Avocado Consumption by Adults is Associated with Better Nutrient Intake, Diet Quality, and Some Measures of Adiposity: National Health and Nutrition Examination Survey, 2001-2012
Abstract
Abstract
Background
Avocados contain a beneficial lipid profile, including a high level of monounsaturated fatty acids, as well as dietary fiber, essential nutrients, and phytochemicals. However, little epidemiologic data exist on the effect that consumption of avocados has on overall nutrient intake, diet quality, adiposity parameters, and other metabolic disease risk factors.
Objective
The objective of this research was to investigate whether there were any associations between avocado consumption and overall diet quality, energy and nutrient intakes, physiological indicators of health, and risk of metabolic syndrome.
Methods
Avocado consumption and its association with these diet and health parameters were assessed using a nationally representative sample of adults (n=27,684) participating in the 2001-2012 NHANES. Intake was determined from one day 24-hour dietary recalls. Covariate adjusted means, standard errors, and ANOVA for food groups, nutrients, and health biomarkers were determined using appropriate sample weights. Diet quality was measured using the Healthy Eating Index-2010 (HEI-2010). For linear and logistic regression analyses, p<0.001 and p<0.01, respectively were used.
Results
Average consumption of avocados by consumers (n=667) was 75.6±3.8 g/day. Avocado consumers had higher intakes of dietary fiber, mono- and polyunsaturated fats, vitamins E and C, folate, magnesium, potassium, and fruit and vegetables and lower intakes of sodium and meat, poultry, and fish than non-consumers. Consumers also had a higher total HEI-2010. Consumers had lower mean weight, body mass index, waist circumference, insulin, and homocysteine levels and had a lower percentage of those with an elevated waist circumference and metabolic syndrome. Avocado consumers were 33% less likely to be overweight/obese and 32% less likely to have an elevated waist circumference.
Conclusions
Avocado consumption was associated with better dietary measures and weight parameters than seen in non-consumers; consumption should be encouraged as part of an overall healthy lifestyle.
Keywords
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Ahluwalia, N., Dwyer, J., Terry, A., Moshfegh, A. & Johnson, C. (2016). Update on NHANES Dietary Data: Focus on Collection, Release, Analytical Considerations, and Uses to Inform Public Policy. Advances in Nutrition, 7, 121-134.
Ameer, K. (2016). Avocado as a Major Dietary Source of Antioxidants and Its Preventive Role in Neurodegenerative Diseases. Advances in Neurobiology,12, 337-354.
Azagba, S., & Sharaf, M.F. (2012). Fruit and vegetable consumption and body mass index: a quantile regression approach. Journal of Primary Care and Community Health, 3, 210-220.
Bartholomew, A.M., Young, E.A., Martin, H.W., & Hazuda, H.P. (1990). Food frequency intakes and sociodemographic factors of elderly Mexican Americans and non-Hispanic whites. Journal of the American Dietetic Association, 90,1693-1696.
Blanton, C.A., Moshfegh, A.J., Baer, D.J., & Kretsch, M.J. (2006). The USDA Automated Multiple-Pass Method accurately estimates group total energy and nutrient intake. Journal of Nutrition,136, 2594-2599.
Briefel, R.R., Sempos, C.T., McDowell, M.A., Chien, S., & Alaimo, K. (1997). Dietary methods research in the third National Health and Nutrition Examination Survey: underreporting of energy intake. American Journal of Clinical Nutrition, 65,1203S–1209S.
Buil-Cosiales, P., Toledo, E., Salas-Salvadó, J., Zazpe, I., Farràs, M., Basterra-Gortari, F.J.,…PREDIMED investigators. (2016). Association between dietary fibre intake and fruit, vegetable or whole-grain consumption and the risk of CVD: results from the PREvención con DIeta MEDiterránea (PREDIMED) trial. British Journal of Nutrition, 116, 534-546.
Carranza-Madrigal, J., Herrera-Abarca, J.E., Alvizouri-Muñoz, M., Alvarado-Jimenez, M.R., & Chavez-Carbajal, F. (1997). Effects of a vegetarian diet vs. a vegetarian diet enriched with avocado in hypercholesterolemic patients. Archives of Medical Research, 28, 537-541.
Cavallo, D.N., Horino, M., & McCarthy, W.J. (2016). Adult Intake of Minimally Processed Fruits and Vegetables: Associations with Cardiometabolic Disease Risk Factors. Journal of the Academy of Nutrition and Dietetics, 116, 1387-1894.
Centers for Disease Control and Prevention a. National Center for Health Statistics. National Health and Nutrition Examination Survey Analytic Guidelines, 2011-2012. http://www.cdc.gov/nchs/data/nhanes/analytic_guidelines_11_12.pdf. Accessed October 11, 2016.
