TLC Diet Guide: Investigating Heart Healthy Eating Plans

Keep reading to see if the Therapeutic Lifestyle Changes diet is right for you!

Although many fad weight loss diets, crash diets, cleanses, and weight loss detox programs exist, few diet plans are nutritionally sound and sustainable as lifetime eating practices.

However, a few notable exceptions exist, such as the Mediterranean diet and the DASH diet eating plans.

Another relatively sound healthy diet plan is called the Therapeutic Lifestyle Changes diet, or TLC diet.

This TLC diet guide will discuss the TLC diet plan, the principles behind the TLC program, foods to eat and avoid, and potential TLC diet health benefits and drawbacks.

Let’s jump in!

A person holding a ceramic heart up to his heart.

What Is the TLC Diet?

The TLC diet is the shortened name for the Therapeutic Lifestyle Changes diet, which is a healthy diet plan created by the National Institutes of Health (NIH) to help support heart health through nutrition and physical activity.

The TLC diet is designed to reduce the risk of cardiovascular disease using nutrition and exercise as the key to disease prevention and heart health.

Ultimately, the TLC diet was created by health experts over a decade ago as a structured way to help people make changes to common yet modifiable risk factors for cardiovascular disease, including poor dietary choices and a sedentary lifestyle.

Rather than being a weight loss diet, the TLC diet is primarily designed to promote heart health with the goal of eating foods that will help reduce LDL cholesterol levels and increase physical activity to boost HDL cholesterol levels.

Note that LDL cholesterol is considered to be the “bad cholesterol“ associated with atherosclerosis (a condition marked by the thickening and hardening of blood vessels and plaque formations within them, which causes a narrowing of the patent blood vessel for blood).

In contrast, HDL cholesterol is “good cholesterol” that helps carry excess cholesterol to the liver for removal from the body.

A person holding a sign with the types of cholesterol on it.

How Do You Follow the TLC Diet Plan?

One relatively unique aspect of the TLC diet plan is that there are different guidelines for the macros and calories depending on your sex and health goals, meaning that any two people following the TLC diet plan may have fairly different meal plans.

While the TLC diet program still has some merit and may improve heart health, the principles and foundations of the diet plan were established all the way back in 2005 with the original publication of “Your Guide to Lowering Your Cholesterol with TLC1.”NHLBI. (2006). National Institutes of Health National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf

‌Much of the TLC meal plan structure research came out in the early 2000s, with little to no update to the TLC heart-healthy diet since that time.

However, research has continued to evolve, particularly in regard to our thoughts on cholesterol and saturated fat.

Therefore, while there isn’t any staunch evidence in support against the tenets of the TLC diet, some of the concepts may be outdated and unnecessary in terms of foods to avoid to reduce the risk of cardiovascular disease.2Carson, J. A. S., Lichtenstein, A. H., Anderson, C. A. M., Appel, L. J., Kris-Etherton, P. M., Meyer, K. A., Petersen, K., Polonsky, T., & Van Horn, L. (2020). Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. Circulation141(3). https://doi.org/10.1161/cir.0000000000000743

Because the primary aim of the TLC diet is to lower LDL cholesterol levels to promote heart health, the meal plan focuses on foods that are low in saturated fat, cholesterol, and trans fats and high in fiber.

The word fiber on a chalkboard surrounded by high fiber foods.

The TLC exercise and diet programs together are intended to help you achieve a healthy body weight, as being overweight or obese increases your risk of cardiovascular disease, heart attack, and stroke.

The TLC diet program has quite a number of rules and stipulations though it has reportedly helped many people successfully lower their cholesterol levels and reduce their risk of heart disease (so likely the juice is worth the squeeze!).3Li, Z., Otvos, J. D., Lamon-Fava, S., Carrasco, W. V., Lichtenstein, A. H., McNamara, J. R., Ordovas, J. M., & Schaefer, E. J. (2003). Men and Women Differ in Lipoprotein Response to Dietary Saturated Fat and Cholesterol Restriction. The Journal of Nutrition133(11), 3428–3433. https://doi.org/10.1093/jn/133.11.3428

‌Here are the TLC diet plan rules:

