Can't stand keto? This top-ranked diet could be for you.

By Cynthia Sass, MPH, RD
January 24, 2019

If you've tried to lose weight on the ketogenic diet or another low-carb plan and found it too difficult to all but abstain from bread, whole grains, and other carbohydrates, then you might be in need of a little TLC—the TLC diet, that is.

TLC stands for Therapeutic Lifestyle Changes. Created by the National Institutes of Health, the plan focuses on helping people make heart-healthy food choices. It encouraging followers to get 50%-60% of their daily calories from carbs, 24%-35% from fat, and 15% from protein. The plan debuted in 2002 and was updated in 2013, and earlier this month it landed on the list of best-ranked diets by U.S. News and World Report.

Here's how to follow it, what the pros and cons are, and how to know if TLC is right for you.

RELATED: The Best Diets of 2019—and Why the Keto Diet Ranked So Low

What is the TLC diet?

Designed as a way to manage cholesterol, TLC may also help you lose weight and lower your risk of other chronic illnesses. Following the diet means keeping track of the percentage of macronutrients you take in daily. No food group is banned, but you might have to whip out a calculator to make sure you're consuming the right balance of carbs, protein, and fats. The breakdown of what to eat goes like this: 

25–35% of your daily calories should come from fat. As for types of fat, less than 7% of your daily calories should come from saturated fat. Up to 10% of your daily calories should be from polyunsaturated fat, and about 20% of your total calories should come from monounsaturated fat.

50–60% of your daily calories should come from carbohydrates, with 20–30 grams per day of dietary fiber. 

Approximately 15% of your daily calories should come from protein.

Less than 200 mg a day of cholesterol is allowed. Sweets and desserts are okay too, but definitely in moderation.

As for calories, only consume enough to reach or maintain a healthy weight.

TLC also advises at least 30 minutes of a moderate intensity physical activity, such as brisk walking, on most, and preferably all, days of the week.

RELATED: 5 Superfood Carbs You're Probably Missing on the Keto Diet

Pros and cons of the TLC diet

The plan offers a few key pros. Because it recommends 20-30 grams of fiber daily, whole foods that are high in healthy carbohydrates like vegetables, fruit, pulses, nuts, and whole grains are encouraged. This also fits with the 200 mg per day limit on cholesterol, as dietary cholesterol is not found in plant-based foods. And the allowance of up to 20% of calories from monounsaturated fat makes the TLC diet avocado- and olive oil–friendly, giving it some alignment with the highly regarded Mediterranean diet.

There are a handful of cons however. The high percentage of calories from carbs and modest allotment of protein may be slightly off base for some. In my practice, I often cap carbs at 40% of calories for less active people, or those with lower energy needs, including older adults. And my active clients typically require a higher protein intake, depending on their training regime and goals.

In addition, the 200 mg cholesterol limit now appears to be unnecessary. You may have heard that the 2015 Dietary Guidelines scientific advisory panel deemed cholesterol (from food) “not a nutrient of concern for overconsumption.” That designation was based on a growing consensus that cholesterol intake has little effect on cholesterol in the bloodstream. In addition, some high-cholesterol foods, like whole eggs, can contain health-protective nutrients, including anti-inflammatory vitamin D and omega-3 fatty acids. 

The other challenging aspect of TLC is translating the numbers into practical everyday meals. The 85-page TLC explainer from the National Institutes of Health offers suggested daily servings from various food groups, answers questions about sodium, omega-3 fatty acids, and alcohol, and provides tips for seasoning food, snacking, dining out, exercise, and weight loss. But you'll have to look further for sample menus and recipes. 

Plus, many of the food suggestions are outdated, in my opinion. These include eating lower-fat hot dogs, using margarine, and opting for Jello as dessert, to name a few. In the face of today’s clean eating mantra and advice to slash sugar, I believe TLC could use another update.

RELATED: This Diet Could Cut Your Risk of Dementia, Heart Disease, and Cancer—and Help You Lose Weight, Too

Should you try TLC?

Even if your aim isn’t to target your cholesterol, adopting many of the TLC guidelines may help with weight loss. Simply hitting the 20-30 gram daily fiber target can help you shed pounds if your current intake is closer to the American average of 15 grams. A recent World Health Organization report found that a higher fiber intake is associated with lower body weight, and there's a bonus: For every 8 g increase in dietary fiber eaten per day, total deaths and incidence of heart disease, type 2 diabetes, and colorectal cancer decreased by up to 27%.

If you decide to give TLC a try, consider modernizing the plan with a focus on whole foods, which further supports anti-inflammation and weight loss. And if you need help personalizing the plan based on things like food allergies or intolerances, or you want to adapt it to meet the needs of your very active lifestyle, consider meeting with a registered dietitian nutritionist.

Cynthia Sass, MPH, RD, is Health's contributing nutrition editor, a New York Times best-selling author, and a consultant for the New York Yankees and Brooklyn Nets.

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