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Unique Probiotic Targets Cardiovascular Disease

October 2014

By Celine Thompson

Superior Cardiovascular Support

A direct comparison of L. reuteri supplementation with other heart health-promoting supplements is eye-opening. Plant-derived sterols, soy, and fiber supplements all have beneficial effects on cholesterol reduction. However, the probiotic is superior in terms of its effects on inflammatory markers of cardiovascular risk (e.g., CRP and fibrinogen), in promoting gastrointestinal health, and in terms of its low dose (100 mg/dose) compared with doses in the range of 1 to 50 grams for the others. (See Figure 2)

Pharmacology researchers are eager to exploit the role of bile acids as cholesterol-regulating signals, and have already rushed to produce semisynthetic versions aimed at lowering cholesterol.10 But simply supplementing with L. reuteri, a patent-protected strain of probiotic, can provide effective results using a safe, natural strain of a common, beneficial member of your own intestinal microbiome.

Although, many Lactobacillus bacteria are “generally recognized as safe” by the Food and Drug Administration, L. reuteri has also undergone extensive laboratory characterization and safety testing. L. reuteri has demonstrated no adverse effects associated with its consumption as a supplement, including no loss of fat-soluble vitamins (A, D, E, and beta carotene).36-40 In fact, research demonstrates that L. reuteri supplementation can increase levels of the heart-protective vitamin D by nearly 26%.37 (See Figure 1)

How L. Reuteri Helps The Body  


With high cholesterol and other lipid disturbances remaining unchecked, premature deaths from cardiovascular disease continue to occur, despite drug treatments and their attendant side effects.

A new strain of natural probiotic, Lactobacillus reuteri, is about to change all that. This organism can lower cholesterol in two ways: by increasing cholesterol loss from the body through stool and increasing cholesterol metabolism.

Probiotic L. reuteri does all this by secreting a potent enzyme called bile salt hydrolase, which traps cholesterol in the intestinal tract and increases signaling to liver cells to metabolize cholesterol.

Clinical studies demonstrate that L. reuteri effectively lowers levels of total and LDL-cholesterol, while driving down inflammation and reducing other metabolic disturbances that raise cardiovascular risks.

A safe, natural probiotic, L. reuteri is one of the first “condition-specific” probiotics, designed and developed specifically to fight risk factors that lead to heart attacks, strokes, and other cardiovascular catastrophes.

Even those without overtly elevated cardiovascular risk factors will benefit from L. reuteri supplementation; the probiotic has been shown to prevent diet-induced lipid disturbances as well as resolve them. L. reuteri supplementation is an important part of an overall strategy for reducing the risk of heart disease.

If you have any questions on the scientific content of this article, please call a Life Extension Wellness Specialist at 1-866-864-3027.

