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Are you at risk of heart disease? Is lowering cholesterol a priority? The key to better heart health may be in your hands — or in your kitchen.
The Therapeutic Lifestyle Changes (TLC) diet is recommended by the National Cholesterol Education Program of the National Institutes of Health for people who have high cholesterol, heart disease or significant risk factors for heart disease. The premise is simple. Lower your cholesterol — and reduce your risk of heart disease — by limiting the amount of saturated fat and cholesterol in your diet.
The TLC diet allows just enough calories to help you achieve or maintain a healthy weight. Work with your doctor or a registered dietitian to determine the right number of daily calories for you. Plan your meals based on these general guidelines:
- Fat. Up to 25 percent to 35 percent of your total daily calories can come from fat — but limit saturated fat to less than 7 percent of your total daily calories. The specific amount of fat will vary depending on how many calories you're allowed a day.
- Cholesterol. Limit cholesterol intake to less than 200 milligrams a day.
- Sodium. Limit sodium intake to less than 2,400 milligrams a day — or even less if you have high blood pressure.
Focus on foods low in saturated fat — which are often low in cholesterol, too. This includes fruits, vegetables, whole grains, low-fat or fat-free dairy products, and lean cuts of meat. Avoid fatty meat and poultry with the skin. To reduce your sodium intake, flavor your food with herbs and spices rather than salt.
You can also think of your food choices in terms of daily servings. For example:
| Food group |
Number of daily servings |
Serving size |
| Fruits |
2 to 4 |
1 piece of fruit, 1/2 cup diced fruit or 3/4 cup fruit juice |
| Vegetables |
3 to 5 |
1 cup leafy or raw vegetables, 1/2 cup cooked vegetables or 3/4 cup vegetable juice |
| Grains |
6 to 11 |
1 slice of bread, 1 ounce dry cereal or 1/2 cup cooked pasta |
| Low-fat dairy |
2 to 3 |
1 cup skim milk, 1 cup yogurt or 1 ounce fat-free cheese |
| Protein |
Varies (up to 5 ounces a day of lean meat, poultry and fish; up to 2 egg yolks a week; egg whites or egg substitutes are unlimited) |
Substitute 1/2 cup dry beans, peas or tofu for 1 ounce meat |
| Fats and oils |
6 to 8 |
1 teaspoon soft margarine or vegetable oil, 1 tablespoon salad dressing or 1 ounce nuts |
Challenge yourself to modify your typical eating habits. Instead of a muffin for breakfast, top cold cereal with fresh fruit or eat whole-grain toast. Try pasta with stir-fried veggies rather than heavy meat or cream sauces. Add barley or beans to stews and casseroles. Eat fresh fruit for dessert. Occasional sweets and snacks are OK, as long as healthier foods are the main part of your diet.
What you eat is important — and so is physical activity. Regular exercise can help you maintain a healthy weight, lower low-density lipoprotein (LDL or "bad") cholesterol and boost high-density lipoprotein (HDL or "good") cholesterol. With your doctor's OK, begin a regular exercise program. Try a brisk daily walk, swim laps or join an exercise class.
The principles are much the same. But the TLC diet restricts saturated fat and cholesterol intake more than do other diets intended to promote heart health. Although the TLC diet may be appropriate for anyone, it's designed for people who have high cholesterol, heart disease or significant risk factors for heart disease.
Diet, exercise and weight control are often the key to lowering cholesterol. But sometimes a more aggressive approach is needed. If your doctor prescribes medication to lower your cholesterol, take it as directed — and use the principles of the TLC diet as the foundation for a lifetime of healthy eating.
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