Potential of Probiotics in Hypercholesterolemia: A Review of In Vitro and In Vivo Findings

Anura V Kurpad, MD, DNB, PhD; Seema Puri, PhD; Smriti Sharma, PhD(c), MSc

Context • Coronary heart disease (CHD) is a major public health problem in developing and developed countries. Elevated cholesterol levels, especially low-density lipoprotein (LDL) cholesterol, and the emergence of CHD, have been positively correlated in many clinical and epidemiological studies. The health benefits of probiotics have received a great deal of attention, including their blood cholesterol–lowering effects on humans.

Objective • The research team intended to determine the current state of research examining the effects of various probiotic strains on lipid profiles, including measures in serum of total cholesterol, LDL cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol.

Design • The review examined studies, in both animal and human models and focused on the potential of various probiotic strains to be dietary adjuncts in lowering levels of serum cholesterol with the aim of reducing the risk of cardiovascular disease (CVD) and CHD. Articles were reviewed systematically from Web search bases including PubMed and Cochrane Clinical Trial Registry. Articles meeting the inclusion search criteria were selected for further review and analysis. Only randomized controlled trials evaluating the effects of probiotics on lipid profiles in animals or humans were considered for inclusion in the review.

Setting • The selection of articles and further inclusion in the review was performed in Institute of Home Economics, University of Delhi (New Delhi, India).

Results • Some of the studies, in both animal and human models, have revealed that several strains were able to improve at least 1 lipid fraction. Although the results from animal studies have been fairly consistent, the findings from studies on humans have varied. Some strains when evaluated in human studies have shown insignificant effects on lipid fractions.

Conclusions • Although several mechanisms for cholesterol removal by probiotics have been proposed, they need further investigation to be validated.

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