We demonstrated that therapeutic ketosis could be induced without dietary (calorie or carbohydrate) restriction and that this acute elevation in blood ketones was significantly correlated with a reduction in blood glucose (Figs. 2, ​,33 and ​and4).4). The BMS ketone supplement did not significantly induce blood hyperketonemia or reduced glucose in the rats. The KE supplemented rats trended towards reduced glucose levels; however, the lower dose of this agent did not lower glucose significantly, as reported previously in acute response of mice [59]. MCTs have previously been shown to elicit a slight hypoglycemic effect by enhancing glucose utilization in both diabetic and non-diabetic patients [86–88]. Kashiwaya et al. demonstrated that both blood glucose and blood insulin decreased by approximately 50 % in rats fed a diet where 30 % of calories from starch were replaced with ketone esters for 14 days, suggesting that ketone supplementation increases insulin sensitivity or reduced hepatic glucose output [89]. This ketone-induced hypoglycemic effect has been previously reported in humans with IV infusions of ketone bodies [90, 91]. Recently, Mikkelsen et al. showed that a small increase in βHB concentration decreases glucose production by 14 % in post-absorptive health males [92]. However, this has not been previously reported with any of the oral exogenous ketone supplements we studied. Ketones are an efficient and sufficient energy substrate for the brain, and will therefore prevent side effects of hypoglycemia when blood levels are elevated and the patient is keto-adapted. This was most famously demonstrated by Owen et al. in 1967 wherein keto-adapted patients (starvation induced therapeutic ketosis) were given 20 IU of insulin. The blood glucose of fasted patients dropped to 1–2 mM, but they exhibited no hypoglycemic symptoms due to brain utilization of ketones for energy [93]. Therefore, ketones maintain brain metabolism and are neuroprotective during severe hypoglycemia. The rats in the MCT group had a correlation of blood ketone and glucose levels at week 4, whereas the combination of BMS + MCT produced a significant hypoglycemic correlation both at baseline and at week 4. No hypoglycemic symptoms were observed in the rats during this study. Insulin levels were not measured in this study; however, future ketone supplementation studies should measure the effects of exogenous ketones on insulin sensitivity with a glucose tolerance test. An increase in insulin sensitivity in combination with our observed hypoglycemic effect has potential therapy implications for glycemic control in T2D [40]. Furthermore, it should be noted that the KE metabolizes to both AcAc and βHB in 1:1 ratio [29]. The ketone monitor used in this study only measures βHB as levels of AcAc are more difficult to measure due to spontaneous decarboxylation to acetone; therefore, the total ketone levels (βHB + AcAc) measured were likely higher, specifically for the KE [14]. Interestingly, the 10 g/kg dose produced a delayed blood βHB peak for ketone supplements MCT and BMS + MCT. The higher dose of the ketogenic supplements elevated blood levels more substantially, and thus reached their maximum blood concentration later due to prolonged metabolic clearance. It must be noted that the dosage used in this study does not translate to human patients, since the metabolic physiology of rats is considerably higher. Future studies will be needed to determine optimal dosing for human patients.
and by the way! the product you’re marketing has way too much salt – it will negate the true, natural process of any keto diet. salt will make you retain water, which is exactly what you don’t want to do, if you ever really want to lose weight! and if higher than normal blood pressure is your goal, enjoy responsibly! in fact, if you lower your overall salt intake, you will shed much more water weight in the first weeks, as mentioned elsewhere.. one of the secret cheats to get you going. drinking plenty of water and frequent urination will keep you properly hydrated – just be aware when testing with urine strips, too much water will give you a lower reading. stay hydrated, stay healthy – have fun losing the weight!

