Effect of Probiotics on Blood Lipid Concentrations: A Meta-Analysis of Randomized Controlled Trials
Open accessAbstract
Previous clinical studies have reported mixed results regarding the effect of probiotics on lipid metabolism. Therefore, we conducted a meta-analysis of randomized controlled trials to quantify the direction and magnitude of the potential effect of probiotics on blood lipid concentrations.Eligible studies were randomized, placebo-controlled trials whose interventions were probiotic products containing live bacteria. The studies reported net changes in lipid profiles (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides) and their associated standard deviations (or the data to calculate them). The probiotic products did not contain prebiotics or other active ingredients, and the full article was accessible in English.The pooled mean net change in lipid profiles and 95% confidence intervals (95% CIs) were calculated. Q statistics and I were calculated to examine heterogeneity. Potential sources of heterogeneity were investigated via subgroup and sensitivity analyses, and publication biases were estimated.A total of 30 randomized controlled trials with 1624 participants (828 in intervention groups and 796 in placebo groups) were included in this analysis. Subjects treated with probiotics demonstrated reduced total cholesterol and LDL cholesterol compared to control subjects by 7.8 mg/dL (95% CI: -10.4, -5.2) and 7.3 mg/dL (95% CI: -10.1, -4.4), respectively. There was no significant effect of probiotics on HDL cholesterol or triglycerides. The effect of probiotics on total cholesterol and LDL cholesterol depended on a variety of factors. The significant effects were greater for higher baseline total cholesterol levels, longer treatment durations, and certain probiotic strains. In addition, these associations seem stronger in studies supported by probiotics companies.The studies included in this meta-analysis showed significant heterogeneity as indicated by the Q statistics and I. In addition, industry sponsorship may affect study findings.These results suggest that the use of probiotics may improve lipid metabolism by decreasing total and LDL cholesterol concentrations. However, both the efficacy of probiotics for cholesterol lowering and safety should be investigated further in well-designed clinical trials.
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Probiotics reduce LDL-C by a pooled mean net change of −0.19 mmol/L compared to controls.
“The pooled mean net change in LDL-C was of − 0.19 mmol/L (7.35 mg/dL) (p < 0.01) compared to controls.”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [29]
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1 retracted
Asemi, Z., Samimi, M., Tabasi, Z., Talebian, P., Azarbad, Z., Hydarzadeh, Z., & Esmaillzadeh, A. (2011) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2011.640372 · Cited by 60 · see citing works
RetractedThe Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817 · see citing works
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,577 · see citing works
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582 · see citing works
Zhang, Q., Wang, C., Zheng, M., Li, Y., Li, J., Zhang, L., Shang, X., & Yan, C. (2014) · Cerebrovascular Diseases · doi:10.1159/000369778 · Cited by 11,609 · see citing works
Dong, Y., Hao, L., Shi, Z., Wang, G., Zhang, Z., & Han, C. (2013) · Urologia Internationalis · doi:10.1159/000351405 · Cited by 4,556 · see citing works
Investigating and dealing with publication and other biases in meta-analysis
Sterne, J. A. C., Egger, M., & Smith, G. D. (2001) · BMJ · doi:10.1136/bmj.323.7304.101 · Cited by 2,225 · see citing works
Zeng, X., Zhang, Y., Kwong, J. S. W., Zhang, C., Li, S., Sun, F., Niu, Y., & Du, L. (2015) · Journal of Evidence-Based Medicine · doi:10.1111/jebm.12141 · Cited by 2,082 · see citing works
Potential Uses of Probiotics in Clinical Practice
Reid, G., Jaß, J., Sebulsky, M. T., & McCormick, J. K. (2003) · Clinical Microbiology Reviews · doi:10.1128/cmr.16.4.658-672.2003 · Cited by 918 · see citing works
