Effects of an Optimized Aged Garlic Extract on Cardiovascular Disease Risk Factors in Moderate Hypercholesterolemic Subjects: A Randomized, Crossover, Double-Blind, Sustainedand Controlled Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Experimental Design
2.3. Outcomes
2.4. Sample Size
2.5. Statistical Analysis
3. Results
3.1. Study Population
3.2. Compliance, Adverse Events, and Product Tolerance
3.3. Cardiovascular Disease Risk Factors
3.3.1. Blood and Pulse Pressure
3.3.2. Lipid Profile, Apos, and NEFAs
3.3.3. Homeostatic Glucose Profile Biomarkers and Systematic Inflammatory, Oxidative, and Vasodilatory Biomarkers
3.3.4. Anthropometric Measures
3.3.5. Dietary Adherence
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Description | Aged Black Garlic Extract Weight (mg Per Tablet) | Placebo Weight (mg Per Tablet) |
---|---|---|
Pharmactive’s aged black garlic Extract | 250 (1.25 mg SAC) | - |
Maltodextrin | - | 250 |
Microcrystalline cellulose | 90 | 90 |
Dicalcic phosphate | 157 | 157 |
Sodium croscarmellose | 10 | 10 |
Magnesium stearate | 7 | 7 |
Sodium alginate | 3.06 | 3.06 |
Stearic acid | 0.03 | 0.03 |
Oleic acid | 1.54 | 1.54 |
Medium-chain triglycerides (MCTs) | 2.80 | 2.80 |
Ethylcellulose | 13.17 | 13.17 |
Hydroxypropyl methylcellulose (HPMC) | 4.86 | 4.86 |
Hydroxypropyl cellulose (HPC) | 4.86 | 4.86 |
Talc | 2.88 | 2.88 |
Titanium dioxide | 1.80 | 1.80 |
Natural Vanilla flavor | 1.00 | 1 |
Total | 550 | 550 |
Sequence 1 (n = 33) | Sequence 2 (n = 34) | p-Value | |
---|---|---|---|
Age, y | 53.7 ± 8.12 | 52.7 ± 8.59 | 0.609 |
Female, % | 54.5 | 50.0 | 0.449 |
Systolic blood pressure, mm Hg | 124 ± 17.7 | 125 ± 15.0 | 0.784 |
Diastolic blood pressure, mm Hg | 76 ± 11.4 | 76 ± 9.77 | 0.854 |
Pulse pressure, mm Hg | 48 ± 8.47 | 50 ± 10.1 | 0.489 |
Weight, kg | 72 ± 14.0 | 72 ± 11.4 | 0.991 |
Body mass index, kg/m2 | 25.7 ± 3.06 | 25.8 ± 3.23 | 0.993 |
Waist circumference, cm | 91 ± 8.74 | 90 ± 9.55 | 0.644 |
Waist/height | 0.55 ± 0.05 | 0.54 ± 0.06 | 0.561 |
Conicity index | 1.28 ± 0.08 | 1.26 ± 0.08 | 0.341 |
Fat mass, % | 28.1 ± 8.56 | 27.3 ± 8.98 | 0.727 |
Fat mass, kg | 20.9 ± 6.62 | 20.2 ± 6.66 | 0.675 |
Lean mass, kg | 51.1 ± 11.0 | 51.4 ± 9.83 | 0.901 |
Muscle mass, kg | 48.5 ± 10.4 | 48.8 ± 9.37 | 0.900 |
Bone mass, kg | 2.58 ± 0.53 | 2.60 ± 0.47 | 0.881 |
Total water, % | 49.1 ± 4.46 | 50.2 ± 5.83 | 0.411 |
Total water, kg | 35.4 ± 7.65 | 36.0 ± 7.33 | 0.740 |