There are a couple factors that will make this look much more viable and achievable. For example, if you were to skip breakfast and have your first meal at 12PM, you could eat up until 8PM. This will also mean that dinner needs to be eaten slightly earlier. But let’s not forget about the fact that if we were to combine this with the 6-10 hours of sleep that you would normally have each night, that’ll take up the majority of your fasting period. Obviously, you’re not restricted to these hours, as everyone has a different schedule. Doesn’t sound as bad as you initially thought? Well let’s make it even more enticing! During your fasting hours, and this is extremely helpful during mornings up until you can have your first meal, non-caloric beverages such as tea and coffee can help starve away those hung pangs. Just make sure you’re taking these drinks on it’s own, without any added sugar or milk. There are many variations of intermittent fasting with the most common being 16/8. But depending on your schedule, there are other options advocated such as 20/4, 22/2, and if you’re crazy enough and can eat a full day’s worth of calories in one sitting then there is also OMAD (one meal a day).


Hello! We have a section on this in our weight loss plateau post—it’s fine to use them, but be careful if you have any digestive issues as a result of them, and make sure they’re not interfering with your weight loss goals. “In addition to potentially contributing too many calories, sources of fat like coconut oil (including concentrated supplements) contain medium chain triglycerides (MCT). These cannot be stored in body fat, meaning that whatever is consumed has to be promptly burned for energy. So you’re adding these sources on top of your dietary fat consumption for satiety, this type of fat takes priority. Often times people fall into the trap of adding supplements of coconut oil or straight up MCT oil and it ends up adding extra calories. Yes, it may raise your ketones a bit, but the overall cost may impact your weight loss.”
The liver is always producing ketones to some small degree and they are always present in the bloodstream. Under normal dietary conditions, ketone concentrations are simply too low to be of any significant benefit. A ketogenic diet and exogenous ketone supplements will increase the amount of ketone in your body. The idea that  ketones are “toxic” is ridiculous. Ketones are a normal physiological substance that play many important roles in the human body.
Keep these studies in mind as your body tries to play tricks on you during your first day of fasting.  Even after three days of fasting, health complications are highly unlikely. However, it is important to know about the possible issues that can be caused by fasting. If you choose to incorporate fasting into your daily diet, you typically want to eat every day as well. Occasionally going on a longer period of fasting.
A typical serving of racemic ketone salts contains around 12g of beta hydroxybutyrate, of which only half is the D- form (6g). Compared to the 40g ketone esters I consumed (which are 100% D- form), I would need to consume somewhere around seven to nine packets of ketone salts to get the same amount of D-β-hydroxybutyrate (some D- form is wasted burning of the L- form), along with the huge amount of salts contained and more than a gallon of water (since the powders must be mixed). Even if one could consume that amount of ketone salts, they will probably suffer from what people often refer as “disaster pants” (aka diarrhea) due to the amount of salt consumed.
Baseline measurements showed no significant changes in triglycerides or the lipoproteins (data not shown). Data represent triglyceride and lipoprotein concentrations measured after 4 weeks of daily exogenous ketone supplementation. No significant change in total cholesterol was observed at 4 weeks for any of the ketone treatment groups compared to control. (Fig. 1a). No significant difference was detected in triglycerides for any ketone supplement compared to control (Fig. 1b). MCT supplemented animals had a significant reduction in HDL blood levels compared to control (p < 0.001) (Fig. 1c). LDL levels in ketone-supplemented animals did not significantly differ from controls (Fig. 1d).
Every 7 days, animals were briefly fasted (4 h, water available) prior to intragastric gavage to standardize levels of blood metabolites prior to glucose and βHB measurements at baseline. Baseline (time 0) was immediately prior to gavage. Whole blood samples (10 μL) were taken from the saphenous vein for analysis of glucose and βHB levels with the commercially available glucose and ketone monitoring system Precision Xtra™ (Abbott Laboratories, Abbott Park, IL). Blood glucose and βHB were measured at 0, 0.5, 1, 4, 8, and 12 h after test substance administration, or until βHB returned to baseline levels. Food was returned to animals after blood analysis at time 0 and gavage. At baseline and week 4, whole blood samples (10 μL) were taken from the saphenous vein immediately prior to gavage (time 0) for analysis of total cholesterol, high-density lipoprotein (HDL), and triglycerides with the commercially available CardioChek™ blood lipid analyzer (Polymer Technology Systems, Inc., Indianapolis, IN). Low-density lipoprotein (LDL) cholesterol was calculated from the three measured lipid levels using the Friedewald equation: (LDL Cholesterol = Total Cholesterol - HDL - (Triglycerides/5)) [51, 52]. Animals were weighed once per week to track changes in body weight associated with hyperketonemia.
Hi Rob thanks so much, many people experience inconclusive results from the pee strips, as the ketone concentration in our pee is a measure of ketones not being used by the body. Basically the overflow or unused ketones. As our body becomes more adapted to using ketones, there will be less in our urine. It’s tough to keep the variable constant of how hydrated you are across many pee tests. Don’t be discouraged by pee test results. We have had many times where our blood tests show 1-3mmol/dl BHB but our pee test showed no results. Definitely keep testing (consider using a precision Xtra) and changing the dose to suit your needs. Hope this is helpful!
Ketone Esters: These are not normally found in the body, but exogenous ketone esters convert into BHB once it is in the body. They are also synthetically (lab) made compounds that link an alcohol to a ketone body, which can then be metabolized by the liver into a ketone. They are like ketone salts on steroids as they have 5-10 time more BHB per serving/maximum daily intake than ketone salts. To date, pure ketone esters have been very expensive to produce and have only been available to researchers, elite athletes (Tour de France cyclists), and the US Department of Defense (people have spent more than $20,000 to have an independent lab produce a single serving!).

Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...


Ketōnd discloses everything right there on their label so you know EXACTLY what you are getting. I have tried numerous ketone supplements and I can tell you I was not surprised that Ketōnd gave me more energy, mental clarity and improved my training more than any other ketone supplement. But take a few minutes and look at the product comparisons. You will see that Ketōnd has more ketones per serving and comes in at a fraction of the cost of every other product out there.
We designed a test for each of the chosen benefit claims and enlisted the help of four of our Diet Doctor teammates to try out the supplements and go through the testing. They were Jonatan and Giorgos from the video team, Emőke from the recipe team and Erik from the IT team. We had a mix of people who were naturally in endogenous ketosis during testing, and people who were not.
Ketone supplementation did not affect the size of the brain, lungs, kidneys or heart of rats. As previously mentioned, the rats were still growing during the experimental time frame; therefore, organ weights were normalized to body weight to determine if organ weight changed independently to growth. There could be several reasons why ketones influenced liver and spleen weight. The ratio of liver to body weight was significantly higher in the MCT supplemented animals (Fig. 5). MCTs are readily absorbed in the intestinal lumen and transported directly to the liver via hepatic portal circulation. When given a large bolus, such as in this study, the amount of MCTs in the liver will likely exceed the β-oxidation rate, causing the MCTs to be deposited in the liver as fat droplets [94]. The accumulated MCT droplets in the liver could explain the higher liver weight to body weight percentage observed with MCT supplemented rats. Future toxicology and histological studies will be needed to determine the cause of the observed hepatomegaly. It should be emphasized that the dose in this study is not optimized in humans. We speculate that an optimized human dose would be lower and may not cause hepatomegaly or potential fat accumulation. Nutritional ketosis achieved with the KD has been shown to decrease inflammatory markers such as TNF-α, IL-6, IL-8, MCP-1, E-selectin, I-CAM, and PAI-1 [8, 46], which may account for the observed decrease in spleen weight. As previously mentioned, Veech and colleagues demonstrated that exogenous supplementation of 5 mM βHB resulted in a 28 % increase in hydraulic work in the working perfused rat heart and a significant decrease in oxygen consumption [28, 41, 42]. Ketone bodies have been shown to increase cerebral blood flow and perfusion [95]. Also, ketone bodies have been shown to increase ATP synthesis and enhance the efficiency of ATP production [14, 28, 40]. It is possible that sustained ketosis results in enhanced cardiac efficiency and O2 consumption. Even though the size of the heart did not change for any of the ketone supplements, further analysis of tissues harvested from the ketone-supplemented rats will be needed to determine any morphological changes and to understand changes in organ size. It should be noted that the Harlan standard rodent chow 2018 is nutritionally complete and formulated with high-quality ingredients to optimize gestation, lactation, growth, and overall health of the animals. The same cannot be said for the standard American diet (SAD). Therefore, we plan to investigate the effects of ketone supplements administered with the SAD to determine if similar effects will be seen when the micronutrient deficiencies and macronutrient profile mimics what most Americans consume.
Intermittent fasting is using the same reasoning – instead of using the fats we are eating to gain energy, we are using our stored fat. That being said, you might think it’s great – you can just fast and lose more weight. You have to take into account that later on, you will need to eat extra fat in order to hit your daily macros (the most important thing). If you’re overeating on fats here, you will store the excess.
