FROM:
Ann Intern Med 1993 (Oct 1); 119 (7 Pt 1): 599–605
Warshafsky S, Kamer RS, Sivak SL
Department of Medicine,
New York Medical College,
Valhalla 10595
OBJECTIVE: To assess the size and consistency of
garlic's effect on total serum cholesterol in persons with
cholesterol levels greater than 5.17 mmol/L. (200 mg/dL).
DATA SOURCES: Clinical trials were identified by a
computerized literature search of MEDLINE and by an assessment of
the bibliographies of published studies and reviews.
STUDY SELECTION: Trials were selected if they were
randomized and placebo-controlled and if at least 75% of their
patients had cholesterol levels greater than 5.17
mmol/L (200 mg/dL). Studies were excluded if they did not provide
enough data to compute effect size. Five of 28 studies were
selected for review.
DATA EXTRACTION: Details of study design, patient
characteristics, interventions, duration of therapy, and
cholesterol measurements were extracted by one author and were
verified by another.
DATA SYNTHESIS: Study quality was evaluated by
multiple reviewers using a closed-ended questionnaire. Patients
treated with garlic consistently showed a greater decrease in
total cholesterol levels compared with those receiving placebo.
Meta-analysis of homogeneous trials estimated a net cholesterol
decrease attributable to garlic of 0.59 mmol/L (95% Cl, 0.44 to
0.74) (23 mg/dL {Cl, 17 to 29}) (P < 0.001).
CONCLUSIONS: Meta-analysis of the controlled trials
of garlic to reduce hypercholesterolemia showed a significant
reduction in total cholesterol levels. The best available
evidence suggests that garlic, in an amount approximating one
half to one clove per day, decreased total serum cholesterol
levels by about 9% in the groups of patients
studies.