Warrier JeanSimon NUSC 4295 Bradley Bolling 11/9/13 Avocados and Blood Lipids Persa Americana, commonly known

as the avocado is a fruit that consist of a creamy and smooth texture. The avocado is a great source for a variety of vitamins and minerals such as potassium, magnesium, vitamin B6, niacin, etc (1,2). Avocado also contain eighty percent of water and dietary fiber. Unlike other fruits, avocados are low in sugar and contain 15% monounsaturated fatty acid rich oil which contributes to the increase of carotenoid absorption. Three research studies published in the Journal of Nutrition has shown the benefits of avocado as well as the regulation of blood lipids. The evidence provided in both the Natural standard and the Natural Medicine Comprehensive databases are the same. In the Natural Standard database, hypercholesterolemia and osteoarthritis is given a B grade according to the level of scientific evidence that has supported the claim that avocado can have a positive effect on these conditions (1). Psoriasis is given a C grade because the evidence provided avocados that impacts this condition is still unclear (1). Avocados effectiveness against hypercholesterolemia, osteoarthritis, and psoriasis also has been given the same grade in the Natural Medicine Comprehensive database (2). Moreover, avocados have the ability to lower serum total cholesterol, LDL cholesterol, and apolipoprotein B. They also increase HDL cholesterol concentrations in test results have been shown in both databases (1-2). The difference between these two databases in grading and effectiveness of the avocado in these conditions is that the Natural Medicine Comprehensive database gives a summary of various research articles that supports or refute claims on avocados. In both databases, the avocado is generally regarded as safe except for individuals who are hypersensitive to latex. In contrast to the Natural Medicine Comprehensive database, the Natural Standard database has a different recommendation the amount of avocado that
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should be consumed by people. For example, when used in the combination product ASU/Piascledine 300, its standardized to 100mg of 1/3 avocado oil (1). Three studies have shown that - 1 avocado consumed daily for two to four weeks can decrease serum lipids (2). The Natural Medicine Comprehensive database only states that for lowering cholesterol, the amount of avocado consumed is dependent on dietary calorie intake or fat intake. To treat osteoarthritis, 300 mg of avocado has been prescribed to be taken daily (2). In the Natural Medicine Comprehensive database, there are no known interactions between avocados, herbs or supplements. In pertaining to drugs, Warfarin was the only drug that was reported to have an adverse interaction when combined with avocados because the fruit may antagonize the anticoagulant effects of Warfarin (1). Table 1. Summary table for avocado Name Indication Standardized components/ingredients Interactions Persa Americana, Avocado Improves blood lipid concentration Dietary fiber, carbohydrate, fat (monounsaturated), protein, vitamin C&K, folate, magnesium, potassium, pantothenic acid, vitamin B6, niacin (1,2) Avocado may antagonize the anticoagulant effects of Warfarin, but only one case has been reported (2). Topical avocado oil in combination with B12 cream can cause itching when applied initially (2). Natural Medicine Comprehensive: People who are allergic to latex should avoid eating avocado due to the possibility of cross hypersensitivity between latex and avocado (2). None Natural Standard: Variable dosing is used based on fat intake or dietary calorie content. When used in combination with ASU/Piasclendine 300, standardized dose is 100 mg of 1/3 avocado oil. Natural Medicines Comprehensive Database (NMCD): For lowering cholesterol, dosage is based on fat intake or dietary calorie content To treat osteoarthritis, 1/3 of an avocado is recommended Approximately < $ 2.00/ Varies According to the evidence reviewed by the Natural Standard database
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Warnings or contraindications

Side effects Recommended doses

Cost Strength of evidence

for indication

and the Natural Medicine Comprehensive database studies have shown that avocado-enriched diet high in monounsaturated fatty acids seems to lower total serum cholesterol, LDL cholesterol, and apolipoprotein B (1-2).