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Given that blood βHB after identical ketone drinks can be affected by factors such as food or exercise (Cox et al., 2016), the accuracy of tools for non-invasive monitoring of ketosis should be investigated. Breath acetone and urinary ketone measurements provide methods to approximate blood ketosis without repeated blood sampling (Martin and Wick, 1943; Taboulet et al., 2007). However, breath acetone did not change as rapidly as blood βHB following KE and KS drinks. Acetone is a fat-soluble molecule, so may have been sequestered into lipids before being slowly released, resulting in the differences observed here. Similarly, significant differences in blood d-βHB between study conditions were not reflected in the urinary d-βHB elimination. As the amount of d-βHB excreted in the urine (≈0.1–0.5 g) represented ~1.5% of the total consumed (≈23.7 g), it appears that the major fate of exogenous d-βHB was oxidation in peripheral tissues. These results suggest that neither breath acetone nor urinary ketone measurements accurately reflect the rapid changes in blood ketone concentrations after ketone drinks, and that blood measurement should be the preferred method to quantitatively describe ketosis. That said, it should be noted that although commercial handheld monitors are the most practical and widely available tool for measuring blood ketones, they can overestimate blood D-βHB compared to laboratory measures (Guimont et al., 2015) and these monitors do not measure L-βHB and so may not provide accurate total blood ketone concentrations, especially if a racemic ketone salt has been consumed.
Exogenous ketones are also for those just looking to try it out. It lets anyone be able to access ketones simply by consuming these exogenous forms of ketones. Technically, MCTs are not an exogenous ketone such as BHB salts. They’re not ketones. But they readily convert into ketones. So MCT oils and powders are a great source of endogenous ketones. The end result is similar, and thus this top 5 list includes MCT oil powders as well as BHB salts.
Core BHB™ provides pure goBHB™ in an all-natural formula with no artificial sweeteners, making ideal for those on the keto diet, athletes, and people who are health-conscious. Even if you’re on a high-carb diet, Core BHB™ will rapidly elevate blood ketone levels and help your body enter a state of ketosis (often with 30 minutes of consumption). In turn, you will experience increases in energy, fat loss, endurance, and mental acuity. With regular use of Core BHB™, you can also speed up the transition from a higher-carb diet to the ketogenic diet and reduce symptoms of the “keto flu”.
Those of you who have tried this form of weight loss before are probably more than aware of how hard it can be to first get your body to adapt to such a dramatic change in your daily intake of food, let alone without the help of a single exogenous ketone supplement. And the situation isn’t made any easier if you use a poor quality ketosis supplement because the wrong ketone product may actually do you more harm than good.
Divided attention involves processing multiple streams of information. The game involves observing a pond full of koi fish swimming around, and tapping each fish only once to feed it a pellet without feeding any fish previously fed. Each level adds more fish with increasing speed and redirection. It’s similar to pretending to be an air-traffic controller who must keep track of every plane on their radar.
That’s not all. Though Prüvit in particular has a legion of fans (the brand has nearly 35,000 Instagram followers and some 256,000 likes on Facebook) and a small team of affiliated medical experts, there’s no hard science on Prüvit or similar products. (Prevention reached out to several Prüvit experts and employees for interviews but did not receive a response.) The research page on the brand’s website does include links to legit scientific studies. But the studies are on the keto diet—not on Prüvit’s products. When it comes to research on the actual supplements, the brand’s website simply says “Human studies on finished products (underway) at various universities and research facilities.” In other words, there’s no scientific evidence available yet to show that they actually work.

