The Portfolio Eating Plan with Almonds Delivers a Solid Return

New Portfolio Study Supports More Than a Decade of Research Showing Dietary Approach Including Nuts, such as Almonds, Helps Maintain Healthy Cholesterol Levels

Nov 28, 2011, 07:00 ET from Almond Board of California


MODESTO, Calif., Nov. 28, 2011 /PRNewswire/ -- Financial portfolios are not the only portfolios that yield a return on investment, according to a new study published in the Journal of the American Medical Association about the Portfolio Eating Plan (PEP).(1)  The dietary approach is referred to as the "portfolio" eating plan because it includes a variety of heart-healthy foods, such as almonds.(2)  The study is the fifth installment in a series of studies confirming the ability of the PEP to help people maintain healthy levels of cholesterol.(3) Distinct from previous PEP studies, it found that this diet provides health benefits irrelevant of the amount of nutrition counseling, which indicates that individuals were able to successfully follow and see positive results from the Portfolio Eating Plan without intensive dietary counseling.(1)

The Portfolio Eating Plan was developed by Dr. David Jenkins and Dr. Cyril Kendall of the University of Toronto. Their current study builds on more than a decade of previous research of the Portfolio Eating Plan to show that incorporating nuts, including almonds, in the diet along with other known cholesterol-lowering foods, may help to maintain healthy levels of cholesterol more effectively than a diet low in saturated fat alone.(1) Almonds deliver 3.5 grams of fiber, 13 grams of unsaturated fat and only 1 gram of saturated fat per one-ounce serving.(4)  Please visit to access an overview of the extensive body of PEP research in addition to practical resources such as a sample eating plan and recipes to help put the diet recommendations into practice.

The study tested the effect of one of three diets in 345 men and women with high cholesterol levels over a 6-month period. The participants were randomly assigned to either a low-saturated fat therapeutic diet, which acted as the control, a routine portfolio diet or an intensive portfolio diet. The portfolio diet emphasized plant sterols, soy protein, viscous fibers and nuts, including almonds.  Both the low-saturated fat therapeutic control diet and the routine portfolio diet involved 2 dietary counseling visits over the 6 month period and the intensive portfolio diet involved 7 counseling visits over the 6 month period. The study found that the participants following the portfolio diets experienced a greater reduction in "bad" (LDL) cholesterol levels compared to those following the low-saturated fat diet.(1)

"More than a decade of research has been conducted on the Portfolio Eating Plan. This type of research is significant, as it illustrates that dietary changes as simple as including nuts, such as almonds, and other heart-healthy foods could have such an impact on heart health," said Karen Lapsley, DSc., Chief Science Officer for the Almond Board of California. "This study not only adds to the body of evidence that the PEP diet may positively affect heart health, but that beneficial effects occur because of the diet, regardless of the intensity of counseling."

Study at a Glance:

Jenkins, DA, et al. Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in Hyperlipidemia. JAMA. 2011;306[8]:831-839.

The People: 

  • This study examined three 345 participants (137 men and 214 post-menopausal women) with high levels of cholesterol, or hyperlipidemia, across Canada (Quebec City, Toronto, Winnipeg and Vancouver).
  • Participants were excluded if they had a history of cardiovascular disease, cancer or a strong family history of cancer, untreated hypertension (blood pressure >140/90 mm Hg), diabetes, renal or liver disease, or are currently taking lipid-lowering medications.

The Diet: 

  • The participants were randomized into one of three groups to consume one of three diets over 6 months:
    • Control: therapeutic low-fat diet
    • Routine: portfolio eating plan of cholesterol-lowering foods (including nuts such as almonds) with 2 visits with an RD
    • Intensive: portfolio eating plan of cholesterol-lowering foods (including nuts such as almonds) with 7 visits with an RD
  • The goal of the Portfolio Eating Plan was to provide plant sterols in a plant sterol ester–enriched margarine; viscous fibers from oats, barley, and psyllium; soy protein as soy milk, tofu, and soy meat analogues; and nuts, including tree nuts and peanuts.

The Results: 

  • In the modified intention-to-treat analysis of 345 participants, the overall attrition rate was not significantly different between treatments (18% for intensive dietary portfolio, 23% for routine dietary portfolio, and 26% for control; Fisher exact test, P=.33).
  • The LDL-C reductions were −13.8%, or −26 mg/dL,  (P<.001) for the intensive dietary portfolio; −13.1% , or –24 mg/dL (P<.001) for the routine dietary portfolio; and −3.0%, or −8 mg/dL (P=.002) for the control diet.
  • Percentage LDL-C reductions for each dietary portfolio were significantly more than the control diet (P<.001, respectively). The 2 dietary portfolio interventions did not differ significantly (P=.66).
  • Among participants randomized to one of the dietary portfolio interventions, percentage reduction in LDL-C on the dietary portfolio was associated with dietary adherence (r=−0.34, n=157, P<.001).
  • The use of a dietary portfolio compared with the low−saturated fat dietary advice resulted in greater LDL-C lowering and dietary adherence over 6 months.


  • The complexity of the intervention did not permit the researchers to pinpoint any one individual dietary component as the cause of the cholesterol lowering nature of the diet and intervention.
  • The study was not metabolically controlled in terms of providing all food to the participants.
  • The study had a high overall dropout rate of 22.6%. This attrition rate is common to dietary studies provided at these levels of intensity.
  • Because the study participants were predominantly white with low to intermediate risk of cardiovascular disease and relatively low mean body mass index levels, application of the results of this study to higher-risk, more overweight, or obese patient populations is unknown.

About Almond Board of California

Consumers all over the world enjoy California Almonds as a natural, wholesome and quality food product, making almonds California's leading agricultural export in terms of value. The Almond Board of California promotes almonds through its research-based approach to all aspects of marketing, farming and production on behalf of the more than 6,000 California Almond growers and processors, many of whom are multi-generational family operations. Established in 1950 and based in Modesto, California, the Almond Board of California is a non-profit organization that administers a grower-enacted Federal Marketing Order under the supervision of the United States Department of Agriculture. For more information on the Almond Board of California or almonds, visit

(1) Jenkins, DA, et al. Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in Hyperlipidemia. JAMA. 2011;306[8]:831-839.

(2) Scientific evidence suggests, but does not prove, that eating 1.5 ounces per day of most nuts, such as almonds, as part of a diet low in saturated fat and cholesterol may reduce the risk of heart disease.

(3) In the first four PEP studies, almonds were the only nut included in the diet. The fifth included mixed nuts, including almonds.

(4)  U.S. Department of Agriculture, Agricultural Research Services, 2011. USDA Nutrient Database for Standard Reference, Release 24.


For More Information:
Lanier Dabruzzi, MS, RD
(202) 973-4780

Jenny Heap, MS, RD
(209) 343-3244







SOURCE Almond Board of California