Garlic (Allium sativum L.) is a widely consumed spice in the world. Garlic contains diverse bioactive compounds, such as allicin, alliin, diallyl sulfide, diallyl disulfide, diallyl trisulfide, ajoene, and S-allyl-cysteine. Substantial studies have shown that garlic and its bioactive constituents exhibit antioxidant, anti-inflammatory, antibacterial, antifungal, immunomodulatory, cardiovascular protective, anticancer, hepatoprotective, digestive system protective, anti-diabetic, anti-obesity, neuroprotective, and renal protective properties. In this review, the main bioactive compounds and important biological functions of garlic are summarized, highlighting and discussing the relevant mechanisms of actions. Overall, garlic is an excellent natural source of bioactive sulfur-containing compounds and has promising applications in the development of functional foods or nutraceuticals for the prevention and management of certain diseases.

Bioactive Compounds and Biological Functions of Garlic ( Allium sativum L.)

Hypercholesterolemia is associated with an increased risk of heart disease The effect of garlic on blood lipids has been studied in numerous trials and summarized in meta-analyses, with conflicting results This meta-analysis, the most comprehensive to date, includes 39 primary trials of the effect of garlic preparations on total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides The findings suggest garlic to be effective in reducing total serum cholesterol by 17 ± 6 mg/dL and low-density lipoprotein cholesterol by 9 ± 6 mg/dL in individuals with elevated total cholesterol levels (>200 mg/dL), provided garlic is used for longer than 2 months An 8% reduction in total serum cholesterol is of clinical relevance and is associated with a 38% reduction in risk of coronary events at 50 years of age High-density lipoprotein cholesterol levels improved only slightly, and triglycerides were not influenced significantly Garlic preparations were highly tolerable in all trials and were associated with minimal side effects They might be considered as an alternative option with a higher safety profile than conventional cholesterol-lowering medications in patients with slightly elevated cholesterol

/pdf/effect-of-garlic-on-serum-lipids-an-updated-meta-analysis-3qegawmtrx.pdf

Effect of garlic on serum lipids: an updated meta‐analysis

Background
Garlic is widely used by patients for its blood pressure lowering effects. A meta-analysis published in 2008 concluded that garlic consumption lowers blood pressure in hypertensive and normotensive patients. Therefore, it is important to review the currently available evidence to determine whether garlic may also have a beneficial role in the reduction of cardiovascular events and mortality rates in patients with hypertension.

Objectives
To determine whether the use of garlic as monotherapy, in hypertensive patients, lowers the risk of cardiovascular morbidity and mortality compared to placebo.

Search methods
A systematic search for trials was conducted in the Cochrane Hypertension Group Specialised Register, CENTRAL, MEDLINE, EMBASE, AGRICOLA, AMED, and CINAHL up to November 2011. A hand search of reference lists of identified reviews was conducted. Experts in the area were also contacted to identify trials not found in the electronic search. Clinicaltrials.gov was searched for ongoing trials.

Selection criteria
Randomized, placebo-controlled trials of any garlic preparation versus placebo for the treatment of hypertension were included.

Data collection and analysis
Two reviewers independently extracted data and assessed trial quality using the risk of bias tool. Data synthesis and analysis was performed using RevMan 5.

Main results
The search identified two randomized controlled trials for inclusion. One trial included 47 hypertensive patients and showed that garlic significantly reduces mean supine systolic blood pressure by 12 mmHg (95% CI 0.56 to 23.44 mmHg, p=0.04) and mean supine diastolic blood pressure by 9 mmHg (95% CI 2.49 to 15.51 mmHg, p=0.007) versus placebo. The authors state that garlic was "free from side effects" and that no serious side effects were reported. There were 3 cases "where a slight smell of garlic was noted."

The second trial could not be meta-analysed as they did not report the number of people randomized to each treatment group. They did report that 200 mg of garlic powder given three times daily, in addition to hydrochlorothiazide-triamterene baseline therapy, produced a mean reduction of systolic blood pressure by 10-11 mmHg and of diastolic blood pressure by 6-8 mmHg versus placebo.

Neither trial reported clinical outcomes and insufficient data was provided on adverse events.

Authors' conclusions
There is insufficient evidence to determine if garlic provides a therapeutic advantage versus placebo in terms of reducing the risk of mortality and cardiovascular morbidity in patients diagnosed with hypertension. There is also insufficient evidence to determine the difference in withdrawals due to adverse events between patients treated with garlic or placebo.