Comparison Of L. Reuteri With Other Heart-Healthy Supplements  


  1. Tuohy KM, Fava F, Viola R. The way to a man’s heart is through his gut microbiota–dietary pro-and prebiotics for the management of cardiovascular risk. Proc Nutr Soc. 2014;73(02):172-85.
  2. Taranto MP, Perdigón G, Médici M, de Valdez GF. Animal model for in vivo evaluation of cholesterol reduction by lactic acid bacteria. Methods Mol Biol . 2004;268:417-22.
  3. Vindigni SM, Broussard EK, Surawicz CM. Alteration of the intestinal microbiome: fecal microbiota transplant and probiotics for clostridium difficile and beyond. Expert Rev Gastroenterol Hepatol . 2013 Sep;7(7):615-28.
  4. Ebel B, Lemetais G, Beney L, et al. Impact of probiotics on risk factors for cardiovascular diseases. A review. Crit Rev Food Sci Nutr. 2014;54(2):175-89.
  5. Jones ML, Martoni CJ, Parent M, Prakash S. Cholesterol-lowering efficacy of a microencapsulated bile salt hydrolase-active Lactobacillus reuteri NCIMB yoghurt formulation in hypercholesterolaemic adults. Br J Nutr . May 2012;107(10):1505-13.
  6. Jones M, Martoni C, Prakash S. Cholesterol lowering and inhibition of sterol absorption by Lactobacillus reuteri NCIMB : a randomized controlled trial. Eur J Clin Nutr. 2012;66(11):1234-41.
  7. Birjmohun RS, Hutten BA, Kastelein JJ, Stroes ES. Efficacy and safety of high-density lipoprotein cholesterol-increasing compounds: a meta-analysis of randomized controlled trials. J Am Coll Cardiol . 2005 Jan 18;45(2):185-97.
  8. Golomb BA, Evans MA. Statin adverse effects : a review of the literature and evidence for a mitochondrial mechanism. Am J Cardiovasc Drugs. 2008;8(6):373-418.
  9. Hottelart C, El Esper N, Rose F, Achard JM, Fournier A. Fenofibrate increases creatininemia by increasing metabolic production of creatinine. Nephron. 2002;92(3):536-41.
  10. Roda A PR, Gioiello A, et al. Semi-synthetic bile acid fxr and tgr5 agonists: physicochemical properties, pharmacokinetics, and metabolism in the rat. J Pharmacol Exp Ther. 2014 Jul;350(1):56-68.
  11. Mondot S, de Wouters T, Doré J, Lepage P. The human gut microbiome and its dysfunctions. Dig Dis. 2013;31(3-4):278-85.
  12. Kovatcheva-Datchary P, Arora T. Nutrition, the gut microbiome and the metabolic syndrome. Best Pract Res Clin Gastroenterol. 2013;27(1):59-72.
  13. DiRienzo DB. Effect of probiotics on biomarkers of cardiovascular disease: implications for heart-healthy diets. Nutr Rev. 2014 Jan;72(1):18-29.
  14. Khanna S, Tosh PK. A clinician’s primer on the role of the microbiome in human health and disease. Mayo Clin Proc. 2014 Jan;89(1):107-14.
  15. Jones ML, Tomaro-Duchesneau C, Martoni CJ, Prakash S. Cholesterol lowering with bile salt hydrolase-active probiotic bacteria, mechanism of action, clinical evidence, and future direction for heart health applications. Expert Opin Biol Ther. 2013 May;13(5):631-42.
  16. Smet ID, Boever PD, Verstraete W. Cholesterol lowering in pigs through enhanced bacterial bile salt hydrolase activity. Br J Nutr. 1998;79(02):185-94.
  17. Taranto M, Medici M, Perdigon G, Ruiz Holgado A, Valdez G. Evidence for hypocholesterolemic effect of Lactobacillus reuteri in hypercholesterolemic mice. J Dairy Sci. 1998;81(9):2336-40.
  18. Taranto M, Medici M, Perdigon G, Ruiz Holgado A, Valdez G. Effect of Lactobacillus reuteri on the prevention of hypercholesterolemia in mice. J Dairy Sci. 2000;83(3):401-3.
  19. Fåk F, Bäckhed F. Lactobacillus reuteri prevents diet-induced obesity, but not atherosclerosis, in a strain dependent fashion in Apoe−/− mice. PloS One. 2012;7(10):e46837.
  20. Davidson MH, Ballantyne CM, Jacobson TA, et al. Clinical utility of inflammatory markers and advanced lipoprotein testing: advice from an expert panel of lipid specialists. J Clin Lipidol. 2011 Sep-Oct;5(5):338-67.
  21. Ramasamy K, Abdullah N, Wong MC, Karuthan C, Ho YW. Bile salt deconjugation and cholesterol removal from media by Lactobacillus strains used as probiotics in chickens. J Sci Food Agric. 2010 Jan 15;90(1):65-9.
