台灣不同世代老年人的肥胖盛行率及相關因素之探討

Prevalences of obesity across different cohorts of Taiwanese elders, 1989 to 2007

林書郁(Lin Shu-Yu)

指導教授 ： 董和銳

亞洲大學/健康學院/健康管理研究所/碩士(2011年)

摘要

背景與目的：肥胖將是21世紀全球重要的公共衛生問題之一，台灣近年來肥胖盛行逐年增加，從「2005-2008國民營養健康狀況調查」與「1993-1996國民營養健康狀況調查」之間的變化，台灣成人的輕度肥胖（BMI≧27）及中重度肥胖（BMI≧30）的盛行率分別從8.1%及2.4%增加為13.0%與6.0%。而肥胖與許多主要死因疾病高度相關。本研究利用具全國代表性的「台灣中老人身心狀況長期追蹤調查」資料，實證地檢視在20世紀前半出生的老人家所經歷的社會變遷與肥胖盛行情形的世代效果（Cohort Effect ）。
研究方法：本研究利用1989年、1999年及2007年之「台灣地區中老年身心社會生活狀況長期追蹤調查」之身高及體重資料來檢視不同世代出生之台灣老人之肥胖率變化情形，並將出生世代化為虛擬變項，以邏輯斯迴歸分析不同出生世代對肥胖盛行率之影響。
研究結果：不同出生世代的台灣老年人口在肥胖情形上有明顯的世代間差異。就體位過輕（BMI<18.5）的盛行情形來看，從1989年的70-74歲（1915-1919年出生者），到1999年的70-74歲（1925-1929年出生者），再到最近的2007年的68-72歲（1935-1939年出生者），「肥胖」的盛行率從12.3%降到7.0%，再降到4.0%。就肥胖（BMI>27.0）的盛行情形來看，從1989年的60-64歲（1925-1929年出生者），到1999年的60-64歲（1935-1939年出生者），再到最近的2007年的58-67歲（1940-1949年出生者），「肥胖」的盛行率從11.9%增加到17.0%，再增加到20.5%-21.2%。此外，肥胖之情形隨著年齡的增加而增加，到達某一年齡層後，肥胖會有下降之可能性。而女性和外省人其肥胖之比例較高；接受教育十年以上者肥胖之比例較低。
結論與建議：研究結果顯示，台灣不同世代老人之間營養狀況及生活水準有顯著的變遷，愈後面的世代體重過輕的現象愈來愈少，而體重過重或肥胖的現象則愈來愈普遍，因此，對未來的老人族群而言，肥胖預防已是刻不容緩。

關鍵字

肥胖 ； 盛行率 ； 世代

並列摘要

Background and objective:Obesity is going to become a serious public health problem around world in the 21st century. Over recent years, the obesity prevalence rates in Taiwan have been on the rise every year. The changes shown by the results of “2005-2008 Nutrition and Health Survey In Taiwan” and “1993-1996 Nutrition and Health Survey in Taiwan” suggested the prevalence rates of mild obesity (BMI≧27) and moderate-to-severe obesity （BMI≧30）among the adults in Taiwan have increased respectively from 8.1% and 2.4% to 13.0% and 6.0%. Obesity is closely related to many death-causing diseases. This study was conducted based on data obtained from “the Survey of the Health Status of the Middle-aged and the Elderly in Taiwan” to examine the cohort effect of the social changes and obesity prevalence experienced by the elderly born before the first half of the 20th century.

Study Method:In this study data such as heights and weights from “the Survey on the Health and Living Status of the Middle-aged and the Elderly in Taiwan” conducted from 1989, 1999 and 2007 were used to examine the changes in obesity prevalence rates among the elder people of difference birth cohorts in Taiwan. Birth cohorts were converted into dummy variables to analyze their influence on obesity prevalence rates using logistic regression analysis.

Study results:The study found that there were obvious differences in the obesity conditions among the seniors of different birth cohorts in Taiwan. In terms of underweight prevalence (BMI<18.5), the “obesity” prevalence rates among the senior citizens aged 70-74 in 1989 (born in 1915-1919), those aged 70-74 in 1999 (born in 1925-1929) and those aged 68-72 in 2007 (born in 1935-1939) went down from 12.3% to 7.0% and then to 4.0%. In terms of obesity prevalence (BMI>27.0), the obesity prevalence rates among the elders aged 60-64 in 1989 (born in 1925-1929), those aged 60-64 in 1999 (born in 1935-1939), and those aged 58-67 in 2007 (born in 1940-1949) went up from 11.9% to 17.0%, and then to 20.5%-21.2%. Moreover, obesity rates would increase with age, and then might decrease after a certain age. Besides, it was found that the obesity rates among females and mainlanders (those who relocated to Taiwan from China after 1948) were higher compared with other communities and there was a lower obesity rate among those who had received education for longer than 10 years.

Conclusion and suggestions:The results of the study suggested that there were significant changes in the nutrition and living standards of senior citizens of different birth cohorts. There were less and less underweight seniors of later birth cohorts, but overweight and obesity have become more and more common. Consequently, the prevention of obesity has now become a task of great urgency to the elderly in Taiwan.

並列關鍵字

obesity ； prevalence rate ； birth cohorts

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