Table of ContentsView AllTable of ContentsHow It WorksIs It Still Recommended?Potential IssuesWho May BenefitFoods to EatFoods to AvoidOther Cholesterol-Lowering Diets
Table of ContentsView All
View All
Table of Contents
How It Works
Is It Still Recommended?
Potential Issues
Who May Benefit
Foods to Eat
Foods to Avoid
Other Cholesterol-Lowering Diets
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How Does the TLC Diet Work?
As part of an overall heart-healthy eating plan, the TLC diet also recommends to:
A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
Is the Diet Still Recommended to Improve Cholesterol?
The TLC diet was originally included in clinical guidelines to manage high cholesterol in adults in 2002.It was not included in the updated guidelines in 2013.
Though some aspects of the TLC diet are considered outdated, the overall principles are still recommended.Many elements of the diet continue to be beneficial for health.
A 2024 study examined the effect of the TLC diet on cholesterol levels in 82 people living with human immunodeficiency virus (HIV) who also had dyslipidemia (abnormal cholesterol levels). The researchers found that the TLC diet was effective at improving cholesterol levels. Triglycerides, total cholesterol, and LDL cholesterol levels significantly improved in the intervention group compared to the control group.
While there are beneficial aspects of the TLC diet that are still recommended today, there may be a few cons of the diet. Some of the potential issues with the TLC diet include:
Who May Benefit From the TLC Diet?
The TLC diet is specifically designed for people with high blood cholesterol levels. However, anyone looking to improve their overall heart health may benefit from following it. The TLC diet can help reduce the risk for other conditions, such asmetabolic diseaseand heart disease.
The TLC diet is considered safe and suitable for most people. If you are considering making dietary changes to follow it, talk to a healthcare provider or a registered dietitian.
Foods to includeon the TLC diet include:
Foods to limit or avoid on the TLC diet include:
While the TLC diet is an option for lowering your cholesterol levels, it is not the only diet that can help. TheDASH diet (Dietary Approaches to Stop Hypertension diet), while originally created to help people lower theirblood pressure, has also been shownto help lower both total andlow-density lipoprotein (LDL) cholesterol (“bad cholesterol")levels.
The National Institutes of Health supports both the TLC and DASH diets.The main difference between the TLC and DASH diets is that the DASH diet focuses on reducing sodium intake while increasing vegetables, fruits, legumes, whole grains, and low-fat dairy. It also recommends limiting fatty meats, sweets, sugar-sweetened beverages, and full-fat dairy.
TheMediterranean dietis also known for promoting health.A study of people with overweight or obesity found that the Mediterranean diet may help lower cholesterol levels.
Another study of people with metabolic syndrome who had overweight or obesity found that the Mediterranean diet may help lower triglyceride levels and improvehigh-density lipoprotein (HDL) cholesterol (“good cholesterol")levels.
The Mediterranean diet emphasizes plant-based foods, including fruits, vegetables, legumes, whole grains, nuts, seeds, and healthy fats (such as olive oil).It includes fish, seafood, lean poultry, and low-fat dairy (in small amounts). The Mediterranean diet recommends limiting red and processed meats,added sugars,refined grains, andhighly processed foods.
Summary
The therapeutic lifestyle changes (TLC) diet aims to lower cholesterol through a heart-healthy eating plan. It recommends eating less total and saturated fats and cholesterol, while eating more soluble fiber and plant sterols and stanols.
Though the TLC diet is still recommended, some experts consider aspects of the diet outdated. They cite issues such as dietary cholesterol not affecting blood cholesterol as once thought, daily calorie limits being too low, and total carbohydrates being too high.
Foods encouraged on the TLC diet include fruits, vegetables, whole grains, low-fat dairy, lean meats and poultry, fish and seafood, legumes, nuts, seeds, egg whites, and plant-based vegetable oils such as olive, canola, or avocado oils.
Foods to limit or avoid include full-fat dairy, fatty cuts of meat, processed meats, alcohol, pastries, sweets and desserts, sugar-sweetened beverages, egg yolks, fried foods, butter, lard, shortening, and palm and coconut oils.
