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Effect of garlic (Allium sativum L.) as a functional food, on blood pressure: a meta-analysis of garlic powder, focused on trials for prehypertensive subjects

기능성식품으로서 마늘의 혈압 개선 기능성 평가: 마늘건조분말의 준건강인 대상 연구에 대한 메타분석

  • Kwak, Jin Sook (Biofood CRO Co., Ltd.) ;
  • Kim, Ji Yeon (Department of Food Science and Technology, Seoul National University of Science and Technology)
  • 곽진숙 (주식회사 바이오푸드씨알오) ;
  • 김지연 (서울과학기술대학교 식품공학과)
  • Received : 2021.08.22
  • Accepted : 2021.10.07
  • Published : 2021.10.31

Abstract

Purpose: Although numerous systematic reviews or meta-analysis have reported the hypotensive effects of garlic, the application of these results in the area of functional food is limited. This is because the trials used various garlic preparations and patients with differing hypertensive intensities. To validate the use of garlic powder as a blood pressure lowering functional food, we performed the current meta-analysis, focusing on the study of prehypertensive subjects. Methods: Literature search was carried out using various database up to July 2020, including PubMed, Cochrane, ScienceDirect and Korean studies Information Service System, and each study was screened by pre-stated inclusion/exclusion criteria. We identified nine trials that met the eligibility, of which two studies with moderate or high risk of bias were excluded. Results: Meta-analysis of the seven studies revealed that an intake of garlic powder significantly lowered the systolic blood pressure (SBP) and diastolic blood pressure (DBP) by -6.0 mmHg (95% confidence interval [CI], -11.2, -0.8; p = 0.025) and -2.7 mmHg (95% CI, -5.3, -0.1; p = 0.046), respectively. Shapes of the funnel plot for both SBP and DBP seemed symmetrical, and the Egger's regression revealed no publication bias. Moreover, duration of the intervention period was inversely associated with the pooled effects of garlic powder on SBP (p = 0.019) and DBP (p = 0.019), and this result was supported by the subgroup-analysis. The daily dose of garlic powder, baseline value of each biomarker, and subject number, did not moderate the effects on SBP and DBP. Conclusion: Results of the present meta-analysis indicate that garlic powder supplements are superior to placebo for improving the BP in prehypertensive individuals.

마늘건조분말을 준건강인이 섭취하였을 때 혈압 개선 효과가 있는지를 평가하기 위하여 메타 분석 기법으로 평가를 수행하였다. 2020년 7월까지 총 3,203건의 자료를 검색하여, 미리 계획한 선정 기준 및 제외 기준에 따라 선별한 결과 총 9건의 연구가 분석에 포함되었다. 편향 위험이 중등도 이상인 2건을 제외하고 총 7건의 연구를 포함하여 분석 결과, 마늘건조분말의 섭취는 수축기혈압 및 이완기혈압을 각각 -6.0 mmHg, -2.7 mmHg 수준으로 대조군 대비 유의하게 개선시키는 것으로 분석되었다.

Keywords

Acknowledgement

This research was supported by '2021 Discorvering Functional Crops Project' of The Food Industry Promotional Agency of Korea.

