Written by: Kelley R. Hill, MSN, RN-BC
In a Nutshell:
- The Portfolio Diet is a vegan diet plan to fight high cholesterol (NO animal products)
- Developed by the same physician who developed the glycemic index
- Daily physical activity is recommended
This diet is so called because it emphasizes a “portfolio” of foods that when eaten together as part of a healthy diet (based on 2,000 calories daily), can help lower LDL (bad) cholesterol.
Portfolio of cholesterol-lowering foods, to be eaten daily:
As the portfolio diet excludes seafood, if you don’t enjoy loads of pulses and soy foods – or may even have a soy allergy – it will be challenging to get enough protein. You will then need to add a plant-based protein supplement. Protein helps us feel fuller longer, and even with the addition of a protein supplement, achieving satisfaction after eating may be difficult.
Don’t forget you’ll need to make time for daily physical activity during this diet regimen.
Scientific & Expert Support
Many aspects of the portfolio diet are supported by research, such as choosing some plant protein sources over animal sources and getting much more fruits and vegetables into your daily diet. Preeminent healthcare organizations like the American Heart Association also recommend plant sterols for lowering LDL cholesterol, soluble fiber for lowering LDL and total cholesterol, and promote nuts for their heart-healthy unsaturated fats.
There is some debate about soy, however, because recently it was found not to lower cholesterol as much as previously thought. Just a couple years ago, the FDA considered revoking the right for soy food producers to claim that soy reduces risk of heart disease. That is not to suggest that it oppositely increases the risk for heart disease; rather it may simply not have impact one way or the other. So, while it remains an excellent source of plant protein, it may not aid in lowering cholesterol.
The whole diet, not just components, has been clinically studied. In all of the studies, the groups following the portfolio diet had better outcomes that those who didn’t, and one trial found that less of the cholesterol-fighting elements were required (34 grams of soy versus 50 grams, 16 grams of soluble fiber, 44 grams of almonds versus 50 grams, and no sterols).
A 2018 analysis of all current evidence concluded that the portfolio diet leads to improvements in LDL as well as other established cardiometric risk factors (obesity, high blood pressure, insulin resistance) and estimated 10-year coronary artery disease risk.
There remains some concern by experts, even those who are convinced of its effectiveness, that the portfolio diet is not balanced and should only be used in the short-term to bring cholesterol levels into acceptable range. Once in range, they encourage switching to a more complete and balanced diet.
Those who are at risk for of have a history of eating disorder should not attempt this diet.
As this diet does not allow for animal products of any kind, adequate protein intake may become an issue. Protein is essential for maintaining muscle mass, healing, and feeling satisfied after eating. Vitamin B-12 and iron deficiencies may also occur, which are essential for healthy blood and nervous system. Iron supplementation requires careful monitoring.
You should always consult with your physician, and ideally a registered dietician (RD) or nutritionist, before radically changing your diet or eating habits. Especially if you are pregnant, breastfeeding, are taking prescription medications, or have existing health conditions.
STRENGTH OF EVIDENCE: B
Conclusions are based on number of high-quality, patient-centered trials, though all have been of short duration. There is abundant and strong research supporting many individual components of the diet.
For those at high cardiovascular risk due to extremely elevated cholesterol, the portfolio diet may be a good option to get your cholesterol under control. The Portfolio diet is similar to the Vegan approach and the goal is better cardio health and not necessarily a crash diet to lose pounds quickly.
Sign up here for reminder texts that can help you stay on top of your treatment plan.
- Chiavaroli, L., Nishi, S.K., Khan, T.A., Braunstein, C.R., Glenn, A.J., Mejia, A.B., Rahelic, D., Kahleova, H., Salas-Salvado, J., Jenkins, D.J.A., Kendall, C.W.C., & Sievenpiper, J.L. (2018). Portfolio dietary pattern and cardiovascular disease: A systematic review and meta-analysis of controlled trials. Progress in Cardiovascular Diseases, 61(1), 43-53.
- Cleveland Clinic. (2018, February 16). Heart healthy eating to help lower cholesterol levels. Retrieved from: https://my.clevelandclinic.org/health/articles/17281-heart-healthy-eating-to-help-lower-cholesterol-levels
- Cleveland Heart Lab. (2018, September 11). The diet that lowers your cholesterol naturally. Cholesterol, Diet. Retrieved from: https://www.clevelandheartlab.com/blog/the-diet-that-lowers-your-cholesterol-naturally/#:~:text=So%20what%20is%20the%20Portfolio,specifically%20help%20to%20reduce%20cholesterol.
- London Health Sciences Centre. (n.d.). In depth: The portfolio diet. Lipid Genetics Clinic. Retrieved from: http://www.lipidgeneticsclinic.ca/pdf/2015%2009%2022%20The%20Portfolio%20Diet.pdf
- Richard, N.A., & Joyner, M.J. (2019, February 01). Effective lowering of cholesterol with portfolio diet in a highly trained young man. Mayo Clinic Proceedings, 94(2), 363-364.