TLC Diet Plan Rules

  • Consume a total daily caloric intake that is appropriate for maintaining a healthy body weight for your height, sex, and weight goals. According to the TLC diet calorie guidelines, if you are just trying to improve your heart health without losing weight, men should eat 2500 total calories daily, and women should consume 1800 total calories daily. If you are following the TLC diet for weight loss in addition to heart health, total daily calories should be reduced to 1200-1600 calories a day for men and only 1000-1200 for women.
  • Limit your fat intake to no more than 25 to 35% of your total daily calories.
  • Saturated fat should be limited to no more than 7% of your total caloric intake.
  • Consume no more than 200 mg of cholesterol per day.
  • Consume no more than 5 ounces of meat per day.
  • Consume at least 10 to 25 grams of soluble fiber per day; the more the better.
  • Consume at least 2 grams of plant sterols or plant stanols per day.

What Can You Eat On the TLC Diet?

#1: Vegetables

You should eat at least 3-5 servings of vegetables per day, particularly those high in fiber.

#2: Fruit

You should eat at least 2-4 servings of fruits per day, particularly those high in fiber and low in sugar.

While canned and dried fruits are allowed, the TLC diet plan recommends fresh fruit in all cases, and only unsweetened canned and dried fruits are permitted.

#3: Whole grains

Along the lines of the original food pyramid, the TLC diet is a high-carbohydrate diet that emphasizes whole grains (not refined grains).

You should have at least six servings of whole grains per day.

A variety of legumes in bowls.

#4: Legumes

Legumes such as beans and lentils are a great source of soluble fiber, which is a central nutritional goal for the TLC diet meal plan.

#5: Nuts and seeds

Nuts and seeds are permitted in moderation so that you don’t go above 25-35% of your calories per day from fat.

#6: Low-Fat Dairy Products

You can have 2-3 servings of fat-free or low-fat dairy per day, as long as there is no more than 3 grams of fat per serving.

#7: Lean Cuts of Skinless Meat

Skinless lean fish, poultry, and lean meat are permitted (no more than 5 ounces of lean red meat per day). You can also have tofu.

#8: Some Vegetable Oils and Margarines

Olive oil, canola oil, and certain plant oils with plant sterols and stanols are allowed as they are thought to help lower cholesterol.

You cannot eat any processed meats, fatty cuts of meat, fried foods, processed foods, full-fat dairy products, and excess sodium, sugar, and alcohol.4Srour, B., Fezeu, L. K., Kesse-Guyot, E., Allès, B., Méjean, C., Andrianasolo, R. M., Chazelas, E., Deschasaux, M., Hercberg, S., Galan, P., Monteiro, C. A., Julia, C., & Touvier, M. (2019). Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé). BMJ365(8201), l1451. https://doi.org/10.1136/bmj.l1451

Two women smiling and exercising with dumbbells.

Exercise

In addition to the TLC diet meal plan, you are supposed to get at least 30 minutes of moderate-intensity exercise most–if not all–days per week.

This is because physical activity helps support weight loss and healthy weight management and improves heart health, lowers LDL cholesterol, and increases HDL cholesterol.

Weight Management

Central to the TLC is reaching and maintaining a healthy body weight because excess body weight is associated with a higher risk of high cholesterol, high blood pressure, diabetes, heart disease, and metabolic syndrome.5Cercato, C., & Fonseca, F. A. (2019). Cardiovascular risk and obesity. Diabetology & Metabolic Syndrome11(1), 1–15. https://doi.org/10.1186/s13098-019-0468-0

‌To lose weight, you need to consume fewer calories than you are burning per day.

A doctor holding a heart.

Is the TLC Diet Good for Weight Loss and Health?

As with most diets, there are some pros and cons to the TLC diet program for weight loss and health.

Here are some of the potential TLC diet benefits and good aspects of the TLC diet for weight loss and health:

  • The inclusion of exercise will help support overall health and weight loss.
  • Encourages healthy behaviors for lifelong health rather than a quick fix or fad weight loss diet.
  • Focuses on healthy whole foods and eliminates processed foods, excessive alcohol, sugar, and sodium.

There are also some potential downsides to the TLC diet plan.

