What is the keto 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.

How does the keto diet work?

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.

Is the keto diet safe?

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.

How can a keto diet be beneficial?

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.

What are some other benefits of keto?

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.

What is a ketogenic ratio?

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.

What does the ketogenic ratio mean?

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.

What is ketosis?

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.

What is nutritional ketosis?

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.

How can nutritional ketosis be achieved?

Nutritional ketosis can be induced by following a ketogenic diet.

What is the LCHF 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.

What is VLCD?

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

What is a high calorie diet?

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.

What is meal replacement?

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.

What is intermittent fasting?

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.

What are medical foods?

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.

What is ketoacidosis?

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.

What kind of seizures can the ketogenic diet help manage?

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.

What is the “Keto Flu?”

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.  

Can I consume any sugar on a ketogenic diet?

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.

Does keto raise your cholesterol?

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

What is “keto breath”?

“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.

What is “keto crotch”?

“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.

Is the keto diet anti-inflammatory?

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.

Is the keto diet hard to follow?

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.  

Is keto good or bad for athletes?

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.

Is the keto diet sustainable?

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.

What should I do to be successful on the keto 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.

What is obesity management?

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

What does it mean to have food as medicine?

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

What is positive energy balance?

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

How can the ketogenic diet help patients with cancer?

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.

How can the ketogenic diet help patients with Alzheimer’s disease?

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.


What is BHB?

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.

What are MCTs?

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.


How do I order 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.

How do the meals come?

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.

What’s the best way to heat the meals?

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.

Can I customize a meal on your menu?

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.”

Are the meals Organic and/or Non-GMO?

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.

When do you ship?

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

Which states are outside of your delivery area?

New Mexico

What are your shipping options?

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

How do I know if my meals are good to eat on arrival?

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

Why can’t I place an order where I live?

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

Is your packaging eco-friendly?

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.

What quality standards are kept at your facility?

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.

What is your Refund and Return Policy?

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


What is a medical food?

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.

How are medical foods different from other foods, dietary supplements, and drugs?

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.

Why do I need my doctor to complete a form before I can order trumacro™ ketogenic medical foods?
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: