Effects of Avocado Consumption on Abdominal Adiposity and Glucose Tolerance: Findings from the Persea Americana for Total Health (PATH) Randomized Controlled Trial (P21-005-19)

Abstract

Abstract Objectives Over 35% of adults have elevated abdominal obesity. This is concerning because abdominal obesity increases risk for type 2 diabetes. Therefore, dietary interventions with the potential to prevent abdominal obesity and its metabolic consequences have gained increasing importance. Habitual intake of the Hass avocado (Persea Americana) has been cross-sectionally linked to lower abdominal obesity; however, the effects of regular avocado consumption for abdominal adiposity and glycemic measures are unknown. Accordingly, we conducted a single-blind, randomized, controlled trial examining the effects of daily avocado consumption on abdominal adiposity and oral glucose tolerance (OGTT). Methods 111 adults (65 females) between 25 and 45y with overweight or obesity (BMI >= 25 kg/m2) were randomized to an intervention group (N = 54) that received a daily meal with one fresh avocado or a control group (N = 57) that received an isocaloric meal without avocado for 3 months. DXA was used to assess abdominal fat distribution changes, calculated as the ratio of visceral adipose tissue to subcutaneous abdominal tissue (VS Ratio) and an OGTT was conducted following an overnight fast. Results A group by time effect (P = 0.04) was observed whereby the intervention group exhibited a reduction in the VS Ratio (0.02; 95% CI, 0.0003 to 0.04) whereas there was no change in the control group (0.003; 95% CI, −0.02 to 0.01). Changes in the VS ratio were driven by a reduction in visceral adipose tissue among intervention participants (28.3 g; 95% CI, 3.4 to 53.3). Avocado consumption did not affect the Matsuda Insulin Sensitivity Index (P = 0.28), Glucose AUC (P = 0.37), or Insulin AUC (P = 0.09). However, there was a group by time effect (P = 0.005) whereby the control group exhibited an increase in insulin concentration at 120 m (21.9 µU/ml; 95% CI, 3.3 to 40.5) whereas there was no change in the intervention group (6.1 µU/ml; 95% CI, −4.4 to 16.5). Conclusions Inclusion of one fresh avocado per day over 3 months had abdominal adiposity lowering effects. However, the effects for oral glucose tolerance were limited to insulin secretion 2 h postprandial. Our results demonstrate that avocados have beneficial effects on fat distribution while maintaining insulin sensitivity over time among adults with overweight and obesity. Funding Sources This work was supported by funds provided by the Hass Avocado Board. Partial support was also provided by the Department of Kinesiology and Community Health at the University of Illinois and the USDA National Institute of Food and Agriculture, Hatch project 1009249.