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Soylent in the Clinic: A plant-based meal replacement makes it easier to stick to a healthy diet.

The Benefits of a Plant-based Diet

Plant-based diets have been associated with various health benefits such as improving glycemic control through increased insulin sensitivity, improving blood lipid profile, improving Body Mass Index (BMI), and reducing cardiovascular mortality.[1-5] Not only are plant-based diets beneficial for our health, but including soy in our diet has also been shown to be beneficial for lowering LDL and total cholesterol.[6] The scientific literature strongly supports this effect so much so that health claims have been approved in Canada and in the United States to support these findings.[7, 8] According to the recommendation made by Health Canada, 25g of soy protein per day is the minimum daily intake needed to help lower cholesterol. Each bottle of Soylent contains 20g of high-quality soy protein so including it as part of your daily routine is not only a convenient way to get your vitamins and minerals, but also a healthy dose of soy protein.

What is the Portfolio Diet

The portfolio diet is a plant-based diet built on a combination of cholesterol-lowering foods such as fruits, vegetables, whole grains and soy. Recent studies have shown that the Portfolio diet can reduce LDL cholesterol more than a low saturated fat vegetarian diet alone.[9] The reduction in LDL cholesterol seen with the Portfolio diet is even comparable to reductions seen with statin (the most commonly prescribed drug to lower cholesterol levels).[10] The diet also provides other benefits including improving blood pressure and glucose metabolism and decreasing inflammation.[11]

The Portfolio Diet Menu

The portfolio diet is based on 4 pillars: plant protein, plant sterols, soluble fiber (the viscous, sticky kind) and nuts. Here is a breakdown of the targets for each pillar based on a 2000 calories/day menu:

- Soluble fiber (the viscous sticky kind): 20g/day from whole grains such as oatmeal, psyllium and some fruits and vegetables.
- Nuts: 45g/day (a handful)
- Plant protein: 50g/day from soy-based foods such as soy milk, tofu, beans, soy meat substitutes and of course Soylent (20g of protein/serving)!
- Plant sterols: 2g/ day (1 to 2 tablespoons) from enriched vegetable oils, margarines, yogurt, supplements and also Soylent (0.08g phytosterol/serving).

Soylent, the Portfolio Diet and Clinical Research

Although the portfolio diet has been the subject of several clinical trials so far, more work remains to be done to understand its benefits. Beginning this year and running through the end of 2022, the portfolio diet will be the subject of another clinical trial led by a team of researchers from the University of Toronto. This trial will explore whether the portfolio diet, together with a structured exercise program, can reduce the progression of carotid and coronary lesions, LDL cholesterol and blood pressure, while reducing the number of individuals requiring statins.[12] The trial will take place at various locations across Canada.

To aid the participants in completing the study, and to encourage the inclusion of the Portfolio diet principles outside the clinic, an app was created to provide food options and recipes and track progress and adherence to the diet (www.PortfolioDiet.app). Participants will also have access to our newly-released Canadian Soylent free of charge for the duration of the trial to provide an easy on-the-go solution to meet the diet’s guardrails.

Soylent is a great solution for anyone looking for an easy way to include more plant-based protein into their diet, including those seeking meal replacements that fit their vegetarian diet, including the Portfolio diet. Soylent contains 20g of complete soy protein, which would fulfill nearly half of the soy protein requirements of the Portfolio diet while also providing fiber, vitamins and minerals, some phytosterols and unsaturated fats, including omega 3 fatty acids.

For anyone trying to make changes to their diet, sticking to the plan can be difficult while away from home, so having ready-to-eat options like Soylent can make all the difference. Additionally, figuring out what to cook can sometimes be daunting, so for those days when the motivation is lacking, Soylent is there when you need it. A nice aspect of introducing plant-based foods to the diet is that the effects are additive and even a few changes make a difference. As Professor Sievenpiper, the lead researcher for the trial, wisely said, “it’s not an all or nothing diet, it’s incremental, which is why we also call it a dietary portfolio”.

Soylent in the Clinic: Where have we been?

