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Explore the myths surrounding this popular health topic and learn how to restore and maintain healthy cholesterol.

How to Lower Bad Cholesterol Levels with Therapeutic Lifestyle Choices

The Therapeutic Lifestyle Changes (TLC) is a cholesterol-lowering program you may have heard of before. Now learn what it is and how it may help you lower "bad" cholesterol.


Heart disease is the leading cause of death in the U.S., taking the lives of 1 out of every 4 men and women.

While there are major risk factors for heart disease beyond internal control, including age and gender, there are others that can be self-managed, including blood cholesterol levels.

What’s more, lowering cholesterol can be achieved by making simple lifestyle changes, including recommendations from the "TLC Program."

What is LDL Cholesterol?

Low-density lipoprotein (LDL) cholesterol is also known to be that "bad" cholesterol. Too much of LDL cholesterol in the bloodstream contributes to plaque.

The thick build-up can clog and harden the arteries, a condition known as atherosclerosis. Consequently, a clot can form and block the arteries and result in a heart attack or stroke.

A healthy LDL cholesterol range is less than 100 milligrams/deciliter (mg/dL) for men and women of all ages.

While anyone can benefit from a heart-healthy lifestyle, any number greater than 100 mg/dL warrants making modifications and potential medications. Fortunately, doctors and researchers can teach you how to lower LDL cholesterol.

Though plans are personalized, dietary and total lifestyle changes can lower bad cholesterol and the prospective risk of heart disease.

Lifestyle Changes to Lower Cholesterol

The TLC Diet

Recommended by the National Cholesterol Education Program of the U.S. National Institutes of Health, the Therapeutic Lifestyle Changes (TLC) is a cholesterol-lowering program.

The concept of the TLC diet is a total lifestyle change. It includes the components of diet, physical activity, and weight management and aims to teach individuals how to reduce cholesterol without medication.

Following the TLC diet shows to lower bad cholesterol by:

• 25 to 35 percent compared to a traditional U.S. diet.
• 2 percent for every 1 percent decrease in total calories from saturated fat.
• 8 percent when reducing saturated fat to less than 7 percent.

Research also shows a reduction in sodium intake reduced the risk of cardiovascular disease by 25 percent.

Foods that Lower Cholesterol

The TLC dietary recommendations target all aspects of the diet, not just single nutrients.

Comprehensively, the TLC diet focuses on heart-healthy and whole foods, including plenty of fruits and veggies, whole grains, low or non-fat dairy products, fish, and lean and plant-based protein sources.

The table below identifies targeted TLC diet recommendations:

In addition to being mindful of specific recommendations, general tips to follow the TLC diet include:

• Avoid trans fats altogether by eliminating fried foods, chips, margarines, and other products manufactured with hydrogenated or partially hydrogenated oils
• Limit the consumption of products rich in added sugars and flours, including cookies, cakes, doughnuts, and other sweet treats and baked goods
• Incorporate more fiber products in the day, including oatmeal for breakfast and a piece of fruit with peanut butter as a snack
• Swap out refined grains for whole grain products
• Reduce saturated fat and cholesterol by limiting processed and red meats
• Increase PUFAs and MUFAs by consuming more avocados, seeds, nuts, and olive and vegetable oils
• Strive for lean and plant proteins such as chicken, turkey, and beans to achieve protein recommendations
• Skip out on the salt shaker and flavor dishes with fresh herbs, spices, and seasonings

Physical Activity – Exercises to Try

Incorporating physical activity can further reduce LDL cholesterol, especially with the coordination of diet and weight management. There are additional beneficial effects on insulin resistance, blood pressure, serum triglycerides, and HDL cholesterol.

The pairing of physical activity and calorie reduction can improve metabolic syndrome risk factors approximately 3.5-fold compared to diet alone. The TLC diet recommends adults engage in at least 30 minutes of moderate-intensity exercise on most days of the week.

Additional recommendations encourage exercising for 60 minutes to manage weight and prevent weight gain, and 60 to 90 minutes to sustain weight loss.

Cardiovascular exercises to try include:

• Brisk walking
• Jogging/running
• Biking
• Swimming
• Dancing
• Rowing

In addition to cardiovascular exercise, incorporating strength training two or three times each week is beneficial for overall health.

Managing a Healthy Weight

In general, the TLC diet is not a weight loss program. However, since the TLC diet is low in saturated fats, dietary cholesterol, and sodium and filled with MUFAs and PUFAs, weight loss and maintenance is likely to follow.

And because carbohydrates, protein, and fat are in healthy balance, the diet is considered safe. Nutrients are also ample despite reduced calorie levels.

Ultimately, the diet's totality and composition paired with increased exercise can ultimately lead to successful weight loss.


Can Lifestyle Modifications Using Therapeutic Lifestyle Changes (TLC) Reduce Weight and the Risk for Chronic Disease? Centers for Disease Control and Prevention.

Written By Sarah Asay, RDN. Published on March 22, 2016. Updated on February 08, 2019.


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