長期追蹤研究台灣家庭之二到六歲幼童飲食變化與生長速度

飲食狀況與生長發展息息相關，但較少研究針對食物類別與生長速度進行探討，因此本研究將以食物類別及營養素的角度，觀察幼童2~6歲期間的飲食變化，分析其食物類別及營養素攝取量對於生長速度的影響。同時，觀察幼童飲食與母親之間的相關性，藉以了解母親對於幼童飲食的影響程度。研究對象為民國91年及98年招募的2個長期追蹤世代，包括北中南區家庭，每年定期以電話訪問的方式收集24小時飲食回憶及體位等資料，持續追蹤至6歲(n=150)，而本研究將幼童2~6歲及其母親的資料利用統計軟體SPSS23.0進行分析。研究結果顯示，北中南區幼童和母親飲食並無地區差異。體位方面，分析幼童2~6歲體重、身高、BMI及生長速度（體位增加量）皆符合國內外生長曲線之正常範圍。飲食攝取方面，大部分食物類別攝取量隨著年齡增加多呈顯著增加的趨勢，奶粉及起司攝取量則隨著年齡增加呈顯著降低的趨勢，且蔬菜類、水果類、奶類攝取量偏低；熱量及大部分營養素攝取量隨著年齡增加多呈顯著增加的趨勢，但維生素C、鈣、鐵的攝取量隨著年齡增加呈顯著降低的趨勢，而幼童2~6歲熱量攝取量皆比DRIs適度活動量之建議量低，蛋白質攝取量皆比建議量高，鐵的攝取量皆比建議量低，鈣的攝取量則在4歲之後低於建議量。觀察幼童2~6歲飲食變化，2歲時奶類為熱量和多種營養素的主要食物來源，3、4歲後熱量及營養素來源大多非由奶類所供應，逐漸以一般家庭飲食為主，顯示3、4歲為幼童飲食變化的轉變點。觀察影響幼童生長速度之因素，發現雙親體位可能會影響幼童2~6歲體重及身高增加量，另外，飲食方面顯示2~6歲平均植物油類攝取量與體重增加量(r=0.319)及體重z分數增加量(r=0.269)呈顯著正相關，平均肉類及水果類攝取量與身高增加量(r肉=0.231，r果=0.251)及身高z分數增加量(r肉=0.229，r果=0.249)呈顯著正相關；2~6歲平均植物性脂質攝取量與體重增加量呈顯著正相關(r=0.215)，平均熱量(r=0.225)、維生素B6(r=0.240)、膽鹼(r=0.247)、鉀(r=0.217)攝取量與身高增加量呈顯著正相關，平均熱量(r=0.217)、脂質(r=0.227)、膽鹼(r=0.219)攝取量與身高z分數增加量呈顯著正相關。而母親與幼童之間飲食攝取相關性中，發現3歲後多種食物類別及營養素攝取量與母親飲食皆有顯著正相關，海鮮類(r=0.225~0.455)、肉類(r=0.170~0.346)及水果類(r=0.223~0.601)的攝取量在3~6歲皆與其母親攝取量有顯著正相關，而相關係數隨著年齡增加而降低；幼童植物性蛋白質(r=0.216~0.418)、膳食纖維(r=0.200~0.486)、葉酸(r=0.182~0.398)、鈉(r=0.221~0.765)、鎂(r=0.171~0.455)攝取量在3~6歲亦與其母親攝取量有顯著正相關。綜合以上，雖然家庭遺傳（雙親體位）可能為影響幼童生長速度（體位增加量）的因素，但藉由後天適當的飲食攝取─選擇高營養密度食物，提供幼童充足的微量營養素，有助於身高之生長。而幼童轉變為一般家庭飲食後，家庭（母親）的飲食習慣會直接影響孩子，因此除了了解幼童平時的飲食攝取情形之外，母親亦須注意自己的食物選擇，才能培養孩子均衡的飲食習慣。

關鍵字

幼童；生長速度；飲食變化；食物類別；母親

並列摘要

The dietary status is related to growth and development, but few studies focus on the influence between the food groups and growth rate. Therefore, this study would observe dietary transition in young children aged 2 to 6 years old and analyze their food groups and nutrients intake impact on the growth rate. In addition, this study examines the relationships of diets between young children and their mothers. The subjects were recruited in 2002 and 2009 from two cohorts inclouded north, middle and south Taiwan. Interviewers gathered the 24-hour dietary recalls, anthropometric measures, and other information every year by telephone until children was 6 years old (n=150). In this study, data from 2 to 6 years old young children and their mothers were using software SPSS 23.0 for statistical analysis. The results of the study show that no difference in the diet of young children and mothers in the north, middle and south Taiwan. The weight, height, BMI and growth rate (weight/height gain) of young children aged 2 to 6 years old were in the normal ranage of the Taiwan and international growth standards. This study found most food groups intake of young children increased annually but dried milk and cheese intake decreased annually, and the vegetables, fruits and dairy products were low intake, energy and most nutrients intake of young children increased annually but vitamin C, calcium and iron intake decreased annually. The energy intake of young children aged 2 to 6 years old was lower than the recommended value of DRIs moderate activity, protein intake was higher than the recommended value, iron intake was lower than the recommended value and calcium intake after 4 years old was lower than the recommended value. Dietary transition in young children from 2 to 6 years old, dairy products were the main source of energy and various nutrients at the age of 2. Energy and most of the nutrients after 3 and 4 years old were not supplied by dairy products, and they were gradually dominated by the general family diet. Therefore, the ages at 3 and 4 years old were the point for dietary transition in young children. We found that parents’ weight and height may affect the weight gain and height gain of young children aged 2 to 6 years. In addition, there were significantly positive correlations between vegetable oil intake and weight gain (r=0.319), weight-for-age z-score (WAZ) gain (r=0.269), meat and fruit intake and height gain (rmeat=0.231, rfruit=0.251), height-for-age z-score (HAZ) gain (rmeat=0.229, rfruit=0.249) during 2 to 6 years of age. In the mealtime, we also found that significantly positive correlations between plant fat intake and weight gain (r=0.215), energy (r=0.225), vitamin B6 (r=0.240), choline (r=0.247) and potassium (r=0.217) intake and height gain, energy (r=0.217), fat (r=0.227), choline (r=0.219) intake and height-for-age z-score (HAZ) gain during 2 to 6 years of age. In relation to dietary intakes between mothers and young children, this study shows that various food groups and nutrients intake were significantly positive correlations with mothers after 3 years old. Seafood (r=0.225-0.455), meat (r=0.170-0.346) and fruit (r=0.223-0.601) intakes had significantly positive correlations between young children aged 3 to 6 years old and their mothers; however, the correlation coefficients decreased with age. Plant protein (r=0.216-0.418), dietary fiber (r=0.200-0.486), folic acid (r=0.182-0.398), sodium (r=0.221-0.765) and magnesium (r=0.171-0.455) intakes also had significantly positive correlations between young children aged 3 to 6 years old and their mothers. In conclusion, our results show that parents’ weight and height may be factors that affected young children's growth rate (weight/height gain), but acquired by proper dietary intakes, choose high nutrient density foods to provide young children with sufficient micronutrients to help height growth. However, the eating habits from the family (mothers) would directly affect the children after their diet transition to the general family diet. Therefore, in addition to understand the dietary intakes of young children, mothers must also pay attention to their own food choices in order to train their children for healthy diet habits.