Cholesterol-Lowering Effects of Probiotics and Prebiotics: A Review of in Vivo and in Vitro Findings

Abstract

Probiotics are live microorganisms that promote health benefits upon consumption, while prebiotics are nondigestible food ingredients that selectively stimulate the growth of beneficial microorganisms in the gastrointestinal tract. Probiotics and/or prebiotics could be used as alternative supplements to exert health benefits, including cholesterol-lowering effects on humans. Past in vivo studies showed that the administration of probiotics and/or prebiotics are effective in improving lipid profiles, including the reduction of serum/plasma total cholesterol, LDL-cholesterol and triglycerides or increment of HDL-cholesterol. However, other past studies have also shown that probiotics and prebiotics had insignificant effects on lipid profiles, disputing the hypocholesterolemic claim. Additionally, little information is available on the effective dosage of probiotics and prebiotics needed to exert hypocholesterolemic effects. Probiotics and prebiotics have been suggested to reduce cholesterol via various mechanisms. However, more clinical evidence is needed to strengthen these proposals. Safety issues regarding probiotics and/or prebiotics have also been raised despite their long history of safe use. Although probiotic-mediated infections are rare, several cases of systemic infections caused by probiotics have been reported and the issue of antibiotic resistance has sparked much debate. Prebiotics, classified as food ingredients, are generally considered safe, but overconsumption could cause intestinal discomfort. Conscientious prescription of probiotics and/or prebiotics is crucial, especially when administering to specific high risk groups such as infants, the elderly and the immuno-compromised.

The effects of prebiotic, probiotic and synbiotic diets containing Bacillus coagulans and inulin on serum lipid profile in the rat

“…2 Considering the mentioned reasons hypothesized by Ooi and Liong, 20 normolipidemic condition of used rat model in the current study may be a reason for failure of these probiotic bacteria in changing lipid profile. 20 In addition to all of the above, the feeding period of 30 days may not be sufficient to observe a significant change in lipid profile.…”

“…[19][20][21] Ooi and Liong 20 in a review article attributed these controversial findings to various factors such as different strains of probiotics, administration dosage, analytical accuracy of lipid analyses, duration of treatment period, clinical characteristic of subjects, inadequate sample sizes, and lack of suitable controls or placebo groups. 2 Considering the mentioned reasons hypothesized by Ooi and Liong, 20 normolipidemic condition of used rat model in the current study may be a reason for failure of these probiotic bacteria in changing lipid profile. 20 In addition to all of the above, the feeding period of 30 days may not be sufficient to observe a significant change in lipid profile.…”

A Combination of Prebiotic Inulin and Oligofructose Improve Some of Cardiovascular Disease Risk Factors in Women with Type 2 Diabetes: A Randomized Controlled Clinical Trial

“…Acetate may act as a precursor for cholesterol synthesis, while propionate could inhibit hepatic cholesterol synthesis by decreasing the use of acetate as a precursor of cholesterol. 26 Also, inulin-type fructans may contribute to cholesterol reduction by increasing fecal bile acid excretion, reducing intestinal cholesterol absorption, as well as increasing of the expression of 3-hydroxy-3-methylglutaryl-COA reductase (HMG-COA reductase). 27 Their impact on TLR4 signaling and proinflammatory cytokines might be explaining the role of their lipid lowering.…”

Nanotechnology and its Partnership with Synbiotics

“…Dysbiosis, resulting from an assault received from the long-term use of antibiotics, disease processes of the gastrointestinal tract such as Colon Carcinoma, Ulcerative colitis, IBS, Crohns Disease, Inflammatory Bowel Disease, Celiac Disease, and Traveler's Diarrhea, can leave the gut susceptible, and can benefit from its implementation. Research has supported probiotics to have antiinflammatory properties beneficial for the entire body, improve post menopausal symptoms, to address lactose intolerance, and to lower cholesterol levels [6], as one study stated by treating rats with L. plantarum with nanoparticle Tellurium, observed a reduction in the levels of the triglycerides [7].…”