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True or False: Eating garlic lowers cholesterol?

Posted on April 24, 2019

False.

GARLIC (ALLIUM SATIVUM) is often used to flavor foods and is well known for its strong, distinctive odor. Because of its aromatic properties, garlic is sometimes affectionately referred to as the “stinking rose.”

Many years ago my wife and I went to San Francisco to attend a conference, and while on a long walk we came across a restaurant called The Stinking Rose. She LOVES garlic, so we decided to stop for dinner.

I’ll never forget the overwhelming smell of garlic when we walked in    the door. I’ll also never forget the first item on the menu: 50 Clove Garlic Chicken Breast—chicken breast adorned with 50 cloves of garlic. My wife was in heaven!

Garlic contains allicin, which has been shown to kill some bacteria and fungi. Garlic is touted for having many health benefits such as preventing colds and the flu as well as lowering high blood pressure and  cholesterol.

But let’s focus on whether garlic is effective at lowering cholesterol, and let’s begin by reviewing the two types of cholesterol we measure: LDL and HDL.

LDL, or low-density lipoprotein (often called bad cholesterol), is a fat/ protein complex that carries cholesterol to the arteries and contributes to cardiovascular disease.

HDL, or high-density lipoprotein (often called good cholesterol), is a fat/ protein complex that carries cholesterol from the arteries to the liver for removal and helps decrease the risk of cardiovascular  disease.

Health professionals recommend keeping total cholesterol below 200 mg/dl and LDL cholesterol below 100 mg/dl. Ideally, HDL should be 60 mg/dl or higher.

Now back to garlic. Garlic can be eaten raw or can be taken as a supplement available as a powder, tablet or capsule. Garlic is generally considered to be safe, but there can be some mild side effects from garlic such as bad breath, general body odor and gastrointestinal distress.

It is also important to note that garlic can affect the body’s ability to clot blood, so individuals taking a blood thinner should talk to their physician if they decide to start eating lots of garlic or taking a garlic supplement.

The author Khoo (2009) published a meta-analysis in the Journal of Clinical Pharmacy and Therapeutics on whether garlic lowers cholesterol levels. Khoo identified 1,228 research articles on garlic and, using strict inclusion criteria to ensure that he chose only studies of the highest quality, identified 13 research studies that tested 1,056 subjects. Khoo’s findings: “The available evidence from randomized controlled trials does not demonstrate any beneficial effects of garlic on serum cholesterol.”

Khoo also states that recommendations by proponents of complementary and alternative medicine to increase garlic consumption as a way to reduce the risk of cardiovascular disease should be viewed with caution.

I’m not a huge garlic fan, but I do think it adds a desirable flavor to many of the foods we prepare at home. If my wife and I ever take another trip to San Francisco, you can bet that we will likely make a repeat visit to The Stinking Rose restaurant.

Khoo., Y.: Garlic supplementation and serum cholesterol: a meta-analysis. Journal of Clinical Pharmacy and Therapeutics (2009), Vol 34, pp. 133-145.

Categories: Myths

True or False: Grapefruit juice can impact many medications?

Posted on April 2, 2019

True.

I WASN’T MUCH of a grapefruit fan growing up—that is, unless my mother cut the grapefruit in half, separated the pulpy and meaty portion of the fruit from the tough—and sometimes bitter—skin surrounding it, and covered the entire surface with sugar.

I find it interesting that my kids are the same way—and they weren’t even around when I was growing up! As an adult I now enjoy peeling a grapefruit and eating it slice-by-slice, the way most people eat oranges.

Grapefruit is healthy; it’s low in calories, it contains lots of vitamins and minerals, it’s a good source of fiber, and it contains antioxidants. Most of us can consider grapefruit a “safe” fruit.

However, it is true that grapefruit or its juice can have a negative impact on many medications. You should exercise caution if you take medication and you want to eat grapefruit or drink grapefruit  juice.

Grapefruit juice doesn’t interact directly with medications; it inhibits an enzyme in your small intestine that works to break down certain medica- tions. Interfering with that enzyme can result in too much medication enter- ing your blood, potentially leading to a dangerous situation.

This phenomenon was accidentally discovered in the late 1980s. Researchers investigating the interaction of alcohol and the prescription drug felodipine used grapefruit juice to cover up the taste of the alcohol. However, one result of the study was a large increase of felodipine in the blood of research participants.

Grapefruit juice can also have the opposite effect, lowering the concentra- tion of a few medications in the blood.

There are dozens of medications that can be negatively affected by grape- fruit juice, including those for pain control, hypertension, allergies, high cholesterol, depression, epilepsy, heart disease and asthma.

In an article published in Nutrition Journal, authors Kiani and Imam (2007) state, “Grapefruit juice is consumed widely in today’s health-conscious world as a protector against cardiovascular disease and cancers. It  has, however, been found to be an inhibitor of the intestinal cytochrome P-450 3A4 system, which is responsible for the first-pass metabolism of many drugs.”

The authors also cautioned, “In light of the wide-ranging effects of grape- fruit juice on the pharmacokinetics of various drugs, physicians need to be aware of these interactions and should make an attempt to warn and educate their patients regarding potential consequences of concomitant ingestion of these two items.”

Other citrus fruits that may interact with medications  include  Seville oranges and tangelos. Lemons, limes and regular oranges generally are thought to have a low risk of interacting with  medications.

If you take prescription or over-the-counter medications, have a conversation with your doctor or pharmacist if you wish to eat grapefruit or drink grapefruit juice.

Kiani, J., & Imam, S.: Medicinal importance of grapefruit juice and its interaction with various drugs. Nutrition Journal (2007), Vol 6, pp. 33-41.

 

Categories: Myths