Therapeutic Lifestyle Changes (TLC) diet for high cholesterol

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 it 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 that you eat no more than 200 mg of dietary cholesterol per day. However, 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 servingsServing size

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

No more than 142 g (5 oz) total per day

  • 140 g (5 oz) maximum per day of lean meat, poultry, or fish
  • Substitute 120 mL (0.5 cups) dry beans or peas for 30 g (1 oz) of meat.

Eggs

No more than 2 yolks per week

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

Low-fat milk and milk products

2 to 3 per day

  • 240 mL (1 cup) non-fat or 1% milk
  • 240 mL (1 cup) non-fat or low-fat yogourt
  • 30 g (1 oz) fat-free or low-fat cheese (3 grams of fat or less per ounce)

Fruits

2 to 4 per day

  • 1 piece fruit, such as apple, orange, or banana
  • 120 mL (1/2 cup) canned fruit
  • 240 mL (1 cup) berries or melon
  • 180 mL (3/4 cup) fruit juice

Vegetables

3 to 5 per day

  • 240 mL (1 cup) raw leafy greens
  • 120 mL (1/2 cup) cooked or raw vegetables
  • 180 mL (3/4 cup) vegetable juice

Bread, cereals, pasta, rice, and other grains

6 to 11 per day

  • 1 slice of bread
  • 1/2 hot dog or hamburger bun, bagel, or English muffin
  • 30 g (1 oz) cold cereal
  • 120 mL (1/2 cup) cooked pasta, rice, noodles, or other grains

Fat and oils

6 to 8 per day

  • 5 mL (1 tsp) monounsaturated oil, such as canola, olive, or peanut
  • 5 mL (1 tsp) polyunsaturated oil, such as corn or safflower
  • 5 mL (1 tsp) soft margarine (one that does not contain hydrogenated oils)
  • 15 mL (1 Tbsp) salad dressing
  • 5 mL (1 tsp) mayonnaise
  • 30 mL (2 Tbsp) nuts or seeds

Sweets and snacks

Within calorie limit

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

Adapted from the food guide pyramid to help you plan a diet that is low in saturated fat and cholesterol.



Author: Douglas Dana
Ralph Poore
Last Updated: November 13, 2006
Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Tom Bailey, MD - Family Medicine
Neil J. Stone, MD, FACC, FACP - Internal Medicine, Cardiology

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