My love affair with garlic began when I was a small child. My mother, a fabulous home cook, introduced me to the white papery cloves, thyme and bay leaves as her way of transforming simple casseroles into dishes of wonder. But it wasn’t until I was an undergraduate pharmacy student that garlic’s true powers became apparent. Pharmacognosy is the study of medicinal drugs obtained from plants or other natural sources. By learning of garlic’s use in medicine this humble spice took on a whole new meaning. 
 
Garlic has inspired belief in its healing abilities for centuries. The ancient Egyptians prescribed garlic for circulatory ailments, infections and general malaise. Hippocrates recommended it for pulmonary ailments, treating sores and for abnormal growths and the ancient Chinese prescribed it to aid digestion, treat diarrhoea, fatigue, headache and insomnia. More recently, Louis Pasteur demonstrated garlic’s antiseptic activity and garlic was used during WW1 in the form of a diluted solution to prevent infections and gangrene. To date, thousands of publications have confirmed the efficacy behind garlic’s use in medicine.(1) 

So how does garlic exert health benefits? 

When raw garlic cloves are damaged through crushing, cutting, chewing, wetting, or dehydrating, the enzyme allinase is released which rapidly converts sulphur compounds within the clove to compounds called allyl thiosulphinates, of which allicin is the most abundant. This bio-active sulphur, containing phytochemicals, are responsible for the flavour and aroma as well as many of garlic’s beneficial effects.(2) Studies have shown garlic to exhibit antioxidant, anti-inflammatory, antibacterial and antifungal activity(3). Research also shows that garlic also exerts protective effects on immune and cardiovascular systems reduces blood pressure and improving lipid profiles. It has anti-cancer, anti-diabetic and anti-obesity actions and displays properties that are protective of the digestive system, liver, kidneys and the nervous system.(4) 
 
Although much research focusses on the bio-active sulphur containing compounds in the bulb, garlic also contains inulin. Inulin is a prebiotic fibre and a fructo-oligosaccharide which indirectly benefit our health.(5) We humans lack the enzymes to break down these prebiotic fibres, also referred to as non-digestible carbohydrates, but these fibres feed our good gut bacteria, nurturing the health of our microbiome. Regular consumption of foods like garlic indirectly protect us from many degenerative diseases by maintaining the health of our gut microbiome. (6) 

Can you have too much of a good thing? 

Consuming garlic as a whole food as part of a well-balanced diet is completely safe and always the way I recommend its use. Chop it, crush it, slice it and let it stand for a few minutes before using to allow the beneficial compounds to form, then simply use raw or cook. For those who suffer from digestive issues such as irritable bowel syndrome and who may be following a low FODMAP diet, it’s better to introduce garlic slowly with the help of a nutrition professional as it may aggravate symptoms. 
 
Garlic can be purchased as a supplement but no daily recommended dose has been established. As a pharmacist, I’m all too aware that supplements are not created equally and unless they are pharmaceutical grade they do not undergo the same scrutiny as pharmaceutical products. It’s tricky trying to establish how much allicin is bioavailable in the preparations and toxicity may be an issue with high doses and so, like most things taken to excess, there may be issues.(1) Try to use the food wherever you can. 

Get growing 

My love affair continues. Garlic is an excellent addition to any healthful diet and something I recommend to all my patients. When we finally moved to house with a large enough garden, garlic was the first thing we experimented with in our newly formed vegetable patch. Planted on the shortest day of the year and harvested on the longest, it’s simple and successful. Nature at its best. We now plant garlic every year and look forward to celebrating our annual healthful harvest. Once the bulbs are lifted we dry them in the sun for a few days, plat the stems and hang by the cooker ready for use. 
 
I hope the next time you look at the humble garlic bulb you learn to love it as much as I do. 
 
Get eating, growing and enjoy in health. 
 
Charlotte x 
 
1. Rana S V, Pal R, Vaiphei K, Sharma SK, Ola RP. Garlic in health and disease. 2021 [cited 2021 Mar 21]; Available from: https://doi.org/10.1017/S0954422410000338 
 
2. Dorrigiv M, Zareiyan A, Hosseinzadeh H. Garlic (Allium sativum) as an antidote or a protective agent against natural or chemical toxicities: A comprehensive update review. Phyther Res. 2020;34(8):1770–97. 
 
3. Hosseini A, Hosseinzadeh H. A review on the effects of Allium sativum (Garlic) in metabolic syndrome [Internet]. Vol. 38, Journal of Endocrinological Investigation. Springer International Publishing; 2015 [cited 2021 Mar 22]. p. 1147–57. Available from: https://pubmed.ncbi.nlm.nih.gov/26036599/ 
 
4. Shang A, Cao SY, Xu XY, Gan RY, Tang GY, Corke H, et al. Bioactive compounds and biological functions of garlic (allium sativum L.) [Internet]. Vol. 8, Foods. MDPI Multidisciplinary Digital Publishing Institute; 2019 [cited 2021 Mar 22]. Available from: https://pubmed.ncbi.nlm.nih.gov/31284512/ 
 
5. Pandey KR, Naik SR, Vakil B V. Probiotics, prebiotics and synbiotics- a review [Internet]. Vol. 52, Journal of Food Science and Technology. Springer India; 2015 [cited 2021 Mar 22]. p. 7577–87. Available from: /pmc/articles/PMC4648921/ 
 
6. So D, Whelan K, Rossi M, Morrison M, Holtmann G, Kelly JT, et al. Dietary fiber intervention on gut microbiota composition in healthy adults: A systematic review and meta-analysis. Am J Clin Nutr. 2018;107(6):965–83. 
 
7. Boozari M, Hosseinzadeh H. Natural medicines for acute renal failure: A review [Internet]. Vol. 31, Phytotherapy Research. John Wiley and Sons Ltd; 2017 [cited 2021 Mar 22]. p. 1824–35. Available from: https://pubmed.ncbi.nlm.nih.gov/29027276/ 
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