Portfolio Diet: Using Foods To Lower Cholesterol

by Cindy

Using Foods to Lower Cholesterol

STOP & SHOP Deluxe Mixed Nuts
Creative Commons License photo credit: s58y
For diabetic patients, following a proper diet is not only essential to lowering blood sugar but also for keeping cholesterol levels low.  Unfortunately, diabetes and hyperlipidemia (high cholesterol) tend to go hand in hand. 

Diabetics can see the effects of food on their blood sugar every day.  It should come as no surprise that choosing proper foods also can have a profound effect on controlling cholesterol levels.  For years patients have been told to adhere to a diet that is low in saturated fats.  However, research has been emerging over recent years suggesting that there are more powerful dietary foods to reduce cholesterol.

Diabetic patients have more aggressive goals for controlling their cholesterol than the general population does.  When cholesterol levels become elevated, diabetic patients are often prescribed medications to help lower cholesterol.  This can be frustrating for patients who are already taking multiple medications to control blood sugar levels.  Interestingly, for only mildly elevated cholesterol levels it may be possible to reduce cholesterol naturally.  In recent years, clinical trials have supported the use of dietary changes for lowering bad cholesterol (LDL). 

What is the Portfolio Diet?

Using foods to lower cholesterol is not a new concept but for decades the emphasis has been placed on following a low fat diet to keep cholesterol in check.  In recent years, studies have shown that a combination of low fat diet and the incorporation of cholesterol lowering foods can have a significant impact on cholesterol levels.  This is great news for patients that are resistant to starting medications that have side effects and potential interactions with other drugs.  In fact, a recent study published in JAMA has demonstrated that using the portfolio diet method can decreased LDL levels by more than 25 points!  This reduction can make a significant difference for a diabetic patient who has an aggressive LDL goal of less than 100 mg/dl (and sometimes even lower!).

The portfolio diet menu includes foods that reduce cholesterol by adding the following four types of heart healthy foods:

  • Soy Protein:  Patients with high cholesterol are encouraged to substitute meats with soy based proteins, soy milk, tofu or soy beans.  Patients should aim for two servings per day.
  • Soluble Fiber:  The portfolio diet advises the use of sticky fiber such as eggplant, okra, oats, psyllium and barley to help lower cholesterol naturally.  Try to incorporate two servings of soluble fiber per day.
  • Plant Sterols:  The use of plant sterol esters, which can be found in specialty margarines, can be used instead of butter and can help decrease LDL substantially.  Two teaspoons of plant sterol foods to reduce LDL every day.
  • Nuts:  It is no secret that nuts have heart healthy qualities.  The portfolio diet advises the daily use of a handful of tree nuts, particularly almonds, for this high cholesterol diet. 

Supported By Research: Using Foods to Lower Cholesterol

Adding these four types of foods to lower cholesterol has been most effective when combined with a low fat diet.  When combined with regular dietary counseling, this diet strategy was even more effective. 

A 2011 publication in the Journal of the American Medical Association revealed results of a six month study containing 351 patients that compared the use of the portfolio diet and a traditional low fat diet and demonstrated that the portfolio diet plan can significantly reduce LDL cholesterol levels.  This research showed a 13.8% (or 26 mg/dl) reduction in LDL levels for patients using the portfolio diet as compared to a 3.0% (or 8 mg/dl) reduction in LDL levels for standard low fat diet (Jenkins, et. al.).

Another study, based in Canada, compared the use of portfolio foods to lower cholesterol with both a very low saturated fat diet and with 20 mg of lovastatin therapy.  This study found similar reduction in LDL levels between the dietary portfolio group and the lovastatin group.  Both groups showed a significant reduction in comparison to the dietary control group of a very low saturated fat diet (Gigleux, et. al.).

The good news for diabetic patients is that these types of foods that are included in the portfolio diet to reduce cholesterol naturally can be part of a healthy diabetic diet as well.  Soy proteins and nuts provide a healthier alternative to red meats as a protein source but diabetic patients must not forget to keep portion sizes appropriate.  In addition, fiber is an excellent way to stabilize blood sugar and now evidence supports the use of soluble fiber to lower LDL cholesterol!  Explore Know Your Sugar for more information about natural ways to improve your health and how to control your diabetes!


Jenkins, et. al., (2011) Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in Hyperlipidemia: A Randomized Controlled Trial JAMA. 2011;306(8):831-839.  http://jama.ama-assn.org/content/306/8/831.short
Gigleux, et. al., (2007) Comparison of a dietary portfolio diet of cholesterol-lowering foods and a statin on LDL particle size phenotype in hypercholesterolaemic participants.  Br J Nutr. 2007 Dec;98(6):1229-36. Epub 2007 Jul 30.  http://www.ncbi.nlm.nih.gov/pubmed/17663803

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