Effect of probiotics on biomarkers of cardiovascular disease: implications for heart-healthy diets

The objectives of this article are to review clinical trials that have examined the effects of probiotics on low-density lipoprotein cholesterol (LDL-C) and to assess the potential of probiotic intake as a therapeutic lifestyle change (TLC) dietary option. Twenty-six clinical studies and two meta-analyses are reviewed. Significant LDL-C reductions were observed for four probiotic strains: LactobacillusreuteriNCIMB 30242, Enterococcusfaecium, and the combination of LactobacillusacidophilusLa5 and BifidobacteriumlactisBb12. Two synbiotics, L.acidophilusCHO-220 plus inulin and L.acidophilus plus fructo-oligosaccharides, also decreased LDL-C. Of the probiotics examined, L.reuteriNCIMB 30242 was found to best meet TLC dietary requirements by 1) significantly reducing LDL-C and total cholesterol, with robustness similar to that of existing TLC dietary options, 2) improving other coronary heart disease risk factors, such as inflammatory biomarkers, and 3) having generally recognized as safe (GRAS) status. Based on these results, the probiotic L.reuteriNCIMB 30242 is a viable candidate both for future TLC dietary studies and as a potential option for inclusion in TLC dietary recommendations. (C) 2013 International Life Sciences Institute