基隆地區第二型糖尿病患在足量的膳食纖維攝取狀況下魚類供應之多寡對其血糖及血脂質濃度之影響

Effects of dietary fish intake on blood glucose and lipids concentrations with type 2 diabetic patients on adequate dietary fiber intake in Kee-Lung city

張皇瑜(Huang-Yu Chang)

指導教授 ： 鄭心嫻

臺北醫學大學/公共衛生暨營養學院/保健營養學研究所/碩士(2004年)

摘要

基隆因地利之便，漁產品新鮮且容易取得。魚類攝取或魚油補充對於心血管具有保護效果，惟針對第二型糖尿病患者飲食中魚類攝取情況與心血管之相關性研究極為有限。隨著基隆地區糖尿病共同照護網展開，針對此類門診病人飲食中魚類攝取情況對血液生化值影響，為本研究之探討目的。本研究共分三部分，首先比較多吃魚與少吃魚之受試者血糖與血脂質，所得結果發現不如預期，深入分析受試者飲食內容後發現，常吃魚組普遍有膳食纖維攝取不足情況，因而加入了第二部分之米麩介入實驗，藉以確立膳食纖維對第二型糖尿病患之影響程度，在第三部分便修正為在足量膳食纖維 (每日蔬果攝取5份以上) 攝取情況下，多吃魚與少吃魚之第二型糖尿病患血糖與血脂質比較。研究方法為?針對門診119位50-80歲第二型糖尿病患者，依據門診固定專任營養師詢問之飲食紀錄，篩選出蔬果類攝取大於5份者72位，再從中依多吃魚 (? 75 g/週) 與少吃魚 (< 75 g/週) 分成A、B二組，針對受試者血糖、血脂質和血液中脂肪酸組成二組進行分析比較。由本實驗結果看來，對第二型糖尿病人來說，在足量膳食纖維（5份蔬果以上/天）飲食條件下，每週攝取75克以上的魚類相較於少吃魚組，其三酸甘油酯有較低的趨勢，平均值分別為143.3±19.39、169.45±21.75 (mg/dL) ;分析血液中脂肪酸組成，多吃魚組有較低的linoleic acid (18:2) (A:29.96±1.2 ; B:34.23±1) (g/100g total fatty acids)，與較高的n-3族: Docosahexaenoic acid (22:6) (A:2.68±0.2 ; B:2.07±0.28) (g/100g total fatty acids)，二組相比皆有統計上的差異 ( p<0.05)。由以上結果可得結論: 對基隆地區第二型糖尿病人來說，在足量膳食纖維（5份以上/天）飲食條件下，每週攝取75克以上的魚類可明顯降低受試者心血管疾病危害程度，但在膳食纖維不足情形下，即使飲食內容加強魚類攝取，也無法有效發揮魚類對糖尿病患之有利效果。故而對於第二型糖尿患者，營養諮詢時，應在均衡、高纖維飲食原則之下，建議多攝取魚類作為飲食中蛋白質來源，對於病情將有較佳的控制。

關鍵字

魚 ； 膳食纖維 ； 糖尿病患 ； 血糖 ； 血脂質 ； 基隆

並列摘要

Keelung is located near the sea.It is easy to get fresh fishing products there. It has been demonstrated that by consuming fish and fish oil, cardiovascular diseases can be prevented. The relationship between food supplementation of fishing products and cardiovascular diseases in patients suffered from type 2 diabetes mellitus is still not very clear.The objective of the present study was to evaluate relationship between consuming fishing products and the biochemical data of type 2 diabetes.This study included three sections. In the first section, we gave different amounts of fishing product to the diabetes. Then, we evaluated the results of their blood glucose and lipids. However, the results from section one did not meet our expectation. Therefore, we analyzed the dietary food intake of the patients. We found that the patients who consumed more fish had less dietary fiber intake. Based on the results of section one, we gave the subjects rice bran as food supplementation in the section two of the study to evaluate the relationship between dietary fiber and the type 2 diabetes. We refined the study methods again.All patients took sufficient amount of dietary fiber (5 servings of vegetable and fruit per day) in section three. We compared the contents of blood lipid and blood glucose between type 2 diabetes with high and low fish consuming. 119 patients who were 50 to 80 years old were recruited.Seventy-two patients who took more than 5 servings of vegetable and fruit based on the food records recorded by a specific dietitian were included. The patients were randomly assigned to group A (intake ? 75g of fish per week) and group B (intake ? 75g of fish per week). We evaluated the concentrations of blood glucose, lipid, and fatty acid of all patients. Results showed that, the cholesterol content was lower in patients who consumed ? 75g of fish per week than patients who consumed ? 75g of fish per week. The mean value of cholesterol concentration in group A and group B were 143.3 ± 19.4 mg/dL and 169.5 ± 21.8 mg/dL, respectively.The linoleic acid concentration was lower in goup A (30.0 ± 1.2 g/100g total fatty acids) than in group B (34.2 ± 1.0 g/100g total fatty acids) (18:2). Plasma docosahexaenoic acid level in group A and group B were 2.7 ± 0.2 and 2.1 ± 0.3 (g/100g total fatty acids), respectively. The results of fatty acid were statistically significantly (p < 0.05).In conclusion, with sufficient dietary fiber intake(5 servings per day), cardiovascular diseases can be reduced by consuming more than 75g fish per week.However,without sufficient dietary fiber intake,the effect from consuming fish is not significantly beneficial on diabetes. Based on the results of the study, we suggest that type 2 diabetes should have balanced, high dietary fiber, and high fish content diets. It may be helpful for controlling blood glucose and lipid by type 2 diabetes.

並列關鍵字

fish ； dietary fiber ； diabetes ； blood glucose ； blood lipid ； Keelung

參考文獻

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