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Current Atherosclerosis Reports

, Volume 9, Issue 6, pp 501–507 | Cite as

The portfolio diet for cardiovascular risk reduction

  • David J. A. JenkinsEmail author
  • Andrea R. Josse
  • Julia M. W. Wong
  • Tri H. Nguyen
  • Cyril W. C. Kendall
Article

Abstract

Prompted by current dietary recommendations for the control of serum cholesterol to new targets to reduce the risk of coronary heart disease (CHD), and by the CHD risk reduction claims made for certain foods or food components, studies are now being undertaken using combinations of cholesterol-lowering foods in one diet (eg, a dietary portfolio) rather than single foods to achieve more effective dietary control of serum cholesterol. This approach has increased the potential relevance of dietary therapy and may yield nutrition strategies that bridge the gap between what is regarded as a good diet and drug therapy.

Keywords

National Cholesterol Education Program Plant Sterol Vegetable Protein Health Claim Glucomannan 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References and Recommended Reading

  1. 1.
    Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002, 106:3143–3421.Google Scholar
  2. 2.
    Krauss RM, Eckel RH, Howard B, et al.: AHA Dietary Guidelines: revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation 2000, 102:2284–2299.PubMedGoogle Scholar
  3. 3.
    United States Food and Drug Administration: Food Labeling: Health Claims; Soluble Fiber from Certain Foods and Coronary Heart Disease. 1998, Docket No. 96P-0338.Google Scholar
  4. 4.
    United States Food and Drug Administration: FDA final rule for Food Labeling: Health Claims: Soy Protein and Coronary Heart Disease. Federal Register 1999, 64:57699–57733.Google Scholar
  5. 5.
    United States Food and Drug Administration: FDA Authorizes New Coronary Heart Disease Health Claim for Plant Sterol and Plant Stanol Esters. 2000, Docket No. 001-1275, OOP-1276.Google Scholar
  6. 6.
    United States Food and Drug Administration: Food labeling: health claims: nuts & heart disease. Federal Register 2003, Docket No. 02P-0505.Google Scholar
  7. 7.
    Grundy SM, Cleeman JI, Merz CN, et al.: Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004, 110:227–239.PubMedCrossRefGoogle Scholar
  8. 8.
    Schaefer EJ, Lichtenstein AH, Lamon-Fava S, et al.: Effects of National Cholesterol Education Program Step 2 diets relatively high or relatively low in fish-derived fatty acids on plasma lipoproteins in middle-aged and elderly subjects. Am J Clin Nutr 1996, 63:234–241.PubMedGoogle Scholar
  9. 9.
    Shepherd J, Cobbe SM, Ford I, et al.: Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med 1995, 333:1301–1307.PubMedCrossRefGoogle Scholar
  10. 10.
    Downs JR, Clearfield M, Weis S, et al.: Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA 1998, 279:1615–1622.PubMedCrossRefGoogle Scholar
  11. 11.
    Shepherd J, Blauw GJ, Murphy MB, et al.: Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet 2002, 360:1623–1630.PubMedCrossRefGoogle Scholar
  12. 12.
    HPS: MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 2002, 360:7–22.CrossRefGoogle Scholar
  13. 13.
    McPherson R, Frohlich J, Fodor G, Genest J: Canadian Cardiovascular Society position statement-recommendations for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease. Can J Cardiol 2006, 22:913–927.PubMedGoogle Scholar
  14. 14.
    Yan AT, Yan RT, Tan M, et al.: Contemporary management of dyslipidemia in high-risk patients: targets still not met. Am J Med 2006, 119:676–683.PubMedCrossRefGoogle Scholar
