|Weight Loss Short-term|
|Weight Loss Long-term|
|Easy to Follow|
|For Heart Health|
Scores are based on experts' reviews
Pros & Cons
- Heart healthy
- Not a fad diet—it’s government-endorsed
- On your own
- Must decode nutrition labels
Do's & Don'ts
Cutting high cholesterol.
You’ll lower your “bad” LDL cholesterol by 8 to 10 percent in six weeks.
Created by the National Institutes of Health’s National Cholesterol Education Program, the Therapeutic Lifestyle Changes Diet (TLC) is endorsed by the American Heart Association as a heart-healthy regimen that can reduce the risk of cardiovascular disease. The key is cutting back sharply on fat, particularly saturated fat. Saturated fat (think fatty meat, whole-milk dairy, and fried foods) bumps up bad cholesterol, which increases the risk of heart attack and stroke. That, along with strictly limiting daily dietary cholesterol intake and getting more fiber, can help people manage high cholesterol, often without medication.
How does the TLC Diet work?
Start by choosing your target calorie level. If your only concern is lowering LDL, the goal is 2,500 per day for men and 1,800 for women. Need to shed pounds, too? Shoot for 1,600 (men) or 1,200 (women). Then cut saturated fat to less than 7 percent of daily calories, which means eating less high-fat dairy, such as butter, and ditching fatty meats like salami. And consume no more than 200 milligrams of dietary cholesterol a day—the amount in about 2 ounces of cheese. If after six weeks your LDL cholesterol hasn’t dropped by about 8 to 10 percent, add in 2 grams of plant stanols or sterols and 10 to 25 grams of soluble fiber each day. (Soluble fiber and plant stanols and sterols help block the absorption of cholesterol from the digestive tract, which helps lower LDL. Stanols and sterols are found in vegetable oils and certain types of margarine, and are available as supplements, too.) On TLC, you’ll be eating lots of fruits, vegetables, whole grains, low-fat or nonfat dairy products, fish, and skin-off poultry. Exactly how you meet these guidelines is up to you, though sample meal plans are available.
Each day, you’ll keep meat to a minimum (no more than 5 ounces, and stick to skinless chicken and turkey or fish); eat 2 to 3 servings of low-fat or nonfat dairy; enjoy fruits (up to 4 servings) and vegetable (3 to 5); and have 6 to 11 servings of bread, cereal, rice, pasta, or other grains.
Will you lose weight?
Unclear, since the TLC diet was designed to improve cholesterol levels, not for weight loss. But research suggests that in general, low-fat diets tend to promote weight loss.
- In one study, 120 overweight people followed either the Atkins diet or the TLC diet for six months. At the end of that period, Atkins dieters had lost an average of 31 pounds, compared with 20 for TLC dieters, according to findings published in 2004 in the Annals of Internal Medicine. (If you’re overweight, losing just 5 to 10 percent of your current weight can help stave off some diseases.)
- In an analysis of 19 clinical trials, researchers found that participants following low-fat diets lost significantly more weight than those in control groups—typically about 7 additional pounds per year, according to findings published in the International Journal of Obesity in 2000. On average, reducing daily fat calories by 10 percent was associated with a loss of 6.3 pounds over six months.
Does it have cardiovascular benefits?
Yes. It reflects the medical community’s widely accepted definition of a heart-healthy diet. An eating pattern heavy on fruits, veggies, and whole grains but light on saturated fat and salt is considered the best way to keep cholesterol and blood pressure in check and heart disease at bay.
- In one study, 36 adults transitioned between two diets, which they followed for 32 days each: a typical American diet (16 percent saturated fat and 180 mg. of cholesterol) and the TLC diet (7 percent saturated fat and 75 mg. of cholesterol). After making the shift to TLC, their LDL cholesterol decreased by 11 percent, according to findings published in the Journal of Lipid Research in 2003.
- In a study published in the Journal of Atherosclerosis and Thrombosis in 2007, 16 participants with high levels saw their total cholesterol drop from 254.8 milligrams per deciliter to 224.2 mg/dL after six months, andtheir LDL dropped from 174 mg/dL to 143 mg/dL. In general, a 40-point drop in total cholesterol leads to a 20 percent reduced risk of heart disease.
- In another study, 32 adults followed the TLC diet for nearly 8 months. (They were given all their meals, making compliance easier than when going it alone.) By study’s end, their LDL cholesterol had decreased by 18 percent, according to findings published in Arteriosclerosis, Thrombosis, and Vascular Biology in 1995. The response was slightly more profound in men than women—though exactly why was unclear.
Can it prevent or control diabetes?
Little research has examined TLC’s effect on diabetes. But the Journal of Atherosclerosis and Thrombosis study mentioned above found TLC significantly lowered the fasting insulin levels of participants with high cholesterol. That’s important because elevated insulin levels can predict whether someone will develop type 2 diabetes. (The normal-cholesterol group didn’t appreciably change their fasting insulin levels.) In general, most experts consider an eating pattern like what TLC promotes to be the gold standard of diabetes prevention—it emphasizes the right foods and discourages the wrong ones.
Are there health risks?
No indications of serious risks or side effects have surfaced. The TLC diet’s eating pattern is safe for children and teens, too.