Intervention | Change Intertreatments | |||||
---|---|---|---|---|---|---|
Variable | ABG | Placebo | ABG vs. Placebo | |||
Baseline | Change at 6 Weeks | Baseline | Change at 6 Weeks | Mean | p-Value | |
(95% CI) | ||||||
SBP, mm Hg | 124 ± 17.9 | 1.32 (−4.1; 6.7) | 121 ± 18.4 | 2.84 (−2.4; 8.1) | −1.51 (−9.1; 6.1) | 0.694 |
DBP, mm Hg | 75 ± 10.3 | −1.85 * (−3.7; 0.001) | 74 ± 9.80 | 1.77 (−0.10; 3.6) | −3.623 (−6.2; −0.99) | 0.007 |
PP, mm Hg | 48 ± 14.9 | 1.74 (−3.1; 6.6) | 47 ± 14.7 | −0.363 (−5.1; 4.4) | −2.00 (−8.9; 4.7) | 0.544 |
CF, beats/min | 66 ± 17.8 | −1.32 (−2.4; 5.0) | 66 ± 13.7 | −0.422 (−6.9; 3.5) | −1.75 (−8.9; 4.7) | 0.507 |
Intervention | Change Intertreatments | |||||
---|---|---|---|---|---|---|
Variable | ABG | Placebo | ABG vs. Placebo | |||
Baseline | Change | Baseline | Change | Mean (95% CI) | p-Value | |
Gender | ||||||
Male | 80 ± 9.4 | −3.17 (−6.4; 0.03) | 76 ± 9.9 | 2.71 (−0.59; 6.0) | −5.85 (−10.5; −1.3) | 0.013 |
Women | 71 ± 9.9 | −0.579 (−2.5; 1.4) | 72 ± 9.4 | 0.936 (−0.98; 2.8) | −0.151 (−4.2; 1.2) | 0.271 |
Categories in DBP at V0 | ||||||
DBP ≤ 75 mm Hg | 69 ± 6.7 | 0.061 (−2.1; 2.2) | 69 ± 6.3 | 2.86 (0.70; 5.0) | −2.80 (−5.8; 0.23) | 0.070 |
DBP > 75 mm Hg | 83 ± 8.8 | −4.42 (−6.2; −0.99) | 80 ± 9.6 | 0.400 (−3.0; 3.8) | −4.82 (−9.7; −0.02) | 0.049 |
Intervention | ||||||||
---|---|---|---|---|---|---|---|---|
Variable | ABG | Placebo | Change Intertreatments | |||||
Baseline | Change | P for Trend | Baseline | Change | P for Trend | Mean (95% CI) | p-Value | |
Total cholesterol, mg/dL | ||||||||
Global | 243 ± 32 | 0.865 (−4.1; −5.9) | 0.047 † | 240 ± 30 | 2.15 (−3.1; 7.4) | 0.421 * | −1.29 (−8.6; 6.0) | 0.727 |
≤242 mg/dL | 219 ± 19 | 5.52 (−1.3; 12) | 0.028 † | 218 ± 22 | 6.90 (−1.9; 18) | 0.120 * | 0.914 (−8.7; 10) | 0.849 |
>242 mg/dL | 267 ± 24 | −3.94 (−11; 3.4) | 0.283 * | 263 ± 21 | −0.329 (−8.6; 8.0) | 0.872 † | −3.49 (−7.7; 15) | 0.535 |
LDLd, mg/dL | ||||||||
Global | 165 ± 24 | −0.390 (−4.1; 3.3) | 0.011 † | 165 ± 22 | 0.560 (−4.8; 3.7) | 0.279 † | 0.156 (−5.8; 5.5) | 0.956 |
≤166 mg/dL | 151 ± 14 | 3.33 (−1.1; 7.6) | 0.143 * | 147 ± 19 | 0.718 (−4.7; 6.1) | 0.131 † | 2.69 (−9.6; 4.2) | 0.438 |
>166 mg/dL | 188 ± 17 | −8.20 ‡ (−15; −1.6) | 0.017 * 0.014 † | 182 ± 18 | −2.55 (−9.8; 4.7) | 0.475 † | −6.28 (−16; 3.1) | 0.184 |
LDL (Friedewald), mg/dL | ||||||||
Global | 162 ± 26 | 1.47 (−2.7; 5.6) | 0.049 † | 161 ± 25 | 1.91 (−3.3; 7.2) | 0.308 † | −0.258 (−6.6; 7.1) | 0.941 |
