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Keto increases renal excretion of sodium because low insulin reduces sodium reabsorption in the kidneys

Lifestyle interventions including structured dietary programmes, increased physical activity, and behavioural support remain the cornerstone of sustainable weight management and should underpin any pharmacological approach

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Short half-life suggests rapid clearance, but clinical data suggest waiting 812 weeks allows full metabolic adaptation and weight stabilization before conception attempts

However, one study described the case of a 5-year-old boy who used this diet for epilepsy and was able to continue this dietary approach after cholecystectomy without further complications [209]