***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Hypercholesterolemia is a major risk factor for cardiovascular disease . Not all patients respond well to traditional cholesterol lowering medications . Probiotics have been evaluated for their cholesterol-lowering effects in humans with variable results . This study was performed to evaluate the efficacy of two probiotics in lowering the serum cholesterol of hypercholesterolemic patients . MATERIAL S AND METHODS A r and omized double-blind controlled trial was conducted comparing placebo to Lactobacillus acidophilus plus Bifidobacterium bifidum in patients diagnosed with hypercholesterolemia .  Placebo or probiotic capsules were taken three times daily for six weeks . Pre- and post-treatment total cholesterol ( TC ) , HDL-cholesterol ( HDL-C ) , LDL-cholesterol ( LDL-C ) and triglyceride ( TG ) levels and demographic parameters of the two groups were compared . From a total of 70 participants , 64 completed the assigned treatment ( 31 in probiotics group and 33 in the control group).The two treatment groups were matched for age , sex , weight , height , BMI , waist and hip circumferences , and blood pressure . RESULTS Baseline evaluation revealed no difference between the probiotics group and control group levels of TC , HDL-C , LDL-C and TG . TC levels in the probiotics group decreased during treatment ( 237.2 vs. 212.7 mg/dL , p<0.05 ) . TC and LDL-C levels in the control group increased significantly from their baseline levels during treatment . TC ( 212.7 vs 252.8 mg/dL , p<0.001 ) , HDL-C ( 52.0 vs 59.1 mg/dL , p=0.04 ) and LDL-C ( 153.9 vs 182.1 mg/dL , p<0.01 ) levels in the probiotics group were significantly lower at the end of treatment than the corresponding levels in the control group . CONCLUSION A combination of Lactobacillus acidophilus and Bifidobacterium bifidum decreased serum total cholesterol , LDL-cholesterol and HDL-cholesterol levels in hypercholesterolemic patients over a six week period . There was no effect on serum triglyceride or fasting blood glucose levels BACKGROUND The short-chain fatty acids formed in the human colon by the bacterial fermentation of fiber may have an antiinflammatory effect , may reduce insulin production , and may improve lipid metabolism . We previously showed in hypercholesterolemic patients that supplementation with the probiotic bacteria Lactobacillus plantarum 299v significantly lowers concentrations of LDL cholesterol and fibrinogen . OBJECTIVE We determined the influence of a functional food product containing L. plantarum 299v on lipid profiles , inflammatory markers , and monocyte function in heavy smokers . DESIGN Thirty-six healthy volunteers ( 18 women and 18 men ) aged 35 - 45 y participated in a controlled , r and omized , double-blind trial . The experimental group drank 400 mL/d of a rose-hip drink containing L. plantarum 299v ( 5 x 10(7 ) colony-forming units/mL ) ; the control group consumed the same volume of product without bacteria . The experiment lasted 6 wk and entailed no changes in lifestyle . RESULTS Significant decreases in systolic blood pressure ( P < 0.000 ) , leptin ( P < 0.000 ) , and fibrinogen ( P < 0.001 ) were recorded in the experimental group . No such changes were observed in the control group . Decreases in F(2)-isoprostanes ( 37 % ) and interleukin 6 ( 42 % ) were also noted in the experimental group in comparison with baseline . Monocytes isolated from subjects treated with L. plantarum showed significantly reduced adhesion ( P < 0.001 ) to native and stimulated human umbilical vein endothelial cells . CONCLUSION L. plantarum administration leads to a reduction in cardiovascular disease risk factors and could be useful as a protective agent in the primary prevention of atherosclerosis in smokers Aim Evidence of a possible connection between gut microbiota and several physiological processes linked to type 2 diabetes is increasing . However , the effect of multi-strain probiotics in people with type 2 diabetes remains unclear . This study investigated the effect of multi-strain microbial cell preparation — also refers to multi-strain probiotics — on glycemic control and other diabetes-related outcomes in people