Caregiver’s Guide to the

Ketogenic Dietand KetoCal®

C A R E G I V E R ’ S G U I D E T O T H E K E T O G E N I C D I E T A N D K E T O C A L ®2 1

Table of Contents

Section 1:

General Information about the Ketogenic Diet ................... 2

Section 2:

What is KetoCal®? ............................................................ 5

Section 3:

How Is KetoCal Helpful for the Ketogenic Diet? ................ 6

Section 4:

Cooking with KetoCal ....................................................... 7

Section 5:

KetoCal Nutrition Information ............................................ 8

Section 6:

Directions for Preparation, Use and Storage ................... 11

Section 7:

Ordering and Reimbursement Information ..................... 12

Section 8:

Important Contacts and Provider Notes .......................... 14

Please note that this guide is intended for caregivers in the United States only. The information included may not be accurate for caregivers outside of the US.

KetoCal should be used under medical supervision.

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Section 1: General Information about the Ketogenic Diet

What is the ketogenic diet?

The ketogenic diet is a special high-fat, low-carbohydrate diet that is used for the dietary management of seizures in children with intractable epilepsy, as well as for certain metabolic disorders, including GLUT1 Deficiency Syndrome and Pyruvate Dehydrogenase Deficiency. The ketogenic diet is strictly controlled and precisely calculated. It should only be used under close medical and nutritional supervision1.

How effective is the ketogenic diet?

Research shows that just over half of children on the ketogenic diet will have 50% or more improvement in seizures2. About 1/3 of children will have over 90% improvement in seizures and about 10-15% will become seizure-free. In addition to seizure control, the ketogenic diet has been reported to help improve sleep quality3, behavior4, and quality of life5.

What is the ketogenic ratio?

The ketogenic ratio describes the amount of fat in the diet compared to the amount of protein plus carbohydrate in the diet. The healthcare provider determines which ratio is most appropriate for the needs of each patient. The traditional ketogenic diet is usually a 4:1 ratio, however, adolescents and children under the age of 2 are sometimes started on a 3:1 ratio to allow for more protein in the diet1. A 4:1 ketogenic diet provides 4 grams of fat for every 1 gram of carbohydrate plus protein while 3:1 ketogenic diet provides 3 grams of fat for every 1 gram of

1 Kossoff EH, Freeman J, Turner Z, Rubenstein J. Ketogenic Diets: Treatments for Epilepsy and Other Disorders; Fifth Edition. Demos Health Publishing, NY, NY, 2011.2 Freeman JM, et al. The efficacy of the ketogenic diet-1998: a prospective evaluation of intervention in 150 children. Pediatrics. 1998 Dec;102(6):1358-63. 3 Hallböök T, et al. Ketogenic diet improves sleep quality in children with therapy-resistant epilepsy. Epilepsia. 2007 Jan;48(1):59-654 Hallböök T, et al. The effects of the ketogenic diet on behavior and cognition. Epilepsy Res. 2012 Jul;100(3):304-9.5 Kayyali HR, et al. Ketogenic diet efficacy in the treatment of intractable epileptic spasms. Pediatr Neurol. 2014 Mar;50(3):224-7.

carbohydrate plus protein. Another way to look at this ratio is by the percentage of calories provided by each energy source. Fat provides more calories per gram than carbohydrates and protein, so a 4:1 ketogenic diet provides 90% of calories from fat and a 3:1 ketogenic diet provides 87% of calories from fat.

How does the ketogenic diet work?

With a typical diet, the body uses mostly glucose (carbohydrate) for energy. The ketogenic diet limits the number of carbohydrates in the diet while increasing the intake of fat so that the body uses fat for energy instead.

