Skip to main content
Review

The effects of garlic supplementation on weight loss: A systematic review and meta-analysis of randomized controlled trials

Published Online:https://doi.org/10.1024/0300-9831/a000607

Abstract. Obesity is related to increase in the incidence of morbidity and mortality. Studies have suggested anti-obesity properties of garlic; however, results are inconsistent. This systematic review and meta-analysis is done to summarize the data obtained from available randomized clinical trials on the effect of garlic supplementation on body weight, Body Mass Index (BMI), and Waist Circumference (WC). The online databases of Scopus, PubMed, Google Scholar and Cochrane library were searched until March 2018 for related publications using relevant keywords. Effect sizes of eligible studies were pooled using random-effects models. Cochran’s Q-test and I2 index were used for assessing heterogeneity. We found 1241 records in our initial search, of which 13 randomized clinical trials (RCTs) with 15 treatment arms were included. Pooled analysis showed that garlic administration might significantly decrease WC (Weighed Mean Difference (WMD): −1.10 cm, 95% CI: −2.13, −0.07, P = 0.03, I2 = 0%). However, garlic intervention had no significant effect on body weight (WMD): −0.17 kg, 95% CI: −0.75 to 0.39, P = 0.54, I2 = 0%) and BMI (WMD: −0.17 kg/m2, 95% CI: −0.52, 0.16, P = 0.30, I2 = 44.5%) as compared to controls. From Subgroup analysis, it was ascertained that the effect of garlic supplementation on BMI was significant in trials with duration < 12 weeks (WMD: −0.58 kg/m2, 95% CI: −1.08, −0.08, I2 = 19.8%, P = 0.02) compared to those with higher duration (>12 weeks). The current meta-analysis results suggest that garlic supplementation seems to reduce waist circumference unlike body weight and BMI.

References

  • 1 Puhl, R.M., & Heuer, C.A. (2010) Obesity stigma: important considerations for public health. Am J Public Health. 100, 1019–1028. First citation in articleCrossref MedlineGoogle Scholar

  • 2 Williams, E.P., Mesidor, M., Winters, K., Dubbert, P.M., & Wyatt, S.B. (2015) Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Current Obesity Reports. 4, 363–370. First citation in articleCrossref MedlineGoogle Scholar

  • 3 World Health Organization. (2017) Obesity and Overweight factsheet from the WHO. Health (NY). First citation in articleGoogle Scholar

  • 4 Malnick, S.D., & Knobler, H. (2006) The medical complications of obesity. J Assoc Physicians. 99, 565–579. First citation in articleMedlineGoogle Scholar

  • 5 Stuart, B., Lloyd, J., Zhao, L., & Kamal-Bahl, S. (2008) Obesity, disease burden, and prescription spending by community-dwelling Medicare beneficiaries. Curr Med Res Opin. 24, 2377–2387. First citation in articleCrossref MedlineGoogle Scholar

  • 6 Alley, D., Lloyd, J., Shaffer, T., & Stuart, B. (2012) Changes in the association between body mass index and Medicare costs, 1997–2006. Arch Intern Med. 172, 277–278. First citation in articleCrossref MedlineGoogle Scholar

  • 7 Quesenberry, C.P., Caan, B., & Jacobson, A. (1998) Obesity, health services use, and health care costs among members of a health maintenance organization. Arch Intern Med. 158, 466–472. First citation in articleCrossref MedlineGoogle Scholar

  • 8 Dietz, W.H., Baur, L.A., Hall, K., Puhl, R.M., Taveras, E.M., Uauy, R., & Kopelman, P. (2015) Management of obesity: improvement of health-care training and systems for prevention and care. The Lancet. 385, 2521–2533. First citation in articleCrossref MedlineGoogle Scholar

  • 9 Group D.P.P.R. (2009) 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. The Lancet. 374, 1677–1686. First citation in articleCrossref MedlineGoogle Scholar

  • 10 Soeliman, F.A., & Azadbakht, L. (2014) Weight loss maintenance: A review on dietary related strategies. J Res Med Sci. 19, 268. First citation in articleMedlineGoogle Scholar

  • 11 Derosa, G., & Maffioli, P. (2012) Anti-obesity drugs: a review about their effects and their safety. Expert Opin Drug Saf. 11, 459–471. First citation in articleCrossref MedlineGoogle Scholar

  • 12 Mousavi, S.M., Sheikhi, A., Varkaneh, H.K., Zarezadeh, M., Rahmani, J., & Milajerdi, A. (2018) Effect of Nigella sativa supplementation on obesity indices: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 38, 48–57. First citation in articleCrossref MedlineGoogle Scholar

  • 13 Suleria, H.A.R., Butt, M.S., Khalid, N., Sultan, S., Raza, A., Aleem, M., & Abbas, M. (2015) Garlic (Allium sativum): diet based therapy of 21st century – a review. Asian Pac J Trop Dis. 5, 271–278. First citation in articleCrossrefGoogle Scholar

  • 14 Kimura, S., Tung, Y.-C., Pan, M.-H., Su, N.-W., Lai, Y.-J., & Cheng, K.-C. (2017) Black garlic: A critical review of its production, bioactivity, and application. J Food Drug Anal. 25, 62–70. First citation in articleCrossref MedlineGoogle Scholar

  • 15 Schafer, G., & Kaschula, C.H. (2014) The immunomodulation and anti-inflammatory effects of garlic organosulfur compounds in cancer chemoprevention. Anticancer Agents Med Chem. 14, 233–240. First citation in articleCrossref MedlineGoogle Scholar

  • 16 Devasagayam, T., & Sainis, K. (2002) Immune system and antioxidants, especially those derived from Indian medicinal plants. First citation in articleGoogle Scholar

  • 17 Maidment, D., Dembny, Z., & Watts, D. (2001) The anti-bacterial activity of 12 Alliums against Escherichia coli. Nutr Food Sci. 31, 238–241. First citation in articleCrossrefGoogle Scholar

  • 18 Jain, A.K., Vargas, R., Gotzkowsky, S., & McMahon, F.G. (1993) Can garlic reduce levels of serum lipids? A controlled clinical study. Am J Med. 94, 632–635. First citation in articleCrossref MedlineGoogle Scholar

  • 19 Mulrow, C., Lawrence, V., Ackermann, R., Ramirez, G.G., Morbidoni, L., Aguilar, C., Arterburn, J., Block, E., Chiquette, E., & Gardener, C. (2000) Garlic: effects on cardiovascular risks and disease, protective effects against cancer, and clinical adverse effects: summary. First citation in articleGoogle Scholar

  • 20 Ashraf, R., Aamir, K., Shaikh, A.R., & Ahmed, T. (2005) Effects of garlic on dyslipidemia in patients with type 2 diabetes mellitus. J Ayub Med Coll Abbottabad. 17, 60–64. First citation in articleMedlineGoogle Scholar

  • 21 Lee, M.-S., Cho, S.-M., Lee, M.-H., Lee, E.-O., Kim, S.-H., & Lee, H.-J. (2016) Ethanol extract of Pinus koraiensis leaves containing lambertianic acid exerts anti-obesity and hypolipidemic effects by activating adenosine monophosphate-activated protein kinase (AMPK). BMC Complement Altern Med. 16, 51. First citation in articleCrossref MedlineGoogle Scholar

  • 22 Jayarathne, S., Koboziev, I., Park, O.-H., Oldewage-Theron, W., Shen, C.-L., & Moustaid-Moussa, N. (2017) Anti-inflammatory and anti-obesity properties of food bioactive components: effects on adipose tissue. Prev Nutr Food Sci. 22, 251. First citation in articleCrossref MedlineGoogle Scholar

  • 23 Joo, H., Kim, C.-T., Kim, I.-H., & Kim, Y. (2013) Anti-obesity effects of hot water extract and high hydrostatic pressure extract of garlic in rats fed a high-fat diet. Food Chem Toxicol. 55, 100–105. First citation in articleCrossref MedlineGoogle Scholar

  • 24 İnce, Dİ., Sönmez, G.T., & İnce, M.L. (2000) Effects of garlic on aerobic performance. Turk J Med Sci. 30, 557–561. First citation in articleGoogle Scholar

  • 25 Keophiphath, M., Priem, F., Jacquemond-Collet, I., Clément, K., & Lacasa, D. (2009) 1, 2-vinyldithiin from garlic inhibits differentiation and inflammation of human preadipocytes. J Nutr. 139, 2055–2060. First citation in articleCrossref MedlineGoogle Scholar

  • 26 Yang, J.Y., Della-Fera, M.A., Nelson-Dooley, C., & Baile, C.A. (2006) Molecular mechanisms of apoptosis induced by Ajoene in 3T3-L1 adipocytes. Obesity. 14, 388–397. First citation in articleCrossref MedlineGoogle Scholar

  • 27 Aslani, N., Entezari, M.H., Askari, G., Maghsoudi, Z., & Maracy, M.R. (2016) Effect of garlic and lemon juice mixture on lipid profile and some cardiovascular risk factors in people 30–60 years old with moderate hyperlipidaemia: A randomized clinical trial. Int J Prev Med. 2016-JULY. First citation in articleGoogle Scholar

  • 28 Soleimani, D., Paknahad, Z., Askari, G., Iraj, B., & Feizi, A. (2016) Effect of garlic powder consumption on body composition in patients with nonalcoholic fatty liver disease: A randomized, double-blind, placebo-controlled trial. Adv Biomed Res. 5, 2. First citation in articleCrossref MedlineGoogle Scholar

