The Role of Detoxification in the Prevention of Chronic Degenerative Diseases: A Summary

Low-level, long-term exposure to toxins such as heavy metals (e.g. lead, mercury, arsenic, cadmium), pesticides, industrial compounds, and pollutants is associated with chronic fatigue syndrome (CFS), multiple chemical sensitivities (MCS), fibromyalgia (FM), neurodegenerative diseases such as Parkinson’s and atherosclerosis, and many types of cancers.^1-4 Common signs and symptoms of environmental toxicity include acne, rashes, headaches, aches and pains, fatigue, muscle weakness, tinnitus, fertility problems, memory loss, and chronic immune system depression.

Toxins can remain in the body for many years; therefore, we are exposed to much higher toxin doses than present environmental concentrations suggest. Research suggests we all maintain toxin contamination within our bodies on a regular basis due to this lifetime of exposure.

How Does the Body Remove Toxic Substances?

An individual’s ability to remove–or detoxify–toxins is a primary factor in susceptibility to toxin-related conditions.^5-11 In order to remove (excrete) the multitude of diverse toxins, the body has a complex system that converts them into non-toxic molecules for removal. This complex system occurs in two phases—Phase I and Phase II—that together convert (biotransform) a toxic molecule into a non-toxic molecule that can be easily excreted. The majority of detoxification occurs in the liver; however, all tissues have some ability to detoxify, including the intestines, skin, and lungs.

In Phase I, a functional group is added to the toxic molecule producing an intermediate that needs to be further transformed. Phase II detoxification involves a process called conjugation, in which various enzymes in the liver attach protective compounds to the intermediate, making it less harmful and more readily excretable. Because the products of Phase I can be highly reactive and more harmful than the original compound, achieving and maintaining a balance between the Phase I and Phase II processes is critical. Furthermore, a significant side effect of all this metabolic activity is the production of free radicals as the toxins are transformed, resulting in oxidative stress. Nutrients that help protect from oxidative stress include vitamins C and E, zinc, selenium, and copper.^12,13

Achieving Balanced Detoxification

Optimal detoxification requires that both Phase I and Phase II pathways function optimally and in balance with each other. Bifunctional modulators are phytonutrients that support balanced detoxification by modulating Phase I and promoting Phase II. This minimizes damage by reactive intermediates and free radicals. Fruits and vegetables contain many bifunctional modulators, which is one reason these foods are associated with reduced susceptibilities to cancer and degenerative diseases.¹⁴

Nutritional Support for Detoxification

Detoxification is an energy-requiring process that puts a metabolic burden on the body. Therefore, water or juice fasts are not beneficial because they deplete the body of the essential nutrients required for healthy detoxification. These fasts can have many adverse health effects, including decreased energy production, breakdown of lean tissue instead of fat, increased oxidative stress, and unbalanced detoxification.^15,16

Instead of decreasing nutrient support, a focused, high-impact, low-allergy-potential source of macronutrients should be provided. High-quality protein provides methionine and cysteine, which are beneficial to Phase II and may help with toxic metal burdens.¹⁷ Medium chain triglycerides (MCTs) support energy production,¹⁸and olive oil may protect against chemically-induced liver damage.¹⁹ Fiber supports fecal excretion of toxins and the integrity of the intestinal barrier, which decreases toxic burden. In particular, rice bran can directly bind some toxins, thereby removing them before they can enter the body and cause damage.²⁰

Nutrients that support energy production include vitamin B1 (thiamin), vitamin B2 (riboflavin), niacin, vitamin B5 (pantothenic acid), and magnesium. In addition, the following nutrients and phytonutrients provide targeted support for optimal detoxification:

N-Acetylcysteine and Sodium Sulfate promote generation of glutathione, which is used in Phase II and is a major route for detoxification of heavy metals, and supports Phase II sulfation.^16,21