Based on 2 trials in 87 hypertensive patients, it appears that garlic reduces mean supine systolic and diastolic blood pressure by approximately 10-12 mmHg and 6-9 mmHg, respectively, over and above the effect of placebo but the confidence intervals for these effect estimates are not precise and this difference in blood pressure reduction falls within the known variability in blood pressure measurements. This makes it difficult to determine the true impact of garlic on lowering blood pressure.

/pdf/garlic-for-the-prevention-of-cardiovascular-morbidity-and-3p9c7e9uxx.pdf

Garlic for the prevention of cardiovascular morbidity and mortality in hypertensive patients

The present study evaluated the effects of garlic on blood pressure in patients with essential hypertension. Patients (n=210) with stage 1 essential hypertension were divided into 7 groups named as A, B, C, D, E, F and G. Each group comprised of 30 patients. Each patient in group A, B, C, D and E has received garlic tablets at the dose of 300/mg. 600/mg, 900/mg, 1200/mg and 1500/mg in divided doses per day respectively for 24 weeks while Group F & group G were given tablet atenolol and placebo respectively. Blood pressure readings were recorded at weeks 0, 12 and 24. Present study showed significant decrease in both Systolic and Diastolic blood pressure in both dose and duration dependent manner. In each garlic treated group, significant reduction in SBP and DBP (p<0.005) were observed when compared with atenolol (P<0.005) and placebo.

/pdf/effects-of-allium-sativum-garlic-on-systolic-and-diastolic-5baxvba3qw.pdf

Effects of Allium sativum (garlic) on systolic and diastolic blood pressure in patients with essential hypertension.

The medicinal characteristics of garlic’s (Allium sativum L.) dynamically bioactive constituents such as alliin, allicin, ajoene, S-allyl-cysteine, S-trityl-L-cysteine, diallyl sulfide, and S-allylmercaptocysteine, have gained a lot of scientific attention from a large number of investigators who have occupied the related pre-clinical and clinical studies, as well as in the industrial sector. The outcomes from basic investigations demonstrated that, depending on the type of food processing, the presence of bioactive compounds in the matrix of garlic have a coherent and direct relation with the appearance/development of health-promoting effects in the host. Besides, it can be acknowledged that at present spectroscopic and chemometric techniques are powerful tools to detect fraud, prevent criminal activities of fraudsters, and ensure food chain safety, and future studies should lead to further progress, such as portable and hand-held spectroscopy devices for rapid on-site analysis, in this field. There have been also many issues on the effects of processing on garlic’s bioactive compounds, potential toxicities, pharmacokinetics, and safety profile of these elements that should be studied to validate the health advantages of garlic in humans. In this review, the outcomes of recent experimental and clinical reports are reviewed and metabolism pathway, bioavailability, biological/therapeutically effects, food-related applicability, methods of adulteration detection, potential toxicities, and safety profile of garlic’s derived bio-compounds are discussed. © 2022 Taylor & Francis.

A Critical Review on the Nutritional and Medicinal Profiles of Garlic’s (Allium sativum L.) Bioactive Compounds

This study evaluated the effects of processed garlic (PG) on the systolic blood pressure (SBP) and the diastolic blood pressure (DBP) of spontaneously hypertensive rats (SHR) and on the BP of hyperten- sive humans. The color of raw garlic changed to black through enzymatic browning over two-week processing periods, and the active compound S-allyl-ʟ-cysteine was analyzed and calculated as 75.3 mg/100 g in PG. PG was found to effectively reduce the blood pressure of SHR after 4, 6, and 8 weeks with a single daily dose of 30 and 50 mg/kg. We conducted a placebo-controlled trial to test the efficacy of PG on lowering SBP and DBP of 44 hypertensive subjects over a period of 8 weeks. PG significantly lowered SBP after only 2 weeks (p<0.01), while a significant reduction in DBP (p<0.05) took 8 weeks. This significant DBP reduction was also found in the placebo group (p <0.05), which might be attributed to a placebo effect. After 8 weeks, PG lowered SBP by 8.05 mmHg. In conclusion, taking two 500 mg capsules of PG for 8 weeks can significantly lower blood pressure in hypertensive subjects.

/pdf/antihypertensive-activities-of-processed-garlic-on-3wih6rlgkb.pdf

Antihypertensive activities of processed garlic on spontaneously hypertensive rats and hypertensive humans.

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Antihypertensive activities of processed garlic on spontaneously hypertensive rats and hypertensive humans.