Other diets that may benefit heart health and lower cholesterol include the DASH diet and the Mediterranean diet.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report.Circulation. 2002;106(25):3143-421.National Heart, Lung, and Blood Institute.Therapeutic lifestyle changes (TLC) to lower cholesterol.National Heart, Lung, and Blood Institute.Your guide to lowering your cholesterol with therapeutic lifestyle changes (TLC).Eckel RH, Jakicic JM, Ard JD, et al.2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines.Circulation. 2014;129(25_suppl_2). doi:10.1161/01.cir.0000437740.48606.d1National Institutes of Health.NIH-supported DASH and TLC diets earn top spots in “best diets” report.Singhato A, Booranasuksakul U, Khongkhon S, Rueangsri N.Effectiveness of the therapeutic lifestyle change diet intervention to improve biochemical markers of cardiovascular diseases in HIV-infected patients with dyslipidemia.Ann Nutr Metab. 2024;80(4):202-210. doi:10.1159/000538578Soliman GA.Dietary cholesterol and the lack of evidence in cardiovascular disease.Nutrients. 2018;10(6):780. doi:10.3390/nu10060780Dwyer JT, Melanson KJ, Sriprachy-anunt U, Cross P, Wilson M.Dietary treatment of obesity. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. Endotext. MDText.com, Inc.Mohan V, Unnikrishnan R, Shobana S, Malavika M, Anjana RM, Sudha V.Are excess carbohydrates the main link to diabetes & its complications in Asians?.Indian J Med Res. 2018;148(5):531-538. doi:10.4103/ijmr.IJMR_1698_18Lari A, Sohouli MH, Fatahi S, et al.The effects of the Dietary Approaches to Stop Hypertension (DASH) diet on metabolic risk factors in patients with chronic disease: A systematic review and meta-analysis of randomized controlled trials.Nutr Metab Cardiovasc Dis. 2021;31(10):2766-2778. doi:10.1016/j.numecd.2021.05.030Chiavaroli L, Viguiliouk E, Nishi SK, et al.DASH dietary pattern and cardiometabolic outcomes: an umbrella review of systematic reviews and meta-analyses.Nutrients. 2019;11(2):338. doi:10.3390/nu11020338National Heart, Lung, and Blood Institute.DASH eating plan.Guasch-Ferré M, Willett WC.The Mediterranean diet and health: a comprehensive overview.J Intern Med. 2021;290(3):549-566. doi:10.1111/joim.13333Meslier V, Laiola M, Roager HM, et al.Mediterranean diet intervention in overweight and obese subjects lowers plasma cholesterol and causes changes in the gut microbiome and metabolome independently of energy intake.Gut. 2020;69(7):1258-1268. doi:10.1136/gutjnl-2019-320438Salas-Salvadó J, Díaz-López A, Ruiz-Canela M, et al.Effect of a lifestyle intervention program with energy-restricted mediterranean diet and exercise on weightloss and cardiovascular risk factors: one-year results of the PREDIMED-plus trial.Diabetes Care. 2019;42(5):777-788. doi:10.2337/dc18-0836American Heart Association.What is the Mediterranean diet?
