“Portfolio” diet
A fair-quality randomized crossover study with 34 participants found that a “portfolio diet,” which combines the fat intake of the NCEP Step II diet with cholesterol-lowering “functional foods” (including plant sterols, nuts, soluble fibers, and soy protein), markedly reduced total cholesterol and LDL.4 Mean baseline lipid values (mg/dL) were: total cholesterol, 261.41; LDL, 174.40; HDL, 47.56; triglycerides, 199.28.
Mediterranean diet
A fair-quality RCT with 88 participants reported reduced LDL among subjects assigned to a Mediterranean-type diet.5 Mean baseline lipid values (mg/dL) were total cholesterol, 255.22; LDL, 170.15; HDL, 58.01; triglycerides, 141.71.
Recommendations from others
The NCEP Adult Treatment Panel III and the American Heart Association recommend the Therapeutic Lifestyle Changes diet.6,7 The first stage of this diet emphasizes reduction in dietary saturated fat and cholesterol at the levels of the former NCEP Step II diet (≤7% of energy as saturated fat and ≤200 mg dietary cholesterol). If the LDL goal is not achieved, the second stage emphasizes the addition of functional foods and soluble fiber.