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American Pharmaceutical Association

The experts involved (11 child neuropsychiatrists, two adult neurologists, one psychologist, one pharmacologist, one pediatric endocrinologist, one representative of patients' associations, and three dietitians and clinical nutritionists) responded to a survey on current clinical practice issues and were asked to discuss controversial topics related to supplementation, long-term maintenance, transition, and a multidisciplinary approach to ketogenic dietary therapies

That said, harder does not mean impossible

With this there will be a rise in age-related health conditions including but not limited to Alzheimers disease, cardiovascular, metabolic, cancer as well as other diseases that typically double in incidence after every 5 years after 60 years old (Melzer et al., 2020)