Effect of Incorporating 1 Avocado Per Day Versus Habitual Diet on Visceral Adiposity: A Randomized Trial

Oct 11, 2026

Excess visceral adiposity increases cardiometabolic risk, and short-term trials suggest regular avocado intake may support weight, visceral fat, and satiety. The HAT Trial (Habitual Diet and Avocado Trial) tested whether consuming 1 large avocado daily for 6 months would reduce visceral adiposity measured by magnetic resonance imaging in free-living adults with elevated waist circumference (N=1008). Primary outcomes showed no significant between-group difference in visceral adipose tissue volume, and secondary measures largely remained unchanged, with only modest nominal LDL and total cholesterol improvements.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages21

Reading Time53 min

AccessFree to download

Background

Methods and Results

Primary outcome

Secondary outcomes

Additional outcomes

Conclusions

Clinical Perspective

What Is New?

Clinical Implications?

Journal of the American Heart Association ORIGINAL RESEARCH | Effect of Incorporating 1 Avocado Per Day Versus Habitual Diet on Visceral Adiposity: A Randomized Trial
Alice H. Lichtenstein , DSc; Penny M. Kris-Etherton, PhD; Kristina S. Petersen , PhD;
Nirupa R. Matthan , PhD; Samuel Barnes , PhD; Mara Z. Vitolins, DrPH, RDN; Zhaoping Li, MD, PhD; Joan Sabaté, MD, DrPH; Sujatha Rajaram, PhD; Shilpy Chowdhury , MD, MPH; Kristin M. Davis , BA; Jean Galluccio, BS; Cheryl H. Gilhooly , PhD, MPH, RD; Richard S. Legro , MD; Jason Li, BS; Laura Lovato, MS; Letitia H. Perdue, MS; Gayle Petty, MBA; Anna M. Rasmussen, BA;
Gina Segovia-Siapco, DrPH; Rawiwan Sirirat, DrPH, RD; April Sun , BS; David M. Reboussin, PhD
BACKGROUND: Excess visceral adiposity is associated with increased risk of cardiometabolic disorders. Short-term wellcontrolled clinical trials suggest that regular avocado consumption favorably affects body weight, visceral adiposity, and satiety.
METHODS AND RESULTS: The HAT Trial (Habitual Diet and Avocado Trial) was a multicenter, randomized, controlled parallel-arm trial designed to test whether consuming 1 large avocado per day for 6months in a diverse group of free-living individuals (N=1008) with an elevated waist circumference compared with a habitual diet would decrease visceral adiposity as measured by magnetic resonance imaging. Secondary and additional end points related to risk factors associated with cardiometabolic disorders were assessed. The primary outcome, change in visceral adipose tissue volume during the intervention period, was not significantly different between the Avocado Supplemented and Habitual Diet Groups (estimated mean difference (0 .017 L [−0 .024L, 0.058L], P=0 .405). No significant group differences were observed for the secondary outcomes of hepatic fat fraction, hsCRP (high-sensitivity C-reactive protein), and components of the metabolic syndrome. Of the additional outcome measures, modest but nominally significant reductions in total and low-density lipoprotein cholesterol were observed in the Avocado Supplemented compared with the Habitual Diet Group. Changes in the other additional and post hoc measures (body weight, body mass index, insulin, very low-density lipoprotein concentrations, and total cholesterol:high-density lipoprotein cholesterol ratio) were similar between the 2 groups.
CONCLUSIONS: Addition of 1 avocado per day to the habitual diet for 6 months in free-living individuals with elevated waist circumference did not reduce visceral adipose tissue volume and had minimal effect on risk factors associated with cardiometabolic disorders.
REGISTRATION: URL: [https://clinicaltrials.gov](https://clinicaltrials.gov) ; Unique identifier: NCT03528031.
Key Words: avocado ■ habitual diet ■ randomized clinical trial ■ risk factors for cardiometabolic disorders ■ visceral fat | | | --- | --- | | In the United States, ≈60% of adults have visceral
adiposity, defined as a waist circumference of ≥40 inches for women and ≥35 inches for men.1,2 Visceral adiposity is associated with elevated risk of type 2 diabetes, insulin resistance, systemic inflammation, cardiovascular disease, and all-cause mortality.3–6 | To reduce the burden of these chronic disorders, strategies are needed to prevent the development of visceral adiposity.
Independent of total caloric intake, diet quality has been reported to affect visceral adiposity.7–9 One food of recent interest is avocados. Avocados are a good | Correspondence to: Alice H. Lichtenstein, DSc, Tufts University, 711 Washington Street, Boston, MA 02111. Email: [alice.lichtenstein@tufts.edu](alice.lichtenstein@tufts.edu) Supplemental Material is available at [https://www.ahajournals.org/doi/suppl/10.1161/JAHA.122.025657](https://www.ahajournals.org/doi/suppl/10.1161/JAHA.122.025657)[ ](https://www.ahajournals.org/doi/suppl/10.1161/JAHA.122.025657)[For Sources of Funding and Disclosures](For Sources of Fundi

FAQs

What was the main goal of the HAT Trial?

To determine whether 1 large avocado per day for 6 months reduces visceral adiposity, compared with a habitual diet, in free-living individuals with elevated waist circumference.

How was visceral adiposity measured and what was the primary result?

Visceral adiposity was assessed using magnetic resonance imaging; the change in visceral adipose tissue volume was not significantly different between the avocado-supplemented and habitual diet groups.

Did avocado intake affect other cardiometabolic risk factors?

Secondary outcomes such as hepatic fat fraction, hsCRP, and metabolic syndrome components showed no significant group differences; modest nominal reductions in total and LDL cholesterol were observed, while other measures were similar.

Oct 11, 2026

Upload by Jordan Avery