  15. 15.
    Eaton SB, Konner M: Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med 1985, 312:283–289.PubMedCrossRefGoogle Scholar
  16. 16.
    Kay R: Diets of early Miocene African hominoids. Nature 1977, 268:628–630.CrossRefGoogle Scholar
  17. 17.
    Jenkins DJ, Kendall CW, Popovich DG, et al.: Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Metabolism 2001, 50:494–503.PubMedCrossRefGoogle Scholar
  18. 18.
    United States Food and Drug Administration: Food Labeling: Health Claims; Soluble Fiber from Whole Oats and Risk of Coronary Heart Disease. 2001, Docket No. 95P-0197:15343-15344.Google Scholar
  19. 19.
    Stone NJ, Nicolosi RJ, Kris-Etherton P, et al.: AHA conference proceedings. Summary of the scientific conference on the efficacy of hypocholesterolemic dietary interventions. American Heart Association. Circulation 1996, 94:3388–3391.PubMedGoogle Scholar
  20. 20.
    Jenkins DJ, Kendall CW, Mehling CC, et al.: Combined effect of vegetable protein (soy) and soluble fiber added to a standard cholesterol-lowering diet. Metabolism 1999, 48:809–816.PubMedCrossRefGoogle Scholar
  21. 21.
    Jenkins DJ, Kendall CW, Vidgen E, et al.: The effect on serum lipids and oxidized low-density lipoprotein of supplementing self-selected low-fat diets with soluble-fiber, soy, and vegetable protein foods. Metabolism 2000, 49:67–72.PubMedCrossRefGoogle Scholar
  22. 22.
    Gardner CD, Coulston A, Chatterjee L, et al.: The effect of a plant-based diet on plasma lipids in hypercholesterolemic adults: a randomized trial. Ann Intern Med 2005, 142:725–733.PubMedGoogle Scholar
  23. 23.
    Cicero AF, Fiorito A, Panourgia MP, et al.: Effects of a new soy/beta-sitosterol supplement on plasma lipids in moderately hypercholesterolemic subjects. J Am Diet Assoc 2002, 102:1807–1811.PubMedCrossRefGoogle Scholar
  24. 24.
    Cicero AF, Minardi M, Mirembe S, et al.: Effects of a new low dose soy protein/beta-sitosterol association on plasma lipid levels and oxidation. Eur J Nutr 2004, 43:319–322.PubMedCrossRefGoogle Scholar
  25. 25.
    Lukaczer D, Liska DJ, Lerman RH, et al.: Effect of a low glycemic index diet with soy protein and phytosterols on CVD risk factors in postmenopausal women. Nutrition 2006, 22:104–113.PubMedCrossRefGoogle Scholar
  26. 26.
    Shrestha S, Volek JS, Udani J, et al.: A combination therapy including psyllium and plant sterols lowers LDL cholesterol by modifying lipoprotein metabolism in hypercholesterolemic individuals. J Nutr 2006, 136:2492–2497.PubMedGoogle Scholar
  27. 27.
    Yoshida M, Vanstone CA, Parsons WD, et al.: Effect of plant sterols and glucomannan on lipids in individuals with and without type II diabetes. Eur J Clin Nutr 2006, 60:529–537.PubMedCrossRefGoogle Scholar
  28. 28.
    Theuwissen E, Mensink RP: Simultaneous intake of beta-glucan and plant stanol esters affects lipid metabolism in slightly hypercholesterolemic subjects. J Nutr 2007, 137:583–588.PubMedGoogle Scholar
  29. 29.
    Jenkins DJ, Kendall CW, Faulkner D, et al.: A dietary portfolio approach to cholesterol reduction: combined effects of plant sterols, vegetable proteins, and viscous fibers in hypercholesterolemia. Metabolism 2002, 51:1596–1604.PubMedCrossRefGoogle Scholar
  30. 30.
    Jenkins DJ, Kendall CW, Marchie A, et al.: The effect of combining plant sterols, soy protein, viscous fibers, and almonds in treating hypercholesterolemia. Metabolism 2003, 52:1478–1483.PubMedCrossRefGoogle Scholar
  31. 31.
