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Dear patient,
You have been diagnosed with a cancer disease and you decided to change your diet in compliance with the TKTL1 nutritional therapy in addition to traditional therapies. We encourage you to do so since experience has shown us that it is always positive to be active and to do something for oneself and against the cancer. The present brochure will explain the exact procedure for the change in diet to you. We advise you to quite consistently follow the recommendations and daily plans so that the hoped-for success can be reached. At the beginning, we will explain to you on which observations and discoveries the TKTL1 nutritional therapy according to Dr. Coy is based. For your better understanding, we will describe the relevant metabolic functions, explain which biochemical reactions take place in tumour cells and which chances there are in an interaction of nutrition and conservative treatments such as chemotherapy and radiotherapy. In doing so, we wish to inform you as a patient so that you get the necessary knowledge in order to be able to assess what TKTL1 nutritional therapy means for you. As an informed patient, you can better use scientific advances for you and you are able to make decisions yourself and to act according to them. We would like to be sure to point out that the TKTL1 nutritional therapy does not yet form part of the recommendations of nutritional science. The approach is specifically aimed at the metabolism of aggressive cancer cells or metastases showing TKTL1 enzyme activity. The change in diet can be recommended: - when there are aggressive, invasive tumours with metastases - when the test of a biopsy or tissue sample for the enzyme TKTL1 is positive We will be glad to provide you with a list of laboratories where your tumour can be examined by means of a test for TKTL1 enzyme activity.
Full of hope, we accompany and support you in the fight against cancer. You are not alone, you have a large number of allies! Best wishes for a favourable course of your disease, Your TAVARLIN Team TAVARLIN AG Heidelberger Landstr. 190 64297 Darmstadt Germany Phone: ++49-6151-950 55 50 Fax: ++49-6151-950 55 51
As invasive, spreading tumours may develop from some of the non-invasive, not spreading tumours, it is of great importance to detect tumour diseases as early as possible. When a tumour disease is detected early, cancer can be cured very successfully through a treatment such as chemotherapy, radiotherapy or surgical removal of a not spreading tumour.
energy can be produced without the cells power plants the mitochondria. If the cell has enough glucose at its disposal, the cell is able to produce sufficient energy and to reproduce constantly through cell divisions thanks to the enzyme TKTL1. Large amounts of lactic acid are produced during this process.
What are the tumour cells advantages of gaining energy through fermentation?
The metabolic changes in energy production out of fermentation of glucose provide the cancer cells with selective advantages: The lactic acid (lactate) produced during the fermentation of glucose causes destruction of the surrounding tissue. This allows the tumour cells to invade the surrounding tissue and to metastasise. The deactivation of the mitochondria in cancer cells results in resistances (cells are insensitive) to a large number of chemotherapeutics. The dependence of these cancer cells on oxygen decreases drastically. They survive inadequate supply of oxygen as well (hypoxia). Cancer cells in hypoxic regions (of limited oxygen) become more insensitive to radiation therapy. These changes in the metabolism, however, also have disadvantages for the cancer cells: They depend on the supply of glucose since only glucose can be used as source of energy for fermentation. Fructose (fruit sugar) cannot be used directly for energy production. At the same time, fat burning is interrupted in such cancer cells. In terms of biochemistry, this is called inhibition of oxidation. Therefore, these cells cannot use oils or fats as source of energy any more. The TKTL1 nutritional therapy pursues the strategy of using these disadvantages for combating the cancer cell. The absolute dependence on glucose supply and the inability of exploiting oils or fats constitutes the Achilles heel of this type of cancer cell. The TKTL1 nutritional therapy takes advantage of this Achilles heel for the patients sake. The diet is changed specifically in order to supply healthy cells with sufficient energy, 5
Generally, there are two types of cancer cells: a) cancer cells that burn glucose b) cancer cells that ferment glucose Cancer cells that ferment glucose through the activation of the TKTL1 sugar metabolism instead of burning it need extremely much glucose compared to glucose-burning cells (20 30 times more). In addition, glucose-fermenting cancer cells are generally no longer able to burn fats and oils. The large quantity of required glucose and the inability of extracting energy out of fats or oils make these cancer cells vulnerable. The TKTL1 nutritional therapy is based on the newly discovered specific features of TKTL1-positive cancer cells.
