Congratulations on the work you are doing to plan the next White House Conference on Hunger, Nutrition, and Health. The Avocado Nutrition Center is grateful for the opportunity to share information and initiatives as they relate to the questions posed.
The following comments address the posed question: What specific actions should the U.S. federal government take to achieve each pillar? What are the opportunities and barriers to achieving the actions?
Pillar 2. Integrate nutrition and health: Prioritize the role of nutrition and food security in overall health, including disease prevention and management, and ensure that our health care system addresses the needs of all people.
Long-standing dietary patterns are inconsistent with recommendations. While healthy dietary patterns reduce the risk for cardiovascular disease, overweight and obesity, type 2 diabetes, and cancer, most Americans eat too few fruits and vegetables and too much sodium, saturated fat, and added sugars. Further, the American dietary landscape has not changed appreciably over time. Across the lifespan, calcium, vitamin D, potassium, and dietary fiber are underconsumed. Iron and folate are among the nutrients that pregnant women frequently consume too little of during this critical development time. The Dietary Guidelines for Americans, 2020-2025 (DGA) recommend including foods with iron and zinc during infancy.
The Avocado Nutrition Center supports research to address healthy living across all ages and special populations like pregnant and lactating women and Hispanics. We’re committed to supporting nutrition research that is relevant and motivating to support improvements in overall health and well-being. Without the Avocado Nutrition Center, the vast majority of research into the avocado as a whole food wouldn’t exist.
Pillar 3. Empower all consumers to make and have access to healthy choices: Foster environments that enable all people to easily make informed healthy choices, increase access to healthy food, encourage healthy workplace and school policies, and invest in public messaging and education campaigns that are culturally appropriate and resonate with specific communities.
The following are examples related to delivering accurate, understandable, and culturally appropriate information and helping to improve dietary patterns through applicable food assistance programs, targeted nutrition support, and nutrition education:
- USDA states it is leveraging all its resources to ensure access to healthy foods that promote well-being in an equitable way. Rates of food insufficiency worsened during COVID-19, disproportionately affecting specific population segments. Hispanic Americans are highly susceptible to food insecurity, with close to four in 10 Hispanic households having income levels that qualify within the free- and reduced school lunch program. In the first half of 2021, Hispanic households (16%) experienced high rates of food insufficiency. Additionally, as of May 2022, 23.8% of Hispanic households reported their children sometimes or often did not have enough to eat over the past week.i Hispanics are also disproportionately burdened with chronic disease. Hispanics in the U.S. have the second-highest obesity rate after non-Hispanic Blacks, and the diabetes mortality rate for Hispanic Americans is 1.3 times higher than non-Hispanic whites. We know that, as Hispanics acculturate in the U.S., their diet quality decreases. Regardless of income, avocados are a traditionally consumed vegetable among Hispanics, helping this population meet nutrient needs in culturally relevant meals and snacks. Based on the Dietary Guidelines for Americans 2020-2025 (DGA), the Avocado Nutrition Center has been working with partners within the USDA MyPlate National Strategic Partnership program to create culturally-relevant nutrition education resources for Hispanic Americans. Additionally, the Hass Avocado Board has a Spanish language version of the Love One Today information website (https://saboreaunohoy.com/en/).
- The “WIC benefit bump,” an increase in WIC benefits to be used to purchase fruits and vegetables during COVID among program participants, resulted in increased fruit and vegetable consumption for young children.
- Ninety-five percent of daycare providers feel it’s essential to choose foods children enjoy eating. In contrast, 84% of daycare providers believe choosing foods containing vitamins and minerals is important. Among those providing avocados in a recent survey, 68% of daycare centers reported that infants and toddlers in their care like eating avocados. As a result of increased servings of avocados, 42% of centers also reported serving more whole grains and vegetables, which are underconsumed in this population.
- Nine out of 10 Americans do not meet daily recommendations for vegetable intake. Through data generated by the Dietary Guidelines Advisory Committee (DGAC), and others, we know what types of fruits and vegetables consumers are choosing more and less than others. For example, avocados are an increasingly consumed vegetable, and people say they purchase them because of their perceived health benefits, beneficial fat content, taste, and texture. According to the 2020 DGAC Report, avocados are a widely consumed vegetable, in the “other” subgroup, across various population age groups. Both the 2015 and 2020 Produce for Better Health Foundation State of the Plate Reports show the increased frequency of avocado consumption. Finally, since the 1990s, fresh avocado consumption has grown by 344% (from 1.6 lbs. per capita to 7.1 lbs. per capita, on average), while vegetable intake remained flat overall and even declined in adolescents.