    Jenkins DJ, Kendall CW, Marchie A, et al.: Effects of a dietary portfolio of cholesterol-lowering foods vs lovastatin on serum lipids and C-reactive protein. JAMA 2003, 290:502–510.PubMedCrossRefGoogle Scholar
  32. 32.
    Jenkins DJ, Kendall CW, Marchie A, et al.: Direct comparison of a dietary portfolio of cholesterol-lowering foods with a statin in hypercholesterolemic participants. Am J Clin Nutr 2005, 81:380–387.PubMedGoogle Scholar
  33. 33.
    Jenkins DJ, Kendall CW, Faulkner DA, et al.: Assessment of the longer-term effects of a dietary portfolio of cholesterollowering foods in hypercholesterolemia. Am J Clin Nutr 2006, 83:582–591.PubMedGoogle Scholar
  34. 34.
    Ratnayake WM, L’Abbe MR, Mueller R, et al.: Vegetable oils high in phytosterols make erythrocytes less deformable and shorten the life span of stroke-prone spontaneously hypertensive rats. J Nutr 2000, 130:1166–1178.PubMedGoogle Scholar
  35. 35.
    Jones PJ, Raeini-Sarjaz M, Jenkins DJ, et al.: Effects of a diet high in plant sterols, vegetable proteins, and viscous fibers (dietary portfolio) on circulating sterol levels and red cell fragility in hypercholesterolemic subjects. Lipids 2005, 40:169–174.PubMedCrossRefGoogle Scholar
  36. 36.
    Lamarche B, Desroches S, Jenkins DJ, et al.: Combined effects of a dietary portfolio of plant sterols, vegetable protein, viscous fibre and almonds on LDL particle size. Br J Nutr 2004, 92:657–663.PubMedCrossRefGoogle Scholar
  37. 37.
    Jenkins DJ, Kendall CW, Marchie A, et al.: Direct comparison of dietary portfolio vs statin on C-reactive protein. Eur J Clin Nutr 2005, 59:851–860.PubMedCrossRefGoogle Scholar
  38. 38.
    Jenkins DJ, Kendall CW, Faulkner DA, et al.: Long-term effects of a plant-based dietary portfolio of cholesterol-lowering foods on blood pressure. Eur J Clin Nutr 2007, In press.Google Scholar
  39. 39.
    Jenkins DJ, Kendall CW, Nguyen TH, et al.: Effect on hematologic risk factors for coronary heart disease of a cholesterol reducing diet. Eur J Clin Nutr 2007, 61:483–492.PubMedGoogle Scholar
  40. 40.
    Krauss RM, Blanche PJ, Rawlings RS, et al.: Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia. Am J Clin Nutr 2006, 83:1025–1031.PubMedGoogle Scholar
  41. 41.
    Turnbull WH, Leeds AR, Edwards GD: Effect of mycoprotein on blood lipids. Am J Clin Nutr 1990, 52:646–650.PubMedGoogle Scholar
  42. 42.
    Turnbull WH, Leeds AR, Edwards DG: Mycoprotein reduces blood lipids in free-living subjects. Am J Clin Nutr 1992, 55:415–419.PubMedGoogle Scholar
  43. 43.
    Heber D, Yip I, Ashley JM, et al.: Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr 1999, 69:231–236.PubMedGoogle Scholar
  44. 44.
    Liu J, Zhang J, Shi Y, et al.: Chinese red yeast rice (Monascus purpureus) for primary hyperlipidemia: a meta-analysis of randomized controlled trials. Chin Med 2006, 1:4.PubMedCrossRefGoogle Scholar
  45. 45.
    Vuksan V, Sievenpiper JL, Owen R, et al.: Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. Diabetes Care 2000, 23:9–14.PubMedCrossRefGoogle Scholar
  46. 46.
    LaRosa JC, Grundy SM, Waters DD, et al.: Treating to New Targets (TNT) Investigators: Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005, 352:1425–1435.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2007

Authors and Affiliations

  • David J. A. Jenkins
    • 1
    Email author
  • Andrea R. Josse
  • Julia M. W. Wong
  • Tri H. Nguyen
  • Cyril W. C. Kendall
  1. 1.Department of Nutritional Sciences, Faculty of MedicineUniversity of TorontoTorontoCanada

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