How to Lower Cholesterol with the Portfolio Diet

Kristine Dennis PhD, MPH · February 23, 2026 · Volume 72

Can a plant-based Portfolio Diet lower LDL cholesterol as effectively as statin drugs?

Discuss

Transcript

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Intro: In this video series we take a deep dive into maximally lowering LDL cholesterol through diet, as LDL is the primary driver of our primary killer and the lower the better. We’ll talk about expanding the Portfolio diet; we’ll talk about plant sterols, cholesterol-lowering supplements, foods, herbs, spices, you name it, ending up with a Dr. Greger in the kitchen-type video where I share how to make this cholesterol-lowering powder you can sprinkle on food. Anyway, if you don’t want to wait for each video to be released, I have compiled all the information into a brand new book available at nutritionfacts.org/books.

Of the top ten take-home messages for the primary prevention of cardiovascular disease, take-home number nine is that cholesterol-lowering statin drugs are considered the first-choice drug treatment for preventing heart disease in those with sufficiently elevated LDL cholesterol––though side effects, like muscle pain or weakness, may impact up to a quarter of users. Regardless, whether you and your doctor decide to start drugs, the number one take-home message is that the most important way to prevent heart disease—the number one killer of men and women—is to promote a healthy lifestyle throughout life. Enter The Portfolio Diet for the maximal reduction of LDL cholesterol.

There are three main added factors in our diet that raise LDL cholesterol: trans fat, saturated fat, and dietary cholesterol. Therefore, the tolerable upper intake levels for trans fat, saturated fat, and cholesterol are essentially zero, since any intake above zero increases LDL cholesterol concentration, and therefore increases risk of coronary heart disease. So trans fat, saturated fat, and cholesterol intake should be as low as possible. That means cutting back as much as possible on meat, dairy, eggs, and junk.

And since partially hydrogenated oils must be removed from the U.S. food supply by law, all these other uses have been banned. So, animal products are now the leading source of trans fat in the American diet as well.

Those eating a Western diet have circulating LDL levels around 120 mg/dL. No surprise, then, that those eating plant-based tend to have lower LDL, with lower levels the longer they have been eating a whole food, plant-based diet; as low as 70, but even though that’s an excellent number compared to most people, if you remember from a previous video, there really isn’t a safe cut off. When it comes to LDL, the lower the longer, the better—even if you’re at low risk.

That’s where the Portfolio Diet can come in. By eating a healthy plant-based diet, you’ve already subtracted all the major foods that increase your cholesterol. The Portfolio Diet is a plant-based diet with a bonus, a portfolio of foods— four food types you can add to your diet to pull cholesterol out of your system. The food components include one and a half ounces of nuts (45 g) a day, good sources of plant protein––in other words, legumes, like soy, other beans, split peas, chickpeas, or lentils––lots of foods with viscous fiber (that’s the kind of slimy fiber found in oats, okra, eggplant, barley, and ground flax seeds), and finally, two grams a day of plant sterols from fortified foods or supplements. Dr. Greger is going to take a deep dive into phytosterols. But first, let’s just see what this diet can do.

The Portfolio Diet was tested head-to-head against statin treatment plus a very low saturated-fat diet in a four-week randomized, controlled trial among people with high cholesterol. And incredibly, those in the Portfolio Diet group had nearly a 30% drop in LDL cholesterol – similar to the 33% drop observed in the statins plus low saturated-fat group. Simply by emphasizing the addition of four dietary components that are each likely to contribute 4 to 7% to overall cholesterol reduction, you have a diet that reduces LDL cholesterol with drug-like potency.

In a systematic review and meta-analysis of controlled trials of the Portfolio Diet, we still see consistent LDL-lowering benefits from the Portfolio Diet––about a 17% drop above and beyond the currently recommended relatively strict National Cholesterol Education Program Step 2 diet, along with lowering of systemic inflammation, and an estimated 13% decrease in ten-year heart disease risk. And these results weren’t even in individuals who all actually went on a Portfolio Diet; they were merely told to eat that way. Even just two educational sessions over six months telling people to adopt it can have a significant effect.

I mentioned the four food components, but what does a sample menu look like? Nuts for snacks; soy foods and beans for plant protein; oats, barley, okra, eggplant, Metamucil, and oranges for soluble fiber; and what’s all this margarine for? They were using plant-sterol-fortified margarine, like Benecol and Promise Activ, formerly known as Take Control. Yes, they have added plant sterols, but they’re also chock full of salt, saturated fat, and artificial flavors. I mean, if you’re going to use some sort of spread, this would be better than non-sterol fortified margarine or butter, but seems like a strange way to prevent heart disease. Plant sterols are naturally concentrated in sesame seeds and wheat germ, and also found in a variety of grains and legumes. To get that recommended two or three grams a day, though, you may have to take plant sterol supplements. In fact, should we all be doing that? That’s what Dr. Greger will tackle next, and then see if there’s any other cholesterol-lowering supplements that might be worth taking.

Finally, what about all the other foods that lower cholesterol? What about expanding our portfolio to make some kind of Portfolio Plus diet with as many different cholesterol-lowering foods and herbs and spices as we can? Again, not as a replacement for drugs, but as a way to drive our LDL as low as possible with our fridge and pantry, in addition to anything we might have in our medicine cabinet.

Please consider volunteering to help out on the site.