- The most recent DGAs recommend “making every bite count” to improve diet quality and provide information on what nutrients are underconsumed during various age and life stages. In addition to avocados containing many of the nutrients needed at critical stages in life, while free of sodium and added sugars and low in saturated fat, avocado consumption is associated with increased diet quality, intake of food groups habitually under-consumed, intake of under-consumed nutrients across the life span, and decreased intake of overconsumed nutrients. In an analysis of NHANES 2001-2012 data, avocado and guacamole intake were associated with higher diet quality in both children and adults (Table 1). Children (2 to 18 years) who consumed avocado or guacamole had a higher intake of vegetables, fiber, magnesium, potassium, monounsaturated fatty acids, and vitamin E. For adults (19+ years), avocado and guacamole consumption was associated with a higher intake of vegetables, fiber, folate, magnesium, potassium, monounsaturated fatty acids, polyunsaturated fatty acids, vitamin B6, vitamin C, vitamin E, vitamin K, and a lower intake of sodium, added sugar, and discretionary solid fats.
- Health claims serve as a vehicle to educate consumers on the healthfulness of foods and beverages. Many existing health claims were approved in 1993 and have not been updated since, creating an incongruence between FDA-approved health claims and current DGA. For example, the FDA fruits and vegetables and cancer health claim requires that a food be a fruit or vegetable, be low in fat, and be at least a “good source” of vitamin A, vitamin C, or dietary fiber. Avocados meet two out of three of these requirements but are not low in fat. Current US nutrition policy recommends a diet low in saturated (but not total) fat and counts calcium, vitamin D, potassium, and dietary fiber as food components underconsumed and not vitamins A or C anymore. Avocados also meet the current FDA definition of healthy.
Table 1*: NHANES 2001-2012 avocado intake: grams per day (mean +/- standard error).
| Children 2+ years & Adolescents | Adults | |
| Male | 85.5 +/- 15.0 | 82.9 +/- 6.2 |
| Female | 36.7 +/- 11.1 | 66.0 +/- 4.7 |
| All | 63.1 +/- 11.4 | 73.8 +/- 3.8 |
*50 grams is approximately 1/3 of a medium Hass avocado.
We thank you for this opportunity to provide evidence-centered comments. The Avocado Nutrition Center greatly appreciates your consideration of the information provided.
Thank you,
Nikki A. Ford
Hass Avocado Board
Avocado Nutrition Center
i 2021 HAB tracking report, https://hassavocadoboard.com/wp-content/uploads/hab-research-insights-consumer-research-acculturation-report-2021.pdf
ii https://www.ers.usda.gov/covid-19/food-and-consumers/
iii https://www.cdc.gov/nchs/products/databriefs/db360.htm
iv https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=63
v Hass Avocado Board. (2018). Hispanic Study Part 2 Action Guide. Retrieved from: https://hassavocadoboard.com/research/hispanic-avocado-shopper-insights/
vi Congress Extends WIC Benefit Bump to Invest in Healthy Start for Kids. National WIC Association. Published September 30, 2021. Accessed May 23, 2022. https://www.nwica.org/press-releases/congress-extends-wic-benefit-bump-toinvest-in-healthy-start-for-kids#.YjOLV2QpCEc.
vii Infant and Toddler Caregiver Survey of daycare centers responsible for providing at least 3 eating occasions to at least 10 infants or toddlers aged four to 24 months, fielded Spring/Summer 2021.
viii Infant and Toddler Caregiver Survey of daycare centers responsible for providing at least 3 eating occasions to at least 10 infants or toddlers aged four to 24 months, fielded 2022.
ix Produce for Better Health Foundation. (2015). State of the Plate.
x Produce for Better Health Foundation. (2015). State of the Plate.
xi Hass Avocado Board. (2018). Five-Year Evaluation of The Hass Avocado Board’s Promotion Programs: 2013 – 2017.