DIET

Keto is short for ketogenic. The ketogenic diet is a high-fat, adequate protein, and low-carbohydrate diet. A standard ketogenic diet follows a ratio of approximately 75% of calories from fat; 20% from protein; and 5% from carbohydrates. The ketogenic way of eating helps promote ketosis, the natural metabolic state when your body relies on ketones for fuel instead of glucose. Your body can transition to ketosis when you replace carbs with fat and protein. Medically, the keto diet ─ which is based on the principle of nutritional ketosis ─ has been used as medical nutrition therapy (MNT) to address conditions such as Angelman Syndrome and epilepsy. Other research has been examining potential new applications, such as helping people with diabetes, cardiovascular disease, and obesity. Scientists have been pointing to possible use in conditions such as Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), autism, brain cancer, headache, neurotrauma, pain, Parkinson’s disease, and sleep disorders.

The diet reprograms the body to burn fats rather than carbohydrates. Normally, carbohydrates ─ important in fueling brain function ─ contained in food are converted into glucose. This glucose is transported around the body. With few carbohydrates remaining in the diet, the liver converts fat into fatty acids and ketone bodies. The ketones are able to help the brain replace glucose as an energy source.

Yes! The keto diet is safe for medical and non-medical uses. In fact, several studies show that ketogenic medical nutrition therapy can even be used for neurological diseases, like epilepsy. For health support, a keto diet can help people achieve their weight loss goals.

A ketogenic diet is medically used for certain conditions and non-medically used to support weight loss and heart health. Getting the majority of calories from fat forces the body to use different energy pathways. Instead of using carbs for energy, the body burns fat, entering a state called ketosis. Keto has been emerging as a good nutritional alternative compared to other diets, such as Atkins or low-carb.

Keto has been emerging as a good nutritional alternative compared to other diets such as Atkins or low-carb. Potential new applications for the ketogenic diet can help people with diabetes, cardiovascular disease, and obesity. The ketogenic diet is also being tested to treat conditions such as Alzheimer’s disease, amyotrophic lateral sclerosis, autism, brain cancer, headache, neuro-trauma, chronic pain, Parkinson’s disease, and sleep disorders.

The ketogenic ratio is defined as the ratio of grams of fat to grams of carbohydrate plus protein in food. Higher ratios result in greater degrees of ketosis.

The most commonly used ketogenic ratios are 4:1 and 3:1. A 4:1 keto ratio describes a diet that is made of 4 grams of fat for every 1 gram of protein plus carbohydrate. In other words, for every 5 grams of food consumed, there are 4 grams of fat and 1 gram of protein and/or carbohydrate. Therefore, a 4:1 ketogenic diet contains 80% fat and 20% protein plus carbohydrate. Likewise, a 3:1 ketogenic diet contains 75% fat and 25% protein plus carbohydrate.

Ketosis is a metabolic state that occurs when your body begins drawing its energy primarily through ketones rather than glucose. Ketones can readily be converted into energy when transported to your body through the bloodstream. They are formed in your liver and are derived from fat, a process which accelerates when the body has few other sources of energy (like carbohydrates).Most people can enter ketosis within one to two weeks of adopting a ketogenic diet. It can be difficult to pinpoint the exact point you enter ketosis, but if you are maintaining a healthy caloric count while keeping your carb intake to a minimum (20 grams or less to start is recommended), then your body will enter this state when it runs out of glycogen stores. You can also measure your ketone levels if you want a more precise understanding.

Nutritional ketosis is a natural metabolic state in which your body adapts to burning fat rather than carbohydrates as its primary fuel. It is clinically proven to directly reduce blood sugar, improve insulin sensitivity, and reduce inflammation.

Nutritional ketosis can be induced by following a ketogenic diet.

LCHF stands for Low Carb High Fat diet. A low-carb diet is low in carbohydrates, primarily found in sugary foods, pasta and bread. Instead of carbohydrates, you eat foods rich in protein, natural fats, and vegetables.

VLCD stands for Very Low Calorie Diet. Diets with energy levels between 200 and 800 kcal/day are called very low calorie diets.

Diet that consists of food high on protein, carbohydrates, fat, vitamins, and minerals. The calories consumed per day are between 4,000 and 5,000.

