NEW YORK: Diets rich in fruits, vegetables, whole grains, olive oil, nuts and fish are widely recognised for supporting heart health. New research now suggests that a lesser-known eating pattern — the largely plant-based Portfolio Diet — may also reduce the risk of death from cardiovascular disease and other chronic conditions.
Two recent studies led by researchers from the Temerty Faculty of Medicine at the University of Toronto suggest that adherence to the largely plant-based Portfolio Diet may lower both cardiovascular disease mortality and overall mortality.
Researchers say this is the first time the diet has been linked to reductions in deaths from heart disease and from all causes.
What is the Portfolio Diet?
The Portfolio Diet was developed in 2003 by University of Toronto professor David Jenkins. It is named after a “portfolio” of cholesterol-lowering foods that replace less healthy items in a person’s usual diet.
The diet focuses on four key components:
- Soy and other plant proteins that replace saturated fats
- Plant sterols that reduce cholesterol absorption
- Tree nuts that provide unsaturated, heart-healthy fats
- Soluble fibre that binds cholesterol and bile acids
According to Wellstar cardiovascular dietitian Erin Sheehan, the strength of the Portfolio Diet lies in the combined effect of these foods.
“When it comes to specifically lowering LDL, or ‘bad’, cholesterol, that’s where the portfolio diet really shines,” Sheehan told Healthline. “By combining these foods, we maximise the cholesterol-lowering effect.”
As with other heart-healthy diets, experts advise avoiding highly processed foods and products with added sugar.
Long-term health benefits
Previous research has shown that the Portfolio Diet can improve heart health.
A 2023 peer-reviewed study published in the American Heart Association journal Circulation found that the diet could lower the risk of cardiovascular disease, including heart attacks and strokes.
The new research goes further by examining long-term outcomes.
In one study, published in BMC Medicine in May 2025, researchers analysed data from nearly 15,000 racially diverse Americans followed for about 20 years.
Participants recorded their food intake and completed questionnaires. Higher scores were given for eating Portfolio Diet foods, while lower scores were assigned for foods high in saturated fat and cholesterol.
The study found that moderate adherence to the diet reduced the risk of death from cardiovascular disease by 12 per cent and from coronary heart disease by 14 per cent. Overall mortality fell by 12 per cent.
Stronger adherence produced even greater benefits. High adherence was associated with a 16 per cent reduction in cardiovascular disease deaths and an 18 per cent reduction in coronary heart disease deaths.
“Reducing mortality is not an easy thing to demonstrate,” said Dr Chandan Devireddy, an interventional cardiologist with Emory Healthcare in Atlanta, who was not involved in the research.
“The size of the reductions seen with these dietary changes is fairly impressive.”
Benefits of starting early
A second study, also published in BMC Medicine, examined the impact of following the Portfolio Diet from a younger age.
Researchers found that early adherence among ethnoculturally diverse young adults could limit lifetime exposure to LDL cholesterol and delay the onset of cardiovascular events.
Following the diet about half of the time could delay heart-related events by around six years. Full adherence could extend that delay to about 13 years.
“These findings suggest that paying attention to what children and young adults eat could have a major impact on their long-term heart health,” Devireddy said.
Sheehan described the results as particularly encouraging for prevention. “Delaying the age-related rise in LDL cholesterol also delays cardiovascular risk,” she said. “That should be very motivating.”
Researchers noted that both studies included racially diverse participants and younger adults. Earlier studies had often focused on older, predominantly white male populations.
Despite the benefits, experts acknowledge challenges in adopting the diet. Changing long-established eating habits can be difficult.
“Dietary instincts are deeply ingrained,” Devireddy said. “It can be hard for people to change what they find palatable, know how to cook, or can afford.”
Sheehan agreed that cost can be a concern but said many recommended foods are affordable. Beans, for example, are often cheaper than meat. Canned or frozen fruits and vegetables, without added salt or sugar, can also be economical.
