Beating cholesterol with the Portfolio Diet - Sydney Morning Herald (blog)

Barley and soybeans might not be high on your shopping list but they may do better at   lowering 'bad' LDL cholesterol than just avoiding saturated fat.  That's the verdict on the Portfolio Diet, the cholesterol lowering plan developed by Canadian researcher Professor David Jenkins nine years ago.

Back then Jenkins looked at all the foods that help reduce LDL cholesterol – soy, nuts and viscous fibre (found in oats  and barley, as well as legumes and  vegetables like eggplant and okra), and plant sterols. Each food was known to lower cholesterol individually, but would eating all of them daily have a bigger effect?

It did. Those who stuck to this diet shrank their LDL cholesterol by 20 per cent after a year – similar to taking a low dose statin, a drug that lowers cholesterol. But in a recent study published in the Journal of the American Medical Association,  the researchers looked at how this plan stacked up against a diet low in saturated fat – the usual approach to lowering cholesterol. The result?  After 24 weeks the Portfolio foods had lowered LDL cholesterol by 13 per cent compared to three per cent on the low saturated fat diet.

That's no surprise to Sydney dietitian Monica Kubizniak of the Nutrition and Wellbeing Clinic who often uses these foods to help people lower their cholesterol. 

"I get a lot of clients who try to reduce LDL cholesterol by cutting out saturated fat and they can't understand why their levels aren't coming down. But we've had   people who've  been able to avoid going on cholesterol lowering  medication or have  reduced their dose after trying the Portfolio diet, "  says  Kubizniak. Some GPs who refer patients for nutrition advice to lower cholesterol now   request the Portfolio approach, she adds.    

But how easy – or hard – is it to follow this plan?  

"Barley and soy  are foods that many  people aren't used to eating, but after four to eight weeks we find people adjust to cooking with them and  are doing well,  " she says.

 Let's start with the easy bits – eating nuts and oats.  Kubizniak suggests about five handfuls of raw unsalted nuts each week, and traditional raw oats for breakfast either in muesli or as porridge. You also need:

• Soy Protein Aim for 25 g daily: two slices of soy and linseed bread, 250 mls of soymilk –maybe in a smoothie -   and 100g of tofu, for instance. Tofu absorbs flavours well and is good in curries and stir fries, or try adding add half a cup cooked soybeans to soups, casseroles and salads.  Other soy options are convenience foods like soy burgers -   or half a cup of edamame, those green beans you get in Japanese restaurants or from Asian food stores.

•  More viscous fibre. You need one of the following foods every day -breakfast oats, a serve of barley – easily cooked in a rice cooker and good with curries and stir fries or as a base for a grainy salad, says Kubizniak - or a serve of eggplant, beans or lentils. You also need  five teaspoons of psyllium husks (from supermarkets and health food stores) spread over the day – it's tasteless and you can stir it into water or juice or add it to cereal.

• Plant sterols   Opt for two teaspoons of plant sterol margarine, or a plant sterol supplement.  Plant sterols are also found naturally in small amounts in nuts, vegetables, fruit and cereals so a diet rich in plant foods will help – but won't deliver the 2-3g daily needed to lower cholesterol. 

Still, heading off heart disease isn't just about cholesterol  – arteries have other enemies like inactivity and  high blood sugar levels, for example. But there's no argument that cholesterol damages arteries, says Professor  Simon Stewart, Head of Preventative Cardiology at the Baker IDI Heart & Diabetes Institute.

 "Large epidemiological  studies show that people with  high cholesterol are more likely to have heart disease and stroke. We are born with barely detectable cholesterol levels and if you look at epidemiological studies the populations with low cholesterol don't get heart disease," he says.

"If you  look at the arteries of people after sudden death from a heart attack you often find a clot beside a fatty streak or fully developed plaque in the arteries. These fatty streaks and plaques not only restrict blood supply to the heart as they increase in size, but generate life-threatening blood clots that often lead to a fatal heart attack. "

As for a US study that found most people who have heart attacks don't have high cholesterol, Stewart believes that's because what we now accept as a healthy cholesterol level is too high –  3.5 mmol/L sounds good but 2.5 mmol/L or less is what's ideal, he says.

Have you improved your cholesterol levels with a  lifestyle change?

PS Interested in healthy ageing? If you're in the Sydney area, the Prince of Wales Hospital is running a free public forum - How to Have a Healthy Ageing Brain  - at 10am on Monday October 24 at South Sydney Junior Rugby Leagues Club, Kingsford. Speakers include expert on brain ageing Professor Henry Brodaty, and I'll be giving tips on how to put healthier meals on your plate. Bookings essential - call Irina Vukolova on 9382 3753.

18 Oct, 2011

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