Therapeutic Lifestyle Changes Diet For High Cholesterol

Treatment For High Cholesterol

Therapeutic Lifestyle Changes and Supplements Outperform a Statin

Making lifestyle changes, especially changing some of the foods you eat, and regular physical activity, are very important to help reduce high LDL cholesterol.

You may also need to take cholesterol-lowering medicines to help manage your cholesterol and reduce your risk of having a heart attack or stroke. Talk to your doctor about finding the most appropriate treatment for you.

High Cholesterol Causes And Risk Factors

Lots of things can raise — or lower — your cholesterol levels. They include:

Saturated fats and simple carbohydrates. Reducing the amount of saturated fat, simple carbohydrates, and cholesterol in your diet can help lower your blood cholesterol.

Trans fats. Avoid artificial trans fats, which can raise your cholesterol. Check labels on baked goods, snack foods, frozen pizza, margarine, coffee creamer, vegetable shortenings, and refrigerated dough . Keep in mind that items that say they have “0 g trans fat” can actually have a tiny bit of trans fat in each serving, which adds up. So check the ingredients list. “Partially hydrogenated” means it has trans fat in it.

Good fats. Unsaturated fats don’t raise cholesterol levels. You can find unsaturated fats in foods like nuts, fish, vegetable oil, olive oil, canola and sunflower oils, and avocados. Limit saturated fats, which you find in animal products, and don’t eat processed meats.

Sugar. Eating and drinking too much sugar raises your triglyceride levels. High levels of triglycerides make heart disease more likely. Check food and drink labels to see how much sugar has been added, apart from sugars that are naturally part of a food. The average woman should get no more than 5 teaspoons per day from added sugars, and men shouldn’t get more than 9 teaspoons per day calories, according to the American Heart Association.

Heredity. High blood cholesterol can run in families.

Overview: Where Did The Tlc Diet Come From And What Is It Exactly

The TLC was developed by the National Institutes of Healths National Cholesterol Education program in order to help patients lower their cholesterol levels using diet. Although it wasnt designed specifically for weight loss, many people use it as a weight loss diet plan. It is endorsed by the American Heart Association as a heart-healthy regimen.

The main focus of the TLC Diet is to reduce saturated fat and cholesterol intake. Saturated fat increases LDL cholesterol levels , which increase the risk of heart disease and stroke. Understandably, the consumption of dietary cholesterol, which is found in eggs, dairy, and meat also increases blood cholesterol levels. According to the TLC diet plan, saturated fat should be kept to less the 7% of daily calories and cholesterol should be kept to 200 mg a day . In place of saturated fat, the TLC Diet focuses on increasing ones intake of fruits, vegetables, grains, low fat protein, monounsaturated fats and polyunsaturated fats . The fiber in fruits, vegetables, and grains helps remove cholesterol from the body, while both monounsaturated fats and polyunsaturated fats have been shown to reduce LDL levels. Monounsaturated fats have also been shown to increase HDL levels . If after six weeks LDL levels havent dropped by 8 to 10% then 2 grams of plant stanols or sterols and 25 grams of soluble fiber are added each day.

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The Tlc Diet Includes:

Breads/Cereals/Grains: 6 or more servings a dayGood examples: Brown rice, quinoa, potatoes

Vegetables/Beans/Peas: 3-5 servings/day Good examples: Leafy greens, cucumbers, bell peppers, onions, zucchini, yellow squash, acorn squash, pumpkin, romaine lettuce, carrots, eggplant, spinach, and beets

Fruits: 24 servings a dayGood examples: Berries, peaches, apples, nectarines, bananas, cantaloupe, watermelon, etc.

Dairy Products: 23 servings a dayfat-free or low fat Good examples: Low-fat milk, low-fat, unsweetened Greek yogurt, low-fat cheese

Eggs: 2 or fewer yolks per weekincluding yolks in baked goods and in cooked or processed foods

Meat/Poultry/Fish: 5 or fewer ounces a dayGood examples: Chicken without skin, fish, sirloin steak, extra lean hamburger, ground turkey, pork tenderloin.

Fats/Oils: Amount depends on daily calorie levelGood examples: Avocados, olives, avocado & olive oil, and nuts.

