A dietary approach should not be substituted for doctor-prescribed statins. Statins have been proven to reduce the risk of heart attacks and death, whereas the Portfolio Eating Plan approach, while proven to lower LDL cholesterol, has not been put to that test. And statins may also protect the heart in ways that go beyond their effect on cholesterol.

That said, researchers note that the Portfolio Eating Plan approach provides an option for those who, due to personal preference or concern about side effects, wish to use diet rather than medication as the primary way they control LDL cholesterol. The Portfolio Eating Plan approach also may have very exciting potential for those whose doctors are reluctant to prescribe statins due to elevations of muscle or liver enzymes. And these studies indicate that those on statin therapy would likely benefit from making an effort to eat more heart-healthy foods every day.

This study is also helpful for the many people who learn they have high cholesterol and would like to make dietary changes as a first step. For example, adding almonds to a heart-healthy eating plan is less expensive than adding a cholesterol-lowering drug. It can provide a cholesterol-reducing benefit without the negative side effects. Plus, almonds deliver more eating enjoyment—taste, crunch, and versatility—than a pill.

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.