Avocado

Scientific Name(s): Laurus persea L., Persea americana Mill., Persea gratissima Gaertn
Common Name(s): Ahuacate, Alligator pear, Avocado, Avocato, Bitter fruit, Pae (African name), Paya (African name), Pee (African name)

Medically reviewed by Drugs.com. Last updated on Jan 15, 2024.

Clinical Overview

Use

All plant parts of avocado have been investigated for therapeutic applications. Most research has focused on effects of avocado on markers of metabolic syndrome (eg, lipids, blood pressure, blood sugar, weight). Additionally, avocado has been evaluated for its antimicrobial, cytotoxic, and dermatological effects.

Dosing

No dosing for clinical purposes has been determined. The US Nutrition Labeling and Education Act defines a serving size of avocado as 30 g (1 oz) or one-fifth of a fruit.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Avocado fruit is generally recognized as safe (GRAS) when used as food. Avoid extracts from other plant parts and dosages above those found in food because safety and efficacy have not been established.

Interactions

Avocado contains small to moderate amounts of vitamin K (ie, 21 mcg per 100 g of avocado), which may reduce the antithrombotic effects of warfarin (ie, decrease international normalized ratio [INR]).

Adverse Reactions

Hypersensitivity to avocado has been described and includes rare instances of anaphylaxis. An allergen cross-reactivity has been shown with avocado, melons (eg, cantaloupe), peaches, bananas, chestnuts, tomatoes, potatoes, and kiwi fruits and natural rubber latex ("latex-fruit syndrome"). Additionally, case reports exist regarding food protein–induced enterocolitis syndrome following ingestion of avocado in children 5 to 9 months of age.

Toxicology

No data.

Scientific Family

• Lauraceae

Botany

The avocado tree grows up to 20 m in height and bears a large, oval, or spherical fleshy fruit, the skin of which can be thick and woody. Although the plant is native to Mexico and Central America, numerous varieties are now widely distributed throughout the world.Leung 1980

History

Avocado was first cultivated in Mexico, dating as early as 500 BC. The first English language mention of avocado was in 1696.Ameer 2016 Avocado has been widely used for food and medicinal purposes. In traditional medicine, Guatemalan Indians used the pulp as a pomade to stimulate hair growth, to hasten healing of wounds, and as an aphrodisiac and emmenagogue. The seeds have been used to treat dysentery and diarrhea. American Indians used powdered seeds to treat pyorrhea. Today, avocado fruit is widely consumed throughout the world, and the oil is a component of numerous cosmetic formulations.Leung 1980 Ghanaians use avocado as an anticonvulsant.Amoateng 2018

Chemistry

The pulp of the avocado fruit contains fiber, sugars, minerals, vitamins, and other phytochemicals and lipids. The fruit is thought to provide large amounts of potassium and magnesium, with a similar nutrient profile to tree nuts, such as walnuts, almonds, and pistachios. In addition, avocado contains riboflavin, folate, pantothenic acid, lutein, beta-carotene, omega-3 and omega-6 fatty acids, and vitamins C, E, K, and B₆.Ameer 2016 Avocado oil is derived from the fruit pulp and is primarily composed of glycerides of oleic acid and approximately 10% unsaponifiable (ie, cannot be hydrolyzed) compounds, such as sterols and volatile acids. Oleic acid is a beneficial monounsaturated fatty acid present in avocado (concentration range, 61% to 95%). The vitamin D content of the oil exceeds that of butter and eggs. The large seed contains fatty acids, alcohols, and several unsaturated compounds with exceedingly bitter tastes; the seed has been the subject of several investigational studies. The leaves of the Mexican avocado reportedly contain approximately 3% of an essential oil primarily composed of estragole and anethole.Dabas 2013, Dreher 2013, Duke 2003, Leung 1980, USDA 2018

Uses and Pharmacology

Antimicrobial effects

Animal and in vitro data

Antibacterial activity

Several unsaturated oxygenated aliphatic compounds in the fruit pulp and seed possess strong in vitro activity against bacteria, including Staphylococcus aureus, Trichomonas vaginalis, Entamoeba histolytica, and Giardia lamblia. Antimycobacterial activity has also been demonstrated in vitro.(Dabas 2013, Guzman-Rodriguez 2013, Jimenez-Aellanes 2013, Lu 2012) The butanolic fraction of P. americana in a concentration of 10 mg/mL exhibited antimicrobial activity against bacterial isolates of Bacillus cereus, a gram-positive bacteria often associated with food poisoning.(Akinpelu 2014)

