The enthusiasm is based on a collection of double-blind studies that, when put together, find that garlic can lower total cholesterol levels by about 9 to 12%. However, new studies have cast doubt on whether garlic really works at all.

A negative study on garlic was recently published in the Journal of the American College of Cardiology. This well-designed double-blind placebo-controlled trial followed 50 individuals with high cholesterol. Half of the participants received 900 mg daily of a standardized garlic extract for 12 weeks. The results showed no significant difference between the treated and placebo groups. Other studies with negative results were reported in 1995, 1996, and 1998; they enrolled a total of about 175 individuals.

Based on these four studies, serious questions have surfaced regarding using garlic to reduce cholesterol.

Older Studies Found Benefits
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Looking back, older studies provide impressive evidence for garlic. One relatively well-designed, double-blind placebo-controlled study followed 261 patients at 30 medical centers who were given either 800 mg of standardized garlic daily or placebo. Over 16 weeks, patients in the treated group experienced a 12% drop in total cholesterol and a 17% decrease in triglyceride levels; these results were significantly better than the placebo group. This study enrolled more participants than any of the negative studies.

Another well-designed study compared garlic to the standard cholesterol-lowering drug bezafibrate, and found them equally effective. Dozens of other studies have also found positive benefits.

Why are there contradictory studies? Can garlic treat high cholesterol or not?

The Power of Diet

A close look at all the negative studies shows there is one feature in common: the researchers put all participants on a heart-healthy diet.

A heart-healthy diet, which is low in saturated fat and high in healthy foods, is well-known to lower cholesterol quite effectively by itself. This type of diet typically achieves an 8 to 10% reduction in total cholesterol, making it about as powerful as garlic (according to the positive studies).

Therefore, it is perfectly possible that any benefit in the negative studies due to garlic was hidden behind the benefits of a healthy diet. To put it another way, if you eat a cholesterol-lowering diet, taking garlic may not provide much additional benefit. On the other hand, if you don’t eat the way you should, garlic may be very helpful.

Other Possible Heart Healthy Benefits of Garlic

Keep in mind that garlic may benefit the heart in other ways. It seems to help many factors at once, including reducing blood pressure, protecting against free radicals, and slowing blood coagulation. The combined effects appear to be positive. One double-blind placebo-controlled study that followed 152 individuals for 4 years found that garlic significantly reduced the development of atherosclerosis.

Putting all this information together, it does seem that garlic can be helpful in preventing heart disease, strokes, and other consequences of atherosclerosis.

How to Use Garlic

The usual dose of garlic is 300 mg three times daily of an extract standardized to contain 1.3% alliin. Aged garlic extracts (which contain no alliin) at a dose of 1 to 7.2 g daily may be effective as well.

Warning: Garlic presents certain health risks because it thins the blood. See the Garlic Encyclopedia entry for more information.

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