Can guacamole lower your cholesterol as well as other wholefood fat sources like nuts, or is that just spin by the avocado industry? 

Avocados are the richest known fruit source of phytosterols,” the cholesterol-lowering nutrients found in plant foods, brags a review sponsored by the HASS Avocado Board. The operative word, though, is fruit. 

Yes, avocados contain more phytosterols compared to other fruit, but phytosterols are fat-soluble substances. Most other fruits hardly have any fat in them at all, so avocados will obviously come out on top compared to other fruit. What if you compare phytosterol content of avocados to nuts and seeds, though? One avocado has about 100 milligrams of phytosterols. On the same scale, sesame seeds and tahini have 400 milligrams; pistachios, pumpkin seeds, and sunflower seeds have about 300; almonds, almond butter, flaxseeds, and macadamia nuts have around 200; and even chocolate has about twice as many phytosterols as avocados, as you can see at 0:51 in my video Are Avocados Good for Your Cholesterol. 

Even though nuts and seeds have the highest levels of phytosterols overall, the studies that have been done on lowering bad LDL cholesterol with phytosterols have used supplements starting with 600 milligrams and going up into the thousands. So, yes, you can lower LDL cholesterol by about 8 percent with a dose of phytosterols around 2,100 milligrams, but that would be 20 avocados a day, as you can see at 1:17 in my videoAnd 2,100 milligrams of phytosterols would also be a lot of nuts, but you can get an 8 percent drop in LDL by just eating a palmful of nuts, just a single ounce a day, as you can see at 1:36 in my video. So, phytosterols aren’t the only components of nuts responsible for driving down cholesterol. Nuts must have other components, perhaps fiber or other phytonutrients, that contribute to their cholesterol-lowering effects. Might avocados have such components, too? You don’t know untilyou put it to the test. 

 As you can see at 2:10 in my video, there are studies dating back more than a half century that appear to show that if you add an avocado to people’s daily diets, their cholesterol drops. When you remove the daily avocados, however, their cholesterol goes back up, and then it drops down again when you add the avocados back inThe data are pretty convincinguntil you see how the study was done. The researchers didn’t just add an avocado. They swapped out animal fat. No wonder their cholesterol went down! Rather than a study about cholesterol and avocados, it may have just as well been about cholesterol and being on or off lard—and nearly all the studies on cholesterol and avocadoare like this. 

What happened when researchers performed a meta-analysis of ten studies involving hundreds of people? When they put them all together and looked at the results, what did they find? Iappears that adding avocados led to a significant drop in cholesterol and triglyceridesan average of about a 17point drop in bad LDL cholesterol. But, nearly all of the studies were substitution studies, where saturated fat was removed from people’s diets and avocados were substituted in. If you cut down on saturated animal fat, your cholesterol will drop regardless. You can tell this review was not funded by the avocado industry because the researchers point this out, saying that “it is important to note that substituting avocados for saturated dietary fats as opposed to adding avocado to an already established baseline diet poses the greatest benefit.” Simply adding avocado may confer no benefits to cholesterol at all. 

So, yes, the avocado industry is right in saying that avocados are a healthy substitute for butter / margarine, cheese, cream cheese, but that’s a pretty low bar. 


Compared with all other fruits, avocados contain more phytosterols, the cholesterol-lowering nutrient found in plant foods, but phytosterols are fat-soluble and most fruits are very low in fat, so it isn’t surprising that avocados top the chart.
When comparing phytosterol content of avocados, chocolate, nuts, and seeds, to scale, nuts and seeds have the highest levels overall and even chocolate has roughly twice the phytosterols as avocados.
So-called bad LDL cholesterol may be lowered with doses of phytosterols equivalent to around 20 avocados or a single ounce of nuts (around a palmful) a day.
Most studies showing that cholesterol drops when a daily avocado is consumed and rises again when avocados aren’t eaten before falling once more when they’re resumed did not only add avocado to the subjects’ diets, but they swapped out animal fat, so it’s no wonder cholesterol went down with avocado consumption.
Removing saturated fat from the diet and substituting in avocados may lead to a significant drop in cholesterol and triglycerides, but simply adding avocado without also reducing saturated animal fat intake does not appear to result in any benefits to cholesterol.

What about adding avocado to a plant-based diet? Would there be any benefit then? Learn more:  

Avocados Lower Small Dense LDL Cholesterol 
Are Avocados Fattening? 
The Effects of Avocados and Red Wine on Meal-Induced Inflammation
Are Avocados Healthy?

Flashback Friday: The Effects of Avocados on Inflammation 

Flashback Friday: Are Avocados Good for You? 

Recipe: Easy Veggie Tacos 

Recipe: Edamame Guacamole 

Why do we care about cholesterol? See, for example 

Cholesterol Crystals May Tear Through Our Artery Lining
Flashback Friday: Amla vs. Drugs for Cholesterol, Inflammation, & Blood-Thinning
Flashback Friday: Does Cholesterol Size Matter?
Flashback Friday: Optimal Cholesterol Level
Oxidized Cholesterol as a Cause of Alzheimer’s Disease 
Dietary Cholesterol and Cancer 
Oxidized Cholesterol 27HC May Explain Three Breast Cancer Mysteries

How Do We Know That Cholesterol Causes Heart Disease? 

Should All Children Have Their Cholesterol Checked?

What should we shoot for? See Flashback Friday: Optimal Cholesterol Level. 

To learn more about cholesterollowering foods, check out The Best Food for High Cholesterol and The Benefits of Kale and Cabbage for Cholesterol 

In addition to adding cholesterollowering foods, we also need to reduce our intake of cholesterol-raising foods. See:  

Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero
Switching from Beef to Chicken & Fish May Not Lower Cholesterol
Eggs & Cholesterol: Patently False & Misleading Claims
Carnitine, Choline, Cancer, & Cholesterol: The TMAO Connection
How to Reduce Cholesterol Oxidation 
Does Coffee Affect Cholesterol? 

In health, 

Michael Greger, M.D. 

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: 

2019: Evidence-Based Weight Loss 

2016: How Not To Die: The Role of Diet in Preventing, Arresting, and Reversing Our Top 15 Killers 

2015: Food as Medicine: Preventing and Treating the Most Dreaded Diseases with Diet 

2014: From Table to Able: Combating Disabling Diseases with Food 

2013: More Than an Apple a Day 

2012: Uprooting the Leading Causes of Death