For those looking to get their cholesterol under control, the TLC (Therapeutic Lifestyle Changes) diet promises to get you back to healthy numbers.
This eating strategy was created by the National Institute of Health’s National Cholesterol Education Program as a way to boost heart health by cutting cholesterol from your diet.
Developed in 2001, the TLC plan is endorsed by the American Heart Association and calls for cutting fatty meats and full-fat dairy from your diet in favor of filling it with fruits, vegetables, whole grains, and lean meats.
You’ll also make changes beyond what you eat to become more physically active to achieve better heart health—and potentially less belly fat.
The program’s official online guide provides the information you need to get started, but does the TLC diet make sense in the first place? Here, we’ll go through the details so you can make the right decision for your health.
Unlike many diet plans available today, the TLC program is intended to be followed as a permanent lifestyle change in order to achieve and maintain positive results, said Caleb Backe, a certified personal trainer.
“TLC is not necessarily a diet for losing weight; it is better described as a lifestyle change for living a longer, healthier life. In practice, it will help you lose weight if you are overweight, and if you’re at a healthy weight, it will help you maintain a healthy weight,” he said.
To achieve these results, the TLC diet breaks down into four categories:
Eat more lean meats, low-fat dairy, whole grains, legumes, fruits, vegetables, nuts, and seeds. These are foods that naturally contain stanols, sterols and soluble fiber, and they can help prevent your digestive tract from absorbing cholesterol from your meals, which lowers the levels in your blood. Daily suggested intake is two grams of stanols or sterols and 10-25 grams of soluble fiber.
Eat less fried and fatty foods, including whole-fat dairy. These foods are high in cholesterol, saturated and trans fats. Your goal should be to limit less than 7% of your daily calories to saturated fat and fewer than 200 milligrams of dietary cholesterol—approximately the amount in one egg. For most people, this means eating less than five ounces of meat per day.
Stay physically active by committing to a minimum of 30 minutes of moderate-intensity exercise each day.
Maintain a healthy BMI (body mass index) to reduce your risk of developing heart disease and chronic health conditions like diabetes. The plan states that you will need to be extra cautious about carrying excess weight around your middle.
We found in the program’s online guide that the first step for starting the TLC plan is choosing your target calorie level based on your health goals.
While the recommendations will differ per individual, the plan recommends that those who want to lower their cholesterol eat fewer than 2,500 (men) or 1,800 (women) calories per day. If your goal includes weight loss, this should be adjusted to 1,600 calories for men and 1,200 for women.
While the TLC diet provides space for personalization, most foods are categorized based on whether they are banned, encouraged, or permitted in small amounts.
Below are some of the common foods in each category:
- Fish and poultry (preferably skinless)
- High-fiber fruits and vegetables
- Whole grains like oatmeal, quinoa, whole wheat bread, cereal, pasta, and brown rice
- Egg whites
- Plant stanols and sterols from fruits, vegetables, nuts, and fortified fruit juices
- Unsaturated fats like fatty fish, nuts, avocado, nut butter, olive oil
- Low-fat dairy
- Water, unsweetened tea or coffee, orange juice
- Fatty or processed meats like bacon and sausage
- Full-fat dairy
- Sugary beverages, including alcohol
- Processed foods high in trans fats, saturated fats, or added sugars
- Salty foods
- Egg yolks (two per week)
- Full-fat butter and sour cream
The focus on the TLC diet is to improve your health by reducing your dietary cholesterol intake, but does this make sense? We turned to the experts to learn a little more about this oft-misunderstood compound.
“The target demographic [of the TLC diet] is those who have high cholesterol, a family history of high cholesterol, or someone generally interested in heart health,” sports dietician Jason Machowsky told us.
The plan’s official guide states that cholesterol is a fatty, waxy substance that is critical for daily functioning, including digestion and hormone production.
It states that TLC’s goal is to minimize your “bad” LDL cholesterol and elevate your “good” HDL cholesterol so that your arteries stay clear for optimal heart health.
Too much low-density lipoprotein (LDL) cholesterol can cause problems because it raises your chance of heart disease.
The theory is that amount within your system of each type of cholesterol is largely dependent on what you eat, so the TLC diet purportedly works to optimize your HDL levels while lowering LDL cholesterol.
Does this match reality? We’ll explore this and more of TLC’s promises next.
Unlike the majority of diet plans, the stated purpose of TLC isn’t to help you lose weight, but rather to lower your cholesterol levels.
However, there’s evidence that improvements in one will affect the other, as an analysis of clinical trials in the International Journal of Obesity shows that low-fat diets often lead to weight loss.
The TLC diet claims to offer other positive health outcomes, including lower LDL cholesterol, triglyceride, and glucose levels. According to Healthline, the plan can also boost your glycemic control, reduce inflammation and lower your risk of complications during pregnancy.
