The Portfolio Diet Again

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The Portfolio Diet, by D , has been discussed here before. This new

study is on the results after one year... a 20% reduction

Abstract and PR release below

American Journal of Clinical Nutrition, Vol. 83, No. 3, 582-591, March 2006

© 2006 American Society for Clinical Nutrition

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ORIGINAL RESEARCH COMMUNICATION

Assessment of the longer-term effects of a dietary portfolio of

cholesterol-lowering foods in hypercholesterolemia1,2,3

JA , Cyril WC Kendall, Dorothea A Faulkner, Tri Nguyen,

Kemp, Augustine Marchie, MW Wong, de Souza, Azadeh Emam,

Vidgen, Elke A Trautwein, G Lapsley, Holmes, G Josse,

Lawrence A Leiter, Philip W Connelly and Singer

1 From the Clinical Nutrition and Risk Factor Modification Center (DJAJ, CWCK,

DAF, TN, AM, JMWW, RdS, AE, EV, CH, RGJ, LAL, and WS) and the Department of

Medicine, Division of Endocrinology and Metabolism (DJAJ, RGJ, LAL, PWC, and

WS), St 's Hospital, Toronto, Canada; the Departments of Nutritional

Sciences (DJAJ, CWCK, DAF, TN, AM, JMWW, RdS, AE, EV, RGJ, LAL, and WS),

Medicine (DJAJ, RGJ, LAL, and WS), Biochemistry (PWC), and Laboratory Medicine

and Pathobiology (PWC), Faculty of Medicine, University of Toronto, Toronto,

Canada; the Dewsbury and District Hospital, Dewsbury, United Kingdom (TK); the

Unilever Food and Health Research Institute, Unilever R & D, Vlaardingen,

Netherlands (EAT); and The Almond Board of California, Modesto, California (KGL)

Background: Cholesterol-lowering foods may be more effective when consumed as

combinations rather than as single foods.

Objectives: Our aims were to determine the effectiveness of consuming a

combination of cholesterol-lowering foods (dietary portfolio) under real-world

conditions and to compare these results with published data from the same

participants who had undergone 4-wk metabolic studies to compare the same

dietary portfolio with the effects of a statin.

Design: For 12 mo, 66 hyperlipidemic participants were prescribed diets high in

plant sterols (1.0 g/1000 kcal), soy protein (22.5 g/1000 kcal), viscous fibers

(10 g/1000 kcal), and almonds (23 g/1000 kcal). Fifty-five participants

completed the 1-y study. The 1-y data were also compared with published results

on 29 of the participants who had also undergone separate 1-mo metabolic trials

of a diet and a statin.

Results: At 3 mo and 1 y, mean (±SE) LDL-cholesterol reductions appeared stable

at 14.0 ± 1.6% (P < 0.001) and 12.8 ± 2.0% (P < 0.001), respectively (n = 66).

These reductions were less than those observed after the 1-mo metabolic diet and

statin trials. Nevertheless, 31.8% of the participants (n = 21 of 66) had

LDL-cholesterol reductions of >20% at 1 y ( ± SE: -29.7 ± 1.6%). The

LDL-cholesterol reductions in this group were not significantly different from

those seen after their respective metabolically controlled portfolio or statin

treatments. A correlation was found between total dietary adherence and

LDL-cholesterol change (r = -0.42, P < 0.001). Only 2 of the 26 participants

with <55% compliance achieved LDL-cholesterol reductions >20% at 1 y.

Conclusions: More than 30% of motivated participants who ate the dietary

portfolio of cholesterol-lowering foods under real-world conditions were able to

lower LDL-cholesterol concentrations >20%, which was not significantly different

from their response to a first-generation statin taken under metabolically

controlled conditions.

Cholesterol-Lowering Diet Packs Punch

Diet Rich in Cholesterol-Lowering Foods Lowers Cholesterol Level by 20%

By Warner

WebMD Medical News Reviewed By Louise Chang, MD

on Friday, March 10, 2006

March 10, 2006 -- Eating a mostly plant-based diet rich in several

cholesterol-lowering foods may lower cholesterol levels nearly as effectively as

taking cholesterol-lowering statin drugs.

A new study showed people who ate a diet rich in cholesterol-lowering foods,

such as soy protein, almonds, plant sterol-enriched margarines, and natural

fiber (from items such as oats, psyllium, okra, and eggplant) for a year lowered

their cholesterol levels by 20% or more, a reduction comparable with that found

with statins.

Researchers say the results suggest that cholesterol-lowering foods are most

effective when combined rather than eaten individually to lower cholesterol and

reduce the risk of heart disease.

" The benefit of statins to individuals at high risk for cardiovascular disease

is not in question here, " says researcher , professor of

nutritional sciences at the University of Toronto, in a news release.

" Emphasizing diet changes in general can boost the success rate of statins while

providing additional health benefits and a possible alternative for those for

whom drugs are not a viable option. "

Portfolio Diet Lowers Cholesterol

In the study, published in the American Journal of Clinical Nutrition,

researchers compared the cholesterol-lowering effects of one month of statin use

vs. one year of following a diet rich in a portfolio of cholesterol-lowering

foods under real-world conditions.

For one year, 55 adults with high cholesterol followed a mostly plant-based diet

including soy protein, plant sterol-enriched margarine, increased fiber, and

almonds. The people were also asked to eat five to 10 servings of fruits and

vegetables a day and eat more plant protein (such as beans).

" The participants found it easiest to incorporate single items such as the

almonds and margarine into their daily lives, " says . " The fiber and

vegetable protein were more challenging since they require more planning and

preparation, and because these types of niche products are less available. It's

just easier, for example, to buy a beef burger instead of one made from soy,

although the range of options is improving. We considered it ideal if the

participants were able to follow the diet three-quarters of the time. "

The results showed that the participants who followed the diet for one year had

lowered their cholesterol levels by 20%. Researchers say that cholesterol

reduction is comparable with the reduction achieved by 29 of the participants

who took a statin for one month before following the diet in a separate study.

" The study's findings suggest that the average person can do a lot to improve

their health through diet, " says . " People interested in lowering their

cholesterol should probably acquire a taste for tofu and oatmeal, keeping in

mind that portable alternatives fit best with a modern lifestyle. Save the

experimenting for the evening, when you have more time to prepare more

complicated meals. "

" Taking a pill may give people the false impression that they have nothing

further to do to protect their health and prevent them from making serious

lifestyle changes, " says .

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SOURCES: , D. American Journal of Clinical Nutrition, March 2006: vol 83;

pp 582-591. News release, University of Toronto.