garlic supplementation for hyperlipidemia soto, tanggol, teo, torio, torregrosa, tuddao, tumangday,...
TRANSCRIPT
![Page 1: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/1.jpg)
GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA
Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil
![Page 2: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/2.jpg)
![Page 3: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/3.jpg)
![Page 4: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/4.jpg)
NORMAL VALUES:
Total cholesterol:< 200 mg / dL (for >19 y/o)
Triglycerides:< 150 mg / dL
HDL-c:40 – 60 mg / dL
LDL-c:< 100 mg / dL
![Page 5: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/5.jpg)
![Page 6: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/6.jpg)
![Page 7: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/7.jpg)
![Page 8: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/8.jpg)
![Page 9: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/9.jpg)
![Page 10: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/10.jpg)
$
(+)
(-)
![Page 11: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/11.jpg)
“Does garlic
supplementation have a
lipid lowering effect in
hyperlipidemic patients?”
![Page 12: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/12.jpg)
P = Hyperlipidemic PatientsI = Garlic SupplementationC = PlaceboO = Lipid ProfileM = RCTs
![Page 13: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/13.jpg)
METHODOLOGY
![Page 14: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/14.jpg)
CRITERIA FOR CONSIDERING STUDIES
![Page 15: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/15.jpg)
• Randomized Controlled Trial- May or may not involve crossover period
• May be unblinded, single-blinded or double-blinded
• Published or Unpublished
• English Articles
TYPE OF STUDY
![Page 16: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/16.jpg)
• Adults (19 years old above)• With mild, moderate or severe
hypercholesterolemia• No comorbid illnesses• No other pathological clinical chemistries• Not taking any other medications• Not taking any substantial amount of
garlic in the diet
TYPES OF PARTICIPANTS
![Page 17: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/17.jpg)
• Garlic Supplementation– Any form (tablet, capsule, aged garlic
extract or oil for) versus placebo – May have minor ingredients that are not
known to have an effect on the outcome– May or may not be taken with meals– Any dose– At least four weeks of intervention
TYPES OF INTERVENTIONS
![Page 18: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/18.jpg)
• Total Cholesterol
• Low Density Lipoprotein Cholesterol (LDL-C)
• High Density Lipoprotein Cholesterol (HDL-C)
• Triglycerides
TYPES OF OUTCOME MEASURES
![Page 19: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/19.jpg)
• Systematic online article search via PubMed– MESH terms “garlic AND dyslipidemias”– LIMITS: humans, RCTs, English, All adult
19+
SEARCH METHODS FOR IDENTIFICATION OF STUDIES
![Page 20: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/20.jpg)
LIMITS: RCT, Humans, all adults > 19 y/o, English only
LIMITS: RCT, Humans, all adults > 19 y/o, English only
24RCTs 24RCTs
Studies that met the inclusion criteria
(n=14)
Studies that met the inclusion criteria
(n=14)
3 Full-text RCTs cannot be retrieved3 Full-text RCTs cannot be retrieved
11 Full-text RCTs included
11 Full-text RCTs included
Excluded studies (n=10)Excluded studies (n=10)
“Garlic” [MESH] AND “dyslipidemias” [MESH] (n=111) “Garlic” [MESH] AND “dyslipidemias” [MESH] (n=111)
![Page 21: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/21.jpg)
• Cross-referencing of all appraised articles– 2 articles included
• Free text search via Yahoo and Google search engine– Various combinations of the search terms
(cholesterol-lowering effects, garlic, allicin, allium sativum, hyperlipidemia, and hypercholesterolemia)
– 1 article included
SEARCH METHODS FOR IDENTIFICATION OF STUDIES
![Page 22: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/22.jpg)
SEARCH METHODS FOR IDENTIFICATION OF STUDIES
• Other Databases—Cochrane —Medscapepharmacist—HighWire Press (a
