Browse > Article
http://dx.doi.org/10.4162/nrp.2014.8.6.644

Garlic powder intake and cardiovascular risk factors: a meta-analysis of randomized controlled clinical trials  

Kwak, Jin Sook (Department of Nutritional Science and Food Management, Ewha Womans University)
Kim, Ji Yeon (Department of Food Science and Technology, Seoul National University of Science and Technology)
Paek, Ju Eun (Department of Nutritional Science and Food Management, Ewha Womans University)
Lee, You Jin (Department of Nutritional Science and Food Management, Ewha Womans University)
Kim, Haeng-Ran (Department of Agrofood Resources, Rural Development Administration)
Park, Dong-Sik (Department of Agrofood Resources, Rural Development Administration)
Kwon, Oran (Department of Nutritional Science and Food Management, Ewha Womans University)
Publication Information
Nutrition Research and Practice / v.8, no.6, 2014 , pp. 644-654 More about this Journal
Abstract
BACKGROUND/OBJECTIVES: Although preclinical studies suggest that garlic has potential preventive effects on cardiovascular disease (CVD) risk factors, clinical trials and reports from systematic reviews or meta-analyses present inconsistent results. The contradiction might be attributed to variations in the manufacturing process that can markedly influence the composition of garlic products. To investigate this issue further, we performed a meta-analysis of the effects of garlic powder on CVD risk factors. MATERIALS/METHODS: We searched PubMed, Cochrane, Science Direct and EMBASE through May 2014. A random-effects meta-analysis was performed on 22 trials reporting total cholesterol (TC), 17 trials reporting LDL cholesterol (LDL-C), 18 trials reporting HDL cholesterol (HDL-C), 4 trials reporting fasting blood glucose (FBG), 9 trials reporting systolic blood pressure (SBP) and 10 trials reporting diastolic blood pressure (DBP). RESULTS: The overall garlic powder intake significantly reduced blood TC and LDL-C by -0.41 mmol/L (95% confidence interval [CI], -0.69, -0.12) (-15.83 mg/dL [95% CI, -26.64, -4.63]) and -0.21 mmol/L (95% CI, -0.40, -0.03) (-8.11 mg/dL [95% CI, -15.44, -1.16]), respectively. The mean difference in the reduction of FBG levels was -0.96 mmol/L (95% CI, -1.91, -0.01) (-17.30 mg/dL [95% CI, -34.41, -0.18]). Evidence for SBP and DBP reduction in the garlic supplementation group was also demonstrated by decreases of -4.34 mmHg (95% CI, -8.38, -0.29) and -2.36 mmHg (95% CI, -4.56, -0.15), respectively. CONCLUSIONS: This meta-analysis provides consistent evidence that garlic powder intake reduces the CVD risk factors of TC, LDL-C, FBG and BP.
Keywords
Allium sativum; garlic; CVD risk factor; meta-analysis; systematic review;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Kim JY, Kwon O. Garlic intake and cancer risk: an analysis using the Food and Drug Administration's evidence-based review system for the scientific evaluation of health claims. Am J Clin Nutr 2009;89:257-64.
2 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;53:215-30.   DOI   ScienceOn
3 Ried K, Frank OR, Stocks NP, Fakler P, Sullivan T. Effect of garlic on blood pressure: a systematic review and meta-analysis. BMC Cardiovasc Disord 2008;8:13.   DOI   ScienceOn
4 Reinhart KM, Coleman CI, Teevan C, Vachhani P, White CM. Effects of garlic on blood pressure in patients with and without systolic hypertension: a meta-analysis. Ann Pharmacother 2008;42:1766-71.   DOI   ScienceOn
5 Ried K, Toben C, Fakler P. Effect of garlic on serum lipids: an updated meta-analysis. Nutr Rev 2013;71:282-99.   DOI   ScienceOn
6 Silagy CA, Neil HA. A meta-analysis of the effect of garlic on blood pressure. J Hypertens 1994;12:463-8.
7 Khoo YS, Aziz Z. Garlic supplementation and serum cholesterol: a meta-analysis. J Clin Pharm Ther 2009;34:133-45.   DOI   ScienceOn
8 You SJ, Ahn BK, Kang CW. Effects of dietary garlic powder on growth performance and mRNA expression of hepatic HMG-CoA reductase in broiler chickens. J Anim Sci Technol 2009;51:307-14.   DOI   ScienceOn
9 Kim-Park S, Ku DD. Garlic elicits a nitric oxide-dependent relaxation and inhibits hypoxic pulmonary vasoconstriction in rats. Clin Exp Pharmacol Physiol 2000;27:780-6.   DOI   ScienceOn
10 Adler AJ, Holub BJ. Effect of garlic and fish-oil supplementation on serum lipid and lipoprotein concentrations in hypercholesterolemic men. Am J Clin Nutr 1997;65:445-50.
