Step 6: Therapeutic Lifestyle Changes (TLC)

Poor dietary habits, physical inactivity, and obesity contribute to the risk of CHD. TLC's should be initiated at all levels of treatment but are not used to set therapy goals. If the patient does not respond to TLC's within 6 weeks, drug treatment may be needed. TLC's should be continued even if drug therapy is needed. The two go hand in hand in prevention and decreasing risk of CHD.

Features of TLC include:

• TLC Diet:
  • Saturated fat <7% of calories, cholesterol <200 mg/day
  • Polyunsaturated fat up to 10%, Monounsaturated fat up to 20%
  • Total fat 25 to 35% of calories
    
  • Dietary fiber intake should be 20 to 30 gm/day; primarily soluble fiber (10-25 g/day)
  • Recommended consumption of plant stanols/sterols (2g/day) found in medical margarine substitutes (Benecol, Take Control)
  • 1600 Calorie Sample Meal Plan
  • 2000 Calorie Sample Meal Plan
• Weight management
• Increased Physical Activity

NIH Therapeutic Lifestyle Changes Section