Diet

***Disclaimer: This blog is not meant to be used as legal or medical advice.  It is written as my person perspective on how medical professionals could blend western medicine with other modalities***

Greetings, and welcome to another episode of the Integrated Pharmacist Podcast.  Fad diets come and go.  So often, they're built on extreme limitations with the goal of dropping weight quickly or offering longer, more vibrant life.  These fad diets came into being during the 19th century when people drifted culturally away from ethnic and locally grown foods to diets based more on comfort and pleasure.  This new style of eating obviously had a negative effect on health and wellness, so new diet trends continue to spring up.  Extreme diets have included low-fat, low-carb, high fiber, and high protein.  There have been diets based on specific foods or food-groups like cabbage and grapefruit, restrictive diets, liquid diets, and much more.
Of course, fad diets don't last long, because they're meant to get around the hard way... which is the way of dropping weight that makes sense.  There are 4 basic principles to an appropriate diet, especially if you want to weigh less: eat less, move more, eat more fruits and vegetables, and avoid junk food.  Now, I'm not a nutritionist.  Although there is some evidence that suggests a plant-based diet is best, I am unconvinced that it's the best for everyone.  I don't have evidence to support my hypothesis, but it seems like eating foods customary to your ancestors might by a good place to start.  I think we need to take a look at what our ancestors lived on.  Their bodies likely adapted to optimal living on the foods that were available to them.  Because many of us today have diverse lines of heritage, it is likely that we are built to deal with lots of different kinds of foods.  And in fact, many nutrition experts today would agree that a variety in our diet is a good idea.

What I do know is that there are some foods that have health benefits for many people.  A growing body of evidence suggests that garlic has benefit for cholesterol.  A meta-analysis in the journal Medicine in Baltimore discussed a set of 14 well designed clinical trials involving several forms of garlic including aged black garlic, garlic oil, and garlic powder.  The 14 trials included 1093 patients wherein 527 were in the experimental arms and 566 were in the control groups.  Across the board, the studies found trends in the experimental groups for decreased LDLs and total cholesterol levels.  Some studies also indicated an increase in HDL (the good cholesterol).  Although the mechanism of action for garlic's beneficial cholesterol properties is still unclear, it is likely and possible that this whole-food product targets a variety of pathways simultaneously.  The authors of this analysis suggest that one such pathway is the same target as statin drugs which inhibit the HMG-CoA reductase enzyme for lowering LDL.  There was a caution that the garlic powder was less efficacious that the other forms, perhaps due to some loss in the manufacturing process.
One of the best ways to consume garlic is to cook with it, of course.  Fresh garlic can be bought today for a little over $10 a pound.  There are also many garlic products in the supplement section.  It's important to make sure when buying supplements that you get a product that really has what it says it has.  An easy way to do this is to look for a golden seal that has the letters USP.  This is a seal from a separate company that inspects products and how they are made.  There are other companies like this including Consumer Labs and NSF which have websites you can find that have their endorsements on a variety of supplement products.
When it comes to patients asking questions about supplements for their cholesterol, easy

recommendations include appropriate exercise and adding garlic to their diet.  If they prefer a supplemental pill, you could recommend encapsulated garlic oil or aged black garlic.  The garlic powder may not have the same benefit.  If a pill-form supplement is the option they're looking for, you can help them look for those special seals of approval - USP, NSF, or CL.
This has been a particularly interesting episode as it pertains to an oral product that pharmacists will likely encounter.  I know that diet plays an integral part of health.  We should pay attention to what we eat and why we're eating it.  I know that consciousness toward diet will have a positive affect on overall health.
I hope you enjoyed this episode of the Integrated Pharmacist.  It really helps others find this podcast if you rate and review this show on Apple Podcast.  If you know anyone who is interested in this topic, please tell them where they can find it.  If you'd like to get a hold of me for questions, concerns, comments, or suggestions, you can email me at integratedpharmacist@gmail.com.  You can also find me on Facebook and Instagram as the Integrated Pharmacist.  Please join us again next week for the next episode of the Integrated Pharmacist Podcast.

References:

Sun YE, Wang W, Qin J. Anti-hyperlipidemia of garlic by reducing the level of total cholesterol and low-density lipoprotein: A meta-analysis. Medicine (Baltimore). 2018;97(18):e0255. doi:10.1097/MD.0000000000010255

https://www.consumerlab.com/reviews/Garlic_Supplements/Garlic/