Siervo, M., Lara, J., Chowdhury, S., Ashor, A., Oggioni, C., & Mathers, J. C. (2015) · British Journal of Nutrition · doi:10.1017/s0007114514003341 · Cited by 656 · see citing works
Assimilation of cholesterol by Lactobacillus acidophilus
Gilliland, S. E., Nelson, C. R., & Maxwell, C. V. (1985) · Applied and Environmental Microbiology · doi:10.1128/aem.49.2.377-381.1985 · Cited by 652 · see citing works
Guarner, F. (1998) · International Journal of Food Microbiology · doi:10.1016/s0168-1605(97)00136-0 · Cited by 638 · see citing works
A placebo-controlled study of the effect of sour milk on blood pressure in hypertensive subjects
Hata, Y., Yamamoto, M., Ohni, M., Nakajima, K., Nakamura, Y., & Takano, T. (1996) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/64.5.767 · Cited by 508 · see citing works
Effects of Consumption of Probiotics and Prebiotics on Serum Lipid Levels in Humans
Pereira, D. I. A., & Gibson, G. R. (2002) · Critical Reviews in Biochemistry and Molecular Biology · doi:10.1080/10409230290771519 · Cited by 450 · see citing works
Ejtahed, H., Mohtadinia, J., Rad, A. H., Niafar, M., Jafarabadi, M. A., Mofid, V., & Akbarian-Moghari, A. (2011) · Journal of Dairy Science · doi:10.3168/jds.2010-4128 · Cited by 416 · see citing works
Effect of Lactobacillus plantarum 299v on cardiovascular disease risk factors in smokers
Naruszewicz, M., Johansson, M.-L., Zapolska‐Downar, D., & Bukowska, H. (2002) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/76.6.1249 · Cited by 365 · see citing works
Removal of Cholesterol by Lactobacilli via Incorporation and Conversion to Coprostanol
Lye, H.-S., Rusul, G., & Liong, M.-T. (2010) · Journal of Dairy Science · doi:10.3168/jds.2009-2574 · Cited by 338 · see citing works
Xiao, J. Z., Kondo, S., Takahashi, N., Miyaji, K., Oshida, K., Hiramatsu, A., Iwatsuki, K., Kokubo, S., & Hosono, A. (2003) · Journal of Dairy Science · doi:10.3168/jds.s0022-0302(03)73839-9 · Cited by 322 · see citing works
Effect of 8 week intake of probiotic milk products on risk factors for cardiovascular diseases
Agerholm-Larsen, L., Raben, A., Haulrik, N., Hansen, A., Manders, M., & Astrup, A. V. (2000) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1600937 · Cited by 319 · see citing works
Anderson, J. W., & Gilliland, S. E. (1999) · Journal of the American College of Nutrition · doi:10.1080/07315724.1999.10718826 · Cited by 303 · see citing works
Rajkumar, H., Mahmood, N., Kumar, M., Varikuti, S. R., Challa, H. R., & Myakala, S. P. (2014) · Mediators of Inflammation · doi:10.1155/2014/348959 · Cited by 301 · see citing works
Jones, M. L., Martoni, C. J., & Prakash, S. (2012) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2012.126 · Cited by 277 · see citing works
Molin, G. (2001) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/73.2.380s · Cited by 261 · see citing works
Long-term consumption of fermented dairy products over 6 months increases HDL cholesterol
Kiessling, G., Schneider, J., & Jahreis, G. (2002) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601399 · Cited by 256 · see citing works
Guo, Z., Liu, X. M., Zhang, Q. X., Shen, Z., Tian, F., Zhang, H., Sun, Z., Zhang, H. P., & Chen, W. (2011) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2011.04.008 · Cited by 249 · see citing works
Imamura, T., Doi, Y., Arima, H., Yonemoto, K., Hata, J., Kubo, M., Tanizaki, Y., Ibayashi, S., Iida, M., & Kiyohara, Y. (2009) · Stroke · doi:10.1161/strokeaha.108.529537 · Cited by 235 · see citing works
Kawase, M., Hashimoto, H., Hosoda, M., Morita, H., & Hosono, A. (2000) · Journal of Dairy Science · doi:10.3168/jds.s0022-0302(00)74872-7 · Cited by 230 · see citing works
Sharafedtinov, K. K., Plotnikova, O. A., Исмаиловна, А. Р., Sentsova, T. B., Songisepp, E., Štšepetova, J., Smidt, I., & Mikelsaar, M. (2013) · Nutrition Journal · doi:10.1186/1475-2891-12-138 · Cited by 226 · see citing works
Pereira, D. I. A., McCartney, A. L., & Gibson, G. R. (2003) · Applied and Environmental Microbiology · doi:10.1128/aem.69.8.4743-4752.2003 · Cited by 215 · see citing works
Hypocholesterolaemic effect of a new fermented milk product in healthy middle-aged men.
