What is the Difference Between the Mediterranean Diet and the Portfolio Diet?

October 11, 2025 •

5 min read

According to a 2023 study published in Circulation, individuals with higher adherence to the portfolio diet demonstrated a 14% lower risk of cardiovascular disease compared to those with lower adherence. To make an informed decision about your heart health, it is essential to understand the core principles and distinctions, so what is the difference between the Mediterranean diet and the portfolio diet?

Quick Summary

This article explains the Mediterranean diet and the portfolio diet, detailing their unique approaches to improving heart health. It compares their food focuses, goals, and flexibility, helping you understand which plan might better suit your health needs and lifestyle.

Key Points

Targeted vs. Holistic: The portfolio diet is a highly targeted plan for reducing LDL cholesterol, while the Mediterranean diet is a holistic, long-term lifestyle for overall health.
Core Components: The portfolio diet relies on four specific food groups—nuts, soy, viscous fiber, and plant sterols—to achieve its results, unlike the broader Mediterranean approach.
Protein Source: The portfolio diet is more plant-forward, emphasizing soy protein and discouraging most animal proteins, whereas the Mediterranean diet includes moderate amounts of fish, poultry, and dairy.
Prescribed vs. Flexible: The portfolio diet involves specific, daily quantitative targets for its key components, in contrast to the flexible, qualitative guidance of the Mediterranean diet.
Cholesterol Impact: Studies show the portfolio diet can lower LDL cholesterol significantly, comparable to some statins, making it a potent option for managing high cholesterol.
Fat Sources: While both use healthy fats, the Mediterranean diet centers on olive oil, whereas the portfolio diet incorporates fortified foods to ensure adequate plant sterol intake.
Lifestyle vs. Therapy: The Mediterranean diet integrates eating with regular physical activity and social connections, framing itself as a lifestyle. The portfolio diet is a therapeutic dietary pattern.

Understanding Heart-Healthy Diets

Both the Mediterranean and portfolio diets are widely recognized for their heart-protective benefits, but they achieve this goal through distinct strategies. The Mediterranean diet, inspired by the traditional eating patterns of regions like Greece and Italy, is a broad, plant-forward lifestyle approach. The portfolio diet, on the other hand, is a more targeted therapeutic eating plan specifically engineered to lower LDL ("bad") cholesterol through a combination of key plant-based foods. Understanding these fundamental differences is crucial for choosing the right dietary path for your specific health objectives.

The Mediterranean Diet Explained

The Mediterranean diet is less a restrictive diet and more a flexible, lifelong eating pattern centered on whole, minimally processed foods. It emphasizes abundant consumption of fruits, vegetables, whole grains, legumes, nuts, and healthy fats, primarily extra virgin olive oil. Protein sources like fish and poultry are consumed in moderate amounts several times a week, while red meat and sweets are limited. Wine may also be consumed in moderation with meals. Beyond just the food, it encompasses a lifestyle that includes regular physical activity and social dining. Its wide-ranging health benefits include a lower risk of cardiovascular disease, better blood sugar control, and improved longevity.

Key components of the Mediterranean diet:

Daily Focus: Fruits, vegetables, whole grains, beans, nuts, and olive oil.
Weekly Focus: Fish, poultry, eggs, and dairy products like cheese and yogurt.
Limited Consumption: Red meat and sweets.
Primary Fat Source: Extra virgin olive oil is the main source of fat.

The Portfolio Diet Explained

Created by Dr. David J.A. Jenkins and his team at the University of Toronto, the portfolio diet is a therapeutic, plant-based approach specifically designed to lower cholesterol effectively. It is structured around incorporating a "portfolio" of four specific cholesterol-lowering food components into a low-saturated-fat diet. This targeted strategy can significantly reduce LDL cholesterol, in some cases offering results comparable to first-generation statin medications. Adherence is key, and the more closely the dietary pattern is followed, the greater the cholesterol-lowering effect. The diet is more plant-forward than the Mediterranean diet and actively discourages high-fat animal products.

The four core components of the portfolio diet are:

Plant Sterols: Naturally occurring plant compounds found in nuts, seeds, and fortified products like special margarines and yogurts. They block cholesterol absorption in the gut.
Viscous Fiber: Soluble fiber that forms a gel in the digestive tract, binding to and removing cholesterol. It's found in foods like oats, barley, eggplant, okra, and psyllium.
Soy Protein: Protein derived from soy, which research shows helps lower LDL cholesterol. Sources include tofu, edamame, and soy milk.
Nuts: A daily intake of nuts, especially almonds and walnuts, provides healthy fats, fiber, and additional plant sterols.

