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Huttenlocher and colleagues first demonstrated that diets containing fewer calories from lipids than a ‘classic’ ketogenic diet—around 60%–75% of calories—can induce NK if they include a high proportion of medium chain triglycerides (MCTs) (Huttenlocher, Wilbourn & Signore, 1971). Interestingly, vinegar is commonly prescribed as a ‘free food’ in ketogenic diet trials (Rother, 2007; Perez-Guisado & Munoz-Serrano, 2011; Nebeling & Lerner, 1995), and may provide an under-recognized stimulus for ketogenesis. Higher leucine (and isoleucine) concentrations result from a ketogenic diet and are related to reduced glutamate-to-GABA ratio and this might explain some of the anti-seizure activity of a ketogenic diet in epilepsy (Roy et al., 2015). The aim of this paper, therefore, is to elucidate the evidence for and against commonly applied nutritional supplements, purported to be ketogenic, to inform clinical practice in the growing field of ketogenic diets for common-use. 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