References

  1. Kang JR, Kang MJ, Byun HW, Shin JH. Effects of freeze-dried garlic powder on lipid improvement in rats fed a high fat-cholesterol diet. J Korean Soc Food Sci Nutr 2017; 46(9): 1035-1044. https://doi.org/10.3746/JKFN.2017.46.9.1035
  2. Shin JH, Ju JC, Kwen OC, Yang SM, Lee SJ, Sung NJ. Physicochemical and physiological activities of garlic from different area. Korean J Food Nutr 2004; 17: 237-245.
  3. Kim HJ, Han CH, Kim NY, Lee EK, Lee KN, Cho HE, et al. Effect of garlic extracts with extraction conditions on antioxidant and anticancer activity. Korean J Orient Physiol Pathol 2010; 24(1): 111-117.
  4. Sivam GP. Protection against Helicobacter pylori and other bacterial infections by garlic. J Nutr 2001; 131(3): 1106S-1108S. https://doi.org/10.1093/jn/131.3.1106S
  5. Iciek M, Kwiecien I, Wlodek L. Biological properties of garlic and garlic-derived organosulfur compounds. Environ Mol Mutagen 2009; 50(3): 247-265. https://doi.org/10.1002/em.20474
  6. Jain RC, Vyas CR. Garlic in alloxan-induced diabetic rabbits. Am J Clin Nutr 1975; 28(7): 684-685. https://doi.org/10.1093/ajcn/28.7.684
  7. Lea MA, Randolph VM. Induction of histone acetylation in rat liver and hepatoma by organosulfur compounds including diallyl disulfide. Anticancer Res 2001; 21(4A): 2841-2845. PUBMED
  8. Zeng T, Guo FF, Zhang CL, Song FY, Zhao XL, Xie KQ. A meta-analysis of randomized, double-blind, placebocontrolled trials for the effects of garlic on serum lipid profiles. J Sci Food Agric 2012; 92(9): 1892-1902. https://doi.org/10.1002/jsfa.5557
  9. Silagy C, Neil A. Garlic as a lipid lowering agent--a meta-analysis. J R Coll Physicians Lond 1994; 28(1): 39-45.
  10. Stevinson C, Pittler MH, Ernst E. Garlic for treating hypercholesterolemia. A meta-analysis of randomized clinical trials. Ann Intern Med 2000; 133(6): 420-429. https://doi.org/10.7326/0003-4819-133-6-200009190-00009
  11. Warshafsky S, Kamer RS, Sivak SL. Effect of garlic on total serum cholesterol. A meta-analysis. Ann Intern Med 1993; 119(7 Pt 1): 599-605. https://doi.org/10.7326/0003-4819-119-7_part_1-199310010-00009
  12. Ried K. Garlic lowers blood pressure in hypertensive individuals, regulates serum cholesterol, and stimulates immunity: an updated meta-analysis and review. J Nutr 2016; 146(2): 389S-396S. https://doi.org/10.3945/jn.114.202192
  13. Ried K. Garlic lowers blood pressure in hypertensive subjects, improves arterial stiffness and gut microbiota: a review and meta-analysis. Exp Ther Med 2020; 19(2): 1472-1478.
  14. Wang HP, Yang J, Qin LQ, Yang XJ. Effect of garlic on blood pressure: a meta-analysis. J Clin Hypertens (Greenwich) 2015; 17(3): 223-231. https://doi.org/10.1111/jch.12473
  15. Rohner A, Ried K, Sobenin IA, Bucher HC, Nordmann AJ. A systematic review and metaanalysis on the effects of garlic preparations on blood pressure in individuals with hypertension. Am J Hypertens 2015; 28(3): 414-423. https://doi.org/10.1093/ajh/hpu165
  16. Xiong XJ, Wang PQ, Li SJ, Li XK, Zhang YQ, Wang J. Garlic for hypertension: A systematic review and meta-analysis of randomized controlled trials. Phytomedicine 2015; 22(3): 352-361. https://doi.org/10.1016/j.phymed.2014.12.013
  17. Kwak JS, Kim JY, Paek JE, Lee YJ, Kim HR, Park DS, et al. Garlic powder intake and cardiovascular risk factors: a meta-analysis of randomized controlled clinical trials. Nutr Res Pract 2014; 8(6): 644-654. https://doi.org/10.4162/nrp.2014.8.6.644
  18. Kim JY, Kwon O. Culinary plants and their potential impact on metabolic overload. Ann N Y Acad Sci 2011; 1229(1): 133-139. https://doi.org/10.1111/j.1749-6632.2011.06090.x
  19. Ministry of Food and Drug Safety. Regulations on the approvals of the ingredients or standard/specifications of Health Functional Foods (2020-63). Cheongju; 2020.
  20. U. S. Food Drug Administration. Draft guidance for industry: dietary supplements: new dietary ingredient notifications and related issues. Silver Spring (MD); 2016.
  21. Amagase H, Petesch BL, Matsuura H, Kasuga S, Itakura Y. Intake of garlic and its bioactive components. J Nutr 2001; 131(3): 955S-962S. https://doi.org/10.1093/jn/131.3.955S
  22. Zeng T, Zhang CL, Zhao XL, Xie KQ. The roles of garlic on the lipid parameters: a systematic review of the literature. Crit Rev Food Sci Nutr 2013; 53(3): 215-230. https://doi.org/10.1080/10408398.2010.523148
  23. Rahman K, Lowe GM. Garlic and cardiovascular disease: a critical review. J Nutr 2006; 136(3 Suppl): 736S-740S. https://doi.org/10.1093/jn/136.3.736S
