Effects of Varying Avocado Intake on Energy and Nutrient Intake of Hispanic Families: A Cluster Randomized Trial

Abstract

Abstract Objectives Avocados are nutrient-dense and could be a favorable component of a healthy dietary pattern, yet there are limited data on the effects of avocado intake on nutritional status. To test if avocados impact energy intake, we examined the effects of two levels of avocado intake, plus a standard nutrition education intervention, on energy and nutrient intake in families of Hispanic Heritage. Methods Between April 2017 and June 2018, we conducted a cluster randomized controlled trial in families consisting of at least 3 members residing in the same home, at least 5 years of age, free of severe chronic disease, not on specific diets, and self-identified of Hispanic heritage. Seventy-two (n = 72) families were randomized to one of two groups: nutrition education with low avocado allotment (3 avocados/family/week) or nutrition education with high avocado allotment (14 avocados/family/week). Community health workers (i.e., Promotoras) led 12 bi-weekly in-home nutrition education sessions per family and delivered weekly avocado allotments. Dietary patterning, energy and nutrient intake were measured at baseline, and after 3- and 6-months. The primary outcome was change in a family's total energy intake after 6 months. Secondary outcome measures included differences in macro- and micronutrients between groups. Results Over the 6-month follow-up period, the mean difference in energy intake for the high versus low avocado intervention group was −1884 kcals/family/day (95% CI −3205 to −563 kcals, P < 0.01). The high avocado intake group also had significant reductions in carbohydrate, animal and vegetable protein saturated and polyunsaturated fat calcium, magnesium, sodium, potassium, iron, and vitamin D intakes (P < 0.05 for all). There were no significant changes in MUFA or dietary fiber intakes. Conclusions In families of Hispanic heritage, an intervention including nutrition education combined with 14 avocados/week, compared to 3 avocados per week, resulted in a significant reduction in calories and select macro- and micronutrients. This trial suggests interventions with specific plant foods, but without specific counseling on energy restriction, may lead to reductions in total energy intake. Future studies should investigate the effects of avocado intake in other populations. Funding Sources Hass Avocado Board.