Defatted avocado pulp reduces body weight and total hepatic fat but increases plasma cholesterol in male rats fed diets with cholesterol. The objective of this research experiment is to study the influence of dry, defatted avocado pulp as a dietary fiber source on some dietary and metabolic measures such as food consumption, weight gain, cecum weight, hepatic fat content, and plasma & hepatic cholesterol levels in male rats. The rationale for conducting the study is to evaluate the potential use of avocado as a fiber source (4). Two randomized, control studies were conducted in this experiment. In the first study, researchers selected 40 rats and divided them equally into two groups, avocado versus cellulose. The fibers at a level of 100 g/kg diet were added with 10 g/kg with or without cholesterol. The second study consisted of 60 rats, which were randomly assigned two groups, cellulose vs. avocado (4). The rats were equally divided into three subgroups which were assigned 30, 60, or 100g of fiber diets with 10 g/kg cholesterol, and the cellulose groups were pair-fed to the group mean of their counterpart avocado groups (4). After 28 days of experimentation the rats were killed and the researchers analyzed their bodies. The rats blood was examined; their livers, cecum, kidneys, an d pancreas were removed and weighted. A histomorphometry was used to evaluate fat content in the liver of the rats fed dietary fibers either from avocado or cellulose. The results yielded from this experiment indicated that daily food consumption, feces excretion and weight gains were lower in the avocado group than in those that wasnt in the avocado group (4). The rats fed cholesterol containing diets were observed to have higher plasma and hepatic cholesterol levels than rats fed non-cholesterol diets. Plasma cholesterol levels were also high in rats
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fed diets high in avocado. Rats in the first study that consumed cholesterol based diets contained more fat in their livers than the rats that were not fed cholesterol based diet. The data collected in the second study were similar to the results observed in the first study. Rats fed avocado pulps in the second study resulted in their body weight decreasing as they consumed more fibers and their cecum weight also increased as they consumed more avocados. Regardless of the amount of fiber given to the rats, cecum relative weights were higher in avocado fed rats than in the cellulose pair fed rats. At all fiber levels, hepatic cholesterol levels of avocado-fed rats were greater than in cellulose-fed rats (4). It is clearly illustrated, based on the result, that avocados when used as a source of dietary fiber can affect food consumption, body weight gain, cholesterol and fat metabolism in rats. Unlike human studies, animal studies are more controlled. In this study, the rats were closely monitored and their diets were strictly maintained. Animal studies are beneficial because they provide fewer variables that can skew the data gathered in the study. For example, in a human trial study, researchers cannot tell participants to eliminate any food group from their diet because it would be unethical to cause someone to develop a deficiency. In turn, using animal studies is a safer way to observe the outcomes of experiments on test subjects. On the other hand, because this experiment was not done in humans it cannot be determined if the same results will be observed in human test subjects. After reading this study, I wonder if 28 days was enough time to observe changes in both plasma and hepatic cholesterol levels. Consumers shouldnt to put too much of their faith into one study because it is not a human clinical trial study. It is difficult to say if the same results will be seen in human subject. However, I would recommend that people consume avocados in moderation because it is a great source of omega-3 fatty acid, proteins, and vitamins. Also, avocados can be an alternative to consuming fruits

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high in sugar such as bananas, cherries, apples for those looking to reduce carbs in their diet since it is low in carbohydrates.

Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil. The objective of the experiment is to examine the effects of consuming a carotenoid rich meal composed of salad or salsa, with or without avocado or avocado oil on the absorption rate of alpha carotene, beta carotene and lycopene (3). The purpose of this study is to assess whether the addition of avocado as a lipid source will enhance the absorption of carotenoids in humans. In this experimental trial eleven healthy subjects between the ages of 21 to 42 were selected to participate in two crossover, postprandial (3) studies. In the first study the absorption of lycopene and betacarotene from salsa was examined. Subjects in this part of the study were given salsa with or without avocado at 2 to 4 weeks. In study two, the absorption of alpha-carotene, beta-carotene, and lutein were assessed after subjects consumed salad containing 75 or 150 grams of avocado and with 24 grams of avocado oil at 2, 4, 6, and 8 weeks following a crossover design. In both studies, avocadocontaining meals were served in a nonrandomized order to avoid compositional changes in avocados during storage (3). Subjects were required to attend clinical visits for ten hours and give blood samples. The test meals given to the subjects were individually analyzed for their carotenoid content. Researchers performed various statistical analyses on the postprandial absorption for each carotenoid in the plasma TRL fraction expressed as baseline-corrected area under the concentration versus time curve during the 9.5 hours after the test meal consumption was calculated (3). The data shown in this study indicates that lycopene absorption from salsa with avocado was higher than the control meal. Beta-carotene absorption from salsa was also greater when avocado was added to the salsa. In second study carotenoid absorption from the salad with the addition of either avocado or avocado oil
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had a greater impact than consuming salad alone. The high dose of avocado and fat-equivalent avocado oil both increased the absorption from salad of all carotenoids studied (3). According to the results yielded from this study adding 75 grams of avocado to salad increased both the absorption of alpha-carotene and beta-carotene with the exception of lutein. The addition of 24 grams of avocado oil to the salad on the other hand, did enhanced the absorption of lutein, alpha-carotene, and betacarotene to an extent that didnt differ from the yielded results by adding 150 grams of avocado to the salad (3). Overall, the increased consumption of avocados did not affect the absorption of lutein, alpha-carotenoid absorption in either study. The evidence shown in this study shows notable increases in the absorption of carotenoids from vegetable based foods consumed with avocados. There is a large variety of nutrients found in avocados and by adding it to carotenoid rich food as a lipid source will enhance the increase in carotenoid absorption and provide additional health benefits! Contrary to the results presented in this study, the population selected for this study was small. It would have been better to obtain a larger population. This I think would have made the resulted compiled more accurate due to increase variability in the population. In addition, the data might have been skewed due to variability in the subjects diet outside the clinic. Aside from that, some of positives in this study are that it is human clinical trial and subjects were closely monitored. My take-home message to consumers is to incorporate avocados to food high in carotenoids but low in fat because this study has shown that carotenoid absorption did increase after adding avocado to food product. Avocado isnt necessarily the only food that is a great source of monounsaturated fatty acids but it is one of many.

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Comparison of the effects on lipoproteins and apolipoproteins of a diet high in monounsaturated fatty acids, enriched with avocado, and a high-carbohydrate diet.

