This story about the LDL-lowering properties of avocados included significant detail on the cost of avocados, something lacking from competing stories that we reviewed. However, it didn’t get to the bottom of what the findings mean for consumers. If they follow the advice suggested in the story — eating an avocado a day — how is that likely to affect their risk of a heart attack or stroke? The headline and first sentence state that eating avocados may be good for the heart. How do we know that?
Obesity and cardiovascular disease are reaching near epidemic proportions in the United States, and the average American diet is a major contributing factor. The study reported on here suggests that modest changes in diet could have important public health implications. It found about a 10% reduction in LDL cholesterol when participants ingested a moderate-fat diet with the addition of an avocado. That’s roughly half the LDL cholesterol drop seen with the starting dose of one of the statins.
The story provides both qualitative and quantitative information on the costs of avocados. “Avocados aren’t a mainstream food in the U.S., and they can be expensive, especially at certain times of the year, Kris-Etherton said.” Retail prices for Hass avocados rose to an average $1.25 each as of Dec. 19, up from $1.23 a year earlier, according to the U.S. Department of Agriculture.” Competing stories lacked this information.
The story notes: “Those who ate an avocado along with a cholesterol-lowering, moderate-fat diet reduced their so-called “bad” cholesterol by 10 percent compared with people on an average American diet, according to an industry-funded study today in the Journal of the American Heart Association.” But how big is this 10% drop in terms of the LDL scores that many readers are familiar with? The story doesn’t say. The story also doesn’t provide any sense of what the decrease means in terms of an individual’s risk of heart attack or stroke. Those are the outcomes that people should care about most.
The story does suggest that consumers will need to take some nutrient-poor foods out of their diets if they’re going to accommodate increased consumption of high-calorie avocados. That addresses the main concern associated with more avocado intake — weight gain.
The story provides a good description of the study and the participants. But that’s where it ends. How strong was the study design? What are its limitations? How important is the 10% reduction in LDL? What are the implications to reducing cardiovascular risk? The story would have to do more here to earn a satisfactory rating.
We aren’t provided with an independent source of information in the story, and therefore we’ll rate this unsatisfactory. Unlike the competing Medical News Today story, however, Bloomberg clearly spoke to one of the study authors and didn’t rely entirely on a press release. In addition, the authors’ potential conflicts of interest are noted including participation in Hass’s Avocado Nutrition Science Advisors group.
The story notes that it’s uncertain if the benefits seen are “unique to the avocado or if it’s similar to the heart-healthy effects seen in nuts and other plant foods.” We’ll call this nod in the direction of alternatives sufficient for a satisfactory. However, given the ubiquity of statin drugs, we would have liked to have seen some comparison of the effects seen in this study with those attained via statin therapy. An independent expert could have easily provided that information had the story consulted one.
The story makes it clear that avocados are indeed available and provides pricing information to boot. We would have liked to have seen some acknowledgment that there are areas where avocados may be more difficult to find.
The role of avocados in the lowering of total and LDL cholesterol has been studied previously. The author lists several notable studies in the reference list of the article. Several parts of the study including the methods of determining the changes in the various forms of LDL cholesterol were novel. However these were not highlighted in the story.
One of the study researchers is interviewed, so we can be certain the story wasn’t based entirely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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