  • 29 Atkin, M., Laight, D., & Cummings, M.H. (2016) The effects of garlic extract upon endothelial function, vascular inflammation, oxidative stress and insulin resistance in adults with type 2 diabetes at high cardiovascular risk. A pilot double blind randomized placebo controlled trial. J Diabetes Complications. 30, 723–727. First citation in articleCrossref MedlineGoogle Scholar

  • 30 Xu, C., Mathews, A.E., Rodrigues, C., Eudy, B.J., Rowe, C.A., O’Donoughue, A., & Percival, S.S. (2018) Aged garlic extract supplementation modifies inflammation and immunity of adults with obesity: A randomized, double-blind, placebo-controlled clinical trial. Clin Nutr ESPEN. First citation in articleCrossrefGoogle Scholar

  • 31 Moher, D., Liberati, A., Tetzlaff, J., & Altman, D.G., Group P.. (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 6, e1000097. First citation in articleCrossref MedlineGoogle Scholar

  • 32 Jadad, A.R., Moore, R.A., Carroll, D., Jenkinson, C., Reynolds, D.J.M., Gavaghan, D.J., & McQuay, H.J. (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 17, 1–12. First citation in articleCrossref MedlineGoogle Scholar

  • 33 Moher, D., Cook, D., Jadad, A., Tugwell, P., Moher, M., Jones, A., Pham, B., & Klassen, T. (1999) Assessing the quality of reports of randomised trials: implications for the conduct of meta-analyses. First citation in articleCrossrefGoogle Scholar

  • 34 Sahebkar, A. (2014) Are curcuminoids effective C-reactive protein-lowering agents in clinical practice? Evidence from a meta-analysis. Phytother Res. 28, 633–642. First citation in articleCrossref MedlineGoogle Scholar

  • 35 Mahdavi-Roshan, M., Rismanchi, M., & Nasrollahzadeh, J. (2016) Garlic tablet supplementation reduces lipopolysaccharide-induced TNF-alpha production by peripheral blood mononuclear cells. Eur J Inflamm. 14, 190–195. First citation in articleCrossrefGoogle Scholar

  • 36 Gomez-Arbelaez, D., Lahera, V., Oubina, P., Valero-Munoz, M., de Las Heras, N., Rodriguez, Y., Garcia, R.G., Camacho, P.A., & Lopez-Jaramillo, P. (2013) Aged garlic extract improves adiponectin levels in subjects with metabolic syndrome: a double-blind, placebo-controlled, randomized, crossover study. Mediators Inflamm. 2013, 285795. First citation in articleCrossref MedlineGoogle Scholar

  • 37 Gardner, C.D., Chatterjee, L.M., & Carlson, J.J. (2001) The effect of a garlic preparation on plasma lipid levels in moderately hypercholesterolemic adults. Atherosclerosis. 154, 213–220. First citation in articleCrossref MedlineGoogle Scholar

  • 38 Isaacsohn, J.L., Moser, M., Stein, E.A., Dudley, K., Davey, J.A., Liskov, E., & Black, H.R. (1998) Garlic powder and plasma lipids and lipoproteins: a multicenter, randomized, placebo-controlled trial. Arch Intern Med. 158, 1189–1194. First citation in articleCrossref MedlineGoogle Scholar

  • 39 Kumar, R., Chhatwal, S., Arora, S., Sharma, S., Singh, J., Singh, N., Bhandari, V., & Khurana, A. (2013) Antihyperglycemic, antihyperlipidemic, anti-inflammatory and adenosine deaminase-lowering effects of garlic in patients with type 2 diabetes mellitus with obesity. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 6, 49–56. First citation in articleCrossref MedlineGoogle Scholar

  • 40 Mahdavi-Roshan, M., Zahedmehr, A., Mohammad-Zadeh, A., Sanati, H.R., Shakerian, F., Firouzi, A., Kiani, R., & Nasrollahzadeh, J. (2013) Effect of garlic powder tablet on carotid intima-media thickness in patients with coronary artery disease: A preliminary randomized controlled trial. Nutr Health. 22, 143–155. First citation in articleCrossref MedlineGoogle Scholar

  • 41 Seo, D.Y., Lee, S.R., Kim, H.K., Baek, Y.H., Kwak, Y.S., Ko, T.H., Kim, N., Rhee, B.D., Ko, K.S., Park, B.J., & Han, J. (2012) Independent beneficial effects of aged garlic extract intake with regular exercise on cardiovascular risk in postmenopausal women. Nutr Res Pract. 6, 226–231. First citation in articleCrossref MedlineGoogle Scholar

  • 42 Sharifi, F., Sheikhi, A., Behdad, M., & Mousavinasab, N. (2010) Effect of garlic on serum adiponectin and interleukin levels in women with metabolic syndrome. Int J Endocrinol Metab. 8, 68–73. First citation in articleGoogle Scholar