Glucose is a simple sugar and component of double sugars such as table sugar (cane sugar, crystallised sugar, saccharose) and milk sugar (lactose); in addition, glucose also is the basic element of polysaccharides such as starch. Some basic foodstuffs have a high content of carbohydrates such as starch, that release glucose very fast during digestion. These foodstuffs include bread, noodles, rice and potatoes. The glucose released during digestion in the intestine is absorbed through the intestinal mucosa and delivered into the blood very quickly. Since a quick rise in the blood sugar level is very dangerous, the pancreas spills out the hormone insulin. Insulin docks to the cell wall and causes glucose to be actively taken up from the blood into the cells and the blood sugar level thus to be normalised. Insulin prevents the damage involved in excessively high blood sugar levels by means of this mechanism. If, on the contrary, the blood sugar level falls below a certain value, the hormone glucagone is spilled out which releases glucose from the glycogen stores and delivers it into the blood. These mechanisms ensure a relatively constant glucose concentration in the blood. If, however, the glycogen stores are empty, glucose will be made from amino acids, the components of the proteins. Glucose can never be made of oils or fats. This means that it is possible not to eat any carbohydrates or glucose, if you take sufficient quantities of protein. The sufficient supply of proteins ensures a sufficient blood sugar level. A diet 7
only consisting of oils or fats is not possible. This would result in death. In a diet that hardly contains any glucose or glucose-releasing carbohydrates and shows a high content of oils/fats, the glucose present in the food and the quantity of glucose made of protein is enough in order to ensure the necessary blood sugar level. In this case, however, the energy supply of the cells cannot be permanently ensured by glucose. The same situation occurs when a person is deliberately fasting or is starving due to lack of food. A regular supply of foodstuffs is a rather young achievement. During World War II, a large part of the population starved. If the human body was not adapted to such a situation, it would inevitably die. Therefore, the human body is adapted to this situation very well. If the content of glucose or glucose-releasing carbohydrates in the food decreases below a threshold value (approximately 70 g), most of the cells will change over to another supply of energy. In this case, glucose no longer is the cells principal source of energy. To be able to use the stored energy reserves in the form of fat reserves very rich in energy, most of the cells start to exploit ketone bodies, that are then the organisms source of energy. By means of this changeover, the cells are able to live on the decomposition products created in the breakdown of fats. In this case, the cells principal source of energy no longer is glucose, but the ketone bodies. Glucose is used for special purposes only. By the way, the heart always does this. It lives on these ketone bodies even in times of best glucose supply. This explains the fact why it is extremely rarely affected by cancer (heart cancer) and metastases are hardly ever developed there. The changeover to ketone bodies as main source of energy is a process for which the human body is prepared and that even is the normal condition in some tissues. By means of the TKTL1 nutritional therapy, you can gently change your body over to the use of ketone bodies as source of energy. At the same time, you are supplied with sufficient nutrients and sources of energy.
The quick rise in the blood sugar level is avoided; hardly any insulin is released anymore. After the changeover to the TKTL1 nutritional therapy, hardly any insulin is released anymore. That is why blood glucose can no longer be taken up by the tissue cells. Due to the limitation of the glucose supply, they only have the possibility to change over to ketone bodies (metabolic products that are formed during extraction of energy from fat) as source of energy. This changeover is not possible in TKTL1-positive cells since oxidation is blocked there. They cannot change over to burning ketone bodies, fats or oils like healthy cells can do. This is how TKTL1 cells are cut off from glucose supply without release of insulin. Dependence on glucose as sole source of energy constitutes the Achilles heel of this special type of cancer cell. Without energy supply or production, no cell is able to reproduce, not even a cancer cell.
Conclusion:
Even if glucose concentration in the blood remains constant, the glucose supply of the cell can be influenced decisively through a change in diet according to the TKTL1 nutritional therapy. The TKTL1-positive tumour cell is cut off from energy supply.
