Associations between avocado intake and measures of glucose and insulin homeostasis in Hispanic individuals with and without type 2 diabetes: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Authors: SENN, MACKENZIE - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC); GOODARZI, MARK - CEDARS-SINAI MEDICAL CENTER; RAMESH, GAUTAM - UNIVERSITY OF CALIFORNIA, SAN DIEGO; ALLISON, MATTHEW - UNIVERSITY OF CALIFORNIA, SAN DIEGO; GRAFF, MARIAELISA - UNIVERSITY OF NORTH CAROLINA; YOUNG, KRISTIN - UNIVERSITY OF NORTH CAROLINA; TALAVERA, GREGORY - SAN DIEGO STATE UNIVERSITY; MCCLAIN, AMANDA - SAN DIEGO STATE UNIVERSITY; GARCIA, TANYA - UNIVERSITY OF NORTH CAROLINA; ROTTER, JEROME - HARBOR-UCLA MEDICAL CENTER; WOOD, ALEXIS - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)

Submitted to: Nutrition Metabolism and Cardiovascular Disease
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/1/2023
Publication Date: 8/17/2023
Citation: Senn, M.K., Goodarzi, M.O., Ramesh, G., Allison, M.A., Graff, M., Young, K.L., Talavera, G.A., McClain, A.C., Garcia, T.P., Rotter, J.I., Wood, A.C. 2023. Associations between avocado intake and measures of glucose and insulin homeostasis in Hispanic individuals with and without type 2 diabetes: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Nutrition Metabolism and Cardiovascular Disease. https://doi.org/10.1016/j.numecd.2023.08.002.
DOI: https://doi.org/10.1016/j.numecd.2023.08.002

Interpretive Summary: US adults with Hispanic/Latino ancestry are at a higher risk of developing type 2 diabetes (T2D) compared to many US groups with different ancestral origins. A healthy diet is the cornerstone of diabetes prevention and management, but few studies have examined which foods are associated with a lower risk of T2D in Hispanic/Latino adults. In other populations, eating avocado consumption is linked to a lower risk of type 2 diabetes (T2D). However, T2D is a complex condition, and many biological processes contribute to its development. This study aimed to better understand which of the processes related blood sugar control might be improved by eating avocado in US adults with Hispanic/Latino ancestry. In a large-scale analysis of older US adults with Hispanic/Latino ancestry, we found that consuming avocado was associated with better blood sugar control, in the general population. In those adults with Hispanic/Latino ancestry who had T2D, eating avocado was also associated with lower average blood glucose levels over the past three months (lower HbA1c), as well as better insulin sensitivity and better blood glucose control after eating. Together, these analyses suggest that eating avocado might be helpful for blood sugar control in US Hispanic/Latino adults, especially those with T2D.

Technical Abstract: Our objective was to investigate associations between avocado intake and glycemia in Hispanic/Latino adults. The associations of avocado intake with measures of glycemia were evaluated in a cross-sectional analysis of up to 14,591 Hispanic/Latino adults. Glycemia was assessed via: average glucose levels (hemoglobin A1c; HbA1c), fasting glucose and insulin, glucose and insulin levels after an oral glucose tolerance test (OGTT), and via calculated measures of insulin resistance (HOMA-IR, and HOMA-%Beta), and insulinogenic index. Associations between avocado intake and glycemia were assessed using multivariable linear regression models, which controlled for sociodemographic factors and health behaviors, and which were stratified by dysglycemia status. In those with normoglycemia, avocado intake was associated with a higher insulinogenic index (Beta=0.17+/-0.07, P=0.02). In those with T2D (treated and untreated), avocado intake was associated with lower hemoglobin A1c (HbA1c; Beta=-0.36+/-0.21, P=0.02), and lower fasting glucose (Beta=-0.27+/-0.12, P=0.02). In the those with untreated T2D, avocado intake was additionally associated with HOMA-%Beta (Beta=0.39+/-0.19, P=0.04), higher insulin values 2-hours after an oral glucose load (Beta=0.62+/-0.23, P=0.01), and a higher insulinogenic index (Beta=0.42+/-0.18, P=0.02). No associations were observed in participants with prediabetes. We observed an association of avocado intake with better glucose/inulin homeostasis, especially in those with T2D.