The What and How of the Portfolio Diet: A Brief Summary

It’s been around for over 20 years, but the portfolio diet has only recently gained attention outside of medical circles. Its newfound popularity is well earned: The principles behind it have been helping prevent heart disease for decades.

As cardiologist Leslie Cho, MD, explains, the portfolio diet is a flexible approach to heart-healthy eating that can help reduce your cholesterol.

What is the portfolio diet?

The portfolio diet is a plant-based, heart-healthy eating plan to reduce and manage cholesterol. It’s called the portfolio diet because, like a financial portfolio, diversifying can yield big benefits. But instead of having a range of different investments or income streams, your goal is to eat a wide variety of cholesterol-busting, plant-based foods.

The portfolio diet doesn’t focus on weight loss or restrict portion sizes. And — unless you and your provider decide otherwise — no food is strictly “off limits.” On the portfolio diet, your goal is to consistently choose foods that reduce “bad” LDL cholesterol and raise “good” HDL cholesterol.

Think of it as an approach to eating, similar to the Mediterranean diet or the DASH diet.

“The main difference between the portfolio, DASH and Mediterranean diets has to do with your goals,” Dr. Cho clarifies. “If you want to target cholesterol, cardiologists tend to favor a portfolio diet approach over DASH, which focuses on reducing blood pressure. The Mediterranean diet is about cardiovascular health more broadly.”

The great thing about these three approaches? They play well together. You could technically follow the principles of all three eating plans at the same time — and many people do!

“The portfolio diet doesn’t replace the Mediterranean diet,” she continues. "Think of it as an add-on approach, a modification to the Mediterranean diet that helps you better address high cholesterol.”

How to follow it

The portfolio diet has four main pillars:

1. Plant proteins: Animal proteins and dairy can be high in saturated fat. Replace them whenever possible with plant-based proteins whenever you can. The Mediterranean and DASH diets promote plant-based eating, too, but the portfolio diet calls for 50 grams of plant-based protein a day, making it extra vegetarian- and vegan-friendly.
2. Nuts and seeds: Eating 45 grams worth of nuts and seeds a day is a quick way to add healthy fats, protein, fiber and antioxidants to your diet.
3. Soluble fiber: “Soluble fiber — also known as viscous or sticky fiber — binds to cholesterol and removes it from your body,” Dr. Cho explains. If you aren’t getting enough soluble fiber from the food you eat, add psyllium to your daily regimen for an extra boost.
4. Plant sterols that are high in monounsaturated (healthy) fat: Also called phytosterols, plant sterols are compounds that reduce the amount of cholesterol your body can absorb. Foods that are rich in both plant sterols and monounsaturated fats keep LDL cholesterol in check while also boosting HDL cholesterol levels.

Foods to eat

The portfolio diet is all about eating a wide variety of plant-based, nutritious foods. But where should you start? The following are great additions to your eating plan, if they aren’t on the menu already:

• Legumes
• Whole grains
• Soy products
• Broccoli
• Prunes
• Citrus
• Avocados
• Olive Oil
• Walnuts

Does it really lower cholesterol?

Research on the portfolio diet suggests it does a good job of reducing cholesterol, which, in turn, reduces heart disease risk. But it’s important to remember that your blood test results are determined by more than just the food you eat. Other factors that influence cholesterol include your age, genetics, physical activity level and more.

Dr. Cho says gut health can influence your cholesterol levels, too. By that, she means both the balance of bacteria in your gut (your microbiome) and how well your intestines work to process and absorb nutrients.

“Most of us absorb a moderate amount of cholesterol from our small intestine,” she explains. “For moderate absorbers, even following a very restrictive version of the portfolio diet may only cause a moderate reduction in cholesterol. Other people see an amazing LDL reduction. It’s very individual.”

To get the best possible results, Dr. Cho recommends working with a dietitian to build a portfolio diet meal plan that’s tailored to your needs.

“The portfolio diet really should be personalized,” she emphasizes. “It should account for your work schedule. For the kinds of foods you can tolerate, if you have allergies or gastrointestinal issues. And even for your budget.”

Final thoughts: Diet isn’t everything

The portfolio diet isn’t a shortcut to low cholesterol. It’s one part of a heart-healthy lifestyle that should also include:

• Building physical activity and exercise into your day
• Staying hydrated
• Getting plenty of quality sleep
• Achieving or maintaining a healthy weight
• Limiting alcohol intake and not smoking
• Managing stress levels
• Consistently taking prescribed medications, including statins
• Getting regular check-ups with your primary care provider and any specialists you see

Building healthy habits takes time. So does lowering your cholesterol. It happens by making small, healthy choices every day — and embracing heart-healthy principles like the ones behind the portfolio diet. But with patience, persistence and support, you can make meaningful changes to your heart health.