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An avocado a day keeps the heart doctor away?
Incorporating one fresh avocado per day into a moderate fat diet results in a greater improvement of high density lipoprotein cholesterol (HDL; ‘good’) to low density lipoprotein (LDL; ‘bad’) cholesterol ratio and total LDL reduction than a moderate or low fat diet without avocado in obese or overweight adults. This is the main finding of a new study in the Journal of the American Heart Association.

Elevated blood cholesterol has been associated with increased cardiovascular disease risk factors. It is recommended that a ‘heart healthy’ diet be adopted to keep cholesterol levels in the normal range and in particular to improve the LDL to HDL cholesterol ratio and reduce overall levels of LDL cholesterol. To this end, public health advice such as the 2010 Dietary Guidelines for Americans recommends limitation of saturated fat in the diet and replacement with unsaturated fats and increased fruits and vegetables intake.

In the current randomized, cross-over, controlled feeding trial, 45 healthy overweight or obese men and women were recruited. To establish a baseline prior to the study diet, subjects followed a typical American high saturated fat diet for two weeks. Participants then followed three different calorie controlled diets for five weeks each, in which 6-7% of energy from the saturated fat in the American diet was differentially replaced. In the low fat diet, it was replaced with complex carbohydrates mainly from grains and in the moderate fat diet it was replaced with monounsaturated fat mainly from high oleic acid oils (sunflower oil and canola oil) and some low-fat dairy products. Finally the avocado diet was similar to the moderate fat diet but the 6-7% of energy was replaced by monounsaturated fat, mainly from one fresh avocado daily (~ 136 g, without skin and seeds). The diets were matched for calories, macronutrients and fatty acids but not for fibre, phytosterols, or other bioactives.

The results of the study showed that the reduction in both LDL and non‐ HDL cholesterol on the avocado diet was significantly greater than for the MF or LF diets. Also, only the avocado diet significantly decreased LDL particle number, small dense LDL cholesterol and the ratio of LDL/HDL. Possible reasons why the avocado element in the moderate fat diet was beneficial include the unique combination of vitamins, minerals, fibre, phytosterols, and other dietary bioactives from the avocados that was missing in the other two diets. It is noteworthy that the avocado diet provided 35% more fibre, for example, than the other diets. These results were based on daily consumption of one whole avocado. Additional research should determine whether similar results are achieved with the recommended daily serving size of 1/5 of an avocado.

Lead author on the study Dr Penny Kris-Etherton of Pennsylvania State University says: "The results of this study suggest that the monounsaturated fat, fibre, phytosterols and other dietary bioactives in avocados may provide greater benefits to cardiovascular disease risk factors compared to a calorie matched low fat diet...Furthermore, using novel advanced lipid testing methods, this study demonstrated that consumption of one avocado a day may affect atherogenic lipoprotein particle numbers (APL)."

The conclusions from this study are encouraging, although they cannot be generalised to all populations. Nevertheless, the study does support the notion that the monounsaturated fat, fibre, phytosterols and other bioactives in avocados are likely to be beneficial to heart health.

Reference: Wang L, Bordi PL, Fleming JA, Hill AM, Kris‐Etherton PM. Effect of a Moderate Fat Diet With and Without Avocados on Lipoprotein Particle Number, Size and Subclasses in Overweight and Obese Adults: A Randomized, Controlled Trial. JAMA doi: 10.1161/JAHA.114.001355

Press release: FoodMinds LLC; available at
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An avocado a day keeps the heart doctor away?00