Study analysis · The Journal of Nutrition · 2020

Eating a daily avocado changed gut bacteria and bile acids in 12 weeks — but not weight, and the stats may not survive scrutiny.

In adults with overweight or obesity, eating an avocado daily for 12 weeks shifted the mix of gut bacteria and stool chemicals in relative terms, but it didn't change body weight and the findings are early.

Reading level
Moderate certainty
Level 1b · Individual RCT

Overview

What the study found

The study in plain English — the bottom line, every takeaway we extracted, and what to do with them.

In simple terms

This study is a randomized controlled trial, which is one of the best ways to test if something causes a change. They randomly assigned people to eat avocado or not, so we can be fairly confident that avocado caused the differences in gut bacteria and metabolites. However, these were not the main outcomes, and some results were not strong after statistical correction, so we should be cautious.

What’s the bottom line?

Scientists gave adults with overweight or obesity a daily meal with or without avocado for 12 weeks. They checked gut bacteria and chemicals in stool to see if avocado made a difference.

How strong is this study?

The study was well-designed: people were randomly put into groups, meals were controlled, and measurements were done with fancy lab tests. But the researchers only blinded themselves, not the participants, and some results were only seen in people who followed the diet perfectly. Also, they tested many things without adjusting for chance, so some findings might be false positives.

Reporting

0 / 100

  • COI disclosureconflicts of interest not disclosed
  • Data availabilitydata not shared
  • Code availabilitycode not shared
Methodology

81 / 100

  • Randomization+20/20
  • Blinding+9/15
  • Control group+15/15
  • Sample size (n=163)+11.2/20
  • Follow-up+10/10
Publication

100 / 100

Statistical

46 / 100

  • P-values+15/15
  • Effect sizeno effect size reported
  • Confidence intervalsno confidence intervals
  • Pre-registration+15/15

Each component is scored out of 100 and then capped by the study design — a case series cannot reach the ceiling a randomised trial can, however well it is reported.

Where it sits

RCT reviews

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

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Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Randomized Trials
Level 1b
60

60 / 100

Probability of being correct

Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.

This design can establish causation. The study is an RCT, so it can establish causation for the intervention effect. However, the outcomes analyzed here are secondary and exploratory, with no correction for multiple comparisons, and some results are per-protocol only. Participant blinding was not used (only investigator-blinded), and compliance was self-reported. Thus, causal claims should be tempered.

COI Unknown

Could not determine conflict of interest status

No conflict of interest or funding statement was present in the provided text, so potential conflicts cannot be assessed.

Independent Analysis Safeguards

  • Investigator-blinded trial
  • Randomization conducted by a research staff member not involved in data collection
  • Trial registered at clinicaltrials.gov (NCT02740439)

The provided text includes no conflict of interest, funding, or author affiliation section. It appears to be an academic study conducted at the University of Illinois, but funding source and author disclosures are not included in the excerpt.

Key takeaways

  1. 01

    Compared with the control group, the avocado group had 26% to 65% higher relative amounts of three gut bacteria (Faecalibacterium, Lachnospira, Alistipes), 18% higher relative fecal acetate, 70% higher relative stearic acid, and 98% higher relative palmitic acid (measured in only 45 people).

  2. 02

    They also had 91% lower relative cholic acid and 57% lower relative chenodeoxycholic acid.

  3. 03

    Body weight was about the same: 96.2 kg in the avocado group vs 96.0 kg in the control group.

  4. 04

    These are relative differences in bacteria and chemicals, not absolute amounts.

  5. 05

    The study did not report absolute bacterial abundance or metabolite concentrations, so we cannot say exactly how many more bacteria or how much more acetate a person would have.

  6. 06

    For weight, the absolute difference was only 0.2 kg, which is not meaningful.

  7. 07

    The findings are early and could be due to chance because many comparisons were made.

