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  • 學位論文

影響孩童膳食補充品使用之因素探討∼以益生菌、鈣補充品與綜合維生素與礦物質為例∼

Dietary supplements use in Taiwan young children

指導教授 : 陳怡君

摘要


本研究目的為探討影響台灣地區幼兒膳食補充品使用的相關因素及使用之可能原因。 本研究的資料來源為「台灣出生世代研究(Taiwan Birth Cohort Study, 簡稱TBCS)」中在孩童十八個月時收集的資料,包括餵食母乳時間、副食品添加時間及部分家庭背景資料。以分層分階段隨機抽樣的方法,將2005年出生的嬰兒抽出24,200人做為研究樣本。本研究中排除先天性缺陷、早產兒(出生週數在37週以下)、低出生體重(出生體重不到2,500克)及未完成問卷調查之孩童,共計有17,771人進行後續分析,以羅吉斯回歸分析影響孩童十八個月大膳食補充品使用率之重要因素,並輔以育兒雜誌廣告內容分析探討影響膳食補充品使用之可能原因。 育兒雜誌廣告內容分析選定閱讀率前四名雜誌,嬰兒與母親、媽媽寶寶、育兒生活、媽咪寶貝各13本,共計52本進行內容分析。膳食補充品相關廣告選擇以台灣出生世代研究中使用率前六名的補充品為主要目標,依序為益生菌、鈣補充品、綜合維生素/礦物質、魚肝油、乳鐵蛋白、魚油。因補充品也會以添加於幼兒配方奶粉及副食品的型式中並標榜功效,本研究亦將幼兒配方奶粉及副食品等食品廣告均納入分析樣本中,並排除以成人為訴求對象的膳食補充品廣告,共計1,230則廣告做為後續的分析樣本。 結果顯示益生菌、鈣補充品、綜合維生素/礦物質既是台灣出生世代研究資料中孩童最常使用的膳食補充品,也是育兒雜誌食品廣告中較常出現的幾種膳食補充品。因此選定此三種補充品探討影響孩童使用補充品之相關因素,並分為孩童基本特性、孩童飲食型態、孩童健康狀況和家庭狀況四個面向來討論。 在控制其他變項後,羅吉斯回歸結果顯示,母親母乳哺育不到六個月相較於以配方奶哺育的母親、幾乎天天攝取其他乳製品相較於幾乎天天攝取配方奶的孩童、在過去一年中曾因腹瀉而就醫超過三次的孩童相較未因腹瀉而就醫的孩童,其益生菌、鈣補充品、綜合維生素/礦物質使用率均顯著較高。 出生為老大的孩童相較於出生非老大的孩童、每天看電視時間超過二小時相較於每天看電視不到二小時的孩童,其益生菌及鈣補充品的使用率較高。有過敏體質相較沒過敏體質的孩童、本國籍母親相較於外籍的母親、母親教育程度在大學以上相較於教育程度在高中以下的母親、雙親為健康生活型態相較於不健康生活型態,其孩童益生菌及綜合維生素/礦物質使用率顯著較高。 綜合上述結果顯示孩童的胎別、母親哺育方式、乳製品攝取頻率、孩童看電視時間、母親國籍、母親的教育程度、孩童的過敏體質以及腸胃道的狀況為孩童使用膳食補充品重要的影響因素。然而部分雜誌廣告中所宣稱的功能訴求與前述孩童健康狀況和補充品使用率相符合,因此膳食功能訴求亦可能為影響的重要因素。

並列摘要


This study examined the factors influencing the use of dietary supplements among infants in Taiwan. The data for the study was sourced from the Taiwan Birth Cohort Study (TBCS) which provides a wide range of information on infants aged up to 18 months, including breastfeeding duration, complementary feeding time, and certain family background factors. A total of 24,200 research subjects were selected from the Taiwan National Birth Registration database for 2005using multistage stratified systematic sampling. The sample population was 17,771 children after screening out infants with birth defects, infants born preterm with a gestational age of less than 37 weeks, infants born weighing less than 2,500g, and incomplete questionnaires. Logistic regression was used to analyze the effects of the use of dietary supplements on 18-month-old children in Taiwan and to investigate the possible influencing effects of dietary supplement advertisements in local child-care magazines. This research analyzed the advertising content of 52 issues of Taiwan’s top four child-care magazines (Baby & Mother, Mom Baby, Baby Life, and Mami Baby), according to 2010 readership-survey ratings by Nielsen Media Research, published between June 2006 and June 2007. Based on the findings of the TBCS, the targeted advertisements were for probiotics, calcium, multivitamins/minerals, cod-liver oil, lactoferrin, and fish oil. As such supplements were also added to infant formula and complementary foods to reinforce their dietary benefits, the advertisement sample also covered these additional supplements. The sample totaled 1,230 advertisements after screening out those targeted at adults. The TBCS revealed that probiotics, calcium and multivitamins/minerals were the most commonly used supplements for children, and these were also found to be the most frequently advertised in child-care magazines. Accordingly, this research focused on these three types of dietary supplements and examined the factors influencing their use in terms of the child’s basic characteristics, dietary and health conditions, and family-related factors. After controlling some confounding factors, the Logistic regression showed that, in the period covered by this research, formula-fed infants took more quantities of probiotics, calcium and multivitamins/minerals than infants breast-fed for less than six months. Children fed on various dairy products were also found to consume more of these dietary supplements than formula-fed infants. Likewise for children with diarrhea problems who visited doctors more than three times a year compared to children with no diarrhea complaints. Probiotics and calcium usage was found to be the highest among first-born children who watched TV for more than two hour a day. Consumption of probiotics and multivitamins/minerals was the highest for children with allergies, where the child’s mother was a university graduate, or the child’s parents followed a healthy lifestyle. Overall, this research found the significant factors influencing the use of dietary supplements among infants in Taiwan to be: birth order; infant feeding status; milk intake frequency; TV time; maternal country; maternal education; allergy status; and gastrointestinal status. The advertisement promotion of dietary supplements as good for children’s health was considered to be another important contributory factor to their usage.

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