Insights & Discussion
Avocado consumption correlates with a wider variety of healthier food choices, offering potential benefits for weight control strategies.
The study created a comprehensive database of avocado-containing foods and drinks based on the AUSNUT 2011-13 food composition structure. The data pulled from four food-based clinical trials consisted of the usual food intake information from overweight and obese volunteers. The Apriori algorithm of association rules was employed as a two-step descriptive methodology to identify the associations between avocado consumption and choices of various foods at each mealtime using a nested hierarchical food group classification scheme.
The findings revealed 34 separate avocado and avocado-inclusive foods and beverages. Avocado intake was prevalent within the studied cohort, with more than half consuming avocados regularly. Avocados were invariably associated with other food groups in main meal occasions, and during breakfast, lunch, and dinner, 68 food items containing avocados were identified for avocado consumers. This avocado-specific database offers insights into the variety of foods and beverages that incorporate avocados, reflecting broad food choices among regular avocado consumers.
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Consumption of unripe avocado extract in the diet may lower postprandial insulin levels in overweight adults with previously elevated insulin levels.
2023 Nutrients Effects of an Unripe Avocado Extract on Glycaemic Control in Individuals with Obesity: A Double-Blinded, Parallel, Randomised Clinical Trial Zhao L, Ingram DK, Gumpricht E, De Paoli T, Teong XT, Liu B, et al.
Randomised Controlled Trial Avocado Blood Sugar Glucose
In this study, a double-blinded, randomised controlled trial was performed on 60 non-diabetic adults (with a majority of 47 being women, average age 48 years, BMI 34.0 kg/m). The participants were stratified by sex and randomised into two groups. One group daily consumed an extract from unripe avocado (10 g finely ground, freeze-dried unripe avocado), while the other took a placebo (10 g finely ground cornmeal supplemented with 5% spinach powder) over a period of 12 weeks. The primary outcome measured was the change in glucose area under the curve (AUC) in response to a 75 g oral glucose tolerance test.
The results showed no significant differences between both groups in terms of glucose AUC, insulin AUC, or cardiovascular outcomes. However, in a subgroup analysis focusing on participants with above median baseline postprandial insulin levels, there was a notable reduction in insulin AUC in those who consumed the avocado extract compared to the placebo. This suggests that the daily consumption of an unripe avocado extract, enriched in MH, might not significantly impact glucose tolerance or insulin sensitivity in obese non-diabetic adults. Nonetheless, there seems to be a potential benefit of this intervention on postprandial insulin levels in individuals with initially elevated insulin responses.
Avocado consumption is linked to better glucose regulation, with metabolomic biomarkers of avocado intake showing even stronger associations with lower glycemia.
2023 The Journal of Nutrition Associations between Metabolomic Biomarkers of Avocado Intake and Glycemia in the Multi-Ethnic Study of Atherosclerosis Wood AC, Goodarzi MO, Senn MK, Gadgil MD, Graca G, Allison MA, et al.
Cohort Study Avocado Blood Sugar
The study used baseline data from 6224 multi-ethnic older adults, including self-reported avocado intake, fasting glucose and insulin. Untargeted plasma proton nuclear magnetic resonance contributed to metabolomic features, with data available for a subset of 3438 participants. The researchers then assessed the incidence of type 2 diabetes over approximately an 18-year follow-up period. They conducted a metabolome-wide association study comparing avocado consumers to nonconsumers and examined the features' associations with glycemia, both cross-sectionally with fasting insulin and glucose, and longitudinally with the incidence of type 2 diabetes.
The research identified three highly-correlated spectral features associated with avocado intake at metabolome-wide significance levels and grouped into a single biomarker. These features didn't demonstrate any strong associations with overall dietary quality or any of the 47 other food groups, reinforcing their validity as an avocado intake biomarker. While avocado intake had a modest effect on lowering fasting insulin, this effect was not significant when adjusting for participants' body mass index. However, the avocado intake biomarker was noticeably related to lower fasting glucose, lower fasting insulin, and a lower incidence of type 2 diabetes, even after adjusting for BMI. This illustrates the considerable influence of metabolomic insights in determining diet-health relationships and the importance of considering individual metabolic differences for health outcomes.
Avocado consumption may lead to a reduction in total cholesterol and low-density lipoprotein cholesterol levels in people with high cholesterol without impacting body weight.
2022 Journal of the Academy of Nutrition and Dietetics Avocado Consumption and Cardiometabolic Health: A Systematic Review and Meta-Analysis James-Martin G, Brooker PG, Hendrie GA, Stonehouse W
Systematic Review Avocado Cholesterol
The study reviewed the impact of diets containing avocado on cardiometabolic risk factors compared with diets containing no or low amounts of avocado. Five electronic databases were searched aiming to identify studies published between 1990 and 2021. The selected studies included randomized controlled trials of three weeks or more and prospective cohort studies. In total, ten studies, nine controlled trials, and one observational study, met the inclusion criteria. Risk of bias was evaluated, and overall quality of the evidence was inspected. Meta-analyses were performed when there were three or more studies of the same design reporting the same outcome.
Upon reviewing the results, the study found a minor, noteworthy reduction in total cholesterol levels in the avocado group as opposed to the control groups. There was no significant difference found in low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triglycerides. However, in populations with hypercholesterolemia, avocado consumption demonstrated significant reductions in both total cholesterol and low-density lipoprotein cholesterol levels. It is also worth noting that consumption of avocados did not negatively affect body weight or composition.
Despite previous suggestions, daily avocado consumption for six months did not decrease visceral adipose tissue volume in individuals with elevated waist circumference.
2022 Journal of the American Heart Association Effect of Incorporating 1 Avocado Per Day Versus Habitual Diet on Visceral Adiposity: A Randomized Trial Lichtenstein AH, Kris‐Etherton PM, Petersen KS, Matthan NR, Barnes S, Vitolins MZ, et al.
Randomised Controlled Trial Avocado Visceral Fat
The HAT Trial was a multicenter, randomized, controlled study designed to observe the effects of consuming one large avocado per day for six months on free-living individuals with an increased waist circumference. The primary measure of effect was the change in visceral adipose tissue volume, which was measured through magnetic resonance imaging. Other conditions related risk factors associated with cardiometabolic disorders were surveyed as secondary and additional endpoints.
In results analysis, there was no significant alteration in visceral adipose tissue volume between the Avocado Supplemented and Habitual Diet Groups. No noteworthy differences were noticed in the secondary outcomes including hepatic fat fraction and certain components of the metabolic syndrome. Of the extra outcome measures, small but significant reductions were seen in total and low-density lipoprotein cholesterol in the Avocado Supplemented compared to the Habitual Diet Group. Changes in body weight, body mass index, insulin concentration and other measured factors were very similar between both groups, showing no considerable change due to avocado consumption.
Eating more avocados, specifically two servings a week, is associated with a significantly lesser risk of cardiovascular disease and coronary heart disease.
2022 Journal of the American Heart Association Avocado Consumption and Risk of Cardiovascular Disease in US Adults Pacheco LS, Li Y, Rimm EB, Manson JAE, Sun Q, Rexrode K, et al.
Cohort Study Avocado Cardiovascular Disease
The research analysis included 68,786 women from the Nurses' Health Study and 41,701 men from the Health Professionals Follow-up Study, who were free of cancer, coronary heart disease, and stroke at the start. Their diet was assessed using validated food frequency questionnaires at the start and then every four years. The researchers used Cox proportional hazards regressions to estimate hazard ratios. Over three decades of follow-up, 14,274 new cases of cardiovascular disease were documented, including 9,185 coronary heart disease events and 5,290 strokes.
After adjusting for lifestyle and other dietary factors, it was found that compared to non-consumers, those who had higher avocado intake exhibited a lower risk of cardiovascular disease and coronary heart disease. No significant associations for stroke were detected. Furthermore, it was noted that replacing half a serving per day of certain fatty foods with equivalent amounts of avocado was linked with lower risk of cardiovascular disease.
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