  24. Ministry of Food and Drug Safety. Guidelines for evaluation the effects of health functional foods 'May help improve blood pressure'. Cheongju; 2019.
  25. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions (version 6.2): the Cochrane collaboration. New York (NY): John Wiley & Sons; 2021.
  26. DerSimonian R, Laird N. Meta-analysis in clinical trials revisited. Contemp Clin Trials 2015; 45(Pt A): 139-145. https://doi.org/10.1016/j.cct.2015.09.002
  27. Lau J, Ioannidis JP, Schmid CH. Quantitative synthesis in systematic reviews. Ann Intern Med 1997; 127(9): 820-826. https://doi.org/10.7326/0003-4819-127-9-199711010-00008
  28. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003; 327(7414): 557-560. https://doi.org/10.1136/bmj.327.7414.557
  29. Sobenin IA, Andrianova IV, Fomchenkov IV, Gorchakova TV, Orekhov AN. Time-released garlic powder tablets lower systolic and diastolic blood pressure in men with mild and moderate arterial hypertension. Hypertens Res 2009; 32(6): 433-437. https://doi.org/10.1038/hr.2009.36
  30. De A Santos O, Gruenwald J. Effect of garlic powder tablets on blood lipids and blood pressure: a six month placebo controlled, double blind study. Br J Clin Res 1993; 4: 37-44.
  31. Vorberg G, Schneider B. Therapy with garlic: results of a placebo-controlled, double-blind study. Br J Clin Pract Suppl 1990; 69: 7-11. PUBMED
  32. Sobenin IA, Andrianova IV, Demidova ON, Gorchakova T, Orekhov AN. Lipid-lowering effects of timereleased garlic powder tablets in double-blinded placebo-controlled randomized study. J Atheroscler Thromb 2008; 15(6): 334-338. https://doi.org/10.5551/jat.E550
  33. Jain AK, Vargas R, Gotzkowsky S, McMahon FG. Can garlic reduce levels of serum lipids? A controlled clinical study. Am J Med 1993; 94(6): 632-635. https://doi.org/10.1016/0002-9343(93)90216-C
  34. Saradeth T, Seidl S, Resch KL, Ernst E. Does garlic alter the lipid pattern in normal volunteers? Phytomedicine 1994; 1(3): 183-185. https://doi.org/10.1016/s0944-7113(11)80062-0
  35. Simons LA, Balasubramaniam S, von Konigsmark M, Parfitt A, Simons J, Peters W. On the effect of garlic on plasma lipids and lipoproteins in mild hypercholesterolaemia. Atherosclerosis 1995; 113(2): 219-225. https://doi.org/10.1016/0021-9150(94)05449-S
  36. De A Santos O, Johns R. Effects of garlic powder and garlic oil preparations on blood lipids, blood pressure and well-being. Br J Clin Res 1995; 6: 91-100.
  37. Zeb F, Safdar M, Fatima S, Khan S, Alam S, Muhammad M, et al. Supplementation of garlic and coriander seed powder: Impact on body mass index, lipid profile and blood pressure of hyperlipidemic patients. Pak J Pharm Sci 2018; 31(5): 1935-1941.
  38. Vahidinia A, Heshmatian B, Salehi I, Zarei M. Garlic powder effect on plasma renin activity, and cardiovascular effects of intravenous angiotensin I and angiotensin II in normotensive and hypertensive male rats. Avicenna J Med Biochem 2015; 3(2): e28581.
  39. Sharifi AM, Darabi R, Akbarloo N. Investigation of antihypertensive mechanism of garlic in 2K1C hypertensive rat. J Ethnopharmacol 2003; 86(2-3): 219-224. https://doi.org/10.1016/S0378-8741(03)00080-1
  40. Ranjini H, Udupa PE, Thomas JM. Angiotensin converting enzyme (ACE): inhibition of sheep kidney and lung ACE in vitro by Rauwolfia serpentina and allium sativum. Sch J Appl Med Sci 2015; 3(5): 1936-1940.
  41. Garcia-Trejo EMA, Arellano-Buendia AS, Arguello-Garcia R, Loredo-Mendoza ML, Garcia-Arroyo FE, Arellano-Mendoza MG, et al. Effects of allicin on hypertension and cardiac function in chronic kidney disease. Oxid Med Cell Longev 2016; 2016: 3850402. https://doi.org/10.1155/2016/3850402
  42. Elkayam A, Peleg E, Grossman E, Shabtay Z, Sharabi Y. Effects of allicin on cardiovascular risk factors in spontaneously hypertensive rats. Isr Med Assoc J 2013; 15(3): 170-173. PUBMED
  43. Brandle M, al Makdessi S, Weber RK, Dietz K, Jacob R. Prolongation of life span in hypertensive rats by dietary interventions. Effects of garlic and linseed oil. Basic Res Cardiol 1997; 92(4): 223-232. https://doi.org/10.1007/BF00788517
  44. Ali M, Al-Qattan KK, Al-Enezi F, Khanafer RM, Mustafa T. Effect of allicin from garlic powder on serum lipids and blood pressure in rats fed with a high cholesterol diet. Prostaglandins Leukot Essent Fatty Acids 2000; 62(4): 253-259. https://doi.org/10.1054/plef.2000.0152