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肥胖者與正常體重者飲食 , 營養狀況及其相關因素 的探討

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(1)

肥胖者與正常體重者飲食 , 營養狀況及其相關因素 的探討

國人肥胖的人口逐年上升,而肥胖與高血壓、糖尿病、心血管疾

病等慢性疾病的罹病率與死亡率有極大的正相關。究竟肥胖者和

正常體重者在飲食和營養素的攝取上是否有不同呢?影響體重的

因素又為何 ? 是本研究探討的重點。本研究以 20 - 60 歲的成年

女性為研究對象,依身體質量指數( BMI )= 22 為標準,分成肥

胖者( BMI * 26.5 , n = 50 )和正常體重者( 19.8 * BMI * 24.2

, n = 46 ),進行體位測量、血液生化值、問卷和 24 小時飲食回

憶的評估。結果顯示: ( 一 ) 在體位測量方面:肥胖者體重、身體

質量指數 (BMI) 、 BMI % 、腰圍、臀圍、腰臀圍比值( WHR )、上臂

圍、上臂肌圍、三頭肌皮脂厚度、收縮壓及舒張壓均大於正常體

重者 (P<0.05) 。 ( 二 ) 在血液生化值方面:肥胖者血清三酸甘油

酯、總膽固醇 / 高密度脂蛋白 (HDL-C) 比值顯著較正常體重者

高,但 HDL-C 值顯著較正常體重者低 (P<0.05) 。腰臀圍比值與

血壓、血脂質呈現顯著的相關性,即腰臀圍比值愈大者,其罹患

高血壓、心血管疾病的危險性就愈高。 ( 三 ) 在飲食習慣方面:肥

胖者嗜吃甜食、高油脂飲食,美食當前較難控制自己攝食的份量

(P<0.05) ,且情緒因素較易引起其攝食行為。 ( 四 ) 在營養知識

方面:兩組無顯著差異。然而正常體重者營養知識與飲食習慣呈

現正相關 (r = 0.46 , P = 0.001) ,但在肥胖者卻無此相關性的存

在。 ( 五 ) 在熱量及營養素攝取量上:兩組無顯著差異,且兩組均

有 60 % 以上的人其三大營養素攝取量的比例不符合建議量。兩組

在運動消耗熱量上也無顯著差異。 ( 六 ) 正常體重者體型誤認率

71.8 % 高於肥胖者的 24.0 % 。而肥胖者體型不安情形略高於正常

體重者。 ( 七 ) 兩組人對於肥胖的態度敘述多呈負面的看法。 ( 八 )

大部分肥胖者在生產後或最近一年開始發胖,其減肥的動機以自

己主動想到居多( 54.5 % ),減肥的目的是為了身體健康或美觀

, 40 % 的人採用節食的方式減肥,最想減重的部位以整體的體態

佔大多數 (71 %) ,運動不足及飲食過度是自認為導致肥胖的主要

原因。 73 % 的人在參加減重計劃後能有效的使體重下降,但 46 %

的人其所減輕的體重只能維持 1 - 3 個月,只有 9 % 的人能維持到

現在。

(2)

Comparison of nutrition-related factors between normal weight and obese group

The prevalence of obesity is increasing in Taiwan,

and obesity is highly correlated to the mortality and

morbidity of hypertension, diabetic mellitus and

cardiovascular disease. It is important to know the

differences on dietary patterns and nutrient intake

between normal weight and obese groups and the factors

that influence body weight. This study was conducted

to investigate the differences on anthropometric,

biochemical, questionnaire and 24-h recall for normal

weight ( 19.8 * BMI * 24.2 , Body Mass Index (kg/m2) ;

n=46 ) and obese groups ( BMI * 26.5 ; n=50 ) . (1) The

anthropometric results showed that the levels of waist,

hip, waist-to-hip ratio (WHR), mid-arm circumference,

triceps skinfold thickness (TSF) and diastolic/systolic

blood pressure were higher in obese group than in the

normal-weight group ( P<0.05 ). (2) The biochemical

data indicated that the obese group had higher

triglyceride and total cholesterol (TC) / high density

lipoprotein cholesterol (HDL-C) ratio but lower HDL-C

level than the normal weight group ( P<0.05 ). The

blood pressure and lipid levels were positively correlated

with WHR level. (3) The dietary pattern questionnaire

showed that the obese group ate more sweet and high fat

content foods than normal weight group ( P<0.05 ). The

tendency of emotional eating existed in obese group.

(4) There was no difference on knowledge score between

two groups, but a positive correlation existed between

knowledge and dietary practices for normal weight group

( r=0.46 , P = 0.001 ). (5) There was no difference on

(3)

Comparison of nutrition-related factors between normal weight and obese group

energy and nutrients intake between two groups. However,

more than 60 % of adults did not meet the recommendation

for the proportion of three macronutrients set by NHA

(National Health Administration). There*s no evidence of

difference in exercise energy expenditure in two groups

. (6) The distoration of body image was significantly

higher in normal weight group than obese group with the

percentage of 71.8 % and 24 % , respectively. Obese

group had a tendency of higher scores on individual body

image attitude statements than normal-weight group. (7)

Both groups showed a negative view on attitudes

regarding obesity. (8) Most obese people gained weight

after delivery or within recent one year. The major

motivation of losing weight was self decision. The

purpose of losing weight were health or beauty. Forty

percent of obese people used diet to lose weight. Less

exercise and excess intake of foods were the major

causes of gaining weight. Seventy-three percent of obese

lost weight after weight-control program. Forty-six

percent obese maintained weight for only 1-3 months, and

only 9 % people could maintain weight until now.

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