Vitamin B12, Folate, Methionine, and Choline promote balanced detoxification by supporting Phase II methylation and healthy homocysteine recycling. Choline deficiency is causative for liver disease, and is a newly-designated essential nutrient.^22-24 The biologically-active, natural form of folate is 5-methyltetrahydrofolate.²⁵

Ellagic Acid from pomegranate significantly reduces tumors in animals with chemically-induced cancers, protects from toxin liver damage, enhances glutathione production, decreases lipid peroxidation, and binds some metals, thus promoting their excretion.^26-29 It is a bifunctional modulator that can bind some toxins directly, rendering them non-toxic, and can directly bind and protect DNA.^30,31

Catechins from green tea are bifunctional modulators that are strong antioxidants possessing anticarcinogenic and antimutagenic potential.^32,33Catechins are associated with lower incidence of Parkinson’s disease.^33,34The National Cancer Institute is currently investigating the chemotherapeutic potential of green tea catechins.³⁵Catechins also promote healthy gastrointestinal function.³⁶

Watercress (Nasturtium officinale) contains high levels of glucosinolates, which are precursors to several bioactives that can inhibit chemically-induced cancers in animals, and promote excretion of carcinogens in humans.^37-41 The bifunctional activity of watercress is one of the proposed mechanisms for its chemoprotective effect.^37,42-44

Silymarin from milk thistle is a well-known liver-protectant that may improve liver function in patients with liver disease and toxicity.^45-47 Silymarin increases glutathione and is a strong antioxidant.^46-49

Artichoke (Cynara scolymus) is also a liver-protectant with a long history of traditional use that provides strong antioxidant protection and may decrease the loss of glutathione after toxic exposure.^50-53

Summary

Minimizing exposure to toxins is only one part of a beneficial detoxification program. Low-allergy potential, targeted nutrition providing the full spectrum of Phase II supportive cofactors, bifunctional modulators for balanced detoxification, and support for energy production and excretion may optimize balanced detoxification and promote optimal health throughout life.

 

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Health Care Guidelines Issued For School Athletes

NEW YORK (Reuters Health) - Schools and other organizations that sponsor teen athletic programs should do more to ensure school-aged athletes stay healthy and injury-free, according to new guidelines.

The recommendations, issued by the National Athletic Trainers' Association (NATA) and 16 other professional organizations, call for high schools and groups that sponsor teen sports to set up "athletic health care teams."

The teams -- including a physician and an athletic trainer who is on-site during practice and competition -- should not only treat injuries but also have comprehensive plans for preventing them, according to the guidelines.

More than 7 million U.S. high school students participate in school sports -- with numerous benefits, NATA points out. Still, roughly 715,000 students suffer sports- or recreation-related injuries in schools each year, and many could be prevented.

"Appropriate medical care of athletes involves more than just basic emergency care during sporting events," Jon Almquist, chair of the task force that created the guidelines, said in a statement.

"To reduce injuries, organizations sponsoring athletic programs need to establish an athletic health care team that functions to ensure appropriate medical care is provided for all participants; this can go a long way in preventing minor injuries from becoming more significant time-loss injuries."

The task force recommendations, which are published in NATA's Journal of Athletic Training, state that yearly pre-season medical screening of all high school athletes is "essential" to spot teens who are at risk for injuries or more serious problems such as a heart defect.

Such pre-participation screening is required in schools, but it should be encouraged in community sports programs as well, according to the guidelines.

The recommendations also call on organizations to ensure that their facilities and equipment are safe and well-maintained; that there is always a qualified professional on site to take care of athletes' injuries or illnesses, and to oversee their recovery after an injury; and that they give athletes sound advice on nutrition and health.

Athletic health care teams should also try to spot potential "psychosocial" problems, such as eating disorder symptoms, and refer those teenagers for a proper diagnosis and treatment.

According to task force member Dr. Keith J. Loud, of Children's Hospital Medical Center in Akron, Ohio, the recommendations underscore the importance of preventing and treating problems that could eventually "sideline an athlete in a variety of ways throughout life."

SOURCE: Journal of Athletic Training, July 2008.

 

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Healthy Habits Key to Longer Life For Men

NEW YORK (Reuters Health) - Elderly men can improve their chances of having an even longer and healthier life by quitting smoking, controlling their weight, getting their blood pressure and blood glucose under control and exercising regularly, a study shows.

But making such changes is, of course, easier said than done, Dr. Laurel B. Yates of Brigham and Women's Hospital, the study's lead author, admitted in an interview with Reuters Health. "Lifestyle factors are the hardest things to do -- it's much easier to take a pill," she said. Nevertheless, she added, the rewards will include not only longer life but healthier, well-functioning years at the end of that life.

While a healthy lifestyle is understood to lead to a healthier life, the issue of whether pursuing healthy habits matters as much among older people has been controversial, Yates noted. To investigate, she and her team followed a group of 2,357 men participating in the Physicians' Health Study to determine which factors were associated with living to age 90. The men, whose average age was 72 at the study's outset, were followed for 25 years.

Forty-one percent of the men lived to be 90 or older. Smokers were half as likely as non-smokers to reach their 90th birthdays, while being diabetic, obese, or having high blood pressure also boosted mortality. Men who exercised regularly were 28 percent less likely to die during the study.

At age 70, men who didn't smoke, weren't obese, had normal blood pressure, were free from diabetes and exercised regularly had a 54 percent chance of living for at least another 20 years. But among 70-year-olds who smoked, were obese, had hypertension and diabetes, and were sedentary, just 4 percent reached age 90.

The longer-lived men also had better physical function and mental well-being as they aged, and developed heart disease or cancer years later than their shorter-lived peers.

"It does seem that, yes, there is something a person can do to increase the probability that he will have increased life span and good years at the end of that time," Yates said. It's likely, she added, that the same would hold true for women.

"This study suggests that adherence to sound medical management and lifestyle management pays enormous dividends in life extension and probably substantial reductions of aggregate medical care costs," Dr. William J. Hall of the University of Rochester School of Medicine & Dentistry in Rochester, New York, writes in an editorial published with the study.

SOURCE: Archives of Internal Medicine, February 11, 2008.

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Bad Backs, Good Sex

Few topics are taboo in chiropractor Donna Schoales's office. Even marital troubles come up for discussion. But when it comes to how back pain is affecting their sex life, most people clam up. "My patients get very open with me with a lot of other issues," Schoales says. "But I think I can count on both hands the number of times that a discussion about sex and back pain has come up over the past 17 years."

That's too bad, because statistics indicate eight in 10 people experience back pain at some point in their life. And when they do, sex is one of the first things that men and women avoid, even though it can be just as comfortable with a few modifications.

In fact, according to Maine physical therapist Lauren Hebert, author of Sex and Back Pain, people with back pain who aim to learn and practice pain-free techniques and positions with their partner often improve their sex life for good. "I have had people say that their sex life is better since they had a back problem and started using my book," he says. "It opens things up for them, forces them to talk about it and communicate."

Schoales, a Toronto-based chiropractor, agrees that communication is essential, because relationship problems often develop when people have long-term, chronic pain and don't explain what they're experiencing to friends and family. "Often, people will say 'my family doesn't understand the pain I'm going through,'" says Schoales. "That can occur when people have pain that's not related to something visible. With back pain, people can't see that you have a cast on your arm or a gash on your leg."

Communication is usually the biggest challenge, as most back pain doesn't involve actual sexual function. In fact, Hebert says that even in extreme cases of back pain he doesn't recommend people stop being sexual. "There can be very passive positions people can take," he says.

The key is to open up enough to discuss which positions are comfortable and which aren't. "Learn what you can and cannot do physically," he says. "If you really can't talk about it, then just use a book-marking technique, where you bookmark pages in my book that contain positions that are of concern to you, hand that to your partner and have him or her do the same."

It's also important that you don't worry excessively about your performance, and that you don't try too hard and get aggravated. To help, it's good to emphasize eroticism and use more foreplay. Romantic massages, hot baths and showers facilitate relaxation and loosen muscles. Massages are especially useful, as they can also help calm the nervous system. "That way you're not starting out with fear, tension, spasm and pain," says Hebert. "You're putting that off and replacing it with something a bit more comforting."

After selling over one million copies of his book and having thousands of clinics in North America and Europe use it to educate patients, Hebert can be confident that his advice will help people with back pain return to sexual activity. And even if the sales weren't enough, there's always the anecdotal evidence. "I frequently get notes from people who say 'I bought your book and it saved my marriage,'" he says.

Part of that success may be due to the book's easy-to-use categorization. Hebert realized that sex generally only involves two back movements: forward bending (flexion) and backward bending (extension). So he used those movements as a starting point. "I thought, well, when it comes to sex there are going to be positions that will bend the spine one way and positions that will bend the spine the other way," he says. "So, using a physical therapist model of categorizing back pain, I could easily fit the various sex positions in."

Patients who have back pain during even slight movements should see Hebert's section on brittle back, while those with more pain while bending backward should see the section on extension pain and those with more pain while bending forward should see the section on flexion pain. Then, they should discuss their concerns with their partner, plan an intimate evening that begins with a warm bath or massage and follow the instructions.

Brittle back

Brittle back refers to serious back conditions that make even slight movements uncomfortable. Patients with such a condition should try lying on their back on a firm surface and using pillows or rolled towels to provide support behind their knees, head and, if it helps, low back. They should also take a passive role while their partner does most movement slowly, and should communicate with their partner to tell him or her when anything is causing discomfort.

Extension pain

Patients who have pain during extension might find many traditional positions uncomfortable. In searching for a more comfortable position, the most important thing they should do is support their low back. A woman can try lying with a rolled towel under her low back and bending her legs as little as possible. A man can try using a rolled towel under his low back while his partner straddles him. Both men and women with extension pain should also consider seated sex. A chair will provide support for a man's low back, and by sitting on her partner's lap a woman can control the pace to minimize discomfort.

Flexion Pain

Patients who have flexion pain should carefully monitor their posture during sex to avoid forward-bending positions. Often, it's best for people with this type of pain to adopt a more passive role during sex. A woman should try lying on her back in the standard missionary position with her knees bent toward her chest, or using a chair and sitting on her partner's lap while controlling the pace. A man with flexion pain may want to sit in a chair as well, or can ask his partner to adopt the traditional missionary position and raise her bottom with pillows to ease the amount of forward bending he must do.

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Adjustments Keep Musicians in Tune

Nothing about playing a musical instrument is comfortable for the body. Holding up a clarinet -- or worse, a flute -- or contorting one's hands through guitar chords takes its toll.

And too often when musicians are injured, the medical advice they get is to just stop playing. That's what happened to Kee Fedak when he was a music student at university. He's now a chiropractor and cofounder of the Performing Artists' Health Center in Arlington, Texas.

"I think my experience with the medical doctor is what a lot of students and a lot of professionals experience," he says. "I was told that I need to stop playing for six months and see how it goes. Well, you can't tell a musician to do that."

After university, Fedak studied piano performance at the esteemed Royal Conservatory of Music in Toronto and at the University of Montreal. He then turned his attention to another calling, and went to Parker College of Chiropractic in Dallas. As a musician himself, he says, he understands how emotionally devastating an injury can be if it prevents you from playing.

"It's very, very dangerous when a musician is told to stop playing because if they're away from their instrument for even a day, it affects their technique and their ability," says Fedak.

Good health reasons

It's not just a matter of staying in the groove, though. Fedak points out some good health reasons for musicians not to stop playing when they're injured.

"If they have to stop for a week or two weeks or, say, even a month, that can be a lot more damaging than good because the tone in the muscles starts to decrease," he says.

The injuries that musicians get are as varied as the instruments they play. Cellists often have problems with their shoulders. Drummers tend to have tendonitis and low-back pain. Brass players sometimes have neck problems. And because playing any musical instrument involves repetitive motions, all musicians are susceptible to cumulative trauma disorders such as carpal tunnel syndrome.

Having an injury can be especially difficult for students of music, says Fedak. They are often forced to change their major within music, out of performance and into composition or history. And some leave their music education behind altogether.

"For professional musicians it's the same thing," says Fedak. "I've seen professional musicians who've injured themselves playing and it's like cutting off an arm for them. They can never get it back. And they have to do something else, some other job that they never dreamt that they would do. That can be extremely depressing."

Biomechanics are key

Fedak's experience with his own injury and medical treatment is part of the reason he got involved with the Performing Artists' Health Center, which opened this past June.

"One of the things that we pride ourselves on in this clinic is that we spend a lot of time looking at the biomechanics, looking at how the musician is holding their instrument, sitting at their instrument," says Fedak. "Because playing any kind of musical instrument is unnatural. There's no way you can say that playing the violin is natural for the body."

And unlike computer equipment, musical instruments can't be redesigned to fit the body better. A flute with a bend in it to make it easier to play no longer sounds just like a flute, says Fedak. It's a different instrument. And while some ergonomic violins have been built with body-contoured slots cut out of them, that's simply not an option for many professional concert violinists.

"If you're a concert master with a major orchestra, you're probably playing a priceless violin and if you have a problem, you cannot cut into a Stradivari," says Fedak.

Chiropractors offer relief

So, if the instruments can't change and the show must go on, musicians are limited in what they can do. That, says Fedak, is where chiropractic comes in. He says that chiropractors' approach to health care -- seeking out and correcting the cause of pain and stiffness -- is ideal for musicians.

"As a student of chiropractic and a musician at the same time, I saw a direct benefit to the musical community in what chiropractors can do. Chiropractors get to the heart of the mechanics of the body and we have seen some dramatic results."

Fedak and his partner Franz Pavalock have cared for professional orchestral musicians in the Dallas-Fort Worth area, as well as students taking music at various Texas universities. But it's not just classical musicians who injure themselves playing. The Performing Artists' Health Center also sees rock and blues musicians who play in area clubs and bars. And it isn't just musicians who play instruments who use the center, either.

"Singers, for instance, they benefit enormously from chiropractic because you can free up the rib cage, free up the back of the neck," says Fedak. "They can breathe a lot better, and because most of the time they're standing on stage, their ability to project their voice is enhanced, as well."

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Glucosamine and Chondroitin for Treatment of Osteoarthritis

Osteoarthritis is a chronic condition of the joints that leads to the degradation of cartilage and friction between bones. This process can cause severe pain, swelling, stiffness, and limited range of motion in affected joints.

Currently, more than 20 million people in the United States have osteoarthritis and according to Dr. Timothy McAlindon and colleagues in The Journal of the American Medical Association, osteoarthritis "...is a major public health problem for which there are few effective medical remedies."

Conventional medical treatment of osteoarthritis generally consists of non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen, and acetaminophen. However, these drugs are often accompanied by adverse side effects including heartburn, indigestion, pain, nausea, and bleeding of the stomach.

In a search for safer treatments, researchers have identified natural alternatives, such as glucosamine and chondroitin. These compounds naturally occur in human cartilage and certain food sources. They have been widely used in Europe and have recently gained popularity in the U.S. as safe and effective anti-inflammatory agents.

In order to fully evaluate the benefits of glucosamine and chondroitin in relieving the pain associated with osteoarthritis, Dr. McAlindon and colleagues examined 15 previously conducted trials that tested the effects of these compounds on knee or hip osteoarthritis.

Upon completion of their in-depth investigation, researchers concluded that glucosamine and chondroitin are safe and effective in treating osteoarthritis symptoms.

JAMA 2000;283(11):1469-75.

 

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Calorie Curb Boosts Heart Function in Obese Diabetics

NEW YORK (Reuters Health) - In obese patients with type 2 diabetes, increased triglyceride stores in the heart can be mobilized by therapeutic prolonged caloric restriction, Dutch researchers report in the September 16th issue of the Journal of the American College of Cardiology.

"As this mobilization is accompanied by improvements in diastolic function," lead investigator Sebastiaan Hammer told Reuters Health, "the study implicates the possibility of reversing, at least to some extent, the effects of obesity and diabetes on the heart."

Hammer and colleagues studied 12 obese insulin-treated patients who adhered to a very low calorie diet (450 kcal/day; Modifast, Nutrition & Sante) for 16 weeks. Insulin treatment was stopped during this period.

At the end of the intervention period, mean body mass index had fallen from 35.6 to 27.5 kg/m², and mean hemoglobin A1c had dropped from 7.9% to 6.3%.

The researchers also found that myocardial triglyceride content had fallen from 0.88% to 0.64%, in association with improved diastolic function (as reflected by the ratio between the early and atrial filling phase).

Hammer told Reuters Health that the magnetic resonance spectroscopy techniques his team used to determine myocardial triglyceride content "show the potential of metabolic cardiovascular imaging in detecting the effects of metabolic disease on the heart."

In particular, he said, "quantification of myocardial triglyceride stores may in the future be used as a new marker for the risk of heart disease in metabolic disease."

J Am Coll Cardiol 2008;52:1006-1012.

 

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Sleep Apnea May Trigger Nighttime Heart Attack

NEW YORK (Reuters Health) - The blood pressure, nerve, and hormonal changes wrought by obstructive sleep apnea (OSA) may increase the risk of heart attack during the night, new research suggests.

OSA is a common problem in which tissues in the back of the throat temporarily collapse during sleep causing numerous, brief episodes of interrupted breathing. The condition, which can cause extreme daytime sleepiness, can be effectively treated with a special breathing device that alleviates the blockage by pushing air into throat.

The body changes that occur with OSA may lead to blockage of the coronary arteries and heart attack, Dr. Virend K. Somers and associates explain in the Journal of the American College of Cardiology. If OSA is a trigger for a heart attack, a peak of heart attack symptoms would be expected during the night.

To investigate this premise, Somers at the Mayo Clinic in Rochester, Minnesota, and colleagues studied 92 heart attack patients in whom the time the chest pain began could be documented. The patients underwent overnight sleep tests 2 to 3 weeks after their heart attack.

OSA was identified in 64 patients (70 percent). Those with and without OSA were generally similar in terms of their health background and current medications.

From midnight to 6 am, the frequency of heart attack was higher in OSA patients, whereas from 6 am to noon, it was higher in patients without OSA. All told, patients with OSA were 6-times more likely to have to have a heart attack at night compared with patients without OSA.

These findings suggest that nighttime heart attacks may contribute to the increased likelihood of nighttime sudden death that has been reported in OSA patients, Somers' group concludes.

The researchers recommend that patients with a heart attack at night be evaluated for OSA.

SOURCE: Journal of the American College of Cardiology, July 2008.

 

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Vitamin B6 and homocysteine changes seen in women with rheumatoid arthritis

NEW YORK (Reuters Health) - Compared with healthy women, those with rheumatoid arthritis are deficient in vitamin B6 and have elevated levels of homocysteine, which may contribute to the increased risk of cardiovascular events seen with the disease, new research shows.

The vitamin B6 deficit appears to be the result of altered metabolism, not reduced dietary intake, according to the report in the Journal of the American Dietetic Association for March. The results also indicate that as vitamin B6 levels drop and homocysteine levels rise, disability status worsens.

Numerous reports have shown that rheumatoid arthritis patients are at risk for early death from cardiovascular disease, the authors point out. The reason for the elevated risk, however, is unclear since there is evidence that traditional cardiovascular risk factors, such as hypercholesterolemia, are no more prevalent in arthritis patients than in healthy individuals.