11 Ashraf R, Aamir K, Shaikh AR, Ahmed T. Effects of garlic on dyslipidemia in patients with type 2 diabetes mellitus. J Ayub Med Coll Abbottabad 2005;17:60-4.
12 Ashraf R, Khan RA, Ashraf I. Garlic (Allium sativum) supplementation with standard antidiabetic agent provides better diabetic control in type 2 diabetes patients. Pak J Pharm Sci 2011;24:565-70.
13 Byrne DJ, Neil HA, Vallance DT, Winder AF. A pilot study of garlic consumption shows no significant effect on markers of oxidation or sub-fraction composition of low-density lipoprotein including lipoprotein(a) after allowance for non-compliance and the placebo effect. Clin Chim Acta 1999;285:21-33.   DOI   ScienceOn
14 Mader FH. Treatment of hyperlipidaemia with garlic-powder tablets. Evidence from the German Association of General Practitioners' multicentric placebo-controlled double-blind study. Arzneimittelforschung 1990;40:1111-6.
15 Gardner CD, Lawson LD, Block E, Chatterjee LM, Kiazand A, Balise RR, Kraemer HC. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Arch Intern Med 2007;167:346-53.   DOI   ScienceOn
16 Holzgartner H, Schmidt U, Kuhn U. Comparison of the efficacy and tolerance of a garlic preparation vs. bezafibrate. Arzneimittelforschung 1992;42:1473-7.
17 Isaacsohn JL, Moser M, Stein EA, Dudley K, Davey JA, Liskov E, Black HR. Garlic powder and plasma lipids and lipoproteins: a multicenter, randomized, placebo-controlled trial. Arch Intern Med 1998;158:1189-94.   DOI   ScienceOn
18 Kannar D, Wattanapenpaiboon N, Savige GS, Wahlqvist ML. Hypocholesterolemic effect of an enteric-coated garlic supplement. J Am Coll Nutr 2001;20:225-31.   DOI
19 Kiesewetter H, Jung F, Jung EM, Blume J, Mrowietz C, Birk A, Koscielny J, Wenzel E. Effects of garlic coated tablets in peripheral arterial occlusive disease. Clin Investig 1993;71:383-6.
20 Lash JP, Cardoso LR, Mesler PM, Walczak DA, Pollak R. The effect of garlic on hypercholesterolemia in renal transplant patients. Transplant Proc 1998;30:189-91.   DOI   ScienceOn
21 Neil HA, Silagy CA, Lancaster T, Hodgeman J, Vos K, Moore JW, Jones L, Cahill J, Fowler GH. Garlic powder in the treatment of moderate hyperlipidaemia: a controlled trial and meta-analysis. J R Coll Physicians Lond 1996;30:329-34.
22 Phelps S, Harris WS. Garlic supplementation and lipoprotein oxidation susceptibility. Lipids 1993;28:475-7.   DOI   ScienceOn
23 Sobenin IA, Nedosugova LV, Filatova LV, Balabolkin MI, Gorchakova TV, Orekhov AN. Metabolic effects of time-released garlic powder tablets in type 2 diabetes mellitus: the results of double-blinded placebo-controlled study. Acta Diabetol 2008;45:1-6.   DOI
24 Sitprija S, Plengvidhya C, Kangkaya V, Bhuvapanich S, Tunkayoon M. Garlic and diabetes mellitus phase II clinical trial. J Med Assoc Thai 1987;70 Suppl 2:223-7.
25 Superko HR, Krauss RM. Garlic powder, effect on plasma lipids, postprandial lipemia, low-density lipoprotein particle size, high-density lipoprotein subclass distribution and lipoprotein(a). J Am Coll Cardiol 2000;35:321-6.   DOI   ScienceOn
26 Sobenin IA, Andrianova IV, Demidova ON, Gorchakova T, Orekhov AN. Lipid-lowering effects of time-released garlic powder tablets in double-blinded placebo-controlled randomized study. J Atheroscler Thromb 2008;15:334-8.   DOI   ScienceOn
27 Amagase H. Clarifying the real bioactive constituents of garlic. J Nutr 2006;136:716S-25S.
28 Zeng T, Guo FF, Zhang CL, Song FY, Zhao XL, Xie KQ. A meta-analysis of randomized, double-blind, placebo-controlled trials for the effects of garlic on serum lipid profiles. J Sci Food Agric 2012;92:1892-902.   DOI   ScienceOn
29 World Health Organization; World Heart Federation; World Stroke Organization. Global Atlas on Cardiovascular Disease Prevention and Control. Geneva: World Health Organization; 2011.
