4 Ingredients to Lower Cholesterol: The Portfolio Diet and How to Adapt It to a Low FODMAP Diet

I was sitting in the last row of a crowded shuttle bus that was taking me from my hotel to Loma Linda University, where I was attending the International Congress on Vegetarian Nutrition, when I noticed I was elbow-to-elbow with one of my nutrition research heroes: Dr. David Jenkins. I couldn’t believe it! My colleague and friend sitting next to me still remembers how excited I was – and teases me about it.

That day Dr. Jenkins would speak about the results of his recently published research on a new dietary approach that lowered blood cholesterol as much as a statin (cholesterol-lowering) drug: the Portfolio Diet. What are the highlights of this research?

  • This diet put together all the foods that, individually, had shown to lower LDL cholesterol in previous research into a “package” named the Portfolio Diet (vegetarian)

  • In the first study, research participants on the Portfolio Diet arm were fed all their food for 4 weeks

  • The average LDL (bad) cholesterol in this group decreased by 29%

  • This change was similar to that observed in the comparison group: participants took a statin drug while eating a low saturated fat diet and dropped their LDL by 31%

  • In a follow-up study, participants did not get their food but were taught the Portfolio Diet and the drop in LDL cholesterol was not as dramatic but still clinically significant (13-14%).

  • In this study, there was a range of response: the better the participants were able to stick to the diet, the bigger their cholesterol reduction (about 20%).

This was not a prisoners’ diet, but a palatable vegetarian diet: the participants liked it and felt it kept them full.  So, what does it look like? It has 4 main ingredients:

  1. Soy-based foods such as soy milk, tofu, and soy-based meat alternatives (instead of meat, poultry or dairy)

  2. Soluble fiber from grains like oats and barley, beans/lentils, certain vegetables (eggplant, okra, Brussels sprouts), and a daily serving of psyllium fiber

  3. Plant sterols as enriched margarine, fortified orange juice or yogurt, or taken in capsule form as a supplement

  4. Nuts. The research studies used almonds but other tree nuts can be substituted.

How much you need to eat of each of these components depends on your daily caloric intake. A registered dietitian can help you figure out how many grams of soy proteins, soluble fiber, plant sterols and nuts you need per day, and translate these into real foods and menu ideas.

If you are following a low or modified FODMAP diet, this plan can be easily fitted into your diet. First, I would advise you to complete the elimination and re-challenge phases of the diet. For starters, it is best to focus on one goal at a time, and first alleviate your IBS symptoms, then tackle the high cholesterol issue. The low FODMAP diet is very challenging to learn and you might be overwhelmed by having to change too many aspects of your diet at once.

Second, you will be in a much more relaxed state of mind, feel better, and be ready for a new challenge, once your symptoms have subsided. And finally, you will know which high FODMAP foods you can tolerate and expand the variety of foods you can eat. For example, you will be able to eat larger servings of okra, Brussels sprouts and beans/lentils if you have passed the oligo-saccharide challenge. If this is a problematic FODMAP category for you, you can focus on lower FODMAP sources of soluble fiber like oats, chia seeds, small servings of broccoli and sweet potato, and psyllium fiber.

Whether you have IBS or not, make sure you talk to your doctor if you decide to try this diet. This may not replace the need for medication for everyone but be a complementary therapy and perhaps allow you to lower the dosage of medications, if you are already taking them. Also, your doctor might know (or remember) about the Portfolio Diet. When I told my doctor how I was able to replicate the results of this research and she could see the 35% drop in LDL (bad) cholesterol in my new lab test results, she asked: do you mind if I use this with my patients? Of course, I answered: please, do!