Garlic
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Garlic Overview

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The story of garlic's role in human history could fill a book, as indeed it has, many times. Its species name, sativum, means cultivated, indicating that garlic does not grow in the wild. So fond have humans been of this herb that garlic can be found almost everywhere in the world, from Polynesia to Siberia.

From Roman antiquity through World War I, garlic poultices were used to prevent wound infections. The famous microbiologist Louis Pasteur performed some of the original work showing that garlic could kill bacteria. In 1916, the British government issued a general plea for the public to supply it with garlic in order to meet wartime needs. Garlic was called Russian penicillin during World War II because, after running out of antibiotics, the Russian government turned to this ancient treatment for its soldiers.

After World War II, Sandoz Pharmaceuticals manufactured a garlic compound for intestinal spasms, and the Van Patten Company produced another for lowering blood pressure.

What Is the Scientific Evidence for Garlic?

Atherosclerosis

Scant evidence hints that garlic might help prevent atherosclerosis , the most common cause of heart attacks and strokes .

Garlic preparations have been found to slow hardening of the arteries in animal studies. 1 In a double-blind, placebo-controlled study that followed 152 people for 4 years, standardized garlic powder at a dosage of 900 mg daily significantly slowed the development of atherosclerosis as measured by ultrasound. 2 Unfortunately, this study suffered from some statistical problems that make its results less than fully reliable.

An observational study of 200 people measured the flexibility of the aorta, the main artery exiting the heart. 3 Participants who took garlic showed more flexibility, indicating less atherosclerosis. However, because this was not a double-blind trial, its results prove little.

Heart Attack Prevention

In one study, 432 people who had suffered a heart attack were given either garlic oil extract or no treatment over a period of 3 years. 4 The results showed a significant reduction of second heart attacks and about a 50% reduction in death rate among those taking garlic.

High Cholesterol

A number of studies published in the 1980s and early 1990s found evidence that garlic preparations can reduce high cholesterol . 5 6 7 8 However, virtually all subsequent studies have failed to find any significant benefit. 9 One carefully designed study failed to find benefits with raw garlic, garlic powder, or aged garlic. 10 The accumulating impact of these repeated negative results indicates that garlic is not, in fact, effective for improving cholesterol profile.

Hypertension (High Blood Pressure)

Numerous studies have found weak evidence that garlic lowers blood pressure slightly, perhaps in the neighborhood of 5% to 10% more than placebo. 11 It remains unclear whether garlic supplements can help patients with high blood pressure safely eliminate or avoid antihypertensive medications.

One study followed 47 subjects with an average starting blood pressure of 171/101. 12 Over a period of 12 weeks, half were treated with 600 mg of garlic powder daily standardized to 1.3% alliin, while the other half were given placebo. The results showed a statistically significant drop of 11% in the systolic blood pressure and 13% in the diastolic pressure. In comparison, blood pressure fell in the placebo group by 5% and 4%, respectively. However, this study suffers from a significant problem: the average starting blood pressure of the placebo and the treated groups were quite different, making comparisons unreliable.

Cold Prevention

The herb garlic has a long history of use for treating or preventing colds . However, up until 2001, there was no scientific evidence that it actually works for this purpose. A US study reported in that year does provide meaningful preliminary evidence that garlic might possess cold-fighting powers. 13 In this 12-week, double-blind, placebo-controlled trial, 146 people received either placebo or a garlic extract between November and February.

The results showed that participants receiving garlic were almost two-thirds less likely to catch cold than those receiving placebo. Furthermore, participants who did catch cold recovered about one day faster in the garlic group as compared to the placebo group.

A study performed in Russia also reported benefits. 14 Thus, regular use of garlic might help prevent colds. However, there is no evidence as yet that if you take garlic at the onset of a cold you will recover more quickly.

Insect Repellent

A 20-week, double-blind, placebo-controlled crossover trial followed 80 Swedish soldiers and measured the number of tick bites received during the garlic and the placebo treatments. 15 The results showed a modest but statistically significant reduction in tick bites when soldiers consumed 1,200 mg of garlic daily for 8 to 10 weeks. Unfortunately, the type of garlic used in this study was not stated.

However, another study failed to find one-time use of garlic helpful for repelling mosquitoes. 16

Cancer Prevention

Evidence from observational studies suggests that garlic may help prevent cancer , particularly cancer of the stomach and colon. 17 18 19 20 21 22 23 In one of the best of these trials, the Iowa Women's Study, a group of 41,837 women were questioned as to their lifestyle habits in 1986 and then followed continuously in subsequent years. At the 4-year follow-up, questionnaires showed that women whose diets included significant quantities of garlic were approximately 30% less likely to develop colon cancer. 24 The interpretations of studies like this one are always a bit controversial. For example, it's possible that the women who ate a lot of garlic also made other healthful lifestyle choices. While researchers looked at this possibility very carefully and concluded that garlic was a common factor, it is not clear that they are right. What is really needed to settle the question is an intervention trial, where some people are given garlic and others are given a placebo. However, none has yet been performed that evaluated garlic for cancer prevention.

Antimicrobial

There is no question that raw garlic can kill a wide variety of microorganisms by direct contact, including fungi, bacteria, viruses, and protozoa. 25 A double-blind study reported in 1999 found that a cream made from the garlic constituent ajoene was just as effective for fungal skin infections as the standard drug terbinafine. 26 These findings may explain why garlic was traditionally applied directly to wounds in order to prevent infection (but keep in mind that it can burn the skin). Nevertheless, there is no real evidence that taking garlic orally can kill organisms throughout the body. Thus, it's not an antibiotic in the usual sense. It's more of an antiseptic.

Oral garlic could theoretically offer benefits against organisms in the stomach or intestines because it can come into direct contact with them. However, there is only the scantiest evidence as yet that it works for any specific infection of this type. 27 28 For example, despite test tube evidence that garlic can kill Helicobacter pylori(the cause of ulcers), studies in people have not been promising. 29

Dosage

A typical dosage of garlic is 900 mg daily of a garlic powder extract standardized to contain 1.3% alliin, providing about 12,000 mcg of alliin daily, or 4-5 mg of “allicin potential.” Alliin-free aged garlic is taken at a dose of 1 to 7.2 g daily.

Alliin is a relatively odorless substance found in garlic. When garlic is crushed or cut, an enzyme called allinase is brought in contact with alliin, turning it into allicin. Allicin is responsible for much of the typical odor of garlic. It is very active chemically and probably helps the garlic bulb defend itself from attack by insects and other threats. However, allicin is unstable, and soon breaks down into a variety of other substances. When garlic is ground up and encapsulated, the effect is similar to cutting the bulb: Alliin contacts allinase, yielding allicin, which then breaks down. Unless something is done to prevent this process, garlic powder won't have any alliin or allicin left by the time it is purchased.

Some garlic producers believe that alliin and allicin are not essential for garlic's effectiveness and do not worry about this. Aged garlic, for example, has very little of either compound. But other manufacturers believe that allicin is the primary active ingredient in garlic. Because allicin is an unstable chemical, these manufacturers are faced with a challenge.

One solution might be to chemically stabilize allicin so that it doesn’t break down. However, allicin has a strong garlic smell, and a relatively odorless product is preferable. Many manufacturers of garlic powder products seek to stabilize the alliin in the product, and to do so in such a way that the alliin converts to allicin after it is consumed. How well their methods work remain a matter of controversy.

Note: Do not confuse essential oil of garlic with garlic oils. The term "garlic oil" refers to garlic extracted by means of oil. Garlic essential oil is the pure oily component of the herb, and, like other essential oils , it is potentially toxic.