Given that blood βHB after identical ketone drinks can be affected by factors such as food or exercise (Cox et al., 2016), the accuracy of tools for non-invasive monitoring of ketosis should be investigated. Breath acetone and urinary ketone measurements provide methods to approximate blood ketosis without repeated blood sampling (Martin and Wick, 1943; Taboulet et al., 2007). However, breath acetone did not change as rapidly as blood βHB following KE and KS drinks. Acetone is a fat-soluble molecule, so may have been sequestered into lipids before being slowly released, resulting in the differences observed here. Similarly, significant differences in blood d-βHB between study conditions were not reflected in the urinary d-βHB elimination. As the amount of d-βHB excreted in the urine (≈0.1–0.5 g) represented ~1.5% of the total consumed (≈23.7 g), it appears that the major fate of exogenous d-βHB was oxidation in peripheral tissues. These results suggest that neither breath acetone nor urinary ketone measurements accurately reflect the rapid changes in blood ketone concentrations after ketone drinks, and that blood measurement should be the preferred method to quantitatively describe ketosis. That said, it should be noted that although commercial handheld monitors are the most practical and widely available tool for measuring blood ketones, they can overestimate blood D-βHB compared to laboratory measures (Guimont et al., 2015) and these monitors do not measure L-βHB and so may not provide accurate total blood ketone concentrations, especially if a racemic ketone salt has been consumed.


A meal high in carbohydrate and calories significantly decreased peak d-βHB by ~ 1 mM (Figure ​(Figure4A)4A) and reduced the d-βHB AUC by 27% (p < 0.001, Figure ​Figure4B).4B). There were no significant changes in d-βHB Tmax (fed = 73 ± 6 min vs. fasted 66 ± 4 min). Despite the differences in d-βHB kinetics after the meal, there were no effects of food on urinary ketone excretion (Figure ​(Figure4C),4C), plasma AcAc (Figure ​(Figure4D)4D) or breath acetone (Figure ​(Figure4E)4E) following KE ingestion. Plasma AcAc kinetics followed a similar time course to d-βHB, with the ratio of blood d-βHB: AcAc being 6:1 when KE drinks were consumed whilst fasted, and 4:1 following the meal. As observed in Study 1, breath acetone concentrations rose more slowly than blood ketone concentrations, reaching a plateau at 150 min and remaining elevated for at least 4 h (Figure ​(Figure4E4E).

If you read about ketosis in magazine or heard about it in a podcast and wanted to jump on the bandwagon, then I think you should avoid it. Remember, it is a strict diet, and the potential health downsides may not be worth the upsides, unless you are working with a medical professional and or you are tracking your labs to see what’s going on with your health (thyroid).

