Understanding the Portfolio Diet: A Comprehensive Guide to the Cholesterol-Lowering Meal Plan

The latest study reveals that a portfolio diet could potentially reduce the chances of experiencing a stroke or heart attack.

A specific eating regimen could be beneficial if you are aiming to maintain a diet that supports heart health.

Last month, new research published by the American Heart Association noted a correlation between a decreased risk of stroke and heart diseases and adherence to the not-so-famous portfolio diet. This is particularly helpful for those aiming to lower their cholesterol levels, decrease stroke risk, or adopt a more plant-based diet.

The main aim of the portfolio diet is to lower the low-density lipoprotein (LDL) technically referred to as "bad" cholesterol, which is majorly responsible for heart disease and stroke.

The focal points of this diet are four major groups seen to lower cholesterol, including plant sterols, soy protein, soluble fiber, and nuts.

This diet promotes swaps like substituting dairy with soy milk and using avocados and plant oils as an alternative to butter due to its focus on these four groups.

Apart from these alternatives, the portfolio diet also highlights the importance of soluble fiber. Foods like lentils, beans, oats, barley, broccoli, eggplant, and psyllium are recommended because they can bind cholesterol in the blood, enabling its excretion.

While many of these foods feature in other existing heart-healthy dietary plans, the uniqueness of the portfolio diet, according to Andrea Glenn, PhD, RD, one of the study's authors, is the combination of these foods into a single diet to decrease heart disease risk.

This research offers insights into the portfolio diet's practical implications and suggested guidelines for its adoption.

To gauge the impact of the portfolio diet on heart health, researchers analyzed food frequency questionnaires filled by participants at the start of the study and every four years subsequently. This formed part of three different large-scale studies.

They also compiled a Portfolio Diet Score ranking the consumption of nuts and seeds, plant protein, monounsaturated fat sources, plant sterols, and viscous fiber sources. The 30-year long study involving over 200,000 individuals found that participants with higher scores had a 14% lower chance of experiencing cardiovascular disease, stroke, and coronary heart disease.

The researcher also underscored that even a partial adoption of the dietary pattern can provide cardiovascular benefits, although individuals in the study did not consume as much as the diet as initially prescribed in the trials.

Earlier research compared the portfolio diet with the usage of statins, drugs that lower cholesterol levels. While diet can significantly lower LDL cholesterol levels, the reduction was similar to the one caused by the drug lovastatin.

However, the study did not evaluate the portfolio diet's efficacy in reducing heart attack or stroke. Although aligning dietary habits with the portfolio diet might reduce disease risk, it cannot replace the use of statins, according to Gregory Katz, MD, a cardiologist at NYU Langone.

The extent of statin usage among study participants also remains uncertain, says Jay Chudow, MD, a cardiologist at Montefiore Medical Center. Chudow further adds that statins are not universally recommended since their usage is dependent on individual conditions like high cholesterol, diabetes, and other related conditions.

Despite evidence suggesting that moving towards a plant-based diet can lower cholesterol levels, increased research is needed to promote the portfolio diet widely for heart health.

The portfolio diet is lesser-known than the DASH and Mediterranean diets yet shares numerous similarities with these diets. Like these diets, the portfolio diet also emphasizes consuming whole grains, fruits, vegetables, plant protein, seeds, nuts, and plant oils, while reducing the intake of saturated fat from red meat and dairy.

The distinction between these diets and the portfolio diet lies in the latter's emphasis on plant protein, particularly soy, viscous fiber sources, and phytosterols, according to Glenn.

Given the positive impact of these diets on heart disease risk, individuals can select elements based on their personal preferences, lifestyle, and values while adopting them.

The best way to implement the portfolio diet in your life is by starting with small, achievable swaps.

Try breaking it down by choosing one of the four parts of the portfolio diet to focus on at a time.

For example, start by swapping out meat for a soy-based protein for one meal a week. Or, add one source of viscous fiber to your diet a day, such as oatmeal for breakfast or roasted broccoli for dinner.

Since the portfolio diet is not the only heart-healthy eating pattern out there, your diet may look like some combination of the portfolio diet, Mediterranean, and DASH diets based on what is suitable for your lifestyle and individual nutrition needs.

The good news is, any step toward heart-healthy choices is a good one.

Chudow recommends patients just choose whatever healthful diet that is easy for them to stick with and make part of their routine, whether that be portfolio, Mediterranean, or DASH diet.

“I discuss with my patients ways to increase their healthy food choices by adding in fruits, vegetables, and whole grains,” he said.

For individualized guidance and advice for your nutrition needs, it’s best to consult a registered dietitian.