減重風險認知及減重成效之生化評估探討

The study on risk perception of weight reduction, and the relationship among degree of weight loss, leptin and superoxide dismutase activity in the obese

施伶穎(Ling-Ying Shih)

指導教授 ： 韓柏檉

共同指導教授 ： 謝明哲

臺北醫學大學/藥學院/藥學研究所/博士(2007年)

https://doi.org/10.6831/TMU.2007.00064

摘要

健康的人生須具備「營養、保養、修養」三養的境界，營養過剩是現代人極為關注及預防的議題，而保養及修養則需先養成對於生活上健康保健、醫學概念、風險認知的建立及提昇，許多備受爭議的議題如受到污染的牡蠣等水產品是否真的該停止養殖及販售？孕婦懷孕期間是否該食用水產品？保健食品真的只有保健而無其他危害健康的顧慮嗎？減重是否有潛藏的危害風險呢？等種種的健康危害風險總是遍佈在我們的生活週遭，但仍有許多民眾對於風險意識十分低落且不知如何才能降低風險。故本研究特別針對民眾對於減重塑身產品或行為上的風險認知進行探討，另外亦進行減重成效、身體狀態的改變、體內瘦體蛋白（leptin）與抗氧化酵素超氧化物歧化酶（Superoxide Dismutase, SOD）等方面的研究。

問卷訪視對象以一般民眾及某醫學中心之減重班個案為主，以便利取樣進行抽樣，並利用自填問卷方式進行資料蒐集，有效樣本共452人。繼而針對165位減重班個案採集血液樣本進行分析。研究結果發現民眾對於塑身減重產品或行為方面，較擔心身體風險及功能風險，較不擔心社會風險及時間風險。最怕買到冒牌的商品、怕會產生副作用以及怕商品太貴而沒有它的價值所在。而認為最能降低風險的策略有：請醫師推薦、選擇和以前有交易過並且滿意的廠商購買以及和可信賴的廠商購買等，認為最沒效用的是：購買經常看到廣告的品牌商品以及有知名藝人代言的廠商商品。

減重前女性的leptin濃度及抗氧化酵素SOD活性明顯比男性高（p<0.001；p<0.05）。經過八週減重後，不論是男性或女性，其體重、BMI值、體脂肪、腰圍及臀圍等皆有顯著下降（p<0.001）。且體內leptin濃度明顯下降，而抗氧化酵素SOD活性則明顯上升。推斷體內抗氧化酵素SOD活性的增加，途徑有三：（一）運動對身體造成氧化壓力；（二）經由減重使得抗氧化能力增加；（三）血中leptin使體內的氧化壓力增加，原因極有可能與SOD有關，當體內leptin濃度降低時，SOD活性便增加。減重前體內leptin濃度較高者，似乎會降低減重成效。另外，本研究利用線性方程式以減重前的leptin濃度推估預測其減重成效。若減重前的leptin濃度為5–30ng/mL，其經過八週的減重課程後，推測可以減少8.13-3.78kg的體重。

關鍵字

風險認知 ； 降低風險 ； 減重成效 ； 瘦體蛋白 ； 抗氧化酵素超氧化物歧化酶

並列摘要

A healthy life must consist of the three followings: nutrition, maintenance of health and cultivation. Overconsumption has been a precautious and concerning issue nowadays. Maintenance of health and cultivation must be based on a good establishment and promotion of health care, medical concept, and risk perception. Should we stop selling and breeding of contaminated seafood? Should a mother eat seafood during their pregnancy? Do health foods really provide only nutrition but other harmful effects? Is there any potential endanger risks during weight reduction? These controversial issues always take place along with our daily life but there are still many people lack of the sense of risks. In addition, people exposed to these risks don’t know what or how to do to reduce the risks. Therefore, we investigate the risk perception of weight reduction products and behaviors of general public. Besides that, we also investigate the degree of weight loss, differences of body composition, leptin concentration and superoxide dismutase (SOD) activities after a body weight reduction (BWR) regime.

General public and personnel participated in the BWR regime held in a medical center are the study subjects. A questionnaire was filled in under a free will and 452 valid questionnaires are collected. Following the questionnaires, 165 BRW regime participants were selected for further blood sample analysis. Our results indicated that people worry about physical and functional risks on weight reduction products and behaviors rather than social and time risks. Fear for purchasing counterfeit merchandise, side-effects and also care about buying the merchandise that is not counter valuable as it was claimed. People recognize that asking for doctor’s recommendation, choosing a seller they deal with and choosing a reliable seller are effective approaches to reduce risk. In contrary, they recognize that products under advertising promotion and represented by artists are less effective.

Prior to the BWR regime, female leptin concentrations and RBC-SOD activities were significantly higher than in males (p<0.001; p<0.05). The BWR regime resulted in a significant decrease in body weight and BMI in both males and females (p<0.001) and significant changes in body composition variables such as body fat mass, waist and hip circumferences (p<0.001). Following the BWR program, leptin concentration decreased significantly (p<0.01) in females and males, respectively. The RBC-SOD activities increased significantly (p<0.01) in females and males, respectively, after the BWR regime. Three possible explanations exist that account for the increase in SOD activity: (A) oxidative stress produced by exercise during the BWR regime; (B) enhanced anti-oxidative ability after losing weight; and, (C) oxidative stress produced by plasma leptin is strongly correlated with SOD as RBC-SOD activity increased as plasma leptin levels reduced. Weight reduction following the BWR regime were negatively correlated with initial leptin (p<0.001). We summarized a linear regression equation that can predict a weight loss of 8.13-3.78 kg with the initial leptin concentration of 5-30ng/ml after 8-week BWR program.

並列關鍵字

risk perception ； reduce risk ； degree of weight loss ； leptin ； superoxide dismutase (SOD)

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