Avocado

What it is

Avocado (Persea americana) is a fruit eaten as food, including Hass avocados used in most trials [1][2]. It is rich in unsaturated fats, fibre and plant compounds [3][4]. A common trial dose was one fruit a day, about 136 to 180 g [1][5].

How it might work

Avocado is proposed to help cholesterol mainly by replacing saturated fat with unsaturated fat [1]. Its fibre and plant compounds are also proposed to play a role, but this remains a proposed explanation rather than an established mechanism [4].

What the research says

A 2016 meta-analysis of 10 trials (229 people) found avocado lowered total cholesterol by 18.8 mg/dL, LDL cholesterol by 16.5 mg/dL and triglycerides by 27.2 mg/dL, with no change in HDL cholesterol [6]. A 2018 meta-analysis of 7 trials found a different pattern: HDL cholesterol rose by 2.8 mg/dL, while total cholesterol, LDL cholesterol and triglycerides did not differ from control [7]. The most recent 2024 meta-analysis of 9 trials (503 people) plus a cohort of 55,407 people found total cholesterol fell by 5.1 mg/dL overall, with no overall difference in LDL, HDL or triglycerides [3]. In people with high cholesterol, LDL fell by 9.4 mg/dL and total cholesterol by 7.5 mg/dL, with no difference in people with normal cholesterol [3]. A 2025 umbrella review of 8 reviews reached a similar conclusion: LDL fell by about 9 to 17 mg/dL and total cholesterol fell in people with abnormal lipids, while HDL and triglyceride results were inconsistent [4].

In a 5-week crossover feeding trial in 45 adults with overweight and raised LDL, one Hass avocado (136 g) a day lowered LDL by 13.5 mg/dL and non-HDL cholesterol by 14.6 mg/dL, more than matching fats from high-oleic oils or a lower-fat diet, and only the avocado diet lowered LDL particle number and small dense LDL [1]. In the same trial, the avocado diet lowered oxidised LDL by 7.0 U/L (8.8%) and raised plasma lutein by 68.7% [8]. In a 3-week crossover feeding trial in 42 adults with raised triglycerides, replacing solid fats and added sugars with one avocado a day (about 180 g) lowered non-HDL cholesterol by 4.7%, triglycerides by 17.4% and small LDL by 13.9% [5]. In a 6-month trial in 1008 adults with a large waist, adding one large avocado a day did not shrink visceral fat but produced small extra drops in total and LDL cholesterol [2]. In 200 stroke survivors, an avocado-based Mediterranean diet for 3 months did not lower LDL more than a low-fat diet [9].

For body weight, an 8-trial meta-analysis (657 people with excess weight) found no change in weight, body mass index or body fat, and concluded avocado did not promote weight gain [10]. The 2024 review likewise found body weight and composition were not harmed by avocado [3].

Doses used in studies

Trials gave one Hass avocado (about 136 g) a day for 5 weeks in crossover feeding trials [1][8]. A 6-month trial added one large avocado a day to the usual diet in 1008 adults with a large waist [2]. A 3-week crossover trial used about 180 g a day (about 300 kcal) to replace energy from saturated fats and added sugars in adults with triglycerides of 135 to 499 mg/dL [5]. A stroke-prevention pilot used an avocado-based Mediterranean diet for 3 months in 200 adults [9]. These are study doses, not recommendations.

Safety and interactions

In trials lasting 3 weeks to 6 months, avocado (about one fruit a day) caused no more side effects than control diets, including in 200 stroke survivors followed for 3 months [9][2]. An 8-trial review found no weight gain, and other reviews found no harm to body weight or composition [10][3]. No upper limit or toxic dose has been set for avocado as a food; trial doses were about 136 to 180 g a day [1][5]. The cholesterol trials above reported no medicine interactions and include no data on pregnancy or breastfeeding [9][3]. No data were found in these reviews on safety for people with kidney or liver disease.

Caveats and open questions

Reviews disagree on size: early reviews found large drops in LDL and total cholesterol, while later reviews found smaller or no overall effects except in people with high cholesterol, with large differences between trial results [6][7][3]. Certainty was rated low to very low, most trials were short and small, and no trial measured heart attacks or strokes [3][7]. One recent feeding trial disclosed funding and fees involving the Hass Avocado Board among other food and drug companies [5]. Longer trials measuring heart outcomes are still needed [6].