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False-positive breath-alcohol test after a ketogenic diet

International Journal of Obesity volume 31, pages 559–561 (2007)Cite this article

Abstract

A 59-year-old man undergoing weight loss with very low calorie diets (VLCD) attempted to drive a car, which was fitted with an alcohol ignition interlock device, but the vehicle failed to start. Because the man was a teetotaller, he was surprised and upset by this result. VLCD treatment leads to ketonemia with high concentrations of acetone, acetoacetate and β-hydroxybutyrate in the blood. The interlock device determines alcohol (ethanol) in breath by electrochemical oxidation, but acetone does not undergo oxidation with this detector. However, under certain circumstances acetone is reduced in the body to isopropanol by hepatic alcohol dehydrogenase (ADH). The ignition interlock device responds to other alcohols (e.g. methanol, n-propanol and isopropanol), which therefore explains the false-positive result. This ‘side effect’ of ketogenic diets needs further discussion by authorities when people engaged in safety-sensitive work (e.g. bus drivers and airline pilots) submit to random breath-alcohol tests.

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Acknowledgements

There was no external funding for preparing this article and neither author considers there to be any conflicts of interest.

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Authors and Affiliations

  1. Department of Forensic Chemistry, National Board of Forensic Medicine and University Hospital, Linköping, Sweden

    A W Jones

  2. Department of Obesity Research, Karolinska Hospital, Stockholm, Sweden

    S Rössner

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  1. A W Jones
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  2. S Rössner
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Correspondence to A W Jones.

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Jones, A., Rössner, S. False-positive breath-alcohol test after a ketogenic diet. Int J Obes 31, 559–561 (2007). https://doi.org/10.1038/sj.ijo.0803444

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