Antifungal activity

In vitro data suggest that a glycolic extract of P. americana exerted antifungal effects against Candida albicans.(Jesus 2015)

Antiviral activity

An extract from avocado inhibited dengue virus-2 replication in a concentration-dependent manner and suppressed serotypes 1 to 4 in a murine model.(Wu 2019)

Larvicidal activity

The ethanol and hexane extracts of the seeds, peel, and pulp of P. americana demonstrated larvicidal activity against Aedes aegypti, with the hexane extract of the seeds having the greatest effect.(Torres 2014)

Cardiovascular effects

In vitro data

According to a review of fruits for prevention and treatment of cardiovascular diseases, acetogenins in the pulp of avocado have demonstrated antiplatelet effects in vitro.(Zhao 2017)

Clinical data

Data from 12 healthy physically active college-educated females enrolled in a double-blind, randomized, placebo-controlled crossover study revealed no significant acute effects between consumption of avocado pulp (600 mg) or placebo on cardiorespiratory parameters (respiratory rate, systolic and diastolic blood pressure, heart rate) after exercise. Similarly, no effect between interventions was found for parasympathetic regulation of heart rhythm or sympathetic autonomic control.(Sousa 2020)

Cytotoxic effects

Animal and in vitro data

Chemoprotective and anticarcinogenic chemical constituents have been found in avocado fruit, seed, leaf, and bark. Inhibition of cell growth and apoptosis have been described in in vitro studies and animal models of human cancer cell lines, including leukemia and breast, colon, esophageal, and oral cancers.(Bonilla-Porras 2013, D'Ambrosio 2011, Dabas 2013, Dreher 2013, Falodun 2013, Guzman-Rodriguez 2016, Mbaveng 2018, Paul 2011, Vahedi 2014)

Dermatological effects

Animal data

In a study of rats, avocado oil increased collagen synthesis and decreased inflammation during wound healing, possibly due to its high oleic acid content.(de Oliveira 2013)

In a murine model of ultraviolet B irradiation–induced burns, topical P. americana leaf extract prevented allodynia on the second and third days after irradiation; however, P. americana did not exert anti-inflammatory effects, as measured by edema and leukocyte infiltration.(Deuschle 2018)

GI effects

Animal data

Avocado demonstrated antidiarrheal effects, which were dose dependent, in rats receiving methanol and chloroform extracts of P. americana.(Christian 2014) In another study, an ethanolic extract of avocado improved clinical and histological parameters in mice with colitis. Avocado also suppressed the production of proinflammatory mediators.(Hong 2019)

Metabolic syndrome risk factors

Animal data

Animal studies have demonstrated improvements in lipid profiles, glucose levels (ie, hypoglycemic effect), and blood pressure with avocado.(Gamboa-Gomez 2015, Giovannini 2016, Marquez-Ramirez 2018, Tabeshpour 2017) In a study of hypercholesterolemic rats, P. americana administration resulted in weight reductions of about 25%.(Gamboa-Gomez 2015) In addition to modestly improving blood pressure in hypertensive rats, avocado oil alleviated impaired renal vasodilation.(Marquez-Ramirez 2018)

Clinical data

Data from the National Health and Nutrition Examination Survey from 2001 to 2008 showed lower body mass index, body weight, and waist circumference, as well as higher high-density lipoprotein cholesterol (HDL-C) levels and decreased risk of metabolic syndrome in avocado consumers compared with nonconsumers, adding significance to findings from older clinical studies.(Dreher 2013, Fulgoni 2013) In a 2018 systematic review and meta-analysis, avocado consumption was associated with significant increases in HDL-C but no improvements in low-density lipoprotein cholesterol (LDL-C), total cholesterol, or triglyceride levels.(Mahmassani 2018) Another meta-analysis of 10 studies showed opposite findings. Substituting dietary fats with avocado reduced total cholesterol by −18.8 mg/dL (95% CI, −24.56 to −13.05; I²=46.9%), LDL-C by −16.5 mg/dL (95% CI, −22.91 to −10.1; I²=72.5%), and triglycerides by −27.2 mg/dL (95% CI, −44.41 to −9.99; I²=91.1%). HDL-C decreased by −0.18 mg/dL (95% CI, −3.23 to 2.88; I²=84.8%), but the decrease was not significant.(Peou 2016)