TKTL1 nutritional therapy may complete chemo- and radiotherapy in an ideal way
Even if a tumour tests positively for TKTL1, there are two different types of tumour cells in the tumour in most cases: TKTL1- positive and TKTL1- negative cells in varying percentage. They differ in their form of energy production. Whereas the burning cells cover their energy requirement through the respiratory chain of the mitochondria, for which they need oxygen, fermenting cells have become completely independent of this metabolism. Therapy strategies against mitochondria (power plants of the cell) or enzymes of the respiratory chain have no effect on these cells.
There is evidence suggesting that TKTL1-positive cells are insensitive to a large number of chemotherapeutic agents. If this is the case, chemotherapy may offer a selective advantage to TKTL1-positive cells. They are better supplied with glucose after the therapy - when TKTL1-positive cells have been combated effectively - and again have more space for spreading out. This is how, in the course of the disease, the ratio between TKTL1-negative and TKTL1positive cells shifts, which might explain why the response rates of chemotherapeutics worsen in the further course and the tumour-free period shortens. The prospects of recovery worsen. Therefore, TKTL1 nutritional therapy should always be applied parallel to chemotherapy if TKTL1-positive cells can be detected in tumour tissue. It is similar with radiotherapy. It is a generally known fact that the effect of radiotherapy is clearly smaller in hypoxic (not adequately supplied with oxygen) and hyperacid tissue. In the TKTL1 metabolic pathway, however, the cancer cell produces large amounts of lactic acid that form a proper acid protection around the tumour. The change in diet according to Dr. Coy de-acidifies the surroundings of the tumour through various mechanisms so that the effectiveness of radiotherapy can also be increased.
Cancer cachexia does the changed metabolic state of TKTL1positive cells explain the phenomenon of cancer cachexia?
The term of cancer cachexia describes the severe loss of weight and the emaciation of the body due to a cancer disease. In Germany for example, more than 20% of the patients do not die of the tumour itself, but from the emaciation accompanying the tumour disease. As we see it, there are two reasons for it: Cancer therapy often is associated with loss of appetite, disorders of the liver function and vomiting. As a rule, this results in a drastic loss of weight. The changed metabolic state, however, can also play a very decisive role. TKTL1positive cells take up 20-30 times more glucose than healthy cells. This is how they ensure that they get the energy they need, and the healthy cells do not get enough of it. Since the tumour does not burn the glucose using oxygen, but produces lactic acid in the fermentation process, the tumour patient permanently has to transform the lactic acid produced by the tumour cells into glucose in the liver, which requires a consider10
able amount of energy. This is a considerable strain on a cancer patients body. In addition, many patients develop a dislike for meat and fat, but a craving for sweets and carbohydrates which exactly corresponds to the needs of the cancer cells. The sugar and carbohydrates supplied, however, no longer are of benefit to the organism, since the glucose absorption of the TKTL1-positive cancer cells is 20-30 times higher than the one of healthy cells. At the end, so much energy is consumed that it is possible that the cancer patient dies of starvation or of the consequences of the changed metabolism (e.g. hyperacidity). The TAVARLIN assortment contains foodstuffs rich in energy that cannot be used by TKTL1-positive cells. This energy will then be at the disposal of the healthy cells and may prevent the threatening loss of weight.
