Habitual Diet and Avocado Trial

NCT ID: NCT03528031

Last Updated: 2023-03-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1008 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-06-19

Study Completion Date

2020-10-30

Brief Summary

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The Habitual Diet and Avocado Trial will evaluate the effects of providing one avocado per day for recommended consumption over a 6 month period in a cohort of approximately 1000 free-living participants with increased waist circumference in comparison with a control group that will maintain their habitual diets. Participants will be recruited and screened at 4 clinics in 4 locations: Pennsylvania State University; Loma Linda University; UCLA, and Tufts University (250 per site).

Detailed Description

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Preliminary evidence suggests that consumption of avocados can modulate body weight, food intake and markers of metabolic syndrome and may reduce visceral adiposity. Visceral adipose tissue is positively correlated with risk of cardiometabolic syndrome that predisposes to cardiovascular disease and diabetes. The Habitual Diet and Avocado Trial (HAT) aims to investigate an impactful outcome (visceral fat reduction) in a relevant population (Americans with an increased weight circumference) with a reasonable lifestyle modification (consumption of 1 avocado per day). HAT will evaluate the effect of providing one avocado per day for consumption over a 6 month period on established health parameters, including visceral adiposity, hepatic lipid content, markers of metabolic syndrome and high sensitivity C-reactive protein (hsCRP) when compared to a habitual diet. Blood specimens will be drawn and analyzed for fasting total cholesterol, triglyceride, HDL-C, glucose, insulin, hsCRP and RBC fatty acid profiles. Two non-contrast MRIs will be performed (at screening to assess eligibility and final participant visit 8 for randomized participants) to assess the volume of visceral adipose tissue and hepatic fat fraction. Four 24-hour dietary recalls will be conducted for study participants to capture dietary intake data. Questionnaires include the following: health and demographic including eating habits and physical activity; diet, food and avocado satisfaction (intervention group only); quality of life; and quality of sleep.

Conditions

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Intra-abdominal Fat Metabolic Syndrome High Cholesterol Triglycerides High Diet Habit High Blood Sugar Liver Fat Dietary Modification HDL Cholesterol, Low Serum Cardiovascular Diseases High Density Lipoprotein Deficiency Low-density-lipoprotein-type Cardiovascular Risk Factor Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This clinical trial aims to assess the effect of providing one avocado per day on established parameters of health in comparison with a control group maintaining their habitual diets. Participants are pre-screened over the telephone initially to assess eligibility and likelihood of compliance. For those that remain eligible, additional screening is conducted at a study visit. Participants' eligibility is confirmed by the data entry system on the trial website when the Inclusion/Exclusion form is complete and entered. Randomization is performed automatically by the data entry system using a block design and stratified by site. Participants are randomly assigned to one of two equally sized groups. Neither participants nor staff will be blinded to intervention assignment. Both groups are instructed to continue to follow their habitual diet but the intervention group will receive one avocado per day. Participants are followed for outcomes for a six-month period.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Intervention Daily Avocado

Participants will follow their usual diet and lifestyle but also be provided with 1 avocado to consume per day for 6 months. To maximize compliance, participants will be provided with resources on how to choose, store and ripen avocados along with simple usage ideas. Specific nutrition guidance will not be provided. Participants will pick up fresh avocados every 2 weeks with minimal interaction with study personnel. Compliance visits will be conducted monthly.

Group Type EXPERIMENTAL

Intervention Daily Avocado

Intervention Type OTHER

Participants follow their usual diet and lifestyle but also are provided with 1 avocado to consume per day for 6 months.

Control Usual Diet and Lifestyle

Participants will be instructed to follow their usual diet and lifestyle. Participants will be allowed to consume up to 2 avocados per month, but avocado consumption will not be encouraged and no avocados will be provided. Compliance visits will be conducted monthly.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Intervention Daily Avocado

Participants follow their usual diet and lifestyle but also are provided with 1 avocado to consume per day for 6 months.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Increased waist circumference defined as ≥35 inches for women, ≥40 inches for men
* At least 25 years old at screening
* Not currently eating more than 2 avocados per month (habitual intake in U.S.)

