Portfolio Diet: Your recipe for lowering cholesterol

Having high cholesterol puts you at risk for heart disease.  If you’ve tried medications to lower it into a healthier range but with little success, consider the Portfolio Diet.  While medications can be effective and easy-to-use, some people don’t want to take medications, or cannot tolerate the side effects.  This is where the Portfolio Diet plan can help.  Research shows that medications and diet both work to lower your cholesterol and can be combined together to do so. This evidenced-based way of eating is a sensible dietary plan to bring your cholesterol levels back to normal as it lowers your chance of having a heart attack or stroke.

Background of the Portfolio Diet

Developed by researchers at the University of Toronto, the Portfolio Diet puts several cholesterol-lowering plant foods and food components together in one meal plan, in the context of a low-saturated fat diet. This diet has gained scientific support over the past 15 years by limiting foods that raise blood cholesterol (primarily animal foods high in saturated fat) but also adding foods that lower it.

How to follow it

The Portfolio Diet is just as it sounds.  It takes a few dietary patterns that have been shown to lower cholesterol and puts them together. To lower your cholesterol, you can “invest” in any one pattern, or some of them, or all of them.

Below is an example of serving amounts listed based on a 2,000 calorie daily diet:

·      Plant protein – 50 grams a day, from soy foods such as tofu, soy milk, and soy meat analogues, plus legumes like beans and lentils

·      Nuts – 45 grams a day (about a handful) of all kinds, including peanuts or nut butters (about 3 tablespoons).

·      Viscous soluble fiber – 20 grams a day from oats, barley, eggplant, okra, apples, berries, oranges, and psyllium.

·      Plant sterols – 2 grams a day from fortified foods such as spreads, juices, and yogurt, or form supplements.  Sterols occur naturally in foods such as wheat bran, peanuts, almonds, and vegetable oils but in amounts too small to meet the diet’s recommendations.

How well does it work?

According to a 2018 meta-analysis and systematic review of seven clinical trials published in Progress in Cardiovascular Diseases, it found that individuals who followed the Portfolio Diet for four to 24 weeks, in conjunction with a low-saturated fat diet, reduced LDL or “bad” cholesterol by 27 percent compared to baseline when compared to just 10 percent of people following low-saturated fat “control” diets. That’s about as much as the starting dose of a lower-strength statin.  The greater an individual followed the diet, the better the results.

Other improvements besides that for lowering cholesterol included lowering of triglycerides, blood pressure, and C-reactive protein (a marker for inflammation, which is implicated not only in heart disease but also in cancer and other chronic illnesses). Several health organizations recognize and support the Portfolio Diet such as The Canadian Cardiovascular Society, Diabetes Canada, the European Atherosclerosis Society, and Heart UK.

Things to consider when following the Portfolio Diet

Always remember there is no single food that is the answer to lowering cholesterol. The best way to approach the Portfolio Diet is to add in healthful foods it suggests over time so that the benefits add up.  Here are other important things to consider:

·      If you have high cholesterol, the Portfolio Diet may not be enough to bring it into a healthy range. Following a regular exercise routine and losing weight if necessary, should also be incorporated into your lifestyle. If this is still not enough, then you may be a candidate for statin therapy.

·      This way of eating can be challenging for some people. Not everyone likes soy foods, beans and foods like eggplant and okra.  The good news is you do not have to follow it 100 percent to still get some benefits from it. Simply substitute some portfolio foods for foods you normally eat daily such as a soy burger in place of a hamburger, nuts instead of chips, or peanut butter instead of butter.

·      This is not a strict vegan diet and elimination of all animal foods is not required. The earliest studies used a strict vegetarian diet, but more recent ones have included low-fat dairy and lean meat.

·      While the diet lowers LDL cholesterol and other risk factors, it’s not yet known if it reduces heart attacks and deaths, as statins do.  It does not provide the same effects as some stronger statins do. But if you’re on a statin and want to try the Portfolio Diet, it may allow you to take a lower dose (with your doctor’s okay) or to reduce your total and LDL cholesterol levels even further on the same statin dose.