What's the TLC Program for High Cholesterol?

You’ve probably heard that you need to keep your cholesterol under control. But do you get confused about what’s good to eat and what’s not? Do you wonder about whether you’re active enough and whether you’re at the right weight?

The TLC Program, short for Therapeutic Lifestyle Changes, could clear up some of your questions.

The National Heart, Lung, and Blood Institute made it for people who want to control their cholesterol. Even if you take medications for it, you may want to consider the possible benefits of this program.

It has three parts: diet, exercise, and weight control. The goal: Reduce your risk of heart disease. This is not a fad diet. It’s considered a “balanced” plan, and the idea is to change your habits for the long run.

It’s good to learn a few basics about your body first and then get an overview of the program.

What Is Cholesterol?

Every cell in your body has cholesterol, a fat-like, waxy substance. And it’s something you need. It helps you digest food as well as make vitamin D and certain hormones. The issue is how much you have.


A substance called lipoprotein carries it throughout your system. It comes in two main varieties:

  1. Low-density lipoprotein(LDL). It’s often called the “bad cholesterol.”
  2. High-density lipoprotein (HDL). That’s the “good cholesterol.”

When levels of LDL are too high, your chance of heart disease increases. The program tries to lower your LDL levels. But you want to raise those good HDL levels, and the diet aims for that, too.

How Does TLC Work?

This plan focuses on foods that are low in natural cholesterol and saturated fat but high in the so-called “good fats.” One class of these good fats is monounsaturated fats. You also get a lot of fiber in this diet.

When you follow the program, you shoot for 2 key numbers every day:

  1. Less than 7% of your calories from saturated fat.
  2. Less than 200 milligrams of dietary cholesterol.

You do this to lower your LDL level. You can always talk to your doctor or dietician in more detail about how to measure how much fat and dietary cholesterol you’re taking in.

You may be surprised how easy it is to find food that tastes great and also satisfies your hunger on the program.

The First Step: Fats

When you follow the TLC Program, you lower the amount of fat you eat and choose things that are better for your heart. All the fat you eat in one day should not go over 35% of total calories.

Try to avoid saturated fats. Some of the foods they can be found in include:

  • Butter
  • Egg yolks
  • Fatty cuts of meat
  • Lard
  • Whole milk dairy products

Trans Fats

These can also raise cholesterol. Avoid them when you can. They are found in products such as:

  • Fried foods
  • Shortening
  • Stick margarine
  • Sweets

Foods made with hydrogenated oil or partially hydrogenated oil should also be limited. When you’re grocery shopping, be sure you’re reading labels.

The Good Fats

Up to 20% of your calories can come from monounsaturated fats. They can help lower your LDL levels. Plus, these fats don’t lower your good, or HDL, cholesterol levels.

Some sources include:

  • Avocados
  • Olive, canola, and almond oils
  • Peanut butter

About 10% of your calories can come from polyunsaturated fats. Use these in moderation. While they lower LDL levels, which you want to happen, they can also lower HDL levels, which is what you don’t want. Some choices:

  • Fatty fish such as salmon, mackerel, herring, and trout
  • Pumpkin and sunflower seeds
  • Soybean, safflower, sunflower, cottonseed, and corn oils

Dietary Cholesterol

Your body makes cholesterol, but you also get it from food. Animal products such as red meat, shellfish, and egg yolks, for example, all contain cholesterol.

With the TLC Program, you must keep your intake of dietary cholesterol to less than 200 milligrams a day. Choose lean meat and reduced-fat dairy products as often as you can.


It’s important to growth and helps your body repair cells. Protein-rich foods should make up about 20% of your daily total calories. But here’s the catch. Many protein sources are also high in cholesterol and saturated fat.

You have options beyond lean meats and reduced-fat dairy. They include:

  • Beans
  • Lentils
  • Seeds
  • Soy products

The Right Carbs

Carbohydrates are an important part of good nutrition, but you need to choose the right kind.


The program calls for about 50% to 60% of your calories to come from them.

Aim for carbs that are complex, meaning they are not heavily processed and are high in fiber. That’s important, because the TLC diet calls for about 20 to 30 grams of fiber a day.

Some great choices:

  • Beans
  • Fruit
  • Lentils
  • Quinoa
  • Vegetables
  • Whole grains and whole wheat sources

That’s a whole lot of information about food to take in, but there are two more pillars to the program.


Physical activity is also part of the plan. You should try to get at least 30 minutes of moderate exercise most, if not all, days of the week.

Brisk walking is a great place for many people to start. Some other suggestions:

  • Bicycling
  • Bowling
  • Dancing
  • Gardening

Of course, you should talk with your doctor before you start a new exercise plan.


The third part of the TLC Program is about shedding unwanted pounds. Besides the cholesterol, extra fat can increase your chances for high blood pressure, diabetes, heart disease, and other issues.


If you’ve improved your diet and exercise, but are still struggling with weight, the program suggests checking with your doctor.

It also offers ideas to help with your goal of weight loss:

  • Slow down while you eat; it takes the brain a while to get the message you’re full
  • Eat more fruits and vegetables; they make you feel full
  • Serve your food on smaller plates
  • Eat three meals a day; don’t skip any

Can I Do This Alone?

The TLC Program is most successful when you work directly with your doctor or dietician, who can also guide you to become more physically active, manage your weight, and reach your cholesterol goals.

Your doctor can also help you control other things that make heart disease more likely, including quitting smoking and controlling high blood pressure, for example.

Can I Stop My Cholesterol Medication?

For some people, lifestyle changes alone may not be enough. You will need medication, too. But with lifestyle changes such as the TLC Program, you may be able to take lower doses.

How Do I Begin?

Talk to your doctor and get your cholesterol levels checked. Based on those results and other factors, they can see whether you have a chance of getting heart disease.

With the TLC Program, you start out meeting with your doctor every six weeks to track how well lifestyle changes are working for you.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on November 19, 2020



U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. “Your Guide to Lowering Your Cholesterol With TLC.”

Press Release, National Heart, Lung, and Blood Institute.

National Heart, Lung, and Blood Institute. “What is Cholesterol?”

American Heart Association. “Good vs. Bad Cholesterol.”

Cleveland Clinic. “Cholesterol and Nutrition – TLC.”

Mayo Clinic, “Weight loss: What are the options?”

American College of Cardiology, “High Cholesterol: The TLC Diet.”

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