with type 2 diabetes . Design A r and omized , double-blind , parallel-group , controlled clinical trial . Setting Diabetes clinic of a teaching hospital in Kuala Lumpur , Malaysia . Participants A total of 136 participants with type 2 diabetes , aged 30–70 years , were recruited and r and omly assigned to receive either probiotics ( n = 68 ) or placebo ( n = 68 ) for 12 weeks . Outcomes Primary outcomes were glycemic control-related parameters , and secondary outcomes were anthropomorphic variables , lipid profile , blood pressure and high-sensitivity C-reactive protein . The Lactobacillus and Bifidobacterium quantities were measured before and after intervention as an indicator of successful passage of the supplement through gastrointestinal tract . Statistical analysis Intention-to-treat ( ITT ) analysis was performed on all participants , while per- protocol ( PP ) analysis was performed on those participants who had successfully completed the trial with good compliance rate . Results With respect to primary outcomes , glycated hemoglobin decreased by 0.14 % in the probiotics and increased by 0.02 % in the placebo group in PP analysis ( p < 0.05 , small effect size of 0.050 ) , while these changes were not significant in ITT analysis . Fasting insulin increased by 1.8 µU/mL in placebo group and decreased by 2.9 µU/mL in probiotics group in PP analysis . These changes were significant between groups at both analyses ( p < 0.05 , medium effect size of 0.062 in PP analysis and small effect size of 0.033 in ITT analysis ) . Secondary outcomes did not change  significantly . Probiotics successfully passed through the gastrointestinal tract . Conclusion Probiotics modestly improved HbA1c and fasting insulin in people with type 2 diabetes Background Gut lactobacilli can affect the metabolic functions of healthy humans . We tested whether a 1500 kcal/d diet supplemented with cheese containing the probiotic Lactobacillus plantarum TENSIA ( Deutsche Sammlung für Mikroorganismen , DSM 21380 ) could reduce some symptoms of metabolic syndrome in Russian adults with obesity and hypertension . Methods In this 3-week , r and omized , double-blind , placebo-controlled , parallel pilot study , 25 subjects ingested probiotic cheese and 15 ingested control cheese .  Fifty grams of each cheese provided 175 kcal of energy . Blood pressure ( BP ) , anthropometric characteristics , markers of liver and kidney function , metabolic indices ( plasma glucose , lipids , and cholesterol ) , and urine polyamines were measured . Counts of fecal lactobacilli and L. plantarum TENSIA were evaluated using molecular methods . The data were analyzed by t-test for independent sample s and Spearman ’s partial correlation analysis . Results The probiotic L. plantarum TENSIA was present in variable amounts ( 529.6 ± 232.5 gene copies ) in 16/25 ( 64 % ) study subjects . Body mass index ( BMI ) was significantly reduced ( p = 0.031 ) in the probiotic cheese group versus the control cheese group . The changes in BMI were closely associated with the water content of the body ( r = 0.570 , p = 0.0007 ) when adjusted for sex and age . Higher values of intestinal lactobacilli after probiotic cheese consumption were associated with higher BMI ( r = 0.383 , p = 0.0305 ) and urinary putrescine content ( r = 0.475 , p = 0.006 ) . In patients simultaneously treated with BP-lowering drugs , similar reductions of BP were observed in both groups . A positive association was detected between TENSIA colonization and the extent of change of morning diastolic BP ( r = 0.617 , p = 0.0248 ) and a trend toward lower values of morning systolic BP ( r = −0.527 , p = 0.0640 ) at the end of the study after adjusting for BMI , age , and sex . Conclusion In a pilot study of obese hypertensive patients , a hypocaloric diet supplemented with a probiotic cheese helps to reduce BMI and arterial BP values , recognized symptoms of metabolic syndrome . Trial registration Current Controlled Trials IS RCT Objective : Two tripeptides ( Val-Pro-Pro and Ile-Pro-Pro ) that have inhibitory activities for angiotensin I-converting enzyme are produced in milk fermented with Lactobacillus helveticus . In this study we evaluated the effect