For some patients with epilepsy, this change in the body’s energy metabolism helps manage seizures. It is still not known exactly why this change in the source of energy can reduce seizures in some patients. When the body burns fat for energy, it produces ketone bodies or “ketones”, which build up in the blood. One theory is that the ketones contribute to improved seizure control, however, its possible that there are other factors not yet known.6

For patients with GLUT1 Deficiency Syndrome or Pyruvate Dehydrogenase Deficiency, it is better understood how the diet works. With these conditions, the body is unable to properly metabolize carbohydrates, so the ketones produced by the ketogenic diet provide an alternative source of energy.

6 Kossoff EH, Freeman J, Turner Z, Rubenstein J. Ketogenic Diets: Treatments for Epilepsy and Other Disorders; Fifth Edition. Demos Health Publishing, NY, NY, 2011.

* Adapted from: Freedman MR, King J, Kennedy E. Popular diets: a scientific review. Obes Res 2001; 9(suppl 1):3S,11S,12S.

Ketogenic Diet – 4:1 RatioPercentage of Calories

Ketogenic Diet – 3:1 RatioPercentage of Calories

Typical American Diet*Percentage of Calories

87% Fat90% Fat

10%Protein+ Carb

13%Protein+ Carb

35%Fat

15%Protein

50%Carbo-

hydrate

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How long do individuals typically stay on the diet?

The ketogenic diet is usually maintained for at least 2 years if it is effective7. After this time, the healthcare provider may recommend weaning off the diet. Many children are able to come off the diet without worsening of seizures.

For patients with GLUT1 Deficiency Syndrome and Pyruvate Dehydrogenase Deficiency, the ketogenic diet is often used for a much longer period and sometimes for life8.

Which type of seizures can the ketogenic diet help manage?

The ketogenic diet can be effective for different kinds of seizures and forms of epilepsy. Research suggests that the ketogenic diet may be particularly beneficial for patients with infantile spasms, myoclonic-astatic epilepsy (aka Doose syndrome), Rett syndrome, GLUT1 Deficiency Syndrome, tuberous sclerosis complex, Dravet syndrome and children on a formula-only ketogenic diet, taken orally or through a feeding tube9.

Are there any adverse effects of the ketogenic diet?

There are side effects associated with a ketogenic diet, which is why it should only be used under medical supervision. The most commonly reported side effects are gastrointestinal disturbances such as constipation, nausea, vomiting, or diarrhea10. Consult with your child’s healthcare provider to learn more about potential side effects.

7 Martinez CC, Pyzik PL, Kossoff EH. Discontinuing the ketogenic diet in seizure-free children: recurrence and risk factors. Epilepsia. 2007 Jan;48(1):187-90.8 Veggiotti P & De Giorgis V. Dietary Treatments and New Therapeutic Perspective in GLUT1 Deficiency Syndrome. Curr Treat Options Neurol. 2014 May;16(5):291. 9 Kossoff EH, Zupec-Kania BA, Amark PE, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the international ketogenic diet study group. Epilepsia. 2009;50(2):304-317.10 Kang HC, Chung DE, Kim DW, Kim HD. Early- and late-onset complications of the ketogenic diet for intractable epilepsy. Epilepsia. 2004 Sep;45(9):1116-23.

Section 2: What is KetoCal®?What is KetoCal?

KetoCal is a family of nutritionally-complete, ketogenic medical foods for children age 1 and up with intractable epilepsy, GLUT1 Deficiency Syndrome, or Pyruvate Dehydronase Deficiency who are following a ketogenic or modified Atkins™ diet.

KetoCal comes in both a 3:1 and a 4:1 ratio, depending on the ketogenic ratio that is prescribed by the healthcare provider. It is available in vanilla or unflavored, and as a ready-to-feed liquid or an easy-to-prepare powder.

KetoCal can be taken as a drink, used as an on-the-go substitute for a meal and even used as the sole source of nutrition.* It can also be used in cooking and baking to create more palatable ketogenic recipes. KetoCal is appropriate for oral consumption or tube-feeding. KetoCal should only be used under the direction and supervision of a health care professional.

