A low cholesterol therapeutic diet, also known as the therapeutic lifestyle changes plan, or TLC diet, is a diet low in saturated fats and cholesterol, and high in fiber. It is recommended for individuals who have an elevated low-density lipoprotein, or "bad," cholesterol reading of over 130 mg per deciliter.
Saturated Fat, Cholesterol and Animal Foods
The recommendations for saturated fat and cholesterol for the TLC diet are stricter than those for the general population. Saturated fat should not exceed 7 percent of total calories. Cholesterol intake should be 200 mg or less daily. The TLC diet recommends limiting egg yolks to two a week and the consumption of only the leanest cuts of beef, such as loin and round cuts. Organ meats should be avoided. Shellfish may be consumed occasionally because they also contain cholesterol. Total meat consumption (including lean pork and skinless poultry) should be limited to 5 oz. daily. Nonfat or low-fat dairy products are limited to two to three servings daily.
Fruits, Vegetables and Grains
The TLC diet recommends three to five servings daily of fresh, frozen or dried vegetables, dried beans and peas. They should be without added salt, fats or sauces. Like vegetables, fruits are important sources of vitamins, fiber and other nutrients. Consume two to four servings daily of fresh, frozen, dried or canned fruits, without added sugars. Eat six or more servings (the amount depends on calorie needs) of grains, cereals and breads daily. Foods in this group are high in complex carbohydrates and dietary fiber and usually low in total fat, especially saturated fat, and cholesterol. Avoid refined grains with added sugars and fats.
Emphasis on Soluble Fiber
Consuming foods rich in dietary fiber, especially soluble fiber (found only in plant foods), lowers LDL levels. Soluble fiber expands in the digestive system, forming a gel that helps "trap" cholesterol and eliminate it from the system. At least one-third of daily fiber consumption should be soluble. Foods that provide the most soluble fiber include all types of beans and legumes, oats and oat bran, unpeeled produce such as apples, carrots, potatoes and pears), dried fruits, and vegetables such as artichokes, broccoli, Brussels sprouts and sweet potatoes.
Fats and Oils
In general, added fats and fatty foods should be minimized. While nuts and seeds are high in calories and total fat, they are rich in heart-healthy unsaturated fat. Unsalted nuts and seeds may be eaten in moderation without exceeding energy (calorie) needs. Unsaturated vegetable oils (such as canola and olive), soft tub margarines or spreads made from vegetable oils without hydrogenated fats, or trans fats, as well as low-fat salad dressings may be eaten in small amounts.
Other TLC Considerations
The TLC plan also encourages exercise and weight control. As weight increases, so do cholesterol levels and blood pressure, in general. Plant stanols or sterols occur naturally in small amounts in many plant foods. They help block the absorption of cholesterol from the digestive tract. Certain food products are fortified with plant stanols or sterols, such as cholesterol-lowering margarines or salad dressings. These can be added to the diet in moderation.
References
- American Heart Association serum cholesterol levels
- American Heart Association: Step I, Step II, and TLC diets
- Current Atherosclerosis Reports; "Cholesterol-Lowering Effect of Plant Sterols"; S.S. AbuMweis and P.J. Jones; December 2008
