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Healthy Heart Prescription: The Portfolio Eating Plan

Healthy Heart Prescription: The Portfolio Eating Plan

Research shows that creating a “portfolio” of healthful food choices can help protect your heart.

There is no shortage of recommendations for foods you should eat to keep your heart healthy: Olive oil, almonds, oat bran, green tea, tofu, and kombucha are top of the list. But one particular dietary approach has held up to scrutiny over years of research: the Portfolio Eating Plan. Developed by researchers at the University of Toronto, the diet is low in saturated fat and cholesterol, similar to the diet recommended by the National Institutes of Health, but higher in viscous fiber, soy protein, plant sterols (compounds found in plant foods), and nuts (see “Create a Daily Portfolio of Healthy Eating”). In addition, the diet is rich in fruits, vegetables, whole grains, and plant proteins, emphasizing the idea that no single food can make a significant difference, but taken together—a portfolio of foods—they can improve cholesterol levels, reduce inflammation, possibly lower blood pressure, and ultimately improve heart health.

An Eating Style with Heart

The effectiveness of the Portfolio Eating Plan was first tested in 2002 among 46 healthy adults with high cholesterol levels, and was found to have significant cholesterol-lowering powers (28.6 percent decrease in “bad” LDL cholesterol) similar to that of the commonly prescribed cholesterol-lowering drug, Lovastatin, (30.9 percent decrease).

The Portfolio Eating Plan also has been found to lower blood pressure, a major risk factor for cardiovascular disease. A six-month study of 241 people with elevated cholesterol compared the effectiveness of the Portfolio Eating Plan with the DASH (Dietary Approaches to Stop Hypertension), a diet rich in fruits, vegetables, whole grains, and reduced-fat dairy proven to significantly reduce blood pressure. While the DASH diet was easier for people to stick with over the study period, the Portfolio Eating Plan was more effective at lowering blood pressure (Nutrition, Metabolism, and Cardiovascular Diseases, 2015). Some studies also have found that following the Portfolio Eating Plan can raise blood levels of “good” HDL cholesterol, which has been linked to a decrease in cardiovascular disease.


Creating Your Own Portfolio Diet

While the original Portfolio Eating Plan is a vegetarian diet, improvements in cholesterol may be possible simply by including many of these foods in your current diet, as well as reducing the consumption of animal foods. According to Cyril Kendall, PhD of the Department of Nutrition Sciences at the University of Toronto, who is a researcher on several of the Portfolio studies, “The majority of participants continued to include some meat products in their diets. The beauty of the Portfolio Eating Plan is that it gives individuals a lot of healthy choices.” Studies have shown that making all positive changes count toward your cholesterol-lowering efforts—and it adds up.


“These recommendations are the same evidence-based guidelines I review with all my patients,” says Mary Donkersloot, RD, a nutritionist in private practice in Beverly Hills, California. “Some are willing to move towards a more plant-based diet, while others are not.” She emphasizes that anyone who wants to follow the Portfolio Eating Plan can pick and choose, based on their food likes and dislikes.

Kendall and his colleagues at the University of Toronto are planning a study that will look at the effects on cardiovascular deaths, stroke, and myocardial infarction in at-risk individuals who follow a Portfolio Eating Plan combined with an exercise program.


Almonds, broccoli, and citrus are some of the heart-healthy foods recommended in the Portfolio Eating Plan.

The Bottom Line

Studies have shown the Portfolio Eating Plan to be almost as effective as some statins for lowering cholesterol. While it has not yet been studied in combination with statins, the two together could potentially provide even more benefits. Flexibility is an advantage of the diet, providing opportunities to make as many substitutions for the foods you currently eat as you are comfortable with. Kendall says, “People can pick and choose which foods they like and want to include in their diets.”

Great article by —Densie Webb, PhD, RD


Cathy Bowers, RD

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