30 Verschuren WM, Jacobs DR, Bloemberg BP, Kromhout D, Menotti A, Aravanis C, Blackburn H, Buzina R, Dontas AS, Fidanza F, Karvonen MJ, Nedelijkovic S, Nissinen A, Toshima H. Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study. JAMA 1995;274:131-6.   DOI   ScienceOn
31 Reinhart KM, Talati R, White CM, Coleman CI. The impact of garlic on lipid parameters: a systematic review and meta-analysis. Nutr Res Rev 2009;22:39-48.
32 Rahmani M, Tabari AK, Niaki K, Allahaverdian S, Sheikholeslami M. Effect of dried garlic supplementation on blood lipids in mild and moderate hypercholesterolemic patients. Arch Iran Med 1999;2:19-23.
33 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.
34 Saradeth T, Seidl S, Resch KL, Ernst E. Does garlic alter the lipid pattern in normal volunteers? Phytomedicine 1994;1:183-5.   DOI
35 Sobenin IA, Pryanishnikov VV, Kunnova LM, Rabinovich YA, Martirosyan DM, Orekhov AN. The effects of time-released garlic powder tablets on multifunctional cardiovascular risk in patients with coronary artery disease. Lipids Health Dis 2010;9:119.   DOI   ScienceOn
36 Vorberg G, Schneider B. Therapy with garlic: results of a placebo-controlled, double-blind study. Br J Clin Pract Suppl 1990;69:7-11.
37 Staba EJ, Lash L, Staba JE. A commentary on the effects of garlic extraction and formulation on product composition. J Nutr 2001;131:1118S-1119S.
38 D'Agostino RB Sr, Grundy S, Sullivan LM, Wilson P; CHD Risk Prediction Group. Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. JAMA 2001;286:180-7.   DOI   ScienceOn
39 Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.1.0 [Internet]. Oxford: The Cochrane Collaboration; 2011 [updated 2011 March; cited 2014 June 1]. Available from: www.cochrane-handbook.org.
40 Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97:1837-47.   DOI   ScienceOn
41 Kim JA, Montagnani M, Koh KK, Quon MJ. Reciprocal relationships between insulin resistance and endothelial dysfunction: molecular and pathophysiological mechanisms. Circulation 2006;113:1888-904.   DOI   ScienceOn
42 Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009;339:b2535.   DOI   ScienceOn
43 Roberts WC. Atherosclerotic risk factors--are there ten or is there only one? Am J Cardiol 1989;64:552-4.   DOI   ScienceOn
44 Al-Qattan KK, Thomson M, Al-Mutawa'a S, Al-Hajeri D, Drobiova H, Ali M. Nitric oxide mediates the blood-pressure lowering effect of garlic in the rat two-kidney, one-clip model of hypertension. J Nutr 2006;136:774S-776S.
45 Anim-Nyame N, Sooranna SR, Johnson MR, Gamble J, Steer PJ. Garlic supplementation increases peripheral blood flow: a role for interleukin-6? J Nutr Biochem 2004;15:30-6.   DOI   ScienceOn
46 Jain AK, Vargas R, Gotzkowsky S, McMahon FG. Can garlic reduce levels of serum lipids? A controlled clinical study. Am J Med 1993;94:632-5.   DOI   ScienceOn
47 Ziaei S, Hantoshzadeh S, Rezasoltani P, Lamyian M. The effect of garlic tablet on plasma lipids and platelet aggregation in nulliparous pregnants at high risk of preeclampsia. Eur J Obstet Gynecol Reprod Biol 2001;99:201-6.   DOI   ScienceOn
48 Rahman K, Lowe GM. Garlic and cardiovascular disease: a critical review. J Nutr 2006;136:736S-740S.
49 Auer W, Eiber A, Hertkorn E, Hoehfeld E, Koehrle U, Lorenz A, Mader F, Merx W, Otto G, Schmid-Otto B. Hypertension and hyperlipidaemia: garlic helps in mild cases. Br J Clin Pract Suppl 1990;69:3-6.