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研究生: 蔡彥如
Yen-Ju Tsai
論文名稱: 長期追蹤兒童飲食研究:膳食纖維攝取
A Long-term Follow-up Study of Children: Dietary Fiber Intakes
指導教授: 盧立卿
Lyu, Li-Ching
學位類別: 碩士
Master
系所名稱: 人類發展與家庭學系
Department of Human Development and Family Studies
論文出版年: 2015
畢業學年度: 103
語文別: 中文
論文頁數: 144
中文關鍵詞: 台灣兒童前瞻型世代研究生長發展膳食纖維
英文關鍵詞: Taiwanese children, prospective cohort study, growth development, dietary fiber
DOI URL: https://doi.org/10.6345/NTNU202205253
論文種類: 學術論文
相關次數: 點閱:255下載:24
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  • 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。

    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.

    第一章 緒論 1 第一節 研究動機 1 第二節 研究目的與問題 2 第三節 名詞解釋 3 第二章 文獻探討 4 第一節 膳食纖維種類及功能 4 第二節 兒童膳食纖維攝取相關研究 7 第三節 兒童生長發展相關研究 10 第四節 膳食纖維與兒童生長發展之相關性 12 第三章 研究方法 15 第一節 研究架構 15 第二節 研究設計與實施程序 17 第三節 研究對象與研究工具 19 第四節 資料收集與處理 24 第四章 結果 36 第一節 兒童基本資料 36 第二節 兒童生長情形 40 第三節 兒童飲食及營養素攝取狀況 46 第四節 兒童膳食纖維攝取狀況 77 第五節 兒童膳食纖維攝取與生長發展之相關性分析 86 第六節 兒童膳食纖維攝取與生長發展之多元迴歸分析 88 第五章 討論 96 第一節 兒童生長狀況 96 第二節 兒童膳食纖維與其它營養素攝取狀況 97 第三節 兒童膳食纖維攝取與生長發展之關係 104 第六章 結論 105 第七章 研究制與建議 107 參考文獻 109 中文 109 英文 111 附 錄 125 附錄一 學童九歲及家庭問卷 126 附錄二 學童九歲及家庭問卷變項編碼 137 附錄三 師大食品營養素資料庫膳食纖維與日本之差異 146 附錄四 兒童體位變化情形 148 附錄五 兒童較常攝取一般家庭食物類別及項目 149

