Background
Epidemiological studies on the relationship between avocado intake and long-term cardiovascular disease (CVD) risk are lacking.
Methods and Results
This study included 68,786 women from the NHS (Nurses’ Health Study) and 41,701 men from the HPFS (Health Professionals Follow-up Study; 1986-2016) who were free of cancer, coronary heart disease, and stroke at baseline. Diet was assessed using validated food frequency questionnaires at baseline and then every 4 years.
Cox proportional hazards regressions were used to estimate hazard ratios and 95% CIs. A total of 14,274 incident CVD cases (9,185 CHD events and 5,290 strokes) were documented over 30 years of follow-up .
After adjusting for lifestyle and other dietary factors, compared with non-consumers, those with higher analysis-specific avocado consumption (≥2 servings/week) had a 16% lower risk of CVD (ratio of pooled hazard ratio, 0.84; 95% CI, 0.75–0.95) and a 21% lower risk of coronary heart disease (pooled hazard ratio, 0.79; 95% CI, 0.68–0.91) ).
No significant associations were observed for stroke. For each half-serving/day increase in avocado intake, the pooled hazard ratio for CVD was 0.80 (95% CI, 0.71–0.91).
Replacing half a serving per day of margarine, butter, egg, yogurt, cheese or processed meats with the equivalent amount of avocado or avocado was associated with a 16% to 22% lower risk of CVD.
Conclusions
Higher intake of avocado was associated with a lower risk of CVD and coronary heart disease in 2 large prospective cohorts of American men and women. Replacing certain fat-containing foods with avocado could lead to a lower risk of CVD.
Clinical Perspective
What’s new?
Clinical trials have studied the changes induced by avocado in cardiovascular risk factors; however, these studies have been limited to intermediate risk factors as endpoints.
In 2 large cohorts of US men and women, higher avocado intake (≥2 servings/week) was associated with lower risk of cardiovascular disease and coronary heart disease.
Replacing margarine, butter, egg, yogurt, cheese or processed meats with avocado or avocado was also associated with a lower risk of cardiovascular disease.
What are the clinical implications?
Our findings support existing evidence on the intake of healthy plant-based fats and their positive impact on diet quality and their role in the prevention of cardiovascular diseases in the general population.
Final message In conclusion, in this large study of US men and women, higher intake of avocados was associated with a significantly lower risk of total CVD and CHD. No significant associations were observed for total or ischemic stroke. In substitution analyses, we observed that replacing margarine, butter, egg, total yogurt, total cheese, and processed meats with avocado was associated with a lower incidence of CVD events. Our study provides additional evidence that the intake of plant-based unsaturated fats can improve diet quality and is an important component in the prevention of CVD in the general population. More studies are needed to evaluate the impact and effectiveness of avocado intake in reducing CVD incidence and CVD risk factors. |
