Int J Clin Pract. 2018;e13208. wileyonlinelibrary.com/journal/ijcp | 1 of 7 https://doi.org/10.1111/ijcp.13208 © 2018 John Wiley & Sons Ltd Received: 18 January 2018 | Accepted: 22 April 2018 DOI: 10.1111/ijcp.13208 ORIGINAL PAPER The effect of 12-week garlic supplementation on symptom relief in overweight or obese women with knee osteoarthritis Ahmad Salimzadeh 1 | Elham Alipoor 2 | Sahar Dehghani 3 | Mehdi Yaseri 4 | Mostafa Hosseini 4 | Christine Feinle-Bisset 5,6 | Mohammad Javad Hosseinzadeh-Attar 2,3,5,6 1 Rheumatology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2 Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran 3 Department of Nutrition and Biochemistry, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran 4 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 5 Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide, Adelaide, Australia 6 Adelaide Medical School, University of Adelaide, Adelaide, Australia Correspondence Mohammad Javad Hosseinzadeh-Attar, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Email: hosseinzadeh.md.phd@gmail.com; mhosseinzadeh@tums.ac.ir Funding information Tehran University of Medical Sciences and Health Services, Grant/Award Number: 18329 Summary Aims: Chronic joint pain and stiffness, and functional disability, are the major debili- tating features of osteoarthritis (OA). The aim of this study was to assess the effect of 12-week supplementation with a garlic supplement on knee osteoarthritis out- comes in overweight or obese women. Methods: Seventy-six postmenopausal overweight or obese women (25≤BMI≤40 kg/m 2 ) with medically diagnosed knee OA participated in this randomised double- blind, placebo-controlled, parallel-design trial. After randomisation into 2 groups, patients received a daily dose of either 1000 mg odourless garlic tablet, or placebo, for 12 weeks. The total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as well as pain, stiffness and physical function subscales, were eval- uated pre- and poststudy. Anthropometric parameters and body composition (using bioelectrical impedance analysis) were also assessed. Results: Following 12-week supplementation in overweight or obese women with OA, stiffness (but not pain, function or WOMAC total score) was significantly lower in the garlic group compared with the placebo group (1.4 ± 1.6 vs 2.5 ± 1.9, P = .023). The changes in WOMAC parameters showed no statistically significant differences between the 2 groups. WOMAC total score (38.4 ± 15.9-30.6 ± 15.7, P = .004) and all the subscales, including pain (8.3 ± 3.7-7 ± 4.4, P = .026), stiffness (2.3 ± 1.6- 1.4 ± 1.6, P = .013) and physical function (27.7 ± 11.9-22.2 ± 12.4, P = .001) improved significantly in the garlic group postintervention compared with pre-intervention; although pain subscale also decreased in the placebo group (9.6 ± 3.1-6.9 ± 3.7, P < .001). Conclusions: Although pre- to postintervention knee OA symptoms were improved in overweight or obese women receiving 12 weeks garlic supplement, there was no significant difference in WOMAC changes compared with the placebo group. Further clinical trials are required to investigate the therapeutic value of garlic ingredients, and the potential role of placebo effect, in the management of OA symptoms. 1 | INTRODUCTION Osteoarthritis (OA) is the most prevalent joint disease worldwide. This debilitating disease results in impaired quality of life and considerable financial burden. 1 Chronic and disabling pain is the main symptom of OA. This pain originates from complex cellular interactions between spinal neurons (central mechanisms) and joints (peripheral level). 2 Unlike the acute pain associated with a trauma or surgery that subsides over time. OA-induced pain per- sists despite treatment, exacerbating the functional incapacity of patients. 1 Pain aetiology in OA is multifactorial. Inflammation