Examining the data

The meta-analysis, published in Nutrition, Metabolism and Cardiovascular Diseases, examined data from 13 trials, which together included 485 participants with high, borderline-high, and normal cholesterol and triglyceride levels. The studies ranged in duration between four and ten weeks. In each study, a probiotic supplement made with one or more strains of lactobacilli, bifidobacteria, and enterococci was compared to placebo.

Probiotics measure up as cholesterol reducers

When analyzed together, the data showed probiotic supplements may have a small, positive effect on lipid levels:

• Taking probiotic supplements led to a greater reduction in total cholesterol levels than placebo.
• Taking probiotics also reduced LDL ("bad") cholesterol levels more
• Triglyceride levels were reduced more in people taking probiotics compared to placebo, although this difference was not statistically significant.

"Based on the currently available literature, we can state that oral probiotics have beneficial effects on total cholesterol and LDL cholesterol for subjects with high, borderline-high and normal cholesterol levels," the study's authors concluded. They noted that the average reduction in lipid levels was less than 3% and therefore relatively small compared with available lipid-lowering medications. They went on to suggest that probiotics might be useful in conjunction with medications in people with high cardiovascular risk.

Probiotics are part of the best plan

The research consistently shows that a healthy diet and lifestyle are the key components to preventing heart disease. In fact, diet and exercise are more effective than cholesterol-lowering drugs when it comes to preventing heart attack and stroke. The findings from this new review show that probiotics can be part of an overall cholesterol-lowering program, which would also include:

• Fiber. Whole grains, beans, and lentils are good sources of the types of fiber that lower cholesterol and prevent heart disease.
• Fruits and vegetables. Full of antioxidant and anti-inflammatory compounds, they are also rich in fiber and other carbohydrates that feed friendly intestinal bacteria.
• Nuts and seeds. Their monounsaturated fats, fiber, and antioxidants may all contribute to their ability to prevent heart disease.
• Fish. The omega-3 polyunsaturated fats found in fish are especially anti-inflammatory and heart-healthy.
• Regular exercise. The more the better, but any is better than none. Aim for 30 to 60 minutes per day of moderately strenuous activity like brisk walking.

(Nutr Metab Cardiovasc Dis 2011;21:844-50)