Therapeutic Lifestyle Changes (TLC) Diet for High Cholesterol

Overview

The Therapeutic Lifestyle Changes (TLC) diet can lower cholesterol. This diet is recommended by the National Cholesterol Education Program of the U.S. National Institutes of Health.1

People have 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 added.

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.

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What can you eat?

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.

  • Saturated fat: Less than 7% of total calories
  • Polyunsaturated fat: Up to 10% of total calories
  • Monounsaturated fat: Up to 20% of total calories
  • Carbohydrate: 50% to 60% of total calories
  • Soluble fiber: At least 5 to 10 grams a day
  • Protein: Approximately 15% of total calories
  • Cholesterol: Less than 200 mg a day
  • Total calories: Balance calories taken in and calories burned to reach and stay at a healthy weight.

Avoid trans fat. Foods with trans fats include some vegetable shortening, crackers, cookies, and packaged snack foods.

Therapeutic Lifestyle Changes (TLC) diet recommendations
Food group Number of servings Serving size

Lean meat, poultry, fish, dry beans, and dry peas

No more than 5 ounces total a day

  • 5 ounces maximum a day of lean meat, poultry, or fish
  • Substitute ¼ cup dry beans or peas for 1 ounce of meat.

Eggs

No more than 2 yolks a week

1 whole egg. Egg whites or substitutes are not limited.

Low-fat milk and milk products

2–3 a day

  • 1 cup fat-free or 1% milk
  • 1 cup nonfat or low-fat yogurt
  • 1 ounce nonfat or low-fat cheese (3 grams of fat or less per ounce)

Fruits

2–4 a day

  • 1 piece fruit, such as apple, orange, or ½ a banana
  • ½ cup canned fruit
  • 1 cup berries or melon
  • ¾ cup fruit juice

Vegetables

3–5 a day

  • 1 cup raw leafy greens
  • ½ cup cooked or raw vegetables
  • ¾ cup vegetable juice

Bread, cereals, pasta, rice, and other grains

At least 6 a day

  • 1 slice of bread
  • ½ hot dog or hamburger bun, bagel, or English muffin
  • 1 ounce cold cereal
  • ½ cup cooked pasta, rice, noodles, or other grains

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.

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  High Cholesterol: Using the TLC Diet

Related Information

References

Citations

  1. Grundy SM, et al. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19): 2486–2497.

Other Works Consulted

  • 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.
  • 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.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Rhonda O'Brien, MS, RD, CDE - Certified Diabetes Educator
Last Revised June 18, 2012

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