Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.
Choose lower-fat dairy products, leaner meats and alternatives, and foods prepared with little or no fat. Shop for low fat (2% or less) or fat-free products such as milk, yogurt, and cottage cheese. Eat smaller portions of leaner meats, poultry, and fish; remove visible fat from meat and the skin from poultry. Limit the use of extra fat like butter, margarine, and oil. Choose more peas, beans, and lentils
If the diet is a quick fix rather than one that promotes lasting lifestyle changes, this could pose a problem. In particular, extreme diets that promise big weight loss up front aren’t always sustainable — and you may end up overeating or even binge eating if you feel deprived. “Consider if the diet’s habits are ones you can continue throughout your lifetime, not just 21 or 30 days,” says Angie Asche, RD, a sports dietitian in Lincoln, Nebraska.
While we've all heard that running shoes break down after logging lots of miles (about 300 to 350), you may still be holding on to your fave pair. (They fit just right! They're so cushy!) Not a good idea. "Glue has a tendency to break down under ultraviolet light, as do the other materials that make up the shoe," says Andrew Kastor. So even if your sneaks have only 150 miles on them but are more than two years old, recycle them (try oneworldrunning.com or recycledrunners.com), because chances are they've already started deteriorating. And as a rule of thumb, always keep tabs on how many miles you've logged on them—tedious, but hey, you'll be proud of how far you've gone.
If you're losing weight but not as fast as you'd like, don't get discouraged. Dropping pounds takes time, just like gaining them did. Experts suggest setting a realistic weight loss goal of about one to two pounds a week. If you set your expectations too high, you may give up when you don’t lose weight fast enough. Remember, you start seeing health benefits when you've lost just 5%-10% of your body weight.