Abstract P104: Impact of Avocado Enriched Diets on Serum Lipids: A Meta-Analysis

Abstract

Introduction: Diet is integral to the management of dyslipidemia. Evidence suggests that diets rich in monounsaturated fatty acids (MUFA) benefit the serum lipid profile. Avocados offer a plant based source of MUFA, but the magnitude of benefit from avocado consumption remains unknown. We performed a meta-analysis to assess the impact of avocados on total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), and triglycerides (TG). Methods: A literature search using the term “avocado” and “Persea Americana” was done using PubMed, CINAHL, Cochrane Database of Systemic Reviews and by hand searching of relevant primary and review articles. Studies were included for analysis if, controlled trials in human subjects evaluating avocado in the diet with adequate data reported for either, TC, LDL-C, HDL-C or TG. A weighted mean difference from baseline was calculated using the DerSimonian-Laird random-effects model. Subgroup analyses and the Q statistic were used to assess for heterogeneity. Publication bias was assessed through the Egger bias statistic and inspection of funnel plots. Results: From the 841 screened studies, 9 were included in the final analysis incorporating 186 unique subjects for all lipid endpoints. Dietary avocado intake resulted in a statistically significant decrease in TC and LDL-C of -15.30 mg/dl (CI -22.25 to -8.35) and -12.55 mg/dl (CI -19.89 to -5.21), respectively. TG reduced significantly by -24.17mg/dl (CI -41.94 to -6.41). HDL-C decreased non-significantly by -1.27mg/dl (CI -4.46 to 1.91). Subgroup analyses suggested that replacing regular dietary fats with avocado based fats results in a higher reduction in TC, LDL-C and TG compared to simply adding avocado to a free diet. The Q statistic was significant for all endpoints (p<0.001) while the Egger bias statistic showed a lack of publication bias for all endpoints except TG. Conclusion: Avocado enriched diets can lower TC, LDL-C and TG by 15, 13, and 24 mg/dl respectively. HDL-C is not significantly impacted. Of note, the reduction appears beneficial with a fat substitution strategy rather than the general addition of avocados to a free diet.