last Christmas season started drinking again. And as of now have picked up 30 pounds. AS I understand it, alcohol goes to the front of the line on entering the liver. Obviously, that takes away from the liver processing the other food that we eat. I like drinking and resent the fact that losing weight and drinking doesn't work. In my case, it's a weight gainer. I've thought about other diets but I have really adapted myself to the LCHF way of eating.
    So it's out with the booze and I can't wait to be back down around 220 again. I feel so much better and my knees will thank me a lot.
  20. Sunflower
    Good focus and understanding Henry. You've got this!!!
  21. 1 comment removed
  22. Christine
    When I started this way of eating 14 months ago I decided to cut all alcohol till I reached my goal weight. When I reached my goal I decided not to tempt fate and since I did not miss alcohol, I stopped permanently. My husband is a wine master and we have an impressive wine cellar but I'm not tempted. Occasionally when everyone is raving about a wine I will take a sip from my husband's glass and that is it. Even though it is excellent I do not want a glass.
    Reply: #26
  23. Deanna
    This explains why for years I've been asked if I drink and why my liver enzymes are up... I don't drink, but I have a rumor on my pancreas which causes me to go hypoglycemic... I've had surgery on this and the tumor wasn't completely removed and I am not interested in another surgery because I don't know that it'll work and I've had enough surgeries... Anyhow, I have to eat a very low carb diet in order to maintain... My blood sugars go very high quickly if I eat concentrated sugars, however, it can go very low if I don't consume enough... I also have lows with stress or fatigue so I'm at a catch-22 at times... I appreciate you sharing your story... It explained things my doctors didn't and makes me feel not so crazy... I get upset and frustrated whenever I'm accused of drinking because I can't because it makes me sick... There are times when I would like to celebrate with everyone else or enjoy a piece of cake at my kids' birthday parties, however, I know I know I can't because my life depends on it. I looked at this page because it offered a job, however, I don't see the information... I, however, really appreciate reading this...
  24. Monica Pappas
    My husband lost 150 pounds on this diet in one year. He doesn't drink...at all..but he loves to eat and bread was his downfall. He had knee surgery about a year ago, also. As part of his recovery plan, he exercises daily and is a textbook recovery. But, the most important issue was his weight which he is thrilled that he lost.
  25. Colin
    OK, I see where I was going wrong. No more carbs! I'm on only protein as from today. But my comments regarding alcohol still stand. I think the main points which are overlooked are the huge amount of unfermented sugars mainly in red wine and the real risk of acute pancreatitis which seems to be almost entirely caused by alcohol consumption; Please read https://www.nhs.uk/conditions/acute-pancreatitis/causes/

    Also, a friend of mine was often very ill after drinking wine and beer. After much research and testing, he found he was allergic to the histamines. He stopped drinking and the symptoms went within days.

