Abstract
BACKGROUND: Low fruit intake is a global risk factor for cardiometabolic diseases. This study sought to investigate vascular and metabolic effects of increasing total and select fruit intake in adults with prediabetes. METHODS: This randomized, 2-arm parallel, partially controlled feeding study provided participants (n=82, aged 45±15 years, 30±6 kg/m(2)) weekly diets (1500 [women] or 1750 kcal/d [men]) incorporating 1 avocado and 1 cup of mango (avocado-mango diet) daily for 8 weeks or energy-matched low-fat, low-fiber foods (control diet). Flow-mediated vasodilation was the primary end point. Central and brachial blood pressure; pulse-wave velocity; metabolic, inflammatory, and kidney function markers; and dietary intake were secondary end points. Change (Δ) data were analyzed by mixed model ANCOVA or Wilcoxon rank-sum test, and postprandial and dietary intake data by repeated-measures ANOVA using SAS 9.4 (SAS Institute, Cary, NC). RESULTS: Changes in percentage of flow-mediated vasodilation were significantly different between interventions (effect, -2.11±0.77%; P=0.008), increasing ≈1% on the avocado-mango diet and decreasing on the control diet, as were changes in central and brachial diastolic blood pressure (P=0.07 and P=0.03, respectively), specifically in men. Other end points were generally not different between diets (P>0.05), although select lipids and kidney markers were marginally different (P<0.1). Total fruit, dietary fiber, vitamin C, and monounsaturated fat intake significantly increased during the avocado-mango diet compared with the control diet (P<0.05). CONCLUSIONS: In adults with prediabetes, daily inclusion of avocado and mango increases fruit consumption, diversifies nutrient composition, and improves vascular function associated with cardiovascular health. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05353790.