  22. Sayin SI, Wahlström A, Felin J, et al. Gut microbiota regulates bile acid metabolism by reducing the levels of tauro-beta-muricholic acid, a naturally occurring FXR antagonist. Cell Metab. 2013 Feb 5;17(2):225-35.
  23. Ridlon JM, Kang DJ, Hylemon PB, Bajaj JS. Bile acids and the gut microbiome. Curr Opin Gastroenterol . 2014;30(3):332-8.
  24. Yu X-H, Qian K, Jiang N, Zheng X-L, Cayabyab FS, Tang C-K. ABCG5/ABCG8 in cholesterol excretion and atherosclerosis. Clin Chim Acta. 2014;428:82-8.
  25. Johnson C, Greenland P. Effects of exercise, dietary cholesterol, and dietary fat on blood lipids. Arch Intern Med. 1990 Jan;150(1):137-41.
  26. Imes CC, Austin MA. Low-density lipoprotein cholesterol, apolipoprotein B, and risk of coronary heart disease: from familial hyperlipidemia to genomics. Biol Res Nurs. 2013 Jul;15(3):292-308.
  27. Jones PJ. Regulation of cholesterol biosynthesis by diet in humans. Am J Clin Nutr. 1997 Aug;66(2):438-46.
  28. Guo X-H, Zhao Z-D, Nam H-M, Kim J-M. Comparative evaluation of three Lactobacilli with strain-specific activities for rats when supplied in drinking water. Antonie Van Leeuwenhoek. 2012 Nov;102(4):561-8.
  29. Kerr TA, Matsumoto Y, Matsumoto H, et al. Cysteine sulfinic acid decarboxylase regulation: A role for farnesoid X receptor and small heterodimer partner in murine hepatic taurine metabolism. Hepatol Res. 2013 Aug 23.
  30. Vaquero J, Monte MJ, Dominguez M, Muntané J, Marin JJ. Differential activation of the human farnesoid X receptor depends on the pattern of expressed isoforms and the bile acid pool composition. Biochem Pharmacol. 2013 Oct 1;86(7):926-39.
  31. Zhou H, Hylemon PB. Bile acids are nutrient signaling hormones. Steroids. 2014;86:62-8.
  32. Suzuki T, Aoyama J, Hashimoto M, et al. Correlation between postprandial bile acids and body fat mass in healthy normal-weight subjects. Clin Biochem. 2014 May 2.
  33. Bustos AY, Raya R, de Valdez GF, Taranto MP. Efflux of bile acids in Lactobacillus reuteri is mediated by ATP. Biotechnol Lett. 2011 Nov;33(11):2265-9.
  34. Nijstad N, Gautier T, Briand F, Rader DJ, Tietge UJ. Biliary sterol secretion is required for functional in vivo reverse cholesterol transport in mice. Gastroenterology. 2011;140(3):1043-51.
  35. Jones ML, Martoni CJ, Ganopolsky JG, Sulemankhil I, Ghali P, Prakash S. Improvement of gastrointestinal health status in subjects consuming Lactobacillus reuteri NCIMB capsules: a post-hoc analysis of a randomized controlled trial. Expert Opin Biol Ther. 2013 Dec;13(12):1643-51.
  36. Jones ML, Martoni CJ, Di Pietro E, Simon RR, Prakash S. Evaluation of clinical safety and tolerance of a Lactobacillus reuteri NCIMB supplement capsule: A randomized control trial. Regul Toxicol Pharmacol. 2012 Jul;63(2):313-20.
  37. Jones ML, Martoni CJ, Prakash S. Oral supplementation with probiotic L. reuteri NCIMB increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial. J Clin Endocrinol Metab. 2013;98(7):2944-51.
  38. Jones ML, Martoni CJ, Tamber S, Parent M, Prakash S. Evaluation of safety and tolerance of microencapsulated Lactobacillus reuteri NCIMB in a yogurt formulation: A randomized, placebo-controlled, double-blind study. Food Chem Toxicol. 2012 Jun;50(6):2216-23.
  39. Branton W, Jones M, Tomaro-Duchesneau C, Martoni C, Prakash S. In vitro characterization and safety of the probiotic strain Lactobacillus reuteri cardioviva NCIMB. Int J Probiotics Prebiotics. 2011;6(1).
  40. Sulemankhil I, Parent M, Jones ML, Feng Z, Labbe A, Prakash S. In vitro and in vivo characterization and strain safety of Lactobacillus reuteri NCIMB 30253 for probiotic applications. Can J Microbiol. 2012 Jun;58(6):776-87.
  41. Bourlioux P. Current view on gut microbiota. Ann Pharm Fr. 2014 Jan;72(1):15-21.
  42. Jorth P, Turner KH, Gumus P, Nizam N, Buduneli N, Whiteley M. Metatranscriptomics of the human oral microbiome during health and disease. mBio. 2014;5(2):e01012-01014.
  43. Jenkins DJ, Kendall CW, Nguyen TH, et al. Effect of plant sterols in combination with other cholesterol-lowering foods. Metabolism. 2008 Jan;57(1):130-9.
