Chapter Three As a conventionally trained medical doctor, I understand and appreciate the value of strong science. In the case of cholesterol management—both preventing high cholesterol and lowering elevated levels—there are some natural substances that have proven to be critical tools we can use. In this chapter, I describe some of the natural alternatives that I feel stand up to strong scientific scrutiny. Aged Garlic Extract There are several different types of garlic including raw garlic, garlic oil, crude garlic powders in tablets or capsules, and Aged Garlic Extract (AGE). I have found that only AGE provides the concentration and standardization required for effectiveness. AGE goes through an extensive two-year proprietary process that removes the odor-­ causing compounds, and enhances and concentrates the herb’s active beneficial components. I have found that patients and research participants prefer a garlic supplement that is truly odorless. This increases compliance and ensures the product is taken consistently. I also like the fact that AGE uses organically grown garlic. ­ Amazingly, there are presently well over 750 published papers in peer- reviewed scientific journals featuring AGE. Clinical studies have also shown AGE is more bioavailable.This means it is found in blood, urine, and body tissue after consumption. Because it is more bioavailable, the body can utilize it more effectively. The aging process also increases the potency of S-allylcysteine (SAC), an important sulfur-containing amino acid.There are only small amounts of SAC in raw garlic. I presented my research on AGE at the Experimental Biology 2014 conference. During earlier studies, my colleagues at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center and I demonstrated that AGE enhances blood flow, clears arteries of deposits, and reduces multiple risk factors for heart disease. In two successive randomized trials, we have shown conclusively that AGE has cardiovascular benefit. In one of our studies, we chose to evaluate 65 patients who were at intermediate risk of developing heart disease. We used a proprietary combination of AGE, the three key B vitamins (B6, B12, and Folate) and L-arginine, a heart-healthy amino acid. The group that took the supplement had less calcified plaque progression, lower total cholesterol, and reduced homocysteine levels compared to the participants who received a placebo. We did another study using this same formula and demonstrated it significantly improved circulation and halted calcified plaque progression in the arteries of patients who did not have heart disease symptoms but did have subclinical fatty deposits in the arteries. AGE has a great safety record. While other forms of garlic may interact with blood thinning medications like warfarin CHOLESTEROL 9