National Cholesterol Education Program
Adult Treatment Panel III (ATP III) Guidelines Slide Set
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| 4 | 5 | 6 | 7
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SLIDE 1: ATP III Guidelines
Therapeutic Lifestyle Changes (TLC)
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SLIDE 2: Therapeutic Lifestyle Changes in LDL-Lowering
Therapy
Major Features
- TLC Diet
- Reduced intake of cholesterol-raising nutrients (same as previous Step II
Diet)
- Saturated fats <7% of total calories
- Dietary cholesterol <200 mg per day
- LDL-lowering therapeutic options
- Plant stanols/sterols (2 g per day)
- Viscous (soluble) fiber (10-25 g per day)
- Weight reduction
- Increased physical activity
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SLIDE 3: Therapeutic Lifestyle Changes Nutrient
Composition of TLC Diet
| Nutrient |
Recommended Intake |
| Saturated fat |
Less than 7% of total calories |
| Polyunsaturated fat |
Up to 10% of total calories |
| Monounsaturated fat |
Up to 20% of total calories |
| Total fat |
25-35% of total calories |
| Carbohydrate |
50-60% of total calories |
| Fiber |
20-30 grams per day |
| Protein |
Approximately 15% of total calories |
| Cholesterol |
Less than 200 mg/day |
| Total calories (energy) |
Balance energy intake and expenditure to maintain desirable body weight/
prevent weight gain |
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SLIDE 4: A Model of Steps in Therapeutic Lifestyle
Changes (TLC)
Visit 1: Begin Lifestyle Therapies
- Emphasize reduction in saturated fat & cholesterol
- Encourage moderate physical activity
- Consider referral to a dietitian
Visit 2: Evaluate LDL response If LDL goal not achieved, intensify
LDL-Lowering Tx
- Reinforce reduction in saturated fat and cholesterol
- Consider adding plant stanols/sterols
- Increase fiber intake Consider referral to a dietitian
Visit 3: Evaluate LDL response If LDL goal not achieved, consider adding
drug Tx
- Initiate Tx for Metabolic Syndrome
- Intensify weight management & physical activity
- Consider referral to a dietitian
Visit N: Monitor Adherence to TLC
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SLIDE 5: Steps in Therapeutic Lifestyle Changes (TLC)
First Visit
- Begin Therapeutic Lifestyle Changes
- Emphasize reduction in saturated fats and cholesterol
- Initiate moderate physical activity
- Consider referral to a dietitian (medical nutrition therapy)
- Return visit in about 6 weeks
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SLIDE 6: Steps in Therapeutic Lifestyle Changes (TLC)
(continued)
Second Visit
- Evaluate LDL response
- Intensify LDL-lowering therapy (if goal not achieved)
- Reinforce reduction in saturated fat and cholesterol
- Consider plant stanols/sterols
- Increase viscous (soluble) fiber
- Consider referral for medical nutrition therapy
- Return visit in about 6 weeks
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SLIDE 7: Steps in Therapeutic Lifestyle Changes (TLC)
(continued)
Third Visit
- Evaluate LDL response
- Continue lifestyle therapy (if LDL goal is achieved)
- Consider LDL-lowering drug (if LDL goal not achieved)
- Initiate management of metabolic syndrome (if necessary)
- Intensify weight management and physical activity
- Consider referral to a dietitian
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