Four foods that lower cholesterol

In 2003 a Canadian physician named David Jenkins, who'd earlier invented the glycemic index, ran a trial that treated food like a drug. He gave people with high cholesterol four things to eat every day: plant sterols, the compounds in margarines and some supplements that block cholesterol absorption; viscous fiber, from oats, barley, psyllium and okra, which carries cholesterol out; soy protein, in place of animal protein; and nuts, especially almonds. Together. Daily. He called it the Portfolio diet, after an investment portfolio: no single holding does the job, but the combination does.

The result, published in a major journal, was that the four foods together lowered LDL cholesterol by about as much as a starting dose of a statin drug. Later trials confirmed it, and the pattern is now in cardiology guidelines as a dietary option.

What I find useful isn't the specific four, though they're sound. It's the idea of a portfolio. Most diet advice is one thing: cut this, add that. Jenkins showed that modest changes, stacked, do more than any one dramatic change, and that the stacking is the strategy. A bowl of oats. A handful of almonds. Tofu instead of chicken twice a week. A spread with sterols. Each is small. The sum moved a lab value by a clinically meaningful amount.

That's this year's method, in a cholesterol trial. No single key changes a life. A hundred and twenty-two of them, stacked, do.

A plain line: if your cholesterol is high, this is a conversation with a physician, and the portfolio is something to bring to it, not a replacement for it.