NCT03528031

Brief Summary

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).

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,008

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jun 2018

Typical duration for not_applicable

Geographic Reach
1 country

4 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 4, 2018

Completed
13 days until next milestone

First Posted

Study publicly available on registry

May 17, 2018

Completed
1 month until next milestone

Study Start

First participant enrolled

June 19, 2018

Completed
2.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 16, 2020

Completed
14 days until next milestone

Study Completion

Last participant's last visit for all outcomes

October 30, 2020

Completed
Last Updated

March 22, 2023

Status Verified

June 1, 2021

Enrollment Period

2.3 years

First QC Date

May 4, 2018

Last Update Submit

March 17, 2023

Conditions

Outcome Measures

Primary Outcomes (1)

  • Visceral adiposity

    Non-contrast MRI scans will be performed to assess the volume of visceral adipose tissue. The outcome will be pre-post difference, compare the estimated mean change from baseline to follow-up in the 2 randomized groups with all tests of group differences performed according to the intent to treat.

    Visit 1 (Screening, -2 to 0 weeks) and Visit 8 (26 weeks)

Secondary Outcomes (12)

  • Hepatic lipid content

    Visit 1 (Screening, -2 to 0 weeks and Visit 8 (26 weeks)

  • Metabolic syndrome markers (serum triglycerides, serum cholesterol, fasting serum glucose, fasting insulin)

    Visit 2 (Baseline visit 0 weeks), Visit 5 (12 weeks), Visit 8 (26 weeks)

  • High-sensitivity C-reactive protein (hs-CRP)

    Visit 2 (baseline/randomization, Week 0), Visit 5 (12 weeks), Visit 8 (26 weeks)

  • Red blood cell (RBC) monounsaturated fat/polyunsaturated fat (MUFA/PUFA) ratio

    Visit 2 (Baseline/Randomization Visit, 0 weeks), Visit 5 (12 weeks), Visit 8 (26 weeks)

  • Blood pressure

    Visit 2 (baseline/randomization 0 weeks) Visit 3 (4 weeks), Visit 4 (8 weeks), Visit 5 (12 weeks), Visit 6 (16 weeks), Visit 7 (10 weeks), Visit 8 (26 weeks)

  • +7 more secondary outcomes

Study Arms (2)

Intervention Daily Avocado

EXPERIMENTAL

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.

Other: Intervention Daily Avocado

Control Usual Diet and Lifestyle

NO INTERVENTION

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.

Interventions

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

Intervention Daily Avocado

Eligibility Criteria

Age25 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • 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.)

You may not qualify if:

  • 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

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Loma Linda University

Loma Linda, California, 92354, United States

Location

University of California Los Angles (UCLA)

Los Angeles, California, 90095, United States

Location

Tufts University

Boston, Massachusetts, 02111, United States

Location

Pennysylvania State University

University Park, Pennsylvania, 16802, United States

Location

Related Publications (18)

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

    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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

MeSH Terms

Conditions

Metabolic SyndromeHypercholesterolemiaHypertriglyceridemiaFeeding BehaviorHyperglycemiaFatty LiverHypoalphalipoproteinemiasCardiovascular DiseasesDiabetes Mellitus

Condition Hierarchy (Ancestors)

Insulin ResistanceHyperinsulinismGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesHyperlipidemiasDyslipidemiasLipid Metabolism DisordersBehavior, AnimalBehaviorLiver DiseasesDigestive System DiseasesHypolipoproteinemiasLipid Metabolism, Inborn ErrorsMetabolism, Inborn ErrorsGenetic Diseases, InbornCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesEndocrine System Diseases

Study Officials

  • David Reboussin, PhD

    Wake Forest University Health Sciences

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Model Details: 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.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 4, 2018

First Posted

May 17, 2018

Study Start

June 19, 2018

Primary Completion

October 16, 2020

Study Completion

October 30, 2020

Last Updated

March 22, 2023

Record last verified: 2021-06

Data Sharing

IPD Sharing
Will share

Investigators may wish to perform ancillary studies using the HAT population, samples or other collected data. All ancillary studies must be approved by the HAT Steering Committee before being allowed access to study participant, samples or the database. De-identified individual participant data for all primary and secondary outcome measures will be made available to participating sites and for at the end of the study and for public use databases.

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
Time Frame
Data will be available within 6 months of study completion.
Access Criteria
Data access requests will be reviewed by the Steering Committee. Requestors will be required to sign a Data Access Agreement.

Locations