The American Heart Association, or AHA, supports the Therapeutic Lifestyle Changes, or TLC Diet developed by the National Heart, Lung and Blood Institute's National Cholesterol Education Program. The TLC diet is recommended for people with or at higher risk of developing cardiovascular disease, including those with high levels of low-density lipoprotein cholesterol, better known as bad cholesterol. The diet emphasizes lifestyle changes that prevent heart attacks and help to lower cholesterol.
Fats
The TLC diet calls for a total fat consumption between 25 percent to 35 percent of total calories consumed. This percentage is then broken down into saturated, polyunsaturated and monounsaturated fats. Saturated fat raises LDL cholesterol and it is recommended to keep intake to less than 7 percent of total calories. Saturated fat is primarily found in animal products. Polyunsaturated and monounsaturated fat can actually lower blood cholesterol levels if consumed in place of saturated fat. Due to this cholesterol lowering effect, the TLC diet calls for a maximum of 10 percent and 20 percent of polyunsaturated and monounsaturated fat respectively. Fish, nuts, oils and seeds contain poly- and mono-unsaturated fat.
Dietary Cholesterol
Dietary cholesterol refers to the cholesterol gained through food, and not the cholesterol produced by the body. Most people naturally produce adequate cholesterol, so any consumed through dietary sources is considered extra and can cause higher LDL levels. For this reason the TLC diet recommends consuming less than 200mg of cholesterol daily. Foods such as dairy products, meats and eggs contain cholesterol, while plant-based foods do not.
Carbohydrates
Carbohydrates, or sugars, provide energy needed by cells for growth and reproduction. Sugar can be naturally found in food or added during processing. The TLC diet recommends between 50 percent to 60 percent of total calories from carbohydrates, with the majority from natural sources such as fruits, whole grains and dairy products.
Protein
The heart is a muscle, and all muscles are composed of protein. Adequate protein allows the heart to pump blood throughout the body. About 15 percent of calories should come from protein, according to the TLC diet recommendations. Lean meats, low fat dairy, nuts and soy products are excellent sources of protein.
Stanols and Sterols
Stanols and sterols are naturally occurring substances found in plants. In the human body, stanols and sterols mimic cholesterol and thus block the absorption of actual cholesterol. There are only so many cholesterol receptors into the blood stream. So when stanols and sterols are using these receptors instead of dietary cholesterol, excess cholesterol in the intestinal tract will be excreted from the body. Two grams of stanols and sterols a day is recommended, but it can be tricky to find them in products. Look for fortified foods such as margarine, yogurt and salad dressings.
Fiber
Soluble fiber works to lower LDL levels in much the same way as many cholesterol medications. Fiber reduces bile absorption in the intestines, thus causing the bile to be excreted. Since bile is necessary for normal function, the body then converts cholesterol into bile, which reduces the amount of cholesterol in the blood stream. The AHA recommends 10 to 25g of fiber daily. Foods high in soluble fiber include whole grains, oatmeal, peas, bran, rice and fruit skins.