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report.Circulation. 2002;106(25):3143-421.National Heart, Lung, and Blood Institute.Therapeutic lifestyle changes (TLC) to lower cholesterol.National Heart, Lung, and Blood Institute.Your guide to lowering your cholesterol with therapeutic lifestyle changes (TLC).Eckel RH, Jakicic JM, Ard JD, et al.2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines.Circulation. 2014;129(25_suppl_2). doi:10.1161/01.cir.0000437740.48606.d1National Institutes of Health.NIH-supported DASH and TLC diets earn top spots in “best diets” report.Singhato A, Booranasuksakul U, Khongkhon S, Rueangsri N.Effectiveness of the therapeutic lifestyle change diet intervention to improve biochemical markers of cardiovascular diseases in HIV-infected patients with dyslipidemia.Ann Nutr Metab. 2024;80(4):202-210. doi:10.1159/000538578Soliman GA.Dietary cholesterol and the lack of evidence in cardiovascular disease.Nutrients. 2018;10(6):780. doi:10.3390/nu10060780Dwyer JT, Melanson KJ, Sriprachy-anunt U, Cross P, Wilson M.Dietary treatment of obesity. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. Endotext. MDText.com, Inc.Mohan V, Unnikrishnan R, Shobana S, Malavika M, Anjana RM, Sudha V.Are excess carbohydrates the main link to diabetes & its complications in Asians?.Indian J Med Res. 2018;148(5):531-538. doi:10.4103/ijmr.IJMR_1698_18Lari A, Sohouli MH, Fatahi S, et al.The effects of the Dietary Approaches to Stop Hypertension (DASH) diet on metabolic risk factors in patients with chronic disease: A systematic review and meta-analysis of randomized controlled trials.Nutr Metab Cardiovasc Dis. 2021;31(10):2766-2778. doi:10.1016/j.numecd.2021.05.030Chiavaroli L, Viguiliouk E, Nishi SK, et al.DASH dietary pattern and cardiometabolic outcomes: an umbrella review of systematic reviews and meta-analyses.Nutrients. 2019;11(2):338. doi:10.3390/nu11020338National Heart, Lung, and Blood Institute.DASH eating plan.Guasch-Ferré M, Willett WC.The Mediterranean diet and health: a comprehensive overview.J Intern Med. 2021;290(3):549-566. doi:10.1111/joim.13333Meslier V, Laiola M, Roager HM, et al.Mediterranean diet intervention in overweight and obese subjects lowers plasma cholesterol and causes changes in the gut microbiome and metabolome independently of energy intake.Gut. 2020;69(7):1258-1268. doi:10.1136/gutjnl-2019-320438Salas-Salvadó J, Díaz-López A, Ruiz-Canela M, et al.Effect of a lifestyle intervention program with energy-restricted mediterranean diet and exercise on weightloss and cardiovascular risk factors: one-year results of the PREDIMED-plus trial.Diabetes Care. 2019;42(5):777-788. doi:10.2337/dc18-0836American Heart Association.What is the Mediterranean diet?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report.Circulation. 2002;106(25):3143-421.National Heart, Lung, and Blood Institute.Therapeutic lifestyle changes (TLC) to lower cholesterol.National Heart, Lung, and Blood Institute.Your guide to lowering your cholesterol with therapeutic lifestyle changes (TLC).Eckel RH, Jakicic JM, Ard JD, et al.2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines.Circulation. 2014;129(25_suppl_2). doi:10.1161/01.cir.0000437740.48606.d1National Institutes of Health.NIH-supported DASH and TLC diets earn top spots in “best diets” report.Singhato A, Booranasuksakul U, Khongkhon S, Rueangsri N.Effectiveness of the therapeutic lifestyle change diet intervention to improve biochemical markers of cardiovascular diseases in HIV-infected patients with dyslipidemia.Ann Nutr Metab. 2024;80(4):202-210. doi:10.1159/000538578Soliman GA.Dietary cholesterol and the lack of evidence in cardiovascular disease.Nutrients. 2018;10(6):780. doi:10.3390/nu10060780Dwyer JT, Melanson KJ, Sriprachy-anunt U, Cross P, Wilson M.Dietary treatment of obesity. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. Endotext. MDText.com, Inc.Mohan V, Unnikrishnan R, Shobana S, Malavika M, Anjana RM, Sudha V.Are excess carbohydrates the main link to diabetes & its complications in Asians?.Indian J Med Res. 2018;148(5):531-538. doi:10.4103/ijmr.IJMR_1698_18Lari A, Sohouli MH, Fatahi S, et al.The effects of the Dietary Approaches to Stop Hypertension (DASH) diet on metabolic risk factors in patients with chronic disease: A systematic review and meta-analysis of randomized controlled trials.Nutr Metab Cardiovasc Dis. 2021;31(10):2766-2778. doi:10.1016/j.numecd.2021.05.030Chiavaroli L, Viguiliouk E, Nishi SK, et al.DASH dietary pattern and cardiometabolic outcomes: an umbrella review of systematic reviews and meta-analyses.Nutrients. 2019;11(2):338. doi:10.3390/nu11020338National Heart, Lung, and Blood Institute.DASH eating plan.Guasch-Ferré M, Willett WC.The Mediterranean diet and health: a comprehensive overview.J Intern Med. 2021;290(3):549-566. doi:10.1111/joim.13333Meslier V, Laiola M, Roager HM, et al.Mediterranean diet intervention in overweight and obese subjects lowers plasma cholesterol and causes changes in the gut microbiome and metabolome independently of energy intake.Gut. 2020;69(7):1258-1268. doi:10.1136/gutjnl-2019-320438Salas-Salvadó J, Díaz-López A, Ruiz-Canela M, et al.Effect of a lifestyle intervention program with energy-restricted mediterranean diet and exercise on weightloss and cardiovascular risk factors: one-year results of the PREDIMED-plus trial.Diabetes Care. 2019;42(5):777-788. doi:10.2337/dc18-0836American Heart Association.What is the Mediterranean diet?
