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Out of all the things likely to shorten our lives in the UK, coronary heart disease is the most likely. It is believed that almost 80 per cent of adults have total cholesterol levels above the ideal and that raised cholesterol and fats in the blood are responsible for well over half the deaths caused by the disease.
Lowering cholesterol levels has, not surprisingly, become a big focus of the NHS, and to this end, the mass prescription of a group of cholesterol-lowering drugs known as statins is under way to those whose cholesterol levels register as “high” in routine GP tests. Statins work by blocking enzymes that play a key role in the production of cholesterol in your liver (most cholesterol in our blood is made in our liver rather than being eaten directly in food).
About three million of us are knocking back statins daily, millions more are being offered them and there is a proposal that these drugs should ultimately be offered to all men over 50 and women from the age of 60. Fat-busting drugs are the most costly class of drugs to the NHS and there has been a 17-fold increase in their prescription since 1997.
Which poses the question, is there an alter-native? For some people the answer is a definite “no”. If, for instance, you have an inherited form of raised cholesterol, have had a heart attack or stroke, have diabetes or raised blood pressure, you should do as your doctor tells you and take your medicine. Furthermore, some doctors argue that patients are more willing to pop a pill once a day than to change their diet. But for those who prefer not to take the pharmaceutical route, the outlook is brighter because recent studies have suggested that including a “portfolio” of certain foods – a portfolio diet – can help to lower cholesterol by up to 30 per cent, a result which reflects the achievement of statins.
A plan that brings remarkable results
Armed with this information, I worked on Heart of the Matter, a piece for the Tonight With Trevor McDonald programme, on ITV1, to test the portfolio eating plan on three people from Huddersfield, one of the country’s worst hot-spots for raised cholesterol levels. One of the most recent and relevant studies into the portfolio diet was published in the American Journal of Clinical Nutrition and builds on evidence gleaned from previous tightly controlled clinical studies. In it, researchers from the University of Toronto revealed how people following what has become known as the portfolio eating plan for a full year in the real world, achieved some remarkable results. Over a 12-month period, 55 middle-aged men and women were asked to follow a diet containing daily quotas of almonds; substances known as plant sterols, most of which came from fortified margarines (such as Benecol or Flora Pro-Activ); soy protein from foods such as tofu and soy milk; and soluble fibre in porridge, fruits and veg.
The guinea-pigs, armed with their list, selected and prepared foods to fit in with their normal routines. After one year, a third of them had achieved a statin-like effect from the portfolio eating plan, lowering their cholesterol levels by 20 per cent or more. Most of them included fish and lean meats in their diet. Another third that tended to follow the eating plan less strictly achieved an average 15 per cent LDL cholesterol – so-called “bad” cholesterol – reduction. Those that had the least compliance lowered their cholesterol an average of 10 per cent.
And so I set off to Huddersfield to perform a UK test of the portfolio diet. Given a similar set of instructions, and told avoid foods that contained saturated fats, such as burgers, Allan Butters, 38, a campus support officer at the University of Huddersfield (see above); Kerena McEvoy-Ives, 31, a hairdresser, and Russ Hay-den, 51, an engineer, took on the challenge. All tried to increase their exercise as well by attempting to walk 10,000 steps daily.
After only four weeks Allan and Kerena’s cholesterol levels fell by more than 30 per cent. Allan’s total cholesterol fell from 6.34 to 4.6 milli-moles per litre (mmol/l), bringing him under the 5mmol/l threshold, with his risk of a heart attack in the next ten years falling from 18 per cent to 8 per cent. Kerena brought her cholesterol down from 6.38mmol/l to 4.3, while Russ lowered his chances of a heart attack or stroke from one in three within the next ten years to one in five.
No one is claiming that the portfolio diet is the answer to all cholesterol problems. However, if your GP diagnoses high cholesterol and gives you the all-clear to try this diet, you may well find yourself leaving the surgery with a shopping list of groceries rather than a prescription. You might also soon discover the added benefits of following a regimen – weight loss and a huge improvement in general intake of vitamins, minerals and supernutrients, improving your quality of life still further.
— Amanda Ursell presents Heart of the Matter, Tonight With Trevor McDonald, ITV1, on Monday, 8pm

‘I’ve lost weight and I feel great’
Allan Butters, 38, is one of three people from Huddersfield who followed the portfolio diet plan
Until three years ago, Allan Butters, a campus support officer at the University of Huddersfield, didn’t pay much attention to his cholesterol levels. However, this changed with the sudden death of his younger sister, from a heart attack, aged 34, three years ago.
