Therapeutic Lifestyle Changes (TLC) Diet for High Cholesterol

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Therapeutic Lifestyle Changes (TLC) Diet for High Cholesterol

Overview

People have varying degrees of success in lowering their cholesterol by changing their diets. People who have high cholesterol because they eat too many fatty foods may be able to lower their cholesterol 10% to 20% with diet changes alone, while others may only achieve a 5% to 8% reduction. 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 Therapeutic Lifestyle Changes (TLC) diet is recommended by the National Cholesterol Education Program of the U.S. National Institutes of Health. 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 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. Monounsaturated fat lowers LDL ("bad") cholesterol if it is substituted for saturated fat and keeps HDL ("good") cholesterol up.

The TLC diet calls for less than 7% of your daily calories to come from saturated fat and for eating no more than 200 mg of dietary cholesterol a day. But the diet allows 25% to 35% of daily calories from fat, mainly from unsaturated fat.1 Most of the fat should be monounsaturated, and only 10% should be polyunsaturated fat. Your diet should include only enough calories to maintain your desired weight and avoid gaining weight.

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 140 g (5 oz) total a day

  • 140 g (5 oz) maximum a day of lean meat, poultry, or fish
  • Substitute 60 mL (¼ cup) dry beans or peas for 30 g (1 oz) 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

  • 240 mL (1 cup) non-fat or 1% milk
  • 240 mL (1 cup) non-fat or low-fat yogourt
  • 30 g (1 oz) non-fat 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
  • 120 mL (½ cup) canned fruit
  • 240 mL (1 cup) berries or melon
  • 180 mL (¾ cup) fruit juice

Vegetables

3–5 a day

  • 240 mL (1 cup) raw leafy greens
  • 120 mL (½ cup) cooked or raw vegetables
  • 180 mL (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
  • 30 g (1 oz) cold cereal
  • 120 mL (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.

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.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Carl Orringer, MD - Cardiology, Clinical Lipidology
Last Revised August 15, 2011

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