Across 3 studies, 2 reported small beneficial effects of Lactobacillus plantarum on reducing total cholesterol, while 1 found a neutral non-significant effect. The aggregate evidence shows a small beneficial effect direction, but the evidence base is very limited. No consistent dose range or study duration could be identified due to incomplete reporting.
Caveats: Evidence base is small (only 3 studies) — conclusions should be considered preliminary. Two of the three studies are meta-analyses/reviews, but one of them (in patients with T2DM and prediabetes) found a non-significant neutral effect, suggesting the benefit may not generalize to all populations. Effect sizes were uniformly small and clinical significance remains unclear.
Subgroup analysis of trials found significantly reduction of TC using L. plantarum
L. plantarum supplementation significantly reduced TC (SMD: -0.233; 95% CI: -0.458, -0.008; p = 0.042)
A non-statistically significant tendency towards improvements in total cholesterol (MD: -4.88; 95%CI: -11.84, 2.07 mg/dL; n = 3)