RCT supports probiotic’s cardiometabolic health potential

By Stephen Daniells

- Last updated on GMT

© image_jungle / Getty Images
© image_jungle / Getty Images
Dietary supplementation with a specific Lacticaseibacillus paracasei probiotic strain may improve the function of the endothelium and overall heart health in people with metabolic syndrome (MetS), says a new study.

Twelve weeks of supplementation with 10 billion CFUs per day of L. paracasei​ 8700:2 (Probi AB, Sweden) led to significant improvements in flow-mediated slowing (FMS), described by the researchers as “a practical, reliable and sensitive alternative technique for the assessment of endothelial function in community residents”.

The endothelium – the thin layer of cells lining the blood vessels – performs many functions including maintaining the suppleness of blood vessels and regulating the activity of neutrophils.

Dysfunction in the endothelium leads to arteries with little suppleness, raising the risk of high blood pressure (hypertension), and arteries that are chronically inflamed, leading to an overabundance of adhesion molecules.

“Collectively, our study demonstrated that L. paracasei​ served as a promising dietary approach for the early prevention of cardiometabolic disorders,” wrote researchers from Sun Yat-sen University in China in Clinical Nutrition​.

"Very promising"

Commenting on the study's findings Christina Vegge, Director of Discovery & Clinical Research at Probi, said: "The significant impact on metabolic components in subjects with metabolic syndrome, even without dietary restrictions or changes in physical exercise is very promising. 

"The data showed improved endothelial function, lipid profile, blood sugar regulation, reduced bodyweight gain, and prevented elevated BMI compared to the placebo group," she added.

Probi's probiotic was used in the study, but the company did not provide funding for the trial. 

Anita Johansen, Probi's CEO added: “Metabolic health is of strategic importance to Probi, and we acknowledge the significant potential of this health area to have a positive impact on numerous lives. People are experiencing longer lifespans, but their overall quality of life and health are declining. Our focus is now to explore further how our probiotic can support metabolic health and potentially reduce the risk of cardiovascular disease and in that way enhance peoples´ number of years spent in good health."

Study details

The randomized, double-blind, placebo-controlled trial included 130 people with MetS. The participants had an average age of 46 and were randomly assigned to receive either the L. paracasei​ 8700: 2 supplements or placebo for 12 weeks. The primary endpoint for the study was endothelial function, which was measured by flow-mediated slowing. In addition, cardiometabolic health was determined by both components and severity of MetS.

Metabolic syndrome (MetS) is a collection of abnormal health conditions that include central obesity, hypertension, impaired fasting blood glucose and dyslipidemia. It affects about a third of all US adults and is associated with significantly increased risks of heart diseases, stroke, type 2 diabetes and other serious health problems.

Results from the 103 participants who completed the study showed that, in addition to the significant improvements in FMS, the probiotic group also experienced statistically significant reductions in “remnant cholesterol”.  

According to Johns Hopkins Medicine​, remnant cholesterol is the “amount of cholesterol in remnant lipoproteins, a form of very low-density lipoproteins (VLDL) from which sugary fatty acids — called triglycerides — have been removed.”

Remnant cholesterol, which is calculated by subtracting LDL and HDL levels from total cholesterol, has been studied as another potential risk marker for heart disease and stroke. Remnant cholesterol levels are basically calculated as the total cholesterol amount minus the LDL and high-density lipoprotein cholesterol (HDL, the so-called “good cholesterol”) counts.

“Reduced remnant cholesterol explained up to 5% improvement in endothelial function, suggesting that L. paracasei​ intervention delays endothelial dysfunction through lowering remnant cholesterol,” wrote the researchers. “Mechanistically, remnant cholesterol particles were reported to accelerate endothelial dysfunction through inducing endothelial progenitor cells senescence and suppressing endothelial nitric oxide synthase activity.”

Additionally, the researchers noted that, for the participants who consumed at least 70% of the supplements (what they called “ideal compliance”) that triglyceride levels were also reduced, while the MetS severity was lowered and weight gain was delayed.

On the other hand, no improvements were observed for measures such as insulin sensitivity or pancreatic beta-cell function.

“Our study demonstrates that L. paracasei supplementation is an effective, feasible and safe strategy for the prevention of cardiometabolic diseases in subjects with severe endothelial dysfunction and dyslipidemia,” they concluded.

Source: Clinical Nutrition
Published online ahead of print, doi: 10.1016/j.clnu.2023.07.017
“Cardiometabolic benefits of ​Lacticaseibacillus paracasei 8700:2: a randomized double-blind placebo-controlled trial”
Authors: J. Yang et al.

                                                                                                                                                                                             

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