If you need to lower your cholesterol and want to try changing your diet first, your best bets are a Mediterranean-type diet or the so-called portfolio diet. In a head-to-head trial, a standard low-fat diet had little effect on cholesterol.

Mediterranean-type diets

There’s no such thing as the Mediterranean diet. You may already be following one and not know it (see “Mediterranean quiz”). Here are the general characteristics:

• Four or more servings of vegetables a day. A serving is ½ cup of raw or cooked vegetables, 1 cup of raw leafy greens, or ½ cup of vegetable juice.

• Four or more servings of fruit a day. A serving is ½ cup of fresh, frozen, or canned fruit, ¼ cup of dried fruit, one medium-sized piece of fruit, or ½ cup of fruit juice.

• Six or more servings of grain — mostly whole grain — a day. A serving is 1 cup of dry breakfast cereal; ½ cup of cooked cereal, rice, or pasta; or one slice of bread.

• Two or more servings of fish a week. A serving is 4 ounces.

• One serving of yogurt or cheese a day.

• One serving of beans or nuts a day. For cooked beans, ½ cup is a serving; for nuts it’s a handful (about 1½ ounces).

• If you enjoy alcohol, limit yourself to one (for women) or two (for men) drinks a day. One drink is 5 ounces of wine, 12 ounces of beer, or 1½ ounces of liquor.

Portfolio diet

What University of Toronto researchers call a "dietary portfolio of cholesterol-lowering foods" includes a variety of foods known to lower cholesterol. These include margarine enriched with plant sterols; oats, barley, psyllium, okra, and eggplant, all rich in soluble fiber; soy protein; and whole almonds. They were added to a diet with plenty of fruits and vegetables; whole grains instead of highly refined ones; and protein mostly from plants. This nearly vegetarian diet added up to 48% of daily calories from carbohydrates, 21% from protein, and 31% from fats.

A sample daily menu looked like this:

Breakfast: Hot oat bran cereal with soy milk, strawberries, sugar, and psyllium; oat bran bread, enriched margarine, and double-fruit jam.

Snack: Almonds, soy beverage, and fresh fruit.

Lunch: Spicy black bean soup and a sandwich (soy deli slices, oat bran bread, enriched margarine, lettuce, and tomato).

Snack: Almonds, psyllium, and fresh fruit.

Dinner: Tofu bake with ratatouille (tofu, eggplant, onions, and sweet peppers), pearled barley, and vegetables.

Snack: Fresh fruit, psyllium, and soy beverage.