Previous studies have indicated that supplementation with probiotic bacteria may improve lipid metabolism. The present study was aimed at investigating the effects of a mixture of three strains of Lactobacillus plantarum (CECT 7527, CECT 7528 and CECT 7529) on cholesterollowering efficacy in hypercholesterolaemic patients. A total of sixty volunteers (thirty participants in the placebo group and thirty counterparts in the L. plantarum group), aged 18-65 years old, participated in a controlled, randomised, double-blind trial. The study group received one capsule daily containing 1·2 £ 10 9 colony-forming units of Lactobacillus strains in a unique dose; the placebo group consumed the same product without bacteria for 12 weeks. A significant reduction of 13·6 % in plasma total cholesterol (TC) levels was observed after 12 weeks of consumption in the L. plantarum group when compared with the placebo group. The lipidic outcomes were also analysed based on TC values at baseline: low initial values (LIV, 2000 -2500 mg/l) v. high initial values (HIV, 2510 -3000 mg/l). In the HIV group, the L. plantarum treatment showed a reduction after 12 weeks of consumption compared with the placebo group in TC, LDL-cholesterol (LDL-C) and oxidised LDL-C (17·4, 17·6 and 15·6 %, respectively). In the LIV, the L. plantarum treatment only showed a reduction after 12 weeks of consumption when compared with the placebo group in TC (9·4 %). The present results showed that the biofunctionality of L. plantarum (CECT 7527, CECT 7528 and CECT 7529) is proportional to the cardiovascular risk of the patient, having a better effect in patients with higher levels of cholesterol.

BACKGROUND: Cardiovascular disease, global leading cause of morbi-mortality, deserve a special attention of efficacious and safe treatments. Development of new principles based on the intestinal microbiome has been revealed as a promising approach. OBJECTIVE: To assess the effects of a combination of three Lactobacillus plantarum strains on low-density lipoprotein cholesterol (LDL-C) and other lipid parameters in hypercholesterolemic adults. METHODS: In this double-blind, placebo-controlled, randomized trial, 60 patients (mean age 51.8 y, BMI 26.2 kg/m 2 , LDL-C 167.5 mg/dL) not receiving lipid-altering treatment were treated either with a L. plantarum-containing probiotic (LpPRO) or placebo (PLBO) single capsule daily for 12 weeks. Lipid and safety parameters were assessed at screening/baseline, 6 and 12 weeks of treatment, and after a 4-week follow-up period. RESULTS: At 12 weeks, compared to PLBO, the LpPRO group had significantly (p < 0.001) larger reductions in LDL-C (24.4 vs. 9.8 mg/dL), total-C (33.7 vs. 10.6 mg/dL), LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (0.8 vs. 0.3), oxidized LDL (7.5 vs. 1.0 U/L) and triglycerides (29.1 vs. 4.1 mg/dL). HDL-C was also significantly (p < 0.001) increased in LpPRO vs. PLBO (2.9 vs. 0.4 mg/dL). CONCLUSIONS: The L. plantarum combination reduced LDL-C and improved other lipid parameters, suggesting its potential for hypercholesterolemia treatment.