  44. Devaraj S, Autret BC, Jialal I. Reduced-calorie orange juice beverage with plant sterols lowers C-reactive protein concentrations and improves the lipid profile in human volunteers. Am J Clin Nutr. 2006 Oct;84(4):756-61.
  45. Acuff RV, Cai DJ, Dong ZP, Bell D. The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects. Lipids Health Dis. 2007 Apr 9;6:11.
  46. Othman RA, Moghadasian MH. Beyond cholesterol-lowering effects of plant sterols: clinical and experimental evidence of anti-inflammatory properties. Nutr Rev. 2011 Jul;69(7):371-82.
  47. Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation . 2002 Nov 19;106(21):2747-57.
  48. Bairati I, Roy L, Meyer F. Effects of a fish oil supplement on blood pressure and serum lipids in patients treated for coronary artery disease. Can J Cardiol. 1992 Jan-Feb;8(1):41-6.
  49. Chung KH, Hwang HJ, Shin KO, Jeon WM, Choi KS. Effects of perilla oil on plasma concentrations of cardioprotective (n-3) fatty acids and lipid profiles in mice. Nutr Res Pract. 2013 Aug;7(4):256-61.
  50. Subbaiah PV, Davidson MH, Ritter MC, Buchanan W, Bagdade JD. Effects of dietary supplementation with marine lipid concentrate on the plasma lipoprotein composition of hypercholesterolemic patients. Atherosclerosis. 1989 Oct;79(2-3):157-66.
  51. Silva Jde A, Trindade EB, Fabre ME, et al. Fish oil supplement alters markers of inflammatory and nutritional status in colorectal cancer patients. Nutr Cancer. 2012;64(2):267-73.
  52. Kelley DS, Siegel D, Fedor DM, Adkins Y, Mackey BE. DHA supplementation decreases serum C-reactive protein and other markers of inflammation in hypertriglyceridemic men. J Nutr. 2009 Mar;139(3):495-501.
  53. Gardner CD, Messina M, Kiazand A, Morris JL, Franke AA. Effect of two types of soy milk and dairy milk on plasma lipids in hypercholesterolemic adults: a randomized trial. J Am Coll Nutr. 2007 Dec;26(6):669-77.
  54. Anderson JW, Johnstone BM, Cook-Newell ME. Meta-analysis of the effects of soy protein intake on serum lipids. New Engl J Med. 1995 Aug 3;333(5):276-82.
  55. Pipe EA, Gobert CP, Capes SE, Darlington GA, Lampe JW, Duncan AM. Soy protein reduces serum LDL cholesterol and the LDL cholesterol:HDL cholesterol and apolipoprotein B:apolipoprotein A-I ratios in adults with type 2 diabetes. J Nutr. 2009 Sep;139(9):1700-6.
  56. Blum A, Lang N, Peleg A, et al. Effects of oral soy protein on markers of inflammation in postmenopausal women with mild hypercholesterolemia. Am Heart J. 2003 Feb;145(2):e7.
  57. Othman RA, Moghadasian MH, Jones PJ. Cholesterol-lowering effects of oat beta-glucan. Nutr Rev. 2011 Jun;69(6):299-309.
  58. Reyna-Villasmil N, Bermudez-Pirela V, Mengual-Moreno E, et al. Oat-derived beta-glucan significantly improves HDLC and diminishes LDLC and non-HDL cholesterol in overweight individuals with mild hypercholesterolemia. Am J Ther. 2007 Mar-Apr;14(2):203-12.
  59. North CJ, Venter CS, Jerling JC. The effects of dietary fibre on C-reactive protein, an inflammation marker predicting cardiovascular disease. Eur J Clin Nutr. 2009 Aug;63(8):921-33.
  60. Stewart ML, Nikhanj SD, Timm DA, Thomas W, Slavin JL. Evaluation of the effect of four fibers on laxation, gastrointestinal tolerance and serum markers in healthy humans. Ann Nutr Metab. 2010;56(2):91-8.
  61. Klosterbuer AS, Hullar MA, Li F, et al. Gastrointestinal effects of resistant starch, soluble maize fibre and pullulan in healthy adults. Br J Nutr. 2013 Sep 28;110(6):1068-74.
  62. Toral M, Gomez-Guzman M, Jimenez R, et al. The probiotic Lactobacillus coryniformis CECT5711 reduces the vascular pro-oxidant and pro-inflammatory status in obese mice. Clin Sci (Lond). 2014 Jul;127(1):33-45.
  63. Barreto FM, Colado Simão AN, Morimoto HK, Batisti Lozovoy MA, Dichi I, Helena da Silva Miglioranza L. Beneficial effects of Lactobacillus plantarum on glycemia and homocysteine levels in postmenopausal women with metabolic syndrome. Nutrition. 2014 Jul-Aug;30(7-8):939-42.
  64. Sanaie S, Ebrahimi-Mameghani M, Mahmoodpoor A, Shadvar K, Golzari SE. Effect of a probiotic preparation (VSL# 3) on cardiovascular risk parameters in critically-ill patients. J Cardiovasc Thorac Res. 2013;5(2):67-70.