    Reply: #55
  26. Vikki
    Christine, I believe you and I are in exactly the same lifeboat. I also have been consuming a Keto diet for the past 14 months, my husband’s studying to be a sommelier and we have a cellar packed with great wines. I LOVE wine. But it definitely has been a causal factor in my slow weight loss. Without changing how I eat, I drink even a little and my weight goes up or stays the same. I stop and my weight goes down. I don’t think I need a scientist or medical doctor to tell me why. Being that I know I cannot stop at just one glass, the only clear answer is that alcohol can’t be part of my lifestyle anymore and I’m really just coming to grips with it now. Giving up sugar was easy. Giving up alcohol - especially in social situations will be a challenge for me.
  27. Rachel
    I used to follow traditional low calorie Weight Watchers diet, and not only was it absolute hell and starvation, for some reason I could not stop drinking even though I had never had a problem in the past. It got so bad I thought I needed a program. I needed to drink entire bottles of wine at least once a week. As soon as I stopped the calorie restricted low fat diet I didn't need to drink anymore. It was like a light switched. I thought that was just me and a strange coincidence so it is interesting to hear others have experienced the same phenomenon. On weight watchers I have constant alcohol cravings every day. I want wine 24/7. On LCHF I never want it at all and can have soda water at bars when everyone else is drinking. My own personal theory is that my body was starving on weight watchers and alcohol was its way of getting the energy it craved so badly. On holiday (while Keto) I went to a famous vineyard and did the wine tasting with my best friend. I was sure to eat high fat snacks with the wine (cheese, olives, macadamias, cured meats) and I struggled to finish what would have been the equivalent of 2-3 standard glasses of wine.
  28. Caroline
    I started the Keto Lifestyle a couple if weeks ago. I did lose 3.5 lbs over the two week challenge. So that combined with how I felt was enough encouragement to keep going.
  29. Kristine Moberg
    I was slimwhen I drank. Quick drinking and gained 30#. Haven't had a drink in 15 months. No cravings until I started keto diet. 2nd week in and I want a drink. Think it's related to ketosis?
  30. bob
    I love to binge drink even at my age of 58. You know 10 drinks between 9pm and 3 am. on a Saturday night! Dancing, singing, telling lies. I have found that on keto that alcohol cravings are close to zero though. I would think the keto diet would be a starting place for most alcoholics like myself. The first couple of times I drank on keto I had raging hangovers. Not so much since then. The article should have mentioned that alcohol is actually a forth food group. It has 7 cals vs 4 for carb/proteins and 9 for fats. It actually goes to the front of the line for absorption as well. Requires no processing to get into the body. I can literally feel a shot within 10 seconds in my brain.
  31. Ceci
    How different is Keto diet from Atkins? I'm just curious because everything I read sounds identical. I had much success with the Atkins diet many years ago, but don't go back to eating the way you used to because it is hell getting back on.
  32. Linda
    After trying to lose weight for almost a year on the keto diet, in December 2017 as a New Year's resolution, I decided to stop all my alcohol, dry red wine, bourbon, scotch. I was at a plateau for most of 2017. I maintained but I was not losing. After some extensive reading about how the liver stops doing everything else and deals with the alcohol (that looks like a toxin) I decided to do a 3 month test. So far 16 days on the wagon and I have lost 5 pounds. I know now how the alcohol affected me. So after my 90 days test period, I may decide to have that red wine. But I know what will happen and I can make an informed decision.
  33. Aleksandra
    A regular dry wine drinker here. Probably more than good for me.
    However, I noticed a strange thing once. It was my birthday, and I got really naughty. Ended up drinking two bottles of wine over 6 hours. Felt a bit cheerful and funny, but no staggering. No hangover the next day. Nada. And that day I had a really nice fatty pork belly for breakfast. Fried in butter with 2 eggs and 2 tomatoes. Later on just before I started sipping the wine I had quite a lot of cheese with salami and chorizo. Hmmm... I read in dr Perlmutter's Grain Brain that saturated fat (among other functions) protects your liver from toxins (including booze).
    The funny point is that before the aforementioned event, I didn't really 'practice', to get a higher tolerance or whatever. I generally tried to be a relatively good girl and not to overindulge. Half a bottle, 3/4, occasionally a full one.
    And speaking of weight, I didn't lose much, it's true about weight loss stall, but I still lost 2 kg out of 5 that I wanted to get rid of. And everybody says I'm blooming. And I feel perfect as well.
  34. George