However, the evidence is mixed about whether there is a strong correlation between what you eat and your cholesterol levels. For instance, one 2016 study found that sugar (rather than saturated fat) seemed to have a stronger link to high LDL cholesterol.
As another example, a meta-analysis of 40 studies found little association between cholesterol intake and cardiovascular health problems, providing evidence that the link between them might be more tenuous than previously thought.
Should you follow the TLC diet? That depends on what your goals are, Cathy Gonzales, family nurse practitioner for MD Diet Weight Loss and Nutrition Clinic told us.
“The TLC diet can help lower your risk of heart disease or stroke… If you are trying to lose weight, I would not recommend the TLC diet as it still has you eating lots of carbs. Legumes, pasta, and breads are all weight gainers. Even in healthy small portions,” she said.
From our research, we couldn’t identify any adverse side effects from following the TLC diet, even when followed by children and teens. As the plan doesn’t prevent you from eating broad categories of food, there’s little risk that you will experience nutrient deficiencies that lead to malnourishment or rapid weight loss.
Saying that, the diet may potentially lead to problems if you’re not following the recommended ratios for nutrients.
“If someone is starting a diet to manage a medical condition,” Machowsky told us, “they should be followed by a physician or registered dietitian to make sure they are adhering to the diet properly and getting the intended effects.”
The world’s best diet won’t do you much good if it’s too complicated, so is the TLC diet easy to follow? Per US News and World Report’s diet rankings, the plan is considered easy to follow so long as you are willing to track what you eat.
They gave it extra points for achievability because it emphasizes fiber-packed fruits and vegetables over empty calories from sugar and simple carbs.
While there are numerous ways you will need to customize the TLC diet to fit your specifications, the plan requires lots of number crunching and label reading to ensure your food intake falls within the accepted parameters.
For instance, you’ll need to do some math to keep your saturated fat intake under 7% each day.
Regarding instruction, we found that the online manual includes suggested meal plans, cooking recommendations, and a guide for ordering at restaurants, but you’ll need to look elsewhere for recipes.
When it comes to comparing the TLC plan to other popular eating strategies, a few things stand out. For one, TLC offers more flexibility than most diet plans.
The guidelines for following it are broad enough that you can make adjustments to match your eating preferences, including going plant-based or gluten-free.
Likewise, this is one of the few health plans that puts equal weight on physical activity. By highlighting the heart-healthy link between cardio exercise and your health, TLC’s approach may give you better results in the long run.
In some ways, the ketogenic diet might be considered an opposite approach to the TLC diet. As we highlighted in our beginner’s guide, the ketogenic diet puts the focus on fat (both saturated and unsaturated) and severely limits your carbohydrate intake.
You’ll eat lots of fatty cuts of meat, whole-fat dairy, and egg yolks- all foods that are banned with TLC.
The overall goal of going keto is to force your body to burn fat as efficiently as possible, rather than lower your cholesterol levels or improve heart health.
For this reason, it’s often followed by people who have plateaued in their weight loss efforts and want to kickstart their metabolism. In most cases, you should consider the ketogenic diet to be a temporary diet transition, rather than plan you can follow for life, like TLC.
There’s a lot more to the keto diet than we can cover here, so we suggest looking to our guide to learn more.
In light of this research, do we recommend following the TLC program? We like that the plan gives you ample choice between a variety of food groups, and since you can still fill up on unsaturated fats, carbohydrates, and protein you aren’t likely to go hungry.
This means that it’s worth considering this plan even if your cholesterol levels are under control.
“Overall, the TLC Diet is sustainable for healthy living since it includes exercise and gives a healthy breakdown of what your diet should consist of,” Backe said.
One thing we like about the TLC diet is that there’s no “gimmick” involved. This plan is the brainchild of the National Institute of Health, and as such, it’s not sponsored by a company trying to sell you a product.
There are no TLC-brand convenience foods for sale at the store, and the plan shies away from making big promises about achieving quick results for your health. In fact, it’s intended to be followed as a lifelong lifestyle rather than a temporary change.
If you struggle with high cholesterol and know your diet has room for improvement, the TLC plan gives you a good foundation for getting started.
This diet follows some of the most popular nutrition advice—eat more vegetables and avoid processed food—and it gives you guidance for tracking key nutrient intakes like saturated fat and cholesterol to keep you accountable.
However, the evidence is scant that restricting your dietary cholesterol consumption will make much difference in your LDL cholesterol levels.
This is a hot button topic in the world of nutrition right now, and we won’t claim to know which side is right because the available research isn’t conclusive either way.
There’s likely not a nutritionist in the world that would argue with the TLC diet’s advice to eat less sugar and get regular exercise. We think that there’s enough right about this plan that it’s well worth looking into if you want to make a change for your health.