Abstract
Cholesterol is important for both humans and animals to maintain their normal health. However, increased serum cholesterol level can cause several cardiovascular diseases. Higher cholesterol in the blood will develop a plaque in the walls of artery. Numerous pharmacological and nonpharmacological methods have been used to decrease the blood cholesterol. Various drugs have been developed to treat hypercholesterolemia, and the most common drugs include atorvastatin and rosuvastatin (statin drugs). However, prolonged usage of these drugs causes severe side effects. During the past decades, various scientists reported that the ingestion of several fermented products with probiotic bacteria decreases the serum cholesterol level. Probiotics are viable microorganisms that promote various health benefits upon consumption, while prebiotics are nondigestible food ingredients, which promote the growth of probiotic microorganisms in the human gut. The cholesterol reduction mechanism of probiotic bacteria is not well understood; however, most of the probiotic bacteria reduce the serum cholesterol level by using the bile salt deconjugation method. Herein, we review the cholesterol-reducing capability of probiotics, prebiotics, and synbiotics and use them as an alternative for cholesterol-reducing drugs which is used for hypercholesterolemia.
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