Division of the Stanford University Library)
—Herdin—DOH-OPAC—UP-PGH College of
Medicine OPAC
—UPD-College of Science OPAC
—UST-OPAC—Kansas University
Libraries OPAC —SLCM-WHQM Medical
Library OVID Program and Journal Collection
![Page 23: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/23.jpg)
SEARCH METHODS FOR IDENTIFICATION OF STUDIES
• Hand Searching– RBD-SLMC– Department of Nutrition-SLMC– Manufacturers of locally available garlic
supplements – Cardiologists at St. Luke’s Medical Arts
Building and Cathedral Heights Building Complex (CHBC) were also contacted through telephone and/or visits to their clinics
![Page 24: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/24.jpg)
• Assessed using the EBM approach
METHODOLOGICAL QUALITY
Rating Description
A All of the primary and secondary criteria was met
B At least one secondary criteria not met
C At least one primary criteria was not met but dropouts <20%
D At least one primary criteria was not met but dropouts >20%
![Page 25: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/25.jpg)
TOTAL NUMBER OF INCLUDED STUDIES
FOURTEEN
![Page 26: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/26.jpg)
• All double-blinded RCTs (n=14)– 4 studies with crossover
• Population– Hyperlipidemic male and female adults – No other comorbidities/abnormal serum
parameters aside from hypercholeserolemia– Not taking any garlic supplementation, any
other medications– No substantial amount of garlic in their diet
DESCRIPTION OF STUDIES
![Page 27: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/27.jpg)
• Thirteen of the fourteen studies were homogenous at baseline, the remaining study adjusted using analysis of covariance
• Thirteen randomized hyperlipidemic subjects with garlic versus placebo or no intervention, the remaining article
randomized hyperlipidemic subjects with garlic versus anethum graveolens or placebo
DESCRIPTION OF STUDIES
![Page 28: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/28.jpg)
• Intervention– Garlic supplementation• Form–Capsule or tablet
• Dose–Range: 400mg/day-7,200mg
• Duration–Range: 6 weeks-5 months
DESCRIPTION OF STUDIES
![Page 29: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/29.jpg)
Description of StudiesRating Description No. of Studies
A All of the primary and secondary criteria was met 3
B At least one secondary criteria not met 2
C At least one primary criteria was not met but dropouts <20%
9
D At least one primary criteria was not met but dropouts >20%
0
![Page 30: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/30.jpg)
• Mean change from baseline– Total Cholesterol, LDL-Cholesterol, HDL-
Cholesterol and Triglycerides
• Mean percent change– Total Cholesterol, LDL-Cholesterol, HDL-
Cholesterol and Triglycerides
MEASUREMENTS OF TREATMENT EFFECT
![Page 31: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/31.jpg)
SUBGROUP ANALYSIS
• Diet– No change in diet (n=7)– Diet Advice (n=2)– Strict Dietary Regimen (n=5)
• Sex– All males (n=3)– Males and Females (n=11)
![Page 32: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/32.jpg)
• Crossover Trials– The group used the lipid parameters
given in the study prior to the crossover period
• One study (Steiner, et al.) did not show the exact values , the group estimated the values through the given graphs
UNIT OF ANALYSIS ISSUES
![Page 33: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/33.jpg)
• Random Effects Model
• Fixed Effects Model
DATA SYNTHESIS
![Page 34: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/34.jpg)
RESULTS AND DISCUSSION
![Page 35: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/35.jpg)
14 INCLUDED STUDIES
1 excluded from statistical analysis
MEAN CHANGE(N = 592-625 )
MEAN PERCENT CHANGE(N = 183 )
SEX DIET
MIXED (M& F)
MALES only
NO dietary change
Dietary advice
Diet regimen
SEX DIET
MIXED (M&F)
MALES only
NO dietary change
Dietary advice
Diet regimen
Total cholesterol, LDL-C, HDL-C, Triglyceride
RESULTS
![Page 36: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/36.jpg)
STANDARD DEVIATION
• Only 3 studies showed the SD for mean change and/or mean percent from baseline:1. Isaacsohn et al.2. Kojuri et al.3. Superko et al.
• 10/13: no SD cited SD values were imputed
![Page 37: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/37.jpg)
NOT INCLUDED IN THE STATISTICAL ANALYSIS
• Berthold et al. No significant effect
• Mader et al. and Vorberg and Schneider Significantly decreased total cholesterol
and triglyceride levels
• Silady et al. no significant differences bet. the 2
groups
![Page 38: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/38.jpg)
TOTAL CHOLESTEROL (TC)
Fig.2 Comparison of Mean Change from Baseline of Total Cholesterol Levels
![Page 39: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/39.jpg)
TOTAL CHOLESTEROL (TC)
Fig.3 Comparison of Mean Percent Change from Baseline of Total Cholesterol Levels
![Page 40: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/40.jpg)
LDL-C
Fig.4 Comparison of Mean Change from Baseline of LDL-C Levels
![Page 41: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/41.jpg)
LDL-C
Fig.5 Comparison of Mean Percent Change from Baseline of LDL-C Levels
![Page 42: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/42.jpg)
HDL-C
Fig.6 Comparison of Mean Change from Baseline of HDL-C Levels
![Page 43: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/43.jpg)
HDL-C
Fig.7 Comparison of Mean Percent Change from Baseline of HDL-C Levels
![Page 44: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/44.jpg)
TRIGLYCERIDE (TG)
Fig.8 Comparison of Mean Change from Baseline of Triglyceride Levels
![Page 45: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/45.jpg)
Fig.9 Comparison of Mean Percent Change from Baseline of Triglyceride Levels
TRIGLYCERIDE (TG)
![Page 46: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/46.jpg)
SUMMARY OF RESULTS• Mean change from baseline of TC and LDL-C
Favored the garlic treatment group Significantly decreased levels
• Mean change from baseline of HDL-C and TG Favoured the garlic treatment group, but not significant
• Mean percent of all lipid parameters Not significant small number of participants
![Page 47: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/47.jpg)
SUBGROUP ANALYSES
![Page 48: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/48.jpg)
SEX
Males OnlyMixed (Males and Females)
![Page 49: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/49.jpg)
SEX: MALES ONLY
Total Cholesterol
![Page 50: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/50.jpg)
SEX: MALES ONLY
LDL-C Levels
![Page 51: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/51.jpg)
SEX: MALES ONLY
HDL-C Levels
![Page 52: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/52.jpg)
SEX: MALES ONLY
Comparison of Mean Change from Baseline of Triglyceride Levels
![Page 53: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/53.jpg)
SEX: MALES ONLY
• Garlic increased triglycerides significantly– (WMD -5.80mg/dL; 95% CI -5.86 to -5.74)
• Exact mechanism is still unclear.• Libby et al. (2008)– the impact of triglycerides in the
development of CHD also remains unclear• imprecision in triglyceride measurements and
the complex interactions between triglycerides and other lipid parameters
![Page 54: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/54.jpg)
Total Cholesterol Levels
SEX: MIXED (MALES AND FEMALES)
![Page 55: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/55.jpg)
HDL-C Levels
SEX: MIXED (MALES AND FEMALES)
![Page 56: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/56.jpg)
SEX: MIXED (MALES AND FEMALES)
Triglyceride Levels
![Page 57: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/57.jpg)
SEX: MIXED (MALES AND FEMALES)
LDL-C Levels
![Page 58: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/58.jpg)
SEX: MIXED (MALES AND FEMALES)
• Decreased LDL-C but not significantly – (WMD 6.86 mg/dL; 95% CI -1.54 to 15.26)
• May be due to presence of confounders gender of the participants
• Protein phosphorylation by AMP-dependent kinase (AMPK) • inhibition of hydroxy-methyl-CoA reductase
(HMGR) and acetyl-CoA-carboxylase
![Page 59: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/59.jpg)
DIET
No Dietary ChangeDietary Advice
Specific Diet Regimen
![Page 60: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/60.jpg)
NO DIETARY CHANGE
Total Cholesterol Levels
![Page 61: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/61.jpg)
NO DIETARY CHANGE
LDL-C Levels
![Page 62: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/62.jpg)
NO DIETARY CHANGE
HDL-C Levels
![Page 63: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/63.jpg)
NO DIETARY CHANGE
Triglyceride Levels
![Page 64: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/64.jpg)
• Defined as low fat (monounsaturated and polyunsaturated) and low carbohydrate diet
• with subsequent reduction in alcohol intake
DIETARY ADVICE
![Page 65: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/65.jpg)
DIETARY ADVICE
Total Cholesterol Levels
![Page 66: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/66.jpg)
DIETARY ADVICE
Triglyceride Levels
![Page 67: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/67.jpg)
DIETARY ADVICE
Comparison of Mean Change from Baseline of LDL-C Levels
![Page 68: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/68.jpg)
DIETARY ADVICE
• Decreased LDL-C but not significant(WMD 11.84 mg/dL; 95% CI -2.45 to 26.13)
• May be attributed to timing of implementation of the dietary advice– done before randomization occurred– diet may have already induced an effect
on the participants’ lipid parameters– effect of garlic treatment underestimated.
![Page 69: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/69.jpg)
DIETARY ADVICE
Comparison of Mean Change from Baseline of HDL-C Levels
![Page 70: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/70.jpg)
• Significantly decreased HDL-C level (WMD 3.31 mg/dL; 95% CI 0.88 to 5.74)
• May be due to compliance– Kannar et al. (2000): compliance with
dietary advice is LOW• May also be due to decreased alcohol
intake– Alcohol is thought to increase the HDL-C
levels
DIETARY ADVICE
![Page 71: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/71.jpg)
SPECIFIC DIETARY REGIMEN
Comparison of Mean Change from Baseline of Triglycerides Levels
![Page 72: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/72.jpg)
SPECIFIC DIETARY REGIMEN
Total Cholesterol Levels
![Page 73: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/73.jpg)
SPECIFIC DIETARY REGIMEN
• Garlic decreased total cholesterol– but not significantly– (WMD 13.21 mg/dL; 95% CI -2.01 to 28.43)
• May be due to also due to timing of diet supplementation
![Page 74: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/74.jpg)
SPECIFIC DIETARY REGIMEN
Comparison of Mean Change from Baseline of LDL-C Levels
![Page 75: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/75.jpg)
SPECIFIC DIETARY REGIMEN
• Garlic decreased LDL-C– but not significantly – (WMD 10.55 mg/dL; 95% CI -5.51 to 26.62)
• May be due to also due to timing of diet supplementation
![Page 76: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/76.jpg)
SPECIFIC DIETARY REGIMEN
Comparison of Mean Change from Baseline of HDL-C Levels
![Page 77: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/77.jpg)
SPECIFIC DIETARY REGIMEN
• Garlic increased HDL-C significantly– (WMD -5.80 mg/dL; 95% CI -5.86 to -5.74)
• May be due to compliance w/ diet– compliance was monitored through a
food diary and calculation of 24 hour nutrient intake
– studies under this subgroup fully met the dietary goals prescribed to the participants
![Page 78: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/78.jpg)
CONCLUSION • Garlic treatment significantly reduces
the total cholesterol and LDL-C levels among hyperlipidemic patients.
• There is no sufficient evidence that garlic affects the HDL-C and triglyceride levels.
![Page 79: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/79.jpg)
CONCLUSION
• Garlic supplementation markedly improves the serum lipid levels of hyperlipidemic men.
• The hypolipidemic effect is augmented by an approved dietary regimen.
![Page 80: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/80.jpg)
IMPLICATION FOR PRACTICE• Recommend the use of garlic as a
supplement to lower the lipid levels among hyperlipidemic patients.
• Garlic should not be used as the primary lipid-lowering medication.
![Page 81: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/81.jpg)
IMPLICATION FOR RESEARCH
• More studies involving a larger number of participants is recommended.
• More well designed studies should be included.
• Normolipidemic patients may also be included in the future to determine the applicability of effects of garlic supplementation to these patients.
![Page 82: GARLIC SUPPLEMENTATION FOR HYPERLIPIDEMIA Soto, Tanggol, Teo, Torio, Torregrosa, Tuddao, Tumangday, Valenzuela, Valerio, Vidal, Villanueva, Ampil](https://reader035.vdocument.in/reader035/viewer/2022062517/56649edd5503460f94bee4e2/html5/thumbnails/82.jpg)
IMPLICATION FOR RESEARCH
• A subgroup analysis may also be done on dose, length of intervention, and the severity of hyperlipidemia to determine the most appropriate dose and duration of garlic supplementation for certain populations.