Overweight, often diagnosed as obesity, has become a major health issue in the United States as well as other countries. During the last four decades the prevalence of obesity has been growing at alarming rates, increasing risk factors that constitute the cluster of metabolic syndrome (MS), a condition characterized by, and rise in the risk of a variety of ailments, notably heart disease, stroke, inflammation, diabetes and certain cancers.

Hallmarks of the metabolic syndrome include abdominal obesity, increased blood pressure, (hypertension), elevated triglycerides and LDL cholesterol, that are harmful lipids, a reduction in plasma high density lipids, HDL cholesterol (the good cholesterol), and insulin resistance, a condition in which the body cannot use its insulin to move sugar into cells for energy, resulting in high blood sugar and diabetes. Studies now show that metabolic syndrome or its components, such as overweight, are associated with increased risk of cardiovascular disease as well as the development and progression of cancers of the breast, endometrium, colorectal, pancreas, liver and kidney.

Overweight And Health Problems
Both clinical and experimental studies have established that overweight increases the risk of a variety of detrimental health conditions, including oxidative stress, high blood pressure, high LDL and triglycerides, promoting atherosclerosis, coronary heart disease and stroke. Overweight can harm other aspects of health. It is a major cause of gallstones, can worsen degenerative joint diseases, play a role in cancer and sleep apnea. Lowering weight to a healthy level reduces these risk factors and causes blood to circulate more effectively. Overweight and frank obesity can lead to low-grade inflammation that is associated with the fat tissue that produces and secretes a variety of inflammatory molecules, increasing the risk of CVD and other pathological conditions.

Adiponectin
Adiponectin is the most abundant protein secreted by fat tissue into the bloodstream. It is considered a protective protein and has anti inflammatory, anti atherogenic as well as insulin sensitizing properties. Ironically, and contrary to expectations, despite being produced in fat tissue, adiponectin is decreased in obesity and its levels are inversely correlated with the percent of body fat; that is, the fatter the person the lower adiponectin levels. Adiponectin has regulatory functions that help combat risk factors associated with metabolic syndrome, including regulation of metabolic changes that occur in persons with conditions of type 2 diabetes, obesity, and atherosclerosis; adiponectin protective effects include increased insulin sensitivity and a lowering of the risk of cardiovascular disease. In cases of overweight and obesity, where adiponectin is low, an enhancement of adiponectin levels would be of therapeutic value.

The search to reduce the risk of the adverse effects of metabolic syndrome and overweight discovered garlic (Allium sativum L.). Garlic has been used as a nutrient with beneficial cardiovascular effects. However, fresh garlic is not for everyone, as its beneficial effects are offset by its pungent odor that lingers on breath and skin and its ability to often cause indigestion. An alternative source of garlic that is odorless and rich in antioxidants is the natural supplement Kyolic Aged Garlic Extract (AGE), having a wide range of health effects, that are often more effective than the fresh bulb.

Kyolic Aged Garlic ExtractTM (AGE)
Kyolic Aged Garlic Extract (AGE), is an odorless natural garlic supplement, manufactured by Wakunaga of America, from organically grown garlic that has been extracted and aged for 20 months, at room temperature. Rich in water-soluble organosulfur compounds, such as S-allyl cysteine and S mercaprocysteine, that has antioxidant activity; AGE is found, in experimental and clinical studies, to help prevent a wide range of ailments, notably coronary plaque formation and atherosclerosis, thereby reducing the risk of heart disease and stroke. Other health benefits include anti-inflammatory effects, boosting immunity, lowering blood pressure, reducing the risk of certain cancers, notably colorectal cancer, and preventing the toxic effects of radiation and certain drugs, such as acetaminophen, that when taken in high doses can cause liver failure. AGE is highly bioavailability and its wide range of health effects have been proven in clinical and experimental studies, reported in over 700 peer reviewed scientific and medical publications.

AGE And Adiponectin
A clinical trial, by D. Gomez-Arbelaez and colleagues, set out to investigate the effects of AGE on adiponectin and metabolic risk factors that constitute the metabolic syndrome. The clinical trial was a double blind, placebo controlled, randomized, crossover study, carried out on a Colombian urban population with metabolic syndrome.

The Study
The study selected 46 men and women over 18 years old with a metabolic syndrome diagnosis, a diagnosis based on obesity (waist circumference larger than 90 cm for males and greater than 80 cm for females).

