藉由認識代謝症候群增加老人蔬果攝取之社區營養 教育
蔬果攝取量不足一直是公共衛生營養的重要議題，而代謝症候群為多種心血管危險因子異常聚集之 疾病，近年來亦成為世界主要的公共衛生問題。多篇研究發現，隨著年齡的增高，代謝症候群的盛 行率也隨之攀升，由此可知，對於老人族群代謝症候群為潛藏的健康威脅因子。
因此本研究欲藉由認識代謝症候群對健康的危害性，加強民眾對蔬果攝取重要性的認知與實行。研 究目的在運用社區支持環境資源，以營養教育介入模式，課程強調在認識代謝症候群，進而提倡增 加蔬果攝取以預防與改善代謝症候群，期望受試者增加對於代謝症候群和蔬果角色的認知，並藉由 感受到對於代謝症候群的威脅而能增加日常生活中蔬菜與水果的攝取。
研究在 2008 年 7 月至 2009 年 3 月於台北市信義區進行，對象為 65 歲以上可自由活動的老人，分 為篩檢、確認營養問題、建立營養教育模式及教育介入課程。在篩檢後針對篩檢的結果擬出信義區 老人營養問題，進而設計營養教育課程，課程結合健康信念模式與社會認知理論兩種教育模式，營 養教育架構具有簡單、可實行、有目標性及強化性等優點，並且是在課程教育理論之下進行。教育 內容以增加知識與促進正向態度及行為為主軸，在知識上增加對於代謝症候群及蔬果的認知，在態 度上提升受試者的興趣及自我效能，在行為上增加蔬果攝取，期望在介入後能使其藉由認識代謝症 候群感受到其對於健康的威脅，因此進而增加蔬果攝取。從篩檢人群中徵求願意參加教育介入受試 者，分為介入組及控制組，兩組人數各約 20 人，在 4 週的「認識代謝症候群與增加蔬果攝取」的 營養教育介入後，增加了受試者對於代謝症候群之認識，分析介入組在不同的社經背景與不同的代 謝症候群風險，比較其前測與後測蔬果攝取變化量，結果得介入組的受試者年紀較輕、男性及教育 程度在中學以上的其蔬菜的攝取量有增加的趨勢，與他人同住之受試者的蔬菜攝取改變量較有顯著 差異，且在營養教育介入之後促進受試者對於蔬果的攝取動機。另外，介入組的受試者依行為改變 階段理論，處於前沉思期、沉思期及準備期的受試者，其蔬菜和蔬果的總和量在介入之後有顯著的 增加。由此推論，在課程介入之後，成功的使這些原本處與較低蔬果攝取動機者，顯著的增加其蔬 果的攝取量，並且以蔬菜的攝取為多，故本研究達到有效「社區營養教育介入臺北市信義區老人藉 由認識代謝症候群達到增加蔬果攝取計劃」目的，並期望未來可以持續推廣給其他社區應用。
Nutrition education program by enhancing awareness of metabolic syndrome to increase elderly veg-fruit consumption
Metabolic syndrome is a latent threat to the elderly, as many researches have discovered that prevalence of metabolic syndrome, which is a disease ass ociated with risk factors of cardiovascular disease, gets higher among people with older ages. Metabolic syndrome and the practice of insufficient inta ke of vegetables and fruits have become important issues in the field of public health and nutrition.
By introducing the negative impact of metabolic syndrome on people’s health, this research aims to enhance the public’s awareness of the importance of intake of vegetables and fruits.
This research, utilizing available community resources via the intervention of nutrition education, focuses on improving subjects’ knowledge about me tabolic syndrome and its relation with veg/fruit intake, in order to prompt more subjects to increase intake amount.
The research was conducted on people aged at or over 65, who are able to move about on their own, between July, 2008, to March, 2009, with Taipei City’s Xinyi District being the study area and covering procedures of screening, confirming nutrition problems, establishing education model and desi gning courses of education intervention.
Courses are combination of health belief model and social cognitive theory. The education framework is based on education theories and is simple and feasible with clear objectives.
The education content emphasizes on increasing subjects’ knowledge about metabolic syndrome and intake of vegetable and fruits, as well as improvi ng their positive attitude and practice, in the hope of allowing them to learn more about the threat of metabolic syndrome to health and prompting the m to eat more vegetables and fruits.
Subjects were separated into two groups: intervention group and control group, each about 20 people.
This research compares intake amounts of vegetables and fruits of subjects in the intervention group before and after 4 weeks of education intervention on “knowing metabolic syndrome and increasing intake of vegetable and fruits,” and analyzes each subject’s different social and economy background and risks of getting metabolic syndrome. The results showed that subjects in the intervention group who are male, younger than 80 years old, with sec ondary education, and live with other people, showed a tendency of increasing the intake amounts of vegetables and fruits after the education intervent ion. Based on the theory of stages of change model, this research also shows that subjects at the stages of precontemplation, contemplation, and prepar ation, had obvious increase of aggregated amounts of veg/fruit intake. Therefore, the intervention courses have successfully helped subjects with lower intention of taking vegetables and fruits before the study to increase their intake amounts, especially that of vegetables. This research is proved to reac h its objective of “effectively helping senior people in Xinyi District to increase their eating amounts of vegetables and fruits by introducing the metab olic syndrome to them.” The research performance can be references for future studies in other communities.
