Written by: Kelley R. Hill, MSN, RN-BC
In a Nutshell:
- The TLC Diet Program aims to reduce cholesterol levels
- It was developed by U.S. Department of Health and Human Services and the National Institutes of Health
- A three-part nutrition program, not just a diet
The Therapeutic Lifestyle Changes (TLC) Program diet is a three-part program that includes diet, physical activity, and weight management. The diet claims that if you follow all the diet’s recommendations, and shed some pounds if you are overweight, you can lower your LDL (bad) cholesterol by 20-30%.
Major components of the diet:
- Keep dietary cholesterol below 200 mg per day
- Reduce saturated fat intake to less than 7% of calories (140 calories in a 2,000-calorie diet)
- Add 5-10 grams of soluble fiber per day
- Add 2 grams of plant sterols per day
While the TLC Program makes the same claims as the portfolio diet, and looks a lot like it, as well, the predominant difference is that there are no food restrictions with the TLC Program (provided that the guidelines are met). The TLC Program diet recommends that 25-35% of calories be from fat, 15-25% from protein, and 50-60% from carbohydrates.
The TLC Program involves some pretty meticulous food tracking and gram- and calorie-counting to make sure you don’t exceed recommended levels of saturated fat and cholesterol. This can sometimes become tedious and therefore easily abandoned. The success of the diet, however, depends on it.
Socialized eating and dining out may be challenging, not for lack of selections but because accurate tracking is difficult with foods prepared by others – especially restaurants that may use more saturated fats in meal preparation than is readily apparent.
The diet emphasizes fiber and reducing fat, though doesn’t offer specific recommendations for whole grains or vegetables. It doesn’t offer much guidance on improving overall diet quality, so the ease or difficulty in following this diet depends greatly on how much or how little you already know about nutrition.
Don’t forget you’ll need to make time for daily physical activity while participating in the TLC Program, as well.
Scientific & Expert Support
The TLC Program recommends keeping dietary cholesterol below 200 mg daily. The latest Dietary Guidelines for Americans, however, no longer recommend a specific cholesterol limit based on findings that dietary cholesterol is not the main factor in our cholesterol levels.
There is concern among experts that the lower end of the protein recommendation may not be adequate for many adults, especially those who are more active or have blood deficiencies.
Several clinical trials have been conducted using the TLC Program with various disease-specific groups of patients such as those who have suffered a heart attack, those with type 2 diabetes, women with polycystic ovary syndrome, those with metabolic syndrome, and chronic kidney disease – all demonstrating a reduction in cholesterol, triglycerides, and oxidative stress.
The TLC Program diet is nutritious, balanced, and generally safe.
However, with any drastic change in diet, you should always consult with your physician, and ideally a registered dietician (RD) or nutritionist. Especially if you are pregnant, breastfeeding, are taking prescription medications, or have existing health conditions.
STRENGTH OF EVIDENCE: A
Conclusions are based on several high-quality, patient-centered trials that all demonstrated a reduction in cholesterol, triglycerides, and oxidative stress. Research also supports the benefits of increasing soluble fiber and the positive effects of plant stanols and sterols.
For those at high cardiovascular risk due to elevated cholesterol, the TLC Diet Program is worthy of consideration. While it does require meticulous notes and planning, the diet has shown positive effects on specific at-risk patient groups.
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- Blaha, M.J. & Blumenthal, R. (n.d.). High cholesterol: Prevention, treatment and research. Johns Hopkins Medicine: Health. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-cholesterol/high-cholesterol-prevention-treatment-and-research
- Hiremath, P.G., Blumenthal, R., & Michos, E. (2019, March 11). New cholesterol guidelines to improve you heart health. U.S. News & World Report: Health. Retrieved from: https://health.usnews.com/health-care/for-better/articles/2019-03-11/how-should-i-monitor-and-treat-my-cholesterol
- McKinney, C. (n.d.). 7 foods to eat to lower cholesterol. Johns Hopkins Patient Guide to Diabetes. Retrieved from: https://hopkinsdiabetesinfo.org/7-foods-to-eat-to-lower-cholesterol/
- U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung and Blood Institute. (2005, December). Your guide to lowering cholesterol with TLC. NIH Publication No. 06-5235. Retrieved from: https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf