Associations between Avocado Intake and Lower Rates of Incident Type 2 Diabetes in US Adults with Hispanic/Latino Ancestry

Association Between Avocado Consumption and Diabetes in Mexican Adults: Results From the 2012, 2016, and 2018 Mexican National Health and Nutrition Surveys

BACKGROUND

Avocado contains numerous vitamins, minerals, and phytochemicals that can contribute to reducing the risk of metabolic syndrome and diabetes. However, limited studies have examined the association between avocados and diabetes risk.

OBJECTIVE

This study aimed to examine the association between avocado consumption and diabetes by sex in Mexican adults.

DESIGN

This was a cross-sectional study.

PARTICIPANTS/SETTING

Participants included a subsample of adults (aged 20 years and older) from the 2012, 2016, and 2018 Mexican National Health and Nutrition Survey. Avocado consumption was assessed using a 7-day, semiquantitative food frequency questionnaire, and participants were classified as avocado consumers (consuming any amount of avocado) or nonconsumers.

MAIN OUTCOME MEASURES

Participants were considered to have diabetes if they answered "yes" to "Has a doctor ever told that you have diabetes or high blood sugar?"

STATISTICAL ANALYSES PERFORMED

This analysis assessed the association between avocado intake and diabetes using multivariate logistic models by sex and adjusted for relevant covariates.

RESULTS

Of 28 239 Mexican National Health and Nutrition Survey 2012, 2016, and 2018 participants, 25 640 met the criteria (ie, have diabetes outcome and plausible energy and avocado intakes) for this study. More than half of the participants were women, and approximately 45% were avocado consumers, with an average (SE) avocado consumption of 34.7 (0.9) among men and 29.8 (0.8) g/day among women. Avocado consumers had lower odds of diabetes in both unadjusted (odds ratio [OR] 0.762, 95% CI 0.639 to 0.907) and adjusted (OR 0.792, 95% CI 0.632 to 0.993) models among women but not men (OR 1.192, 95% CI: 0.907 to 1.566 and OR 0.914, 95% CI 0.675 to 1.239 for unadjusted and adjusted models, respectively).

CONCLUSIONS

Avocado consumption was associated with a lower risk of diabetes, which remained significant even when adjusted for relevant covariates. However, this finding was observed in only women, not men, underscoring the importance of personalized nutrition in diabetes care and prevention.

Associations between avocado intake and measures of glucose and insulin homeostasis in Hispanic individuals with and without type 2 diabetes: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

BACKGROUND AND AIMS

To investigate associations between avocado intake and glycemia in adults with Hispanic/Latino ancestry.

METHODS AND RESULTS

The associations of avocado intake with measures of insulin and glucose homeostasis were evaluated in a cross-sectional analysis of up to 14,591 Hispanic/Latino adults, using measures of: average glucose levels (hemoglobin A1c; HbA1c), fasting glucose and insulin, glucose and insulin levels after an oral glucose tolerance test (OGTT), and calculated measures of insulin resistance (HOMA-IR, and HOMA-%β), and insulinogenic index. Associations were assessed using multivariable linear regression models, which controlled for sociodemographic factors and health behaviors, and which were stratified by dysglycemia status. In those with normoglycemia, avocado intake was associated with a higher insulinogenic index (β = 0.17 ± 0.07, P = 0.02). In those with T2D (treated and untreated), avocado intake was associated with lower hemoglobin A1c (HbA1c; β = -0.36 ± 0.21, P = 0.02), and lower fasting glucose (β = -0.27 ± 0.12, P = 0.02). In the those with untreated T2D, avocado intake was additionally associated with HOMA-%β (β = 0.39 ± 0.19, P = 0.04), higher insulin values 2-h after an oral glucose load (β = 0.62 ± 0.23, P = 0.01), and a higher insulinogenic index (β = 0.42 ± 0.18, P = 0.02). No associations were observed in participants with prediabetes.

CONCLUSIONS

We observed an association of avocado intake with better glucose/insulin homeostasis, especially in those with T2D.

Associations between Metabolomic Biomarkers of Avocado Intake and Glycemia in the Multi-Ethnic Study of Atherosclerosis

BACKGROUND

Avocado consumption is linked to better glucose homeostasis, but small associations suggest potential population heterogeneity. Metabolomic data capture the effects of food intake after digestion and metabolism, thus accounting for individual differences in these processes.

OBJECTIVES

To identify metabolomic biomarkers of avocado intake and to examine their associations with glycemia.

METHODS

Baseline data from 6224 multi-ethnic older adults (62% female) included self-reported avocado intake, fasting glucose and insulin, and untargeted plasma proton nuclear magnetic resonance metabolomic features (metabolomic data were available for a randomly selected subset; N = 3438). Subsequently, incident type 2 diabetes (T2D) was assessed over an ∼18 y follow-up period. A metabolome-wide association study of avocado consumption status (consumer compared with nonconsumer) was conducted, and the relationship of these features with glycemia via cross-sectional associations with fasting insulin and glucose and longitudinal associations with incident T2D was examined.

RESULTS

Three highly-correlated spectral features were associated with avocado intake at metabolome-wide significance levels (P < 5.3 ∗ 10-7) and combined into a single biomarker. We did not find evidence that these features were additionally associated with overall dietary quality, nor with any of 47 other food groups (all P > 0.001), supporting their suitability as a biomarker of avocado intake. Avocado intake showed a modest association only with lower fasting insulin (β = -0.07 +/- 0.03, P = 0.03), an association that was attenuated to nonsignificance when additionally controlling for body mass index (kg/m2). However, our biomarker of avocado intake was strongly associated with lower fasting glucose (β = -0.22 +/- 0.02, P < 2.0 ∗ 10-16), lower fasting insulin (β = -0.17 +/- 0.02, P < 2.0 ∗ 10-16), and a lower incidence of T2D (hazard ratio: 0.68; 0.63-074, P < 2.0 ∗ 10-16), even when adjusting for BMI.

CONCLUSIONS

Highly significant associations between glycemia and avocado-related metabolomic features, which serve as biomarkers of the physiological impact of dietary intake after digestion and absorption, compared to modest relationships between glycemia and avocado consumption, highlights the importance of considering individual differences in metabolism when considering diet-health relationships.