Meal replacements are prepared products such as frozen entrees, canned beverages, and bars which can be used to simplify portion control, which is one of the most difficult strategies for patients to manage. Use of meal replacements in the diet has been shown to result in a 7–8% weight loss.

Intermittent fasting is a broad term that encompasses a variety of programs that manipulate the timing of eating occasions by utilizing short-term fasts in order to improve body composition and overall health. Intermittent fasting is eating within a specific feeding window and not eating the remaining hours of the day.

Medical foods are specially formulated foods intended for the dietary management of certain medical conditions with distinctive nutritional requirements, which cannot be managed by altering a normal diet. Medical foods must be uniquely formulated for particular dietary conditions created by certain diseases. Medical food must comply with manufacturing regulations and adhere to labeling practices for protection against major food allergens.

Ketoacidosis is a metabolic state associated with high concentrations of ketone bodies formed by the breakdown of fatty acids and the deamination of amino acids. The two common ketones produced in humans are acetoacetic acid and beta-hydroxybutyrate. Three common causes of ketoacidosis are alcohol, starvation, and diabetes, resulting in alcoholic ketoacidosis, starvation ketoacidosis, and diabetic ketoacidosis respectively.

The ketogenic diet is effective in treating different kinds of seizures. But this diet is typically used in the management of drug-resistant seizure disorder. The ketogenic diet is regarded as a clinically effective treatment option when the regular combination of a variety of antiepileptic drugs are ineffective.

The term “keto flu,” also known as the carb flu, was coined to describe the symptoms experienced when starting the ketogenic diet. It doesn’t affect everyone, but those who are impacted typically experience mild “flu-like” symptoms ─ fever, headache, body ache, fatigue, and chills. It is believed that these symptoms may be caused when the body transitions from a carb-burning state to a fat-burning state, or when toxins are leaving the body.  

Reduction of carbohydrates in a ketogenic diet also involves slashing sugar consumption. This means most confectionaries, sodas, other beverages, and dressing. Fortunately, artificial sugars like Stevia, Monk Fruit Sweetener, and yacon syrup serve as suitable substitutes in moderation.

A small number of people may experience increased total cholesterol on a low-carb diet. Make sure to rule out any medical or genetic condition that may cause high cholesterol levels. Strong coffee should not be a part of a ketogenic diet because it spikes cholesterol. Dietary fats ─ like those found in olive oil, avocados and nuts ─ have cholesterol lowering effects compared to saturated fats

“Keto breath” is a common side effect of eating high-fat, low-carb meals. While it might be unpleasant at first, it’s actually a sign that your body is in ketosis – the fat-burning state that is the goal of the ketogenic plan. Drinking a lot of water, chewing on fresh mint, and eating foods that increase saliva production, like celery and lemon helps clean out lingering bacteria that cause the smell.

“Keto crotch” refers to a temporary change in vaginal odor in women following the ketogenic diet. Intrinsically, it’s neither positive nor negative. It’s just a change of odor.

Yes! The ketogenic diet specifically impacts mechanisms responsible for excess, or chronic, inflammation. When the body starts burning fat instead of sugar, the body enters ketosis or a ketogenic state. These ketones in the body boast powerful anti-inflammation effects. Beta-hydroxybutyrate (BHB), present in ketogenic meals, is a strong anti-inflammatory, fending off inflammatory markers like NFkB and COX-2. BHB also activates the antioxidant pathways. BHB exerts pain and inflammation-relieving effects by keeping the COX-2 enzyme in check.

The ketogenic diet is easy for some to follow, and challenging for others. It depends on various factors, such as how well you prepare for it, and how strongly addicted to carbs you are when you start. For those who love carbs, giving them up and resisting temptation can be especially challenging. Plus, those who are used to eating a lot of carbs and processed foods are more likely to feel symptoms of the Keto Flu as their body transitions to using fat for fuel. Others find it easy to stick to the keto-approved food list and just say goodbye to carbs cold turkey. As with all diets, the level of discipline varies by individual. What is true for most people is that if you stick with keto and get through the initial transition, most people report enhanced energy, improved mental clarity, and various health benefits (e.g. weight loss, better sleep, improved metabolic markers, etc.) The ketogenic diet works best when you treat it as a permanent lifestyle as opposed to a temporary diet.  