The aim of this study is to evaluate the effects on blood serum lipids, lipoproteins, and apoliproteins of an avocado-enriched diet in comparison with a low-fat, high complex-carbohydrate diet (5). The purpose in conducting this study is to assess how avocado-enriched and complexcarbohydrate diets effect blood lipid concentration. Fifteen women were selected in this study to adhere to either a diet high in monounsaturated fatty acids enriched with avocado or a high complexcarbohydrate diet. The study consisted of three dietary phases: the pre-entry phase, low-fat diet, and the avocado enriched diet. In the pre-entry phase, the dietary intake of all subjects over a period of 3 weeks were analyzed to determine usual food intake before any dietary modifications were suggested for the low-fat and avocado phases of the study (5). The second phase is based on the low fat diet which lasted for 3 weeks. The purpose of this phase is to reduce the subjects total fat intake to 20-25 percent of total energy intake. The third phase is based on the avocado-enriched diet which provided a high fat intake with a large proportion of the total fat intake, contributing 20-35 percent of the total energy intake (5). In the third phase the amount of avocados consumed daily was proportional to the total energy intake for each individual subject. Throughout this study the subjects were required to see a registered dietitian to make sure that they are disciplined to their diets. After an overnight fast of 12 hours, blood samples were taken from each subject on three occasions before the start of the study during the pre-entry phase and on two occasions during the final week of each of the dietary periods (5). In the pre-entry and avocado diet groups, total cholesterol decreased about 8 percent (5). In the low-fat diet group total cholesterol decreased about 4 percent. No significant differences were observed between the pre-entry group and the avocado group in HDL cholesterol reduction (5).
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However, there was a 13 percent decrease between pre-entry and low fat diets and an increase between low-fat and avocado diets of 12.8 percent (5). In conducting this study, researchers observed a strong correlation between apolipoproteins and HDL cholesterol when pre-entry and avocado phases were compared (5). Oppositely, in the low-fat group, apolipoproteins did not change while the HDL cholesterol decreased. In the group that was given avocado-enriched diets their LDL cholesterol decreased in comparison to the group given pre-entry diets. Also, there were no significant difference observed for LDL on the low-fat diet group compared with either the pre-entry or the avocado-enriched diet (5). Between the pre-entry and avocado diet groups, researchers observed a significant decrease in apolipoproteins B; no differences were observed between the preentry diet group and the low-fat diet group. The data shown in this study displayed no changes in the concentration of triglycerides in the various diets assigned to the subjects. The ratio of total cholesterol to HDL was significantly higher for the low-fat diet than for the pre-entry diet group. However, the ratio was reduced by about 15 percent from the low-fat to the avocado-enrich diet group (5). In reading this research article, I have noticed various flaws in the study. For example, the health status of the 15 female subjects was not taken into consideration. This is important to note because that can skew the results gathered in this experiment. Diets might not be as effective in lowering blood lipid concentrations in a healthy individual because they might not have a high concentration of blood lipids to begin with. Also, instead of requiring the subjects to complete a 3day dietary diary, I think it would have been better for the participants to keep a dietary log of everything they consumed on a daily bias. The weekly visit to the registered dietitians throughout the study could have been more frequently just to make sure the subjects did not deviate from their assigned diets. One positive aspect I did find in regards to this study is that it was a randomized

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human trial study. So the results gathered from this experiment can be observed in human subjects. Collaborating with RDs throughout this study is another positive aspect to this study. From reading this study, I recommend that consumers be mindful in the diets in which they choose to follow and to talk to a registered dietitian before restricting any food from the diet. In conclusion, the consumption of avocados is beneficial in various ways. For example, various studies have shown that avocados can reduce total cholesterol levels in human test subjects. Secondly, in rats avocado pulps have also shown reduction in body weight and total hepatic fat in male rats. Lastly, in one research study avocado have been effective in increasing the absorption rate of carotenoid from the diet. Whether avocados are used as a dietary fiber source to increase absorption or taken to improve blood lipid concentrations and/or to reduce body weight consumption of this fruit yields positive benefits. More research should be done to further understand the effectiveness of avocados as health enhancers.

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Work Cited 1. Natural Standard Editorial Board. Avocado (Persea americana) [Internet].Natural Standard The Authority on Integrative Medicine; 2013 [cited 2013 Nov 11].Available from: www.naturalstandard.com 2. Therapeutic Research Faculty, publishers. Avocado [Internet]. Natural Medicines Comprehensive Database; 2013 [cited 2013 Nov 11]. Available from: http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=&s=ND&pt=9&Product=a vocado&btnSearch.x=-420&btnSearch.y=-58 3. Unlu NZ, Bohn T. Clinton SK, Schwartz SJ. Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil. J Nutr. 2005;135:431-6. 4. Naven E., Werman MJ, Sabo E, Neeman I. Defatted avocado pulp reduces body weight and total hepatic fat but increases plasma cholesterol in male rats fed diets with cholesterol. J Nutr. 2002;132:2015-8. 5. David M. Colquhoun, Denise Moores. Comparison of the effects on lipoproteins and apolipoproteins of a diet high in monounsaturated fatty acids, enriched with avocado, and a high-carbohydrate diet. Am J Nutr. 1992;56:671-7.

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