Despite its short and quirky history, Soylent has piqued the interest of several clinical researchers and has been included in a handful of clinical research projects to date. Most notably, we have been collaborating with fellow Angelenos at the Department of Radiation Oncology at UCLA over the last few years on a clinical trial to explore the role that Soylent can play in the diet of patients going through head and neck cancer treatment. In this study, which is still ongoing, researchers found that Soylent could be an effective way to prevent cancer patients from losing excessive weight during treatment.[13]

Few plant-based meal replacements are available in the market today and of those, very few are nutritionally complete or tasty. The fact that Soylent can compete with whey-based products on taste and nutrient density is what makes Soylent an attractive option to meet nutritional goals in and out of the clinic.

References

1. Dinu, M., Abbate, R., Gensini, GF., Casini, A., Sofi, F. Vegetarian, Vegan Diets and Multiple Health Outcomes: A Systematic Review with Meta-Analysis of Observational Studies, Crit. Rev. Food. Sci. Nutr., 2017. 57:17, 3640-3649
2. Barnard, N. D. et al. A Systematic Review and Meta-Analysis of Changes in Body Weight in Clinical Trials of Vegetarian Diets. J. Acad. Nutr. Diet,115(6), 954 - 969
3. Wang, F., Zheng, J., Yang, B. et al. Effects of Vegetarian Diets on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J. Am. Heart Assoc. 2015: 4: e002408.
4. Song M, Fung TT, Hu FB, et al. Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Intern Med. 2016;176(10):1453–1463. doi:10.1001/jamainternmed.2016.4182.
5. Monica Dinu, Rosanna Abbate, Gian Franco Gensini, Alessandro Casini & Francesco Sofi. Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies, Critical Reviews in Food Science and Nutrition, 2017. 57:17, 3640-3649
6. Blanco Mejia, S., Messina, M., Li, S.S, et al. A meta-analysis of 46 studies identified by the FDA demonstrates that soy protein decreases circulating LDL and total cholesterol concentrations in adults. J Nutr. 2019;149(6):968-81.
7. Summary of Health Canada’s Assessment of a Health Claim about Soy Protein and Cholesterol Lowering. Bureau of Nutritional Sciences Food Directorate Health Products and Food Branch. https://www.canada.ca/en/health-canada/services/food-nutrition/food-labelling/health-claims/assessments/summary-assessment-health-claim-about-protein-cholesterol-lowering.html.
8. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=101.82
9. Jenkins DJA, Jones PJH, Lamarche B, et al. Effect of a Dietary Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of Dietary Advice on Serum Lipids in Hyperlipidemia: A Randomized Controlled Trial. JAMA. 2011;306(8):831–839. 
10. Jenkins, D.J.A., Kendall, C.W.C., Marchie, A., et al. Effects of a Dietary Portfolio of Cholesterol-Lowering Foods vs Lovastatin on Serum Lipids and C-Reactive Protein. JAMA. 2003;290(4):502–510. 
11. Chiavaroli, L., Nishi, S.K., Khan, T.H. ,Braunstein, C.R., Glenn, A.J., Blanco Mejia, S., Rahelić, D., Kahleová, H., Salas-Salvadó, J., Jenkins, D. J. A, Kendall, C., W., Sievenpiper, J.L. Portfolio Dietary Pattern and Cardiovascular Disease: A Systematic Review and Meta-analysis of Controlled Trials. Prog. Cardiovasc. Dis. 2018; 61 (1), 43-53.
12. https://clinicaltrials.gov/ct2/show/NCT02481466?term=portfolio+diet&draw=2&rank=3
13. Hegde, J.V. et al. Integrating Exclusive Liquid Meal Replacement Supplementation to Reduce Gastrostomy Tube Rates in Patients with Head and Neck Cancer Undergoing Chemoradiation: Preliminary Results of a Phase II Study. International Journal of Radiation Oncology • Biology • Physics. 2019. 105 (1). https://www.redjournal.org/article/S0360-3016(19)32459-9/fulltext