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Multiple strong studies showed that the traditional means of initiating a KD for inpatients, namely with a 2448 h fast, is not more effective, whilst being associated with an increased burden of adverse symptoms, particularly in the youngest children, when compared to gradual initiation techniques and starting on a full calorie KD (64, 77)

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[2] [3] However, reduced effectiveness can have multiple causes, and patients should consult their healthcare provider rather than simply replacing the medication

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The result is that more calories get stored as fat, while at the same time, the body feels more tired