Another difference between older and newer studies is that the type of patients treated with the ketogenic diet has changed over time. When first developed and used, the ketogenic diet was not a treatment of last resort; in contrast, the children in modern studies have already tried and failed a number of anticonvulsant drugs, so may be assumed to have more difficult-to-treat epilepsy. Early and modern studies also differ because the treatment protocol has changed. In older protocols, the diet was initiated with a prolonged fast, designed to lose 5–10% body weight, and heavily restricted the calorie intake. Concerns over child health and growth led to a relaxation of the diet's restrictions. Fluid restriction was once a feature of the diet, but this led to increased risk of constipation and kidney stones, and is no longer considered beneficial.
The ketogenic diet is usually initiated in combination with the patient's existing anticonvulsant regimen, though patients may be weaned off anticonvulsants if the diet is successful. Some evidence of synergistic benefits is seen when the diet is combined with the vagus nerve stimulator or with the drug zonisamide, and that the diet may be less successful in children receiving phenobarbital.
Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer. A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.
Advocates for the diet recommend that it be seriously considered after two medications have failed, as the chance of other drugs succeeding is only 10%. The diet can be considered earlier for some epilepsy and genetic syndromes where it has shown particular usefulness. These include Dravet syndrome, infantile spasms, myoclonic-astatic epilepsy, and tuberous sclerosis complex.
Grazing between meals used to be on the weight-loss hit list. But nutritionists now know that it's better to satisfy a craving with healthy grub than ignore it and risk a junk-food binge later. The best picks are filling, protein-packed snacks, such as one stick of string cheese, a tablespoon of peanut butter on a piece of fruit, or a medium-size bowl of edamame.
This way of doing intermittent fasting involves fasting from dinner to dinner (or lunch to lunch). If you eat dinner on day 1, you would skip the next day’s breakfast and lunch and eat dinner again on day 2. This means that you are still eating daily, but only once during that day. This would generally be done two to three times per week. Learn more
In the United States, intermittent fasting has become a trend among Silicon Valley companies. According to NHS Choices as of 2012, people considering the 5:2 diet should first consult a physician, as fasting can sometimes be unsafe. A news item in the Canadian Medical Association Journal expressed concern that promotional material for the diet showed people eating high-calorie food, such as hamburgers and chips, and that this could encourage binge eating since the implication was that "if you fast two days a week, you can devour as much junk as your gullet can swallow during the remaining five days".
The Mayo Clinic Diet is the official diet developed by Mayo Clinic, based on research and clinical experience. It focuses on eating healthy foods that taste great and increasing physical activity. It emphasizes that the best way to keep weight off for good is to change your lifestyle and adopt new health habits. This diet can be tailored to your own individual needs and health history — it isn't a one-size-fits-all approach.