A 2000 meta-analysis of 13 clinical trials concluded that garlic is superior to placebo in reducing total cholesterol levels, exerting a modest effect (Stevinson et al 2001). The mechanism of action involves inhibition of cholesterol synthesis by deactivating HMG-CoA reductase via enhanced phosphorylation, but not changing theamount of the enzyme, according to in vitro research (Liu & Yeh 2002). The compounds containing an allyl-d ¡sulfide or a I lyl-su If hyd ryl group are most likely responsible for the inhibition of cholesterol synthesis by garlic and that this inhibition is likely to be mediated at sterol 4-alpha-methyl oxidase (Singh & Porter 2006). Clinical evidence also suggests it raises HDL levels and reduces triglyceride levels (Bordia et al 1998).
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