Home > Health Library > Therapeutic Lifestyle Changes (TLC) for High Cholesterol
Therapeutic Lifestyle Changes
(TLC) is a program that can help you lower cholesterol. The lifestyle changes include diet,
exercise, weight loss, and not smoking. Your doctor will want you to follow
TLC even if you are taking cholesterol-lowering medicine. And medicine will work better if you have healthy habits.
This program is recommended
by the National Cholesterol Education Program of the U.S. National Institutes
varying degrees of success in lowering their cholesterol by changing their diets. Those who are most successful using diet changes
to lower their cholesterol are those who lose excess weight. Diet changes are
usually the first step in lowering cholesterol before medicines are
The diet's main focus is to reduce the amount of saturated fat you
eat, because saturated fat elevates your cholesterol. You can reduce the
saturated fat in your diet by limiting the amount of meat and whole milk products you
eat. Choose low-fat products from those food groups instead. Replace most of
the animal fat in your diet with unsaturated fat, especially monounsaturated
oils, such as olive, canola, or peanut oil. If monounsaturated fat is substituted for
saturated fat, it lowers
LDL ("bad") cholesterol and keeps
HDL ("good") cholesterol up.
The TLC diet recommends that you eat specific amounts of different types of foods. These amounts are sometimes a percentage of your total calorie intake for each day.
Avoid trans fat. Foods with trans fats include some vegetable shortening, crackers, cookies, and packaged snack foods.
Lean meat, poultry, fish, dry beans, and dry
No more than 5 ounces total a day
No more than 2 yolks a week
1 whole egg. Egg whites or substitutes are not
Low-fat milk and milk
2–3 a day
2–4 a day
3–5 a day
Bread, cereals, pasta, rice, and other
At least 6 a day
Sweets and snacks
Within calorie limit
Choose snacks that are low in fat or are made
with unsaturated fat.
Your doctor or dietitian might recommend that you add soluble fiber or a cholesterol-lowering margarine to your diet. These might help you lower LDL cholesterol. Soluble fiber is found in foods like oats, beans, and fruit. Cholesterol-lowering margarines contain plant stanols and sterols.
Here is a sample one-day menu. The menu contains approximately 2,200 calories, with 25% of
calories from total fat (5% from saturated fat, 13% from monounsaturated fat,
and 7% from polyunsaturated fat).
Check food labels for fat and cholesterol content. Try to:
For more information, see:
National Heart, Lung, and Blood Institute (2005). Your Guide to Lowering Your Cholesterol With TLC (NIH Publication No. 06-5235). Available online: http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf.
Other Works Consulted
Raymond JL, Couch SC (2012). Medical nutrition and therapy for cardiovascular disease. In LK Mahan et al., eds., Krause's Food and the Nutrition Care Process, 13th ed., pp. 742–781. St Louis: Saunders.
Current as of:
March 12, 2014
E. Gregory Thompson, MD - Internal Medicine & Rhonda O'Brien, MS, RD, CDE - Certified Diabetes Educator
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