By Mary Hyer, RDN, LD, CCRP

Cinco de Mayo — an annual observance of Mexican culture and heritage — is a wonderful opportunity to celebrate the country's vibrant cuisine, which features fresh ingredients like beans, peppers, tomatoes, and avocados. However, holiday traditions aren’t always centered around health. Celebrations can be challenging for many, especially cardiopulmonary rehab (CR/PR) patients who may struggle to make healthy choices and then feel discouraged or view themselves as lacking willpower when they give in to temptation. They may even skip celebrating altogether.

As CR/PR professionals, we can help patients view holidays in a more positive light. Using behavior change techniques, we can help them prepare ahead of time, including developing a “Plan B.” Encouraging open communication with family members and ensuring they have a supportive companion during the festivities can also make a significant difference.

As a dietitian, I focus on highlighting “always” foods and helping patients modify recipes, start new traditions, and find ways to enjoy traditional flavors in a heart-healthy way. By emphasizing a few key ingredients, patients celebrate holidays like Cinco de Mayo without compromising their health goals. Teaching patients how to mindfully incorporate traditional ethnic foods into their diets can be both simple and effective. Take avocados, for instance — Americans eat an impressive 81 million pounds of them every May 5, second only to the Super Bowl.

In fact, one serving (⅓ of an avocado) is rich in healthy fats, fiber, and nutrients. Research shows that eating more than two servings per week is linked to a 16% lower risk of cardiovascular disease (CVD) and a 21% lower risk of heart attack.¹ Although this study was observational, the findings support clinical trials showing that replacing foods like butter, red meats, or processed meats with plant-based fats can help prevent heart disease.

What Makes Avocados Healthy?

• Avocados are rich in healthy fats, particularly oleic acid, a monounsaturated fat (MUFAs). A serving contains just under 5 grams of oleic acid, the same amount found in 1.3 teaspoons of olive oil. Replacing foods high in saturated fat with foods high in MUFAs can help lower apolipoprotein B and low-density lipoproteins (LDL), especially the small, dense LDL particles that are linked to higher risks of CVD, elevated triglycerides, and lower HDL cholesterol levels.²
• Regular avocado consumption has been associated with lower rates of metabolic syndrome.³ Patients living with metabolic syndrome have at least three of the following conditions: elevated waist circumference, high blood pressure, high blood glucose, high triglycerides, and/or low HDL cholesterol levels. Metabolic syndrome is associated with a 2-fold increase in cardiovascular outcomes and a 1.5-fold increase in all-cause mortality.⁴
•  Avocados, like all plants, are cholesterol-free. They contain phytosterols, which have a chemical structure like cholesterol but are poorly absorbed in the intestines. The American Heart Association has found that phytosterols can help reduce total and LDL cholesterol in the body by cholesterol blocking absorption.⁵
• Avocados are an excellent source of potassium, a key nutrient and electrolyte that regulates blood pressure and fluid balance. Potassium works in conjunction with sodium, helping the body to excrete excess sodium, relaxing the vessel; and it is a vasodilator, increasing blood flow. Potassium is essential in nerve function, muscle contraction (including the heart muscle), and electrical signaling to the heart maintaining heart rhythm. Potassium enhances exercise performance and recovery. Since potassium is lost in sweat, consuming potassium-rich sources pre- and post-exercise can prevent dehydration and reduce muscle cramps and fatigue.
• Avocados are prebiotic foods that ferment in the colon, promoting beneficial bacteria that produce short-chain fatty acids (SCFAs) like butyrate. SCFAs support gut integrity and immune function, reduce inflammation, and may lower cholesterol and vascular stiffness. Prebiotics can improve insulin sensitivity and reduce risk of metabolic syndrome. In one study, daily avocado consumption for 12 weeks improved gut microbiota in participants with elevated BMI.⁶ While this study was industry-funded, the positive effect of fiber-rich diets on the microbiome has been shown.⁷
• Avocados are rich in carotenoids with antioxidant properties. In a randomized crossover-controlled feeding trial including individuals with elevated BMI and LDL levels, eating one avocado a day, significantly decreased circulating oxidized LDL and increased plasma lutein concentrations compared to the control diet (western diet), low-fat diet, and high oleic oil diet.⁹ Given that the avocado-rich diet outperformed the similar oleic-enriched diet, the authors contributed the bioactive compounds of avocados.
• Although calorie-dense, avocados can support both weight gain and weight loss goals. They can help boost calorie intake for patients with cachexia or aid in post-surgery recovery. For weight loss, daily avocado intake is correlated to lower BMI and not associated with weight gain in individuals who are living with obesity or are overweight.¹⁰ When paired with fiber-like non-starchy vegetables and lean protein, avocados can enhance satiety, regulate appetite, and support metabolic hormone responses like GLP-1 and insulin.¹¹ Teaching patients to incorporate fiber, protein, and a serving of healthy fat in a meal can aid in sustaining food changes.