Exclusion Criteria

* Does not eat avocados
* Sensitive / allergic to avocados
* Allergies to latex or oral allergy syndrome
* Not willing or unable to undergo MRI scans
* Unstable medical condition such as on dialysis for renal disease, cardiac, gastrointestinal, or hepatic disease, cancer (non-melanoma skin cancer \>5 years ago acceptable, any cancer site \>10yrs without recurrence).
* Pregnant, lactating, intention of pregnancy
* Lost or gained 10 lbs of body weight in last year
* Following restricted or weight loss dietary patterns
* Unstable anti-anxiety / anti-depressive / anti-psychotic medication use defined as dose change within last 6 months
* Oral steroid use within the last 6 months longer than 7 days
* Elevated alcohol intake (7+ drinks/week females; 14+ drinks/week males)
* Participation in another clinical intervention trial within 30 days of baseline
* PI judgment
Minimum Eligible Age

25 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David Reboussin, PhD

Role: PRINCIPAL_INVESTIGATOR

Wake Forest University Health Sciences

Locations

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Loma Linda University

Loma Linda, California, United States

Site Status

University of California Los Angles (UCLA)

Los Angeles, California, United States

Site Status

Tufts University

Boston, Massachusetts, United States

Site Status

Pennysylvania State University

University Park, Pennsylvania, United States

Site Status

Countries

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United States

References

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Berryman CE, West SG, Fleming JA, Bordi PL, Kris-Etherton PM. Effects of daily almond consumption on cardiometabolic risk and abdominal adiposity in healthy adults with elevated LDL-cholesterol: a randomized controlled trial. J Am Heart Assoc. 2015 Jan 5;4(1):e000993. doi: 10.1161/JAHA.114.000993.

Reference Type RESULT
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Bertoli S, Leone A, Vignati L, Bedogni G, Martinez-Gonzalez MA, Bes-Rastrollo M, Spadafranca A, Vanzulli A, Battezzati A. Adherence to the Mediterranean diet is inversely associated with visceral abdominal tissue in Caucasian subjects. Clin Nutr. 2015 Dec;34(6):1266-72. doi: 10.1016/j.clnu.2015.10.003. Epub 2015 Oct 20.

Reference Type RESULT
PMID: 26499033 (View on PubMed)

Cespedes Feliciano EM, Tinker L, Manson JE, Allison M, Rohan T, Zaslavsky O, Waring ME, Asao K, Garcia L, Rosal M, Neuhouser ML. Change in Dietary Patterns and Change in Waist Circumference and DXA Trunk Fat Among Postmenopausal Women. Obesity (Silver Spring). 2016 Oct;24(10):2176-84. doi: 10.1002/oby.21589. Epub 2016 Aug 22.

Reference Type RESULT
PMID: 27548405 (View on PubMed)

Dhillon J, Tan SY, Mattes RD. Almond Consumption during Energy Restriction Lowers Truncal Fat and Blood Pressure in Compliant Overweight or Obese Adults. J Nutr. 2016 Dec;146(12):2513-2519. doi: 10.3945/jn.116.238444. Epub 2016 Nov 2.

Reference Type RESULT
PMID: 27807041 (View on PubMed)

Estruch R, Martinez-Gonzalez MA, Corella D, Salas-Salvado J, Ruiz-Gutierrez V, Covas MI, Fiol M, Gomez-Gracia E, Lopez-Sabater MC, Vinyoles E, Aros F, Conde M, Lahoz C, Lapetra J, Saez G, Ros E; PREDIMED Study Investigators. Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med. 2006 Jul 4;145(1):1-11. doi: 10.7326/0003-4819-145-1-200607040-00004.

Reference Type RESULT
PMID: 16818923 (View on PubMed)

Gower BA, Goss AM. A lower-carbohydrate, higher-fat diet reduces abdominal and intermuscular fat and increases insulin sensitivity in adults at risk of type 2 diabetes. J Nutr. 2015 Jan;145(1):177S-83S. doi: 10.3945/jn.114.195065. Epub 2014 Dec 3.

Reference Type RESULT
PMID: 25527677 (View on PubMed)

Paniagua JA, Gallego de la Sacristana A, Romero I, Vidal-Puig A, Latre JM, Sanchez E, Perez-Martinez P, Lopez-Miranda J, Perez-Jimenez F. Monounsaturated fat-rich diet prevents central body fat distribution and decreases postprandial adiponectin expression induced by a carbohydrate-rich diet in insulin-resistant subjects. Diabetes Care. 2007 Jul;30(7):1717-23. doi: 10.2337/dc06-2220. Epub 2007 Mar 23.

Reference Type RESULT
PMID: 17384344 (View on PubMed)

Ross R, Rissanen J, Pedwell H, Clifford J, Shragge P. Influence of diet and exercise on skeletal muscle and visceral adipose tissue in men. J Appl Physiol (1985). 1996 Dec;81(6):2445-55. doi: 10.1152/jappl.1996.81.6.2445.

Reference Type RESULT
PMID: 9018491 (View on PubMed)

National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002 Dec 17;106(25):3143-421. No abstract available.

