(EA02-02-25) Effects of Replacing Solid Fats and Added Sugars with Avocado in Adults With Elevated Cardiometabolic Risk: A Randomized, Double-Blind, Controlled Feeding Trial

Scientific conference where the work was recently presented: American Heart Association Epi Lifestyle 2025

Date on which the work was previously presented at the scientific conference listed: March 9, 2025

Objectives: >Limited high-quality evidence exists from controlled trials on the impact of avocado-containing diets on cardiometabolic risk factors.  The purpose of this randomized, double-blind, outpatient, controlled feeding, crossover study in adults with increased cardiometabolic risk was to assess the effects of replacing energy from solid fats and added sugars with energy from one avocado daily on cardiometabolic risk factors.

Methods: >For two 3-week periods, separated by a 2-week washout, 42 healthy adults with elevated triglycerides (TG, 135-499 mg/dL) consumed an average American diet or a diet in which one avocado (~180 g/day, ~300 kcal/day) replaced energy from saturated fatty acids and added sugars. The same study products (muffins, granola bites, dressing, salsa, marinade, pesto) delivered the avocado or control ingredients. Green food dye was added to the control study products to facilitate the double-blinding. Non-high-density lipoprotein (non-HDL) cholesterol (primary outcome), other lipoprotein lipids, and fasting and postprandial glucose, insulin, and blood pressures were measured at baseline and the end of each condition. Linear mixed models were used to generate estimates for percentage changes in outcomes.

Results: Of 42 participants, 37 completed the avocado condition and 39 completed the control condition. An intention-to-treat analysis showed significantly larger percentage changes from baseline during the avocado condition, compared to after the control condition, for non-HDL cholesterol (-4.65%, 95% confidence interval [CI]: -9.01%, -0.08%; P = 0.047), TG (-17.4%, 95% CI: -25.0%, -8.99%; P < 0.001), and total cholesterol:HDL cholesterol ratio (-6.56%, 95% CI: -12.0%, -0.79%; P = 0.028). Percentage changes from baseline for other lipoprotein lipids, fasting and postprandial glucose, insulin, and blood pressures did not significantly differ (P > 0.05) between conditions.

Conclusions: Replacing solid fats and added sugars with avocado in a typical American diet improved the lipoprotein lipid profile in adults with elevated TG.

Funding Sources: The Avocado Nutrition Center of the Hass Avocado Board funded this research.