Even though there is mixed evidence regarding the association between calcium supplementation and cardiovascular events, there may be other reasons to avoid high calcium supplementation. In one of his studies, Dr. Bolland claimed that calcium supplements do not prevent hip fractures. Rather, they may lead to kidney stones, acute gastrointestinal events, and increased risk of myocardial infarction and stroke. Thus, the risks involved with high-calcium supplementation potentially outweigh the benefits[21].
International Patent # PCT/US2014/031237, University of South Florida, D.P. D’Agostino, S. Kesl, P. Arnold, “Compositions and Methods for Producing Elevated and Sustained Ketosis”. P. Arnold (Savind) has received financial support (ONR N000140610105 and N000140910244) from D.P. D’Agostino (USF) to synthesize ketone esters. The remaining authors have no conflicts of interest.
It's also a smart idea to start slowly with this supplement. We can thank Dave Asprey for the term “disaster pants” which has been used by those who try MCT oil at too high a dose when they first start using it. There is a chance that you can experience the same unpleasant gastrointestinal effect with exogenous ketones if you start with too high a dose, or if you maintain a higher carbohydrate diet while using this supplement. Used in appropriate doses, it gets absorbed through your stomach into your liver, then sent out to the rest of your body.
Think about it like building muscle, good supplements can enhance your results, but if you don't eat right and exercise, supplements are just useless. You can't just sit on the couch to watch TV, eat potato chips all day and drink some supplements and expect to gain muscle. A supplement is not a miracle. It's just an addition and before you add it to your diet, you need to get the basics right first, which is dieting and exercise in the case of building muscles. The supplements are not going to lift the heavy weights for you. You do!
Participants refrained from alcohol and caffeine for 24 h prior to each visit AND were asked to consume a similar meal the night before each visit. All studies were carried out at the University of Oxford Human Physiology Laboratories and started at 0800 h following an overnight (>8 h) fast, with a minimum of 72 h between visits. Visit order was randomized prior to commencement by an administrative investigator using a pseudo-random number generator to produce a list of combinations of visit order, which were then allocated based on order of enrolment by a different investigator.
I heard a rep from Perfect Keto on a podcast and your Exogenous Ketones. I ordered and received it the other day. I see from this article that I should not do a full scoop at once, but break it up in a day. Good to know. I had about a half scoop before I worked out this morning and could tell I had more energy. Loved that. Just curious….any ideas how long it will take me to get back into ketosis and fat burning?? (I know it depends on what I eat, but a general idea that I promise not to hold you too! (I’m actually missing having ‘keto breath!)
Anti-carcinogenic properties: Data seems to suggest that exogenous ketones are an effective anti-carcinogen. The reason behind this is that cancer cells are unable to use ketone bodies effectively, unlike most healthy tissues in the body. In fact, dietary ketone supplementation has been shown to increase survival rates of mice with systematic cancer by as much as 70%.17
In Study 2 a Student's unequal variance t-test with equal SD was used to compare urine βHB concentrations. Additionally, a linear mixed effects model was constructed to estimate partitions of variance in R, using the lme4 and blme packages (Chung et al., 2013; Bates et al., 2015). Feeding state and visit number were fixed effects in this model, and inter-participant variability was a random effect. Inter-participant variability was calculated according to the adjusted generalized R2 metric (as proposed by Nakagawa and Schielzeth, 2013), to partition variance between the fixed effects of feeding, inter-participant variability, and residual variability. The coefficient of variation for βHB Cmax and AUC were calculated using the method of Vangel (1996).
On day 29, rats were sacrificed via deep isoflurane anesthesia, exsanguination by cardiac puncture, and decapitation 4–8 h after intragastric gavage, which correlated to the time range where the most significantly elevated blood βHB levels were observed. Brain, lungs, liver, kidneys, spleen and heart were harvested, weighed (AWS-1000 1 kg portable digital scale (AWS, Charleston, SC)), and flash-frozen in liquid nitrogen or preserved in 4 % paraformaldehyde for future analysis.

Exogenous ketones can lower appetite during a fast. After an overnight fast, normal weight human subjects either drank a ketone ester supplement or a calorie-matched glucose drink. Compared to the glucose drinkers, the ketone drinkers had lower insulin, lower ghrelin, greater satiety, and less hunger. This can be useful for people trying to extend their fast who don’t want to or can’t yet deal with the hunger. You’re still taking in energy, but the metabolic profile remains similar to that of a fasted person.

Supplemental BHB’s are ideal for people new to the ketogenic way of eating. The changes that happen in your brain and body when adapting to a VLC diet are both immediate and profound. For example, our kidney’s start processing minerals salts much more efficiently. Ironically, after years of being advised to decrease our intake of salt (sodium), it turns out that for people transitioning away from the Standard American Diet (SAD diet) towards a lower carb or ketogenic diet there is actually a need to increase dietary mineral salts such as potassium, sodium, magnesium and calcium. During the process of becoming keto-adapted, it is very important to increase your intake of these essential minerals, in order to prevent the onset of unpleasant symptoms (known as “keto flu”).


I’m getting an increasing number of questions about exogenous ketones. Are they good? Do they work for performance? Is there a dose-response curve? If I’m fasting, can I consume them without “breaking” the fast? Am I in ketosis if my liver isn’t producing ketones, but my BOHB is 1.5 mmol/L after ingesting ketones? Can they “ramp-up” ketogenesis? Are they a “smart drug?” What happens if someone has high levels of both glucose and ketones? Are some products better than others? Salts vs esters? BHB vs AcAc? Can taking exogenous ketones reduce endogenous production on a ketogenic diet? What’s the difference between racemic mixtures, D-form, and L-form? What’s your experience with MCTs and C8?

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