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Cholesterol & Triglycerides Health Center

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Topic Overview

    Therapeutic Lifestyle Changes (TLC) is a program that can help you lower cholesterol. The lifestyle changes include diet, exercise, weight loss, and not smoking. Your doctor will want you to follow TLC even if you are taking cholesterol-lowering medicine. And medicine will work better if you have healthy habits.

    This program is recommended by the National Cholesterol Education Program of the U.S. National Institutes of Health.1

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    TLC diet

    People have varying degrees of success in lowering their cholesterol by changing their diets. Those who are most successful using diet changes to lower their cholesterol are those who lose excess weight. Diet changes are usually the first step in lowering cholesterol before medicines are added.

    The diet's main focus is to reduce the amount of saturated fat you eat, because saturated fat elevates your cholesterol. You can reduce the saturated fat in your diet by limiting the amount of meat and whole milk products you eat. Choose low-fat products from those food groups instead. Replace most of the animal fat in your diet with unsaturated fat, especially monounsaturated oils, such as olive, canola, or peanut oil. If monounsaturated fat is substituted for saturated fat, it lowers LDL ("bad") cholesterol and keeps HDL ("good") cholesterol up.

    What can you eat?

    The TLC diet recommends that you eat specific amounts of different types of foods. These amounts are sometimes a percentage of your total calorie intake for each day.

    • Saturated fat: Less than 7% of total calories
    • Polyunsaturated fat: Up to 10% of total calories
    • Monounsaturated fat: Up to 20% of total calories
    • Carbohydrate: 50% to 60% of total calories
    • Soluble fiber: At least 5 to 10 grams a day
    • Protein: Approximately 15% of total calories
    • Cholesterol: Less than 200 mg a day
    • Total calories: Balance calories taken in and calories burned to reach and stay at a healthy weight.

    Avoid trans fat. Foods with trans fats include some vegetable shortening, crackers, cookies, and packaged snack foods.

    Therapeutic Lifestyle Changes (TLC) diet recommendations
    Food group Number of servingsServing size

    Lean meat, poultry, fish, dry beans, and dry peas

    No more than 5 ounces total a day

    • 5 ounces maximum a day of lean meat, poultry, or fish
    • Substitute ¼ cup dry beans or peas for 1 ounce of meat.

    Eggs

    No more than 2 yolks a week

    1 whole egg. Egg whites or substitutes are not limited.

    Low-fat milk and milk products

    2–3 a day

    • 1 cup fat-free or 1% milk
    • 1 cup nonfat or low-fat yogurt
    • 1 ounce nonfat or low-fat cheese (3 grams of fat or less per ounce)

    Fruits

    2–4 a day

    • 1 piece fruit, such as apple, orange, or ½ a banana
    • ½ cup canned fruit
    • 1 cup berries or melon
    • ¾ cup fruit juice

    Vegetables

    3–5 a day

    • 1 cup raw leafy greens
    • ½ cup cooked or raw vegetables
    • ¾ cup vegetable juice

    Bread, cereals, pasta, rice, and other grains

    At least 6 a day

    • 1 slice of bread
    • ½ hot dog or hamburger bun, bagel, or English muffin
    • 1 ounce cold cereal
    • ½ cup cooked pasta, rice, noodles, or other grains

    Sweets and snacks

    Within calorie limit

    Choose snacks that are low in fat or are made with unsaturated fat.

    Your doctor or dietitian might recommend that you add soluble fiber or a cholesterol-lowering margarine to your diet. These might help you lower LDL cholesterol. Soluble fiber is found in foods like oats, beans, and fruit. Cholesterol-lowering margarines contain plant stanols and sterols.

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      or
      Answer:
      Desirable
      0-199
      Borderline
      200-239
      High
      240+

      Your level is currently

      Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

      Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

      Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

      Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

      Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

      Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

      Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

      Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

      Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

      Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

      Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

      Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

      Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

      Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

      Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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