The keto diet is good for many athletes. Many endurance athletes turn to low-carb, high-fat diets to boost their performance. In fact, endurance athletes ─ such as marathon runners and long-distance cyclists ─ might even fare better on a ketogenic diet than athletes who use short bursts of energy. Recreational athletes tend to see more consistent benefits from adopting a ketogenic diet because, on average, they have a greater emphasis on weight loss, metabolic, and health benefits.

Research shows that a long-term ketogenic diet is safe and effective. It is recommended that you treat the keto diet as a long-term or permanent lifestyle change versus a temporary diet.

The best way to be successful on the keto diet is to stick to consuming only keto-approved foods and ingredients.

We recommend following these two principles:

  1. Eat mostly protein-dense and fiber-rich whole foods
  2. Eliminate all calorically-dense processed foods from your diet

Track your health stats.

One of the best ways to stay on track is by using a calorie tracking app and a scale. By using both, you will know what you’re consuming and how you need to adjust your diet to achieve long-term success. On the keto diet, some people also track their success by measuring their ketones with ketone meters. Measuring your ketone levels can tell you whether or not you’re in ketosis, which is when your body is in fat-burning mode.

Prepare for the effects of dietary changes.

Going from a diet that doesn’t limit carbs to a ketogenic diet will cause adjustments throughout the body. Luckily, most symptoms can be cleared up by drinking plenty of water, by replenishing your electrolytes, and by consuming mineral-rich, nutrient-dense foods.

Obesity management is the process of managing progressive weight loss for people with BMI of ≥ 30 kg/m2 through diet, exercise or lifestyle modification.

Improving the individual’s nutritional status in order to benefit health and wellness or help a patient better fight their disease.

Positive energy balance occurs when the caloric value of the food intake exceeds energy loss; energy is stored, and the individual gains weight.

While researchers are currently investigating ketogenic diet’s influence in cancer therapy, results of rigorous preclinical and clinical studies performed thus far shows the ketogenic diet to be a promising and powerful option for adjuvant therapy for a range of cancers.

Research is ongoing. However, evidence from current studies show that changing the body’s energy fuel from mainly sugar towards ketones may have a significant role in brain health and in Alzheimer’s treatment. A higher number of mitochondria in brain cells is believed to help improve learning and memory abilities, leading to a better quality of life for people with Alzheimer’s disease.

PRODUCTS

BHB stands for beta-hydroxybutyrate. It’s a source of exogenous ketones and is taken to enhance ketone production, which can support a state of ketosis.

MCTs stand for medium-chain triglycerides. They are found in certain ingredients such as coconut, butter, and MCT oil. MCTs are a source of fuel for the brain and body while in ketosis because they are easily digestible and efficiently converted to ketones.

MEALS

You can order meals in packages of 5, 10, or 30. They are then shipped to your door via FedEx in an insulated package. Orders typically leave the facility on the next business day and is in transit for 2-3 business days.

The meals arrive frozen. We flash freeze our meals after production to lock in nutritional value and extend shelf life. Our meals are good for six months when kept in your freezer. Meals leave the facility frozen, packed on dry ice in a recycled, insulated box. By the time the meals arrive, they will not always be frozen solid. Immediately place the meals in the freezer. The meals can be heated straight from the freezer or you can thaw them in the refrigerator up to 36 hours before heating.

We recommend taking the meals out of the freezer a day before you plan to eat them and store them in the refrigerator. This will begin to thaw the meal and allow it to reheat more evenly. They can also be heated directly from frozen.

In order to keep costs low, all meals are made in large batches. This prevents us from making modifications to individual meals such as “no onions” or “extra protein.”

Some of our ingredients include these titles but our meals are not certified as organic or non-GMO. In our experience, the food industry misleads consumers by using trendy adjectives (Organic, All-Natural, Pasture-Raised, Grass-Fed, Non-GMO, Antibiotic Free) to sell more of their products. Some of these adjectives are not defined or strictly-enforced by the USDA or FDA, allowing producers to slap labels on their food that may or may not have any truthful substance. In-season, we are able to obtain local or organic vegetables to use in our products but out-of-season, we have to be more flexible to keep our meals priced affordably. We believe in eating food in balanced proportions, in its most natural state.

