肥胖者與正常體重者飲食,營養狀況及其相關因素的探討
Comparison of nutrition-related factors between normal weight and
obese group
中文摘要 國人肥胖的人口逐年上升，而肥胖與高血壓、糖尿病、心血管疾 病等慢性疾病的罹病率與死亡率有極大的正相關。究竟肥胖者和 正常體重者在飲食和營養素的攝取上是否有不同呢？影響體重的 因素又為何 ? 是本研究探討的重點。本研究以 20 - 60 歲的成年 女性為研究對象，依身體質量指數（BMI）＝22 為標準，分成肥 胖者（BMI * 26.5 , n＝50）和正常體重者（19.8 * BMI * 24.2 , n＝46），進行體位測量、血液生化值、問卷和 24 小時飲食回 憶的評估。結果顯示：(一)在體位測量方面：肥胖者體重、身體 質量指數(BMI)、BMI %、腰圍、臀圍、腰臀圍比值（WHR）、上臂 圍、上臂肌圍、三頭肌皮脂厚度、收縮壓及舒張壓均大於正常體 重者 (P<0.05)。(二)在血液生化值方面：肥胖者血清三酸甘油 酯、總膽固醇 / 高密度脂蛋白(HDL-C) 比值顯著較正常體重者 高，但 HDL-C 值顯著較正常體重者低 (P<0.05)。腰臀圍比值與 血壓、血脂質呈現顯著的相關性，即腰臀圍比值愈大者，其罹患 高血壓、心血管疾病的危險性就愈高。(三)在飲食習慣方面：肥 胖者嗜吃甜食、高油脂飲食，美食當前較難控制自己攝食的份量 (P<0.05)，且情緒因素較易引起其攝食行為。(四)在營養知識 方面：兩組無顯著差異。然而正常體重者營養知識與飲食習慣呈 現正相關 (r＝0.46 , P＝0.001)，但在肥胖者卻無此相關性的存 在。(五)在熱量及營養素攝取量上：兩組無顯著差異，且兩組均 有 60 %以上的人其三大營養素攝取量的比例不符合建議量。兩組 在運動消耗熱量上也無顯著差異。(六)正常體重者體型誤認率 71.8 %高於肥胖者的 24.0 %。而肥胖者體型不安情形略高於正常 體重者。(七)兩組人對於肥胖的態度敘述多呈負面的看法。(八) 大部分肥胖者在生產後或最近一年開始發胖，其減肥的動機以自 己主動想到居多（54.5 %），減肥的目的是為了身體健康或美觀 ，40 %的人採用節食的方式減肥，最想減重的部位以整體的體態 佔大多數(71 %)，運動不足及飲食過度是自認為導致肥胖的主要 原因。73 %的人在參加減重計劃後能有效的使體重下降，但 46 % 的人其所減輕的體重只能維持 1 - 3 個月，只有 9 %的人能維持到 現在。英文摘要
The prevalence of obesity is increasing in Taiwan, and obesity is highly correlated to the mortality and morbidity of hypertension, diabetic mellitus and cardiovascular disease. It is important to know the differences on dietary patterns and nutrient intake
between normal weight and obese groups and the factors that influence body weight. This study was conducted to investigate the differences on anthropometric, biochemical, questionnaire and 24-h recall for normal weight（19.8 * BMI * 24.2 , Body Mass Index (kg/m2)； n=46）and obese groups（BMI * 26.5 ; n=50）. (1) The anthropometric results showed that the levels of waist, hip, waist-to-hip ratio (WHR), mid-arm circumference, triceps skinfold thickness (TSF) and diastolic/systolic blood pressure were higher in obese group than in the normal-weight group ( P<0.05 ). (2) The biochemical data indicated that the obese group had higher
triglyceride and total cholesterol (TC) / high density lipoprotein cholesterol (HDL-C) ratio but lower HDL-C level than the normal weight group ( P<0.05 ). The blood pressure and lipid levels were positively correlated with WHR level. (3) The dietary pattern questionnaire showed that the obese group ate more sweet and high fat content foods than normal weight group ( P<0.05 ). The tendency of emotional eating existed in obese group. (4) There was no difference on knowledge score between two groups, but a positive correlation existed between knowledge and dietary practices for normal weight group ( r=0.46 , P＝0.001 ). (5) There was no difference on energy and nutrients intake between two groups. However, more than 60 % of adults did not meet the recommendation for the proportion of three macronutrients set by NHA (National Health Administration). There*s no evidence of difference in exercise energy expenditure in two groups . (6) The distoration of body image was significantly higher in normal weight group than obese group with the percentage of 71.8 % and 24 % , respectively. Obese
group had a tendency of higher scores on individual body image attitude statements than normal-weight group. (7) Both groups showed a negative view on attitudes
regarding obesity. (8) Most obese people gained weight after delivery or within recent one year. The major motivation of losing weight was self decision. The purpose of losing weight were health or beauty. Forty percent of obese people used diet to lose weight. Less exercise and excess intake of foods were the major causes of gaining weight. Seventy-three percent of obese lost weight after weight-control program. Forty-six
percent obese maintained weight for only 1-3 months, and only 9 % people could maintain weight until now.
