Probiotics and heart health: hype or real benefit?

Walk into any pharmacy in India today and the probiotic shelf has expanded considerably from where it was five years ago. The claims on packaging have expanded too. Claimed benefits started with gut health, immunity, digestion and now, increasingly include heart health too. This last claim is worth examining carefully, because the science behind it is more interesting and more nuanced than either the marketing of these products or the scepticism of many tend to acknowledge.

The starting point is the gut-heart axis, a term that has appeared with growing frequency in cardiology research over the past decade. The gut microbiome, the community of bacteria and other microorganisms living in the digestive tract, influences cardiovascular health through several pathways that are now reasonably well characterised. When the microbiome is disrupted and causes a state called dysbiosis, gut permeability increases, inflammatory markers rise in the bloodstream, and the body’s handling of fats and blood sugar becomes less efficient. These are not peripheral concerns in cardiology. Chronic inflammation, dyslipidaemia, and impaired glucose regulation are among the primary drivers of atherosclerosis and coronary artery disease.