The Portfolio Diet: Lowering Cholesterol With 4 Food Groups

It is actually a “diet without being a diet” as it was designed to work with any healthy food choices to lower cholesterol levels by keeping a focus on 4 food groups in most or all meals. Originally published by David Jenkins, MD, and researchers at the University of Toronto in 2002, it has gained new support. I frequently mention the Portfolio Diet on my podcast (Heart Doc VIP) and routinely give information on it to patients at the Kahn Center.

What is the Portfolio Diet?

In 2002, Dr. Jenkins noted that plant sterols (found in sesame and sunflower seeds and avocados), soy proteins (found in tofu, edamame, tempeh), nuts, and viscous fibers (found in oats, oat bran) were advised for cholesterol reduction but their combined effect had never been tested. They evaluated eating a diet with this “portfolio” of added food choices and showed that LDL cholesterol fell by 29% in a month versus baseline levels. The reduction was similar to another group given a low dose statin medication and most of the changes were seen as soon as 2 weeks.

New Data

Recently, the Portfolio diet, using these plant-based foods of plant soy proteins, nuts, viscous fiber, and plant sterols was assessed from dietary records in 123,330 women in the Women’s Health Initiative study from 1993 to 2017. Heart disease outcomes were assessed and the impact of adhering to the Portfolio Diet was measured in an average follow-up of 15 years. Adherence to the Portfolio Diet was associated with a lower risk of all heart events (11% lower), heart attacks (14% lower), and heart failure (17% lower). The authors concluded from this non-randomized study that “higher adherence to the Portfolio Diet was associated with a reduction in incident cardiovascular and coronary events, as well as heart failure. These findings warrant further investigation in other populations”.

How to Implement the Portfolio Diet?

What do you do? If you take an example of a 2,000-calorie diet that incorporates nuts, legumes, and various sources of dietary fiber, a breakdown of what’s included might look like this:

• A few walnuts, pecans, brazil nuts, and raw almonds if not allergic  
• Beans and legumes (peas, various beans, peas, chickpeas, and lentils, tofu) added to salads and other meals
• 2 ounces of foods with B-glucan and other viscous dietary fiber (oats, barley, psyllium, okra, eggplants, and fruits such as apples and pears, citrus, and berries)
• A tbs of sesame seeds, a ¼ cup of sunflower seeds, or ½ of an avocado (all rich in plant sterols)

Conclusions

Overall, the Portfolio Diet is a great plan to lower your cholesterol without medication or as an add-on to necessary Rx drugs. It can be done with an all plant-based diet or as part of a MED diet plan.  Adding plant sterol, nuts, fiber, and soy proteins is a winning plan for all diets.