透過您的圖書館登入
IP:44.192.75.131
  • 學位論文

健康飲食及運動可有效降低社區中老年人代謝異常的風險

Healthy Diet and Exercise is Effective in Improving Metabolic Abnormalities in Community-Living Older Adults

指導教授 : 蔡仲弘
若您是本文的作者,可授權文章由華藝線上圖書館中協助推廣。

摘要


背景與目的:健康生活是預防代謝異常及慢性疾病的重要策略,其關鍵在健康飲食及保持適當體重及體適能。此策略常被運用於社區民眾的健康促進,但其成效未被證實。本研究探討此策略運用於社區有代謝異常民眾的成效。 方法:2010年臺中縣21個社區全面推動減糖減脂健康促進班,招募體位過重、肥胖或三高(高血糖、高血壓、高血脂)的民眾為對象進行類實驗介入研究。其中隨機選1社區為對照組,其他社區為介入組。所有社區都提供圖文單張並鼓勵學員執行自我健康管理;但介入社區又運用各社區衛生人員給予標準化營養衛教課程,且定期討論、激勵及追蹤,以突破障礙及養成健康飲食及運動行為。以t檢定分析減重及代謝改善成效,並以邏輯回歸分析影響因子。 結果:經16週,介入組個案(553人)的體重減1.76 kg, BMI降0.70 kg/m2,腰圍減2.67 cm;而對照組(30人)分別減0.75 kg,0.32 kg/m2,及0.18 cm (二組間的差異皆p<0.05)。介入組的收縮壓亦降4.15 mmHg,舒張壓降2.36 mmHg,三酸甘油酯減8.73 mg/dL,血清膽固醇減6.85 mg/dL,皆顯著(p<0.001)低於啟始點。迴歸分析顯示減重的顯著因子是多運動,降低膽固醇是多運動及多吃蔬菜,改善血糖及血壓是多吃水果。 結論:健康飲食及多運動可經由有組識有系統的健康促進方法推廣到社區且可有效的改善中老年人的代謝異常現象。本縣所採用的模式應可適用於其他縣市。

關鍵字

代謝症候群 糖尿病 減重 健康飲食 運動

並列摘要


Objectives: To determine the effectiveness of healthy diet and physical exercises on reducing the risk of metabolic abnormalities in community-living adults. Methods: Taichung Health Bureau and Asia University partnered to design a program and trained field workers to carry out a health-promoting project in summer 2010. Twenty-one community groups totaling 583 adults participated in the project and one group was randomly chosen to serve as controls. All participants received graphic leaflets on healthy living but treatment groups received class sessions on healthy eating and exercise activities for the first four weeks. Field workers empowered group leaders to organize and choose appropriate group activities. Group leaders served as role models and helped break learning barriers. Participants shared progress and experiences of action-learning at monthly meetings. Results: After 16 weeks, significant (all p<0.05) treatment effects were observed in body weight, BMI and waist circumference. The net changes from baseline were -0.75 vs. -1.74 kg for weight, -0.32 vs. -0.70 kg/m2 for BMI, -0.18 vs. -2.67 cm for waist circumference for control and treatment groups, respectively. Logistic regression analyses suggested that weight reduction was significantly associated with greater physical activity; cholesterol lowering with physical exercise and eating more vegetables; and improved blood glucose and blood pressure with eating more fruits. Conclusions: Empowerment of local group leaders was an effective strategy in promoting healthy eating and physical activity to reduce the risk of metabolic disorders in community-living adults. The program can serve as a model of community health-promotion in other counties.

參考文獻


張敬仁、張文道、張文瀚、蔡森蔚、周崇頌、陳妍蒨、趙蘭芬:以生活型態調整探討減重及健康相關生活品質之改善。台灣衛誌2003;l22(4):308-317。
Akbaraly TN, Kivimaki M, Ancelin ML, Barberger-Gateau P, Mura T, Tzourio C, Touchon J, Ritchie K, Berr C. Metabolic syndrome, its components, and mortality in the elderly. J Clin Endocrinol Metab. 2010; 95(11): E327-332.
Brunner E, Rees K, Ward K, Burke M, Thorogood M. Dietary advice for reducing cardiovascular risk. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD002128. DOI:10.1002/14651858.CD002128.pub3.
Carter P, Gray L J, Troughton J, Khunti K, Davies MJ. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ. 2010; 341: c4229-c4237.
Chan R, Woo J. Prevention of overweight and obesity: How effective is the current public health approach. Int. J. Environ. Res. Public Health 2010; 7: 765-783.

延伸閱讀