Soluble Fiber: Make half your fiber soluble Good examples of soluble fiber: Black beans, lima beans, kidney beans, avocados, turnips, broccoli, sweet potato, barley, oats, psyllium, apples, bananas, berries, citrus fruits, figs, apricots, nectarines, peaches, pears, plums, prunes, brussels sprouts, carrots, flaxseed, chia seeds, sunflower seeds, hazelnuts, peas, soy productsGood examples of insoluble fiber: Wheat bran, oat bran, beans, lentils, berries, whole grains, most vegetables, fruits and other plant foods

How Can Employees Participate In A Tlc Program

Low Cholesterol Diet Recipes

The National Institutes of Health have produced a nice brochure that describes the various components of a TLC program, but again, this is just a brochure. Employees need an organized, comprehensive, easy to follow program that takes them through everything they need to lower their elevated health risks.

Effective TLC programs are thorough. They teach individuals all the specific skills and tools they need to make dietary changes that last. They also help individuals overcome the common barriers to healthy eating and regular exercise. They are grounded in behavior change science.

Staying true to the earlier research and current science, WellSteps has developed WellSteps TLC. WellSteps TLC is a lifestyle change program that consists of extensive behavior change programming that specifically targets employee nutrition and physical activity.

It includes all of the education, tools and strategies, motivation, and support from others that individuals need to successfully adopt healthy behaviors. It is a clinically backed program that teaches and encourages changes in nutrition and physical activity that result in lower employee health risks.

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Healthy Eating Tips To Lower Cholesterol

As well as sticking to a varied and healthy diet, try these tips to help you manage your cholesterol:

  • Limit takeaway foods to once a week .
  • Limit salty, fatty and sugary snack foods to once a week .
  • Eat plenty of vegetables aim for 5 serves of vegetables every day. .
  • Choose wholegrain breads, cereal, pasta, rice and noodles.
  • Snack on plain, unsalted nuts and fresh fruit .
  • Include legumes such as chickpeas, lentils, split peas), beans into at least two meals a week. Check food labels and choose the lowest sodium products.
  • Use spreads and margarines made from healthy unsaturated fats instead of those made with saturated fat .
  • Use healthy oils for cooking some include canola, sunflower, soybean, olive , sesame and peanut oils.
  • Use salad dressings and mayonnaise made from oils such as canola, sunflower, soybean, olive , sesame and peanut oils.
  • Include 2 or 3 serves of plant-sterol-enriched foods every day .
  • Have 2 to 3 portions of oily fish every week. Fish may be fresh, frozen or canned.
  • Include up to 7 eggs every week.
  • Select lean meat and limit unprocessed red meat to less than 350g per week.
  • Choose reduced fat, no added sugar milk, yoghurt, or calcium-added non-dairy food and drinks.
  • Limit or avoid processed meats including sausages and deli meats .

If you are having trouble with your cholesterol levels, a dietitian can help you to eat healthily for your specific needs.

What Can You Eat

Overall, the TLC diet is considered a low-fat diet thats low in cholesterol and can be followed long-term. While it imposes many rules and restrictions, its been known to successfully help people lower their cholesterol levels. Followers of the TLC plan adhere to the following nutritional rules:

  • Take in only enough calories to maintain a healthy weight.
  • 25% to 35% of calories should come from total fat, including saturated fat.
  • Saturated fat should account for less than 7% of calories.
  • Limit dietary cholesterol to less than 200 mg per day.
  • Consume 2 grams of plant sterols or stanols per day.
  • Increase soluble fiber to between 10 grams and 25 grams per day.
  • Limit meat consumption to 5 ounces or less per day.

If heart health is the only goal, the TLC manual recommends 2,500 calories per day for men and 1,800 for women. If weight loss is a secondary goal, men should decrease calories to 1,200 to 1,600 daily, and women should target around 1,000 to 1,200 calories per day.

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Questions To Ask Your Doctor

  • Am I at risk for heart disease?
  • How often should I get my cholesterol tested?
  • What are my cholesterol levels? What do they mean?
  • What lifestyle changes do I need to make to help improve my cholesterol levels and heart health?
  • Is there a chance that Ill need cholesterol-lowering medicine?
  • What are the risks and benefits of taking this medicine?

