Got high cholesterol? You're not alone. Seventy one million American adults—or one in three—have high levels of LDL, the so-called bad cholesterol, which raises the risk for heart disease.
All that artery-narrowing and clogging LDL didn't happen overnight. Your cholesterol got to be as high as it because of what you ate: juicy steaks, ice cream sundaes, creamy cheeses, whole milk. You get the drift. So wouldn't it be nice if you could eat your way to lower numbers? It may not be so far-fetched.
Meet the so-called “portfolio diet”—a vegetarian plan rich in fruits, veggies and whole grains that includes four foods with known cholesterol-lowering properties. Researchers have found that it can lower LDL dramatically. Even the U.S. Food and Drug Administration (FDA) recognizes that the foods it emphasizes can bring cholesterol down.
The portfolio diet isn't really a diet—it's an approach to eating. For the average person who consumes 2,000 calories per day, the regimen calls for eating the following:
- 1.8 grams per day of plant sterols, found in plant-sterol enriched margarine. (That's the equivalent of one to two tablespoons of margarine.)
- 19.6 grams per day of soluble fiber—which soaks up cholesterol—from foods like oat bran, barley, psyllium, peas and legumes. (One-half cup peas has 1.3 grams of soluble fiber; 3/4 cup cooked oat bran has 2.2 grams; 1/2 cup black beans has 2.4 grams; 1/2 cup cooked pearled barley has 0.8 grams; and 1/2 cup kidney beans has 2 grams. Psyllium is found in supplements like Metamucil and some foods, like Kellogg's All-Bran Buds, which has 3 grams of soluble fiber.)
- 45 grams (about 1 1/2 ounces) per day of nuts
- 45 grams per day of soy protein. One cup of fortified soy milk has 6 to 7 grams of soy protein; one soy burger has 13 to 14 grams; 1/2 cup cooked soy pasta has 13 grams; and 4 ounces tofu has 13 grams.
While the portfolio eating plan emphasizes these four foods, it should be used as an adjunct to—and not a substitute for—a standard heart-healthy diet. "It is absolutely complementary," says Dr. Vincent Bufalino, senior vice president at Advocate Cardiovascular Institute in metropolitan Chicago and spokesperson for the American Heart Association (AHA).
The AHA-recommended diet calls for:
- limiting total fat intake to less than 25 to 35 percent of total daily calories;
- limiting saturated fat to less than seven percent of daily calories;
- limiting trans fats to less than one percent of total daily calories
- focusing on monounsaturated and polyunsaturated fats for any additional fat, such as those found in unsalted nuts and seeds, fish and vegetable oil
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- limiting dietary cholesterol to less than 300 mg per day. (People with heart disease or whose LDL is over 100 should limit cholesterol to less than 200 mg per day.)
- four to five servings of brightly colored fruits and veggies per day
- six to eight servings of fiber-rich grains per day; at least half should be whole grains;
- two to three servings of fat-free, one percent and low-fat dairy products each day;
- four to five servings per week (in limited amounts) of nuts, seeds and legumes
- regular exercise
Adding the portfolio foods to this kind of heart-healthy lifestyle could make a considerable difference when it comes to cholesterol, according to Canadian researchers who followed two groups of people with high LDL on the plan for six months. One group visited a clinic twice during the study, meeting with a dietitian who counseled participants about sticking to a vegetarian diet and helped them incorporate the portfolio foods into their meals; the other group met with a dietitian seven times during the study. A third control group followed a low saturated fat diet that emphasized fiber and whole grains.
At the end of the study, published in the Journal of the American Medical Association in 2011, people in the control group had reduced their LDL by 3 percent, a drop of 8 mg/dL. The people who visited the clinic only twice lowered their LDL by 13 percent, a drop of 24 mg/dL; the other group lowered their LDL by 13.8 percent, a drop of 26 mg/dL.
What's more, the people in the routine portfolio diet group reduced their calculated 10-year risk for coronary heart disease by 10.8 and 11.3 percent respectively. In comparison, people in the control group lowered their 10-year risk by a meager 0.5 percent. (Calculated 10-year risk uses information such as gender, age, total and HDL cholesterol and systolic blood pressure to predict a person's chances of having a heart attack within 10 years. To determine your risk, use the calculator at the National Heart, Lung and Blood Institute website.
Adopting even a few of the components of the portfolio diet can help. According to the government's cholesterol-lowering program, eating soluble fiber (5 to 10 grams per day) and plant sterols (2 grams per day)—plus limiting saturated fat to the AHA-recommended level, getting less than 200 mg per day of dietary cholesterol; and losing 10 pounds if you’re overweight—can reduce LDL cholesterol by 20 to 30 percent. That’s comparable to what you could expect from taking a cholesterol-lowering drug: Widely popular statins, for instance, may lower LDL by 20 to 55 percent.
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Page 3 of 3 - For people who don’t want to take medication because of the side effects and cost, the portfolio approach offers a viable option. "It is very realistic," says registered dietitian Ruth Frechman, a spokesperson for the Academy of Nutrition and Dietetics and author of The Food Is My Friend Diet. "There is nothing exotic about this way of eating. You can eat food and have real results."
Even if you can't reach the recommended amounts of the four portfolio foods, you can still reap benefits, says Bufalino. "I wouldn't get carried away with amounts," he says. Simply eat more of those foods, while also cutting back on total fat, saturated fat and dietary cholesterol. "You need to pay attention what you are consuming each day," he says. "You can’t eat everything you want and expect your cholesterol to go down. That doesn't work." At the same time, work up to at least 30 to 40 minutes of moderately vigorous exercise three to four times a week, he advises.
Depending on how high your LDL is to start, you may not reach your ultimate cholesterol goal. But here's the good news, says Bufalino: "Whether you get to not take any statins or get to take a reduced dose, it's a benefit for you."
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