Research shows that avocado can lower the risk of diabetes in women, but not in men

In a recent cross-sectional study published in the Journal of the Academy of Nutrition and Dietetics, Researchers from Mexico investigated the possible link between avocado consumption and diabetes in Mexican adults. They found that compared to those who did not consume avocados, avocado-consuming women showed a lower risk of diabetes, while no significant association was observed in men.

Study: Association between avocado consumption and diabetes in Mexican adults: results from the 2012, 2016 and 2018 Mexican National Health and Nutrition Surveys. Image credits: Deckar 007 / Shutterstock

Background

The global prevalence of diabetes has tripled since 2000, prompting a focus on dietary modifications to reduce the risk of the disease. Fruits and vegetables, rich in vitamins and phytochemicals, are known for their potential to combat insulin resistance and related conditions. While the collective benefits of dietary patterns such as the Mediterranean diet are recognized, understanding the specific impact of individual foods is critical.

Increasingly popular worldwide, avocados provide essential nutrients and are associated with metabolic health benefits. However, research on their relationship with diabetes risk is limited and often characterized by small sample sizes and acute outcome assessments. Considering the influence of biological sex on the pathogenesis of diabetes, particularly noted among Mexican women, the current study examined the potential link between avocado consumption and diabetes, analyzing data from the Mexico National Survey of Health and Nutrition (ENSANUT).

About the study

The current study included a secondary analysis of a subgroup of the Mexican population aged ≥20 years from the 2012, 2016, and 2018 versions of the ENSANUT survey. The surveys followed a nationally representative sampling design with probabilistic multistage and cluster sampling, stratified by residential area. Pregnant or lactating women were excluded. The initial sample size was 2,824 individuals from the 2012 survey, 8,530 from the 2016 survey, and 16,885 from the 2018 survey. During the study, 2,599 participants were excluded due to missing diabetes data or unlikely energy or avocado intakes, resulting in a final analysis of 25,640 participants. About 59% of them were women. The majority of them were overweight or obese, while more than 60% suffered from abdominal obesity.

Following established protocols, the surveys used a validated semiquantitative food frequency questionnaire (SFFQ) to collect dietary information from adults. Implausible data were excluded and avocado consumption was assessed using the SFFQ, with participants classified as consumers or non-consumers based on reported intake.

Diabetes was diagnosed by participants reporting whether a doctor had diagnosed them with diabetes or high blood sugar. The primary analysis used self-reported diagnosis. A subset of participants (n=15,349) underwent sensitivity analysis using laboratory data. Diabetes was defined as glycated hemoglobin (HbA1c) ≥ 6.5% or fasting plasma glucose (FPG) ≥ 126 mg/dl.

Various covariates including age, gender, indigenous status, socio-economic level, education, area of ​​residence, geographic region, marital status, body mass index (BMI), abdominal obesity, physical activity, Healthy Eating Index score (HEI-2015), energy intake, smoking, alcohol consumption, hypertension and acute myocardial infarction were taken into account. Weight, height and waist circumference were measured. The socio-economic level was determined by principal components analysis and divided into low, medium and high levels. The study used descriptive statistics, logistic regression (adjusted and unadjusted models), sensitivity analysis using FBG or HbA1c, and assessment of multicollinearity.

results and discussion

Of the participants in the three studies, approximately 45% were avocado consumers, with an average daily consumption of 34.7 grams for men and 29.8 grams for women. Avocado consumers tended to have higher socioeconomic status and higher education levels than non-consumers. Avocado consumption was found to be associated with a lower risk of diabetes in women in both the unadjusted (OR: 0.762) and adjusted (OR: 0.792) models, but not in men (p-value >0.05 for both). This association remained consistent when using laboratory measurements for diabetes diagnosis (FPG or Hb1AC). These findings highlight the potential protective role of avocado consumption against diabetes, especially among women.

The study takes advantage of a large, nationally representative dataset in Mexico, where avocado consumption is culturally significant, and uses a validated survey instrument to accurately assess intake, control for relevant covariates, and perform sensitivity analyses. However, the reliance on self-reported avocado consumption may lead to measurement bias, and the cross-sectional design limits the ability to establish causality, highlighting the need for longitudinal studies to examine long-term effects. Furthermore, although the large sample size increases statistical power, replication in other cohorts is crucial to confirm these findings.

Conclusion

In conclusion, the current study identifies an association between avocado consumption and reduced diabetes risk, which is particularly significant in women, even after adjusting for relevant factors. The findings suggest the potential role of avocados as a beneficial component of dietary interventions aimed at reducing the risk of diabetes, especially in women. They emphasize the need for further research into personalized nutrition in the prevention and treatment of diabetes and nutritional recommendations based on individual characteristics.