Medications To Lower High Cholesterol

Patient Counseling: Therapeutic Lifestyle Changes (TLC) Diet

The goal of cholesterol treatment is to help you prevent a heart attack or stroke. So the drugs your doctor prescribes also depend on your chances for heart disease.

The higher your risk, the more important it is to get your levels down. Your doctor will look at all of your risk factors and decide which medications will help you the most.

Cholesterol-lowering drugs include:

Cholesterol-lowering drugs work best when combined with a low-cholesterol diet and an exercise program.


Statins block the production of cholesterol in the liver. They lower LDL and triglycerides and can slightly raise HDL. These drugs are the first treatment for most people with high cholesterol. If you already have heart disease, statins reduce the chances of heart attacks. Side effects can include diabetes, liver damage, and, in a few people, muscle tenderness or weakness. If your doctor prescribes statins, you should ask them the percentage by which you should lower your cholesterol. Generally, it will be between 30% and 50%. Commonly used statins include:


Bile acid sequestrants

These drugs work inside the intestine, where they bind to bile and prevent your circulatory system from reabsorbing it. Bile is made largely from cholesterol, so these drugs work by reducing the body’s supply of cholesterol. That then lowers both total and LDL cholesterol. The most common side effects are constipation, gas, and upset stomach. Commonly used bile acid sequestrants include:

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How Effective Is Therapeutic Lifestyle Change

Heres what some of the research shows about the impact of TLC. There is even evidence that a TLC program is helpful in the treatment of depression and diabetes. Employees who will decrease their saturated fat to less than 7% of total calories can reduce their LDL-cholesterol by 10%. Here are the documented effects of Therapeutic Lifestyle Change on blood cholesterol.

20-30% reduction

Done right, a Therapeutic Lifestyle Change can be effective at reducing elevated cholesterol, blood pressure, blood glucose, and body fat without medication.

Rationale For Management Of Asymptomatic Hypercholesterolemia

Serum cholesterol level is a major risk factor for CHD. A continuous relationship between low density lipoprotein cholesterol and CHD risk is evident and is graded over a wide variety of LDL levels ranging from low to elevated . Higher serum levels of total cholesterol increased the risk of CHD in the Multiple Risk Factor Intervention Trial . Even in low serum cholesterol level populations it is clear that lower levels of LDL cholesterol have a direct impact on reduced coronary event rates compared with those patients with relatively elevated serum LDL levels . This is a finding that has been sustained by multiple other studies .

There was more than a third reduction in coronary end point incidence in dyslipidemic men receiving gemfibrozil in the Helsinki Heart Study . A relative risk reduction of almost a third was described in the risk of coronary events with Pravastatin in the West of Scotland Coronary Prevention Study . Diabetic patients with normal or near currently accepted target levels with one other cardiovascular risk factor, have obtained significant reductions in cardiovascular events on taking lipid-lowering 10mg Atorvastatin daily in the Collaborative Atorvastatin Diabetes Study primary prevention trial .

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Tlc Diet Review: Will It Help You Lower Cholesterol Levels reports on the TLC diet, an eating strategy created by the National Institute of Health, which may help lower low-density lipoprotein cholesterol levels. The TLC diet is designed to cut out fatty meats, full-fat dairy and replenishing those foods with fruits, vegetables, whole grains and lean meats. spoke to Jason Machowsky, RD, CSSD, RCEP, CSCS, exercise physiologist at HSS, about the targeted demographic for the TLC diet who said, The target demographic is those who have high cholesterol, a family history of high cholesterol, or someone generally interested in heart health. However, Machowsky cautioned, If someone is starting a diet to manage a medical condition, they should be followed by a physician or registered dietitian to make sure they are adhering to the diet properly and getting the intended effects.

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Which Foods Are Highest In Cholesterol

TLC Diyeti (Therapeutic Lifestyle Changes Diet)

Only animal products contain cholesterol. These include:

  • Cheese.
  • Meat.
  • Milk and dairy products.

Plant-based foods dont have cholesterol. You wont find it in peanut butter or avocados, says Zumpano. However, dietary cholesterol doesnt necessarily cause elevated blood cholesterol. The real problem lies with eating the wrong kind of fats.