    Been on the Keto diet for 4 weeks now and have to say, I've lost 15 pounds and feel a lot better about myself. I've taken out the beer, all sweets, and the high carbs like pasta, and it has made a difference. I also feel like I have a lot more energy, with the occasional drag at night because of cutting carbs to less than 10 grams per day. I increased the intake of water, seltzer water and Pellegrino which helps a lot to control cravings and overeating. I drink dry wines like Pinot Noir or Chianti, and limit myself to two, 6oz glasses a week. As long as you walk or exercise the next day, I see no reason why someone can't splurge occasionally and have a second, or even a third. I ate a piece of cake on my Birthday and did not crave any other sweets the next few days. My goal is to lose 48-60 pounds by August so I can fit into my size 40 suit for a wedding we are attending.
  35. Mike
    I am a bacon and eggs, ribeye, cheese fries, and beer kind of guy. About 6 months ago a buddy of mine told me to try it out and I flat out refused since I figured the zero tolerance for alcohol was in there. He explained it was ok in moderation and that wine and whiskey were ok. One of my favorite drinks is a double jameson on the rocks. I weighed 248 lbs to start, ate 6 strips of bacon and 2-3 eggs fried in the grease for breakfast. Would head to work and grab a low carb monster and a coke zero along with a bag of pork rinds. That would usually be lunch. Dinner would either be steak, chicken thighs smothered in cheese or some fried chicken using smashed up rinds as the coating. Every day I would make my normal walk to and from the bar and drink 2, sometimes 3, double Jamesons then walk home. The only real difference in my diet was switching from beer to jmo, using pork rinds as my crunchy snack, and using the low carb monster and coke zero to replace the normal monsters and Dr pepper. My wife loves veggies so ill try them sometimes. Within 6 weeks I lost 25 lbs. Since then, I've splurged on a beer here or there or downed a whole plate of cheese fries or stopped at McDonald's for a filet o fish 2 mcdoubles and a dp. Last 3 months I've only gained 5 lbs. I think it's due to the cold weather and not being able to walk (uber instead). But all in all I do not think the alcohol is keeping any weight on me. Or my body is just used to it. My body is healthy per my doc and as of yesterday he said it w ouldnt hurt to lose 5 lbs but I'm in good shape.
  36. Diana
    If Ian in Ketosis and i have a shot or two of tequila will it really mess with weight loss? I don’t drink often (weddings, special occasions) but there is a celebration coming up and I would like to drink just a bit.
  37. Tracey
    Last year I stopped drinking for a few months, because I felt like I was drinking too much. Within a week, I started craving sugar. I'm not a big sweets eater - my carb cravings are bread and pasta - but I couldn't stop eating gummy candies. I gained ten pounds during my abstinence experience and my A1C increased significantly. So I decided to try keto. I've lost 41 pounds and hit my goal weight within six months (now I'm just trying for five more vanity pounds). I switched out my beloved Belgian tripel for bourbon. Now I've found that I drink every day. It's usually two drinks and I don't crave more, but I feel like I must have that drink every evening around the same time. I've noticed on my occasional cheats that when I eat carbs, I don't crave alcohol. I suspect that I'm craving alcohol because the sugar is gone.
  38. Kat
    I just found out that I have fatty liver disease. I drank dry, red, low alcohol wine regularly (I make wine!) with a couple days off a week until my diagnosis. I have been eating keto for two years but increased my carb intake over the holidays and gained 15 lbs! Prior to beginning the keto diet I suffered from mycotoxicity which affected my liver. I thought my liver was better but I didn't have a scan for past/present comparisons. Doc said my fatty liver could be from the damage caused by mycotoxicity, alcohol, or "falling" off my diet. I am a post-menopausal woman and 15 lbs over my optimal weight with decreased physical activity over the last 6 months.
    Now I am back on keto, taking liver helping supplements, off alcohol, and increasing my activity level. I have been off alcohol 8 days without any cravings or thought of having a glass of wine. Will I ever be able to have an occaisonal glass of wine again not knowing if my fatty liver is from alcohol or not? Not the whole bottle, just a glass or two a couple times a week with dinner or friends?
  39. SC-M
    After 12 years of sobriety I slowly started to tempt fate and it was doing ok. I had one close call (got a little loose tongue) , but was fine the next morning. I was able to quit drinking for a couple of weeks. Then I started Ketos and it got crazy fast! I only drank wine. However, last Monday in the course of a few hours, I was silly gone and don't remember how I got to bed. That scared me straight. I've made it to AA meetings every day since. However, one thing I noticed is that my craving for alcohol is still gone. I mean completely gone. But the hangover! I'm almost 4 days sober and I'm still feeling it! Again, it was wine and only wine. I could not figure out why I am still feeling foggy and achy.This article has helped make sense and I'm happy. 1) I should have know better. However, it is not taking something drastic (jail) for me to hit my bottom. 2) I have no cravings. 3) I know what to do. No Alcohol - get back to meetings.

