Written by Taylor Woosley, Staff Writer. Subjects consuming ≥2 servings/week of avocadoes had a 16% lower risk of developing cardiovascular disease and a 21% lower risk of coronary heart disease incidence. 

fruits and vegetables - AvocadoCardiovascular diseases (CVD) are the leading cause of mortality globally, with coronary heart disease and stroke accounting for the highest rates of mortality 1. Worldwide an estimated 17.8 million people die every year from CVD and the prevalence only continues to rise with the aging population 2. The pathogenesis of CVD involves the formation of atherosclerotic lesions, resulting in the narrowing of arteries, exacerbating the formation of a thrombus and acute clinical event 3. Modifiable risks factors for CVD include a high BMI, elevated BP, elevated LDL-C and triglycerides, high blood glucose, and insulin resistance 4.

Diet and lifestyle factors such as adequate sleep and exercise can play a substantial role in the prevention of CVD. Certain fruits such as avocado have been studied for its high monounsaturated fatty acid levels, along with being a rich source of antioxidants and polyphenols 5. Avocadoes can effectively reduce LDL-C which is an important measure for cardiovascular prevention 6. Past epidemiological studies have reported that frequent avocado consumption effectively decreased total cholesterol and triglyceride levels, while also increasing serum HDL-C concentrations 7.

Pacheco et al. conducted a study using data provided by two prospective cohort studies: the Nurses’ Health Study (women, n=62,225) and the Health Professionals Follow-up Study (men, n=41,701) which took place from 1986-2016. Participants from both cohorts answered questionnaires related to lifestyle practices, medical history, and other health information at baseline and then every 2 years. Subjects were asked how often they consumed different foods, with a specific question geared towards number of avocados consumed, while also focusing on butter, olive oil, and other plant oil intake. Primary outcomes included CVD occurrence and secondary outcomes were incident cases of coronary heart disease (CHD), defined as fatal CHD and nonfatal myocardial infarction or stroke incidence. Multivariable Cox proportional hazards models were used to estimate the hazard ratios and 95% CIs of CVD occurrence according to avocado intake. Spearman correlations were used to assess possible correlations between avocado and other types of fats. After evaluating 30 years of follow-up data, the significant findings are as follows:

  • After adjusting for diet and lifestyle factors, participants with a higher avocado intake (≥2 servings/week) had a 16% lower risk of CVD (pooled HR, 0.84; 95% CI, 0.75-0.95; P trend=0.0007).
  • When avocado models were mutually adjusted for other types of high-fat food sources, the pooled HR for CVD was 0.89 (95%CI, 0.80-0.98; P trend=0.02).
  • Per each half serving increase of avocado a day, the pooled HR for CVD was 0.80 (95% CI, 0.71 to 0.91; P trend=0.0007).
  • The pooled estimate for the overall HR of ischemic stroke was 0.93 (95%CI, 0.69-1.25; P trend=0.62) per each half a serving/day increase in avocado consumption.
  • Substituting half a serving/day of avocado in place of the equivalent amount of margarine was estimated to be associated with 16% lower risk of CVD (HR, 0.84; 95% CI, 0.75-0.95; P=0.004). Additionally, when substituting in place of the equivalent amount of eggs and cheese, avocado consumption was estimated to be associated with 18% (HR, 0.82; 95% CI, 0.73-0.93; P=0.001) and 13% (HR, 0.87; 95%CI, 0.77 to 0.98; P=0.02) lower risk of CVD.

Significant findings of the 2 large prospective cohorts of men and women over the course of 30 years resulted in associations between higher avocado intake and lower risk of CVD and CHD. Limitations of the study include the use of a self-reported diet assessment which may not always be accurate and the lack of a causal association due to the observational design of the study. Future research should continue to explore the cardioprotective benefits of increased avocado consumption.

Source: Pacheco, Lorena S., Yanping Li, Eric B. Rimm, JoAnn E. Manson, Qi Sun, Kathryn Rexrode, Frank B. Hu, and Marta Guasch‐Ferré. “Avocado Consumption and Risk of Cardiovascular Disease in US Adults.” Journal of the American Heart Association 11, no. 7 (2022): e024014.

© 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. 

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Posted June 10, 2022.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

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