Our goal is to get you your meals as fast as possible. Our transit times are dictated by FedEx. Note, no orders can straddle a weekend as FedEx doesn’t move packages on the weekend. For example, if you live in Texas, which is a 3-day ship, we cannot ship the package Thursday-Friday or it will sit in a warehouse over the weekend. Therefore, Texas packages will only ship on Mondays, Tuesdays, and Wednesdays. You should have your order submitted 24 hours before the end of your shipping window for the week to ensure we are able to fulfill your order.

Days We Ship Residential Orders by State:

Monday – Wednesday: Maine, Minnesota, South Dakota, Iowa, Nebraska, Colorado, Kansas, Oklahoma, Texas, Wisconsin

Monday – Thursday: New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York, New Jersey, Pennsylvania, Delaware, Maryland, Virginia, West Virginia, Ohio, Michigan, Indiana, Illinois, Missouri, Arkansas, Louisiana, Mississippi, Kentucky, Tennessee, Alabama, Georgia, Florida

Monday – Friday: North Carolina, South Carolina

Alaska
Arizona
California
Hawaii
Idaho
Montana
Nevada
New Mexico
Oregon
Utah
Washington
Wyoming

All product is shipped FedEx Ground. By not offering expedited shipping, we are able to keep prices reasonable.

If you have a question about the temperature of your food upon arrival, immediately place in the freezer. Then, contact support@trumacro.com or call (336) 438-2269. While the majority of our food will arrive frozen, the product is still ok if it arrives cold.

We ship all food from the facility in Wilmington, NC. We only ship FedEx Ground within a 3-day radius from zip code 28412. If your zip code is outside this radius, the system will not let you place an order. If you have a specific request about shipping that our site will not let you process, contact us at support@trumacro.com.

We use post-recycled cardboard and plastic and encourage you to recycle (or reuse) it again. Our insulators are made from blue-jean production scraps (cut them open, it’s cool). They can be recycled with cotton clothing. We use dry ice that’s captured from “recycled” carbon dioxide that would otherwise be released into the atmosphere as a byproduct of other product manufacturing.

We are a USDA-inspected meal production company (one of very, very few). This means we have a USDA inspector on-premises at all times during production monitoring our food handling and storage procedures. This is the highest level of quality control in the food industry.

Due to the perishable nature of our product, we are unable to accept returns. In the event you receive an incorrect or damaged order, we will replace or refund the incorrect or damaged product. Please email support@trumacro.com.

MEDICAL FOODS

The Orphan Drug Act of 1988 defines a medical food as “a food which is formulated to be consumed or administered enterally (or orally) under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.” Medical foods are specially formulated and intended for the dietary management of patients with medical conditions with distinctive nutritional requirements, which cannot be managed solely by altering a normal diet. Medical foods must be used under the supervision of a licensed health care practitioner.

Medical foods differ from traditional foods in that medical foods are formulations, not “whole” foods. The ingredients in medical foods are classified by the FDA as generally recognized as safe (GRAS), dietary ingredients, or food additives. A medical food is specially formulated to meet distinctive nutritional requirements for the specific dietary management of a patient.
Medical foods are also different from dietary supplements. Medical foods are intended for patient nutrition, while dietary supplements are intended for healthy individuals ages 18 and up. Medical foods may include specific claims for a patient suffering from a medical condition, while dietary supplements may only include general health and wellness claims. Therefore, the labeling and use of the products are significantly different. Traditional foods, dietary supplements and medical foods may all contain similar ingredients, but the product formula, labeling, and intended use are very different.
Medical foods are not drugs. Medical foods are intended to improve the nutrition of a patient with distinct nutritional requirements. Drugs are the only products that can be labeled as a substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease.

