- Research has linked adherence to the Portfolio Diet with a reduction in the risk of death from heart disease by up to 18%.
- The diet’s success comes from combining four specific cholesterol-lowering food categories for a powerful “additive effect.”
- Starting the portfolio diet at an earlier age could delay the onset of cardiovascular events by as much as 13 years.
- Experts say consistent, small additions (like nuts or beans) offer great results, even with moderate adherence.
The Mediterranean and
Yet a lesser-known heart-healthy diet is drawing attention for its ability to seemingly reduce the risk of death from cardiovascular disease and other chronic health conditions.
It’s known as the Portfolio Diet, and a pair of recent studies shows that the benefits of the plant-based regimen may go beyond lowering the risk or
According to researchers from the Temerty Faculty of Medicine at the University of Toronto, this is the first time the Portfolio Diet has been linked to a reduction in cardiovascular disease mortality and all-cause mortality.
The Portfolio Diet was developed in 2003 by University of Toronto professor David Jenkins. The plant-based eating pattern gets its name because it calls for substituting foods already in someone’s diet with those from a “portfolio” of cholesterol-lowering ingredients that fall into four categories:
- Soy/plant proteins that displace saturated fat
- Plant sterols that block cholesterol absorption
- Tree nuts that provide heart-healthy, unsaturated fats
- Soluble fiber that binds and removes bile/cholesterol
It’s through this combination of ingredients, which creates an “additive” effect in lowering cholesterol, that Wellstar cardiovascular dietitian Erin Sheehan has said sets the portfolio diet apart from others.
“When it comes to looking specifically at lowering (bad) LDL cholesterol, that’s where the portfolio diet really shines,” Sheehan told Healthline. “What we’re doing with this diet is combining a whole bunch of these foods to compound on top of each other and maximize that LDL-lowering effect.”
Like with any diet looking to improve heart health, people should avoid foods that are highly processed and contain added sugar.
Researchers have already demonstrated that adherence to the portfolio diet can positively impact heart health.
A 2023 peer-reviewed study published in the American Heart Association (AHA) journal
Two recent studies by the University of Toronto Temerty Faculty of Medicine delved deeper into the lasting effects of following this eating plan.
In a study published in BMC Medicine in May 2025, researchers collected data from nearly 15,000 racially diverse Americans over a two-decade period.
Participants documented their daily food intake and completed supplemental questionnaires, earning positive points for consuming foods from the portfolio diet and negative points for eating foods high in saturated fat and cholesterol.
The study found that moderate adherence to the portfolio diet could decrease the risk of mortality from cardiovascular disease and coronary heart disease by 12% and 14%, respectively. That level decreased overall mortality by 12%.
However, the closer someone followed the diet, the higher those numbers increased, to 16% and 18% reductions in mortality for cardiovascular and coronary heart disease, respectively. Overall mortality dropped by 14%.
It’s a surprising and “impressive” result, said Chandan Devireddy, MD, an interventional cardiologist with Emory Healthcare in Atlanta. Devireddy wasn’t involved in the studies.
“Reducing mortality is not an easy thing to demonstrate,” he told Healthline. “When you see the kind of numbers that are suggested in reduction with these dietary changes, it’s fairly impressive.”
In a second study, also conducted by the University of Toronto and recently published in BMC Medicine, researchers examined the effects of starting the portfolio diet at a younger age.
They found that the benefits of early adherence to the diet among “ethnoculturally diverse young adults” were two-fold: it could limit exposure to the “bad” LDL cholesterol over their lifetime and delay the onset of cardiovascular events.
Adhering to the diet 50% of the time may delay the onset of cardiovascular events by 6 years, and adhering to the diet 100% of the time could expand that to 13 years.
Those results elicited by the dietary changes were similarly impressive, Devireddy said.
“It does provide some evidence that paying attention to the type of foods that we expose school and college kids to may have a huge impact in both their exposure to cholesterol and also potentially in their long-term dietary preferences,” Devireddy said.
Sheehan agreed that the study’s results among young adults were particularly “exciting” from a dietitian’s perspective, as they provide a pathway to lifelong prevention rather than just intervention. Sheehan wasn’t involved in the study.
“There are things that we can do to prevent cardiovascular disease and other chronic diseases, and I think it’s exciting to think about the delay of that age-related rise in LDL cholesterol, which in turn delays our cardiovascular risk,” she said. “I think it should be a very motivating argument for anybody.”
In both studies, the inclusion of racially diverse and younger participants was significant, as earlier studies had tended to focus on older, predominantly white, and male populations.
But in looking at a wider swath of the population, researchers not only showed that the benefits are realized across the different groups, “but in these minority subsets, there may even be a bigger impact of the portfolio diet realized within those groups,” Devireddy said.
While there appear to be benefits to following the Portfolio Diet, experts note that there are also hurdles. Devireddy said that changing eating habits can be difficult to overcome.
“Dietary choices and instincts are so ingrained after a lifetime that it may be very challenging for many to suddenly make a 180-degree turn in the type of diet that they find palatable, and that they know how to cook and prepare, and whether they have the resources to obtain these type of foods when they’re walking the grocery store aisle,” he said.
Sheehan acknowledged that current grocery store prices are certainly a barrier, but she challenged shoppers to take a second look.
“A lot of the foods that are recommended in this diet, and others, are actually pretty affordable when you really look,” she said. “Look at beans. You can get a can of beans or even a bag of dried beans for very, very cheap compared to some of the chicken and ground beef that you see.”
“So, I kind of back patients into thinking that way: What can we find that works with that budget?”
Once committed to the Portfolio Diet, Sheehan recommended taking a slow approach and focusing on adding, rather than taking away, to help make the transition a little easier — one of the benefits of the diet.
“You can have a handful of nuts every day, and you can have a couple of meatless meals throughout a week, and that’s still enough to see great results,” she said. “It really is just about consistency, not just perfection.”
