Prebiotics and Lipid Metabolism: A Review

Coronary heart disease (CHD) is the leading cause of morbidity and mortality worldwide. Modifiable risk factors of CHD have been identified, including high levels of low-density lipoproteins (LDLs) and triglycerides (TGs). Attempts by various researchers have been made to alter them. Several approaches, both pharmacological and nonpharmacological, have been identified to deal with the soaring numbers of individuals with those high levels. Current CHD treatment includes dietary interventions and use of statins, fibrates, niacin, cholesterol absorption inhibitors, and bile acid sequestrants. Those formulations have limitations and can possess long-term, unwanted side effects, and, therefore, other cholesterol-lowering, dietary adjuncts need to be identified and supplemented. Prebiotics are indigestible, fermented food substrates that selectively stimulate the growth and increase the activity of 1 or a limited number of microbial genus species, thereby changing the composition of the gut microbiota to confer health benefits to the hosts. Prebiotics are also nondigestible carbohydrates with specific fermentative properties, stimulating specific microbial growth associated with health and well-being. Some animal and human studies have provided strong evidence that suggests that prebiotics, as functional foods, can positively alter an individual's serum lipid profile, thereby lowering his or her risk of developing CHD. Therefore, the current review focuses on evaluating the role of prebiotics as potential dietary adjuncts in lowering cholesterol levels, with the aim of reducing the risks of cardiovascular and CHD.