and safety of powdered fermented milk with L. helveticus CM4 on subjects with high-normal blood pressure or mild hypertension . Methods : A r and omized , placebo-controlled , double-blind study was conducted using 40 subjects with high-normal blood pressure ( HN group ) and 40 subjects with mild hypertension ( MH group ) . Each subject ingested 6 test tablets ( 12 g ) containing powdered fermented milk with L. helveticus CM4 daily for 4 weeks ( test group ) or the same amount of placebo tablets for 4 weeks ( placebo group ) . Results : During treatment , the decrease in systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) in the test group tended to be greater than in the placebo group for both blood pressure groups . At the end of treatment ( week 4 ) , a significant decrease in DBP in the HN group was observed ( i.e. 5.0 mm Hg ( 0.1 , 9.9 ; p = 0.04 ) compared with the placebo group ) . There was no significant change in SBP ( 3.2 mm Hg ( 95 % CI −2.6 , 8.9 ; p = 0.27 ) . In the MH group , SBP decreased by 11.2 mm Hg ( 4.0 , 18.4 ; p = 0.003 ) and there was a statistically non-significant decrease in DBP of 6.5 mm Hg ( −0.1 , 13.0 ; p = 0.055 ) compared with the placebo group . No marked changes were observed in other indexes , including pulse rate , body weight and blood serum variables , and no adverse effects attributed to the treatment was found in each group . Conclusions : Daily ingestion of the tablets containing powdered fermented milk with L. helveticus CM4 in subjects with high-normal blood pressure or mild hypertension reduces elevated blood pressure without any adverse effects BACKGROUND AND AIMS Despite strong mechanistic data , and promising results from in vitro and animal studies , the ability of probiotic bacteria to improve blood pressure and serum lipid concentrations in humans remains uncertain . The aim of this study was to determine the effect of Lactobacillus acidophilus La5 and Bifidobacterium animalis subsp lactis Bb12 , provided in either yoghurt or capsule form , on home blood pressure and serum lipid profile . METHODS AND RESULTS Following a 3-week washout period , 156 overweight men and women over 55 y were r and omized to a 6-week double-blinded , factorial , parallel study . The four intervention groups were : A ) probiotic yoghurt plus probiotic capsules ; B ) probiotic yoghurt plus placebo capsules ; C ) control milk plus probiotic capsules ; and D ) control milk plus placebo capsules . Each probiotic test article provided a minimum L. acidophilus La5 and B. animalis subsp . lactis Bb12 dose of 3.0 × 10⁹ CFU/d . Home blood pressure monitoring , consisting of 7-day bi-daily repeat measurements , were collected at baseline and week 6 . Fasting total cholesterol , low density lipoprotein cholesterol ( LDLC ) , high density lipoprotein cholesterol ( HDLC ) , and serum triglyceride were performed at baseline and week 6 . When compared to control milk , probiotic yoghurt did not significantly alter blood pressure , heart rate or serum lipid concentrations ( P > 0.05 ) . Similarly , when compared to placebo capsules , supplementation with probiotic capsules did not alter blood pressure or concentrations of total cholesterol LDLC , HDLC , or triglycerides ( P > 0.05 ) . CONCLUSIONS The probiotic strains L. acidophilus La5 and B. animalis subsp . lactis Bb12 did not improve cardiovascular risk factors The blood pressure-lowering effect of dairy products holds the potential to decrease the risk of cardiovascular disease ( CVD ) . An open question is if the successful expression of functional properties of the probiotic strain depends on host biomarkers and /or food matrix properties . The probiotic Lactobacillus plantarum strain TENSIA ® ( DSM 21380 ) is a novel microorganism with 
    Output:
    
Our meta- analysis showed a modest but a significant reduction in SBP and DBP in patients with hypertension , particularly in those with diabetes mellitus , following probiotic supplementation .
This effect was associated with treatment duration , dosage , and the age of subject but was not associated with single or multiple strains usage .
Additionally , probiotic supplement had a beneficial effect in reducing BMI and blood glucose