ABSTRACT
Coronary heart disease (CHD) is a major cause of morbidity and mortality in industrialized countries. Several epidemiologic and clinical studies reveal a positive correlation between elevated total serum cholesterol levels, mainly reecting the low-density lipoprotein (LDL) cholesterol fraction, and risk of CHD.1 Specically, large-scale epidemiologic surveys suggest that elevated fasting triglyceride levels are associated with a greater risk of CHD, and that this effect is independent of any association with high-density lipoprotein (HDL) cholesterol.2 Elevated postprandial triglyceride concentrations may also predict CHD risk.3,4 Intervention studies have
CONTENTS
10.1 Introduction ..................................................................................................209 10.2 Cholesterol Metabolism ................................................................................ 210 10.3 Bile Acid Metabolism ................................................................................... 211 10.4 Probiotics and Lipid Metabolism .................................................................. 212 10.5 Prebiotics and Lipid Metabolism .................................................................. 213
10.5.1 Experimental (Animal) Studies ........................................................ 213 10.5.2 Human Studies .................................................................................. 214
10.6 Mechanism by Which Prebiotics Exert Their Effect on Lipid Metabolism ................................................................................................... 215 10.6.1 Effects on Hepatic Cholesterol Synthesis ......................................... 215 10.6.2 Fermentation Products as Mediators of the Systemic Effects .......... 215 10.6.3 Increase in Cholesterol Excretion ..................................................... 216 10.6.4 Effect on Bacterial Flora .................................................................. 216
10.7 Conclusion .................................................................................................... 217 References .............................................................................................................. 217
then gone on to prove that reduction in total plasma cholesterol levels in patients with primary hypercholesterolemia can lower the incidence of coronary thrombosis.5