Small clinical studies suggest that the addition of avocado to meals improves satiety and postprandial glycemic indices.(Li 2013, Wien 2013)

As a component of medical nutrition therapy for patients with type 2 diabetes, the American Diabetes Association Standards of Care (2014) recommends higher quality dietary fat intake, as an alternative to decreased fat intake, by replacing saturated and/or trans fats with mono- and poly-unsaturated fatty acids (including avocado) in the diet. This Mediterranean-style approach to eating may improve glycemic control and cardiovascular disease risk factors (moderate-quality evidence).(ADA 2014)

Neurological effects

In vitro data

In an in vitro study, aqueous seed and leaf extracts of P. americana inhibited both acetylcholinesterase and butyrylcholinesterase, key enzymes linked to Alzheimer disease; studies are needed to further assess these effects. The seed extract had a greater inhibitory effect than the leaf extract.(Oboh 2016)

Radioprotective effects

Animal data

P. americana exerted radioprotective effects in a study of rats exposed to whole body X-ray irradiation.(Kumar 2017)

Dosing

No dosing for clinical purposes has been determined. The US Nutrition Labeling and Education Act defines a serving size of avocado as 30 g (1 oz) or one-fifth of a fruit.Dreher 2013

Pregnancy / Lactation

Avocado fruit is GRAS when used as food. Avoid extracts from other plant parts and dosages above those found in food because safety and efficacy have not been established. An animal study suggested that maternal supplementation with avocado oil and pulp accelerates reflex maturation and somatic postnatal development, as well as improves memory during adolescent and adult phases in the offspring.de Melo 2019

Interactions

Beta-carotene: Avocado may increase the serum concentration of beta-carotene. No action needed.(Kopec 2014, Unlu 2005)

Warfarin: Avocado may diminish the anticoagulant effect of warfarin. Monitor therapy.(Blickstein 1991) Avocado contains small to moderate amounts of vitamin K (ie, 21 mcg per 100 g of avocado), which may reduce the antithrombotic effects of warfarin. Two case reports suggest an association between ingestion of avocado and reduced INR levels.(Norwood 2015)

Adverse Reactions

Hypersensitivity to avocado has been described and includes rare instances of anaphylaxis. Manifestations of allergy to avocado may be limited to the mouth or throat (eg, oral allergy syndrome with itchy mouth, throat, and swollen tongue) or oral symptoms with generalized symptoms (eg, wheezing, chest tightness, abdominal cramping, diarrhea). An allergen cross-reactivity has been shown with avocado, melons (eg, cantaloupe), peaches, bananas, chestnuts, tomatoes, potatoes, and kiwi fruits and natural rubber latex ("latex-fruit syndrome"). An immunoglobulin E–mediated inflammatory mechanism has been shown to similarly produce an allergic reaction to latex, bananas, and avocados.Abrams 2011, Wagner 2002 Case reports exist regarding food protein–induced enterocolitis syndrome following ingestion of avocado in children 5 to 9 months of age.Cherian 2018

Toxicology

Poisoning in grazing animals and other species, including fish and birds, that ingested avocado has been reported.Craigmill 1984, Leung 1980 Acetogenins in the seed extract have demonstrated cardiotoxicity in isolated cardiomyocytes in vitro.Silva-Platas 2012 However, avocado seed extract has not been shown to possess genotoxic properties or mutagenicity in mice erythrocytes.Padilla-Camberos 2013 The fruit pulp oil of P. americana did not exert genotoxic effects in vitro or in in vivo models; instead the fruit pulp oil exerted protective effects against methyl methanesulfonate–induced chromosomal damage in vitro and in vivo. P. americana fruit pulp oil also reduced genotoxicity associated with doxorubicin in vivo but not in vitro. The highest test dose of the fruit pulp oil (ie, 1,000 mg/kg) was associated with an increase in AST but not ALT.Nicolella 2017 Death and signs of toxicity such as sluggishness and swollen eyes and face were noted in rats receiving 5,000 mg/kg of methanolic and chloroformic extracts of P. americana. However, these effects were not noted at 10, 100, 1,000, 1,900, and 2,600 mg/kg doses of these extracts.Christian 2014

References

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This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

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