This study used metabolomic data from the Multi-Ethnic Study of Atherosclerosis (MESA) to better understand the relationship between avocado intake and dysglycemia. At baseline, 6,224 older adults had data on self-reported avocado intake, as well as fasting glucose and insulin, while a randomly selected subsample (N=3,438) also had plasma untargeted 1H NMR metabolomic features. Subsequently, incident T2D, defined by ADA 2003 criteria, was assessed over an ~18 year period. First, a metabolome-wide association analysis was used to identify metabolomic features associated with avocado consumption. Next, the relationships of these biomarkers, and of avocado consumption, to contemporaneous dysglycemia, and incident T2D, were examined in models that initially adjusted for demographic factors and health behaviors, and subsequently also for BMI. Three highly correlated spectral features (all r≥0.77), tentatively annotated as CH2-lysl, were associated with avocado consumption (P=5.3*10-7). A mean value for CH2 was used as our biomarker, which, when adjusted for BMI, was strongly associated with avocado intake (β= 0.16 ± 0.04, P=4.7*10-5), but not additionally with any of 47 other food groups (P≥.01). Avocado intake showed a modest inverse association with fasting insulin (β= -0.07 ± 0.03, P=.03). When controlling for BMI, this was attenuated (β= -0.02 ± 0.03, P=.37), while strong inverse associations remained between the potential avocado biomarker and fasting glucose (β= -0.22 ± 0.02, P<2.0*10-20), fasting insulin (β= -0.17 ± 0.02, P<2.0*10-20), and T2D incidence (HR: 0.68 [0.63-074], P<2.0*10-20). The highly significant associations between glycemia and avocado-related metabolomic features, which serve as biomarkers of food intake after digestion and absorption, compared to modest relationships between glycemia and avocado consumption, highlights the importance of considering individual differences in metabolism when considering diet-health relationships.


A. Wood: None. M. O. Goodarzi: Advisory Panel; Nestlé Health Science, Other Relationship; Nestlé Health Science. M. D. Gadgil: None. M. Allison: None. G. Graça: None. M. Y. Mi: None. P. Greenland: Stock/Shareholder; Eli Lilly and Company, Novartis AG. D. M. Herrington: None. J. I. Rotter: None.


National Cattleman?s Beef Association; U.S. Department of Agriculture/Agricultural Research Service (58-3092-5-001); National Heart, Lung, and Blood Institute (75N92020D00001, HHSN268201500003I, N01-HC-95159, 75N92020D00005, N01-HC-95160, 75N92020D00002, N01-HC-95161, 75N92020D00003, N01-HC-95162, 75N92020D00006, N01-HC-95163, 75N92020D00004, N01-HC-95164, 75N92020D00007, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169, UL1TR000040, UL1TR001079, UL1TR001420, UL1TR001881, DK063491, R01HL133932, R01HL105756); European Union COMBI-BIO Project (FP7, 305422); National Institute of Diabetes and Digestive and Kidney Diseases (DK063491); National Center for Advancing Translational Sciences (UL1TR001881)

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