Effect of incorporating 1 avocado per day versus habitual diet on visceral adiposity: A randomized trial

Authors: LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; KRIS-ETHERTON, PENNY - Pennsylvania State University; PETERSEN, KRISTINA - Texas Tech University; MATTHAN, NIRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; BARNES, SAMUEL - Loma Linda University; VITOLINS, MARA - Wake Forest School Of Medicine; LI, ZHAOPING - University Of California (UCLA); SABATE, JOAN - Loma Linda University; RAJARAM, SUJATHA - Loma Linda University; CHOWDHURY, SHILPY - Loma Linda University; DAVIS, KRISTIN - Pennsylvania State University; GALLUCCIO, JEAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; GILHOOLY, CHERYL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; LEGRO, RICHARD - Pennsylvania State College Of Medicine; LI, JASON - University Of California (UCLA); LOVATO, LAURA - Wake Forest School Of Medicine; PERDUE, LETITIA - Wake Forest School Of Medicine; PETTY, GAYLE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; RASMUSSEN, ANNA - University Of California (UCLA); SEGOVIA-SIAPCO, GINA - Loma Linda University; SIRIRAT, RAWIWAN - Loma Linda University; SUN, APRIL - University Of California (UCLA); REBOUSSIN, DAVID - Wake Forest School Of Medicine

Submitted to: Journal of the American Heart Association
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/23/2022
Publication Date: 7/5/2022
Citation: Lichtenstein, A.H., Kris-Etherton, P.M., Petersen, K.S., Matthan, N., Barnes, S., Vitolins, M.Z., Li, Z., Sabate, J., Rajaram, S., Chowdhury, S., Davis, K.M., Galluccio, J.M., Gilhooly, C., Legro, R.S., Li, J., Lovato, L., Perdue, L.H., Petty, G., Rasmussen, A.M., Segovia-Siapco, G., Sirirat, R., Sun, A., Reboussin, D.M. 2022. Effect of incorporating 1 avocado per day versus habitual diet on visceral adiposity: A randomized trial. Journal of the American Heart Association. 11(14):e025657. https://doi.org/10.1161/JAHA.122.025657.
DOI: https://doi.org/10.1161/JAHA.122.025657

Interpretive Summary: Fat in the mid-section (visceral adiposity) is associated with elevated risk of cardiometabolic disorders, such as heart disease and type-2 diabetes. A multi-center, randomized, controlled trial in over 1000 individuals with an elevated waist circumference was conducted to determine whether consuming one large avocado per day for six months compared to a habitual diet would have beneficial effect on visceral adiposity and improve cardiometabolic risk factors. There was no overall effect of avocado intake on visceral adiposity, cardiometabolic risk factors or on body weight. There was a modest improvement in overall diet quality score. In summary, providing one avocado a day for six months to free-living individuals with elevated waist circumference did not reduce visceral adiposity and had minimal effect on risk factors.

Technical Abstract: BACKGROUND: Excess visceral adiposity is associated with increased risk of cardiometabolic disorders. Short-term well-controlled clinical trials suggest that regular avocado consumption favorably affects body weight, visceral adiposity, and satiety. METHODS AND RESULTS: The HAT Trial (Habitual Diet and Avocado Trial) was a multicenter, randomized, controlled parallel-arm trial designed to test whether consuming 1 large avocado per day for 6 months in a diverse group of free-living individuals (N=1008) with an elevated waist circumference compared with a habitual diet would decrease visceral adiposity as measured by magnetic resonance imaging. Secondary and additional end points related to risk factors associated with cardiometabolic disorders were assessed. The primary outcome, change in visceral adipose tissue volume during the intervention period, was not significantly different between the Avocado Supplemented and Habitual Diet Groups (estimated mean difference (0.017 L [-0.024 L, 0.058 L], P=0.405). No significant group differences were observed for the secondary outcomes of hepatic fat fraction, hsCRP (high-sensitivity C-reactive protein),and components of the metabolic syndrome. Of the additional outcome measures, modest but nominally significant reductions in total and low-density lipoprotein cholesterol were observed in the Avocado Supplemented compared with the Habitual Diet Group.Changes in the other additional and post hoc measures (body weight, body mass index, insulin, very low-density lipoprotein concentrations, and total cholesterol:high-density lipoprotein cholesterol ratio) were similar between the 2 groups. CONCLUSIONS: Addition of 1 avocado per day to the habitual diet for 6 months in free-living individuals with elevated waist circumference did not reduce visceral adipose tissue volume and had minimal effect on risk factors associated with cardiometabolic disorders.