*KetoCal 3:1 can be used as a sole source of nutrition for children 1-8, Ketocal 4:1 Powder for children 1-13 and KetoCal 4:1 Liquid for children age 1-10. Older children and adults may need to supplement with certain nutrients to meet 100% of their nutritional requirements.

Product Features Benefits to you

4:1 or 3:1 ratio of fat to carbohydrates and protein

Ketogenically balanced, whether one sip or an entire serving is consumed

2 flavors to choose from Flavor and recipe options for even the pickiest eaters

Nutrient dense for children with low-energy needs

Helps meet nutritional needs with low volume

Convenient ready-to-feed liquid or easy-to-prepare powder

Choose the form that best fits your lifestyle!

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Section 3: How is KetoCal Helpful for the Ketogenic Diet?KetoCal’s ease of preparation and convenience help make the ketogenic diet more manageable for caregivers. Below are just a few of the ways that KetoCal can be helpful.

Nutritional Reassurance

KetoCal provides complete nutrition and can help fill in the nutritional gaps of the ketogenic diet. Parents can rest assured knowing that their child is getting the right ketogenic ratio and the right nutrition from KetoCal.

Help for Picky Eaters at Mealtime

We don’t have to tell you that meal-time can be challenging. KetoCal’s smooth, sweet taste and kid-friendly drink box were designed to be accepted by even the pickiest of eaters. Because it is ketogenically balanced and nutritionally complete, KetoCal makes mealtime a little less stressful for mom and dad too.

Solution for Sick Days

KetoCal can be helpful for sick days when your child is not hungry for a solid meal. Because KetoCal has a consistent ketogenic ratio, you don’t have to worry that the ratio is off if they don’t finish it.

Travel ConvenienceKetoCal is easily transported as a ready-to-drink liquid or an easy-to-prepare powder. It’s great for vacations and outings when you don’t have access to a kitchen.

Peace-Of-Mind For Meals Without Mom Or DadKetoCal is an easy meal substitute to provide at times when the usual “ketogenic chef” is unavailable. KetoCal works great for daycare, school days, babysitters and play dates!

Quick Solution for Unexpected Situations

Working late, stuck in traffic, or forgot to pack the lunch box? Keep some KetoCal on hand for unexpected situations.

Section 4: Cooking with KetoCalCooking with KetoCal adds variety and texture to create more palatable and nutritious ketogenic recipes. Visit our website, myketocal.com, to find a wide variety of ketogenic recipes, including pizzas, pancakes, muffins, smoothies, soups, and more. We even have lunch box meal ideas and a chocolate cake recipe that is perfect for keto-friendly birthdays!

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Per Per Tetra Pak Nutrients 100 mL (237 mL)

Calories 150 356

Protein, g 3.09 7.32

Carbohydrate, g 1.73 4.10

Fiber, g 1.12 2.65

Soluble, g 0.56 1.33

Insoluble, g 0.56 1.33

Fat, g 14.8 35.1

Saturates, g 2.2 5.2

Monounsaturates, g 8.3 19.7

Polyunsaturates, g 3.7 8.8

Linoleic Acid, mg 3228 7650

a-Linolenic Acid, mg 313 741

DHA, mg 55 131

ARA, mg 55 131

Vitamins

Vitamin A, IU (mcg R.E.) 264 (79.2) 626 (188)

Vitamin D, IU (mcg) 92.0 (2.3) 220 (5.5)

Vitamin E, IU (mg a T.E.) 2.3 (1.5) 5.5 (3.6)

Vitamin K, mcg 5.6 13.3

Thiamine, mg 0.19 0.45

Riboflavin, mg 0.15 0.36

Vitamin B6, mg 0.15 0.36

Vitamin B12

, mcg 0.17 0.40

Niacin, mg 1.5 3.6

Folic Acid, mcg 28.7 68.0

Pantothenic Acid, mg 0.62 1.5

Biotin, mcg 4.1 9.7

Vitamin C, mg 9.3 22.0

Choline, mg 51.5 122

Inositol, mg 4.1 9.7

Per Per Tetra Pak Minerals, Trace Elements 100 mL (237 mL)