References

  1. Efendy JL, Simmons DL, Campbell GR, Campbell JH. The effect of the aged garlic extract, 'Kyolic', on the development of experimental atherosclerosis. Atherosclerosis. 132(1):37-42.
  2. Koscielny J, Klussendorf D, Latza R, et al. The antiatherosclerotic effect of Allium sativum.Atherosclerosis. 1999;144:237-249.
  3. Breithaupt-Grögler K, Ling M, Boudoulas H, Belz GG. Protective effect of chronic garlic intake on elastic properties of aorta in the elderly. Circulation. 96(8):2649-55.
  4. Bordia A. Garlic and coronary heart disease. The effects of garlic extract therapy over three years on the reinfarction and mortality rate [translated from German]. Dtsch Apoth Ztg. 1989;129(suppl 15):16-17.
  5. Silagy CA, Neil HA. A meta-analysis of the effect of garlic on blood pressure. J Hypertens. 12(4):463-8.
  6. Warshafsky S, Kamer RS, Sivak SL. Effect of garlic on total serum cholesterol. A meta-analysis. Ann Intern Med. 119(7 Pt 1):599-605.
  7. Mader FH. Treatment of hyperlipidaemia with garlic-powder tablets. Evidence from the German Association of General Practitioners' multicentric placebo-controlled double-blind study. Arzneimittelforschung. 40(10):1111-6.
  8. Steiner M, Khan AH, Holbert D, Lin RI. A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J Clin Nutr. 64(6):866-70.
  9. 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. 30(4):329-34.
  10. 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. 167(4):346-53.
  11. Silagy CA, Neil HA. A meta-analysis of the effect of garlic on blood pressure. J Hypertens. 12(4):463-8.
  12. 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. 69():3-6.
  13. Josling P. Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Adv Ther. 18(4):189-93.
  14. Andrianova IV, Sobenin IA, Sereda EV, Borodina LI, Studenikin MI. [Effect of long-acting garlic tablets "allicor" on the incidence of acute respiratory viral infections in children] Ter Arkh. 75(3):53-6.
  15. Stjernberg L, Berglund J. Garlic as an insect repellent [letter]. JAMA. 2000;284:831.
  16. Rajan TV, Hein M, Porte P, Wikel S. A double-blinded, placebo-controlled trial of garlic as a mosquito repellant: a preliminary study. Med Vet Entomol. 19(1):84-9.
  17. Fleischauer AT, Poole C, Arab L. Garlic consumption and cancer prevention: meta-analyses of colorectal and stomach cancers. Am J Clin Nutr. 72(4):1047-52.
  18. Agarwal KC. Therapeutic actions of garlic constituents. Med Res Rev. 16(1):111-24.
  19. Dausch JG, Nixon DW. Garlic: a review of its relationship to malignant disease. Prev Med. 19(3):346-61.
  20. Dorant E, van den Brandt PA, Goldbohm RA, Hermus RJ, Sturmans F. Garlic and its significance for the prevention of cancer in humans: a critical view. Br J Cancer. 67(3):424-9.
  21. Lau BH, Tadi PP, Tosk JM. Allium sativum (garlic) and cancer prevention. Nutr Res. 1990;10:937-948.
  22. Steinmetz KA, Kushi LH, Bostick RM, Folsom AR, Potter JD. Vegetables, fruit, and colon cancer in the Iowa Women's Health Study. Am J Epidemiol. 139(1):1-15.
  23. You WC, Blot WJ, Chang YS, Ershow A, Yang ZT, An Q, Henderson BE, Fraumeni JF Jr, Wang TG. Allium vegetables and reduced risk of stomach cancer. J Natl Cancer Inst. 81(2):162-4.
  24. Steinmetz KA, Kushi LH, Bostick RM, Folsom AR, Potter JD. Vegetables, fruit, and colon cancer in the Iowa Women's Health Study. Am J Epidemiol. 139(1):1-15.
  25. Agarwal KC. Therapeutic actions of garlic constituents. Med Res Rev. 16(1):111-24.
  26. Ledezma E, Lopez, JC, Marin P, et al. Ajoene in the topical short-term treatment of tinea cruris and tinea corporis in humans. Randomized comparative study with terbinafine. Arzneimittelforschung. 1999;49:544-547.
  27. Chowdhury AKA, Ahsan M, Islam SN, et al. Efficacy of aqueous extract of garlic & allicin in experimental shigellosis in rabbits. Indian J Med Res. 1991;93:33-36.
  28. Sharma VD, Sethi MS, Kumar A, et al. Antibacterial property of Allium sativum Linn. : in vivo & in vitro studies. Indian J Exp Biol. 1977;15:466-468.
  29. Graham DY, Anderson SY, Lang T. Garlic or jalapeno peppers for treatment of Helicobacter pylori infection. Am J Gastroenterol. 1999;94:1200-1202.
 
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