Medical foods are intended to be consumed or administered enterally (or orally) under the supervision of a physician or other licensed health care practitioner (HCP). Your HCP will decide how much of the medical food you should take each day and how often. Without the HCP’s involvement, a patient may inadvertently take too much or too little of the formula. Improved nutrition can have many positive benefits on a patient’s response to their underlying illness, disease, or disorder. The HCP will take into consideration:
  • Age
  • Body weight
  • Activity level
  • Diet
  • Diagnosis and medical conditions (genetics, metabolic disorders, seizures, etc.)
  • Medications
  • Other health concerns

trumacro™ Ketogenic BHB is a medical food for the dietary management of a patient requiring a source of ketone bodies, such as certain inborn errors of metabolism and genetic disorders (fatty acid oxidation disorders; glycogen storage disease type III; 3-hydroxy-3-methylglutaryl-coenzyme A lyase deficiency; congenital hyperinsulinism). trumacro™ Ketogenic BHB + MCT is a medical food for the dietary management of a patient requiring a source of ketone bodies where medium-chain triglycerides are tolerated, and other medical conditions for which the ketogenic diet is indicated. trumacro™ ketogenic medical foods are not intended to be used as a sole source of nutrition and must be used under the supervision of a licensed health care practitioner. trumacro™ Ketogenic BHB + MCT is currently in clinical trials as a nutritional intervention for pediatric patients with Angelman syndrome (NCT03644693) and drug-resistant epilepsy (IRB#2020-3267).

trumacro™ ketogenic medical foods are intended to be used under medical supervision. Your doctor will evaluate your condition and the available clinical evidence in order to decide whether beta-hydroxybutyrate-containing medical foods should be part of your nutrition plan. There is emerging evidence that patients with certain metabolic disorders, genetic conditions, and drug-resistant seizures may benefit from nutritional ketosis and fuel from beta-hydroxybutyrate. Not all patients will benefit from improved nutrition using beta-hydroxybutyrate.

trumacro™ ketogenic medical foods contain beta-hydroxybutyrate. Upon ingestion, blood ketone levels will rise, and the patient will be in “ketosis.” Consuming beta-hydroxybutyrate-containing medical foods can be an adjunct to the ketogenic diet in order to boost ketone levels quickly. Ketones provide an alternate source of fuel for the body, which can be critical for good nutrition for patients with certain metabolic disorders, genetic conditions, and seizures. Your physician will determine what outcomes are most likely from this shift in nutrition. The goal of improved nutrition is to better equip the patient to respond to their disease which can lead to better outcomes.

Within 60-90 minutes of consuming trumacro™ ketogenic medical foods, blood ketone levels will increase, and soon thereafter, urine ketone levels will also go up. The level of ketones circulating in the body will depend on many factors including the patient’s underlying medical conditions, basal diet, amount and type of formula consumed, fasted or fed state, activity level, concurrent medications, etc. Other long-term effects of improving nutrition through ketosis will vary depending on these same factors, so it is important to work with your medical team to evaluate the effectiveness of this type of dietary approach. In patients with drug-resistant seizures, families are encouraged to give the ketogenic diet a try for at least three months in order to determine whether there will be any benefits.

trumacro™ ketogenic medical foods are intended to be used under medical supervision. Your doctor will evaluate your condition and the available clinical evidence in order to decide which beta-hydroxybutyrate-containing medical food should be part of your nutrition plan. We offer products that solely contain beta-hydroxybutyrate and others that are a combination of beta-hydroxybutyrate and medium-chain triglycerides (MCT). Not all patients can tolerate fats or MCTs and your doctor will decide whether a combination is suitable or not. We offer unflavored and flavored formulas. trumacro™ Ketogenic BHB Unflavored is not suitable for eating or drinking by mouth. The unflavored formula is very bitter and unpalatable so it is recommended for tube feeding.

trumacro™ ketogenic medical foods can be used in tube-fed patients. Your medical team will work with you to determine the best dilution for tube feeding of the chosen formula.

