Therapeutic Lifestyle Changes (TLC) Diet for High Cholesterol

Topic 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 consume. 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. 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 5 ounces total a day

  • 5 ounces maximum per 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 nonfat 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

6–11 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

Fat and oils

6–8 a day

  • 1 teaspoon monounsaturated oil, such as canola, olive, or peanut
  • 1 teaspoon polyunsaturated oil, such as corn or safflower
  • 1 teaspoon soft margarine (one that does not contain hydrogenated oils)
  • 1 tablespoon salad dressing
  • 1 teaspoon mayonnaise
  • 2 tablespoons nuts or seeds

Sweets and snacks

Within calorie limit

Choose snacks that are low in fat or are made with unsaturated fat.

Adapted from MyPyramid to help you plan a diet that is low in saturated fat and cholesterol.

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

Author Robin Parks, MS
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
Last Updated July 11, 2008

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