Cholesterol has a bad reputation. Clogging arteries, damning up blood supply and eventually, on some fine day, causing a heart attack. This means cardiac tissue death, reduced pumping ability, forays into stents, balloons, and bypasses and for some of the worst cases, heart transplants.
Cholesterol though has a purpose. And it is not to kill us in exchange for our loving juicy burgers.
- Component of cell membranes—vital for our structures
- Precursor for steroid hormones and vitamin D
Still, too much of a good thing is bad. Luckily, getting all those numbers in order is possible.
- First option (and best): a prudent diet similar to a Mediterranean diet—vegetables, fruits, and fish with whole grains, beans, nuts and olive oil. A stricter regime such as the Ornish diet may actually reverse hardened plaque buildup. Add exercise to the mix. Go ahead, don’t be shy. Sweat. A lot.
- Second option: Medications work fast. But statins have side effects and many take them over decades.
- Third option: Ignore all the prevention and undo the mess after a heart attack. Call the plumber (surgeon) but continue stuffing junk into the pipes. Not advised.
Probiotics can be part of the diet or part of the supplement mix, taken as “meds”.
Are they helpful?
A 2015 study from Thailand title A Randomized Double-blind Controlled Trial of Lactobacillus acidophilus Plus Bifidobacterium bifidum versus Placebo in Patients with Hypercholesterolemia addressed that question.
A small trial of 64 patients with high blood cholesterol was used. Groups were matched for age, sex, weight, height, BMI, waist and hip circumferences, and blood pressure. Placebo or capsules containing Lactobacillus acidophilus plus Bifidobacterium bifidum three times daily for six weeks.
Baseline and post-treatment levels were taken:
- Total cholesterol (TC)
- HDL-cholesterol (HDL-C)
- LDL-cholesterol (LDL-C)
- Triglyceride (TG)
Total cholesterol and LDL decreased but HDL (the “good” cholesterol where a higher number is better) also decreased. Triglycerides showed no difference.
Probiotics may lower cholesterol, researchers propose in an excellent review here, via several different mechanisms:
Probiotic bacteria may:
- Feed on soluble fiber, thus producing short chain fatty acids (SCFA) such as propionic acid. Inhibiting cholesterol synthesis at the liver, SCFA play a similar role as statin drugs. Also, SCFA direct plasma cholesterol to the liver. Both actions result in lower cholesterol in the bloodstream.
- Break down bile acids which are made from cholesterol in the liver. When the bile acids are deconjugated, the liver is forced to make more, thus removing cholesterol from the blood.
- Interfere with cholesterol absorption in two ways: affecting metabolism of cholesterol via bile salt breakdown AND directly affecting cholesterol assimilation.
- Enhance cholesterol deposits in cell membranes.
There are many ways to keep cholesterol in check. Probiotics have been toiling away forever but we didn’t give them credit. Back in 1974, researchers studied Maasai warriors as models of fitness and a population with few cardiac events. The work appears here in the American Journal of Clinical Nutrition.
By adding milk to their diets, they expected to see weight gain—which they did—but were unprepared to see drops in blood cholesterol even as weight increased. The sour milk had reduced cholesterol—but no one knew what that secret ingredient may be.
Forty years later, we do.