Sources

Acknowledgements

Motion graphics by Avo Media

Topics

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Intro: In this video series we take a deep dive into maximally lowering LDL cholesterol through diet, as LDL is the primary driver of our primary killer and the lower the better. We’ll talk about expanding the Portfolio diet; we’ll talk about plant sterols, cholesterol-lowering supplements, foods, herbs, spices, you name it, ending up with a Dr. Greger in the kitchen-type video where I share how to make this cholesterol-lowering powder you can sprinkle on food. Anyway, if you don’t want to wait for each video to be released, I have compiled all the information into a brand new book available at nutritionfacts.org/books.

Of the top ten take-home messages for the primary prevention of cardiovascular disease, take-home number nine is that cholesterol-lowering statin drugs are considered the first-choice drug treatment for preventing heart disease in those with sufficiently elevated LDL cholesterol––though side effects, like muscle pain or weakness, may impact up to a quarter of users. Regardless, whether you and your doctor decide to start drugs, the number one take-home message is that the most important way to prevent heart disease—the number one killer of men and women—is to promote a healthy lifestyle throughout life. Enter The Portfolio Diet for the maximal reduction of LDL cholesterol.

There are three main added factors in our diet that raise LDL cholesterol: trans fat, saturated fat, and dietary cholesterol. Therefore, the tolerable upper intake levels for trans fat, saturated fat, and cholesterol are essentially zero, since any intake above zero increases LDL cholesterol concentration, and therefore increases risk of coronary heart disease. So trans fat, saturated fat, and cholesterol intake should be as low as possible. That means cutting back as much as possible on meat, dairy, eggs, and junk.

And since partially hydrogenated oils must be removed from the U.S. food supply by law, all these other uses have been banned. So, animal products are now the leading source of trans fat in the American diet as well.

Those eating a Western diet have circulating LDL levels around 120 mg/dL. No surprise, then, that those eating plant-based tend to have lower LDL, with lower levels the longer they have been eating a whole food, plant-based diet; as low as 70, but even though that’s an excellent number compared to most people, if you remember from a previous video, there really isn’t a safe cut off. When it comes to LDL, the lower the longer, the better—even if you’re at low risk.

That’s where the Portfolio Diet can come in. By eating a healthy plant-based diet, you’ve already subtracted all the major foods that increase your cholesterol. The Portfolio Diet is a plant-based diet with a bonus, a portfolio of foods— four food types you can add to your diet to pull cholesterol out of your system. The food components include one and a half ounces of nuts (45 g) a day, good sources of plant protein––in other words, legumes, like soy, other beans, split peas, chickpeas, or lentils––lots of foods with viscous fiber (that’s the kind of slimy fiber found in oats, okra, eggplant, barley, and ground flax seeds), and finally, two grams a day of plant sterols from fortified foods or supplements. Dr. Greger is going to take a deep dive into phytosterols. But first, let’s just see what this diet can do.

The Portfolio Diet was tested head-to-head against statin treatment plus a very low saturated-fat diet in a four-week randomized, controlled trial among people with high cholesterol. And incredibly, those in the Portfolio Diet group had nearly a 30% drop in LDL cholesterol – similar to the 33% drop observed in the statins plus low saturated-fat group. Simply by emphasizing the addition of four dietary components that are each likely to contribute 4 to 7% to overall cholesterol reduction, you have a diet that reduces LDL cholesterol with drug-like potency.

In a systematic review and meta-analysis of controlled trials of the Portfolio Diet, we still see consistent LDL-lowering benefits from the Portfolio Diet––about a 17% drop above and beyond the currently recommended relatively strict National Cholesterol Education Program Step 2 diet, along with lowering of systemic inflammation, and an estimated 13% decrease in ten-year heart disease risk. And these results weren’t even in individuals who all actually went on a Portfolio Diet; they were merely told to eat that way. Even just two educational sessions over six months telling people to adopt it can have a significant effect.

I mentioned the four food components, but what does a sample menu look like? Nuts for snacks; soy foods and beans for plant protein; oats, barley, okra, eggplant, Metamucil, and oranges for soluble fiber; and what’s all this margarine for? They were using plant-sterol-fortified margarine, like Benecol and Promise Activ, formerly known as Take Control. Yes, they have added plant sterols, but they’re also chock full of salt, saturated fat, and artificial flavors. I mean, if you’re going to use some sort of spread, this would be better than non-sterol fortified margarine or butter, but seems like a strange way to prevent heart disease. Plant sterols are naturally concentrated in sesame seeds and wheat germ, and also found in a variety of grains and legumes. To get that recommended two or three grams a day, though, you may have to take plant sterol supplements. In fact, should we all be doing that? That’s what Dr. Greger will tackle next, and then see if there’s any other cholesterol-lowering supplements that might be worth taking.

Finally, what about all the other foods that lower cholesterol? What about expanding our portfolio to make some kind of Portfolio Plus diet with as many different cholesterol-lowering foods and herbs and spices as we can? Again, not as a replacement for drugs, but as a way to drive our LDL as low as possible with our fridge and pantry, in addition to anything we might have in our medicine cabinet.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

This is the fifth video in an extended series on the critically important topic of how to lower LDL cholesterol, the primary driver of our primary killer. In this series, we take a deep dive into ways we may lower our cholesterol through diet. We’ll explore the Portfolio Diet, plant sterols, and cholesterol-lowering supplements, foods, herbs, and spices, and then conclude with my Portfolio Plus Powder recipe “cooking” video.

If you don’t want to wait for all the videos to be released over time, we’ve compiled all the information into my latest book, Lower LDL Cholesterol Naturally with Food, available as a softcover, ebook, and audiobook.

If you missed the previous videos in this series, see:

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