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Two mixtures of vegetable oil: TAVARLIN Oil basis and TAVARLIN Oil addition. Both vegetable oils are selected mixtures of vegetable oils and extracts of vegetable oils that are specifically adapted to the TKTL1 metabolism. They contain bioactive substances and a high content of omega-3 fatty acids. There is more and more evidence indicating that they have a life-prolonging effect for some types of tumours. Both vegetable oil mixtures are high in energy and permit the supply energy to healthy cells without TKTL1-positive tumour cells where fat burning is blocked being able to use these oils for their energy supply. Both oils are intended for use for cold dishes and must not be heated. TAVARLIN Oil basis is particularly suitable for salad dressings, TAVARLIN Oil addition can also be stirred e.g. into curd. It is also important to consume fermented dairy products having a low content of milk sugar and a high oil/fat content. The assortment includes a TAVARLIN lactate drink made of yoghurt, selected vegetable oils and cream. This drink is intended as snack between meals. Lactic-acid bacteria are added to the milk in order to produce fermented dairy products such as yoghurt. In the TAVARLIN Lactate Drink, the bacteria have used nearly all the milk sugar, also 12
called lactose, and transformed it into lactic acid (lactate). Therefore the remaining content of carbohydrates is very low in contrast to traditional yoghurt where the fermentation process is interrupted earlier for reasons of taste. Especially fruit yoghurts are sweetened additionally using sugar and often contain more than 10 g carbohydrates/100 g. The high content of dextrorotatory lactic acid in the TAVARLIN Lactate Drink has been used successfully for a rather long period in biological cancer defence for de-acidifying the tissue (RMS drops) and presumably leads to end-product inhibition of the TKTL1 metabolism. B) Guaranteeing the energy metabolism of the healthy cells
High-quality TAVARLIN protein powder serves as source of essential amino acids and additional source of energy. It prevents the transformation of the bodys own amino acids into glucose in case of a diet low in carbohydrates. C) Products high in omega-3 fatty acids and low in carbohydrates The TAVARLIN Protein Bread is a wholemeal sourdough bread where a part of the glucose-releasing starch has already been decomposed to lactic acid thanks to bacterial fermentation of starch. The flour content of the protein bread has been clearly reduced by adding rice flakes, bran and milk protein and the protein content has been increased considerably. In addition, the protein bread is very rich in dietary fibres. 100 g of the protein bread only contain 14.1 g carbohydrates, that is only approximately a third of the quantity of carbohydrates contained in a traditional wholemeal bread. In addition, 2.2 g omega-3 fatty acids are contained. TAVARLIN hemp nuts are included in shelled form. They are used for additionally increasing the oil content in the daily food intake. They, too, contain an ideal combination of omega-3 fatty acids that are very important in terms of nutritional physiology as well as all eight essential amino acids which the human body cannot produce itself and therefore have to be supplied through food. The body can use these elements for example to produce immunoglobulins that are indispensable to defence against infections.
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Meat and sausage: Feeding and way of life of livestock have great influence on quality, composition and taste of the meat. The content of omega-3 fatty acids is considerably higher in free-range animals not fed with grain than in other animals. If you have the opportunity, always buy high-quality meat from free-range animals as often as possible. We offer TAVARLIN salami and sausage made of the meat of buffaloes from the Swabian Mountains. The meat of the buffaloes from the Swabian Mountains excels by a pleasant, discreet gamey taste, contains 40% less cholesterol and 27% less fat than beef, has a high content of protein and vitamins (rich in vitamin A and B12) and is high in omega-3 fatty acids. The high-quality buffalo meat has been processed into salami and sausage without addition of sugar or glutamate. Caution! For reasons of taste, traditional sorts of salami contain large quantities of added sugar (10-15%). Sugar is added to many sorts of sausages and cold cuts as well in order to drown the taste of the table salt added for reasons of preservation. By eating these sausages, you would consume hidden sugar and put the success of the TKTL1 nutritional therapy at risk. D) Complementary products
Basic foodstuffs naturally high in carbohydrates such as noodles as well as foodstuffs of taste appeal such as cake, jam and sweets have been produced using far less carbohydrates or using sugar substitutes. TAVARLIN protein noodles contain considerably less flour than traditional noodles. They mainly consist of whey and soybean protein as well as wheat gluten and dietary fibres. They only have 21 g carbohydrates / 100 g instead of 75 g carbohydrates / 100 g of usual noodles.
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Caution!
Please only use the products included in the TAVARLIN assortment and do not buy alternative products in the supermarket. The daily plans are designed in a way so that the allowed maximum supply of carbohydrates is achieved using the TAVARLIN products only. The consumption of other basic food (bread and noodles) and sweets (jam, chocolate, cake, chocolate hazelnut spread) would quickly exceed the daily allowed amount of carbohydrates by far and the change in diet would miss its goals and compromise the therapy.
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On account of the energy content, milk and milkshakes are already not considered to be drinks, but foodstuffs, and have to be avoided because of the (milk) sugar contained.
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Regarding the TAVARLIN products, please stick to the quantities indicated in the daily plans. These products partly contain carbohydrates, that are, however, clearly reduced compared to normally available foodstuffs. When larger quantities are eaten (e.g. four slices of bread instead of two), however, you run the risk of exceeding the daily quantity of carbohydrates allowed. The same applies to the protein noodles.
