About 20% of children on the ketogenic diet achieve freedom from seizures, and many are able to reduce the use of anticonvulsant drugs or eliminate them altogether. Commonly, at around two years on the diet, or after six months of being seizure-free, the diet may be gradually discontinued over two or three months. This is done by lowering the ketogenic ratio until urinary ketosis is no longer detected, and then lifting all calorie restrictions. This timing and method of discontinuation mimics that of anticonvulsant drug therapy in children, where the child has become seizure free. When the diet is required to treat certain metabolic diseases, the duration will be longer. The total diet duration is up to the treating ketogenic diet team and parents; durations up to 12 years have been studied and found beneficial.
Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often there is no initial fast (fasting increases the risk of acidosis and hypoglycaemia and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size but alter the ketogenic ratio from 2:1 to 4:1.
Rothenberg offers a more realistic approach to weight loss by recommending a balance of healthy carbs, lean protein, and healthy fat for every meal. Finally, she suggests, “Eat when you are hungry and stop when you are full. I personally am an intuitive eater. I eat when I am hungry and I stop when I am full, and I eat foods that make me feel good. When I try to feel good, I end up making healthier food choices as opposed to when I am in ‘diet mode.’”
The military diet is a restrictive three-day plan—a concept that’s nothing new in the health industry. That may explain why the originator of the military diet is unknown—it’s not a unique diet. The three-day diet concept “has been dressed up differently and brought out to dance before,” writes Kimberly Gomer, RD, director of nutrition at Pritikin Longevity Center, at the DailyBurn.com.
"When going out for fast food, I used to get the large-size value meal. Now, I satisfy a craving by ordering just one item: a small order of fries or a six-piece box of chicken nuggets. So far, I've shaved off 16 pounds in seven weeks, and I'm on track to being thinner than my high school self for my 10-year reunion later this year." —Miranda Jarrell, Birmingham, AL