Combining foods with recognized cholesterol-lowering properties (dietary portfolio) has proven highly effective in lowering serum cholesterol under metabolically controlled conditions.
The objective of this study was to assess the effect of a dietary portfolio administered at two levels of intensity on percentage change in low-density lipoprotein cholesterol (LDL) among participants following self-selected diets.
This parallel-design study included 351 participants with hyperlipidemia from four participating academic centers across Canada (Quebec City, Toronto, Winnipeg and Vancouver) randomized between June 25, 2007, and February 19, 2009, to one of three treatments lasting 6 months.
Participants received dietary advice for 6 months on either a low saturated fat therapeutic diet (control) or a dietary portfolio—for which counseling was delivered at different frequencies—that emphasized dietary incorporation of plant sterols, soy protein, viscous fibers and nuts. Routine dietary portfolio involved two clinic visits over 6 months and intensive dietary portfolio involved seven clinic visits over 6 months.
The LDL reductions from an overall mean of 171 mg/dL were −13.8% or −26 mg/dL for the intensive dietary portfolio; −13.1% or –24 mg/dL for the routine dietary portfolio; and −3.0% or −8 mg/dL for the control diet. Percentage LDL reductions for each dietary portfolio were significantly more than the control diet. The two dietary portfolio interventions did not differ significantly. Among participants randomized to one of the dietary portfolio interventions, percentage reduction in LDL on the dietary portfolio was associated with dietary adherence.
Researchers concluded use of a dietary portfolio compared with the low saturated fat dietary advice resulted in greater LDL lowering during 6 months of follow-up.