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Green list
Meat Beef Veal Lamb Pork
Sausages and cold cuts
Fish Eel Trout Shark Halibut Herring** Cod Carp Wild salmon** Ocean perch Sardine Haddock Plaice Swordfish Sole Tuna** Zander Crustaceans Shrimp Lobster Crayfish Mollusks Oysters Mussels
Vegetables Cauliflower Green beans Broccoli Aubergines Sauerkraut Fennel Slicing cucumber Kale Red cabbage White cabbage Savoy cabbage Kohlrabi Cress Celery Pumpkin Leek Chard Parsley Red radishes Brussels sprouts Olives Asparagus Spinach Tomatoes Chicory Onions Lentils Avocado Garlic Black salsify
Dairy products Cream Curd Sour cream Buttermilk Eggs Hens egg Fats + oils
Chinese cabbage Chicory Romaine lettuce Rocket Mushrooms Meadow mushrooms Chanterelles Ceps Shiitake Nuts + seeds No restriction: Linseed Poppy seed Sesame
Raw ham Cooked ham Salami* Poultry Duck Goose Chicken Ostrich meat Turkey Game Hare Deer meat Rabbit Venison Wild boar
Butter Linseed oil Rapeseed oil Hempseed oil Animal fat Cheese Full-fat cheese Camembert Edam /Gouda Emmental Parmesan
Portion corresp. to Roquefort 5g carbohydrates: Hard cheese 50 g peanuts 140 g Brazil nuts 60 g pine nuts 45 g hazelnuts 100 g coconut 120 g almonds 45 g walnuts 35 g macadamia Hand cheese Goats cheese Sheeps cheese Mascarpone Miscellaneous
Stevia, steviol glyc.
Tofu
* Be careful with sausages and cold cuts: For prolonging the shelf life, they are often salted and then sugared in order to improve the taste. ** Foodstuffs marked with two asterisks are particularly valuable and should be preferred to the other foodstuffs of the group, if possible.
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The products included in the yellow list can be consumed in addition from time to time in the corresponding quantities, if you leave out carbohydrates/sugar stated elsewhere in the daily plan.
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Red list
Amaranth Maize Drinks Alcohol (exception 1 glass of red wine) Beer Vegetable juices Pomegranate Liqueur Fruit juices, undiluted Spirits Milk
Bananas
Farinaceous food Noodles Quinoa Rice Raisins Salt sticks, biscuits Chocolate Breadcrumbs (breadcrumb coating!) Syrup Sauces, thickened Soups, thickened Sweets Tortilla Dry fruits White bread Sugar
Peas
Figs Ready-to-serve meals Biscuits and pastry Cereal products Pomegranate Honey Potatoes Chickpeas Cake
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Day 1
Breakfast 125 g curd 4 tsp. TAVARLIN Oil basis dill 80g smoked salmon Snack TAVARLIN Lunch rib of pork sauerkraut 50 -100 g TAVARLIN nut cake
Day 2
Breakfast coffee / green tea 50-100g TAVARLIN nut cake
Day 3
Breakfast 125 g curd
Day 4
Breakfast 100 g TAVARLIN protein bread
Day 5
Breakfast 125 g curd 1 tbsp. TAVARLIN hemp nuts 4 tsp. TAVARLIN Oil basis fruit,vege fruit,vege -tables Snack
4 tsp. TAVARLIN 100 g TAVARLIN Oil basis 50 g sour cream chives, red radishes slicing cucumber Snack
-tables
Snack TAVARLIN Lunch (marinated) roast red cabbage 70 g TAVARLIN protein noodles beef Lactate drink
TAVARLIN Lunch
Lactate drink
Lactate drink
Lactate drink
bacon
Snack TAVARLIN Dinner 100 g TAVARLIN protein bread butter 2 eggs, slicing cucumber 70 g blue cheese
Snack TAVARLIN Dinner 125 g curd 1 tbsp. TAVARLIN hemp nuts 4 tsp. TAVARLIN Oil basis 1 tbsp. peanuts
Snack TAVARLIN Dinner 100 g TAVARLIN protein bread buffalo sausage 1 egg 1 tomato
Snack TAVARLIN Lactate drink Dinner 125 g curd Oil basis TAVARLIN Lactate drink Dinner fried goats cheese tomatoes
Lactate drink
Lactate drink
Lactate drink
1 glass of red wine 1 glass of red wine 1 glass of red wine 1 glass of red wine
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Day 6
Breakfast 50 g TAVARLIN protein bread
Day 7
Breakfast 125 g curd 4 tsp. TAVARLIN Oil basis
