Can Probiotics Control Cholesterol Levels?

The four-chambered heart of the human body is an evolution marvel. Life and death is defined by its action. It is the central part of the circulatory system (which also includes blood-vessels) that supplies blood (a connective tissue) throughout the body. Our body is a heterogeneous collection of many compounds; one of them is cholesterol. So what links cholesterol and blood-vessel, and where does the probiotics fit in the jigsaw of well-being of these vessels.

Cholesterol is important for the healthy working body, but an altered lipid-profile can lead to deposition of these fatty substances in the vessels making them harder. When these vessels become hard, heart has to put more effort to pump the blood to match the requirements of the body. Cholesterol is classified as either LDL (low density lipoprotein) or HDL (high density lipoprotein), which is commonly called bad and good cholesterol respectively. Higher the level of LDL, greater is the chance of heart attack (coronary artery disease). With the loss of flexibility of the arteries, the blood pressure also goes up, making it difficult to supply the nutrients and oxygen to the different organs including heart. Interestingly, our body also has HDL that helps in de-clogging the LDL onto the arteries, hence christened as “good cholesterol”. The altered level of the two cholesterol(s) and their ratio in the blood leads to coronary artery disease (CAD).

According to WHO research,”By 2030, cardiovascular disease would affect around 23.6 million people and will remain the leading cause of the death.” Management of CAD is therefore important and includes life style modifications, medications and even surgery. However, one of the newer management strategies is the use of probiotics.

As per the review published in Clinical Microbial Reviews, Probiotic is defined as live micro-organisms which when administered to the patients in adequate amountscan confer health benefits to the host.

How Does Probiotic Work To Lower Cholesterol?

To understand the functioning of probiotic, understanding of bile and its functioning is imperative. For perspective, it is important to know that cholesterol in our body comes from the diet as well as is inherently built in the body. Fate of bile is either to aid in digestion or to be broken down by deconjugation in liver.  Additionally, at any point of time, the gall-bladder needs some bile in its ducts, which it gets from its recirculation. Cholesterol is the precursor of bile and if the level of bile is reduced, the liver will use the cholesterol to build more bile and the cycle continues. Probiotics act on the bile in the intestine, cutting down its levels for recirculation to gall-bladder and liver then utilizes excess cholesterol to satisfy the needs of the gall-bladder for bile. Thus, the intervening probiotic helps in reducing the cholesterol level in the body. It is also important to note that to be effective, the probiotics must be protected from the gastric juices and bile. Hence, probiotic must be bile and gastric-acid resistant.

“Necessity is the mother of invention”. With the growth in number of cases with CAD, the research in the field has also grown. Two important micro-organisms that aid in reduction of cholesterol are Lactobacillus acidophilus (LA) and Lactobacillus reuteri(LR). Use of high concentration of Lactobacillus acidophilus (LA) at about 100 billion live organisms per dose in person helps regulate the cholesterol level. It helped in decreasing the total cholesterol level. A breakthrough in the use of probiotic use in managing cholesterol came with the introduction of Lactobacillus reuteri(LR). At a very low dose level, LR showed significant control on the cholesterol level.  LR is found to be an effective probiotic in managing cholesterol levels even at low doses probably because it is acid and bile-resistant, thus it is capable to reduce the bile levels and complete its journey through the intestine. Reduction in cholesterol level and the risk of the CAD can be understood by this statement-“A 1% reduction in cholesterol level is believed to reduce the risk of CAD by 2%.” Incidentally, LR has shown to reduce the total cholesterol by 38%, which means a risk reduction of 76%, which is a significant figure.

It must be noted that not only correct selection of the micro-organism is essential, but the specificity of the strain to be used a probiotic is equally important. Such active strains can be selected by different techniques such as cell-wall structure analysis or DNA finger-printing method.

Summing up, though CAD and high cholesterol level is a menace for the modern society; probiotic can be a savior in such patients. Further research in this direction is sought.