Surprising findings

  • Body weight did not change despite daily avocado.Avocado is commonly promoted as a weight-loss-friendly food because of fiber and satiety, yet the absolute difference was only 0.2 kg and not statistically significant.
  • Bile acids were lower, not higher, with avocado.Avocado is rich in fat, and dietary fat often increases bile acid secretion; here cholic acid was 91% lower relative and chenodeoxycholic acid 57% lower relative.
  • Fecal fatty acids increased by 70% and 98% relative in a subset.It suggests more dietary fat reached the colon or was excreted, which is counterintuitive for a food often associated with improved lipid profiles.
  • The findings did not survive multiple-comparison correction.The headline percentages are eye-catching, but the study itself notes they were exploratory and did not hold after FDR correction.
  • Intent-to-treat and per-protocol results diverged.In intent-to-treat, Alistipes and Ruminococcus were greater and alpha diversity did not differ (P = 0.13), while per-protocol showed alpha diversity differences — showing how much compliance and analysis choice matter.

Practical takeaways

Eat avocado for fiber and monounsaturated fats, but don't expect it to cause weight loss on its own.

This was a 12-week isocaloric trial in adults with overweight/obesity; weight was not different between groups.

medium confidence

If you're interested in gut health, daily avocado may shift gut bacteria and metabolites in relative terms — but the evidence is early.

Findings were secondary/exploratory, did not survive FDR correction, and absolute changes are unknown.

low confidence

Be skeptical of headlines citing '91% lower bile acid' or '98% higher palmitic acid' from this study.

These are relative differences, not absolute changes, and the fatty acid subset was only n=45.

high confidence

Keep overall calorie balance in mind; replacing a meal with an avocado meal did not change weight in this study.

Real-world diets are less controlled than provided study meals, and self-reported intake has limitations.

medium confidence

Why this study matters

Avocado feeds fiber-fermenting gut bugs

In the per-protocol analysis, the avocado group had 26% to 65% higher relative abundance of Faecalibacterium, Lachnospira, and Alistipes compared with the control group. Alpha diversity was also greater in the avocado group. These are relative between-group differences, and the findings were secondary/exploratory and did not hold after FDR correction.

Gut health is a huge wellness topic, and avocado is a popular 'superfood' — this gives a concrete, if preliminary, microbial signal.

Acetate bump: 18% relative higher

The avocado group had 18% greater fecal acetate concentrations than the control group in per-protocol analysis. Acetate is a short-chain fatty acid produced when gut bacteria ferment fiber. This is a relative difference, absolute concentrations were not reported, and it was an exploratory outcome.

Short-chain fatty acids are linked to gut and metabolic health, so a food-based way to raise acetate is appealing.

Bile acids plummet in relative terms

Cholic acid was 91% lower and chenodeoxycholic acid was 57% lower in the avocado group compared with control — again, relative between-group differences. Secondary bile acids deoxycholic and lithocholic acid were numerically lower by 23% and 14%. Absolute values were not reported.

Bile acids affect fat digestion and gut microbes, and lower levels could be beneficial — but the 91% number can easily be misread as an absolute risk drop.

Fecal fats up — but measured in only 45 people

The avocado group had 70% higher relative stearic acid and 98% higher relative palmitic acid concentrations in a subset of 45 participants. These are exploratory fecal fatty acid outcomes, and the small subset limits confidence.

It suggests avocado fats may reach the colon in measurable ways, but the small sample makes it a weak signal.

No weight change: 96.2 vs 96.0 kg

Body weight did not differ between groups at 12 weeks: control 96.0 ± 2.68 kg vs avocado 96.2 ± 2.76 kg; P = 0.95. That is an absolute difference of only 0.2 kg, which is not meaningful.

Avocado is often marketed for weight loss or satiety, but this isocaloric trial found no weight benefit.

The fine print: exploratory and no FDR correction

The microbial and metabolite outcomes were secondary/exploratory and did not remain significant after Benjamini-Hochberg false discovery rate correction. The study also did not report absolute differences for microbiota or metabolites.

This is a masterclass in why headlines should not treat every statistically significant secondary outcome as definitive.

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If this is your work, this is how we attribute it on Fit Body Science. Sharon V. Thompson is listed as the lead author.