Day 8
Breakfast coffee / green tea
50 - 100 g TAVARLIN nut cake
Day 9
Breakfast 125 g curd 4 tsp. TAVARLIN Oil basis Fruit, Fruit, vegetables vegetables
Day 10
Breakfast 50 g TAVARLIN protein bread
butter
butter
1 tbsp. TAVARLIN
hemp nuts
Snack
TAVARLIN
Snack
TAVARLIN
Snack
TAVARLIN
Snack
TAVARLIN
Snack
TAVARLIN
lettuce
nut cake
Rocket salad
courgettes
Snack
TAVARLIN
drink Dinner
protein bread
protein bread
butter 50gTAVARLIN
fried shrimps
buffalo salami
fried shrimps
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Day 11
Breakfast
Day 12
Breakfast
100 g TAVARLIN
Day 13
Breakfast
Day 14
Breakfast
50 g TAVARLIN protein
protein bread
bread
butter
4 tsp. TAVARLIN oil 50 g buffalo basis TAVARLIN salami slicing cucumber, tomato
half of an avocado
nut cake
Bacon
protein noodles
rocket, chanterelles
rocket salad
fruit
50 - 100 g
fruit
mushrooms, tomatoes
TAVARLINnut cake
Snack
TAVARLIN Lactate TAVARLIN Lactate
Snack
TAVARLIN Lactate
Snack
TAVARLIN Lactate
drink Dinner
drink Dinner
drink Dinner
100 g TAVARLIN
drink Dinner
protein bread
basis
butter
hemp nuts
dill
fried shrimps
salami
80 g smoked salmon
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Ingredients:
cup of TAVARLIN Lactate Drink 2.5 tsp. TAVARLIN protein powder ( = 10 g) 2 tsp. TAVARLIN Oil addition (= 8 g) Each snack is made up of the ingredients mentioned above. The lactate drink forms the basis. Ideally, you pour it into a measuring cup or shaker of a capacity of at least 500 ml so that you can easily add the other ingredients, the protein powder as well as the oil using a hand blender or immersion blender. We recommend using an immersion blender since shaking alone will not result in an ideal consistency and creaminess. Patients who have already lost a considerable amount of body weight may use 3.5 tsp. of protein powder for each snack for regaining weight. You can also add allowed fruit and vegetables in order to improve the taste.
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5. How can the patient check that the approach is applied correctly and/or the allowed quantities of sugar are not exceeded? The safest approach consists in sticking consistently to the quantities stated in the recipes and only replacing foodstuffs by other foodstuffs the content of carbohydrates of which is identical or lower. According to our assessment, it is better to follow the TKTL1 nutritional approach very consistently for a rather short period of time than less consistently for a long period of time. When your body uses fats and no longer carbohydrates to produce the main part of its required energy, products of fat breakdown (ketone bodies) can be detected both in the blood circulation and in the urine. 6. Are the costs refundable, does a health insurance bear the costs? Currently, the costs are not refundable yet. 7. Are there already data available regarding a prolonged survival time for patients suffering from cancer? There are more and more progress reports stating a positive effect of the nutritional therapy according to Dr. Coy. 8. Are there different effects of food in case of different forms of cancer? Approx. 30 different tumours have been tested for TKTL1 activity and the TKTL1 fermentative metabolism has been identified in all of them. It does not seem to be a phenomenon that occurs in some types of cancer only, but a general phenomenon Not every tumour of a type of cancer, however, has the TKTL1 metabolism. Therefore, Coy's nutritional therapy does only make sense when TKTL1-positive tumour cells have been detected. These are the only cell forms to ferment glucose, and the burning of fatty acids is deactivated in these cells. If no TKTL1-positive cells are detected in the tumour, a therapeutic effect of Coys diet cannot be expected.
