The evidence in the literature and the NCEP Adult Treatment Panel Consensus Position suggest that adults with elevated lipids, CHD or CHD risk equivalent should be following the ATP III Therapeutic Lifestyle Changes (TLC) diet or something more aggressive.

The TLC diet lowers saturated fat to less than 7% of calories – avoiding trans fat, limiting dietary cholesterol to less than 200 mg/day – and adds dietary options such as 2 grams/day plant stanols/sterols and at least 5-10 grams/day viscous soluble fiber to enhance LDL lowering, and has an increased emphasis on weight management and physical activity.

It is desirable to have the assessment and education for these individuals carried out by a registered dietitian when possible (Arntzenius, 1985 [B]; Blankenhorn, 1990 [B]; LaRosa, 1990 [R]; Ornish, 1990 [A]; Schuler, 1992 [A]; Stefanick, 1998 [A]; Summary of the Second Report of the National Cholesterol Education Program, 1993 [R]).