Ketone drinks: a buzzy and safe alcohol-alternative?

What are ketone drinks?

In recent years, alcohol-free drinks have become a popular niche in the drinks market. These promise to remind consumers of their favourite boozy drinks while they avoid the hangovers and health risks of real alcohol.

What most of these drinks have never promised is the alcoholic buzz - the sensation of getting tipsy. Now, brands selling ethanol-free drinks containing a natural chemical called ketones are claiming that these non-alcoholic beverages can mimic this feeling - and many TikTok users are reporting it works.

Yet it's only recently that ketone drinks have been marketed as an alcohol replacement. In fact, they have received most attention as an energy source that doesn't cause spikes in blood sugar, unlike the energy we get from carbohydrates. They've also been promoted for their potential in improving athletic performance.

What are ketones? - the basics

Ketones, or ketone bodies, are a type of chemical that your body naturally produces in the liver. Ketones provide you with energy when you're fasting, not eating as many carbs - your main energy source from food - or when doing a lot exercise, when you quickly use up energy stores.

Ketone drinks contain an artificial version of ketones, known as exogenous ketone supplements. They are designed to give you the benefits of ketones without restricting calories or carbs. They come in two forms - ketone salts, which are often powders, and ketone esters, usually liquids.

Health benefits of ketones

It's thought that supplementing artificial ketones can benefit some people - in the right circumstances. Exogenous ketone drinks, by directly elevating your blood ketone levels, can act as an alternative fuel source for the brain and muscles. This is especially beneficial during periods of low carbohydrate intake.

Other known benefits:

• Support during athletic performance - athletes might benefit from the immediate energy that ketone drinks provide, especially during prolonged endurance events where carbohydrate stores might be used up¹.

• Appetite suppression - ketone drinks, by aiding ketosis, can lower levels of the hunger hormone ghrelin². However, while ketone drinks can support a ketogenic diet (keto diet) in achieving weight loss, people shouldn't solely rely on them. The body should naturally produce ketones through dietary practices.

• Enhanced brain function - some studies indicate that ketone drinks might support brain function³. Like muscles, the brain can also use ketones as an energy source, potentially offering mental clarity.

Research into ketone drinks is ongoing, and evidence regarding appetite suppression and brain function is not conclusive - especially when it comes to studies involving humans⁴. Bear this in mind, as high-quality ketone drinks can be expensive.

How safe are ketone drinks?

Although generally considered safe, there are some circumstances where ketone drinks may cause problems.

Side effects and considerations:

• Not a replacement for a balanced diet - consuming ketone drinks does not replace the need for a well balanced diet. Your body needs various nutrients from diverse food sources.

• Gastrointestinal discomfort - some people have reported stomach issues, such as nausea or stomach cramps, after consuming ketone drinks.

Ketones - an alternative to alcohol?

Alcohol can affect our mood and behaviour. This can be bad for our health - especially when it comes to prolonged and excessive drinking - but many people who cut down on alcohol miss the buzz they feel from two or three drinks.

The TikTok trend for testing ketone drinks, in their appealing range of alcohol flavours like G&T, beer and Piña Colada, has led to mixed results and confusion. Some report feeling a mild but enjoyable sensation after a few cans, while others felt no different. It's also worth bearing in mind that many of these popular flavours contain added sugars, which are linked to poor heart health and other problems associated with weight gain.

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The evidence - jury's out

When it comes to the science, the reality is there are very few human studies exploring how ketone drinks can make people feel. Instead, most explore ketones for athletic performance, where mood effects have sometimes been reported in limited detail. For example, one study of cycling performance noted some participants experienced low levels of euphoria⁵.

While ketone drinks may give our brains and muscles a boost, these effects are likely to feel different to drunkenness. For example, they appear to reduce exhaustion after exercise⁶, and may have a therapeutic effect on people with some psychiatric diseases⁷.

Science hasn't proved that ketone drinks can mimic the effects of alcohol. Rather, alcohol and ketones have different effects on mood, behaviour, and brain function. While alcohol has a psychoactive effect, ketone drinks provide energy.

Sifting through the confusion

Research into ketones and cognitive performance is not necessarily proof that ketones make a great booze-free drink - even if the alcohol-free drink brands cite these studies as proof.

There are also important differences between the effects of ketones your body naturally produces and ketone drinks. There's anecdotal evidence that the initial stage of fasting or a low-carb diet, which causes your body to produce ketones, leads some people to experience mild euphoria⁸. In these cases, it's likely that eating less sugar and fats and having more stable blood sugar levels plays a role - something that doesn't apply with ketone drinks if your diet stays the same.

Should I buy ketone drinks?

It's not clear if ketone drinks will give you an alcohol-like buzz. No matter your reasons for drinking them, having little or no alcohol is healthier for you.

Like any nutritional supplement or practice, it's a good idea to check with a healthcare provider or nutritionist before incorporating new supplements into your routine.

Further reading

1. University of Oxford: Ketone drink gives competitive cyclists a boost by altering their metabolism.

2. Stubbs et al: A ketone ester drink lowers human ghrelin and appetite.

3. Alzeimer's Association: A ketogenic drink improves cognition in mild cognitive impairment: Results of a 6-month RCT.

4. Pendergrass and Rafi: Exogenous ketones, ketone esters and ketone salts.

5. Shaw et al: The effect of 1,3-butanediol on cycling time-trial performance.

6. Evans and Egan: Intermittent running and cognitive performance after ketone ester ingestion.

7. Kovács et al: Therapeutic potential of exogenous ketone supplement induced ketosis in the treatment of psychiatric disorders: review of current literature.

8. Brown: Low-carb diets, fasting and euphoria: is there a link between ketosis and gamma-hydroxybutyrate (GHB)?