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Plant Sterols And Stanols

Plant sterols and stanols are chemically similar in structure to cholesterol but a methyl or ethyl group in their side chains means they are absorbed weakly in the gastrointestinal tract when contrasted with cholesterol. Plant sterols and stanols are thought to inhibit cholesterol absorption and appear to be active in lowering cholesterol . These compounds are most commonly commercially found in margarines and are a source of their cholesterol lowering marketing campaigns. Table 11 illustrates the plant sterol content of common commercially available margarines . When taken between 2 to 2.5 g/day, products enriched with plant stanol/sterol esters may lower plasma LDL cholesterol levels by 10% to 14% without any reported side effects . A further study has shown daily intake can be increased to 9g, further reducing serum LDL-cholesterol concentrations linearly up to 17.4% .

There is no significant difference between plant sterols and stanols in their cholesterol lowering ability . Plant sterols and stanols may have a role in patients with borderline normo/hypercholesterolemia . However there is little evidence directly correlating plant sterol or stanol intake with cardiovascular clinical outcomes. Nonetheless their importance in modifying lipid profiles of patients is reflected in their incorporation in the National Cholesterol Education Program ATP III guidelines on lifestyle changes for elevated LDL-C levels .

Sometimes You Can Lower Cholesterol Without Medication

This diet is a great way to lower your cholesterol without medication. If you have high cholesterol levels, its worth a try. However, we still recommend that you consult a doctor about your labs. If you are on medication to lower your cholesterol, we recommend having your labs checked regularly. Sometimes our patients are able to quit taking their cholesterol medication after following a diet like this one and consulting their doctor. A dietitian would be able to help you identify what changes you can make to improve your lab levels. Feel free to contact us if you have any questions.

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How Is Cholesterol Measured

Most people with high cholesterol feel perfectly well and often have no symptoms. The best way to find out if your cholesterol is high is to have a blood test .

Visit your GP to determine whether you need to lower your cholesterol level and what action to take.

GPs can also do a heart health check, that calculates your heart disease and stroke risk.

Side Effects And Risks

Therapeutic Lifestyle Change (TLC Diet )Transformation tlc intro
  • Itâs important to follow your health care providerâs instructions for treating high blood cholesterol. Donât take dietary supplements instead of your prescribed medicine. Although thereâs evidence that some supplements, such as garlic and soy, can lower cholesterol, their effects are small compared to those of cholesterol-lowering medicines.
  • Red yeast rice products may be contaminated with citrinin, a substance that may cause kidney damage.
  • To use dietary supplements safely, read and follow the label instructions, and recognize that ânaturalâ does not always mean âsafe.â Keep in mind that dietary supplements can cause health problems if not used correctly or if used in large amounts, and some may interact with medicines. Most dietary supplements have not been tested in pregnant women, nursing mothers, or children.

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What Is High Cholesterol

There are two major forms of cholesterol: Low-density lipoprotein or LDL, also known as “bad” cholesterol, and high-density lipoprotein or HDL, also called “good” cholesterol. LDL is the main source of artery-clogging plaque. HDL, on the other hand, clears cholesterol from your blood.

Besides LDL and HDL, thereâs another kind of fat in your blood called triglycerides. Research shows that high levels of triglycerides, just like high levels of LDL, are linked to heart disease.

Your body needs cholesterol to build new cells, insulate nerves, and make hormones. Having too much, though, is a major risk for heart disease.

Ordinarily, your liver makes all the cholesterol your body needs. But you also get cholesterol from food. You’ll find these in many processed foods like doughnuts, frozen pizza, cookies, and crackers. You can also get it from milk, eggs, meat, and other animal products. Over time, without your even being aware, this extra cholesterol collects inside your body and begins to do damage.

Therapeutic Lifestyle Change Is The Missing Piece

To help employees with elevated health risks, most wellness programs offer challenges, courses, or coaching designed to help employees and their significant others improve nutrition habits and exercise patterns. Unfortunately, these relatively simple offerings arent always sufficient to help employees make large, sustainable improvements in elevated health risks.

The hardest thing for people to do is to change behaviors. Elevated blood cholesterol, blood pressure, and blood glucose doesnt just happen overnight. These elevated health risks develop over decades of exposure to unhealthy lifestyles. Since it takes decades to develop these elevated health risks and the habits that precede them, reversing the process takes concerted, long-term effort.

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