Abstract Context Chronic inflammation and oxidative stress are associated with the development of chronic diseases such as diabetes, osteoarthritis (OA), and cardiovascular conditions, while avocado (Persea americana) has anti-inflammatory and antioxidant potential, which supports its nutritional and nutraceutical prescription. Objective In this review we sought to investigate the effects of acute and chronic consumption of avocado and its byproducts on molecular pathways related to oxi-inflammation in adults. Data Sources In this systematic review, we searched the PubMed, Embase, and Cochrane databases from May 2024 through April 2025. Data Extraction To identify randomized clinical trials (RCTs), we used Population, Intervention, Comparator, Outcomes, Study design (PICOS) criteria and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for result presentation. The risk of bias analysis was performed using the JBI (Joanna Briggs Institute) tool. Additionally, a nutrigenomic theoretical model was developed and validated by experts to integrate clinical findings with mechanistic evidence on transcriptional pathways related to oxi-inflammation. Data Analysis Among 982 studies identified, 14 RCTs (n = 2438) of moderate to high quality were included in this review, with 10 studies evaluating avocado pulp, 3 evaluating avocado and soy unsaponifiable (ASU), and 1 study evaluating the effect of avocado pulp and powder skin. The byproducts included fresh pulp, pulp combined with meals, freeze-dried pulp flour, and fatty acids extracted from pulp (ASU). From the 4 postprandial studies (n = 67), with doses ranging from 68 to 489 g of avocado pulp, 3 had reduction in inflammatory markers such as tumor necrosis factor α (TNF-α), nuclear factor–κB (NF-κB), and interleukin 6 (IL-6), as well as an increased total antioxidant capacity. In the 10 chronic studies (n = 2371), with a mean duration of 18.4 ± 5.6 weeks, doses of 300 mg/d of ASU or avocado in various quantities and types, concentrations of interleukin-1 beta (IL-1β), TNF-α, and oxidized low-density lipoprotein (ox-LDL) were reduced, while antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) increased in individuals with overweight, obesity, or osteoarthritis compared to the placebo control group. Among the studies, only 1 chronic study investigated gene expression of inflammatory and oxidative stress markers, highlighting a research gap in this area. Although this review was conceptually grounded in a nutrigenomics perspective, we acknowledge the limited number of RCTs directly assessing gene expression or transcriptomic outcomes. The validated model highlighted potential modulation of nuclear factor erythroid 2-related factor 2 (Nrf2-) dependent antioxidant pathways and inhibition of toll-like receptor 4 (TLR4)/NF-κB signaling by bioactive compounds from avocado and its byproducts. Conclusion Despite the limited data on gene expression, the results suggest that both acute and chronic avocado consumption may beneficially modulate oxi-inflammation, especially in pro-inflammatory conditions. The theoretical model reinforces the biological plausibility of the clinical findings and provides a mechanistic framework for understanding how avocado components may influence oxi-inflammatory responses. Further studies are necessary to evaluate these effects using a molecular approach. Systematic Review Registration PROSPERO registration No. CRD42024567854.
Fortini et al. (Sun,) studied this question.
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