Centers for Disease Control and Prevention b. National Health and Nutrition Examination Survey (NHANES). MEC In-Person Dietary Interviewers Procedures Manual. https://www.cdc.gov/nchs/data/nhanes/nhanes_11_12/mec_in_person_dietary_procedures_manual_jan_2012.pdf. Accessed October 11, 2016.
Centers for Disease Control and Prevention c. National Health and Nutrition Examination Survey (NHANES). Anthropometry Procedures Manual. https://www.cdc.gov/nchs/data/nhanes/nhanes_11_12/Anthropometry_Procedures_Manual.pdf. Accessed October 11, 2016.
Centers for Disease Control and Prevention d. National Health and Nutrition Examination Survey (NHANES). 2011 - 2012 Data Documentation, Codebook, and Frequencies. Blood Pressure (BPX_G). https://wwwn.cdc.gov/Nchs/Nhanes/2011-2012/BPX_G.htm. Accessed October 11, 2016.
Centers for Disease Control and Prevention e. National Health and Nutrition Examination Survey (NHANES). 2011-2012 Lab Methods. https://www.cdc.gov/nchs/nhanes/nhanes2011-2012/lab_methods_11_12.htm. Accessed October 11, 2016.
Centers for Disease Control and Prevention f. National Health and Nutrition Examination Survey (NHANES). Survey Interviews. https://www.cdc.gov/nchs/nhanes/nhanes2011-2012/questionnaires11_12.htm. Accessed October 11, 2016.
Centers for Disease Control and Prevention g. The National Health and Nutrition Examination Survey. NCHS Research Ethics Review Board (ERB) Approval. http://www.cdc.gov/nchs/nhanes/irba98.htm. Accessed October 11, 2016.
Davidson A (ed). The Oxford Companion to Food: A. New York. Oxford University Press. 1999; p. 43.
Dreher, M.L., & Davenport, A.J. (2013). Hass avocado composition and potential health effects. Critical Reviews in Food Science and Nutrition, 53, 738-750.
Fulgoni, V.L. 3rd, Dreher, M., & Davenport, A.J. (2013). Avocado consumption is associated with better diet quality and nutrient intake, and lower metabolic syndrome risk in US adults: results from the National Health and Nutrition Examination Survey (NHANES) 2001-2008. Nutrition Journal, 12, 1.
Grooms, K.N., Ommerborn, M.J., Pham, D.Q., Djoussé, L., & Clark, C.R. (2013). Dietary fiber intake and cardiometabolic risks among US adults, NHANES 1999-2010. American Journal of Medicine, 126, 1059-1067.
Guenther, P.M., Kirkpatrick, S.I., Reedy, J., Krebs-Smith, S.M., Buckman, D.W.,…Carroll, R.J. (2014). The Healthy Eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans. Journal of Nutrition, 144, 399-407.
Hammad, S., Pu, S., & Jones, P.J. (2016). Current Evidence Supporting the Link Between Dietary Fatty Acids and Cardiovascular Disease. Lipids, 51, 507-517.
Harcombe, Z., Baker, J.S., Cooper, S.M, Davies, B., Sculthorpe, N., DiNicolantonio, J.J., & Grace, F. (2015). Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis. Open Heart, 2:e000196.
Harcombe, Z., Baker, J.S., DiNicolantonio, J.J., Grace, F., & Davies, B. (2016). Evidence from randomised controlled trials does not support current dietary fat guidelines: a systematic review and meta-analysis. Open Heart, 3:e000409.
Hartley, L., Igbinedion, E., Holmes, J., Flowers, N., Thorogood, M., Clarke, A.,…Rees, K. (2013). Increased consumption of fruit and vegetables for the primary prevention of cardiovascular diseases. Cochrane Database of Systematic Reviews, CD009874.
Hoy, F., Carman, H.F., Li, L., & Sexton, R.J. (2009). An Economic Evaluation of the Hass Avocado Promotion Order’s First Five Years. Giannini Foundation Research Report 351. Retrieved from: http://s.giannini.ucop.edu/uploads/giannini_public/f1/0e/f10ee8b2-f932-4783-8b12-b43be92939d3/351_avocados.pdf.
Hoy, M.K., Goldman, J.D., & Sebastian, R.S. (2016). Fruit and vegetable intake of US adults estimated by two methods: What We Eat In America, National Health and Nutrition Examination Survey 2009-2012. Public Health Nutrition, 19, 2508-2512.
Jakobsen, M.U., O'Reilly, E.J., Heitmann, B.L., Pereira, M.A., Bälter, K., Fraser, G.E.,…Ascherio A. (2009). Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. American Journal of Clinical Nutrition, 89, 1425-1432.
