台灣地區成人體型狀況及其體重控制行為相關因素探討

A study on weight control behavior and related factors among different Somatotype of adults in Taiwan Area

蔡坤圻(Kun chyi,Tsai)

指導教授 ： 廖宏恩

亞洲大學/健康學院/健康管理研究所/碩士(2005年)

摘要

維持理想體重是維護健康的基礎，我國國民飲食指標的第一項即是「維持理想體重」(行政院衛生署，2005)，九十三年台灣地區十大死因惡性腫瘤、腦血管疾病、心臟疾病、糖尿病、慢性肝病及肝硬化及高血壓性疾病(行政院衛生署衛生統計資訊網，2005)，主要原因是社會環境快速變化、生活習慣改變、不當飲食、缺乏運動及肥胖增加等不當生活形態所致，且體重過重、過輕均與人類的死亡率有關(Bray,1985; Dwyer et al.,1987)。
本研究分析民國九十年「國民健康訪問調查」資料，由人口與社會學變項(性別、年齡、職業、婚姻狀況、教育程度、個人月收入…等變項)探討台灣地區成人民眾體型分佈狀況，並研究台灣地區成人不同體型間選擇各種體重控制方法上之相關，此外，更進一步地分析影響台灣地區成人體型狀況的健康相關因素(i.e.,自覺心理健康、自覺身體健康、社會活動參與及健康行為四個層面)。
本研究利用民國九十年「國民健康訪問調查」進行次級資料分析，悉調查母體以民國九十年一月十六日台灣地區戶籍資料之普通戶為抽樣母體，對359個鄉鎮市區進行分層三段等機率抽樣，完訪率達94.1%，其中12歲以上問卷有18144筆，本研究選擇20歲以上成人為研究對象，經篩選後有15411筆，為本研究之研究樣本。
本研究利用雙變項與多變項分析，其主要結果與建議如下：
（一）台灣地區成人體型狀況過重比例佔22.8%、肥胖佔12.7%，過重以上的盛行率有35.53%。建議衛生單位針對年齡層50-59歲、教育程度國小及識字、婚姻狀況已婚及有偶同居者、有宗教信仰者、原住民族群、職業從事自營業者經理和公家機構主管、及個人月收入在六萬至八萬元之群體為重點對象，強化體重控制行為宣導相關之健康促進活動。
（二）台灣地區成人半數以上並沒有做體重控制行為，有體重控制行為者多選擇「減少熱量攝取」、「多運動」及「減少脂肪攝取」的方式；而「參加體重控制班」的只佔0.29%，「選擇使用市售減肥代餐包或減肥茶」及「服用減肥藥」的成人，卻佔有進行體重控制行為者的3.55%及2.94%。本研究認為體重控制方法應尋求醫護專業人員評估與諮商，選擇正確的且不傷害健康為前提的體重控制方式，改變不良飲食及運動習慣的生活型態。
（三）在控制人口與社會學因素下，有慢性疾病者、心理健康不佳者、身體健康不佳者、無運動習慣者，其過重體型及肥胖體型的比率較高，有喝酒習慣者呈現過重體型及肥胖體型比率較無喝酒習慣者低，而普通均衡飲食卻過重及肥胖體型比率高於無均衡飲食者。若健康定義不再侷限身、心有無疾病，而是平日有無良好生活習慣及生活環境之下，則此研究顯示每個人需為自己健康與維持體重負責，避免有害健康行為之相關因子以及不健康的生活形態，以努力地增進自己的健康，因應衛生署施政理念「健康是權利，保健是義務」之呼籲。

關鍵字

健康促進 ； 身體質量指數(BMI） ； 體重控制行為

並列摘要

Maintaining the ideal weight is not only a foundation of health management but also a suggestion of National Diets Index (DOH, 2005). Among ten leading causes of the death in Taiwan in Year 2004 (Health and National Health Insurance Annual Statistics Information Service, 2005), most of diseases, such as malignancy, cerebrovascular diseases, heart disease, diabetes, chronic liver diseases, cirrhosis and hypertensive diseases, are regarded as the results of fast social changes, lifestyle changes, improper diets, lack of exercises, and gaining weights. In addition, overweight and underweight problem are correlated with death rates of human beings.
This study adopted the “2001 National Health Interview Survey” as the resource of databank. We observe the distribution of the adults’ somatotypes in Taiwan area by social and demographic variables (i.e., gender, age, occupation, marital status, education level, personal monthly income, etc.). We also study various weight-controlling choices among different somatotypes of the adults. Moreover, this study tried to analyze the influencing factors of the somatotypes of the adults from four health related perspectives (i.e., perceived mental health, perceived physical health, social activity participation, and life style behavior).
The “2001 National Health Interview Survey” employed registered households in January 16th, 2001 as sampling population. A three-stage stratification scheme was applied on totally 359 districts (i.e., Hsiang) in Taiwan. Interviews were completed in 18,144 individuals with age 12 and above, for a response rate of 94.1%. This study chose totally 15,411 individuals with age 20 and above as eligible samples.
This study proceeded the binany and multi-variate analysis. The major outcomes and suggestion are as follows.
1. Among the somatotypes of adults in Taiwan area, the overweight rate is accounting for 22.8%, the obesity rate is accounting for 12.7%, and the prevalence rate for overweight and above is accounting for 35.53%. This study found that people whose age between 50 to 59, with elementary education or literacy, married or accompanied partner, religious believer, aboriginal group, engaging in management position in private-owned business or in public organizations, and with income NT$60,000 and NT$80,000, were our target population for promoting weight-controlling activities.
2. There are more than half adults in Taiwan area didn’t control their weight, and for those who did, they usually chose “reduction of calorie ingestion”, “more exercises”, and “reduction of fat ingestion methods”, however, people who chose the“participation of weight-control class” method is only accounting for 0.29%. On the other hand, for those adults who chose the methods of “substitute diet pack or weight-lose teabag” and “weight-lose pills” are accounting for 3.55% and 2.94% respectively. This study suggests that people should look for the weight-control evaluation and counsellings from professionals to change unhealthy diet and related life style without trading their health off.
3. After controlling social and demographic factors, those adults who have chronic disease, who have poor psychological health, who have poor physical health, and who have no regular exercise, have higher rates of overweight or obesity. In addition, those adults with drinking habit have higher rates of overweight or obesity, compared to those who have no drinking habit. Nevertheless, our research finds that people who have balanced diet have relatively higher rates of overweight or obesity. If we define “health” from the ecological viewpoint, this study emphasizes the importance of healthy life style and encourage people paying more attentions on ways of weight control and health promotion to fulfill the idea of “health privilege as a human right, health promotion as a human obligation” propagated by Department of Health.

並列關鍵字

Health Promotion ； Body Mass Index (BMI) ； Weight Control Behavior

參考文獻

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