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Symptom scores were stable in both groups during this phase, indicating 45 days of a very-low-carbohydrate ketogenic diet followed by 45 days of a low-glycemic and insulinemic diet had a lasting benefit that could not be achieved by 90 days on a low-glycemic and insulinemic diet

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People following vegetarian or vegan diets may also need a more reliable source, since B12 is primarily found in animal products