The Cholesterol Controversy – and How Probiotics Might Help

The Cholesterol Controversy – and How Probiotics Might Help

  • Gut Health

  • By Desiree Nielsen, Registered Dietitian

    The role of cholesterol in our cardiovascular health has been one of the most hotly debated topics in nutrition research over the last 50 years1. The original diet-heart hypothesis, proposed by Ansel Keys, stated that fats in the diet lead to high blood cholesterol levels, which in turn lead to heart disease1.

    Over the years, our focus shifted from total fat to saturated fat and dietary cholesterol as the primary culprits in heart health. Now, research has dismissed the role of dietary cholesterol in raising blood cholesterol while saturated fat remains an area of controversy1.

    So what is this cholesterol that takes many forms in the body – and how does it impact our heart health?


    Many Forms, One Name

    Cholesterol is a type of fat that is essential to the structure and function of our bodies. It is produced in our liver and used to build cell membranes, vitamin D, hormones such as estrogen, and to create bile salts – vital to digesting and absorbing the fats in our food.

    However, the conversation about cholesterol and health shifts when we talk about its circulation in our blood. Because cholesterol is a fat, it needs to be shuttled through our watery bloodstream in a protein coat known as a lipoprotein – this is what we refer to as blood (or serum) cholesterol. However, this name is a bit misleading because lipoproteins carry other fats from our diet too.

    Our liver makes very low-density lipoproteins (VLDL) to transport fatty acids to the cells that need them. After dropping off some of their fatty acids, they either return to the liver or continue their delivery journey as low-density lipoproteins (LDL) through the bloodstream.

    We’ve heard how low-density lipoproteins (LDL) are bad and high-density lipoproteins (HDL) are good – but why? LDL contains more cholesterol and can deliver that cholesterol to the tissues. If the conditions are right, that cholesterol may accumulate in plaques on the artery walls. In contrast, HDL cholesterol helps collect cholesterol molecules from the artery walls and tissues and return them to the liver.

    In essence, you want more HDL because it acts as a cleanup crew – and less LDL cholesterol potentially littering cholesterol on your arteries. So how do we shift that balance?


    Cholesterol, Diet, and Probiotics

    It is thought that consuming diets lower in saturated fat helps to reduce LDL cholesterol1. Research is debating whether lower LDL cholesterol will lead to less heart disease as it appears that heart disease risk is influenced by multiple factors, including blood sugar control and inflammation; however, high LDL levels are still considered one risk factor for cardiovascular disease1

    Diet is still considered a primary factor in cholesterol levels. Dietary fiber, particularly soluble fiber from oats, barley, and psyllium, has the ability to bind and carry cholesterol out of the gut. It is thought that consuming less saturated fat – and replacing it with unsaturated or polyunsaturated fat – will lead to beneficial cholesterol levels as will avoiding sugars and refined flours. This advice hasn’t changed much in the last 20 years – something that has changed, however, is the potential use of probiotics.

    To understand how probiotics might help, you need to understand that your liver uses cholesterol to form bile salts. These bile salts are released into the gut to help you digest dietary fats – and once used, they are reabsorbed into the bloodstream and recycled. However, it appears that bacteria can prevent this reabsorption by transforming bile salts into a less soluble form2-4.

    Some bacteria, such as the Lactobacillus acidophilus CL1285® in Bio-K+, produce an enzyme called bile salt hydrolase (BSH). This enzyme may serve to make bile salts less toxic to gut bacteria but it also has the effect of blocking reabsorption of bile salts into circulation2-4. Without reabsorption, the liver has to use more cholesterol to produce new bile salts, lowering levels of blood cholesterol2-4.

    In fact, early research suggests that BSH-active probiotics are effective in reducing both total cholesterol and LDL cholesterol2-4. It is also thought that short-chain fatty acids produced by bacterial fermentation may block cholesterol production in the liver, and improve the return of blood cholesterol to the liver4.


    Living with Heart

    Living a prevention-focused lifestyle means moving your body regularly, taking steps to manage stress and quitting smoking. It also means taking a critical look at what you eat. For example, eating fewer animal-based foods such as meat and dairy in favor of more high fiber foods such as vegetables, whole grains, legumes, and seeds helps lower cholesterol levels both by binding it directly and feeding beneficial bacteria that may also support lower blood cholesterol levels.

    As an extra support, choosing a probiotic with the ability to transform bile salts may help strengthen your defenses. Bio-K+ probiotics are clinically proven to be effective on human health and are subjected to rigorous scientific testing and quality control to ensure the viability and efficacy of their formula.

    The World Health Organization predicts that cardiovascular diseases will continue to be the leading cause of death worldwide through 20304. But many of these deaths are preventable through a healthy lifestyle. Eat well, move your body and consider a probiotic as part of your strategy to reduce your risk factors.


    Do you have any other questions about your gut health? Ask us in the comments below. If you are looking to stock up on Bio-K+, head to our store locator. For more information on Bio-K+, probiotics and digestive health, contact us, find us on Facebook and Instagram or join our community



    1. Forouhi, Nita G., et al. "Dietary fat and cardiometabolic health: evidence, controversies, and consensus for guidance." BMJ361 (2018): k2139.
    2. DiRienzo, Douglas B. "Effect of probiotics on biomarkers of cardiovascular disease: implications for heart-healthy diets." Nutrition reviews72.1 (2014): 18-29.
    3. Jones, M. L., C. J. Martoni, and S. Prakash. "Cholesterol-lowering and inhibition of sterol absorption by Lactobacillus reuteri NCIMB 30242: a randomized controlled trial." European journal of clinical nutrition66.11 (2012): 1234.
    4. Kumar, Manoj et al. “Cholesterol-lowering probiotics as potential biotherapeutics for metabolic diseases”  Experimental diabetes research vol. 2012 (2012): 902917.

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    Desiree Nielsen Registered Dietitian
    About the author
    Desiree Nielsen is a registered dietitian, author and host of the vvegetarian ccooking sshow, The Urban Vegetarian. Desiree takes an evidence-based, integrative approach to her dietetics work, with a focus on anti-inflammatory, plant-centredcentered nutrition and digestive health.
    View all articles by Desiree Nielsen
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