Calcium, mg 88.4 210

Phosphorus, mg 88.4 210

Magnesium, mg 22.7 53.8

Iron, mg 1.5 3.6

Zinc, mg 1.2 2.8

Manganese, mg 0.18 0.43

Copper, mcg 120 284

Iodine, mcg 18.5 43.8

Molybdenum, mcg 6.2 14.7

Chromium, mcg 3.2 7.6

Selenium, mcg 7.1 16.8

Sodium, mg 103 244

Potassium, mg 165 391

Chloride, mg 155 367

L-Carnitine, mg 8.3 19.7

Taurine, mg 6.3 14.9

Ingredients:Water, Refined Vegetable Oil (High Oleic Sunflower, Soy, Palm), Sodium Caseinate (Milk), Whey Protein Concentrate (Milk), Soy Fiber, Corn Starch, Inulin, CAEM (an Emulsifier), Dipotassium Phosphate, Gum Arabic, Calcium Chloride, M. Alpina Oil*, Magnesium Acetate, Potassium Chloride, C. Cohnii Oil**, Microcrystalline Cellulose, Fructooligosaccharide , L-Ascorbic Acid, Calcium Phosphate Monobasic, Mono and Diglycerides, Trisodium Citrate, Sodium Hydroxide, Choline Chloride, L-Cystine, Calcium Phosphate Dibasic, Propylene Glycol Alginate, Ferrous Lactate, L-Carnitine, Taurine, M-Inositol, L-Tryptophan, Zinc Sulfate, DL-Alpha Tocopheryl Acetate, Soy Lecithin, Niacinamide, Calcium D-Pantothenate, Manganese Sulfate, Ascorbyl Palmitate, Cupric Sulfate, Thiamine Chloride Hydrochloride, Pyridoxine Hydrochloride, Riboflavin, Vitamin A Acetate, Mixed Tocopherols, DL-Alpha Tocopherol, Folic Acid, Potassium Iodide, Chromium Chloride, Sodium Selenite, Sodium Molybdate, Phylloquinone, D-Biotin, Vitamin D3, Cyanocobalamin.

Unflavored version also contains: Sugar.

Vanilla flavored version also contains: Artificial Flavor, Sugar, Artificial Sweetener: Sucralose, Sodium Hydroxide, Choline Chloride.

*A Source of Arachidonic Acid (ARA)

**A Source of Docosahexaenoic Acid (DHA)

Nutrition Information:

Fiber is not included in calculating the ketogenic ratio.

Section 5: Nutrition InformationThe following nutrition information refers to the US versions of KetoCal products only.

Nutrients Per 100 g Per 100 mL

Calories 701 100

Protein, g 14.4 2.1

Carbohydrate, g 8.1 1.2

Dietary Fiber, g 5.3 0.75

Soluble, g 2.6 0.38

Insoluble, g 2.6 0.38

Fat, g 69.1 9.9

Saturated, g 24.9 3.6

Monounsaturated, g 20.8 3.0

Polyunsaturated, g 20.4 2.9

DHA and ARA, mg 119 17.0

Vitamins

Vitamin A, IU (mcg) 1232 (370) 176 (52.8)

Vitamin D3, IU (mcg) 420 (10.5) 59.9 (1.5)

Vitamin E, IU (mg a T.E.) 10.7 (7.2) 1.5 (1.0)

