Therapeutic lifestyle changes are important for the prevention and management of heart disease. Dyslipidemia (abnormal lipid levels in the blood) is one of the major modifiable risk factors of coronary heart disease and other cardiovascular conditions. Modifications in one’s diet and regimen, collectively known as therapeutic lifestyle changes (TLC), are used by doctors and nutritionists as a key component of treatment in the management of dyslipidemia.
The diet component of therapeutic lifestyle change is based on lowering the intake of saturated fat, cholesterol, and sodium to help reduce the blood cholesterol level and lower cardiovascular risk. According to therapeutic lifestyle change diet guidelines, one should consume just enough calories to achieve or maintain a healthy weight and not more than 25-30% of the day’s total calories from fat. Also, it is advised to consume less than 7% of total calories from saturated fat, less than 10% of total calories from polyunsaturated fats, up to 20% of total calories from monounsaturated fats, and less than 200 mg of dietary cholesterol a day.
In order to minimize saturated fat intake, one needs to limit the consumption of ghee, butter, margarine, coconut, coconut oil, palm oil, and palm kernel oil. Choosing lean meats (like chicken without the skin) and fish over red meat or shellfish may also help to significantly reduce saturated fat intake. To step down the total cholesterol intake, foods mainly egg yolk, cheese, crab, lobsters, pork, mutton, and shrimps should be kept to a minimum.
The therapeutic lifestyle change diet also promotes limiting the intake of sodium to around 2400 mg per day. Dietary restriction of sodium firstly involves restricting the intake of salt and secondly avoiding highly salted foods such as crackers, potato chips, salted nuts, salted popcorn, salted snacks, ready-to-eat and processed foods, canned vegetables, baking powder, soda, and ajinomoto.
The recommendations for cholesterol and sodium remain the same irrespective of the total caloric intake of a person; however, the recommendations for saturated fat and total fat are based on the percentage of calories an individual consumes.
Furthermore, the therapeutic lifestyle change diet emphasizes on the intake of 10-25 grams of soluble fiber every day. Soluble fiber found in many high-fiber foods like oats, citrus fruits, apples, barley, psyllium, flax seeds and beans decreases the absorption of cholesterol by binding to it and thereby eliminating it from the body.
The other major component of the therapeutic lifestyle change is moderate exercise, which has been found to reduce the levels of bad cholesterol (LDL and triglycerides) whilst increasing the level of good cholesterol (HDL) in the blood.