  • 43 Eguchi, Y., Eguchi, T., Mizuta, T., Ide, Y., Yasutake, T., Iwakiri, R., Hisatomi, A., Ozaki, I., Yamamoto, K., & Kitajima, Y. (2006) Visceral fat accumulation and insulin resistance are important factors in nonalcoholic fatty liver disease. J Gastroenterol. 41, 462–469. First citation in articleCrossref MedlineGoogle Scholar

  • 44 Ma, L., Cai, L., Deng, L., Zhu, Y., Ma, J., Jing, J., & Chen, Y. (2016) Waist circumference is better than other anthropometric indices for predicting cardiovascular disease risk factors in Chinese children – a cross-sectional study in Guangzhou. J Atheroscler Thromb. 31302. First citation in articleGoogle Scholar

  • 45 Eidi, A., Eidi, M., & Esmaeili, E. (2006) Antidiabetic effect of garlic (Allium sativum L.) in normal and streptozotocin-induced diabetic rats. Phytomedicine. 13, 624–629. First citation in articleCrossref MedlineGoogle Scholar

  • 46 Aouadi, R., Aouidet, A., Elkadhi, A., Rayana, M.C.B., Jaafoura, H., Tritar, B., & Nagati, K. (2000) Effect of fresh garlic (Allium sativum) on lipid metabolism in male rats. Nutr Res. 20, 273–280. First citation in articleCrossrefGoogle Scholar

  • 47 Gorinstein, S., Leontowicz, H., Leontowicz, M., Drzewiecki, J., Najman, K., Katrich, E., Barasch, D., Yamamoto, K., & Trakhtenberg, S. (2006) Raw and boiled garlic enhances plasma antioxidant activity and improves plasma lipid metabolism in cholesterol-fed rats. Life Sci. 78, 655–663. First citation in articleCrossref MedlineGoogle Scholar

  • 48 Kim, Y., Lee, M.-S., Kim, J.-S., & Lee, H.-S. (2007) Garlic decreases body weight via decrease of serum lipid and increase of uncoupling proteins mRNA expression. FASEB Jour. 21, LB59-LB59. First citation in articleGoogle Scholar

  • 49 Kim, E.J., Lee, D.H., Kim, H.J., Lee, S.J., Ban, J.O., Cho, M.C., Jeong, H.S., Yang, Y., Hong, J.T., & Yoon, D.Y. (2012) Thiacremonone, a sulfur compound isolated from garlic, attenuates lipid accumulation partially mediated via AMPK activation in 3T3-L1 adipocytes. J Nutr Biochem. 23, 1552–1558. First citation in articleCrossref MedlineGoogle Scholar

  • 50 Lee, M.S., Kim, I.H., Kim, C.T., & Kim, Y. (2011) Reduction of body weight by dietary garlic is associated with an increase in uncoupling protein mRNA expression and activation of AMP-activated protein kinase in diet-induced obese mice. J Nutr. 141, 1947–1953. First citation in articleCrossref MedlineGoogle Scholar

  • 51 Joo, H., Kim, C.T., Kim, I.H., & Kim, Y. (2013) Anti-obesity effects of hot water extract and high hydrostatic pressure extract of garlic in rats fed a high-fat diet. Food Chem Toxicol. 55, 100–105. First citation in articleCrossref MedlineGoogle Scholar

  • 52 Lai, Y.-S., Chen, W.-C., Ho, C.-T., Lu, K.-H., Lin, S.-H., Tseng, H.-C., Lin, S.-Y., & Sheen, L.-Y. (2014) Garlic essential oil protects against obesity-triggered nonalcoholic fatty liver disease through modulation of lipid metabolism and oxidative stress. J Agric Food Chem. 62, 5897–5906. First citation in articleCrossref MedlineGoogle Scholar

  • 53 Seo, D.Y., Kwak, H.B., Lee, S.R., Cho, Y.S., Song, I.-S., Kim, N., Bang, H.S., Rhee, B.D., Ko, K.S., & Park, B.J. (2014) Effects of aged garlic extract and endurance exercise on skeletal muscle FNDC-5 and circulating irisin in high-fat-diet rat models. Nutr Res Pract. 8, 177–182. First citation in articleCrossref MedlineGoogle Scholar

  • 54 Steiner, M., Khan, A.H., Holbert, D., & Lin, R. (1996) A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J Clin Nutr. 64, 866–870. First citation in articleCrossref MedlineGoogle Scholar

  • 55 Yilmaz, F., & Çifci, H.E. (2018) Herbal Use among Presurgical Patients in Turkey: A Cross-Sectional Study. Anesthesiol Res Pract. 2018. First citation in articleMedlineGoogle Scholar