What Is the TLC Diet?

The Therapeutic Lifestyle Changes diet, or TLC diet, was created by the National Institutes of Health. It’s designed for people who want to make heart-healthy diet and exercise choices. With millions of people at risk of cardiovascular disease, the TLC diet emphasizes the use of nutrition and exercise as a first-line approach to disease prevention. 

For more than a decade, health experts have regarded the TLC diet as one of the healthiest methods to reduce cholesterol levels and improve heart health. The diet seeks to eradicate unhealthy habits, such as poor dietary choices and a sedentary lifestyle.

Followers of the TLC diet aim for specific calorie and macronutrient intakes depending on their sex and health goals. Though the premise of the program is centered on improving heart health, some people also follow it to lose weight.

However, there is some concern that the TLC diet is outdated. The original manual, "Your Guide to Lowering Your Cholesterol with TLC," was published in 2005. Many of the studies surrounding the TLC diet are also from the early 2000s.

The U.S. News and World Report ranks the TLC diet number five in Best Diets Overall and gives it an overall score of 3.8/5. Learn more about what you can eat on the TLC diet to decide if it's the right choice for your health.

What Can You Eat?

Overall, the TLC diet is considered a low-fat diet that’s low in cholesterol and can be followed long-term. While it imposes many rules and restrictions, it’s been known to successfully help people lower their cholesterol levels. Followers of the TLC plan adhere to the following nutritional rules:

• Take in only enough calories to maintain a healthy weight.
• 25% to 35% of calories should come from total fat, including saturated fat.
• Saturated fat should account for less than 7% of calories.
• Limit dietary cholesterol to less than 200 mg per day.
• Consume 2 grams of plant sterols or stanols per day.
• Increase soluble fiber to between 10 grams and 25 grams per day.
• Limit meat consumption to 5 ounces or less per day.

What You Need to Know

The TLC diet is divided into three components: diet, physical activity, and weight management. The program recommends 30 minutes of moderate-intensity exercise to promote weight management. Followers should aim to exercise most days of the week, if not every day. 

Both diet and physical activity contribute to healthy weight management. According to medical experts, being overweight or obese increases the risk of high cholesterol, high blood pressure, diabetes, heart disease, and more. The TLC diet encourages people to make an effort to reach a healthy weight to further decrease the risk of serious health problems.

The TLC diet also emphasizes eating behaviors more so than the time of day meals are consumed. For example, the program advises against eating dinner or snacking while watching TV, as this can lead to overeating. You can also practice slowing down your eating to give your brain more time to register fullness.

Vegetables

High-fiber vegetables are recommended on the TLC diet. They’re naturally low in fat and calories, so they can be helpful in reaching both heart health and weight management goals. It’s ideal to consume three to five servings of vegetables per day.

Fruit

Fruit is another way to increase fiber intake on this diet. The TLC diet guidelines recommend adding fruit to cereal and consuming fresh fruits instead of fruit juice. Canned and dried fruits without added sugars are permitted. Aim for two to four servings per day.

Whole Grains

The TLC diet is not a low-carb diet, so grains are strongly encouraged—at least six servings of whole grains per day. This includes brown rice; ancient grains like quinoa; and pastas, breads, cereals, and crackers made with whole grains.

Legumes

Increasing the consumption of legumes like beans and lentils will boost your intake of heart-healthy fiber. There’s no recommended amount of servings per day for legumes, but they should be consumed on a regular basis because they’re an excellent source of soluble fiber.

Nuts and Seeds

While the TLC diet is a low-fat diet, it’s not a zero-fat diet. People following this plan are encouraged to consume good sources of fat, such as nuts and seeds. Consume them in moderation to ensure you stay within the range of 25% to 35% of total calories from fat.

Low-Fat Dairy Products

Fat-free or low-fat dairy products can be consumed two to three times per day. Make sure there are no more than 3 grams of fat per ounce.

Lean Cuts of Skinless Meat

Red meat, poultry, and fish are all permitted on the TLC diet as long as they’re lean, skinless, and lower in saturated fat. Lean protein sources made with soy, such as tofu, are also allowed. If you consume meat, the maximum is 5 ounces per day.

Some Vegetable Oils and Margarines

People following the TLC diet can consume unsaturated vegetable oils like olive oil and canola oil. They’re also encouraged to eat specially labeled margarines and vegetable oil spreads that contain plant stanols or sterols, which are believed to help lower cholesterol.

Fatty Cuts of Meat

While you can consume meat on the TLC diet, meats high in saturated fat are off-limits. Examples include fatty cuts of beef, pork, and lamb. You should also avoid meat with skin, such as poultry containing skin. Always trim excess fat off cuts of meat.

Processed Meat

Processed meats like bacon, sausage, and hot dogs are too high in saturated fat and dietary cholesterol for the TLC diet. These are foods that contribute to increased cholesterol levels and the risk of heart disease.

Fried and Processed Foods

To reduce your intake of trans fat, avoid foods fried in hydrogenated oils. Examples include french fries and fried chicken.