≤162 mg/dL | 148± 17 | 4.50 (−0.41; 9.41) | 0.071 * | 148 ± 19 | 4.11 (−2.6; 11) | 0.221 * | 0.729 (−7.9; 9.3) | 0.866 |
>162 mg/dL | 186 ± 18 | −3.79 (−11; 3.7) | 0.063 † | 184 ± 17 | −1.99 (−11; 6.9) | 0.607 † | −1.85 (−13; 9.5) | 0.744 |
HDL, mg/dL | ||||||||
Global | 56.9 ± 11.4 | 0.005 (−0.99; 1.0) | 0.354 † | 55.0 ± 10.9 | 1.02 (−0.41; 2.5) | 0.159 * | −0.695 (−2.5; 1.1) | 0.492 |
≤55.5 mg/dL | 49.3 ± 7.86 | −0.045 (−1.4; 1.3) | 0.136 † | 48.2 ± 7.23 | 1.01 (−0.90; 2.9) | 0.124 † | −1.49 (−3.7; 0.70) | 0.178 |
>55.5 mg/dL | 65.3 ± 8.32 | 0.061 (−1.4; 1.6) | 0.816 † | 62.8 ± 9.19 | 1.04 (−1.2; 3.3) | 0.360 * | 0.105 (−2.9; 3.1) | 0.945 |
Total Cholesterol/ HDL | ||||||||
Global | 4.41 ± 0.92 | 0.006 (−0.09; 0.10) | 0.008 † | 4.48 ± 0.82 | −0.023 (−0.16; 0.12) | 0.239 † | 0.033 (−0.13; 0.20) | 0.694 |
≤4.44 | 3.73 ± 0.45 | 0.062 (−0.03; 0.16) | 0.200 * | 3.86 ± 0.51 | −0.022 (−0.22; 0.18) | 0.358 † | 0.074 (−0.15; 0.29) | 0.506 |
>4.44 | 5.10 ± 0.74 | −0.052 (−0.22; 0.12) | 0.004 † | 5.06 ± 0.60 | −0.024 (−0.23; 0.18) | 0.443 † | −0.023 (−0.30; 0.25) | 0.864 |
LDLd/HDL | ||||||||
Global | 3.02 ± 0.72 | −0.013 (−0.08; 0.05) | 0.001 † | 3.09 ± 0.64 | −0.049 (−0.15; 0.05) | 0.168 † | 0.156 (−5.8; 5.5) | 0.956 |
≤3.07 | 2.47 ± 0.33 | 0.065 (−0.01; 0.14) | 0.105 * | 2.60 ± 0.41 | −0.120 (−0.25; 0.07) | 0.062 * | 0.077 (−0.09; 0.24) | 0.362 |
>3.07 | 3.58 ± 0.58 | −0.114 (−0.24; 0.01) | 0.071 * 0.002 † | 3.55 ± 0.46 | 0.019 (−0.14; 0.18) | 0.356 † | −0.05 (−0.21; 0.16) | 0.782 |
LDL(Fried)/HDL | ||||||||
Global | 2.95 ± 0.72 | 0.038 (−0.04; 0.12) | 0.002 † | 3.00 ± 0.63 | 0.001 (−0.11; 0.11) | 0.089 † | 0.041 (−0.09; 0.18) | 0.551 |
≤2.94 | 2.43 ± 0.40 | 0.072 (−0.01; 0.15) | 0.084 † | 2.52 ± 0.41 | −0.036 (−0.19; 0.12) | 0.154 † | 0.089 (−0.09; 0.27) | 0.319 |
>2.94 | 3.49 ± 0.56 | −0.021 (−0.15; 0.11) | 0.002 † | 3.45 ± 0.45 | 0.035 (−0.14; 0.21) | 0.280 † | −0.021 (−0.22; 0.18) | 0.840 |
TG (log), mg/dL | ||||||||
Global | 2.04 ± 0.18 | −0.031 ‡ (−0.06; − 0.001) | 0.042 * | 2.05 ± 0.19 | −0.016 (−0.05; 0.02) | 0.419 * | −0.016 (−0.03; 0.06) | 0.531 |
≤2.00 | 1.90 ± 0.09 | −0.011 (−0.05; 0.03) | 0.568 * | 1.91 ± 0.09 | 0.024 (−0.04; 0.09) | 0.438 * | −0.021 (−0.10; 0.06) | 0.603 |
>2.00 | 2.16 ± 0.15 | −0.049 (−0.09; −0.002) | 0.040 * | 2.15 ± 0.13 | −0.037 (−0.08; 0.07) | 0.095 * | −0.019 (−0.05; 0.09) | 0.578 |
Log (TG/HDL) | ||||||||