There are no known incremental adverse reactions for the use of Ketogenic BHB + MCT as a part of dietary intervention. Consumption of MCT and D,L-Beta-Hydroxybutyrate mineral salts are well tolerated. Reported side effects include gastrointestinal discomfort, dehydration, metabolic alkalosis, and renal stone formation. Close medical supervision is required. The trumacro™ medical food formulations contain significant amounts of the electrolytes sodium, calcium, magnesium, and potassium and, therefore, should only be used under medical supervision. These formulations may not be suitable for individuals that are sodium sensitive. Not all patients that could benefit from nutritional ketosis are able to digest/metabolize fats, so trumacro™ Ketogenic BHB + MCT is only suitable for patients that can tolerate MCT. There are certain conditions in which a ketogenic diet may be contraindicated, and, therefore, the use of ketone-containing formulations may also be contraindicated such as:
  • Beta-oxidation defects
  • Long-chain 3-hydroxyacyl-CoA deficiency
  • Medium-chain 3-hydroxyacyl-CoA deficiency
  • Carnitine deficiency (primary)
  • Carnitine palmitoyltransferase I or II deficiency
  • Carnitine translocase deficiency
  • Short-chain acyl dehydrogenase deficiency
  • Medium-chain acyl dehydrogenase deficiency
  • Long-chain acyl dehydrogenase deficiency
  • Porphyria
  • Pyruvate carboxylase deficiency

When used as a medical food for supplemental nutrition, ketogenic medical foods may impact how some drugs are metabolized. All medications should be discussed with a physician or pharmacist. Medical supervision by a physician is required.

trumacro™ ketogenic medical foods may be used in conjunction with a variety of diets (standard, low glycemic, ketogenic). Your health care professional will take into account your medical conditions and dietary regimen when deciding whether ketogenic medical foods should be part of your nutrition.

trumacro™ ketogenic medical foods are intended to be used under medical supervision. Your doctor will evaluate your condition and the available clinical evidence in order to decide which beta-hydroxybutyrate-containing medical foods should be part of your nutrition plan. We offer unflavored and flavored formulas of trumacro™ Ketogenic BHB. The unflavored formula is not suitable for eating or drinking by mouth because it is very bitter and, therefore, unpalatable. However, it is suitable for tube feeding.

Medical food labels are intended to convey nutrition information needed for a health care practitioner to determine how much of that formula should be incorporated into a patient’s diet. Medical food regulations for labels are different than those for other foods and dietary supplements; therefore, the labels are not provided in the same format.

Your health care practitioner will determine the appropriate serving size for you. That is why there is no “serving size” listed on the product label. Your HCP will consider many details that are unique for each patient when calculating a serving, including:

  • Age
  • Body weight
  • Activity level
  • Diet
  • Diagnosis and medical conditions (genetics, metabolic disorders, seizures, etc.)
  • Medications
  • Other health concerns

Try our formulation calculator here:
https://docs.google.com/spreadsheets/d/1oxgz8Ms83OpoOl-z0zPoeXzu4l5D02GB/edit#gid=37417704

Your health care practitioner will determine the frequency (how often) and duration (how long) you should consume the formulation. Your HCP will consider many details that are unique for each patient when calculating dosage duration and frequency, including:

  • Age
  • Body weight
  • Activity level
  • Diet
  • Diagnosis and medical conditions (genetics, metabolic disorders, seizures, etc.)
  • Medications
  • Other health concerns

If appropriate, your health care practitioner may suggest a household measurement conversion instead of weighing each serving. You should always consult with your HCP before changing the amount of formula you are consuming. Do not change from weighing your formula in grams to using a household measure without your HCP’s input. Some patients must weigh their formula. If household measures are appropriate, the following conversions can be used. All measures are “leveled” i.e. “one level teaspoon.”

Formula in gramsHousehold Measure
0.351/8 teaspoon
0.7 1/4 teaspoon
 1.4 1/2 teaspoon
 2.8 1 teaspoon
 5.6 2 teaspoons
 9 1 tablespoon
 35 1/4 cup
70 1/2 cup
 140 1 cup

The scoop included with each container of trumacro™ ketogenic medical foods should be used to weigh product using a gram scale if your health care practitioner has determined your serving based on grams of formula. THE SCOOP SHOULD NOT BE USED TO DELIVER A “SERVING SIZE” OF FORMULA. Your health care practitioner will determine the appropriate serving size for you. That is why there is no “serving size” listed on the product label. Your HCP will consider many details that are unique for each patient when calculating a serving. If appropriate, your HCP may suggest a household measurement conversion instead of weighing each serving. You should always consult with your HCP before changing the amount of formula you are consuming. Do not change from weighing your formula in grams to using a household measure without your HCP’s input. Some patients must weigh their formula.