Joris, P.J., & Mensink, R.P. (2016). Role of cis-Monounsaturated Fatty Acids in the Prevention of Coronary Heart Disease. Current Atherosclerosis Reports, 18, 38.
Kearns, K., Dee, A., Fitzgerald, A.P., Doherty, E., & Perry, I.J. (2014). Chronic disease burden associated with overweight and obesity in Ireland: the effects of a small BMI reduction at population level. BMC Public Health, 14, 143.
Keller, C., Fleury, J., & Rivera, A. (2007). Visual methods in the assessment of diet intake in Mexican American women. Western Journal of Nursing Research, 29, 758-773.
Ledoux, T.A., Hingle, M.D., & Baranowski, T. (2011). Relationship of fruit and vegetable intake with adiposity: a systematic review. Obesity Reviews,12, e143-50.
Li, Z., Wong, A., Henning, S.M., Zhang, Y., Jones, A., Zerlin, A.,…Heber, D. (2013). Hass avocado modulates postprandial vascular reactivity and postprandial inflammatory responses to a hamburger meal in healthy volunteers. Food & Function, 4, 384-391.
López Ledesma, R., Frati Munari, A.C., Hernández Domínguez, B.C., Cervantes Montalvo, S., Hernández Luna, M.H., Juárez, C., & Morán Lira, S. (1996). Monounsaturated fatty acid (avocado) rich diet for mild hypercholesterolemia. Archives of Medical Research, 27, 519-523.
Mathur, P., Ding, Z., Saldeen, T., & Mehta, J.L. (2015). Tocopherols in the Prevention and Treatment of Atherosclerosis and Related Cardiovascular Disease. Clinical Cardiology, 38, 570-576.
Miura, K.; Stamler, J.; Brown, I.J.; Ueshima, H.; Nakagawa, H.; Sakurai, M.,… INTERMAP Research. (2013). Relationship of dietary monounsaturated fatty acids to blood pressure: the International Study of Macro/Micronutrients and Blood Pressure. Journal of Hypertension, 31, 1144-1150.
Moore, L.V., & Thompson, F.E. (2013). Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report. Adults Meeting Fruit and Vegetable Intake Recommendations—United States, 2013. Retrieved from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6426a1.htm.
Moshfegh, A.J., Rhodes, D.G., Baer, D.J., Murayi, T., Clemens, J.C., Rumpler, W.V., Paul, D.R.,...Cleveland, L. E. (2008). The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. American Journal of Clinical Nutrition, 88, 324-332.
National Cancer Institute. Division of Cancer Control & Population Sciences. HEI Tools for Researchers. http://epi.grants.cancer.gov/hei/tools.html. Accessed October 11, 2016.
National Cholesterol Education Program. National Heart, Lung, and Blood Institute. National Institutes of Health. Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). 2002. NIH Publication No. 02-5215.
National Institutes of Health. National Heart, Lung, and Blood Institute. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf. October 11, 2016.
Peou, S., Milliard-Hasting, B., & Shah, S.A. (2016). Impact of avocado-enriched diets on plasma lipoproteins: A meta-analysis. Journal of Clinical Lipidology,10, 161-171.
Pieterse, Z., Jerling, J.C., Oosthuizen, W., Kruger, H.S., Hanekom, S.M., Smuts, C.M., & Schutte, A.E. (2005). Substitution of high monounsaturated fatty acid avocado for mixed dietary fats during an energy-restricted diet: effects on weight loss, serum lipids, fibrinogen, and vascular function. Nutrition, 21, 67-75.
Pignotti, G.A., Vega-López, S., Keller, C., Belyea, M., Ainsworth, B., Nagle Williams, A.,…Permana, P. (2015). Comparison and evaluation of dietary quality between older and younger Mexican-American women. Public Health Nutrition, 18, 2615-2624.
Pomerleau, J., Lock, K., Knai, C., & McKee, M. (2005). Interventions designed to increase adult fruit and vegetable intake can be effective: a systematic review of the literature. Journal of Nutrition,135, 2486-2495.
Rodríguez-Sánchez, D., Silva-Platas, C., Rojo, R.P., García, N., Cisneros-Zevallos, L., García-Rivas, G., & Hernández-Brenes, C. (2013). Activity-guided identification of acetogenins as novel lipophilic antioxidants present in avocado pulp (Persea americana). Journal of chromatography. B, Analytical technologies in the biomedical and life sciences, 942-943, 37-45.
Rodriguez-Sanchez, D.G., Flores-García, M., Silva-Platas, C., Rizzo, S., Torre-Amione, G., De la Peña-Diaz, A.,…García-Rivas, G. (2015). Isolation and chemical identification of lipid derivatives from avocado (Persea americana) pulp with antiplatelet and antithrombotic activities. Food & Function, 6, 193-203.
