An Avocado a Day May Keep Heart Disease at Bay

April 7, 2022 at 2:01 p.m.

Replacing cheese or mayonnaise with an avocado may be a great new way to improve your overall diet. A new study has found that eating two or more servings of avocado weekly is associated with a lower risk of cardiovascular disease and substituting avocado for certain fat-containing foods like butter, cheese or processed meats is associated with a lower risk of cardiovascular disease events.

Avocados contain dietary fiber, unsaturated fats especially monounsaturated fat (healthy fats) and other favorable components that have been associated with good cardiovascular health. Clinical trials have previously demonstrated that avocados have a positive impact on cardiovascular risk factors including high cholesterol. A medium avocado contains about 12 grams of fiber. The recommended amount is 28 to 34 grams of fiber per day.

“Our study provides further evidence that the intake of plant-sourced unsaturated fats can improve diet quality and is an important component in cardiovascular disease prevention,” said lead study author Lorena S. Pacheco, who is a postdoctoral research fellow at the Harvard T.H. Chan School of Public Health in Boston. “These are particularly notable findings since the consumption of avocados has risen steeply in the US in the last 20 years, according to data from the U.S. Department of Agriculture.”

For 30 years, researchers followed more than 68,780 women (ages 30 to 55 years) from the Nurses’ Health Study and more than 41,700 men (ages 40 to 75 years) from the Health Professionals Follow-up Study. All the participants were free of cancer, coronary heart disease and stroke at the start of the study.

Researchers documented 9,185 coronary heart disease events and 5,290 strokes during more than 30 years of follow-up. Researchers assessed participants’ diet using food frequency questionnaires given at the beginning of the study and then every four years. They calculated avocado intake from a questionnaire item that asked about the amount consumed and frequency. One serving equaled half of an avocado or a half cup of avocado.

After considering a wide range of cardiovascular risk factors and overall diet, study participants who ate at least two servings of avocado each week had a 16% lower risk of cardiovascular disease and a 21% lower risk of coronary heart disease, compared to those who never or rarely ate avocados. Based on statistical modeling, replacing half a serving daily of margarine, butter, egg, yogurt, cheese or processed meats such as bacon with the same amount of avocado was associated with a 16% to 22% lower risk of cardiovascular disease events.

The study aligns with the American Heart Association’s guidance to follow the Mediterranean diet, which focuses on fruits, vegetables, grains, beans, fish and other healthy foods and plant-based fats such as olive, canola, sesame and other non-tropical oils.

“These findings are significant because a healthy dietary pattern is the cornerstone for cardiovascular health, however, it can be difficult for many Americans to achieve and adhere to healthy eating patterns,” said Cheryl Anderson, who is the chair of the American Heart Association’s Council on Epidemiology and Prevention.

This research compliments and expands the current literature on plant-sourced unsaturated fats and heart disease. These findings further substantiate the evidence on the replacement of certain spreads and saturated fat-containing foods such as cheese and processed meats, with a plant-sourced fat such as avocado, which, for the most part, is a well-accepted and popular food.

Pacheco noted that avocados are readily available and can be included as part of a healthful diet as a spread or dressing or even dipping sauce. You can use the serving size of ½ cup of avocado (approximately 80 grams) and add it to our salads, as a spread on a sandwich in lieu of mayonnaise, or mix it with some cilantro and lime juice as a dressing or dipping sauce with some raw veggies. Avocados can also be included in a smoothie instead of yogurt.


If you are following a medication regimen, Pacheco said you should first check-in with your physician and nutritionist before consuming large amounts of avocado. “In the case of avocados, these contain vitamin K, which is a blood clotting nutrient that may decrease the effect of blood-thinning medications like warfarin, so if you are on warfarin, you need to consider this,” said Pacheco

Avocados are also rich in potassium so someone on a low potassium diet needs to talk with their healthcare provider before including them in their diet. “Lastly, and slightly beyond the potential food-drug interaction, those individuals with a latex sensitivity or allergy should avoid avocados since some proteins in latex that cause latex allergy are also present in avocados, and in other fruits such as bananas, kiwi, and strawberries to name a few,” said Pacheco.

While avocados are a nutrient-rich food item with favorable food compounds including monounsaturated and polyunsaturated fats, they also are a calorie-rich food item.  Pairing avocados with chips may compromise the benefits. “In most cases, when you have guacamole or similar spreads, it is easy to over consume them, increasing your overall calories. Besides this, most of us do not pay attention to the serving size on the bag of chips and keep ‘munching away’, making this a troublesome combination,” said Pacheco.


Dr. Amy Warriner, who is the director of UAB Weight Loss Medicine and professor in the University of Alabama at Birmingham Division of Endocrinology, Diabetes and Metabolism, said there are no specific foods that you should or should not eat to be healthy. Balance is necessary, and all is okay in moderation and with balance.

 “If you are eating a diet full of healthy vegetables and lean proteins, eating a treat every now and again is not harmful,” Dr. Warriner said. “Alternatively, if you are eating fast food for most meals, adding a protein shake is not going to make you healthier.”

The recommended intake for vegetables is five to nine servings a day. However, research shows that roughly 9% of adults meet intake recommendations for vegetables. Experts say a good way to add more vegetables to your diet is to add some to your breakfast menu. It is suggested you add a variety of vegetables in with your eggs, throw some in your hash browns, or sneak some into your muffin or pancake batter.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at

Avocado Toast Recipe

Avocado toast is not just a tasty treat for hipsters at cafes.

Here is a simple avocado toast recipe to try next time you have a ripe avocado at home, courtesy

Yields 4 toasts


4 slices whole-grain bread
1 avocado, halved and pitted
2 tablespoons chopped fresh parsley
1-1/2 teaspoons extra-virgin olive oil
1/2 lemon juiced
1/2 teaspoon salt
1/2 ground black pepper
1/2 teaspoon onion powder
1/2 teaspoon garlic powder

Step 1
Toast bread

Step 2
Scoop avocado into a bowl. Add parsley, olive oil, lemon juice, salt, pepper, onion and garlic powder; mash together using a potato masher (a fork can work too)

Step 3
Spread avocado mixture into each piece of toast -- enjoy!

Per serving: 170 calories; protein 4.9g; carbs 16.8g; fat 10.1g; sodium 429.6mg

If you are not a vegan, consider adding a fried egg to your toast for a hearty breakfast.

Or add sliced onions, bean sprouts, lettuce and tomatoes for a quick and delicious sandwich.

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