Reference Type RESULT
PMID: 12485966 (View on PubMed)

Wien M, Haddad E, Oda K, Sabate J. A randomized 3x3 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. Nutr J. 2013 Nov 27;12:155. doi: 10.1186/1475-2891-12-155.

Reference Type RESULT
PMID: 24279738 (View on PubMed)

O'Neil, et al. Avocado consumption by adults is associated with better nutrient intake, diet quality and some measures of adiposity: NHANES Survey, 2001-2012. Int Med Rev In press.

Reference Type RESULT

Damani JJ, Kris-Etherton PM, Lichtenstein AH, Matthan NR, Sabate J, Li Z, Reboussin D, Petersen KS. Effect of Daily Avocado Intake on Cardiovascular Health Assessed by Life's Essential 8: An Ancillary Study of HAT, a Randomized Controlled Trial. J Am Heart Assoc. 2025 Mar 4;14(5):e039130. doi: 10.1161/JAHA.124.039130. Epub 2025 Feb 19.

Reference Type DERIVED
PMID: 39968784 (View on PubMed)

Clarke AE, LeBeau KS, Oda K, Segovia-Siapco G, Paalani M, Reboussin DM, Lichtenstein AH, Rajaram S, Sabate J. The Effect of Daily Avocado Intake on Food and Nutrient Displacement in a Free-Living Population with Abdominal Obesity. Curr Dev Nutr. 2024 Aug 27;8(10):104451. doi: 10.1016/j.cdnut.2024.104451. eCollection 2024 Oct.

Reference Type DERIVED
PMID: 39886351 (View on PubMed)

Yang J, Lei OK, Bhute S, Kris-Etherton PM, Lichtenstein AH, Matthan NR, Petersen KS, Sabate J, Reboussin DM, Lovato L, Vitolins MZ, Rajaram S, Jacobs JP, Huang J, Taw M, Yang S, Li Z. Impact of daily avocado consumption on gut microbiota in adults with abdominal obesity: an ancillary study of HAT, a randomized controlled trial. Food Funct. 2025 Jan 2;16(1):168-180. doi: 10.1039/d4fo03806a.

Reference Type DERIVED
PMID: 39641169 (View on PubMed)

Matthan NR, Lovato L, Petersen KS, Kris-Etherton PM, Sabate J, Rajaram S, Li Z, Reboussin DM, Lichtenstein AH. Effect of daily avocado consumption for 6 mo compared with habitual diet on red blood cell fatty acid profiles and association with cardiometabolic risk factors in individuals with abdominal obesity: a randomized trial. Am J Clin Nutr. 2024 Oct;120(4):794-803. doi: 10.1016/j.ajcnut.2024.08.002. Epub 2024 Aug 10.

Reference Type DERIVED
PMID: 39128497 (View on PubMed)

Davis KM, Petersen KS, Matthan NR, Legro RS, Kris-Etherton PM. Effect of Incorporating 1 Avocado per Day Versus Habitual Diet on Vascular Function in Adults With Abdominal Obesity: An Ancillary Study of HAT, a Randomized Controlled Trial. J Am Heart Assoc. 2024 May 21;13(10):e030497. doi: 10.1161/JAHA.123.030497. Epub 2024 May 10.

Reference Type DERIVED
PMID: 38726886 (View on PubMed)

Petersen KS, Smith S, Lichtenstein AH, Matthan NR, Li Z, Sabate J, Rajaram S, Segovia-Siapco G, Reboussin DM, Kris-Etherton PM. One Avocado per Day as Part of Usual Intake Improves Diet Quality: Exploratory Results from a Randomized Controlled Trial. Curr Dev Nutr. 2024 Jan 11;8(2):102079. doi: 10.1016/j.cdnut.2024.102079. eCollection 2024 Feb.

Reference Type DERIVED
PMID: 38375072 (View on PubMed)

Lichtenstein AH, Kris-Etherton PM, Petersen KS, Matthan NR, Barnes S, Vitolins MZ, Li Z, Sabate J, Rajaram S, Chowdhury S, Davis KM, Galluccio J, Gilhooly CH, Legro RS, Li J, Lovato L, Perdue LH, Petty G, Rasmussen AM, Segovia-Siapco G, Sirirat R, Sun A, Reboussin DM. Effect of Incorporating 1 Avocado Per Day Versus Habitual Diet on Visceral Adiposity: A Randomized Trial. J Am Heart Assoc. 2022 Jul 19;11(14):e025657. doi: 10.1161/JAHA.122.025657. Epub 2022 Jul 5.

Reference Type DERIVED
PMID: 35861827 (View on PubMed)

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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IRB00047011

Identifier Type: -

Identifier Source: org_study_id

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