title: Impact of avocado-enriched diets on plasma lipoproteins: A meta-analysis.
abstract: BACKGROUND
  Optimizing plasma lipoproteins is the primary goal of pharmacotherapy and diet interventions in people at risk for cardiovascular diseases. Avocados offer a rich source of monounsaturated fat and may pose beneficial effects on the lipid profile.
  
  
  OBJECTIVE
  We aimed to perform a meta-analysis of randomized clinical trials assessing the impact of avocados on TC, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and/or triglycerides (TG).
  
  
  METHODS
  We searched PUBMED, Cumulative Index to Nursing and Allied Health Literature, Index to Nursing and Allied Health Literature, and the Cochrane Database of Systemic Reviews from their inception to February 2015. The weighted mean difference from baseline was calculated for all endpoints. Subgroup analyses were performed to assess heterogeneity, and funnel plots inspected to assess publication bias.
  
  
  RESULTS
  Ten unique studies (n = 229) were included. Avocado consumption significantly reduced TC, LDL-C, and TG by -18.80 mg/dL (95% confidence interval [CI], -24.56 to -13.05; I(2), 46.9%), -16.50 mg/dL (95% CI, -22.91 to -10.10; I(2), 72.5%), -27.20 mg/dL (95% CI, -44.41 to -9.99; I(2), 91.1%) respectively. High-density lipoprotein cholesterol decreased nonsignificantly by -0.18 mg/dL (95% CI, -3.23 to 2.88; I(2), 84.8%).
  
  
  CONCLUSIONS
  Avocado-substituted diets significantly decrease TC, LDL-C, and TG levels. Substituting dietary fats with avocados versus adding to the free diet should be the primary recommendation strategy. Larger trials looking at the impact of avocados on major adverse cardiovascular events are warranted.
authors.affiliation: Department of Pharmacy, David Grant Medical Center, Travis Air Force Base, Fairfield, CA, USA.
authors.forename: Sokunthea
authors.initials: S
authors.lastname: Peou
authors.affiliation: Clinical Investigations Facility, David Grant Medical Center, Travis Air Force Base, USA.
authors.forename: Brittany
authors.initials: B
authors.lastname: Milliard-Hasting
authors.affiliation: Department of Pharmacy, David Grant Medical Center, Travis Air Force Base, Fairfield, CA, USA; Department of Pharmacy Practice, Thomas J Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA, USA. Electronic address: sshah@pacific.edu.
authors.forename: Sachin A
authors.initials: SA
authors.lastname: Shah
mesh_terms: D002986:Clinical Trials as Topic; D004032:Diet; D006801:Humans; D008074:Lipoproteins / Q000097:blood*; D027421:Persea
chemical_list: D008074:Lipoproteins
keywords: Cholesterol; Diet; Lipoproteins; MUFA; Meta-analysis