The Portfolio Approach to Lowering Cholesterol
The Portfolio Approach to Lowering Cholesterol
Information from the Almond Board of California
About the Research and the Foods
July, 2003 – From the University of Toronto comes promising news for those with high cholesterol. Whether you need a 35 percent decrease, a milder decrease, or just want to maintain an alreadyhealthy heart, researchers have found a change in diet to be as effective as taking a starting dose of first-line drugs such as statins, without the side effects.
In three studies conducted to date, people with high LDL cholesterol levels have eaten a “portfolio” of foods with heart-health related health claims – almonds as well as foods high in viscous fiber, plant sterols and soy protein – in a vegetarian diet low in saturated fat. In four weeks, their LDL cholesterol levels decreased up to 35 percent, and their LDL to HDL cholesterol ratio decreased by 30 percent. This is similar to the results of first-line cholesterol-lowering drugs.
While elevated cholesterol is a risk factor for heart disease, researchers have been learning that inflammation of the arteries may also contribute to an increased heart disease risk. That is why the researchers in this study also focused on an indicator of inflammation named c-reactive protein. Almonds, with their high vitamin E content, may be one factor that decreased the subjects’ c-reactive protein levels more than other subjects’ on statins alone. Almonds also contribute fiber and vegetable protein to the eating plan, and they have less saturated fat than any other tree nut, which keeps the diet very low in saturated fat. Viscous fiber, soy protein and plant sterols also work in various different ways within the body, and these various “modes of action” may contribute to the combined effect, the researchers say.
Clearly, these results are intriguing. With the great potential this eating plan has for those with high cholesterol, further research is currently taking place to learn more about why combining cholesterol-lowering foods in the same eating plan appears to be so effective.
Upcoming Learnings
Future Portfolio studies will show how the Portfolio dietary approach could work outside of a controlled study, in “real life.” For example, in studies to date, participants were required to eat enough food to maintain their body weight. The research team wanted a controlled study that showed the decrease in cholesterol was a result of the foods eaten, not because of weight loss.
By conducting future studies, the researchers hope then to begin to answer such questions as, “What if I don’t mind losing weight while I’m on this eating plan?” and “What if I don’t want to eat a vegetarian diet?” and even “What are the long-term effects of this eating plan – will it actually reduce my risk of a heart attack?” These answers are unknown and cannot be conjectured, although it is known that elevated cholesterol and c-reactive protein are both independent risk factors.
Diet Instead of Statins?
Anyone with high cholesterol who is interested in following a Portfolio-type eating plan should first seek the advice of his/her health care professional before making any changes to their diet. A dietary approach should not be substituted for doctor-prescribed statins. Statins have been proven to reduce the risk of heart attacks and death, whereas the Portfolio approach, while proven to lower LDL cholesterol, has not been put to that test. That said, those who are on statin therapy might benefit from making an effort to eat more Portfolio-friendly, heart-healthy foods every day. And, a Portfolio eating plan may have very exciting potential for those whom doctors are reluctant to prescribe statins due to elevations of muscle or liver enzymes, and for those who would prefer to work with their physician to control their cholesterol through non-pharmacological means.
