Therapeutic Lifestyle Changes, also known as the TLC Diet, is a dietary pattern recommended by the National Cholesterol Education Program, part of the National Institutes of Health, to control hypercholesterolemia. This pattern focuses on saturated fats and cholesterol, dietary options to enhance LDL cholesterol lowering, weight control, and physical activity.
High cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack and stroke. The National Institutes of Health created the National Cholesterol Education Program in 1985 to reduce high blood cholesterol levels. They created the TLC diet to be used alone or in conjunction with medication management to elevated cholesterol control. The treatment was established in the Adult Treatment Panel III (ATP III) for high cholesterol in adults which was released in 2002. Updated guidelines for cholesterol management were established in 2013 by the American Heart Association (AHA) and the American College of Cardiology (ACC) .
Essential Components of Therapeutic Lifestyle Changes The Therapeutic Lifestyle Changes components include: Macronutrient Distribution of the TLC Diet The Therapeutic Lifestyle Changes macronutrient profile includes:
The recommendations for cholesterol management through lifestyle changes from the National Cholesterol Education Program have evolved over time from epidemiological observations, animal studies, and clinical trials. Animal models have shown a direct relationship between LDL cholesterol and atherosclerosis. Diets high in saturated fat and cholesterol develop LDL cholesterol elevation and atherosclerosis. Epidemiologic evidence in humans supports this direct relationship between LDL cholesterol and coronary heart disease risk. One randomized crossover study completed at Tufts University and New England Medical Center looked at the Therapeutic Lifestyle Change Diet related to a typical Western diet. Thirty-six participants with moderately elevated cholesterol levels participated in two 32-day phases where the subjects consumed their normal dietary patterns or the experimental diet consistent with the NCEP recommendations. This diet provides 30% calories from fat, 7% calories from saturated fat, and 75 mg cholesterol per 1,000 calories. Relative to the Western diet, the TLC diet resulted in 11% lower LDL cholesterol. Additional studies have looked at the benefits of plant stanol and sterols on lowering LDL cholesterol. One randomized, placebo-controlled, crossover trial assessed the lipid-altering efficacy of a softgel capsule providing sterolated sterol / sterols in 28 subjects with primary hypercholesterolemia. Participants followed the TLC diet for 5 weeks followed by 6 weeks of the sterol / stanol capsule or placebo before crossing over to the other product for 6 weeks while continuing the TLC diet. It was reported that incorporation of sterols / stanols into the TLC diet produced positive changes in LDL cholesterol by 9.2%, total cholesterol by 7.4%, and triglycerides by 9.1%. A 1.800 mg / day of esterified plant sterols / stanols in adjunct to TLC diet to reduce lipid levels in patients with hypercholesterolemia. 1%. A 1.800 mg / day of esterified plant sterols / stanols in adjunct to TLC diet to reduce lipid levels in patients with hypercholesterolemia. 1%. A 1.800 mg / day of esterified plant sterols / stanols in adjunct to TLC diet to reduce lipid levels in patients with hypercholesterolemia.