European Journal of Nutrition

, Volume 57, Issue 3, pp 1073–1082 | Cite as

Effect of AHA dietary counselling on added sugar intake among participants with metabolic syndrome

  • Lijuan Zhang
  • Sherry Pagoto
  • Christine May
  • Barbara Olendzki
  • Katherine L.Tucker
  • Carolina Ruiz
  • Yu Cao
  • Yunsheng MaEmail author
Original Contribution



High added sugar consumption has been associated with the development of metabolic syndrome (MetS). The American Heart Association (AHA) diet is designed to prevent and treat MetS; however, it remains unclear whether the AHA diet is effective on decreasing added sugar consumption. The aim of our study was to evaluate the effect of the AHA dietary counselling on added sugar consumption among participants with MetS.


The AHA dietary counselling was conducted among 119 participants with MetS from June 2009 to January 2014 ( NCT00911885). Unannounced 24-hour recalls were collected at baseline, 3, 6 and 12 months. Added sugar consumption patterns over time were examined using linear mixed models.


After 1-year dietary counselling, intake of added sugars decreased by 23.8 g/day (95% CI 15.1, 32.4 g/day); intake of nonalcoholic beverages dropped from the leading contributor of added sugar intake to number 7 (from 11.9 to 4.4%); the Alternative Healthy Eating Index (AHEI) score increased by 5.4 (95% CI 2.9, 8.0); however, added sugar intake for 48% participants still exceeded the recommendation. Added sugar intake per meal among different meal type was similar (24.2–25.8%) at baseline. After the 1-year dietary counselling, breakfast became the major resource of added sugar intake (33.3%); the proportion of added sugar intake from snacks decreased from 25.8% (CI 23.1, 28.5%) to 20.9% (CI 19.6, 22.3%).


Although the consumption of added sugars in participants with MetS decreased after the 1-year AHA dietary counselling, added sugar intake from majority of participants still exceeds recommended limits. Actions of successful public health strategies that focus on reducing added sugar intake are needed.


Added sugar Metabolic syndrome AHA dietary counselling 



We thank all participants for their dedication to the study.


The work was supported by grant 5R01HL094575-04 to Dr. Yunsheng Ma from the National Heart, Lung and Blood Institute (NHLBI), and in part by China Scholarship Council (No. 201506265015) to Dr. Lijuan Zhang as a visiting scholar.

Compliance with ethical standards

Conflict of interest

None of the authors reported a conflict of interest related to the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Cardiology, Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of MedicineTongji UniversityShanghaiChina
  2. 2.Division of Preventive and Behavioral Medicine, Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.Department of Biomedical and Nutritional SciencesUniversity of Massachusetts at LowellLowellUSA
  4. 4.Department of Computer ScienceWorcester Polytechnic InstituteWorcesterUSA
  5. 5.Department of Computer ScienceUniversity of Massachusetts at LowellLowellUSA

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