What Is the TLC Diet?

bowl of oats with fruit, nuts and milk

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In This Article

The Therapeutic Lifestyle Changes diet, or TLC diet for short, was founded by the National Institutes of Health. It’s designed for people who want to make heart-healthy diet and exercise choices. 

The TLC diet can be especially helpful in lowering cholesterol and reducing the risk of heart disease.

Followers of the diet aim for specific calorie and macronutrient intakes depending on their sex and health goals. The premise of the TLC diet is primarily to improve heart health, but some people also use it to lose weight.

What Experts Say

“The TLC diet is designed to lower LDL cholesterol. Experts agree it’s grounded in evidence-based recommendations like limiting trans fats, achieving a healthy weight, and eating more fiber. Some question whether certain recommendations, such as limiting cholesterol, are outdated.”

Chrissy Carroll, RD, MPH

Background

With millions of people at risk of heart disease, the National Institutes of Health designed a plan to reduce those risks. It’s called the TLC diet, and it emphasizes the use of nutrition and exercise as heart disease prevention rather than prescription medication. 

The diet also seeks to eradicate unhealthy habits, such as poor dietary choices and a sedentary lifestyle. Since these habits contribute to increased risk of high cholesterol and heart disease, the TLC diet aims to overhaul people’s lifestyle from every angle.

For more than a decade, health experts have regarded the TLC diet as one of the healthiest methods to reduce cholesterol levels and risk of coronary heart disease. 

However, there is some concern that the diet is outdated. The original manual, Your Guide to Lowering Your Cholesterol with TLC, was published in 2005. Many of the studies surrounding the TLC diet are also from the early 2000s. The USDA has determined that more research is needed on the relationship between heart health and the methods outlined in the TLC diet.

How It Works

The TLC diet is divided into three components: diet, physical activity, and weight management. 

Followers of the TLC diet adhere to specific nutritional rules. It’s recommended that people on this diet keep track of their overall calories and macronutrients. 

If heart health is the only goal, the manual recommends 2,500 calories per day for men and 1,800 for women. If weight loss is a secondary goal, men are recommended to decrease calories to 1,200-1,600 and women to 1,000-1,200 in order to lose weight.

If heart health is the only goal, the 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 1,200-1,600, and 1,000-1,200 for women.

Other Rules Include:

  • Take in only enough calories to maintain a healthy weight
  • 25-35% 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 10-25 grams per day
  • Limit meat to five ounces or less per day

The TLC diet also recommends getting 30 minutes of moderate-intensity exercise to promote healthy weight management. Followers should aim to exercise most days of the week, if not every day. 

Both the diet and physical activity parts of the TLC diet contribute to the third part, which is weight management. According to the manual, being overweight or obese increases the risk of high cholesterol, high blood pressure, diabetes, heart disease and more. The TLC diet encourages people to make an effort towards getting to a healthy weight to further decrease the risk of serious health problems.

Overall, the TLC diet is considered a low-fat diet that’s low in cholesterol and can be done long-term. While it imposes many rules and restrictions, it’s been known to successfully help people lower their cholesterol levels.

What to Eat

Compliant Foods

  • Vegetables

  • Fruit

  • Whole grains

  • Legumes

  • Nuts and seeds

  • Low-fat dairy products

  • Lean cuts of skinless meat

  • Some vegetable oils and margarines

Non-Compliant Foods

  • Fatty cuts of meat

  • Processed meat

  • Fried and processed foods

  • Egg yolks

  • Full-fat dairy products

  • Excess salt and sugar

  • Large amounts of alcohol

Compliant Foods

Vegetables

High-fiber vegetables like broccoli, brussels sprouts and carrots are recommended on the TLC diet. They’re naturally low in fat and calories, so they can be helpful in reaching both heart health and weight management goals. It’s ideal to consume 3-5 servings of vegetables per day.

Fruit

Fruit is another way to increase fiber intake on this diet. Followers of this diet are recommended to add fruit to cereal and consume fresh fruits instead of fruit juice. Canned and dried fruit without added sugars are permitted. Aim for 2-4 servings per day.

Whole Grains

The TLC diet is not a low-carb diet, so grains are not only allowed, but encouraged. It’s recommended to consume at least six servings of whole grains per day. This includes whole-grain bread, cereal, pasta, rice, potatoes, oatmeal, quinoa, barley and more.

Legumes

Increasing the consumption of legumes like beans and lentils is listed as a fiber solution in the TLC diet manual. There’s no recommended amount of servings per day of legumes, but they should be consumed on a regular basis because they’re an excellent source of soluble fiber.

Nuts and Seeds

While the TLC diet is a low-fat diet, it’s not a zero-fat diet. People following this diet are encouraged to consume healthy sources of fat, such as nuts and seeds. Consume them in moderation to ensure you stay in the 25-35% of total calories from fat range.

Low-fat Dairy Products

Fat-free or low-fat dairy products can be consumed 2-3 times per day. Make sure there are no more than 3 grams of fat per ounce.