Since a growing number of children are obese, and are thusly grappling with some very adult health problems (type 2 diabetes and high cholesterol), doctors sometimes prescribe the TLC diet to combat or prevent those ills.
How well does it conform to accepted dietary guidelines?
Fat. The 2010 Dietary Guidelines for Americans advise that only 20 to 35 percent of daily calories come from fat. Thanks to its emphasis on fruits, veggies, lean meat, and low-fat dairy, TLC keeps you on target.
Protein. The TLC diet provides about 15 percent of daily calories from protein. That’s within the recommended 10 to 35 percent.
Carbohydrates. It’s within the acceptable range for carb consumption.
Salt. The 2010 Dietary Guidelines call for a daily maximum of 2,300 milligrams of sodium, or 1,500 milligrams for those 51 and older or African-Americans, and those with hypertension, diabetes, or chronic kidney disease. The TLC diet will keep you at or below 2,300 mg. daily.
Other key nutrients. The 2010 Dietary Guidelines call these “nutrients of concern” because many Americans get too little of one or more of them:
- Fiber. Getting your recommended amount—between 22 grams and 34 grams for adults—helps you feel full and promotes good digestion. Veggies, fruits, beans, and whole grains are major sources, and they’re encouraged on TLC. Most daily menus provide roughly 40 to 50 grams.
- Potassium. A sufficient amount of this important nutrient, according to the 2010 Dietary Guidelines, counters salt’s ability to raise blood pressure, decreases bone loss, and reduces the risk of developing kidney stones. It’s not that easy to get the recommended daily 4,700 mg. from food. (Bananas are high in potassium, yet you’d have to eat 11 a day.) Most Americans take in far too little. How much you get on the TLC diet is entirely up to you, but because you’re almost certainly eating more fruits and veggies than you were before, you’ll likely get more potassium than most.
- Calcium. This mineral is essential not only to build and maintain bones but to make blood vessels and muscles function properly. Many Americans don’t get enough. Women and anyone older than 50 should try especially hard to meet the government’s recommendation of 1,000 mg. to 1,300 mg. You should be able to succeed with low-fat dairy products and calcium-fortified juices and cereals—or if necessary, a supplement.
- Vitamin B-12. Adults should shoot for 2.4 micrograms of this nutrient, which is critical to proper cell metabolism. Eating yogurt—–a good source of the vitamin—will help you meet the recommendation.
- Vitamin D. Adults who don’t get enough sunlight need to meet the government’s 15 microgram recommendation with food or a supplement to lower the risk of bone fractures. Low-fat dairy will help you get the recommended amount, and eating just 3 ounces of sockeye salmon, which packs about 20 micrograms of vitamin D, will satisfy the requirement.
Supplement recommended? Although the TLC diet is nutritionally sound, an NCEP dietitian says a multivitamin is a good insurance policy.
How easy is it to follow?
Depends on your knack for tracking what you eat. It’s up to you, for example, to ensure that no more than 7 percent of your daily calories come from saturated fat, and that you don’t exceed 200 mg. of daily cholesterol from food.
The TLC diet takes work and a certain aptitude for reading nutrition labels. And aside from an 80-page manual available online—called Your Guide To Lowering Your Cholesterol With TLC—there are few resources to help you along.
Recipes. The manual contains a few suggested meal plans, but no recipes.
Eating out. Allowed, but you’ll have to decipher which menu choices are lowest in saturated fat and cholesterol. Smartest are steamed, broiled, baked, roasted, or poached entrees. Don’t be afraid to make special requests; for example, swap fries for a salad, and get the dressing on the side.
Alcohol. Because alcohol can raise triglycerides—a fatty substance that’s been linked to heart disease—moderation is key. That means a-drink-a-day max for women and two for men.
Extras. Included in the NCEP’s Your Guide To Lowering Your Cholesterol With TLC are dining-out tips, a few sample menus, and primers on why cholesterol matters.
Nutrition experts emphasize the importance of satiety, the satisfied feeling that you’ve had enough. Hunger shouldn’t be a problem on the TLC diet. You’ll be eating lots of fiber-packed fruits and veggies, which quell hunger.
How much will you miss butter, fast food, and creamy sauce? If you like your food greasy or have a sweet tooth, the TLC diet may not make you salivate. But a little lemon and spices can make a seemingly bland chicken breast delicious. For dessert, nonfat frozen yogurt, low-fat sorbet, and Popsicles are all in-bounds.
How much does it cost?
Other than your grocery bill, which should be no higher than usual, there are no expenses.
Does the diet allow for restrictions and preferences?
Most people can customize the TLC diet to their needs—pick a preference for more information.
The bulk of the diet—fruits, vegetables, and whole grains—are staples for vegetarians and vegans, who can easily follow.
People with celiac disease, who can’t tolerate gluten, should have no problem with the help of gluten-free protein like nuts, beans, lentils, and lean meat.
It’s up to you to make sure your choices are low-sodium, but TLC’s emphasis on fruits and veggies (stick with fresh or nothing-added frozen) should make your job easier. It’ll also help that you’re keeping meat and dairy—often high-sodium culprits—to a minimum.
Yes, you can use kosher-only ingredients.
Yes, but it’s up to you to ensure your food conforms.
Last updated by Angela Haupt | December 13, 2013