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Title: Avocado consumption by adults is associated with better nutrient intake, diet quality, and some measures of adiposity: National Health and Nutrition Examination Survey, 2001-2012

Author
item O'NEIL, CAROL - Louisiana State University Agcenter
item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)
item FULGONI III, VICTOR - Nutrition Impact, Llc

Submitted to: Internal Medicine Review
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/13/2017
Publication Date: 4/3/2017
Citation: O'Neil, C.E., Nicklas, T.A., Fulgoni III, V.L. 2017. Avocado consumption by adults is associated with better nutrient intake, diet quality, and some measures of adiposity: National Health and Nutrition Examination Survey, 2001-2012. Internal Medicine Review. 3(4).

Interpretive Summary: Avocados have been defined as a nutrient dense food; contain a beneficial lipid profile, including a high level of monounsaturated fatty acids, as well as dietary fiber, essential nutrients, and phytochemicals. The aim of this study was to investigate whether there were any associations between the consumption of avocado and overall diet quality, energy and nutrient intakes, physiological indicators of health, and risk of metabolic syndrome. Data from adults 19+ y (n=31,093) participating in the NHANES 2001-2012 was collected. Excluding individuals without reliable dietary records and females who were pregnant or lactating, the final analytical sample was 29,684 individuals. Height, weight, and waist circumference were obtained according to NHANES protocols, and body mass index (BMI) was calculated. Systolic and diastolic blood pressures were determined using the standard NHANES protocol. Intake data were obtained from Day 1, in-person 24-hour dietary recall interviews administered using an automated multiple-pass method. This study confirms the findings of a previous study showing an association between avocado consumption and improved nutrient intake, food group consumption, diet quality, weight, and metabolic syndrome. Thus more studies are needed to confirm these epidemiologic data and the potential associations between increased intake of avocados and other dietary components and health outcomes. Avocados can be included in the diet of most adults as part of an overall healthful diet that focuses on increased fruit and vegetable intake.

Technical Abstract: Avocados contain a beneficial lipid profile, including a high level of monounsaturated fatty acids, as well as dietary fiber, essential nutrients, and phytochemicals. However, little epidemiologic data exist on the effect that consumption of avocados has on overall nutrient intake, diet quality, adiposity parameters, and other metabolic disease risk factors. The objective of this research was to investigate whether there were any associations between avocado consumption and overall diet quality, energy and nutrient intakes, physiological indicators of health, and risk of metabolic syndrome. Avocado consumption and its association with these diet and health parameters were assessed using a nationally representative sample of adults (n=27,684) participating in the 2001-2012 NHANES. Intake was determined from one day 24-hour dietary recalls. Covariate adjusted means, standard errors, and ANOVA for food groups, nutrients, and health biomarkers were determined using appropriate sample weights. Diet quality was measured using the Healthy Eating Index-2010 (HEI-2010). For linear and logistic regression analyses, p<0.001 and p<0.01, respectively were used. Average consumption of avocados by consumers (n=667) was 75.6 +/- 3.8 g/day. Avocado consumers had higher intakes of dietary fiber, mono- and polyunsaturated fats, vitamins E and C, folate, magnesium, potassium, and fruit and vegetables and lower intakes of sodium than non-consumers. Consumers also had a higher total HEI-2010. Consumers had lower mean weight, body mass index, waist circumference, insulin, and homocysteine levels and had a lower percentage of those with an elevated waist circumference and metabolic syndrome. Avocado consumers were 33% less likely to be overweight/obese and 32% less likely to have an elevated waist circumference. Avocado consumption was associated with better dietary measures and weight parameters than seen in non-consumers; consumption should be encouraged as part of an overall healthy lifestyle.