ArticleCirculation2023
Portfolio Diet Score and Risk of Cardiovascular Disease: Findings From 3 Prospective Cohort Studies.
Article in Circulation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Dietary Patterns Associated With Anti-inflammatory Effects: An Umbrella Review of Systematic Reviews and Meta-analyses.Nutrition reviews · 2026Pooled it
- Pooled it
- Trial
- Impact of a whole food, plant-based diet on LDL-cholesterol and cardiovascular risk factors in adults with heterozygous familial hypercholesterolemia: a randomized, two-period, two-treatment, crossover, fully controlled feeding trial.Nature communications · 2026Trial
- Metabolomic profiling of a cholesterol lowering plant-based diet from two randomized controlled feeding trials.European journal of clinical nutrition · 2025Trial
- The Portfolio Diet and HbA1c in Adults Living with Type 2 Diabetes Mellitus: A Patient-Level Pooled Analysis of Two Randomized Dietary Trials.Nutrients · 2024Trial
- Healthy diet scores and ultra-processed foods with incident coronary heart disease: a prospective study.Nutrition & metabolism · 2026Article
- Rationale and design of a parallel randomised trial of a plant-based intensive lifestyle intervention for diabetes remission: The REmission of diabetes using a PlAnt-based weight loss InteRvention (REPAIR) trial.Diabetes, obesity & metabolism · 2026Article
- Adherence to Different Dietary Patterns and Subsequent Risk of Total, Ischemic, and Hemorrhagic Stroke.Stroke · 2026Observational
- Article
- Nutritional and lifestyle supportive care recommendations for management of obesity with GLP-1 - based therapies: An expert consensus statement using a modified Delphi approach.Obesity pillars · 2026Review
- Plant-based diets for human health with implications for cardiometabolic health, gut microbiome, and nutritional adequacy.Frontiers in nutrition · 2026Review
- Adherence to Portfolio diet and risk of type 2 diabetes mellitus in a population-based prospective cohort study.Journal of diabetes and metabolic disorders · 2025Article
- Association of herbal tea consumption with cardiovascular diseases in the general population: evidence from the MESA cohort.Nutrition journal · 2025Article
- Diet and Prevention of Cardiovascular Disease and Cancer: JACC: CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2025Review
- Fewer bites of beef to make an impact: even small changes toward a more sustainable diet and lifestyle can meet personal and public health goals while addressing planetary health.The American journal of clinical nutrition · 2025Article
- Effect of intermittent fasting, portfolio-moderate-carbohydrate, and anti-inflammatory diets on cardio-metabolic status in pre-diabetic patients; an open-label randomized clinical trial.Diabetology & metabolic syndrome · 2025Article
- Risk of atherosclerotic cardiovascular disease after cancer diagnosis: findings from 3 prospective cohort studies.Journal of the National Cancer Institute · 2025Article
- Deciphering the angiogenic potential of Zhishi Xiebai Guizhi decoction in coronary heart disease: an in-depth network pharmacology and experimental investigation.Scientific reports · 2025Article
- Evaluating dietary quality and dietary inflammatory potential in cognitive impairment patients in China.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
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Authors and funding
11 authors.
Funding
Abstract
backgroundThe plant-based Portfolio dietary pattern includes recognized cholesterol-lowering foods (ie, plant protein, nuts, viscous fiber, phytosterols, and plant monounsaturated fats) shown to improve several cardiovascular disease (CVD) risk factors in randomized controlled trials. However, there is limited evidence on the role of long-term adherence to the diet and CVD risk. The primary objective was to examine the relationship between the Portfolio Diet Score (PDS) and the risk of total CVD, coronary heart disease (CHD), and stroke.
methodsWe prospectively followed 73 924 women in the Nurses' Health Study (1984-2016), 92 346 women in the Nurses' Health Study II (1991-2017), and 43 970 men in the Health Professionals Follow-up Study (1986-2016) without CVD or cancer at baseline. Diet was assessed using validated food frequency questionnaires at baseline and every 4 years using a PDS that positively ranks plant protein (legumes), nuts and seeds, viscous fiber sources, phytosterols (mg/day), and plant monounsaturated fat sources, and negatively ranks foods high in saturated fat and cholesterol.
resultsDuring up to 30 years of follow-up, 16 917 incident CVD cases, including 10 666 CHD cases and 6473 strokes, were documented. After multivariable adjustment for lifestyle factors and a modified Alternate Healthy Eating Index (excluding overlapping components), comparing the highest with the lowest quintile, participants with a higher PDS had a lower risk of total CVD (pooled hazard ratio [HR], 0.86 [95% CI, 0.81-0.92];
conclusionsThe PDS was associated with a lower risk of CVD, including CHD and stroke, and a more favorable blood lipid and inflammatory profile, in 3 large prospective cohorts.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.