長期追蹤兒童飲食研究：膳食纖維攝取

國內外許多研究皆肯定攝取足夠的膳食纖維對健康的重要，且針對兒童及成人皆有訂出建議攝取量。先前研究發現充足的膳食纖維攝取可幫助抵抗某些疾病，兒童的飲食攝取趨勢改變連帶影響營養素攝取，因此瞭解兒童長期飲食營養的攝取狀況十分重要。本研究為一長期追蹤世代研究，透過問卷調查收集兒童飲食資料及生活背景等相關資料，以瞭解各年齡兒童膳食纖維攝取狀況與生長發展情形。本研究於民國91年於台北市立婦幼醫院招募151位受訪者，利用24小時飲食回憶及家庭問卷，收集孩童從出生至滿10歲的飲食營養、生長發展、健康、家庭背景資料。本研究以兒童的體重、身高及BMI來評估兒童生長狀況，營養狀況則分析兒童2歲至10歲時，兩日24小時平均攝取量，包含：膳食纖維、熱量、蛋白質、脂質、醣類、維生素與礦物質，以此評估兒童之各類營養素攝取是否達到建議攝取量。使用廣義估計公式檢定各年齡的營養素攝取量是否有顯著差異，以t檢定判別男、女童是否有差別。在生長發展方面，2至10歲兒童之身高、體重與BMI均符合國民健康署公布之生長曲線的正常範圍，顯示生長狀況良好，除2歲時男童體重顯著高於女童，其餘年齡皆無顯著差異。營養素攝取方面，三大營養素佔總熱量之比例為：蛋白質14%，脂肪27-30%，醣類57-60%。本研究發現2至10歲兒童之熱量攝取稍低於DRIs，蛋白質攝取皆達DRIs；膳食纖維攝取量在2歲時為4克；3歲時6克；4歲時7克；5歲時8克；6歲時7克；9歲時9克；10歲時為10克，隨年齡增加，攝取量有顯著增加。若以每公斤體重之膳食纖維攝取量來評估，則2至5歲之攝取量皆隨年齡增加，6、9及10歲時，則呈現下降趨勢。大部分的營養素攝取量皆隨年齡增加，而鈣質攝取量則隨年齡增加呈下降趨勢，4歲至10歲兒童之鈣質攝取量僅達DRIs之34-64%，10歲時之鐵攝取量也僅達51%。2至5歲兒童之維生素C攝取量達DRIs，但9及10歲兒童則略低於DRIs。膳食纖維攝取在淨相關分析發現和植物性蛋白質、鎂、葉酸及維生素C(r = 0.3-0.5，p < 0.01 )呈顯著正相關。膳食纖維攝取和體重、身高及BMI在淨相關的部分則未發現顯著相關性。以多元迴歸分析膳食纖維與生長的關係，並未發現相關性。綜上所述，兒童2至10歲的生長情形良好；在營養攝取部分，總膳食纖維的主要食物來源依序為主食類(42~56%)、蔬菜類(18~28%)及水果類(8~20%)。研究發現各年齡層兒童膳食纖維攝取量均低於「年齡加5克」的建議量，若要改善膳食纖維及各類營養素攝取不足的情況，可以將精緻的主食類替換成全穀類食物，以及增加蔬菜、水果的攝取。

關鍵字

台灣兒童；前瞻型世代研究；生長發展；膳食纖維

並列摘要

Many studies have confirmed the health benefits of consumption of dietary fiber during childhood, and have developed the recommendation guidlines for children. Many diseases originate from childhood, thus it is important to examine the nutrient intakes including dietary fibers and growth development for children. This a long term follow-up study, subjects were recruited from Taipei Municipal Women’s and Children’s Hospital in 2002. We collected the information for growth development and nutrition status of children from birth to 10-year-old by using the questionnaires to collect related information including two day 24-hour recalls, health and family background to assess growth and the average intakes of dietary fibers, energy, protein, fat, carbohydrate and other nutrients. We used the generalized estimating equation (GEE) to examine if there were significant differences of nutrient intakes between different ages, and used t-test to examine the differences between boys and girls. The average weight, height and body mass index of the participants lay in normal range when compared with the published growth curve in Taiwan. The percentages of energy from protein, fat and carbohydrate from 2 to 10 years old were from 14%, 27-30% and 57-60% respectively. This study revealed that the average calories intake for children was slightly lower than the DRIs. The average protein intake met DRIs. The total dietary fiber intakes of children at 2 year-old was 4 g, 6 g at 3 year-old, 7 g at 4 year-old, 8 g at 5 year-old, 7 g at 6 year-old, 9 g at 9 year-old, and 10 g at 10 year-old. The means from 2 to 5 years old for dietary fiber per kilogram of body weight increased with age, but 6, 9 and 10 years old decreased. Most ntrient intakes increased with age, while the calcium intake decreased with age. The vitamin C intake reached the recommendation at 2 to 5 years old, but children aged 9 and 10 didn’t meet the DRIs. Partial correlation analysis shows that dietary fiber intake has positive correlation with intakes of plant protein. magnesium (r = 0.50，p < 0.01), folate and vitamin C(r = 0.3-05，p < 0.01 ). There is no significant correlation between dietary fiber intakes and children growth by the multiple regression analysis. Growth and development indices of these children were in the normal ranges. The main food sources of total dietary fiber were grains/tubers (42~58%), vegetables (18~29%) and fruits (9~22%). The children had low intakes of dietary fiber, under the “age + 5” rule, suggesting that increase intake of whole grain food, vegetables and fruits could improve nutritional status.