The Mediterranean diet has rightfully gotten a lot of attention lately as an excellent plan for nutritional wellness, but another has been gaining in popularity. It may be worth discussing with patients for weight loss and overall wellness.

What Is the Portfolio Diet and Why Is It Gaining Attention?

The Portfolio Diet, which prioritizes predominantly plant-based foods and restricts saturated fat intake, has been shown to substantially enhance cholesterol profiles and promote cardiovascular health. The diet also limits ultraprocessed foods, better supporting insulin sensitivity and cholesterol levels, said Theresa Gentile, MS, RDN, CDN, a spokesperson for the Academy of Nutrition and Dietetics. She also manages the home enteral nutrition program at Maimonides Medical Center in New York City.

The diet helps lower low-density lipoprotein (LDL) cholesterol by combining a “portfolio” of several proven cholesterol-lowering foods. It focuses on plant proteins such as beans and tofu, nuts, soluble viscous fiber from foods such as oats, barley, fruits, and vegetables, and plant sterols that help block cholesterol absorption, Gentile said.

Randomized trials reveal LDL reductions of about 15%-30% compared with routine diets, sometimes comparable to early statin therapy’s impact on LDL.

A Suitable Option for Obesity Management

The Portfolio Diet may help people with obesity by promoting weight reduction and improving metabolic health in a balanced and sustainable manner. Fiber and plant protein are significant positive drivers.

“The fiber and plant protein, which are rich in this diet, help people feel fuller longer and reduce overeating,” Gentile said.

Foods such as beans, lentils, oats, fruits, vegetables, and nuts contribute to slower digestion and improved regulation of blood sugar levels, which may help reduce cravings for sweet foods. Additionally, the diet plan also helps reduce the intake of saturated fats, which contribute to a lower total caloric intake, she said.

Offering Self-Reliance to Make Manageable Changes

Patients can feel motivated through manageable changes.

“The Portfolio Diet focuses on small, flexible changes instead of strict rules. It supports adding food to patients’ diets instead of eliminating them,” Gentile said. “By adding more fiber, plant protein, and healthy fats into meals patients already enjoy, patients will not feel deprived.”

This approach can help patients learn how to make simple swaps, adjust portion size, and curate balanced and nutritious meals.

“These small choices eventually increase confidence and patients’ feeling of control of their health, empowering them to adapt their lifestyle for long-term success,” Gentile said.

Ways to Help Patients Adopt the Portfolio Diet

It can be empowering for patients to actively engage in their own wellness. By implementing incremental changes, they can see changes firsthand. Caroline Susie, RDN, LD, a spokesperson for the Academy of Nutrition and Dietetics in Dallas, suggests primary care providers (PCPs) advise patients to consider these guidelines:

Swap one food at a time. For example, patients can replace butter with a plant-sterol spread. She said the plan doesn’t require strict calorie counting; it encourages quality first.

Integrate preferred foods into familiar meals. “Guidance is simplified to four main food groups, making follow-through clearer,” Susie said. She suggested framing patient goals in this matter:

“Add one serving of viscous fiber today (eg, oatmeal at breakfast).”

“Swap one dairy item for a soy substitute each week.”

“Add a handful of nuts as a snack.”

Encourage small steps. Advise patients to build lasting habits and improve diet quality over time, she noted.

Who Should Not Follow the Portfolio Diet?

While generally safe and healthy, Susie reported the Portfolio Diet may not be ideal for patients with these conditions:

• Severe soy allergies or nut allergies
• Fiber intolerance/irritable bowel syndrome flare-ups without careful management
• Certain gastrointestinal conditions, where a high-fiber diet initially may trigger symptoms
• Malabsorption syndromes that require specialized diets

According to Susie, other precautions and considerations regarding the Portfolio Diet and patient care include:

• Patients needing rapid, structured weight loss might require a more targeted plan.
• Those with advanced kidney disease may need adjusted protein/fiber recommendations.
• PCPs should refer to a registered dietitian to tailor the Portfolio Diet to special medical needs.

Gentile reported no disclosures. Susie is a principal at Mercer, a global health consulting firm.