Stephen Andrew Fleming ^1* Tristen L Paul ¹ Rachel Ann Freedman Fleming ¹ Alison K Ventura ² Megan A. McCrory ³ Corrie M Whisner ⁴ Paul A Spagnuolo ⁵ Louise Dye ⁶ Jana Kraft ⁷ Nikki Ann Ford ⁸

• ¹ Traverse Science, Inc., Champaign, United States
• ² Department of Kinesiology, College of Science and Mathematics, California Polytechnic State University, San Luis Obispo, California, United States
• ³ Department of Health Sciences, College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, Massachusetts, United States
• ⁴ College of Health Solutions, Arizona State University, Tempe, Arizona, United States
• ⁵ Department of Food Science, University of Guelph, Guelph, Ontario, Canada
• ⁶ School of Psychology, Institute for Sustainable Food, University of Sheffield, Sheffield, United Kingdom
• ⁷ Department of Animal and Veterinary Sciences & Department of Medicine, University of Vermont, Burlington, Vermont, United States
• ⁸ Avocado Nutrition Center, Hass Avocado Board, Mission Viejo, California, United States

Objective: This scoping review evaluates the breadth of research on avocado intake and health, considering all populations and health outcomes. Design: Any human intervention or observational study where effects could be isolated to consumption of avocado were included. A systematic literature search through April 2024 was conducted (PubMed, Web of Science, Scopus, and CENTRAL) and supplemented by backwards citation screening. Dual screening, data extraction, and conflict resolution were performed by three reviewers and an interactive evidence map was created. Results: After deduplication, 8823 unique records were retrieved; 58 articles met inclusion criteria, comprising 45 unique studies (28 interventions, 17 observational studies). Studies were largely conducted in the United States or Latin America and generally included adults, with overweight/obesity, frequently with elevated lipid concentrations. Interventions assessed the impact of diets enriched in monounsaturated fatty acids, diets higher/lower in carbohydrates, or in free-feeding conditions. Larger amounts of avocados were used in interventions than commonly consumed in observational studies (60-300 vs. 0-10 g/d, respectively). Blood lipids, nutrient bioavailability, cardiovascular risk/risk, glycemia, and anthropometric variables were the most common outcomes reported across all studies. Conclusions: Future recommendations for novel research include the study of: European, Asian, adolescent or younger, and senior populations; dose-response designs and longer length interventions; dietary compensation; and the need for greater replication. The results have been made public and freely available, and a visual, interactive map was created to aid in science translation. This evidence map should enable future meta-analyses, enhance communication and transparency in avocado research, and serve as a resource for policy guidance.