Can I mix with just water? Can I use low-carb milk/almond milk instead of cream?

You can, yes. If your goal is a ketogenic lifestyle, we generally don’t recommend it unless you have a specific reason for doing that. Without added fat, you should be aware certain vitamins (A, D, K) are fat soluble and so may not be absorbed, and your Keto Chow will not be as filling, meaning it will just be a snack and not a meal. We generally only recommend doing this if you are doing something specific like a Protein-Sparing Modified Fast (PSMF) and only for a short period of time. What we are trying to avoid is people not using fat because they still have the mentality that fat is bad and needs to be avoided.