Mediterranean Diet vs. Portfolio Diet: A Comparative Table


Feature	Mediterranean Diet	Portfolio Diet
Primary Goal	Overall heart health, longevity, disease prevention.	Aggressive reduction of LDL cholesterol.
Food Focus	Broad, traditional eating pattern: fruits, vegetables, whole grains, olive oil, fish, and moderate dairy.	Targeted intake of four specific cholesterol-lowering food groups.
Animal Protein	Moderate amounts of fish and poultry; limited red meat.	Strongly favors plant proteins (especially soy) over animal protein.
Flexibility	Highly flexible and adaptable to cultural and personal preferences.	Structured around specific daily intake targets for the four key components.
Primary Fat Source	Extra virgin olive oil is central.	Healthy unsaturated fats from nuts, seeds, and oils, plus targeted fortified products for plant sterols.

Decoding the Dietary Disparities

While both diets share a foundation in plant-based, whole foods and healthy fats, their methodology and intensity differ significantly. The Mediterranean diet is a holistic lifestyle that promotes overall health, with cholesterol reduction as one of its many benefits. It emphasizes the quality of food, variety, and the social experience of eating. The portfolio diet, by contrast, is a specific dietary prescription. Its primary focus is on the four functional foods that work synergistically to lower LDL cholesterol.

For example, while the Mediterranean diet encourages consuming nuts and legumes, the portfolio diet prescribes specific quantities of these foods (e.g., 50g of nuts and 50g of soy protein daily) to maximize their cholesterol-lowering effects. The portfolio diet also incorporates specific supplements or fortified foods to ensure a sufficient intake of plant sterols, a component not typically emphasized in the Mediterranean diet. This targeted, quantitative approach is what gives the portfolio diet its potent cholesterol-reducing power.

Which Diet Should You Choose?

The decision between the Mediterranean and portfolio diets often depends on your specific health goals. If you are seeking a sustainable, long-term eating pattern focused on general wellness and a reduced risk for a wide range of chronic diseases, the Mediterranean diet is an excellent, flexible choice. It encourages a balanced and enjoyable relationship with food, family, and physical activity.

Conversely, if your primary health concern is high LDL cholesterol, and you need a more aggressive and targeted dietary intervention, the portfolio diet is specifically designed for that purpose. It provides a powerful, food-based tool for managing cholesterol, either in place of or in conjunction with medication. It is important to note that the portfolio diet is more prescriptive and may require a higher degree of planning to meet the specific daily food targets. While it is a modified vegan diet, some flexibility exists, and a healthcare professional can help you integrate its principles into your current eating habits effectively.

Ultimately, both diets offer significant health benefits, but the best fit depends on your priorities. For general wellness, the Mediterranean diet provides a flexible framework. For targeted cholesterol reduction, the portfolio diet offers a scientifically-backed, high-impact plan. As with any significant dietary change, it is advisable to consult with a healthcare professional or registered dietitian.

Conclusion

While the Mediterranean diet and the portfolio diet both promote heart health through a focus on plant-based foods, they differ fundamentally in their approach. The Mediterranean diet is a holistic, flexible lifestyle that offers broad health benefits. The portfolio diet is a targeted, structured therapeutic eating plan designed for aggressive cholesterol reduction through four key food components. The choice between them depends on whether you seek a general, long-term wellness strategy or a specific, powerful intervention to address high cholesterol. Both represent scientifically-supported paths toward a healthier heart.

Learn more about the portfolio diet and its components for lowering cholesterol from Heart UK.

Frequently Asked Questions

Yes, you can combine principles from both diets. The portfolio diet's targeted foods can be incorporated into the Mediterranean diet's broader, plant-based framework to maximize cholesterol-lowering effects.

The portfolio diet is specifically engineered for aggressive LDL cholesterol reduction and has shown significant results in studies. While the Mediterranean diet is heart-healthy, the portfolio diet is a more direct and potent tool for addressing high cholesterol.

The portfolio diet is a modified vegan diet, but its principles can be adapted. It strongly favors plant-based foods and discourages high-fat animal products, but it is not necessarily 100% vegan unless followed strictly.

Both diets can support weight management, primarily because of their focus on nutrient-dense, fiber-rich whole foods and limits on processed foods. High fiber content promotes satiety and can help control calorie intake.

To reach the daily target of 2g of plant sterols, you can consume fortified foods like plant sterol-enriched margarine, yogurts, or spreads. Smaller amounts are also found naturally in some nuts and seeds.

Yes, the Mediterranean diet typically includes a moderate amount of red wine, usually with meals. However, this is an optional component and should be avoided by individuals with certain health conditions or a history of alcohol abuse.

The Mediterranean diet is often considered easier for beginners due to its high flexibility and emphasis on overall eating patterns rather than strict daily quantitative goals. It allows for a more gradual transition to healthier eating habits.

If you have a soy intolerance or allergy, you can substitute other legumes for the soy protein component. Soybeans are a key source of plant sterols and isoflavones, but other legumes offer similar, though potentially less potent, cholesterol-lowering benefits.