Can you drink alcohol on the keto diet?

Can you drink alcohol on the keto diet? The short answer is yes. But being able to enjoy a drink and still achieve your goals goes beyond simply counting the carbs in alcoholic drinks.

Many people consume low carb alcohol such as wine or spirits in moderation on a ketogenic diet…and still, lose weight.

Many …. ‘Diets’ … require you to abstain completely from alcohol.

And yes If you’re trying to lose weight then you may wish to keep your alcohol intake to a minimum in order to maximise your results. But completely abstaining often isn’t necessary.

I think if we’re going to move from ‘diet’ to ‘lifestyle’ then we have to acknowledge the role that alcohol plays in our lives and our cultures and look at how we can integrate into our lives and still achieve our goals in the longer term.

I know all too well from my day-to-day medical work that lots of people do have problems with alcohol which causes devastating effects on many areas of their lives.

So I’m not promoting drinking alcohol in this article but I’d like to think we can have an adult conversation about it, and so we also have to acknowledge that drinking is an important part of many cultures.

And in fact, when we look at some of the areas of the world with the longest lifespans, the so-called ‘blue zones’ – such as Sardinia and Piopi in Italy – we find that alcohol consumption, in moderation, is an important part of their social lives.

But there is a lot more to understanding alcohol and ketosis than just knowing the carb counts of various drinks.

We need to consider how alcohol affects you differently when you’re in ketosis – namely, you get drunk quicker and you get worse hangovers and I’ll be explaining why this is! Also I will be looking at why alcohol can actually pause the process of ketosis itself. Then I’ll be answering the question that is important for many people – will alcohol consumption slow down weight loss on the keto diet? To finish up I’ll be taking you through some of the good, and some of the not so good choices for alcohol on a ketogenic diet.

Table of Contents

Ketosis changes the way our bodies respond to alcohol

The first thing you’ll probably notice the first time you have a drink after starting keto is that your alcohol tolerance is really low!

Depending on your perspective this can be a good thing or a bad thing. It will certainly mean you’re a cheap date.

There are lots of things that affect your alcohol tolerance.

  • Genetics
  • Weight
  • Hydration
  • How frequently and how heavily you drink
  • Diet also has an impact and keto is a great example of this.
So why does this happen? Well, there are a couple of things that are involved.

High Carb Meals Slow Alcohol Absorption

If you’ve ever drunk alcohol on an empty stomach you’ll know that you’re going to feel intoxicated more quickly than if you’d eaten.

When you drink on an empty stomach, the stomach absorbs alcohol much faster.

You may have noticed that you need a larger amount of alcohol to reach the same effect after a large carb based meal. We know that alcohol absorption is prolonged for around 2 hours after a high carb meal.

Whilst I’m not aware of any scientific studies that directly compare alcohol absorption after low carb and high carb meals, anecdotally it does seem that alcohol is absorbed more quickly after a low carb meal than after a high carb meal.

Low glycogen levels

Glycogen is our short term stores of easy access carbohydrate that we find in the liver and muscles.

And it’s the liver that we’re interested in as that is where alcohol is mainly metabolised within the body.

If you’re on a high carb diet, then your glycogen stores in your liver are usually pretty full.

If you’ve watched my ‘how are ketones formed in the body’ video, then you’ll know that in order to get into the state of ketosis you must have used up your glycogen stores.

It’s these glycogen stores that act as a cushion for absorbing some of the alcohol. But when you’re in ketosis you’ll process the alcohol much more rapidly and you’ll feel its effects sooner!

Hangovers can be a lot worse

Again, there aren’t any definitive studies that I know about that explain exactly why this is but it likely has to do with dehydration and electrolyte abnormalities which create the perfect recipe for a bad hangover.

Will alcohol affect ketosis?

Alcohol metabolism occurs in the liver and so does ketone production. And yes… alcohol absolutely affects ketone production.

One of the core aims of eating a ketogenic diet is to keep the levels of insulin low to reduce the storage of fat.

Most hormones in the body have an opposite hormone and insulin is no different. Insulin’s opposite hormone is glucagon.

While insulin is produced in response to high blood glucose levels….glucagon is produced in response to low blood glucose

Firstly, to break down those glycogen stores we mentioned earlier, to use as blood glucose and if there is no glycogen left, the liver will produce ketones from stored body fat!

So being in ketosis is low insulin, high glucagon state.

But what’s this got to do with alcohol…. Well, alcohol consumption reduces glucagon levels – reducing, or stopping the production of ketones.

This makes sense… your body has all of a sudden found a new energy source… alcohol is an energy source… therefore it doesn’t need to keep breaking down fat for energy.

So Alcohol pauses ketosis

You can test this yourself if you have a blood ketone meter. Urine ketone sticks are too slow to respond to this change and alcohol will cause a false positive result when using ketone breath monitors.

An exception

There is however one exception which, to be honest, is probably more of interest to me as a doctor … in heavy and frequent drinkers the opposite can be true! There is a condition called alcoholic ketoacidosis where loads of ketones are produced and this is a common reason why people with alcoholism end up admitted into hospitals.

