Individuals with rare inborn errors of metabolism preventing digestion of protein or fat are diagnosed at birth and aware of their dietary restrictions.

“if someone has one of these conditions they know they have it because they were diagnosed either in the womb or shortly after birth they've been to a pediatric geneticist they've been to a pediatric endocrinologist they and they they were in the hospital off and on while they were a baby because until they we you know until the doctors figured out oh you've got a you've got one of these inborn errors you can't digest this or that or the other and so we're gonna have to give you this special diet so these people know who they are they already know they can't eat the protein of the fat of keto”