Agerbæk, M., Gerdes, L. U., & Richelsen, B. (1995) · PubMed · Cited by 196 · see citing works
Ataie‐Jafari, A., Larijani, B. A., Majd, H. A., & Tahbaz, F. (2009) · Annals of Nutrition and Metabolism · doi:10.1159/000203284 · Cited by 194 · see citing works
Agerholm-Larsen, L., Bell, M. L., Grunwald, G. K., & Astrup, A. V. (2000) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601104 · Cited by 192 · see citing works
Cholesterol lowering in pigs through enhanced bacterial bile salt hydrolase activity
Smet, I. D., Boever, P. D., & Verstraete, W. (1998) · British Journal Of Nutrition · doi:10.1079/bjn19980030 · Cited by 182 · see citing works
The effects of probiotic and conventional yoghurt on lipid profile in women
Sadrzadeh-Yeganeh, H., Elmadfa, I., Djazayery, A., Jalali, M., Heshmat, R., & Chamary, M. (2010) · British Journal Of Nutrition · doi:10.1017/s0007114509993801 · Cited by 179 · see citing works
Fuentes, M. C., Lajo, T., Carrión, J. M., & Cuñé, J. (2013) · British Journal of Nutrition · doi:10.1017/s000711451200373x · Cited by 174 · see citing works
Ivey, K. L., Hodgson, J. M., Kerr, D. A., Thompson, P. L., Stojceski, B., & Prince, R. L. (2014) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2014.07.012 · Cited by 159 · see citing works
Randomized controlled trial of sour milk on blood pressure in borderline hypertensive men
Mizushima, S.-I. (2004) · American Journal of Hypertension · doi:10.1016/j.amjhyper.2004.03.674 · Cited by 155 · see citing works
Probiotics to Adolescents With Obesity
Gøbel, R. J., Larsen, N., Jakobsen, M., Mølgaard, C., & Michaelsen, K. F. (2012) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e318263066c · Cited by 151 · see citing works
Liong, M., Dunshea, F. R., & Shah, N. P. (2007) · British Journal Of Nutrition · doi:10.1017/s0007114507747803 · Cited by 149 · see citing works
Effect of Lactobacillus fermentum on serum lipids in subjects with elevated serum cholesterol
Simons, L. A., Amansec, S. G., & Conway, P. L. (2006) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2005.10.009 · Cited by 137 · see citing works
Kim, G.-B., Yi, S.-H., & Lee, B. H. (2004) · Journal of Dairy Science · doi:10.3168/jds.s0022-0302(04)73164-1 · Cited by 135 · see citing works
Savard, P., Lamarche, B., Paradis, M., Thiboutot, H., Laurin, E. L., & Roy, D. (2011) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2010.12.026 · Cited by 128 · see citing works
de Roos, N., Schouten, G. K., & Katan, M. (1999) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1600722 · Cited by 112 · see citing works
A double-blind placebo-controlled study of the effects of Lactobacillus acidophilus on plasma lipids
Lewis, S. J., & Burmeister, S. (2005) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602139 · Cited by 105 · see citing works
Evaluation of the effects of a new fermented milk product (Gaio) on primary hypercholesterolemia
Bertolami, M., Faludi, A., & Batlouni, M. (1999) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1600683 · Cited by 101 · see citing works
Fabian, E., & Elmadfa, I. (2006) · Annals of Nutrition and Metabolism · doi:10.1159/000094304 · Cited by 96 · see citing works
Publication Bias in Recent Meta-Analyses