Furthermore, through mechanisms that are unclear, plasma homocysteine increases the risk of cardiovascular disease. Findings from several studies have indicated that homocysteine metabolism is altered with rheumatoid arthritis, which may in turn relate to changes in how vitamin B6 is processed.

Prior research has shown a poor vitamin B status in rheumatoid arthritis patients, co-authors Dr. Kathleen Woolf and Dr. Melinda M. Manore comment, but the studies did not provide adequate information to determine whether this was simply a result of low dietary intake.

The present findings, from a study of 18 patients and 33 healthy controls, indicate that dietary intake of B vitamins is not decreased in rheumatoid arthritis patients, yet they still show a deficit of vitamin B6. Consistent with this finding, rheumatoid arthritis was also associated with increased levels of homocysteine. None of the subjects in the study were using B vitamin supplements.

Red blood cell folate levels were decreased in rheumatoid arthritis patients relative to controls, whereas no significant differences were noted in plasma levels of folate, vitamin B12, and transcobalamin II.

In agreement with some earlier research, levels of total cholesterol and LDL cholesterol were actually lower in patients than in controls (p < 0.05).

"When registered dietitians are working with individuals with rheumatoid arthritis, they should assess B-vitamin status and plasma total homocysteine concentrations," emphasize Dr. Woolf, from Arizona State University in Mesa, and Dr. Manore, from Oregon State University in Corvallis.

"Individuals with rheumatoid arthritis may need to get more B vitamins through diet, supplements, or fortified foods. Foods that are especially high in vitamin B6 are meats, fish, poultry, legumes, noncitrus fruits, fortified cereals, and soy products."

J Am Diet Assoc 2008;108:443-453.

 

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Garlic supplements help lower high blood pressure

Last Updated: 2008-07-30 13:37:01 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Garlic supplements may lower blood pressure just as effectively as some drugs used to treat hypertension can, according to a new research review.

"Supplementation with garlic preparations may provide an acceptable alternative or complementary treatment option for hypertension," Dr. Karin Ried and colleagues from The University of Adelaide in South Australia write.

Research to date on garlic and blood pressure has had "inconclusive" results, they note, while the last meta-analysis - in which the results of several studies are analyzed collectively -- only included studies done up until 1994.

To provide an updated perspective, Ried and her team included more recently published studies in their analysis, identifying 11 studies in which the patients were randomly assigned to garlic or placebo. In most studies, participants given garlic took it in powdered form, as a standardized supplement. Doses ranged from 600 mg to 900 mg daily, which study participants took for 12 to 23 weeks.

When the researchers pooled the data from the trials, they found that garlic reduced systolic blood pressure (the top number in a blood pressure reading) by 4.6 mm Hg, on average. An analysis limited to people with high blood pressure showed garlic reduced systolic blood pressure by 8.4 mm Hg, on average, and diastolic blood pressure (the bottom number) by 7.3 mm Hg. The higher a person's blood pressure -was at the beginning of the study, the more it was reduced by taking garlic.

The effects were similar to those of widely used drugs for treating hypertension, for example beta blockers, which reduce systolic blood pressure by 5 mm Hg, and ACE inhibitors, which produce an 8 mm Hg average drop in systolic blood pressure, the researchers note.

The 600 mg to 900 mg dosage used in the studies is equivalent to 3.6 mg to 5.4 mg of garlic's active ingredient, allicin, Ried and her team point out. A fresh clove of garlic contains 5 mg to 9 mg of allicin.

In the population as a whole, they note, reducing systolic blood pressure by an average of 4 to 5 points and diastolic blood pressure by 2 to 3 points could cut the risk of heart disease and heart disease-related death by up to 20 percent.

More research is needed to determine whether garlic supplementation might have a long-term effect on heart disease risk, the researchers conclude.

SOURCE: BMC Cardiovascular Disorders, published online June 16, 2008.

 

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