Vitamin K, mcg 26.3 3.8

Thiamine, mg 0.89 0.13

Riboflavin, mg 0.70 0.10

Vitamin B6, mg 0.70 0.10

Vitamin B12

, mcg 0.77 0.11

Niacin, mg 7.0 1.0

Folic Acid, mcg 134 19.1

Pantothenic Acid, mg 2.9 0.41

Biotin, mcg 19.1 2.7

Vitamin C, mg 43.5 6.2

Choline, mg 330 47.1

Inositol, mg 19.1 2.7

Minerals Per 100 g Per 100 mL

Calcium, mg 771 110

Phosphorus, mg 600 85.6

Magnesium, mg 106 15.1

Iron, mg 7.0 1.0

Zinc, mg 5.7 0.81

Manganese, mg 0.84 0.12

Copper, mcg 580 82.7

Iodine, mcg 86.2 12.3

Molybdenum, mcg 28.7 4.1

Chromium, mcg 14.7 2.1

Selenium, mcg 32.9 4.7

Sodium, mg 480 68.5

Potassium, mg 771 110

Chloride, mg 722 103

L-Carnitine, mg 45.0 6.4

Taurine, mg 33.0 4.7

Ingredients:Refined Vegetable Oils (Palm, Soy, Sunflower), Milk Protein (Casein, Whey), Soy Lecithin, Soy Fiber, Tricalcium Phosphate, Tripotassium Citrate, Arabic Gum, Inulin, Corn Syrup Solids, Sodium Chloride, Magnesium Acetate, Microcrystalline Cellulose, Calcium Chloride, Fructo-oligosaccharides, Corn Starch, Artificial Flavor, Calcium Lactate, L-Cystine, M. Alpina Oil*, C. Cohnii Oil**, Choline Bitartrate, L-Tryptophan, Sodium Caseinate (Milk), Silicon Dioxide, Potassium Chloride, Ferrous Sulfate, Sodium Ascorbate, LPhenylalanine, Natural Flavor, L-Valine, L-Tyrosine, L-Carnitine, Taurine, L-Ascorbic Acid, M-Inositol, Mono and Diglycerides, L-Histidine, Zinc Sulfate, Artificial Sweetener: Sucralose, DL-alpha Tocopheryl Acetate, Niacinamide, Calcium D-Pantothenate, Manganese Sulfate, Copper Sulfate, Thiamine Chloride Hydrochloride, Pyridoxine Hydrochloride, Riboflavin, Vitamin A Acetate, Folic Acid, Ascorbyl Palmitate, Mixed Tocopherols, Potassium Iodide, Chromium Chloride, Sodium Molybdate, Sodium Selenite, Phylloquinone, D-Biotin, Vitamin D

3, Cyanocobalamin.

Nutrition Information:

KetoCal® 4:1 Powder

Fiber is not included in calculating the ketogenic ratio.

KetoCal® 4:1 Liquid - Unflavored and Vanilla

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Section 6: Directions for Preparation, Usage & StorageDirections for Preparation:For oral and tube feeding:

KetoCal 3:1 and 4:1 Powders1. Measure the required amount of warm water into a container that

seals with a screw top lid. To completely dissolve the powder, the water must be at a temperature of 113-122°F (45-50°C).

2. Add the prescribed amount of KetoCal to the water.3. Cover and shake until the powder has dissolved.4. Once prepared, the formula should be stored in a refrigerator and kept

no longer than 24 hours.

Directions for Use (Powders and Liquids):1. For oral feeding, best served chilled and consumed immediately. 2. For tube feeding, hang time not to exceed

4 hours. It is recommended that the tube is flushed with lukewarm water (approximately 98°F or 37°C) between each feed.

3. Do not boil or microwave formula. 4. Do not freeze. Recommended storage between 39°F-77°F

(4°C-25°C).5. Once powdered formula is prepared or liquid formula is open, use

immediately or refrigerate promptly at 39°F/4°C or less and use within 24 hours.

Storage:

Store unopened product in a cool, dry place and away from sunlight.

KetoCal 3:1 and 4:1 Powders: Once can has been opened, reseal and store in a cool, dry place (not in a refrigerator) and use within one month.

