The TLC Diet: Is It Right for You?

It can be upsetting and anxiety-inducing when your healthcare provider tells you that your cholesterol is too high. Luckily, there are more options than ever to choose from to lower your cholesterol levels and be healthier.

One option is to change the way you eat. You’ve probably discovered that there are many diets that promise to “Reduce cholesterol! Protect your heart!” Among them is the TLC diet, short for “therapeutic lifestyle changes.” But is it right for you? Registered dietitian Devon Peart, RD, MHSc, BASc, discusses the ins and outs of the food plan and shares if the TLC diet is still recommended today.

What is the TLC diet?

Born out of the National Institutes of Health’s National Cholesterol Education Program, the TLC diet was specifically developed to lower bad cholesterol. The goal? Avoid cholesterol medication entirely (or lower your dosage) by following a heart-healthy diet.

The TLC diet works to lower your cholesterol by decreasing the amount you eat of:

• Saturated fats: This type of fat is solid at room temperature. You can find it in animal products like fatty red meats, whole-milk products, butter and coconut oil.
• Trans fats: Known as the worst type of fat for your health, trans fats are often found in packaged and processed foods. They’re made by turning liquid vegetable oils into solids through a chemical process. Trans fats largely have been banned in North America, but can still be found in some foods, like microwave popcorn, frozen pizza and pastries.
• Dietary cholesterol: You can find this form of cholesterol in animal-based foods.

According to the TLC diet, these three factors negatively impact your cholesterol levels. The diet plan also boosts fiber intake, known for lowering cholesterol. It even recommends taking a fiber supplement if your cholesterol doesn’t come down by 8% to 10% within six weeks on the diet.

Does the TLC diet work?

“Research shows that people who follow the TLC diet have pretty decent outcomes in terms of lowering their cholesterol and heart-disease risk,” notes Peart.

When combined with exercise and weight loss, the TLC program has been shown to lower cholesterol by 25% to 30%. That’s similar to the results you see with medication. The diet alone also lowers triglycerides (fat in the blood) and blood pressure, both heart-disease risk factors.

What foods can you eat on the TLC diet?

“We know that certain foods raise or lower cholesterol levels,” Peart says. “So, when it comes to elevated cholesterol, diet alone can in some cases reverse it.”

The TLC diet menu consists of nutrient- and fiber-rich foods to keep you feeling full. You can eat:

• Beans and lentils.
• Eggs (maximum of two a week).
• Fruits and vegetables.
• Lean meats, like chicken breast and turkey.
• Seafood, especially those high in omega-3 fatty acids like salmon and tuna.
• Unsaturated fats (vegetable oils like olive oil).
• Whole-grain cereals, pasta and bread.

The diet avoids foods that:

• Contain saturated fat.
• Increase cholesterol or triglycerides.
• Could contribute to weight gain by virtue of being low in nutrients and high in calories.

Things you don’t consume on the TLC meal plan include:

• Alcohol.
• Fatty red meat.
• Full-fat dairy like butter, cream, ice cream and high-fat cheeses.
• Processed meats like deli meat, hot dogs and sausage.
• Sugary foods like sweets and pastries.

Do healthcare providers still recommend the TLC diet?

People continue to turn to the TLC diet to improve cholesterol and heart health. But critics point to newer studies that disprove some of the theories behind the TLC diet.

“There’s a lot about the TLC diet that’s very good and still stands in terms of current research. But some aspects of it are outdated,” Peart states. She shares three problems with the TLC diet:

1. Dietary cholesterol isn’t bad for you

The basic premise of the TLC diet is that dietary cholesterol increases your risk of heart disease. But this premise is no longer accurate, says Peart. “About 20 years ago, providers advised people to stop eating eggs, for example, because they contain dietary cholesterol. They thought it would raise your cholesterol levels. But now we know that’s not usually true.”

Recent studies show that dietary cholesterol has little effect on cholesterol levels or heart-disease risk. Saturated fats and sugars are the primary culprits.

2. A high-carbohydrate diet can negatively affect heart health

The TLC diet recommends that carbohydrates (carbs) make up 50% to 60% of what you eat every day. But when it comes to carbs, Peart says the important thing is the quality.

“Eating too many refined carbs, white flour foods and sugary foods can increase triglycerides, contribute to obesity and increase blood sugar. Those factors raise your risk of heart disease.”

3. Daily calories are too low

To lose weight, the TLC diet recommends women and people assigned female at birth (AFAB) eat 1,000 to 1,200 calories a day and men and people assigned male at birth (AMAB) consume 1,200 to 1,600. “Those calorie levels are extremely low, aren’t realistic or attainable for most people,” Peart says. “Furthermore, very low calorie levels make it difficult to meet your nutrient and energy needs.”

Although experts no longer recommend certain parts of the TLC diet, it still has some key components that help you stay healthy — like lowering saturated fat and sugar and increasing fiber. These days, though, you can find those aspects of the TLC diet in other eating plans like the Mediterranean diet, one of the most well-regarded diets in the medical community.

Cholesterol-lowering diets

An overwhelming number of diets claim to be the best diet for high cholesterol.

You’ll likely see an improvement in your cholesterol and heart-disease risk if you make some of the following switches:

• Choose whole grains over refined white-flour products.
• Eat lean meat or fish instead of fattier red meats.
• Opt for lower-fat over full-fat dairy.
• Drink plain or bubbly water instead of alcohol or soda.
• Use heart-healthy vegetable oils like olive and canola instead of butter or lard.

Talk to your healthcare provider or a registered dietitian about your diet and the steps you can take to lower your cholesterol. Most importantly, choose a nutrient-rich way of eating that you can sustain over the long term. Because being heart healthy isn’t a fad, it’s a necessity.