Keto diet holds potential for both treating and worsening health of substance abusers

31 Jul 2023 --- Following a ketogenic diet – high in fat and protein and low in carbohydrates – has proven helpful in treating substance use disorders, according to a team of China-based researchers. While demonstrating the benefits for addiction and overall health, the strict nature of the diet may also lead to an increased risk of malnutrition, worsening the nutritional status of the already vulnerable population with a substance use problem.

The study, published in Frontiers in Nutrition, further notes that the ketogenic diet reduces the intake of carbohydrates and brings other positive effects, such as neuroprotection, reducing inflammation and regulating the gut microbiota.

Gut microbes – bacteria, fungi and viruses found in the gastrointestinal tract – regulate neurological functions and have been associated with several neurological diseases such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, Huntington’s disease, anxiety and depression.

The study details another research on patients with alcohol overconsumption for over ten years. It showed “a higher relative abundance of bacteria from phylum Proteobacteria and higher levels of the genera Sutterella, Holdemania and Clostridium, and a lower relative abundance of bacteria from genus Faecalibacterium compared to control patients with no or low alcohol intake history.”

Ketogenic diets may increase the risk of nutritional deficiency and malnutrition.Gut bacteria
Disorders in the gut microbiota caused by substance abuse might also cause behavior changes. 

Bacteria can also reduce substance-induced behavioral responses, according to the researchers, as they believe that the probiotic Lactobacillus rhamnosus may reduce cocaine-induced behavioral responses.

Keto diets may also benefit substance abusers health through the gut microbiota. “The general decrease in Akkermansia in substance use disorders may be reversed by a ketogenic diet,” argues the study. 

The authors note that sugar intake is associated with an increased risk of substance use disorder and that young people with a higher sweet-liking status have an increased risk of addiction. They further note that heroin, alcohol or cocaine addicts usually prefer highly-sweet foods and higher concentrations of sucrose.

The study also highlights that weight loss surgery patients have an increased risk of substance use disorders.

“It has been shown that excessive intake of carbohydrates, whether monosaccharides (glucose and fructose), disaccharides (sucrose), or polysaccharides (starch and glycogen) can injure human health,” reads the study.

When the withdrawal ends, dietary patterns usually improve, it further explains.

Not all goodWhen the withdrawal symptoms end, dietary patterns usually improve, says the study.
Despite the many health claims, the researchers also note that concerns have been raised about the negative impacts of the keto diet on the gut microbiota and overall health.

The findings showed that one month of following the diet decreased the number of beneficial bacteria for inflammatory bowel disease, increasing inflammation systematically and in the gut. 

The researchers say this may be due to individual differences and require further exploration.

They further point out that ketogenic diets are concerning for neurological diseases, causing a decreased appetite and increased risk of malnutrition. Therefore it should be cautioned for those with a substance use disorder, as this group usually suffers from multisystem disorders and already have a heightened risk of malnutrition. 

Meanwhile, the diet is also difficult to sustain. A Denmark-based study published last year argued that although it’s been shown beneficial for people with diabetes and regulates short-term weight loss and glucose levels, it doesn’t last long after going off the diet.

The diet was also recently labeled as having the worst environmental impact in a US-based study. The keto diet generated 3 kg of carbon dioxide per 1,000 calories consumed. The paleo diet was just a little behind with 2.6 kg per 1,000 calories. The vegan diet was shown to be kindest to the planet, as per 1,000 calories consumed, it generated 0.7 kg of carbon dioxide, followed by the vegetarian and pescetarian diet. 

Edited by Beatrice Wihlander