Allan had his health checked, and his cholesterol level was 5.1 (ideally, it should be under 5, although the UK national average is 5.5). His doctor put him on statins as a precautionary measure, but he reacted badly and stopped taking them. His son was born soon after that, and life got busy -until three months ago when his wife pointed out an ad in the paper for free cholesterol testing, with the possibility of taking part in a TV programme. Allan took the test and was shocked to find that his cholesterol level had crept up to 6.34, and he agreed to take part in the Tonight With Trevor McDonald show. He was asked to follow a special diet for five weeks, with an average day consisting of porridge with prunes for breakfast, mackerel on toast for lunch, and bean chilli for dinner. Allan stuck religiously to the diet, even declining steak and wine at a dinner party in favour of water and a salmon salad. He also started to take more exercise in the form of family bike rides.
The effort was worth it; his cholesterol level was 4.2 by the end of the five weeks. “I was overjoyed when I saw the figure. I immediately rang my wife, who was very happy.” Three months on from the trial, Allan still follows his new diet and lifestyle. “I haven’t touched crisps, and I’ve given up smoking. I feel great; I’m a lot happier, I’ve lost weight and have more energy. It has changed everything. I now hope to be around to see my grandchildren.”

Stocking a nutritious larder
Here is a list of foods, each with their own cholesterol-lowering capabilities, to eat every day
Almonds 30g (a handful or about 23 whole almonds). Great for antioxidants, fibre and monounsaturated fat.
Soluble fibre You need to get 20g of soluble fibre a day. You can get this amount by eating all the following foods: a grapefruit, a big bowl of porridge with prunes, an apple and a pear, some baked beans, a baked sweet potato and a serving of broccoli. Soluble fibre appears to carry some excess cholesterol out of the body in stools.
Plant stanols and sterols 2g, found in about two servings of Benecol or Flora Pro-Activ products each day. Stanols and sterols work in a similar way to soluble fibre.
Soya protein 25g plus of this is equivalent to 3-4 servings of soy-based foods, such as soy milk and yoghurt, tofu, soya beans or soya burgers. The protein appears to help reduce cholesterol being made in your liver. In addition to these foods it is really good to eat oily fish such as salmon, mackerel, sardines, pilchards, anchovies, eel and fresh tuna at least twice a week. They are rich in omega 3 oils, which appear to help raise levels of “good” cholesterol, improve artery health and help to keep blood flowing smoothly.
What to avoid As in any healthy eating plan, avoid foods rich in saturated fats, such as fatty cuts of meat, meat pies, burgers and sausages, full-fat dairy foods, most cakes.
For more information about the portfolio diet and recipes, go to amandaursell.com
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Perhaps doctors are not the best people to be prescribing dietary portfolios. I would image dietitians are better qualified to give appropriate advice.
Anon, Dundee, Scotland
With a family history of heart disease and a cholesterol score of 8.5 aged 40 I was put on a very strict diet and afetr several months the cholesterol droped to 7.3. "Thats all diet can do" saud my GP and put me on statins. The statins certainly drop the cholesterol- by half- but I do worry they are doing harm elsewhere in my body. I'm 47 and get a fair bit of cramp in my feet and lowere legs- increasingly whilst exercising. I've seen 2 or 3 different GPs in the practise and they just aren't interested in discussing any alternative to statins. It is worrying and puzzling what to do for the best.
Keith, Newcastle, UK
after suffering severe leg pains particularly at night I, by a process of elimination, found they all but disappeared when I stopped taking statins. This was not on the advice of my doctor who was not in agreement but I feel so much better and more clear headed that I am determined not to go back on them. I am so fed up with any visit to my GP resulting in another tablet.
P. Stanley. leeds UK
PAT STANLEY, leeds, UK
I agree that healthy eating can lower Cholesterol levels but in my case I was already eating what I would call an decent diet. Plenty of tofu, green tea, fish etc. When my cholesterol was checked it was 7.0!
Some people just have bad genes!
One thing your report doesn't mention is that the Atkins diet was also found to reduce Choesterol significantly after a study that was caried out at the University of Arizona. I wonder where we got our inspiration from?
Even if I wanted to switch to a good diet a lot of doctors are not up to speed when it comes to the best diet for reducing cholesterol, I was just given a Red, Yellow and Green(food) diet sheet, the colours related to fat content and that was it.
I supose we could send doctors on a training course but they would probably want another pay rise. LOL.
Graham Wharton, St Albans, uk
An interesting study, and a good advert for the effects of a healthy diet on cholesterol levels. However the study cannot prove causality of the diet alone as in all cases exercise was increased as well, which is also known to help cholesterol levels.
Jamie Rossi-Stephenson, Manchester, UK
Why shoould statins be given "women over 60" when science has shown that they are meaningless for all women regardless of age?
Bo Piltson, Stuttgart, Germany
No mention here of Extra Virgin Olive Oil which significantly improves the LDL/Total Cholesterol ratio, the more important factor in the the cholestreol risk.
Having an inherited high cholesterol, I was told by my aunt it had done wonders for her. Did the same for me!
Jacob Weinberg, currently in rural Thailand,