Global | 0.30 ± 0.23 | −0.033 ‡ (−0.06; −0.001) | 0.046 * | 0.31 ± 0.23 | −0.023 (−0.07; 0.02) | 0.309 * | −0.020 (−0.07; 0.04) | 0.640 |
≤0.24 | 0.12 ± 0.11 | −0.010 (−0.05; 0.03) | 0.613 * | 0.14 ± 0.12 | 0.009 (−0.06; 0.08) | 0.789 * | −0.020 (−0.10; 0.06) | 0.610 |
≤0.24 | 0.47 ± 0.17 | −0.055 ‡ (−0.11; −0.003) | 0.038 * | 0.49 ± 0.17 | −0.055 (−0.12; 0.006) | 0.073 * | −0.004 (−0.08; 0.07) | 0.909 |
Intervention | Change Intertreatments | |||||
---|---|---|---|---|---|---|
Variable | ABG | Placebo | ABG vs. Placebo | |||
Baseline | Change | Baseline | Change | Mean (95% CI) | p-Value | |
ApoA1, mg/dL | 144 ± 20.2 | −2.25 (−4.6; 0.14) | 141 ± 0.3 | 0.038 (−2.3; 2.4) | −2.29 (−5.6; 1.1) | 0.178 |
ApoB100, mg/dL | 104 ± 15.4 | −0.117 (−3.0; 2.7) | 104 ± 14.2 | −0.516 (−3.4; 2.3) | 0.338 (−4.4; 3.4) | 0.868 |
ApoB100/ApoA1 | 0.74 ± 0.16 | 0.012 (−0.01; 0.03) | 0.75 ± 0.14 | 0.000 (−0.02; 0.02) | 0.012 (−0.02; 0.04) | 0.459 |
TG/ApoB100 | 1.13 ± 0.50 | −0.082 (−0.20; 0.03) | 1.16 ± 0.52 | −0.058 (−0.17; 0.05) | −0.024 (−0.18; 0.13) | 0.766 |
NEFA, nmol/L | 0.39 ± 0.14 | −0.005 (−0.05; 0.04) | 0.40 ± 0.14 | −0.020 (−0.06; 0.02) | 0.015 (−0.05; 0.08) | 0.637 |
Intervention | Change Intertreatments | |||||
---|---|---|---|---|---|---|
Variable | ABG | Placebo | ABG vs. Placebo | |||
Baseline | Change | Baseline | Change | Mean (95% CI) | p-Value | |
Weight, kg | 71.5 ± 12.5 | 0.130 (−0.44; 0.70) | 71.4 ± 12.4 | −0.219 (−0.78; 0.34) | 0.348 (−1.1; 0.46) | 0.393 |
BMI, kg/m2 | 25.7 ± 3.13 | 1.01 (−0.27; 2.3) | 25.9 ± 3.29 | −0.138 (−1.4; 1.1) | 1.14 (−2.9; 0.66) | 0.213 |
Waist circumference, cm | 91 ± 8.93 | −0.149 (−1.2; 0.89) | 90 ± 9.72 | 0.283 (−0.76; 1.03) | 0.432 (−1.0; 1.9) | 0.563 |
Waist/Height | 0.55 ± 0.05 | −0.002 (−0.009; 0.005) | 0.54 ± 0.05 | 0.002 (−0.005; 0.009) | 0.004 (−0.006; 0.01) | 0.403 |
Conicity index | 1.27 ± 0.06 | −0.003 (−0.02; 0.01) | 1.26 ± 0.08 | 0.006 (−0.01; 0.02) | −0.009 (−0.01; 0.03) | 0.410 |
Fat mass, % | 28.7 ± 7.32 | 0.200 (−1.12; 1.52) | 28.9 ± 8.09 | −0.596 (−1.92; 0.73) | 0.796 (−1.01; 2.67) | 0.402 |
Fat mass, kg | 20.3 ± 6.67 | 1.06 (−0.42; 2.5) | 21.2 ± 7.68 | −0.474 (−1.98; 1.0) | 1.53 (−3.6; 0.58) | 0.153 |
Lean mass, kg | 51.4 ± 10.9 | −1.052 (−2.7; 0.64) | 51.2 ± 10.3 | −1.020 (−2.7; 0.66) | −0.032 (−2.4; 2.3) | 0.979 |
Muscle mass, kg | 48.8 ±10.4 | −0.362 (−1.5; 0.80) | 48.3 ± 10.3 | −0.058 (−1.2; 1.1) | −0.304 (−1.9; 1.3) | 0.713 |
Bone mass, kg | 2.59 ± 0.52 | −0.013 (−0.07; 0.05) | 2.58 ± 0.50 | −0.015 (−0.07; 0.04) | 0.002 (−0.08; 0.08) | 0.964 |
