Across 4 meta-analyses and systematic reviews, all 4 reported small beneficial effects of Lactobacillus plantarum on reducing LDL cholesterol, with 3 of the 4 analyses achieving statistical significance. The largest pooled analysis (26 RCTs, 2104 participants) confirmed a significant small reduction. Doses and study durations were not consistently reported across the included reviews.
Caveats: Available evidence is overwhelmingly positive — clinical literature in this area is subject to publication bias (null-result studies are less likely to be published or indexed). The effect size was uniformly small across all analyses, and one meta-analysis limited to patients with T2DM and prediabetes did not reach statistical significance, suggesting the effect may be modest or population-dependent.
While generally safe in healthy populations, rare adverse events (bacteremia, D-lactic acidosis, horizontal gene transfer) have been reported in immunocompromised or critically ill individuals, underscoring the need for individualized risk-benefit assessments and rigorous adverse-event surveillance.
from: Molecular Pathways and Clinical Applications of Probiotics as Effective Supporters of InteSubgroup analysis of trials found ... reduction of LDL-C using ... L. reuteri
L. plantarum supplementation significantly reduced LDL-C (SMD: -0.251; 95% CI: -0.477, -0.025; p = 0.029), but not HDL-C.
low-density lipoprotein cholesterol (-6.87; 95%CI: -15.03, 1.29 mg/dL; n = 3)
Meta-analyses of 30+ RCTs demonstrate that probiotic supplementation (notably L. acidophilus, L. plantarum, B. longum) lowers total and LDL cholesterol (-7 to -10 mg/dL)