High cholesterol: Using the TLC diet

The TLC (Therapeutic Lifestyle Changes) diet is recommended by the National Cholesterol Education Program of the U.S. National Institutes of Health. It calls for limiting fats in your diet.

• You may get 25% to 35% of your daily calories from fat, mainly from unsaturated fat.
• Most of the fat should be monounsaturated, and only 10% of the fat should be polyunsaturated fat.
• Less than 7% of your daily calories should come from saturated fat.
• Eat no more than 200 mg of dietary cholesterol a day.

Continue to Why?

Limiting the amount of fat in your diet can lower cholesterol. The TLC diet helps you limit how much fat you eat.

Diet changes are usually the first step in lowering cholesterol before medicines are added. If you use the TLC diet, you may be able to avoid taking medicine.

Continue to How?

The TLC diet may seem complicated at first, but it's really not. Follow the guidelines in the table below, but take one step at a time. For example, start with the meat and beans group. When you feel confident that you're eating the right amount and type of meat and beans every day, move on to the next category.

You can also get help from a dietitian.

TLC (Therapeutic Lifestyle Changes) 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 a 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 fat-free 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 half 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 (check labels for number of calories per portion)	Choose snacks that are low in fat or are made with unsaturated fat.

Sample menu

Here is a sample one-day menu for the TLC diet. The menu contains approximately 2,200 calories, with 25% of calories from total fat (5% from saturated fat, 13% from monounsaturated fat, and 7% from polyunsaturated fat).

Breakfast

• ½ cup oatmeal with 1 cup fat-free milk, 1 teaspoon of brown sugar, and 1 sliced banana
• Coffee latte made with 1 cup nonfat milk

Lunch

• Sandwich made from 2 slices whole wheat bread, 2 ounces lean turkey, 1 tablespoon mayonnaise, lettuce, and tomato
• Carrot sticks and fruit

Snack

• 1 cup low-fat or nonfat vanilla yogurt
• ½ cup mixed raisins and peanuts

Dinner

• 3 ounces baked or broiled salmon
• 1 cup cooked brown rice
• 1 cup cooked broccoli
• 1 tablespoon olive oil (used in cooking)
• Salad made with 1½ cups romaine lettuce, ½ cup tomatoes, ¼ cucumber, 1 tablespoon vinegar and oil dressing
• 1 slice Italian bread with 1 teaspoon soft margarine

Snack

• 1 sliced peach with 1 cup fat-free milk

Foods to avoid

Check food labels for fat and cholesterol content. Try to:

• Avoid saturated fat and oils, such as butter, bacon drippings, lard, palm oil, and coconut oil. Instead, use soft tub margarine or vegetable oils, such as olive or canola oil.
• Limit trans fatty acids or partially hydrogenated vegetable oils. These oils go through a process that makes them solid. They're found in hard margarines, snack crackers, cookies, chips, and shortenings.
• Limit fatty meats such as corned beef, pastrami, ribs, steak, ground meat, hot dogs, sausage, bacon, and processed meats like bologna. Also limit egg yolks and organ meats like liver and kidney. Replace with skinless chicken or turkey, lean beef, veal, pork, lamb, and fish. Try some meatless main dishes, like beans, peas, pasta, or rice.
• Limit meat, poultry, and fish to no more than two servings, or 5 oz (141.8 g), a day. Remember that a serving is about the size of a deck of playing cards.
• Limit milk products that contain more than 1% milk fat. This includes cream, most cheeses, and nondairy coffee creamers or whipped toppings (which often contain coconut or palm oils). Instead try fat-free or low-fat milk (0% to 1% fat) and low-fat cheeses.
• Limit snack crackers, muffins, quick breads, croissants, and cakes made with saturated or hydrogenated fat, whole eggs, or whole milk. Try low-fat baked goods, and use any spreads or toppings lightly.
• Dip bread in olive oil instead of spreading butter or margarine on your bread.
• Avoid fast foods like hamburgers, fries, fried chicken, and tacos. They are high in both total fat and saturated fat. When you eat out, choose broiled sandwiches or chicken without skin, salads with low-fat dressing, and foods that aren't fried. Ask the server to leave off the cheese and high-fat dressings like mayonnaise.

Tips for success

• Work with your doctor on a plan to lower your cholesterol through diet.
• Collect information about menus, cooking classes, support groups, books, and videos.
• Get support from your family in making changes in your diet.
• Think ahead, and make realistic and customized meal plans.
• Get help from a registered dietitian if you have questions about the TLC diet.
• Learn how to understand food labels. Look for the amount of saturated fat per serving, and figure out its percentage of your total saturated fat intake for the day. "Low-fat" does not always mean what it seems. Some labels measure fat content by weight rather than as a percentage of the calories in a serving.
• Exercise. Always talk to your doctor before you start an exercise program.

For more suggestions on foods to eat and foods to avoid, see Healthy food choices to lower cholesterol .

Continue to Where?

Now that you have read this information, you are ready to start following the TLC diet.

Talk with your doctor

If you have questions about this information, print it out and take it with you when you visit your doctor. You may want to mark areas or make notes where you have questions.