Root, M.M., & Dawson, H.R. (2013). DASH-like diets high in protein or monounsaturated fats improve metabolic syndrome and calculated vascular risk. International Journal for Vitamin and Nutrition Research, 83, 224-231.
Sebastian, R.S., Wilkinson Enns, C., Goldman, J.D., Hoy, M.K., & Moshfegh, A.J. (2010) Sandwiches are major contributors of sodium in the diets of American adults: results from What We Eat in America, National Health and Nutrition Examination Survey 2009-2010. Journal of the Academy of Nutrition and Dietetics, 115, 272-277.
Sharma, S., Sheehy, T., & Kolonel, L. (2014). Sources of vegetables, fruits and vitamins A, C and E among five ethnic groups: results from a multiethnic cohort study. European Journal of Clinical Nutrition, 68, 384-391.
Tan, S.Y., Dhillon, J., & Mattes, R.D. (2014). A review of the effects of nuts on appetite, food intake, metabolism, and body weight. American Journal of Clinical Nutrition,100, 412S-422S.
Tohill, B.C., Seymour, J., Serdula, M., Kettel-Khan, L., & Rolls, B.J. (2004). What epidemiologic studies tell us about the relationship between fruit and vegetable consumption and body weight. Nutrition Reviews, 6, 365-374.
United States Department of Agriculture Agricultural Research Service a. USDA Food Composition Databases. (2016). Retrieved from: https://ndb.nal.usda.gov/ndb/search/list?qlookup=avocado&manu=&SYNCHRONIZER_TOKEN=4eba4bb1-8c62-496d-a802-1e93f548772f&SYNCHRONIZER_URI=%2Fndb%2Fsearch%2Flist&ds=.
United States Department of Agriculture. Agricultural Research Service b. Food and Nutrient Database for Dietary Studies. What’s In the Foods You Eat. https://www.ars.usda.gov/northeast-area/beltsville-md/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/fndds-download-databases/#. Accessed October 11, 2016.
United States Department of Agriculture. Agricultural Research Service c. MyPyramid Equivalents Food Databases. https://www.ars.usda.gov/northeast-area/beltsville-md/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/mypyramid-equivalents-product-downloads. Accessed October 11, 2016.
United States Department of Agriculture. Agricultural Research Service d. Food Patterns Equivalents Database. https://www.ars.usda.gov/northeast-area/beltsville-md/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/fped-overview. Accessed October 11, 2016.
United States Department of Agriculture a. Center for Nutrition Policy and Promotion. Healthy Eating Index 2005. https://www.cnpp.usda.gov/sites/default/files/healthy_eating_index/healthyeatingindex2005factsheet.pdf. Accessed October 11, 2016.
United States Department of Agriculture b. Choose MyPlate. Vegetable Gallery. https://www.choosemyplate.gov/foodgallery-vegetables. Accessed October 11, 2016.
United States Department of Agriculture c. Department of Health and Human Services. Scientific Report of the 2015 Dietary Guidelines Advisory Committee. (2015). Retrieved from: https://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf.
United States Department of Agriculture d. Dietary Guidelines for Americans 2015-2010. Eighth Edition. https://health.gov/dietaryguidelines/2015/resources/2015-2020_Dietary_Guidelines.pdf. Accessed October 11, 2016.
United States Department of Agriculture e. Economic Research Service. Food Availability (Per Capita) Data System. http://www.ers.usda.gov/data-products/food-availability-(per-capita)-data-system.aspx. Accessed October 3, 2016.
United States Department of Agriculture f. Economic Research Service. http://www.ers.usda.gov/data-products/chart-gallery/detail.aspx?chartId=57272. Accessed October 11, 2016.
Wang, L., Bordi, P.L., Fleming, J.A., Hill, A.M., & Kris-Etherton, P.M. (2015). Effect of a moderate fat diet with and without avocados on lipoprotein particle number, size and subclasses in overweight and obese adults: a randomized, controlled trial. Journal of the American Heart Association, 4, e001355.
Wien, M., Haddad, E., Oda, K., Sabaté, J. (2013) A randomized 3×3 crossover study to evaluate the effect of Hass avocado intake on post-ingestive satiety, glucose and insulin levels, and subsequent energy intake in overweight adults. Nutrition Journal,12,155.
Yubero-Serrano, E.M., Delgado-Lista, J., Tierney, A.C., Perez-Martinez, P., Garcia-Rios, A., Alcala-Diaz, J.F.,…Lopez-Miranda J. (2015). Insulin resistance determines a differential response to changes in dietary fat modification on metabolic syndrome risk factors: the LIPGENE study. American Journal of Clinical Nutrition, 102, 1509-1157.
DOI: http://dx.doi.org/10.18103/imr.v3i4.422
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