Limosilactobacillus reuteri consumption significantly reduces the total cholesterol concentration without affecting other cardiovascular disease risk factors in adults: A systematic review and meta-analysis.

2023-09
Nutrition research (New York, N.Y.) 117
- Jinshu Liu
- Ruiting Zhu
- Jinping Song
- Muhammad Sohaib
- Saikun Wang
- Jing Mao
- Jiahe Qi
- Xuance Xiong
- Wei Zhou
- Lirong Guo

PubMed: 37419064
DOI: 10.1016/j.nutres.2023.06.004

Study Design

Type: Meta-Analysis
Sample size: n = 512
Population: 512 participants from 6 studies with 4 different L. reuteri strains
Methods: Systematic search of PubMed, Embase, Scopus, the Cochrane Library, and Web of Science for eligible randomized controlled trials published before May 2022

As one of the most significant probiotics, Limosilactobacillus reuteri (L. reuteri) has been exploited as a nutritional supplement. We hypothesized that L. reuteri consumption might improve the significant risk factors of cardiovascular disease, including blood pressure, blood lipid, and blood glucose. However, previous clinical studies have shown controversial results. This study aims to explore the effect of L. reuteri consumption on these risk factors. PubMed, Embase, Scopus, the Cochrane Library, and Web of Science were searched for eligible randomized controlled trials published before May 2022. A total of 6 studies with 4 different L. reuteri strains and including 512 participants were included. The results showed that L. reuteri consumption significantly reduced total cholesterol (TC) by -0.26 mmol/L compared with the control group. In contrast, it did not affect systolic blood pressure, diastolic blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), or triglycerides. Subgroup analysis showed a significant reduction in TC when participants were <55 years old, had a body mass index between 25 and 30, or had hypercholesterolemia. In addition, TC decreased significantly when L. reuteri supplementation was >5 × 10⁹ colony-forming unit or the length of the intervention was <12 weeks. Strain subgroup analysis showed that L. reuteri NCIMB 30242 significantly reduced TC and LDL-C. In conclusion, L. reuteri consumption has a significant TC-lowering effect, which can effectively reduce the risks of cardiovascular disease associated with hypercholesterolemia. However, the results do not support the effectiveness of L. reuteri consumption on other metabolic outcomes. Further examination of larger sample sizes is needed to confirm these findings.

Research Insights

Lactobacillus reuteri→Reduced Blood Cholesterol
Strain subgroup analysis showed that L. reuteri NCIMB 30242 significantly reduced TC and LDL-C.
Effect
Beneficial
Effect size
Small
Lactobacillus reuteri→Reduced Diastolic Blood Pressure
In contrast, it did not affect systolic blood pressure, diastolic blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), or triglycerides.
Effect
Neutral
Effect size
Small
Lactobacillus reuteri→Reduced Fasting Blood Glucose Levels
In contrast, it did not affect systolic blood pressure, diastolic blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), or triglycerides.
Effect
Neutral
Effect size
Small
Lactobacillus reuteri→Reduced High-Density Lipoprotein Cholesterol Level
In contrast, it did not affect systolic blood pressure, diastolic blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), or triglycerides.
Effect
Neutral
Effect size
Small
Lactobacillus reuteri→Reduced Low-Density Lipoprotein Level
Strain subgroup analysis showed that L. reuteri NCIMB 30242 significantly reduced TC and LDL-C.
Effect
Beneficial
Effect size
Small
Lactobacillus reuteri→Reduced Systolic Blood Pressure
In contrast, it did not affect systolic blood pressure, diastolic blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), or triglycerides.
Effect
Neutral
Effect size
Small
Lactobacillus reuteri→Reduced Triglyceride Levels
In contrast, it did not affect systolic blood pressure, diastolic blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), or triglycerides.
Effect
Neutral
Effect size
Small
Lactobacillus reuteri NCIMB 30242→Reduced Blood Cholesterol
Strain subgroup analysis showed that L. reuteri NCIMB 30242 significantly reduced TC and LDL-C.
Effect
Beneficial
Effect size
Small
Lactobacillus reuteri NCIMB 30242→Reduced Low-Density Lipoprotein Level
Strain subgroup analysis showed that L. reuteri NCIMB 30242 significantly reduced TC and LDL-C.
Effect
Beneficial
Effect size
Small