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

BACKGROUND Avocados contain monounsaturated fatty acids (MUFA) dietary fiber, essential nutrients and phytochemicals. However, no epidemiologic data exist on their effects on diet quality, weight management and other metabolic disease risk factors. The objective of this research was to investigate the relationships between avocado consumption and overall diet quality, energy and nutrient intakes, physiological indicators of health, and risk of metabolic syndrome. METHODS Avocado consumption and nutrition data were based on 24-hour dietary recalls collected by trained NHANES interviewers using the USDA Automated Multiple Pass Method (AMPM). Physiological data were collected from physical examinations conducted in NHANES Mobile Examination Centers. Diet quality was calculated using the USDA's Healthy Eating Index-2005. Subjects included 17,567 US adults ≥ 19 years of age (49% female), including 347 avocado consumers (50% female), examined in NHANES 2001-2008. Least square means, standard errors, and ANOVA were determined using appropriate sample weights, with adjustments for age, gender, ethnicity, and other covariates depending on dependent variable of interest. RESULTS Avocado consumers had significantly higher intakes of vegetables (p<0.05); fruit, diet quality, total fat, monounsaturated and polyunsaturated fats, dietary fiber, vitamins E, K, magnesium, and potassium (p<0.0001); vitamin K (p=0.0013); and lower intakes of added sugars (p<0.0001). No significant differences were seen in calorie or sodium intakes. Body weight, BMI, and waist circumference were significantly lower (p<0.01), and HDL-C was higher (p<0.01) in avocado consumers. The odds ratio for metabolic syndrome was 50% (95th CI: 0.32-0.72) lower in avocado consumers vs. non-consumers. CONCLUSIONS Avocado consumption is associated with improved overall diet quality, nutrient intake, and reduced risk of metabolic syndrome. Dietitians should be aware of the beneficial associations between avocado intake, diet and health when making dietary recommendations.