But for the average person who occasionally consumes a small or moderate amount of alcohol intermittently, this doesn’t occur.

Yes, alcohol will disrupt Ketosis but only temporarily. Alcohol pauses ketosis…

This is really useful to know when we talk about the effect of drinking on weight loss. Which brings me on to ask the all-important question….-

Will alcohol slow down my weight loss?

Tape Measure Around Waist

You’ve probably guessed that it does. It inhibits glucagon which is the hormone that promotes fat breakdown into ketones.

But it’s useful to know that it really only pushes pause on this process, and once the body has finished dealing with the alcohol, ketosis quickly resumes.

Compare that temporary pause to when we consume carbohydrates. Where we begin to fill up our empty glycogen stores, from where it can take several days in order to get back into ketosis.

So in your weight loss journey, consuming alcohol is like standing still for a moment before you continue on with your journey.

Whereas consuming carbohydrates is like taking several steps backwards on your weight loss journey. And those are steps that you will have to take again to get back to where you were before.

We do have to consider the carb count of the alcoholic drink itself and I’m going to be covering some of the better low carb alcohol options later in this article.

Calories In Alcohol

The other thing that we have to consider is that alcohol is an energy source. In fact, it’s often referred to as the 4th macronutrient along with proteins, fats and carbohydrates.

You may have heard of alcohol being referred to as just empty calories and this is true. It provides a source of energy to the body that doesn’t really have any nutritional value.

And the energy that we get from alcohol is energy that we don’t need from elsewhere – such as your fat stores.

So yes, you do have to account for the calories that alcohol provides as well as the carbs.

Alcohol = Bad Decisions

Finally, when it comes to thinking about alcohol and weight loss we have to consider the effect that alcohol has on our decision-making abilities. Especially when we have a lower tolerance to alcohol because we’re in ketosis.

Where will that one low carb drink lead to?

Will you find yourself waking up a 4 o’clock in the morning still drunk from the night before with your face covered in the pizza that you passed out in!

You know yourself better than anyone and so all I ask you to do is be honest with yourself… are you someone who can do alcohol in moderation?

This is one of the areas that I discuss really early on with my coaching clients because I have found time and time again that people whose social lives revolve around drinking quite heavily are unlikely to succeed on a ketogenic diet unless they address this part of their lives.

So of course if you’re trying to lose weight and are struggling to do so while drinking alcohol then you may wish to abstain from alcohol.

Whilst many people do ketogenic diets for weight loss that there are also many people who are doing it to reverse the effects the metabolic syndrome, such as type 2 diabetes and fatty liver disease.

Fatty Liver Disease

It’s worth mentioning if you’re on a ketogenic diet to reverse the effects of fatty liver disease … then you should absolutely abstain from alcohol until you’ve reversed the underlying problem. A fatty liver looks the same whether it has been caused by alcohol or by carbs and consuming either is likely to make it worse or halt recovery.

So if you do decide that you want to drink whilst on keto…

What alcohols are ‘keto friendly’?

Spirits

The best options are the highly distilled spirits such as vodka, tequila & gin and these can be paired with a low carb or no carb mixer.

One really popular zero carb choice is vodka with soda water (which I just found is called Seltzer water in the USA) – basically vodka with fizzy water and lime juice.

Now this ‘cocktail’ has a name… which might be considered somewhat rude. So I’m not going to say it here, but if anyone does know what it’s called then write that into the comments down below.

Wine

Wine is another good option which is low carb but not zero carbs.

White wines are generally lower in carbs than red. Dry wines are better than sweet.

Champagne and Cava – at the dry end of the sparkling wine sections are also good options.

I don’t want to go through the carb counts all the different varieties of wine but I do have a free downloadable pdf guide which contains all that information and also covers the carb counts of loads of different food groups such as fruits, vegetables, nuts and also non-alcoholic low carb drinks. Click the link below to access this.

GET YOUR FREE EASY CARB GUIDE

Annoyingly for me beer is on the list of drinks to avoid, as are any of the liquors and other sweetened alcoholic drinks.

Depending on where you are in the world there are more and more versions of these that are being made for us who chose to live a low carb life. There are some low carb beer options in there and some extra low carb wine options too.

Conclusion

So that’s it, lots to think about there.

I just want to sum things up and talk about some of the ways that you can minimise some of the negative effects that we’ve talked about so far.

Number 1 – Drink in moderation and infrequently – excess alcohol is never good for you.

Number 2 – Drink on a full stomach – low carb might not absorb alcohol as well as a large high carb meal but it’s better than drinking on an empty stomach.

Number 3 – Keep Hydrated when drinking – try alternating alcoholic drinks with water.

Number 4 – If you’re trying to lose weight you may wish to abstain from alcohol but if not, then be sure to measure the effects of drinking alcohol on your weight loss goals.

Number 5 – Avoid alcohol in fatty liver disease or other liver conditions.