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report.Circulation. 2002;106(25):3143-421.
National Heart, Lung, and Blood Institute.Therapeutic lifestyle changes (TLC) to lower cholesterol.
National Heart, Lung, and Blood Institute.Your guide to lowering your cholesterol with therapeutic lifestyle changes (TLC).
Eckel RH, Jakicic JM, Ard JD, et al.2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines.Circulation. 2014;129(25_suppl_2). doi:10.1161/01.cir.0000437740.48606.d1
National Institutes of Health.NIH-supported DASH and TLC diets earn top spots in “best diets” report.
Singhato A, Booranasuksakul U, Khongkhon S, Rueangsri N.Effectiveness of the therapeutic lifestyle change diet intervention to improve biochemical markers of cardiovascular diseases in HIV-infected patients with dyslipidemia.Ann Nutr Metab. 2024;80(4):202-210. doi:10.1159/000538578
Soliman GA.Dietary cholesterol and the lack of evidence in cardiovascular disease.Nutrients. 2018;10(6):780. doi:10.3390/nu10060780
Dwyer JT, Melanson KJ, Sriprachy-anunt U, Cross P, Wilson M.Dietary treatment of obesity. In: Feingold KR, Anawalt B, Blackman MR, et al., eds. Endotext. MDText.com, Inc.
Mohan V, Unnikrishnan R, Shobana S, Malavika M, Anjana RM, Sudha V.Are excess carbohydrates the main link to diabetes & its complications in Asians?.Indian J Med Res. 2018;148(5):531-538. doi:10.4103/ijmr.IJMR_1698_18
Lari A, Sohouli MH, Fatahi S, et al.The effects of the Dietary Approaches to Stop Hypertension (DASH) diet on metabolic risk factors in patients with chronic disease: A systematic review and meta-analysis of randomized controlled trials.Nutr Metab Cardiovasc Dis. 2021;31(10):2766-2778. doi:10.1016/j.numecd.2021.05.030
Chiavaroli L, Viguiliouk E, Nishi SK, et al.DASH dietary pattern and cardiometabolic outcomes: an umbrella review of systematic reviews and meta-analyses.Nutrients. 2019;11(2):338. doi:10.3390/nu11020338
National Heart, Lung, and Blood Institute.DASH eating plan.
Guasch-Ferré M, Willett WC.The Mediterranean diet and health: a comprehensive overview.J Intern Med. 2021;290(3):549-566. doi:10.1111/joim.13333
Meslier V, Laiola M, Roager HM, et al.Mediterranean diet intervention in overweight and obese subjects lowers plasma cholesterol and causes changes in the gut microbiome and metabolome independently of energy intake.Gut. 2020;69(7):1258-1268. doi:10.1136/gutjnl-2019-320438
Salas-Salvadó J, Díaz-López A, Ruiz-Canela M, et al.Effect of a lifestyle intervention program with energy-restricted mediterranean diet and exercise on weightloss and cardiovascular risk factors: one-year results of the PREDIMED-plus trial.Diabetes Care. 2019;42(5):777-788. doi:10.2337/dc18-0836
American Heart Association.What is the Mediterranean diet?
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