    I am actually grateful for both Keto and AA!

  40. Bob
    I started LCHF/Keto/IF on 1/1/18 and have lost 20 pounds since then (I'm 6' tall and now weigh 200 lbs). I have learned this: when I don't drink wine, this way of eating and living works for me. I stayed away from my Cabernet and lost 15 pounds in January. Super Bowl Sunday I fell back into the wine habit (2 or 3, or sometimes 4 glasses a night once or twice a week) and I have lost only 5 pounds in the last 3 and a half weeks. Some of this MIGHT be the snacking that I seem to succumb to when I drink wine but sometimes I haven't snacked and the results are the same: weight flattens out or, worse yet, goes up a pound or two, for a day or two. The message for me is clear: lay off the wine if I expect continue to lose weight.
  41. 1 comment removed
  42. Trish
    Thanks for sharing!!i can relate on so many levels. Love my glass of wine too...
    when you fasted how often and what did you do in fast ... food/ liquid in take? Just curious.
  43. Julie Richardson
    I’ve been on Keto for over 3 weeks and definitely notice that I can’t eat carbs or drink alcohol without getting a headache. I also have lost my cravings for cakes, cookies, candy, which never thought I’d lose that in a million years. Those cravings have sabotaged me on every diet I’ve ever tried. And I’ve tried a lot! I’m not losing weight but I feel 1000 percent better so I’m sticking with it. Just to be sugar free is worth its weight in gold.
  44. Crystal
    The last few years I've had bourbon and diet soda on a fairly regular basis. Not always daily but probably 4-5 nights a week. My tolerance was always very high and I could easily drink half a bottle without so much as a buzz. At start of march I started keto of course my tolerance went way down. I cut back to 1or 2 drinks and eventually over the weeks my tolerance evened back out. any buzz comes and goes quickly and i never have a hangover. I keep myself well hydrated with electrolytes. I've maintained a steady loss of 1.5- 2lbs a week which I am totally ok with. I'm now 18lbs lighter and the alcohol has not seemed to stall me yet. In fact I tried abstaining for one week wondering if i might get a boost, changing nothing else and I stalled. I went back to my usual routine and 3 lbs came off by the end of the week. Maybe it was a coincidence or my body freaked out at another sudden change in diet or as others have suggested it is all just water weight. Apparently nobody thinks I can lose any fat if alcohol is included in my diet. i dont know, I guess we will see as time goes on but for as long as it doesn't cause issues I have no intention of cutting myself off completely.
  45. Jimmy
    So, someone has a drinking problem and that is the argument for moderation? I fink 4 days out of 7, don't have any problems with a keto diet and don't get excessively drunk!

    Nice theory, but bullshit in practice ?