Lean Cuts of Skinless Meat

Red meat, poultry and fish are all permitted on the TLC diet as long as they’re lean, skinless and lower in saturated fat. Lean protein sources made with soy, such as tofu, are also allowed. If you consume meat, the maximum is five ounces per day.

Some Vegetable Oils and Margarines

People following the TLC diet can consume unsaturated vegetable oils like olive oil and canola oil. They’re also encouraged to eat specially labeled margarines and vegetable oil spreads that contain plant stanols or sterols, which are believed to help lower cholesterol.

Non-Compliant Foods

Fatty Cuts of Meat

While you can consume meat on the TLC diet, meats high in saturated fat are off-limits. Examples include fatty cuts of beef, pork and lamb. You should also avoid meat with skin, such as poultry containing skin. Always trim excess fat off cuts of meat.

Processed Meat

Similar to fatty cuts of meat, processed meats like bacon, sausage and hot dogs are too high in saturated fat and dietary cholesterol for the TLC diet. These are foods that contribute to increased cholesterol levels rather than decreased risks. 

Fried and Processed Foods

To reduce your intake of trans fat, avoid foods fried in hydrogenated oils. Examples include french fries and fried chicken. You should also eliminate processed foods from your diet, including potato chips, crackers, cookies and more. These foods are typically high in added salt and sugar.

Egg Yolks

The TLC diet takes a strict stance against egg yolks because they’re high in dietary cholesterol. Egg whites are permitted, however.

Full-fat Dairy Products

Whole milk dairy products include butter, cream, and cheese. Since these are not low-fat options, they’re not recommended on the TLC diet. These foods are high in both saturated fat and dietary cholesterol, which should be limited on this diet.

Excess Salt and Sugar

Reducing salt intake is especially important for people who want to lower their blood pressure. The TLC diet requires its followers to restrict their intake of salt to one teaspoon or less per day. Excess sugar is also prohibited as a measure to lower blood triglyceride levels.

Large Amounts of Alcohol

Alcohol on the TLC diet isn’t recommended, but small amounts are permitted. Women should consume no more than one serving per day, and men have a maximum of two servings per day. High-calorie alcohol isn’t recommended for people who want to lose weight on the TLC diet. Alcohol is also believed to contribute to high blood pressure and high triglycerides.

Recommended Timing

Generally, the TLC diet consists of three meals and one snack. Meals are divided into breakfast, lunch, and dinner.

The TLC diet is concerned with correcting your eating behaviors more than the time of day you eat your meals. For example, they advise against eating dinner or snacking while watching TV as this can lead to overeating.

You can also practice slowing down your eating, as this gives your brain more time to register fullness.

If you normally skip breakfast, that is one habit the TLC diet wants to break. Skipping meals isn’t permitted. Skipping or waiting long periods between meals can lead to overeating later in the day or making food choices that don’t align with the TLC diet guidelines.

Resources and Tips

The National Institutes of Health published a manual designed to walk you through the TLC diet: Your Guide to Lowering Cholesterol with TLC. Though it was originally published in 2005, it’s still referred to as the go-to source for information on this heart-healthy diet.

There are also studies on the effectiveness of the TLC diet. A 2002 study found that the TLC reduced patients’ LDL cholesterol levels by 11% on average. A 2003 study had similar results—the TLC diet can lead to a significant decrease in total cholesterol and triglyceride levels.

Some TLC-friendly recipes include:

Modifications

The TLC diet contains many allergens and animal products, making it difficult for people with dietary restrictions. With a few modifications, the TLC diet can likely suit your needs.

For vegans or vegetarians, a meatless TLC diet can be adopted. Simply swap out lean meats for soy protein or legumes.

Allergens like dairy, soy, gluten, nuts, fish, etc. are all permitted on the TLC diet. No substitutions are mentioned for people with allergies, so these should foods should be omitted or swapped out. If you have alternatives available to you, such as gluten-free bread or dairy-free yogurt, make sure they fit into your calorie and macronutrient goals. Also, make sure they meet the TLC diet guidelines.

Pros and Cons

Pros

  • Encourages healthy lifestyle habits

  • Incorporates many whole foods

  • Sustainable

  • Associated with several health benefits

  • May aid in healthy weight loss

Cons

  • May be based on outdated information

  • Requires diligent tracking

  • Weight loss calories are low

  • Not accommodating to dietary restrictions

Pros

Encourages Healthy Lifestyle Habits

The TLC diet isn’t a quick fix or fad diet. It’s a combination of healthy lifestyle changes that can be sustained long-term to improve overall health. While the focus is primarily on heart-healthy food, the TLC diet also makes an effort at encouraging followers to exercise regularly. Other healthy lifestyle habits promoted on the TLC diet is drinking enough water, eating slower and reading nutrition labels.