Nutrients Per 100 g Per 100 mL*

Calories 699 100

Protein, g 15.3 2.2

Carbohydrate, g 7.2 1.0

Fat, g 67.7 9.7

Linoleic Acid, mg 12700 1817

a-Linolenic Acid, mg 1481 212

DHA, mg 116 16.6

AHA, mg 116 16.6

Vitamins

Vitamin A, IU (mcg RE) 1748 (525) 250 (75.1)

Vitamin D, IU (mcg) 508 (12.7) 72.7 (1.8)

Vitamin E, IU (mg a TE) 11.8 (7.9) 1.7 (1.1)

Vitamin K, mcg 55.9 8.0

Thiamine, mg 0.89 0.13

Riboflavin, mg 0.70 0.10

Vitamin B6, mg 0.70 0.10

Vitamin B12, mcg 1.4 0.20

Niacin, mcg 4900 701

Folic Acid, mcg 140 20

Pantothenic Acid, mg 2.8 0.40

Biotin, mcg 13.9 2.0

Vitamin C, mg 84.0 12.0

Choline, mg 180 25.8

Inositol, mg 153 21.9

Minerals Per 100 g Per 100 mL*

Calcium, mg 760 109

Phosphorus, mg 510 73.0

Magnesium, mg 95.0 13.6

Iron, mg 10.9 1.6

Zinc, mg 7.4 1.1

Manganese, mcg 570 81.5

Copper, mcg 760 109

Iodine, mcg 124 17.7

Molybdenum, mcg 31.3 4.5

Chromium, mcg 26.2 3.7

Selenium, mcg 18.9 2.7

Sodium, mg 287 41.0

Potassium, mg 900 129Chloride, mg 440 62.9

L-Carnitine, mg 50.0 7.2

Taurine, mg 48.0 6.9

Ingredients:Refined Vegetable Oils (Palm, Soy, Sunflower), Milk Protein (Casein, Whey), Lactose (Milk), Tricalcium Phosphate, Tripotassium Citrate, Corn Syrup Solids, Potassium Chloride, Calcium Phosphate Dibasic, Magnesium Acetate, Choline Bitartrate, L-Cystine, M. Alpina Oil*, C. Cohnii Oil**, L-Tryptophan, M-Inositol, Ferrous Sulfate, Sodium Caseinate (Milk), Sodium Chloride, Sodium Ascorbate, L-Ascorbic Acid, L-Carnitine, Taurine, Mono and Diglycerides, Zinc Sulfate, DL-alpha Tocopheryl Acetate, Niacinamide, Soy Lecithin, Calcium D-Pantothenate, Cupric Sulfate, Manganese Sulfate, Thiamine Chloride Hydrochloride, Pyridoxine Hydrochloride, Riboflavin, Vitamin A Acetate, Potassium Iodide, Folic Acid, Ascorbyl Palmitate, Mixed Tocopherols, Chromium Chloride, Sodium Molybdate, Phylloquinone, Sodium Selenite, D-Biotin, Vitamin D

3, Cyanocobalamin.

*A Source of Arachidonic Acid (ARA)

**A Source of Docosahexaenoic Acid (DHA)

Nutrition Information:

*Standard Dilution = 30 kcal/fl oz

KetoCal® 3:1 Powder

Mixing Guide:

KetoCal 4:1 PowderDilution to be determined by medical prescription:Dilution Powder Water Final Volume Osmolality20 kcal/fl oz 9.5 g 91 mL 100 mL 110 mOsm/kg24 kcal/fl oz 11.4 g 89 mL 100 mL 130 mOsm/kg30 kcal/fl oz 14.3 g 86 mL 100 mL 170 mOsm/kg45 kcal/fl oz 21.4 g 79 mL 100 mL 260 mOsm/kg

A gram scale is necessary for proper preparation of formula.

KetoCal 3:1 PowderDilution to be determined by medical prescription:Dilution Powder Water Final Volume Osmolality20 kcal/fl oz 9.5 g 90 mL 100 mL 100 mOsm/kg24 kcal/fl oz 11.4 g 89 mL 100 mL 120 mOsm/kg30 kcal/fl oz 14.3 g 86 mL 100 mL 150 mOsm/kg45 kcal/fl oz 21.4 g 79 mL 100 mL 240 mOsm/kg

A gram scale is necessary for proper preparation of formula.