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9. Have clinical studies been carried out? There is a large number of progress reports stating positive results associated with this diet. Even if the positive results are documented by physicians, they do not constitute clinical studies. Clinical studies require standardised and controlled conditions for proving efficacy in a sufficiently large number of patients including a control group. It is only then that therapies obtain the status scientifically established. These studies are starting in several clinics so that the first results are expected for the near future. 10. What happens in and with the body when the diet is changed to the TAVARLIN approach? When the diet is changed from a mixed diet rich in carbohydrates to a diet low in sugar, the body may react with indisposition. You might have symptoms such as circulatory disorders, lack of concentration, tiredness, constipation or headache during the first days. These signs, however, generally disappear when the TAVARLIN nutritional therapy is continued. After their organism has successfully changed over to ketone bodies as source of energy, most of the persons concerned report that they feel very good physically. 11. Is the approach suitable for vegetarians as well? It is more difficult for vegetarians to perform Coys nutritional therapy. Since one of the main nutrient groups (carbohydrates) is already strongly limited here, doing without animal products would also clearly restrict the possibilities of protein intake. Since the change in diet aims at an increased consumption of meat and fish we advise the persons concerned to at least eat regularly fish if possible. 12. What do I have to bear in mind in case of existing allergies and food incompatibilities? The TKTL1 nutritional therapy does not require a stricter compliance with existing allergies and incompatibilities than required in a usual diet. 13. Which drinks are allowed? Mineral water, coffee and tea and infusions without sugar are allowed. Fruit juices mixed with water may be drunk in a mixing ratio of nine parts of water and one part of fruit juice (100 % fruit juices only). Red wine is even recommended on account of the 30
bioactive substances in the grapes and is an element of the daily plans. A glass of diet beer of < 1 g KH / 100 ml is possible as well. 14. Are fruit juices and fizzy drinks containing sugar allowed? Drinks containing sugar and pure fruit juices should be avoided. For giving some flavour to mineral water, a mixing ratio of fruit juice and water of 1 plus 9 is possible. 15. Are sweets strictly forbidden? Conventional sweets no matter whether bought in the supermarket or the health food store are absolutely forbidden. The food package contains cocoa biscuits, a cocoa spread and strawberry jam, which you may eat. When eating these sweets, please stick to the quantities indicated in the daily plans. These quantities are calculated in a way so that not more than 70 g of carbohydrates are taken in daily. 16. Is the supply with vitamins and minerals secured in the low-carbohydrate diet? If you stick to the given diet plans, the supply will be secured. These plans have been examined regarding the content of all essential nutrients, vitamins and minerals. 17. What effect does sport have on the diet? Sport may contribute much to the success of the nutritional therapy. Carbohydrates taken in can be dissimilated faster through sports and glycogen stores can be emptied. This is how regular sport may maintain glucose concentration in the body at a low level, reduce the insulin requirement and so support Coys nutritional approach. It has been shown generally that sport has positive effects on the immune system and has a positive effect on the course of the disease in cancer patients. 18. Is it absolutely necessary to consume the lactate drinks as snacks? Yes, they are an essential element of Coys diet since lactate is of particular significance in the therapy. In addition, cancer patients have to prevent the imminent risk of losing weight. Therefore, the snack also is of great importance regarding the sufficient supply of nutrients. The lactate drink is enriched with cream and oils and so is rich in calories. In addition, essential amino acids that are essential for a smooth metabolic function are supplied through the TAVARLIN protein powder. 31
19. Is it absolutely required to eat the warm main meal at lunchtime? The main meal can be eaten in the evening as well. It is also possible to eat another warm meal in the evening. 20. What may I eat when I am out or at work? Restaurants offer a large number of dishes that can be eaten within the scope of the TKTL1 nutritional therapy. Salad/vegetables with fish or meat are particularly suitable. 21. Do I have to take additional vitamin preparations? Generally, we recommend no isolated intake of large-dose vitamin preparations since vitamin C, E and B1 may have unfavourable effects on the TKTL1 metabolism.
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