Portfolio Diet May Lower Heart Disease Risk

A lesser-known dietary pattern called "a portfolio diet" designed to lower "bad" cholesterol may help to reduce the risk of heart disease and stroke, a study finds.

Previous research has suggested that a plant-based "portfolio diet" can reduce the levels of "bad" LDL cholesterol, a leading risk factor for cardiovascular disease, as effectively as an early-generation statin.

The new study published in the journal Circulation looked at the diet data of 166,270 women and 43,970 men without cardiovascular disease when they enrolled in two long-term health studies. Every four years, they answered food questionnaires.

Using the portfolio diet score, the researchers ranked the participants' consumption of plant proteins, nuts and seeds, and other foods commonly consumed in the diet.

After up to 30 years of follow-up, the participants with the highest portfolio diet score had a 14% lower risk of coronary heart disease and stroke compared to those with the lowest score.

Coronary heart disease is a condition where the arteries of the heart cannot deliver enough oxygen-rich blood to the heart, increasing the risk of stroke. It affects about 18.2 million American adults and is the leading cause of death in the United States.

What is a portfolio diet?

The portfolio diet shares many similarities to the Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH), except it discourages animal proteins more than other dietary patterns.

The portfolio diet includes:

• Plant-based proteins such as soy and other legumes.
• Foods with viscous fiber, such as oats, barley, berries, apples, and citrus fruit.
• Nuts and seeds.
• Phytosterols that reduce cholesterol absorption through supplements or fortified foods, such as soybeans, peas, sesame oil, and others.
• Avocado and healthy plant-based oils high in monounsaturated fat like olive, peanut, and canola oils.

The study authors say a portfolio diet is a good choice for those who want to follow a vegan or vegetarian diet that offers heart-health benefits.

A 2021 study that included over 123,000 postmenopausal women found that those who ate a higher proportion of portfolio diet foods had an 11% lower risk of cardiovascular disease.

They were also 14% less likely to develop coronary heart disease and were at a 17% lower risk for heart failure. However, the diet did not appear to reduce the risk of stroke or atrial fibrillation, an irregular heart rhythm.

While a healthy diet is essential for a healthy heart, other lifestyle choices can also help to prevent heart disease. The Centers for Disease Control and Prevention (CDC) recommends:

• Keep a healthy weight by maintaining your body mass index (BMI) between 18.5 and 24.9.
• Get regular physical activity. Aim for two hours and 30 minutes of moderate-intensity exercise, like brisk walking or bicycling, every week.
• Quit smoking, as smokers are two to four times more likely to develop heart disease or have a stroke.
• Check your blood levels of cholesterol at least once every four to six years. Or more often if you have been diagnosed with elevated cholesterol levels.
• Have your blood pressure measured regularly. If you have hypertension, talk to your healthcare provider about adopting some lifestyle changes.
• If you have diabetes, monitor your blood sugar levels carefully.

Rich in vegetables, fruits, and nuts, the portfolio diet may not only improve heart health but also provide the body with essential nutrients.