4. Discussion
MH, obesity, cardiometabolic disease, overweight
OBESITY, OXIDATIVE STRESS, OBESE
This double-blinded, randomised clinical trial examined the effects of an extract of unripe avocado that was naturally enriched in MH on glucose tolerance, insulin response, lipids, hsCRP and F2-isoprostanes as markers of oxidative stress, and autophagy in nondiabetic individuals with obesity. The primary outcome measure, glucose AUC, was not different between groups. However, there was a trend towards lower insulin AUC versus placebo, after adjusting for weight change. The exploratory subgroup analysis showed reduced insulin AUC, providing preliminary evidence consistent with animal studies that the supplement reduced insulin requirements in those individuals at high risk for cardiometabolic disease.The findings of the current study add to the limited evidence pertaining to the impact of MH on reducing the insulin response after an OGTT. The only human study in the literature was conducted by Viktora et al. (1969) [Given a previous finding that showed a dose-dependent effect of MH on glucose metabolism in dogs [As many CR mimetics stimulate other protective pathways invoked by CR [Consumption of fresh avocado fruit has increased greatly in the last decades due to increased availability and relatively reduced cost, combined with purported health benefits that include reduced blood lipids [This study has several limitations. Due to the lower-than-expected MH enrichment of the extract, we determined that individuals required 10 g AvX daily (approximately 190 mg MH), which yielded an individual dose of about 2.0 mg/kg. This intake level may have introduced some additional compliance issues and the likelihood that some beneficial outcomes may have been attributed to other bioactives in the AvX. We did not assess the bioavailable levels of MH in blood in response to consumption since they were likely to be undetectable at 24 h post-consumption. Additionally, the study was performed under free-living conditions requiring reliance upon participant compliance to the program, but this was high as shown by the returned weight of the product bags. Interpretation is limited to those individuals who are overweight or obese and nondiabetic. Moreover, a high proportion of predominately Caucasian females chose to enroll, which limits the translation to males and other ethnicities.