Total water, % | 49.6 ± 5.38 | −0.142 (−2.1; 1.8) | 49.3 ± 5.50 | 0.979 (−0.90; 2.9) | −1.121 (−1.6; 3.8) | 0.412 |
Total water, kg | 35.6 ± 7.74 | 0.325 (−0.66; 1.3) | 35.3 ± 7.39 | 0.221 (−0.75; 1.2) | −0.105 (−1.5; 1.3) | 0.881 |
Intervention | Change Intertreatments | |||||
---|---|---|---|---|---|---|
Variable | ABG | Placebo | ABG vs. Placebo | |||
Baseline | Change | Baseline | Change | Mean (95% CI) | p-Value | |
Waist circumference, cm | ||||||
Total | 100 ± 8.93 | −0.149 (−1.2; 0.89) | 90 ± 9.72 | 0.283 (−0.76; 1.03) | 0.432 (−1.0; 1.9) | 0.563 |
Men (n = 32) | 0.513 (−1.4; 2.4) | 1.26 (−0.62; 3.1) | 0.753 (−1.9; 3.4) | 0.574 | ||
Women (n = 35) | −0.755 (−1.8; 0.28) | −0.615 (−1.6; 0.42) | 0.139 (−1.3; 1.6) | 0.849 | ||
Waist/Height | ||||||
Total | 0.55 ± 0.05 | −0.002 (−0.009; 0.005) | 0.54 ± 0.05 | 0.002 (−0.005; 0.009) | 0.004 (−0.006; 0.01) | 0.403 |
Men | 0.55 ± 0.05 | 0.003 (−0.008; 0.01) | 0.54 ± 0.05 | 0.008 (−0.003; 0.02) | 0.005 (−0.01; 0.02) | 0.557 |
Women | 0.54 ± 0.05 | −0.007 (−0.01; 0.000) | 0.54 ± 0.06 | −0.004 (−0.01; 0.003) | 0.003 (−0.007; 0.01) | 0.533 |
Conicity index | ||||||
Total | 1.27 ± 0.06 | −0.003 (−0.02; 0.01) | 1.26 ± 0.08 | 0.006 (−0.01; 0.02) | −0.009 (−0.01; 0.03) | 0.410 |
Men | 1.28 ± 0.06 | 0.008 (−0.02; 0.04) | 1.26 ± 0.10 | 0.016 (−0.01; 0.04) | −0.008 (−0.03; 0.05) | 0.678 |
Women | 1.27 ± 0.06 | −0.014 * (−0.03; 0.004) | 1.26 ± 0.07 | −0.003 (−0.02; 0.01) | −0.011 (−0.01; 0.04) | 0.405 |
Lean mass, kg | (p = 0.045) | |||||
Total | 51.4 ± 10.9 | −1.052 (−2.74; 0.64) | 51.2 ± 10.3 | −1.020 (−2.70; 0.66) | −0.032 (−2.41; 2.35) | 0.979 |
Men | 60.7 ± 7.76 | 0.149 (−2.02; 2.31) | 59.8 ± 7.15 | −0.856 (−2.99; 1.27) | 1.006 (−2.03; 4.04) | 0.510 |
Women | 43.2 ± 5.34 | −2.124 (−4.67; 0.42) | 43.2 ± 5.07 | −1.161 (−3.70; 1.38) | −0.962 (−2.63; 4.56) | 0.595 |
ABG | p-Value | Placebo | p-Value | P for Difference * | |
---|---|---|---|---|---|
Energy, kcal/day Baseline 6 weeks | 2031 ± 579 | 2004 ± 665 0.734 | 1950 ± 543 2015 ± 560 | 0.321 | 0.381 |
CHO, % energy Baseline 6 weeks | 37.1 ± 8.7 36.7 ± 8.8 | 0.628 | 36.9 ± 6.8 36.0 ± 6.4 | 0.251 | 0.687 |
CHO, grams Baseline 6 weeks | 186 ± 62 188 ± 83 | 0.822 | 179 ± 54 179 ± 53 | 0.995 | 0.854 |
Protein, % energy Baseline 6 weeks | 16.7 ± 3.2 16.9 ± 4.7 | 0.759 | 17.0 ± 4.3 17.0 ± 2.9 | 0.930 | 0.864 |
Protein, grams Baseline 6 weeks | 81.9 ± 23.9 82.3 ± 27.3 | 0.895 | 79.0 ± 24.2 | 84.2 ± 22.8 0.080 | 0.225 |
