Organic Avocado Leaf Liquid Extract by Herbal Goodness

POSSIBLY EFFECTIVE

• Hypercholesterolemia. Consuming a diet rich in avocados seems to improve serum lipid levels. Details: Consuming a diet rich in avocados (e.g., 0.5-2 avocados daily or a diet in which avocados account for 75% of total daily fat intake) for 1-4 weeks seems to lower total serum cholesterol, low-density lipoprotein (LDL) cholesterol, and apolipoprotein B. It may also increase high-density lipoprotein (HDL) serum cholesterol levels (668,669,670,671,33256). In contrast, a meta-analysis of 8 clinical studies in adults with various metabolic conditions shows that consuming avocado 99-330 grams daily for 3-24 weeks reduces total cholesterol by 5 mg/dL but does not reduce LDL cholesterol or triglycerides or increase HDL cholesterol when compared with diets containing no or low amounts of avocado. However, subgroup analysis in patients with hypercholesterolemia suggests that consuming avocado reduces LDL cholesterol by 9 mg/dL and total cholesterol by 7.5 mg/dL (112435).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging skin. It is unclear if consuming avocado is beneficial for aging skin. Details: A small study in females with overweight or obesity shows that consuming one avocado daily for 8 weeks improves forehead skin firmness, but not elasticity or tiring, when compared with no avocado consumption. No improvements in under eye skin firmness, elasticity, or tiring were observed (108010).
• Cardiovascular disease (CVD). It is unclear if consuming avocado is beneficial for reducing the risk of CVD. Details: Observational research has found that consumption of at least one avocado weekly is associated with a 16% lower risk of CVD and a 21% lower risk of coronary heart disease (CHD) when compared with no avocado consumption. However, there was no association between avocado consumption and the risk of stroke. Additionally, replacement of half a serving daily of certain fat-containing foods (i.e., margarine, butter, egg, yogurt, cheese, processed meats) with an equivalent amount of avocado is associated with a 16% to 22% lower risk of CVD (108007).
• Cognitive function. It is unclear if consuming avocados is beneficial for improving cognitive function. Details: Preliminary clinical research in adults with overweight or obesity shows that consuming one avocado daily as part of a test meal for 12 weeks improves attentional inhibition, but not response inhibition, during cognitive testing when compared with baseline. Improvements on these tests were not reported in patients receiving an isocaloric control meal (103895). A cross-sectional study in older adults has also found that avocado consumption is associated with improvements in memory performance on immediate learning and delayed recall tests as well as global cognitive scores when compared with no avocado consumption (108013).
• Metabolic syndrome. It is unclear if consuming avocados is beneficial for metabolic syndrome. Details: A very large clinical study in adults with an elevated waist circumference shows that consuming a large avocado daily for 6 months reduces total cholesterol by 3 mg/dL and low-density lipoprotein cholesterol by 2.5 mg/dL but does not change any other measures of metabolic syndrome including visceral adiposity, waist circumference, body weight, body mass index (BMI), systolic and diastolic blood pressure, glucose, insulin, triglycerides, very low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol when compared with a standard diet without avocados (112436). Additionally, a small clinical study in adults with overweight, obesity, and insulin resistance shows that consuming an avocado daily for 12 weeks does not change BMI, body composition, blood pressure, fasting glycemic indices, glucose levels, plasma lipid profiles, insulin sensitivity, or markers of inflammation or endothelial function when compared with control (112438).
• Nonalcoholic fatty liver disease (NAFLD). It is unclear if consuming avocados is beneficial for NAFLD. Details: A secondary analysis of a previous clinical study in adults with overweight and obesity shows that consuming 14 avocados per week per family for 6 months does not improve NAFLD fibrosis score or biomarkers of hepatic function including alanine transaminase (ALT), aspartate transaminase (AST), gamma glutamyl-transferase (GGT), or high-sensitivity c-reactive protein (hsCRP) when compared with low avocado consumption, defined as 3 avocados per week per family (112437).
• Obesity. It is unclear if consuming avocados is beneficial for weight loss or prevention of weight gain. Details: A meta-analysis of clinical trials and a very large clinical study in adults with overweight, obesity, and elevated waist circumference shows that consuming one avocado daily or 136-200 grams daily for 6 weeks to 6 months does not reduce body weight, body mass index (BMI), percent fat mass, or visceral adipose tissue when compared with control (112433,112436). However, a small study in adults with overweight or obesity shows that consuming one avocado daily for 12 weeks changes abdominal adiposity distribution among females, but not males, when compared with no avocado consumption. No significant effects were observed for glucose or insulin outcomes (108008). Preliminary clinical research in adults with overweight or obesity shows that eating half of an avocado with lunch increases satisfaction by 23% to 26% and decreases desire to eat by 28% to 40% when compared with a control lunch with no avocado (93109). A large observational study in the same population has found that habitual consumption of avocado at an average intake of 32 grams or more daily is not associated with reductions in body weight or body mass index (BMI) over 5 years when compared with no avocado consumption. Additionally, this study suggests that while habitual avocado consumption in patients with normal weight may slightly attenuate increases in body weight and BMI, it does not seem to reduce the odds of these patients becoming overweight or developing obesity over time when compared with no avocado intake (100936).
• Psoriasis. Topical avocado has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Preliminary clinical research in patients with psoriasis shows that applying a specific cream containing avocado oil and vitamin B12 (Regividerm, Regeneratio Pharma AG) 0.7 mg/gram to the affected area for 12 weeks reduces symptoms to a similar extent when compared with calcipotriol ointment (Psorcutan). The avocado combination cream also causes significantly less irritation than calcipotriol (14909). It is unclear if these effects are due to avocado, vitamin B12, or the combination. More evidence is needed to rate avocado for these uses.