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Section 7: Ordering and Reimbursement/Coverage Information

Ordering and Sample Requests:

KetoCal® can be ordered directly from Nutricia directly by calling 1-800-365-7354, opt 1. In order to purchase or receive samples of KetoCal, the patient’s healthcare provider must complete a Sample Authorization Request and Consent Form and fax it to Nutricia at 1-301-795-2292.

KetoCal can also be purchased through pharmacies, medical supply companies and home care companies.

Packaging Information and Product Codes:

KetoCal 4:1 Liquid Vanilla

Product Code Reimbursement Code Packaging HCPCS Code

80180 – Vanilla 49735-0187-96 27 x 237 mL (8 fl oz) B4154

KetoCal 4:1 Liquid Unflavored

Product Code Reimbursement Code Packaging HCPCS Code

80183 – Unflavored 49735-0130-54 27 x 237 mL (8 fl oz) B4154

KetoCal 4:1 Powder

Product Code Reimbursement Code Packaging HCPCS Code

82286 49735-0166-70 6 x 300 g (11 oz) B4154

KetoCal 3:1 Powder

Product Code Reimbursement Code Packaging HCPCS Code

16672 49735-0166-72 6 x 300 g (11 oz) B4154

Reimbursement & Coverage:

KetoCal may be covered by insurance, Medicaid, or WIC, especially when used as a sole or main source of nutrition. KetoCal may also be covered through the National School Lunch Program.

We understand the challenges patients and caregivers encounter when attempting to obtain coverage for medical foods like KetoCal. That’s why we are happy to provide the Nutricia Product Coverage Navigator. This program provides assistance with:

• Obtaining prior authorization for any and all Nutricia products

• Answering questions regarding claims submissions

• Drafting letters of medical necessity

• Instructions on how to correct billing errors

• Working with the insurance company on complex reimbursement matters

• Appealing a denied claim

• ….And much, much more

To contact the Nutricia Product Coverage Navigator program, call 1-800-365-7354 extension 1200 or email NutriciaNavigator@nutricia.com. Learn more online at www.nutricia-na.com/NutriciaNavigator.

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Section 8: Important Contacts and Provider Notes

KetoCal® Nutrition Services Helpline:

Phone number: .............................................................................

E-mail address: .............................................................................

Dietitian:

Name: ..........................................................................................

Phone number: .............................................................................

E-mail address: ............................................................................

Neurologist:

Name: ..........................................................................................

Phone number: .............................................................................

E-mail address: ............................................................................

Healthcare Provider Notes:

Mixing Instructions for ________________________________ (patient name)

(To be determined by the healthcare provider)

Mix _____________________ (amount of powder or liquid) of

________________________________ (specific product

name) with __________ (volume) of water. This amount

should be given __________ times per day.

Important:

• When preparing KetoCal Powder (3:1 or 4:1), the temperature of the water should be between 113-122°F (45-50°C) to mix properly. A kitchen thermometer can be used to measure the temperature of the water.

• A gram scale should be used to ensure accurate measurement of KetoCal.

1-800-365-7354, Option 2

NutritionServices@Nutricia.com

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Notes: Notes:

TO PLACE AN ORDER:

www.myketocal.com

US: (800) 365-7354

Caregiver’s Guide to the

Ketogenic Dietand KetoCal®

www.ketoconnect.com

www.facebook.com/KetoCal

www.youtube.com/user/KetoCalUS

twitter.com/KetoCalUS

www.pinterest.com/KetoCalUS

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© 2015 Nutricia North America. All rights reserved.

KetoCal is a registered trademark owned by SHS International Ltd. Nutricia is a registered trademark of N.V. Nutricia.

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