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 Scan

Study Questions:

Does a diet with avocados (replacing saturated fatty acids) lower low-density lipoprotein (LDL) cholesterol?


This was a randomized, crossover, controlled feeding trial conducted in overweight or obese participants, who also had baseline LDL cholesterol levels in the 25th to 90th percentile. Three diets each with saturated fatty acids between 6% and 7% were provided (each for 5 weeks). The diets were a lower-fat diet (24% fat); and two moderate-fat diets (34% fat) provided similar foods and were matched for macronutrients and fatty acids: the avocado diet included one fresh Hass avocado (136 g) per day, and the moderate-fat diet mainly used high oleic acid oils to match the fatty acid content of one avocado. Primary outcomes were change in LDL cholesterol and non–high-density lipoprotein (HDL) cholesterol.


A total of 45 participants were included in this trial. Compared to baseline, reduction in LDL cholesterol was observed for the moderate-fat Avocado diet, which was greater than observed in the moderate-fat diet without avocados (-13.5 mg/dl vs. -8.3 mg/dl) or the low-fat diet (-7.4 mg/dl). A similar result was observed for non–HDL-cholesterol. The moderate-fat diet with avocados also decreased LDL particle number, the number of small dense LDL cholesterol, and the ration of LDL to HDL compared to baseline (p < 0.0001), whereas the other diets did not.


The investigators concluded that inclusion of one avocado per day as part of a moderate-fat, cholesterol-lowering diet has additional LDL cholesterol, LDL particle number, and non–HDL cholesterol lowering effects, especially for small dense LDL particles.


These data suggest the benefits of avocados in the diet, particularly for those who are overweight or obese. Further studies in larger groups are needed prior to a strong recommendation for this dietary intervention.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, Lipid Metabolism, Nonstatins, Diet

Keywords: Cholesterol, Cholesterol, LDL, Cholesterol, HDL, Diet, Food Habits, Lipoproteins, HDL, Lipoproteins, LDL, Overweight, Obesity, Oils

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