  46. 1 comment removed
  47. Brenda
    I have been low carb for over two years. I've lost 60lbs, but have plateaued at about maybe 10 lbs. more than I should weigh. I have drank wine the whole time, probably 2-3 glasses most days. I haven't noticed an increased intolerance for wine. I sometimes think that I should try to quit, but I'm over 60 and am pretty happy the way I am right now since I was obese most of my adult life. I love to garden and now I can run rings around much younger people. So, I don't know. I still debate about it.
  48. Terri
    I definitely fall into the category of needing to abstain completely in order to lose the rest of my excess weight. I've been doing keto and doing great except when I try to have a couple of glasses of wine; that's when weight loss completely stalls. It also increases carb cravings and I never, ever want to return to that torment. Thanks so much for the updated article and to everyone who made some great comments--all the best.
  49. Rich
    I definitely can’t drink. It stalls me and then from time to time my willpower goes away and I binge eat carbs. Terrible combo. No booze zone here.
  50. Justin Campbell
    Notice that weight loss slows greatly when drinking vodka and whiskey daily. Once a week though seems to have no effect.
  51. Deni
    This feels like a Miracle Diet to me. I was as you described a Carb Addict. If I wasn't consuming alcohol at night, I was looking for sugar....then it turned into BOTH: alcohol & sugar! I initially started Keto for weightloss but not even 2 days into it, my cravings for sugar & alcohol completely, and I mean COMPLETELY, dissolved. It blew my mind...I seriously could not believe it and am beyond happy about it.
    I am 57 years old, a woman, and "they" say it's harder for us to lose weight because of a change in our metabolism.... but after just 2 weeks on the Keto diet, and moderate exercise, I not only lost 6 pounds, I feel AMAZING!! I have more energy, clarity and positive outlook then I have had in years. I feel sooo good!! Body, Mind & Soul!! I am very thankful I stumbled upon this diet by "accident". I truly believer it saved my life. I told my husband I feel like I'm an experiment.....I can't wait to see all the other changes. I have already noticed differences in my skin. Facial lesions and this foot fungus thing I always had have completely cleared up. I think my body must be so happy that I am no longer starving it of healthy FAT!! :)
    Thank you for this website...it has been a Godsend!!
    Reply: #57
  52. Deborah
    The excruciating ache in my hips & lower back that came on suddenly & totally unexpectedly after an evening of gluten free potato vodka, club soda & fresh limes was enough to just say NO to any alcohol. I’d been on Keto for 3 weeks & that deep crippling pain lasted for a week. Good to know that dry red wine or whiskey is acceptable on Keto but for now, I’m just a lot fun-shy.
  53. momo
    Same problem here... As long as I don't drink I loose weight regardless what I eat and I lose even more if on any kind of diet. So sad. The choice is very hard as I really enjoy drinking alcohol...
  54. Daniel V.
    hace un año estaba en dieta ceto, decidi suspenderla en un dia festivo aqui en México (15 de septiembre) para beber, sin embargo aun cuando estoy consciente de que no me puse limitaciones en la bebida, si noté como en las primeras dos bebidas comencé a sentirme como si me hubiera tomado 5 o 6, lamentablemente no hice caso a mi sensación de ebriedad y terminé por accidentarme contra otro auto, afortunadamente no hubo más que lesiones leves en todos los involucrados. pero si estoy seguro que debo de pensar muy bien sobre mi relación con la bebida y más si estoy (como lo estoy actualmente) siguiendo una dieta cetogénica. gracias por aclararme este punto. saludos!
  55. Jim
    I’ve made wine in Napa Valley for 20 years, red wine has no unfermented sugars. Red wine is unstable if there exists residual glucose/fructose. Occasionally the winemaker will add back glucose to intentionally sweeten the wine right before bottling but it is not the norm.

    OK, I see where I was going wrong. No more carbs! I'm on only protein as from today. But my comments regarding alcohol still stand. I think the main points which are overlooked are the huge amount of unfermented sugars mainly in red wine and the real risk of acute pancreatitis which seems to be almost entirely caused by alcohol consumption; Please read https://www.nhs.uk/conditions/acute-pancreatitis/causes/
    Also, a friend of mine was often very ill after drinking wine and beer. After much research and testing, he found he was allergic to the histamines. He stopped drinking and the symptoms went within days.

  56. Judy H
    Judy I am trying the Keto diet and bought some “ Keto “ pills to take as well. They were supposed to be recommended by the Shark Tank folks , don’t know if that’s true. I am surprised to read here how much alcohol can sabotage this diet ! I like a few shots of whisky through out the day , l am retired so no worries. I am wondering if anyone has any experience with the using the pills along with the keto diet.
  57. Darla
    I am 58 and started the diet yesterday! I have that annoying foot thing, so hope mine goes away.
  58. Mike
    I'm 63 years old and used to drink beer since I was 16.....my Keto journey began 4 month ago and I could stop drinking beer, my blood glucose level is now in the normal range and I lost 15 kg of body weight. Unfortunately I started to drink vodka/club soda instead of beer, just to find out that I drank it like beer. So I had to stop drinking alcohol....it's just too dangerous for me...

Leave a reply

Reply to comment #0 by