You should also eliminate other processed foods from your diet, including potato chips, crackers, cookies, and more. These foods are typically high in added salt and sugar and are also associated with an increased risk of heart disease.

Egg Yolks

The TLC diet takes a strict stance against egg yolks because they’re high in dietary cholesterol. Egg whites are permitted, however, and the recommendation to avoid dietary cholesterol may be outdated.

Full-Fat Dairy Products

Whole milk dairy products include butter, cream, and cheese. Since these are not low-fat options, they’re not recommended on the TLC diet. These foods are high in both saturated fat and dietary cholesterol, which should be limited on this plan.

Excess Salt and Sugar

Reducing salt intake is especially important for people who want to lower their blood pressure. The TLC diet requires followers to restrict their intake of salt to one teaspoon or less per day. Excess sugar is also prohibited as a measure to lower blood triglyceride levels.

Excess Alcohol

Alcohol on the TLC diet isn’t recommended, but small amounts are permitted. Women should consume no more than one serving per day, and men a maximum of two servings per day.

Sample Shopping List

The TLC diet focuses on heart-healthy whole foods and limits foods high in saturated fat and cholesterol. The following sample shopping list offers suggestions to help you get started on this plan. Note that this shopping list is not all-inclusive and there may be other foods that you prefer.

• High-fiber vegetables (broccoli, Brussels sprouts, carrots )
• Fruit (berries, apples, bananas)
• Whole grains (whole-grain bread, pasta, oatmeal, rice, quinoa, barley)
• Legumes (kidney beans, black beans, lentils, peas)
• Nuts and seeds (almonds, walnuts, cashews, macadamia nuts)
• Low-fat dairy products (milk, yogurt, cottage cheese)
• Lean protein sources (chicken, turkey, lean ground beef, salmon, tuna, tofu)
• Heart-healthy oils (olive oil, canola oil, sunflower oil)
• Margarine (with plant sterols)
• Eggs (consume the whites only)

Sample Meal Plan

Generally, the TLC diet consists of three meals and one snack. Meals are divided into breakfast, lunch, and dinner. If you normally skip breakfast, that is one habit the TLC diet wants to break, as skipping meals is not permitted.

The following three-day meal plan should give you a sense of what a few days on the TLC diet might look like. Note that this meal plan is not all-inclusive, and if you do choose to follow this diet, there may be other meals that are more appropriate for your tastes, preferences, and budget.

Day 1

• Breakfast: 3/4 cup Maple Pumpkin Pie Buckwheat Groats; 8 ounces orange juice
• Lunch: 1 cup Roasted Beet and Feta Salad (substitute low-fat feta); 1 serving Hummus Tuna Cucumber Bites
• Dinner: 1 serving Honey Mustard Herbed Salmon; 1 1/4 cups Oven Roasted Potatoes; 3 ounces spring mix greens tossed with extra virgin olive oil

Day 2

• Breakfast: 1 Papaya Yogurt & Walnut Boat; 1 serving Simple Green Juice
• Lunch: 1 cup Greek Yogurt Almond Chicken Salad served on two slices of 12-grain bread
• Dinner: Kale and Lentil Stuffed Sweet Potato; 1 cup Rainbow Vegetable Soup

Day 3

• Breakfast: 1 serving Overnight Oatmeal topped with 1/2 cup mixed berries
• Lunch: 1 1/2 cups Quick Roasted Tomato Soup With Fennel; 10 Whole Wheat Rosemary Crackers
• Dinner: 1 serving Spinach Spaghetti Aglio e Olio; 1 serving Mediterranean Hearts of Palm Salad

Pros and Cons

Pros

Encourages Healthy Lifestyle Habits

The TLC diet isn’t a quick fix or fad diet. It’s a combination of healthy lifestyle changes that can be sustained long-term to improve overall health.

While the focus is primarily on heart-healthy food, the TLC diet also makes an effort to encourage followers to exercise regularly. Other healthy lifestyle habits promoted on the TLC diet include drinking enough water, eating slower, and reading nutrition facts labels.

Incorporates Nutrient-Dense Whole Foods

In order to lose weight, you must consume fewer calories than you’re burning. That’s the basis of the calories in vs. calories out equation. However, the TLC diet isn’t just about weight loss.

To effectively lower cholesterol and reduce the risk of heart disease, certain foods must be eliminated or drastically reduced. The diet encourages nutrient-dense whole foods like fruits, vegetables, grains, legumes, nuts, and seeds, which are all naturally lower in calories and saturated fat.

Sustainable for Long-Term Health

The TLC diet was designed as a long-term solution to the widespread risk for heart disease. While followers might start to see results in a matter of months, they can drastically improve their cholesterol levels and heart disease markers if they stick with it for the long haul.

Cons

Might Be Outdated

One of the biggest critiques of the TLC diet is that it’s outdated. Many of the studies on the TLC diet are from the early 2000s. There’s concern that some of the suggestions of the TLC diet manual are unnecessary, such as reducing dietary cholesterol to 200 mg per day.

A 2020 report published in Circulation indicates that healthy dietary patterns can reduce the risk of heart disease more effectively than a specific target for dietary cholesterol. "A recommendation that gives a specific dietary cholesterol target within the context of food-based advice is challenging for clinicians and consumers to implement," the researchers concluded.

