The TLC (Therapeutic Lifestyle Changes) diet was created by the National Institutes of Health’s National Cholesterol Education Program with the goal of cutting cholesterol as part of a heart-healthy eating regimen.
It calls for eating plenty of vegetables, fruits, bread, cereals, pasta and lean meats. The guidelines are broad enough that you’ll have a lot of latitude with what you eat.
“TLC is a non-pharmacologic strategy for reducing the risk of cardiovascular disease and therefore does not require dependence on prescription medications for most people, nor does it require making separate meals for you and the rest of your family,” says Luis Rustveld, a registered dietitian and assistant professor in the department of family and community medicine at Baylor College of Medicine in Houston. “Adherence to the TLC diet also does not require buying special foods or eliminating the foods you like. The emphasis is on making product comparisons by reading food labels and choosing healthier versions of the foods you like.”
The TLC diet was based on the premise that dietary cholesterol can influence blood cholesterol and risk of cardiovascular disease. However, more recent studies and reviews of past studies have indicated that dietary cholesterol has a modest effect on low-density lipoprotein (“bad”) cholesterol and very little impact on CVD risk, explains Julia Zumpano, a registered dietitian with Cleveland Clinic’s Center for Human Nutrition.
“Current diet recommendations focus heavily on limiting saturated fats,” she says.
- Family friendly. Family members can easily all eat the meals together with little or no modification. And the food options are healthy and balanced enough for all ages.
- Budget friendly. Foods for this diet are easy to find at a typical grocery and don’t require expensive or specialty food items.
- Planet friendly. The diet considers the environmental effects of food choices. It’s largely plant-based and/or the foods are mainly sustainably grown/produced.
- Vegan or vegetarian friendly. Recipes can be easily modified for a vegan or vegetarian diet.
- Gluten-free friendly. Recipes can be easily modified and still follow a gluten-free diet.
- Halal friendly. Recipes can be easily modified and still follow the diet.
- Kosher friendly. Recipes can be easily modified and still follow the diet.
- Low-fat diet. This diet contains significantly less fat than the government’s recommended limits. Low-fat diets are known to be heart-healthy approaches.
How Does the TLC Diet Work?
- Keep meat consumption to a minimum of 5 ounces or less a day. Stick to skinless chicken or turkey and fish.
- Eat two to three servings a day of low-fat or nonfat dairy.
- Eat up to four servings of fruit and three to five servings of vegetables.
- Eat 11 servings a day of bread, cereal, rice, pasta or other grains. Focus on whole grains.
You can start the TLC diet by choosing your target calorie level. If your only concern is lowering LDL cholesterol levels, the goal is 2,500 calories per day for men and 1,800 for women.
Need to shed pounds? Shoot for 1,200 to 1,600 calories for men or 1,000 to 1,200 calories daily for women. Then, cut saturated fat to less than 7% of daily calories, which means eating less high-fat dairy, like butter, and ditching fatty meats, like salami. Consume no more than 200 milligrams of dietary cholesterol a day, equivalent to about 2 ounces of cheese.
If after six weeks your LDL cholesterol hasn’t dropped by 8%-10% after six weeks, add in two grams of plant stanols or sterols – cholesterol-like compounds naturally found in food – and 10 to 25 grams of soluble fiber each day. Soluble fiber, plant stanols and sterols help block the absorption of cholesterol from the digestive tract to help lower LDL. Stanols and sterols are found in vegetable oils and certain types of margarine and are available as supplements.
“The diet should emphasize a variety of fruits, vegetables and whole-grain products,” Rustveld says. “Total carbohydrate intake should make up 50% to 60% of total calories, mainly from whole grains. Limit total fat to 25% to 34% of daily calories.”
To round out their diet, people should consume fat-free and low-fat dairy products, legumes, (skinless) poultry, lean meats and fish.
Exactly how you meet these guidelines is up to you, though sample meal plans are available.
It’s important to be physically active, as well.
“Exercise is a key component to the TLC diet,” Zumpano says. “Thirty minutes of moderate-intensity exercise is advised most or all days of the week.”