  • Some of the concepts are based on outdated information.
  • Quite restrictive in terms of fat consumption and dietary cholesterol, some of which may not be as bad as we once thought.6Carson, J. A. S., Lichtenstein, A. H., Anderson, C. A. M., Appel, L. J., Kris-Etherton, P. M., Meyer, K. A., Petersen, K., Polonsky, T., & Van Horn, L. (2020). Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. Circulation141(3). https://doi.org/10.1161/cir.0000000000000743
  • Calorie tracking is required if you want to lose weight.
  • Suggested calories for weight loss are too low to support nutrient needs.
A sign that says low fat diets.

Although the evidence may be fairly outdated, the TLC diet is based on scientific evidence suggesting that diets low in fat, particularly saturated fat and trans fats, and low in cholesterol can help improve your cholesterol profile by decreasing LDL cholesterol.

Foods that are high in fiber, as well as the addition of regular exercise can increase HDL cholesterol.7Franczyk, B., Gluba-Brzózka, A., Ciałkowska-Rysz, A., Ławiński, J., & Rysz, J. (2023). The Impact of Aerobic Exercise on HDL Quantity and Quality: A Narrative Review. International Journal of Molecular Sciences24(5), 4653. https://doi.org/10.3390/ijms24054653

‌If you are trying to lose weight or reduce your risk of diseases, consider working with a registered dietitian, nutritionist, and healthcare provider to find the best diet and exercise program for your needs.

If you are interested to know what ideal cholesterol levels are, check out our guide here.

Cholesterol written on a chalkboard.

References

  • 1
    .”NHLBI. (2006). National Institutes of Health National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/files/docs/public/heart/chol_tlc.pdf
  • 2
    Carson, J. A. S., Lichtenstein, A. H., Anderson, C. A. M., Appel, L. J., Kris-Etherton, P. M., Meyer, K. A., Petersen, K., Polonsky, T., & Van Horn, L. (2020). Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. Circulation141(3). https://doi.org/10.1161/cir.0000000000000743
  • 3
    Li, Z., Otvos, J. D., Lamon-Fava, S., Carrasco, W. V., Lichtenstein, A. H., McNamara, J. R., Ordovas, J. M., & Schaefer, E. J. (2003). Men and Women Differ in Lipoprotein Response to Dietary Saturated Fat and Cholesterol Restriction. The Journal of Nutrition133(11), 3428–3433. https://doi.org/10.1093/jn/133.11.3428
  • 4
    Srour, B., Fezeu, L. K., Kesse-Guyot, E., Allès, B., Méjean, C., Andrianasolo, R. M., Chazelas, E., Deschasaux, M., Hercberg, S., Galan, P., Monteiro, C. A., Julia, C., & Touvier, M. (2019). Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé). BMJ365(8201), l1451. https://doi.org/10.1136/bmj.l1451
  • 5
    Cercato, C., & Fonseca, F. A. (2019). Cardiovascular risk and obesity. Diabetology & Metabolic Syndrome11(1), 1–15. https://doi.org/10.1186/s13098-019-0468-0
  • 6
    Carson, J. A. S., Lichtenstein, A. H., Anderson, C. A. M., Appel, L. J., Kris-Etherton, P. M., Meyer, K. A., Petersen, K., Polonsky, T., & Van Horn, L. (2020). Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. Circulation141(3). https://doi.org/10.1161/cir.0000000000000743
  • 7
    Franczyk, B., Gluba-Brzózka, A., Ciałkowska-Rysz, A., Ławiński, J., & Rysz, J. (2023). The Impact of Aerobic Exercise on HDL Quantity and Quality: A Narrative Review. International Journal of Molecular Sciences24(5), 4653. https://doi.org/10.3390/ijms24054653
Photo of author
Amber Sayer is a Fitness, Nutrition, and Wellness Writer and Editor, as well as a NASM-Certified Nutrition Coach and UESCA-certified running, endurance nutrition, and triathlon coach. She holds two Masters Degrees—one in Exercise Science and one in Prosthetics and Orthotics. As a Certified Personal Trainer and running coach for 12 years, Amber enjoys staying active and helping others do so as well. In her free time, she likes running, cycling, cooking, and tackling any type of puzzle.

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