Heart-healthy: Avocados confer cardioprotective benefits

Eating at least two servings of avocado weekly or replacing certain fat-containing foods with the fruit appears to be cardioprotective, reducing the risk of cardiovascular disease (CVD) and coronary heart disease (CHD), as shown in a recent study.

In two large prospective cohorts of men and women in the US with over 30 years of follow‐up, participants with higher avocado intake (≥2 servings/week equivalent to one whole fruit) showed a 16-percent lower risk of CVD (hazard ratio [HR], 0.84, 95 percent confidence interval [CI], 0.75–0.95; p_trend=0.0007) and a 21-percent lower risk of CHD (HR, 0.79, 95 percent CI, 0.68–0.91; p_trend<0.001) compared with those who had never or rarely ate avocados. [J Am Heart Assoc 2022;doi:10.1161/JAHA.121.024014]

What is more, replacing half a serving daily of margarine, butter, egg, yogurt, cheese, or processed meats (eg, bacon) with the same amount of avocado contributed to 16–22 percent reduction in the risk of CVD events. In contrast, the substitution of half a serving of olive oil, nuts, and other plant oils showed no additional benefit.

How much avocado was eaten had no effect on the risk of stroke.

The analysis included 68,786 women from the Nurses’ Health Study and 41,701 men from the Health Professionals Follow‐up Study. Over 30 years of follow‐up, 14,274 participants developed CVD (9,185 CHD events and 5,290 strokes).

“Our study provides further evidence that the intake of plant‐sourced unsaturated fats can improve diet quality and is an important component in CVD prevention in the general population,” according to lead study author Dr Lorena Pacheco, a postdoctoral research fellow in the nutrition department at the Harvard T.H. Chan School of Public Health in Boston.

It can also serve as an additional guidance for healthcare professionals, Pacheco added. “Offering the suggestion to ‘replace certain spreads and saturated fat-containing foods, such as cheese and processed meats, with avocado’ is something physicians and other healthcare practitioners, such as registered dietitians, can do when they meet with patients, especially since avocado is a well-accepted food.”

Nutrient-dense fruit

Avocados contain dietary fibre, potassium, magnesium, monounsaturated fatty acids (MUFA), and polyunsaturated fatty acids, as well as phytonutrients and bioactive compounds, which have been touted for cardioprotection. Specifically, half an avocado provides up to 20 percent of the daily recommended fibre, 10 percent of potassium, 5 percent of magnesium, and 15 percent of folate, as well as 7.5 g of MUFA and 1.5 g of polyunsaturated fatty acid. [Crit Rev Food Sci Nutr 2013;53:738-750; Nutr J 2013;12:1]

“As such, avocados can be a nutrient‐dense component of a healthful dietary pattern,” Pacheco said.

“There are potential biological mechanisms by which avocados offer cardioprotective benefits through modulating cardiovascular risk factors,” she noted.

For the most part, the primary MUFA present in avocados is oleic acid, which has been reported to be helpful in improving endothelial dysfunction, hypertension, inflammation, and insulin sensitivity. Meanwhile, plant sterols (plant analogues of cholesterol), which are found in moderately high amounts in avocados, could exert favourable effects on lipid profile. Lipid profile could also improve with higher fibre intake via avocado consumption. [Cardiovasc Diabetol 2015;14:75; Maturitas 2011;68:245-250; Curr Atheroscler Rep 2016; 18:1-13]

Part of a healthy diet

Commenting on the study by Pacheco and colleagues, American Heart Association's Council on Epidemiology and Prevention Chair Dr Cheryl Anderson pointed out that the findings may have important implications, given that “a healthy dietary pattern is the cornerstone for cardiovascular health.” [tinyurl.com/y6vmt2kw]

Then again, Anderson acknowledged that it can be difficult for a number of people to achieve and adhere to healthy eating patterns.

“Although no one food is the solution to routinely eating a healthy diet, this study is evidence that avocados have possible health benefits. This is promising because it is a food item that is popular, accessible, desirable, and easy to include in meals eaten by many Americans at home and in restaurants,” she said.