Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often, no initial fast is used (fasting increases the risk of acidosis, 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.[9]
“This seems like a fairly intense means of exercise – so perhaps not for those unfamiliar with exercise. Having guidance in the gym, and working out with others can be very motivating – this is an important concept to understand. If new to exercise you can certainly find this environment with more options for beginners,” says Anthony Dugarte MD about Kinobody’s intensity.