Your health care practitioner will determine the appropriate serving size for you. That is why there is no “serving size” listed on the product label. Your HCP will consider many details that are unique for each patient when calculating a serving. The nutrition information on the label of trumacro™ ketogenic medical foods containers are based on 100 grams of formula. The formula is listed at the Charlie Foundation’s Keto Diet Calculator to calculate the macro- and micronutrients for a specific amount of ketogenic medical food formula. If appropriate, your HCP may suggest a household measurement conversion instead of weighing each serving.

Your health care practitioner will determine whether you should use a dietary supplement or a medical food. Medical foods are different from dietary supplements. Medical foods are intended for patient nutrition, while dietary supplements are intended for healthy individuals ages 18 and up. A medical food is specially formulated to meet distinctive nutritional requirements for the specific dietary management of a patient. Medical food labeling can include specific claims for a patient suffering from a medical condition, while dietary supplements may only include general health and wellness claims. Traditional foods, dietary supplements, and medical foods may all contain similar ingredients, but the product formula, labeling, and intended use are very different. All trumacro™ ketogenic medical foods are tested for purity and potency of every labeled macro- and micronutrient– every lot, every test, every time. A certificate of analysis is available upon request.

Silicon dioxide is a safe, widely used food ingredient that is included in small amounts in trumacro™ ketogenic medical foods in order to prevent clumping due to the humid conditions that can occur during home use.

The primary ingredients in trumacro™ ketogenic medical foods, if left unflavored, are not suitable for eating or drinking by mouth because they are very bitter and unpalatable. The flavored formulas contain naturally sourced and derived non-nutritive sweeteners, bitter blockers, and flavors.

Flavored versions of trumacro™ ketogenic medical foods contain the sugar alternative, stevia extract, and are recommended for oral feeding. The primary ingredients in trumacro™ ketogenic medical foods, if left unflavored, are not suitable for eating or drinking by mouth because they are very bitter and unpalatable. The flavored formulas contain naturally sourced and derived non-nutritive sweeteners, bitter blockers, and flavors. Many patients will have dietary restrictions which limit carbohydrate intake; thus, sugar is not used in the formulas.

No artificial sweeteners or flavors are used in any trumacro medical foods. The flavored formulas contain naturally sourced and derived non-nutritive sweeteners (stevia extract), bitter blockers, and flavors.

trumacro™ Ketogenic BHB + MCT contains milk. Trace amounts of milk proteins are present in the formula from the non-fat dry milk in MCT powder.

MCT may cause stomach discomfort to those who are new to MCT. It is possible that patients may experience some stomach discomfort or diarrhea after consuming trumacro™ Ketogenic BHB+MCT. It will be important to talk with your HCP if you experience any side effects after consuming the formula. A typical strategy to avoid any GI upset is to start at a smaller serving size, then gradually increase the amount consumed at each serving as your body gets used to digesting MCT.

Currently, samples are not available for trumacro™ ketogenic medical foods. Please contact your local patient advocacy group for upcoming events where trumacro™ will be having taste tests of the formulations. Typically, your physician or HCP will want to evaluate your response to trumacro™ ketogenic medical foods for 1-3 months before deciding whether ongoing nutritional therapy is appropriate. Thus, a sample would only provide an idea of taste, but not the patient’s response.

Patients that are enrolled in our clinical trials will have trumacro™ ketogenic medical foods for free as part of their participation in a trial. Typically, your physician or HCP will want to evaluate your response to trumacro™ ketogenic medical foods for 1-3 months before deciding if ongoing nutritional therapy is appropriate. Thus, a sample would only give an idea of taste, but not the patient’s response.

We want all of our customers to be satisfied with their experience. If the product is not meeting your expectations, please email your concerns to support@trumacro.com and our customer service team will walk you through the return process.

trumacro™ medical foods are not available outside the U.S. at this time.

COMPANY

Caregivers and patients can purchase trumacro products from select doctors and medical institutions or directly from trumacro after medical consent has been received.