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LIKELY SAFE ...when the fruit is consumed in amounts commonly found in foods (668,669,670,671).

POSSIBLY SAFE ...when the oil is applied to the skin topically and appropriately, short-term. Avocado oil in combination with vitamin B12 appears to be safe when used for up to 12 weeks (14909). There is insufficient reliable information available about the safety of avocado for its other uses.

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using in amounts exceeding those commonly found in foods.

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WARFARIN (Coumadin) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Unlikely •  Level of Evidence = D Avocado may antagonize the anticoagulant effects of warfarin.  Details Avocado may antagonize the anticoagulant effects of warfarin; however, there has been only one case report of this interaction (667).

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General ...Orally, avocado has been generally well tolerated in clinical research.
Most Common Adverse Effects:
Topically: A cream containing avocado oil in combination with vitamin B12 can cause itching.
Serious Adverse Effects (Rare):
Orally: Avocado may lead to allergic cross-sensitivity in latex sensitive patients. While rare, avocado can cause acute food protein-induced enterocolitis syndrome (FPIES), a food hypersensitivity reaction characterized by excessive vomiting and diarrhea.

Dermatologic ...Topically, a cream containing avocado oil in combination with vitamin B12 can cause itching when applied initially, but itching appears to diminish with continued use (14909). Orally, avocado may cause skin rash (112436).

Gastrointestinal ...Orally, avocado can cause acute food protein-induced enterocolitis syndrome (FPIES). This is a rare, delayed, non-IgE-mediated gastrointestinal food hypersensitivity reaction most often reported in infants and young children. Symptoms of FPIES include excessive vomiting within 1-4 hours of avocado consumption and diarrhea. Treatment is generally supportive in nature, including oral or intravenous rehydration, along with avoidance of avocado (100938). There have also been reports of gastrointestinal upset including gas, bloating, and diarrhea due to daily avocado consumption, though it is possible that these symptoms were due to E. coli infection (112436).

Immunologic ...Orally, avocado may lead to type I hypersensitivity reactions in people who are allergic to latex (6197,7853,25216,33248,33253,33254). While rare, avocado can also cause acute food protein-induced enterocolitis syndrome (FPIES). This is a delayed, non-IgE-mediated gastrointestinal food hypersensitivity reaction most often reported in infants and young children. Symptoms of FPIES include excessive vomiting within 1-4 hours of avocado consumption and diarrhea. Many infants and children who experience FPIES after eating avocado will have the same reaction to other foods, such as milk, oat, and rice (100938).

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