Functional foods, blood lipids and coronary heart disease

For the past 20 years, the principal focus of public health strategies for reducing the risk of coronary heart disease (CHD) has been aimed at lowering serum cholesterol levels. However, recent findings have highlighted not only cholesterol but also triacylglycerol as a significant lipid risk factor for CHD. Dietary strategies which are able to reduce these circulating lipid levels and which are able to offer long-term efficacy comparable with effective drug treatments are currently being sought. One dietary strategy that may benefit the lipid profile involves supplementation of the diet with prebiotics, probiotics and synbiotics; this method improves the health of the host by supplementation with and/or fortification of certain health promoting bacteria present in the gastrointestinal tract, by dietary means. Probiotics (live organisms) in the form of fermented milk products have been shown to exert cholesterol lowering properties, whereas non-digestible fermentable carbohydrate prebiotics have been shown to reduce triacylglycerol levels in animal studies. However, in human studies using both prebiotics and probiotics, there have been inconsistent findings with respect to changes in lipid levels, although, on the whole, there have been favourable outcomes.