By Daniel J. DeNoon
WebMD Weight Loss Clinic - Feature
Reviewed By Michael W. Smith, MD
Don't think of the portfolio diet as a diet; think of it as an investment in lower cholesterol.
That advice comes from David J.A. Jenkins, MD, creator of the portfolio diet. Or, as the University of Toronto nutrition expert prefers to call it, a dietary portfolio.
"Now we can say it is a dietary portfolio of cholesterol-lowering foods," Jenkins says. "We hope later to be able to say it is a portfolio of heart risk-reducing foods. And maybe someday we can say it lowers risk of cancer and diabetes, too."
Even the phrase "diet plan" may be too much for the modest Jenkins.
"We are not trying to go for the Atkins diet type impact," he says. "We'd rather have a concept that can evolve as we learn more. We would like to see people do this on their own."
Putting Cholesterol-Lowering Securities in Your Diet Portfolio
When you invest in a retirement portfolio, you spread your money across several different kinds of investments. The idea is to maximize your benefits while minimizing your risks.
The portfolio diet calls for the same kind of investment -- in cholesterol-lowering foods. Just as you wouldn't bet all your money on a single stock, Jenkins says you shouldn't bet your health on a single kind of healthy food.
"We are trying to get paradigm shift from looking at the benefit of a single food," he says. "We want people to look at the combinations of foods -- in real diets for real people in the real world -- that will carry off, as in the financial world, a range of benefits weighted against reducing a range of risks."
As your cholesterol count goes up, so does your risk of heart disease. The safest way to lower cholesterol is by diet. But until recently, experts thought that most people really couldn't significantly lower their cholesterol by diet alone.
True, the experts said, certain changes to the diet can lower cholesterol. Taken alone, however, none of them solves the problem. The big breakthrough came when Jenkins and colleagues showed that all these things add up. They also showed they could be incorporated into the palatable, tasty portfolio diet.
"People don't normally put these things together," Jenkins tells WebMD. "People talk about soy, and oat bran, and plant sterols, and nuts, but nobody has put them all together."
The portfolio diet recipe for lower cholesterol focuses on four kinds of food:
- The portfolio diet substitutes soy-based foods for meat. "We are looking at soy-based meat substitutes such as soy burgers, soy hot dogs, and soy cold cuts," Jenkins says. "And we also used soy milk as a dairy substitute." For Thanksgiving, he suggests, one might replace turkey with "tofurkey."
- The portfolio diet incorporates as much sticky fiber as possible. Those on the portfolio diet take three daily servings of the natural psyllium product Metamucil -- many use it to thicken their soymilk. Oats and barley replace other grains; preferred vegetables include eggplant and okra.
- The portfolio diet replaces butter and margarine with plant sterol-enriched margarine. U.S. brands include Benecol and Take Control and brands in other countries are Becel and Flora pro-activ. Plant sterols are also available in capsule form as dietary supplements.
- The portfolio diet includes nuts. Study participants ate a handful of almonds every day. The Almond Board of California backs portfolio diet research and offers portfolio diet recipes on its web site. However, other tree nuts also help reduce cholesterol.
The foods in the portfolio diet are available in supermarkets and health food stores. A typical day on the portfolio diet offers:
- Breakfast. Including soy milk, oat-bran cereal with chopped fruit and almonds, oatmeal bread, sterol-enriched margarine, and jam
- Lunch. Including soy cold cuts, oat-bran bread, bean soup, and fruit
- Dinner. Including stir-fry with vegetables, tofu, fruit, and almonds
- Snacks. Including nuts, yogurt, and soy milk thickened with Metamucil
Does the Portfolio Diet Work?
Jenkins and colleagues have shown that people who religiously follow the portfolio diet can lower their cholesterol. But how does it work in the real world?
To find out, they signed up people who said they wanted lower cholesterol. They told them what to eat and gave them sample menus -- but they didn't provide any prepared foods.
"Just about a third of them get very good results, with better than a 20% reduction in the 'bad' LDL cholesterol after six months," Jenkins says. "Those results are constant from two weeks to six months. So after two weeks you can say, 'These are the people who are likely to stay the course.'"
Another 31% of participants had about a 15% reduction in LDL cholesterol with the portfolio diet. But 35% of participants failed to lower their cholesterol, probably because they weren't able to follow the portfolio diet.
"Most people complied with the advice to eat almonds and to substitute plant sterol products for margarine," Jenkins said. "But fewer people were able to use soy milk and soy dogs and tofu instead of meat and dairy. Having said that, people who were fairly robust at being able to whip up something at home tended to do best. Those who relied on packaged goods or had to eat out a lot had more of a problem."
Is the Portfolio Diet Right for You?
Should you be on the portfolio diet? Most people who want to lower their cholesterol are worried about their heart health. So WebMD turned to Richard Milani, MD, director of the cardiovascular health center at Ochsner Clinic, New Orleans.
"If your goal is cholesterol reduction, this is a very adequate plan," Milani says. "If your goal is weight reduction, this may not be it. If your goal is reducing your risk of heart attack, the Mediterranean diet may be better -- although plant sterols and nuts are part of the Mediterranean diet, too."
But Milani is quick to note that the foods in the portfolio diet can be added to almost any healthy diet.
"What Jenkins and colleagues are saying is you can take these components and put them in any diet," Milani says. "It can be done -- inexpensively -- to get people's cholesterol under control."
Jenkins notes that cholesterol-lowering drugs have more side effects at high doses. He therefore suggests that the foods in the portfolio diet may help people get the most out of these drugs -- without increasing the dosage.
SOURCES: David J.A. Jenkins, MD, PhD, DSc, director, clinical nutrition and risk factor modification center, St. Michael's Hospital; and professor of nutritional sciences, University of Toronto, Ontario, Canada. Richard Milani, MD, director, cardiovascular health center, Ochsner Clinic, New Orleans. Jenkins, D.J.A. Journal of the American Medical Association, July 23/30, 2003; vol 290: pp 502-510. Almond Board of California web site.
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