Bottom Line

While avocados are not a miracle food, they support cardiometabolic health. They should be encouraged not just on May 5 but year-round by sharing simple recipes that patients can easily integrate into their meal planning. Inviting patients to share how they've modified traditional dishes to be more health-conscious can further support patient engagement and learning. Save time at the end of a session to discuss anticipated challenges related to holidays such as Cinco de Mayo, allowing patients to work together to brainstorm practical solutions — often the most rewarding part of our work. Cinco de Mayo commemorates the hard-fought Battle of Puebla. The quote, “Freedom is not given; it is won,” reflects our mission as clinicians to empower patients with the tools, knowledge, and confidence to take an active role in their health journey. True success is when they empower those around them.

REFERENCES

1. Pacheco, Lorena S., et al. “Avocado Consumption and Risk of Cardiovascular Disease in US Adults.” Journal of the American Heart Association, vol. 11, no. 7, Apr. 2022, p. e024014, https://doi.org/10.1161/JAHA.121.024014.
2. Schoeneck, Malin, and David Iggman. “The Effects of Foods on LDL Cholesterol Levels: A Systematic Review of the Accumulated Evidence from Systematic Reviews and Meta-Analyses of Randomized Controlled Trials.” Nutrition, Metabolism and Cardiovascular Diseases, vol. 31, no. 5, 2021, pp. 1325–38, https://doi.org/10.1016/j.numecd.2020.12.032.
3. Fulgoni, Victor L., et al. “Avocado Consumption Is Associated with Better Diet Quality and Nutrient Intake, and Lower Metabolic Syndrome Risk in US Adults: Results from the National Health and Nutrition Examination Survey (NHANES) 2001–2008.” Nutrition Journal, vol. 12, no. 1, 2013, p. 1, https://doi.org/10.1186/1475-2891-12-1.
4. Mottillo, Salvatore, et al. “The Metabolic Syndrome and Cardiovascular Risk.” Journal of the American College of Cardiology, vol. 56, no. 14, 2010, pp. 1113–32, https://doi.org/10.1016/j.jacc.2010.05.034.
5.  Wang, Li, et al. “A Moderate-Fat Diet with One Avocado per Day Increases Plasma Antioxidants and Decreases the Oxidation of Small, Dense LDL in Adults with Overweight and Obesity: A Randomized Controlled Trial.” The Journal of Nutrition, vol. 150, no. 2, 2020, pp. 276–84, https://doi.org/10.1093/jn/nxz231.
6. Thompson, Sharon V., et al. “Avocado Consumption Alters Gastrointestinal Bacteria Abundance and Microbial Metabolite Concentrations among Adults with Overweight or Obesity: A Randomized Controlled Trial.” The Journal of Nutrition, vol. 151, no. 4, Apr. 2021, pp. 753–62, https://doi.org/10.1093/jn/nxaa219.
7. Bhuyan, Deep Jyoti, et al. “The Odyssey of Bioactive Compounds in Avocado (Persea Americana) and Their Health Benefits.” Antioxidants (Basel, Switzerland), vol. 8, no. 10, Sept. 2019, p. 426, https://doi.org/10.3390/antiox8100426.
8. James-Martin, Genevieve, et al. “Avocado Consumption and Cardiometabolic Health: A Systematic Review and Meta-Analysis.” Journal of the Academy of Nutrition and Dietetics, vol. 124, no. 2, 2024, pp. 233-248.e4, https://doi.org/10.1016/j.jand.2022.12.008.
9. Wang, Li, et al. “A Moderate-Fat Diet with One Avocado per Day Increases Plasma Antioxidants and Decreases the Oxidation of Small, Dense LDL in Adults with Overweight and Obesity: A Randomized Controlled Trial.” The Journal of Nutrition, vol. 150, no. 2, 2020, pp. 276–84, https://doi.org/10.1093/jn/nxz231.
10. khan, Naiman A., et al. “Avocado Consumption, Abdominal Adiposity, and Oral Glucose Tolerance Among Persons with Overweight and Obesity.” The Journal of Nutrition, vol. 151, no. 9, Sept. 2021, pp. 2513–21, https://doi.org/10.1093/jn/nxab187.
11. Bodnaruc, Alexandra M., et al. “Nutritional Modulation of Endogenous Glucagon-like Peptide-1 Secretion: A Review.” Nutrition & Metabolism, vol. 13, no. 1, 2016, p. 92, https://doi.org/10.1186/s12986-016-0153-3.

Mary Hyer is a dietitian at the Newton-Wellesley Cardiac Rehabilitation Program, part of Mass General Brigham. With over 30 years of experience working with cardiac patients, she is passionate about empowering individuals to take control of their health through nourishing nutrition and sustainable lifestyle changes. Her mission is to help patients fuel their bodies, rebuild their strength, and embrace a healthier future — one step at a time.