What to Know About the Cholesterol-Lowering Diet

  • The Portfolio diet is designed to lower cholesterol and is known for its heart-healthy benefits.
  • A new study adds to the collection of research that shows this diet is effective at preventing heart disease and stroke.
  • Cardiologists and nutritionists explain how and why the diet works.

There are several diets know to benefit heart health, like the Mediterranean, DASH diet, and even the new buzzy blue zone diet. Now, the Portfolio diet is a new eating plan that experts say might be the most effective at lowering cholesterol.

A study published in Circulation looked at the diet data of 166,270 women and 43,970 men who did not have cardiovascular disease when they enrolled in the mid-1980s and early 1990s. They answered food questionnaires every four years. After up to 30 years of follow-up, those with the highest Portfolio diet score had a 14% lower risk of heart disease and stroke compared to those with the lowest score.

So, what is the Portfolio diet? And how does it lower cholesterol? Here, experts explain what you need to know about the heart-healthy eating plan and how you to follow it for the best results.

What is the Portfolio diet?

The Portfolio diet is a plant-based eating pattern that is designed to help lower LDL or “bad” cholesterol, which can help reduce the risk of cardiovascular disease, says David Sagbir, M.D., board-certified cardiologist and spokesperson for Avocados-Love One Today. “This way of eating is all about focusing on certain foods that are linked to supporting healthy cholesterol levels,” he explains.

This diet consists of four portfolios to choose from and people can choose to consume one or more of the portfolios for cholesterol-lowering effects, says Melissa Prest, D.C.N., R.D.N., national media spokesperson for the Academy of Nutrition and Dietetics and member of the Prevention Medical Review Board.

What foods are in the Portfolio diet?

The Portfolio diet is low in saturated fat and dietary cholesterol and includes a “portfolio” of four cholesterol-lowering foods and nutrients, says Marie Spano, M.S., R.D., Dymatize sports nutrition consultant. You can easily make the transition to this diet by adopting one of the portfolios and over time adding the others in, says Prest.

The four portfolios are:

  • Plant-based proteins such as soy/tofu and other legumes
  • Foods with viscous fiber such as oats, barley, berries, apples, and citrus fruit
  • Nuts and seeds—sources of “good fat,” per Alexander Postalian, M.D., interventional, general cardiologist at The Texas Heart Institute
  • Phytosterols that reduce cholesterol absorption through fortified foods, like yogurt, or supplements

The diet also includes plant-based monounsaturated fats like avocados and healthy plant-based oils, says Spano.

While the meal plan doesn’t necessarily eliminate any foods, the goal is to limit foods that are high in saturated fat or added sugar, and to emphasize more nutrient-dense foods, says Dr. Sagbir. “The good news is there are a lot of delicious options for this diet, and some may even be a surprise,” he says. For instance, avocados check most of the boxes for this diet having monounsaturated fat, soluble fiber, and phytosterols, he notes.

How does the Portfolio diet lower cholesterol?

This style of eating prioritizes foods with nutrients that have been shown to help reduce LDL, or “bad,” cholesterol, says Dr. Sagbir. “By focusing on these foods and nutrients, you naturally replace less nutrient-dense foods and move towards an overall diet that is supportive of heart health,” he says.

More specifically, research supports the heart-healthy effects of soy, nuts, plant sterols, and fiber, says Keri Gans, M.S., R.D., registered dietitian and author of The Small Change Diet. “Soluble fiber is known to trap cholesterol and prevent your body from reabsorbing it into your bloodstream, plant sterols have been shown to reduce heart disease by blocking the absorption of cholesterol in the small intestine, and replacing saturated fats with monounsaturated fats and plant-based protein has been associated with a decreased risk for heart disease,” she explains.

Each of the four portfolios lowers cholesterol by 5-10%, says Prest. So, “if your diet includes foods from all four portfolios, you may lower your cholesterol level up to 30%,” she adds.

Is the Portfolio diet actually good for heart health?

The short answer is yes, the Portfolio diet has been shown to have a very positive effect on heart health. Research has shown that the Portfolio diet leads to clinical improvements in LDL cholesterol, as well as other established heart disease risk factors, says Gans.

The Portfolio diet favors the use of foods known to be heart-healthy and discourages the use of foods known to contribute to heart disease (such as animal fat and simple carbohydrates), says Dr. Postalian. “While the specifics of the diet can appear novel, there is a lot of overlap with existing ‘healthy-habit’ diets such as the Mediterranean diet [and DASH diet],” he notes.

The biggest takeaway from this new research is that three different research studies have all found that the Portfolio diet is associated with lowering heart disease risk and is beneficial for heart health, says Prest.

Is there anyone who should avoid the Portfolio diet?

The Portfolio diet is a plant-forward diet that should work for most people, says Prest. However, if you are someone with an allergy to tree nuts, you can take some precautions by swapping the nuts for seeds, she notes.

Keep in mind, since this diet includes many foods that are higher in carbohydrates, people watching their blood sugars should balance their plates with lower carbohydrate plant proteins, nuts, and vegetables while enjoying servings of whole grains and fruits, says Prest.

Additionally, since the Portfolio diet is high in fiber, individuals with a history of inflammatory bowel disease, ulcerative colitis, or Crohn’s disease should discuss the meal plan with their gastroenterologist before starting, Gans points out. “Also, anyone who is not used to eating a diet high in fiber should gradually add these foods to allow their body to adjust.”

Anyone with sitosterolemia should not follow this diet as high intake of plant sterols may increase their risk of atherosclerosis (plaque buildup in their arteries), says Sapno.

And if you’re someone with a history of eating disorders or disordered eating, restriction may not be for you. Check with your healthcare professional before starting a new meal plan.

The bottom line

If you think you might want to try out the Portfolio diet for yourself, remember that this diet is not an all-or-nothing approach, says Prest. “Pick the portfolio that is easiest for you, make some smart swaps with foods from that portfolio, and gradually build in the other portfolio foods,” she says. Moreover, the Portfolio diet does not need to be 100% vegan or vegetarian to see results, says Gans, but by including more of the recommended foods on a daily basis, “the greater your results most likely will be.”

There are a lot of overall health benefits of these dietary patterns that have been well-known for many years, says Dr. Postalian, but a reminder—“do not neglect regular physical activity as it is key to maintaining a healthy lifestyle.”

Headshot of Madeleine Haase

Madeleine, Prevention’s assistant editor, has a history with health writing from her experience as an editorial assistant at WebMD, and from her personal research at university. She graduated from the University of Michigan with a degree in biopsychology, cognition, and neuroscience—and she helps strategize for success across Prevention’s social media platforms.