Requires Diligent Tracking

The TLC diet has specific calorie and macronutrient requirements for its followers. People on this diet must diligently track their food intake to ensure that they meet these requirements.

Not Accommodating to Dietary Restrictions

For those with food allergies, adjusting the TLC diet requires some creativity. The manual doesn’t offer advice for people who avoid certain foods that are recommended on this diet.

With a few modifications, however, the TLC diet can still suit the needs of these individuals. Vegans or vegetarians, for example, can adopt a meatless TLC diet by swapping out lean meats for soy protein or legumes.

Is the TLC Diet a Healthy Choice for You?

The TLC diet isn’t the only diet that claims to reduce cholesterol levels and the risk of heart disease. Many diets that encourage heart health tend to emphasize whole foods that are naturally lower in fat. They also tend to be restrictive. Similar heart-healthy diets include:

• Whole foods diet: Like the TLC diet, the whole foods diet encourages unprocessed foods that are naturally lower in calories, saturated fat, salt, and sugar. This is typically regarded as a safe and nutritious diet.
• Engine 2 diet: This restrictive diet eliminates animal products and vegetable oils. It’s known to have heart health benefits and also aid in weight loss.
• Mediterranean diet: Widely known for its heavy use of olive oil, the Mediterranean diet is also associated with a reduced risk of heart disease. It’s also low in processed foods yet high in fiber. However, this diet may be higher in fat than the TLC diet.

In terms of how the TLC diet compares to advice from health experts, there is certainly a lot of overlap. The U.S. Department of Agriculture's 2020–2025 Dietary Guidelines for Americans recommends a variety of nutrient-rich foods like fruits, vegetables, whole grains, lean protein sources, low-fat dairy products, and healthy fats for a well-balanced diet. While the USDA's guidelines are for the general public, the TLC diet is designed specifically with heart health in mind.

The TLC diet is especially low in saturated fat and dietary cholesterol compared to the USDA's recommendations. For adults, the USDA advises no more than 10% of total daily calories from saturated fat. The TLC diet is more strict, with a recommendation of fewer than 7% of calories from saturated fat.

Current federal guidelines indicate that dietary cholesterol consumption should be "as low as possible" without citing a specific number (previous editions of the guidelines have indicated no more than 300 mg). The TLC diet has a maximum dietary cholesterol intake of 200 mg.

The USDA advises that the number of calories needed to maintain a healthy weight varies based on age, sex, and level of physical activity. Those following the TLC diet are also advised to keep track of their daily intake of both calories and macronutrients. Use this calculator to estimate a daily calorie target to help you stay on track with your goals.

Health Benefits

The TLC diet has been shown to reduce cholesterol, decrease the risk of heart disease, lower blood pressure, and more. It may also help stabilize blood sugar and reduce oxidative stress.

This plan can also be an effective strategy for weight loss and weight maintenance. By consuming fewer calories, exercising regularly, and choosing foods that are low-fat, high-fiber, and nutrient-dense, followers can lose weight in a healthy and sustainable way.

While the TLC diet is arguably a healthy choice, some aspects of the plan's guidelines may be out of date. For instance, a 2020 report published in Circulation indicates that healthy dietary patterns can reduce the risk of heart disease more effectively than a specific target for dietary cholesterol, hence why some experts say the TLC diet's limit on dietary cholesterol is unnecessary.

"A recommendation that gives a specific dietary cholesterol target within the context of food-based advice is challenging for clinicians and consumers to implement," the researchers concluded.

Health Risks

While there are no common health risks associated with the TLC diet, the recommendations for calorie intake for weight loss are low, especially for women at just 1,000 to 1,200 calories per day.

A diet that is very low in calories isn’t sustainable, nor is it suitable for athletes, or people who are pregnant or breastfeeding. Following a low-calorie diet for an extended period of time may also increase feelings of hunger and fatigue and slow the body's metabolism.

A Word From Verywell

The TLC diet is not a new diet, yet many people become new followers of this plan each year. Despite some of the critiques, the diet is still recommended by many health professionals as a way to make a heart-healthy lifestyle change.

If you’re at risk of high cholesterol and heart disease, ask your doctor about the TLC diet. Though it’s low in fat and cholesterol, it’s also high in water intake, dietary fiber, nutrients, and complex carbohydrates, and encourages healthy habits, like regular exercise. Overall, the TLC diet isn’t just a diet—it’s a lifestyle with the goal of improved health and well-being.

Remember, following a long-term or short-term diet may not be necessary for you and many diets out there simply don’t work, especially long-term. While we do not endorse fad diet trends or unsustainable weight loss methods, we present the facts so you can make an informed decision that works best for your nutritional needs, genetic blueprint, budget, and goals.

If your goal is weight loss, remember that losing weight isn’t necessarily the same as being your healthiest self, and there are many other ways to pursue health. Exercise, sleep, and other lifestyle factors also play a major role in your overall health. The best diet is always the one that is balanced and fits your lifestyle.