Incorporates Many Whole Foods

In order to lose weight, you must consume fewer calories than you’re burning. That’s the basis of the calories in vs. calories out equation. However, the TLC diet isn’t just about weight loss—it’s designed to lower cholesterol and reduce the risk of heart disease. To do that, certain foods must be eliminated or drastically reduced. The TLC diet incorporates many whole foods, such as fruits, vegetables, grains, legumes, nuts, seeds, etc. that are all naturally lower in calories and saturated fat, yet they’re dense in nutrients.

Sustainable

The TLC diet was designed as a long-term solution to the epidemic of heart health risks. While followers can begin to see results in a matter of months, they can drastically improve their cholesterol levels and heart disease markers if they still with it long-term.

Associated With Several Health Benefits

One of the go-to diets for heart health is the TLC diet. It’s known for its health benefits, including reduced cholesterol, decreased risks of heart disease, lowered blood pressure, weight management and more. It may also help stabilize blood sugar and reduce oxidative stress.

May Aid in Healthy Weight Loss

People following the TLC diet may lose weight and improve their heart health at the same time. Your calorie goal on the TLC diet will differ depending on your sex and goals. By consuming fewer calories, exercising regularly and consuming foods that are low-fat, high-fiber and nutrient-dense, followers may lose weight in a healthy, sustained way.

Cons

May be Based on Outdated Information

One of the biggest critiques of the TLC diet is that it’s outdated. Many of the studies on the TLC diet are from the early 2000s. There’s concern that some of the suggestions of the TLC diet manual are unnecessary, such as reducing dietary cholesterol and saturated fat. 

Requires Diligent Tracking

The TLC diet has specific calorie and macronutrient requirements for its followers. People on this diet must diligently track their food intake to ensure they meet these requirements.

Weight Loss Calories Are Low

The weight loss calories for women are especially low at 1,000-1,200 calories per day. A diet that low in calories isn’t sustainable, nor is it suitable for athletes, pregnant women or breastfeeding women. A low-calorie diet may also increase feelings of hunger and increase the risk of nutritional deficiency

Not Accommodating to Dietary Restrictions

Adjusting the TLC diet to dietary allergies and restrictions requires some creativity. The manual doesn’t offer any advice for people who don’t consume food groups recommended on this diet. Foods containing meat, dairy, gluten, nuts and other allergens are recommended daily on the TLC diet. For vegans, vegetarians and people with dietary allergies, adjusting the TLC diet can be a challenge.

How It Compares

The TLC diet incorporates multiple servings from each of the main food groups, and it emphasizes nutrient-dense foods that are high in fiber. However, it differs slightly from some of the USDA dietary guidelines and those of other diets.

The 2019 U.S. News and World Report Best Diets ranks the TLC diet number 8 in Best Diets Overall and gives it an overall score of 3.7/5.

USDA Recommendations

The USDA recommendations are for the general public, while the TLC diet is designed specifically with heart health in mind. Naturally, there will be some differences. Though there is a lot of overlap, the TLC diet is especially low in saturated fat and dietary cholesterol. 

Low in Saturated Fat

The 2015-2020 USDA Dietary Guidelines recommend fewer than 10% of total calories from saturated fat for adult men and women. The TLC diet is more strict with a recommendation of fewer than 7% of calories from saturated fat.

Low in Dietary Cholesterol

USDA guidelines allow up to 300 mg of dietary cholesterol per day, but the TLC diet has a maximum of 200 mg. There is debate on whether dietary cholesterol affects the risks of heart disease. The guidelines conclude that more research is needed.

Similar Diets

The TLC diet isn’t the only one that claims to reduce cholesterol levels and risks of heart disease. Many diets that encourage heart health tend to be high in whole foods, yet low in fat. They also tend to be restrictive. Similar heart-healthy diets include:

  • Whole foods diet: Like the TLC diet, the whole foods diet is high in unprocessed foods. This results in foods that are naturally lower in calories, saturated fat, salt and sugar. This is typically regarded as a safe and nutritious diet.
  • Engine 2 diet: This diet takes the TLC diet a step further. No animal products or vegetable oils are allowed. It’s known to have heart health benefits and aid in weight loss.
  • Mediterranean diet: Widely known for its heavy use of olive oil, the Mediterranean diet is often associated with reduced risk of heart disease. It’s also low in processed foods yet high in fiber. However, this diet may be higher in fat than the TLC diet.

A Word From Verywell

This is not a new diet, yet many people are new followers of the TLC diet every year. It’s still recommended by many health professionals as a heart-healthy lifestyle change. However, it’s been critiqued in recent years for being too low in dietary cholesterol and saturated fat.

If you’re at risk of high cholesterol and heart disease, consider the TLC diet. Though it’s low in fat and cholesterol, it’s high in water intake, fiber, nutrients, complex carbohydrates and regular exercise. Overall, the TLC diet isn’t just a diet—it’s a lifestyle with the goal of shifting people from unhealthy habits to healthier ones.

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