Kiciński, M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0081823 · Cited by 95 · see citing works
The Multiple Risk Factor Intervention Trial (MRFIT)—Importance Then and Now
Stamler, J. (2008) · JAMA · doi:10.1001/jama.300.11.1343 · Cited by 85 · see citing works
Mohammadshahi, M., Veissi, M., Haidari, F., Javid, A. Z., Mohammadi, F., & Shirbeigi, E. (2014) · Europe PMC (PubMed Central) · Cited by 85 · see citing works
Bifidobacteria supplementation: Effects on plasma lipid profiles in dyslipidemic children
Guardamagna, O., Amaretti, A., Puddu, P. E., Raimondi, S., Abello, F., Cagliero, P., & Rossi, M. (2014) · Nutrition · doi:10.1016/j.nut.2014.01.014 · Cited by 74 · see citing works
Ogawa, A., Kadooka, Y., Kato, K., Shirouchi, B., & Sato, M. (2014) · Lipids in Health and Disease · doi:10.1186/1476-511x-13-36 · Cited by 72 · see citing works
Naci, H., Dias, S., & Ades, A. E. (2014) · BMJ · doi:10.1136/bmj.g5741 · Cited by 61 · see citing works
Usinger, L., Jensen, L. T., Flambard, B., Linneberg, A. R., & Ibsen, H. (2010) · Journal of Human Hypertension · doi:10.1038/jhh.2010.4 · Cited by 39 · see citing works
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Adak, A., & Khan, M. R. (2019) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-018-2943-4 · Cited by 1,485 · see citing works
Cicero, A. F. G., Colletti, A., Bajraktari, G., Descamps, O., Djuric, D. M., Ezhov, M., Fras, Z., Katsiki, N., Langlois, M., Latkovskis, G., et al. (2017) · Archives of Medical Science · doi:10.5114/aoms.2017.69326 · Cited by 281 · see citing works
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Khalesi, S., Bellissimo, N., Vandelanotte, C., Williams, S., Stanley, D., & Irwin, C. (2019) · European Journal of Clinical Nutrition · doi:10.1038/s41430-018-0135-9 · Cited by 242 · see citing works
Yao, K., Zeng, L., He, Q., Wang, W., Lei, J., & Zou, X. (2017) · Medical Science Monitor · doi:10.12659/msm.902600 · Cited by 170 · see citing works
Costabile, A., Buttarazzi, I., Kolida, S., Quercia, S., Baldini, J., Swann, J. R., Brigidi, P., & Gibson, G. R. (2017) · PLOS ONE · doi:10.1371/journal.pone.0187964 · Cited by 161 · see citing works
Raygan, F., Ostadmohammadi, V., Bahmani, F., & Asemi, Z. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.02.007 · Cited by 112 · see citing works
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- Authors
- Cho, Y. A., & Kim, J.
- Affiliations
- National Cancer Center (KR)
- Corresponding author
- Kim, Jeongseon
- Venue
- Medicine
- Published
- 2015-10
- Volume
- 94
- Issue
- 43
- Pages
- e1714
- ISSN
- 0025-7974 (ISSN-L)
- PMC
- PMC4985374
- OpenAlex
- W2327041417
- Cited by
- 143
- References
- 53
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 12 · 2023: 11 · 2022: 18 · 2021: 16 · 2020: 13 · 2019: 13 · 2018: 15 · 2017: 17 · 2016: 4
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- probiotics, blood lipid concentration, lipid metabolism, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, cholesterol lowering, probiotic strains, treatment duration
- MeSH terms
- Humans, Cholesterol, LDL, Randomized Controlled Trials as Topic, Probiotics, Lipid Metabolism
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