Other hallmark characteristics included: triglycerides above 150 mg/dL, HDL lower than 40 mg/dL (male) and 50 mg/dL (female), blood pressure higher or equal to 130/85 mmHg, and fasting plasma glucose levels higher than 100 mg/dL. The investigators divided the subjects into two groups of 23, with each group being randomly assigned to ingest either 1.2 g/day of AGE (Kyolic) or placebo; Following 12 weeks of supplementation, treatment was reversed for another 12 weeks; that is, the ones who received AGE now received a placebo and those who were on placebo received AGE. The subjects received AGE or placebo as identical capsules, taken twice day, with breakfast and dinner. All subjects received recommendations for a lifestyle that included a diet lower in fat and sugar and exercise, and an exercise regimen of 30-minutes/day moderate walking. The subjects were followed every four weeks to evaluate clinical endpoints. At the beginning and end of each phase of the study (week 12 and week 24), investigators assessed weight, height, body mass index (BMI), that measures body fat, depending on height and weight, waist and hip circumferences and blood pressure.

The Findings
Results from the study showed that AGE intake for 12 weeks increases adiponectin levels. The increase in adiponectin, following AGE, was statistically significant, an important finding, since decreased adiponectin levels (4 µg/mL) are associated with doubling the frequency of coronary heart disease, independent of other cardiovascular risk factors, as well as insulin resistance, diabetes type 2, atherosclerosis and hypertension.

This first demonstration of AGE enhancement of adiponectin has a wide range of potential results; adiponectin increases cellular glucose uptake by cells and prevents excess blood glucose levels; adiponectin inhibits inflammation and oxidative stress, protecting blood vessels against oxidative damage that can cause cell death. AGE-induced increase in adiponectin would result in AGE influencing the improvement of insulin resistance and increasing sensitivity, thus playing an important role in helping prevent diabetes.

Another mechanism which can be linked to AGE increasing adiponectin levels and AGE protection against cardiovascular disease, is the regulatory mechanism associated with nitric oxide (NO). Nitric oxide is a regulator of blood pressure and is important in cardiovascular protection. AGE enhances NO production, and NO regulates adiponectin levels, which, as shown above is critical in modulating risk factors in metabolic syndrome.

AGE Improves Metabolic Parameters In Obese Models
While AGE, by enhancing the levels of adiponectin helps protect obese individuals against heart disease and other pathological aspects of metabolic syndrome, an experimental study from Korea, by Seo and colleagues studied the effects of AGE in experimental models fed a high fat diet, and made to exercise. AGE proved to have an additive anti-obesity and cardio-protective effect, reducing body fat, lowering cholesterol and triglycerides and reducing inflammation.

The Bottom Line
The study by Arbelaez adds to the wide range of important AGE health effects. The clinical study shows for the first time that AGE, added to the diet of overweight men and women with metabolic syndrome (MS), for 12 weeks, increases adiponectin, lowering their risk against heart disease, stroke, insulin resistance, diabetes type 2 and other conditions associated with metabolic syndrome. In addition, the study by Seo et al shows that AGE has anti-obesity properties.

Putting the two studies together, AGE can reduce body fat and potentially prevent the onset of MS; moreover, in the situation where a person is already overweight or frankly obese and diagnosed with metabolic syndrome, AGE added to the diet can, within a short period of 12 weeks, help protect against the symptoms of MS by increasing adiponectin production.

References:

Diego Gomez Arbelaez, Vicente Lahera, Pilar Oubina et al Aged Garlic Extract Improves Adiponectin Levels in Subjects with Metabolic Syndrome: A Double Blind, Placebo Controlled, Randomized, Crossover StudyMediators Inflamm. 2013;2013:285795. doi: 10.1155/2013/285795. Epub 2013 Feb 28.

Weiss N, Papatheodorou L, Morihara N, Hilge R, Ide N. Aged garlic extract restores nitric oxide bioavailability in cultured human endothelial cells even under conditions of homocysteine elevation. J Ethnopharmacol. 2013;145:162 7.

Seo DY, Lee S, Figueroa A, Kwak YS, et al. Aged garlic extract enhances exercise mediated improvement of metabolic parameters in high fat diet induced obese rats. Nutr Res Pract. 2012: 6; 513 9. doi: 10.4162/nrp.2012.6.6.513. Epub 2012 Dec 31.

Ahmadi N, Nabavi V, Hajsadeghi F, et al. Aged garlic extract with supplement is associated with increase in brown adipose,decrease in white adipose tissue and predict lack of progression in coronary atherosclerosis Int J Cardiol. 2013;168:2310-4. doi: 10.1016/j.ijcard.2013.01.182. Epub 2013 Mar 1.


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