Frequently Asked Questions
Q: Is the Portfolio Eating Plan approach more effective than a standard cholesterol-lowering diet?A: According to over a decade of research on the Portfolio Eating Plan, yes. One of the studies in a series of clinical trials using the Portfolio Eating Plan, directly compared groups of patients with high cholesterol randomized to three different diets for one month. One group of 16 people ate the US National Cholesterol Education Program’s step II diet, which is a very low-saturated fat diet based on whole wheat cereals and low-fat dairy foods. Another group of 14 people ate this step I diet, in addition to taking 20 mg of Lovastatin, a cholesterol-lowering drug, each day. A third group of 16 people followed the Portfolio Eating Plan, eating meals high in almonds and other foods high in plant sterols and vegetable protein as well as viscous fiber. For the statin and Portfolio Eating Plan methodology groups, the drop in LDL, or “bad,” cholesterol was comparable, with a 31% (± 3.6 percent) drop for the statin group and a 29% (± 3.2%) drop for the Portfolio Eating Plan group. The step 1 group had only an 8% (± 2.1%) drop.1
Q: Can the Portfolio Eating Plan dietary approach be a substitute for cholesterol-lowering drugs such as statins? A: No. At this early point in the research, we urge you not to substitute a dietary approach for doctor-prescribed statins. Before making any changes to your diet, we urge you to share this Portfolio Eating Plan dietary information with your healthcare professional and seek his or her advice. However, if you are taking cholesterol-lowering drugs, it may be beneficial to substitute some Portfolio Eating Plan recommended foods each day for foods you normally eat. For example, try a handful of almonds as a nutritious snack, use plant-sterol margarine or incorporate more soy foods into your daily diet.
Q: What are the Portfolio Eating Plan foods? A: There are many foods from which you can choose. In the most recent study, participants said their favorite foods were nuts, including:
- Almonds
- Minced soy (which looks like miced beef)
- Oat bran cereal
- Oat bran bread
- Plant sterol margarine.
Q: Does the Portfolio Eating Plan approach need to be vegetarian?
A: No. Although initial Portfolio Eating Plan research included a vegetarian diet, in Phase IV included lean meat and fish. This Phase IV research demonstrated that when people followed the Portfolio Eating Plan in a real-world setting for one year, the seven subjects following the plan most closely achieved and sustained a clinically meaningful reduction in LDL cholesterol of more than 20%. Furthermore, 8 subjects lowered their cholesterol by 10% - 20%. The remaining 14 subjects saw cholesterol reductions of <10%.2 Keep in mind that the extent to which study participants lowered their LDL cholesterol level depended on how closely they followed the original Portfolio Eating Plan by including many the recommended heart-healthy foods. Beginning to make changes to your diet with these foods can be of benefit even if you are not eating a vegetarian diet.
1. Jenkins DJ, Kendall CW, Marchie A, Faulkner DA, Wong JM, de Souza R, Emam A, Parker TL, Vidgen E, Lapsley KG, Trautwein EA, Josse RG, Leiter LA, Connelly PW. Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. JAMA. 2003 Jul 23;290(4):502-10.
2. Jenkins DJ, Kendall CW, Faulkner DA, Nguyen T, Kemp T, Marchie A, Wong JM, de Souza R, Emam A, Vidgen E, Trautwein EA, Lapsley KG, Holmes C, Josse RG, Leiter LA, Connelly PW, Singer W. Assessment of the longer-term effects of a dietary portfolio of cholesterol-lowering foods in hypercholesterolemia. Am J Clin Nutr. 2006 Mar;83(3):582-91.
3. In 2003, the US Food and Drug Administration (FDA) released a qualififed health claim stating that scientific evidence suggests but does not prove that eating 1.5 ounces per day of most nuts, such as almonds, as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease.
4. Good news about good fat: Dietary Guidelines recommend that the majority of your fat intake be unsaturated. One serving of almonds (28g) has 13g of unsaturated fat and 1g of saturated fat.
