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Nutrients 2018, 10(10), 1486; https://doi.org/10.3390/nu10101486

Substantial Increase in Compliance with Saturated Fatty Acid Intake Recommendations after One Year Following the American Heart Association Diet

1
School of Clinical Medicine, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
2
Division of Preventive and Behavioral Medicine, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA
3
Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
4
School of Community & Global Health, Claremont Graduate University, Claremont, CA 91711, USA
5
School of Social Work, San Diego State University, San Diego, CA 92182, USA
6
Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA 01655, USA
7
Department of Microbiology & Physiological Systems, University of Massachusetts Medical School, Worcester, MA 01655, USA
*
Author to whom correspondence should be addressed.
Received: 28 August 2018 / Revised: 2 October 2018 / Accepted: 4 October 2018 / Published: 12 October 2018
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Abstract

The American Heart Association (AHA) dietary guidelines recommend 30–35% of energy intake (%E) be from total fat, <7%E from saturated fatty acids (SFA), and <1%E from trans fatty acid (TFA). This study evaluates the effect of AHA dietary counselling on fat intake. Between 2009 and 2014, 119 obese adults with metabolic syndrome (MetS), (71% women, average 52.5 years of age, and 34.9 kg/m2 of body mass index), received individual and group counselling on the AHA diet, over a one-year study period. Each participant attended 2 individual sessions (months 1 and 12) and 12 group sessions, at one-month intervals. At baseline and one-year, we collected three random 24-h diet recalls (two weekdays and one weekend day). Fat intake patterns over time were analyzed using paired-t test and linear mixed-effect models. There was significant variation on SFA and TFA intake per meal, being highest at dinner, in restaurants, and on weekends. Over the one-year study period, daily intake of total fat, SFA, and TFA decreased by 27%, 37% and 41%, respectively (p-value < 0.01, each). Correspondingly, the percentage of participants complying with AHA’s recommendations, increased from 25.2% to 40.2% for total fat (p-value = 0.02); from 2.5% to 20.7% for SFA (p-value < 0.01); and from 45.4% to 62% for TFA (p-value = 0.02). Additionally, SFA intake for all meal types at home decreased significantly (p-value < 0.05, each). AHA dietary counselling significantly increased the compliance with AHA dietary guidelines, with an eightfold increase in compliance in SFA intake. Nonetheless, ~80% of our participants still exceeded the recommended SFA intake. Substantial efforts are needed to encourage low-SFA and low-TFA food preparation at home, with strong public health policies to decrease SFA and TFA in restaurants and prepared foods. View Full-Text
Keywords: fatty acids; metabolic syndrome; American Heart Association (AHA) diet fatty acids; metabolic syndrome; American Heart Association (AHA) diet
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Zhao, M.; Chiriboga, D.; Olendzki, B.; Xie, B.; Li, Y.; McGonigal, L.J.; Maldonado-Contreras, A.; Ma, Y. Substantial Increase in Compliance with Saturated Fatty Acid Intake Recommendations after One Year Following the American Heart Association Diet. Nutrients 2018, 10, 1486.

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