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10.1038/srep13915 26 FeiW.ShuiG.GaetaB.DuX.KuerschnerL.LiP.et al (2008)

Some authorities (Elder et al) have stated that these different growth patterns require cellular alteration or transformation to progress to the next, more biologically aggressive phase

You can also obtain it: In small amounts from foods like spinach, broccoli, and avocados

Meals were provided through a ketogenic meal delivery service (Five One Eight Kitchen or a similar approved service), though participants could also prepare their own meals under dietitian guidance