Total fat, % energy Baseline 6 weeks | 41.8 ± 6.8 41.5 ± 7.0 | 0.769 | 41.8 ± 6.5 43.9 ± 7.3 | 0.030 | 0.102 |
Total fat, grams Baseline 6 weeks | 96.9 ± 34.6 95.7 ± 39.3 | 0.818 | 96.3 ± 40.3 97.8 ± 34.3 | 0.446 | 0.776 |
SFA, % energy Baseline 6 weeks | 11.9 ± 3.8 11.8 ± 3.4 | 0.793 | 12.0 ± 3.5 12.1 ± 3.2 | 0.831 | 0.716 |
SFA, grams Baseline 6 weeks | 27.5 ± 11.8 27.7 ± 14.1 | 0.945 | 26.9 ± 13.0 28.1 ± 12.7 | 0.451 | 0.697 |
MUFA, % energy Baseline 6 weeks | 23.4 ± 6.8 19.0 ± 5.0 | <0.001 | 23.8 ± 5.7 20.2 ± 3.6 | <0.001 | 0.463 |
MUFA, grams Baseline 6 weeks | 55.1 ± 24.5 44.0 ± 19.2 | 0.003 | 52.1 ± 20.8 45.6 ± 15.2 | 0.010 | 0.324 |
PUFA, % energy Baseline 6 weeks | 7.6 ± 2.1 7.1 ± 1.9 | 0.142 | 7.7 ± 2.3 7.0 ± 2.2 | 0.029 | 0.699 |
PUFA, grams Baseline 6 weeks | 17.8 ± 8.0 16.0 ± 7.0 | 0.114 | 16.9 ± 7.3 16.4 ± 8.7 | 0.680 | 0.443 |
Fiber, g/day | |||||
Baseline 6 weeks | 20.2 ± 9.2 20.3 ± 9.6 | 0.958 | 20.4 ± 11.3 19.6 ± 8.0 | 0.259 | 0.606 |
Alcohol, g/day Baseline 6 weeks | 5.8 (2.2–13.3) 5.3 (1.2–14.0) | 0.866 | 8.2 (1.1–17.5) 7.9 (0.00–17.8) | 0.507 | 0.947 |
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Valls, R.M.; Companys, J.; Calderón-Pérez, L.; Salamanca, P.; Pla-Pagà, L.; Sandoval-Ramírez, B.A.; Bueno, A.; Puzo, J.; Crescenti, A.; Bas, J.M.d.; et al. Effects of an Optimized Aged Garlic Extract on Cardiovascular Disease Risk Factors in Moderate Hypercholesterolemic Subjects: A Randomized, Crossover, Double-Blind, Sustainedand Controlled Study. Nutrients 2022, 14, 405. https://doi.org/10.3390/nu14030405
Valls RM, Companys J, Calderón-Pérez L, Salamanca P, Pla-Pagà L, Sandoval-Ramírez BA, Bueno A, Puzo J, Crescenti A, Bas JMd, et al. Effects of an Optimized Aged Garlic Extract on Cardiovascular Disease Risk Factors in Moderate Hypercholesterolemic Subjects: A Randomized, Crossover, Double-Blind, Sustainedand Controlled Study. Nutrients. 2022; 14(3):405. https://doi.org/10.3390/nu14030405
Chicago/Turabian StyleValls, Rosa M., Judit Companys, Lorena Calderón-Pérez, Patricia Salamanca, Laura Pla-Pagà, Berner Andrée Sandoval-Ramírez, Antonio Bueno, Jose Puzo, Anna Crescenti, Josep M. del Bas, and et al. 2022. "Effects of an Optimized Aged Garlic Extract on Cardiovascular Disease Risk Factors in Moderate Hypercholesterolemic Subjects: A Randomized, Crossover, Double-Blind, Sustainedand Controlled Study" Nutrients 14, no. 3: 405. https://doi.org/10.3390/nu14030405