    一、中文
    日本厚生勞動省(民94)。五訂増補日本食品標準成分表說明。民103年9月16日,取自http://www.mext.go.jp/component/b_menu/shingi/toushin/__icsFiles/afieldfile/2011/06/01/1299011_1.pdf
    付全意、劉冬、李堅斌、鄧立高、王彦玲(2008)。膳食纖維提取方法的研究進展。食品科技,33(2),225-228。
    吳幸娟、潘文涵、葉乃華、張新儀(2007)。台灣國小學童營養健康狀況調查 2001-2002以24小時飲食回顧法評估國小學童膳食營養狀況。取自https://consumer.fda.gov.tw/Reasearch/2001%20-%202002/B.pdf
    李芳靚(2010)追蹤孕產期至六歲幼童飲食營養與生長育之前瞻性研究(未出版之碩士論文)。國立臺灣師範大學,臺北市。
    侯金杏、徐光華、林世忠,張仙平(2004)。台北市北投區幼稚園及托兒所膳食供應之營養現況分析。健康促進暨衛生教育雜誌24,95-110。
    張慈桂、藍忠孚、李燕嗚、王本榮(2004)。影響學齡前兒童過重相關因素之探討。臺灣公共衛生雜誌23(6),487-496。
    張慧芝(2001)。人類發展-兒童心理學。台北市:桂冠。
    許瑩瑩(2009)。嬰兒餵食方式對嬰兒生長及行為發展之影響:台灣出生世代之研究。
    陳姮霏(2003)。懷孕婦女飲食狀況對新生兒體型影響之前瞻性研究(未出版之碩士論文)。國立臺灣師範大學,臺北市。
    陳偉德、蔡承諺、陳安琪、吳淑芬、林宗文、林曉娟(2003)。台灣地區兒童及青少年生長曲線圖。依健康體適能訂定之標準。中臺灣醫誌8(2),85-93。
    衛生福利部食品藥物管理署(民100)。國人膳食營養素參考攝取量及其說明(修訂第7版)。台北市。
    衛生福利部食品藥物管理署(民101)。臺灣地區食品營養成份資料庫。2012年3月28日,取自http://consumer.fda.gov.tw/
    衛生福利部食品藥物管理署(民95)。國民飲食指標參考手冊。民95年11月1日,取自http://www.bhp.doh.gov.tw/bhpnet/portal
    嚴金恩、黃怡嘉(2007)。素食與非素食兒童及其父母的飲食攝取與營養狀況之研究。朝陽人文社會學刊2,177-200。
    二、英文
    Aggett, P. J., Agostoni, C., Axelsson, I., Edwards, C. A., Goulet, O., Hernell, O., Michaelsen, K. F. (2003). Nondigestible carbohydrates in the diets of infants and young children: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr, 36(3), 329-337.
    Alexy, U., Kersting, M., & Sichert-Hellert, W. (2006). Evaluation of dietary fibre intake from infancy to adolescence against various references–results of the DONALD Study. European journal of clinical nutrition, 60(7), 909-914.
    Anderson, J. W., Baird, P., Davis Jr, R. H., Ferreri, S., Knudtson, M., Koraym, A., Williams, C. L. (2009). Health benefits of dietary fiber. Nutrition reviews, 67(4), 188-205.
    Berkey, C. S., Rockett, H. R., Field, A. E., Gillman, M. W., Frazier, A. L., Camargo, C. A., & Colditz, G. A. (2000). Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatrics, 105(4), e56-e56.
    Board, F. N. (2002). Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (Macronutrients): Book Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). USA: The National Academies Press.
    Bosscher, D., Van Caillie-Bertrand, M., & Deelstra, H. (2002). Daily dietary fibre intake of children, 2 to 3 years of age, living in Antwerp, Belgium. Nutrition Research, 22(12), 1401-1411. doi: Pii S0271-5317(02)00483-9
    Brooks, S. P., Mongeau, R., Deeks, J. R., Lampi, B. J., & Brassard, R. (2006). Dietary fibre in baby foods of major brands sold in Canada. Journal of Food Composition and Analysis, 19(1), 59-66.
    Butte, N. F., Fox, M. K., Briefel, R. R., Siega-Riz, A. M., Dwyer, J. T., Deming, D. M., & Reidy, K. C. (2010). Nutrient Intakes of US Infants, Toddlers, and Preschoolers Meet or Exceed Dietary Reference Intakes. J Am Diet Assoc, 110(12, Supplement), S27-S37. doi: http://dx.doi.org/10.1016/j.jada.2010.09.004
    Chan, J. S. H. (2005). A community-based study of the prevalence of constipation in young children and the role of dietary fibre. Hong Kong Med J, 11(6), 431-6.
    Crespo, C. J., Smit, E., Troiano, R. P., Bartlett, S. J., Macera, C. A., & Andersen, R. E. (2001). Television watching, energy intake, and obesity in us children: Results from the third national health and nutrition examination survey, 1988-1994. Arch Pediatr Adolesc Med, 155(3), 360-365. doi: 10.1001/archpedi.155.3.360
    da Silva, L. P., & Ciocca, M. d. L. S. (2005). Total, insoluble and soluble dietary fiber values measured by enzymatic–gravimetric method in cereal grains. Journal of Food Composition and Analysis, 18(1), 113-120.
    Davis, J. N., Alexander, K. E., Ventura, E. E., Toledo-Corral, C. M., & Goran, M. I. (2009). Inverse relation between dietary fiber intake and visceral adiposity in overweight Latino youth. American Journal of Clinical Nutrition, 90(5), 1160-1166. doi: DOI 10.3945/ajcn.2009.28133
    Dhingra, D., Michael, M., Rajput, H., & Patil, R. T. (2012). Dietary fibre in foods: a review. J Food Sci Technol, 49(3), 255-266. doi: 10.1007/s13197-011-0365-5 Doi 10.1016/S0271-5317(02)00483-9
    Dwyer, J. T. (1995). Dietary fiber for children: How much?. Pediatrics, 96(5), 1019-1022.
    Englyst, H. N., & Hudson, G. J. (1996). The classification and measurement of dietary carbohydrates. Food Chemistry, 57(1), 15-21.
    Englyst, H. N., Trowell, H., Southgate, D. A., & Cummings, J. H. (1987). Dietary fiber and resistant starch. The American journal of clinical nutrition, 46(6), 873-874.
    Gaskin, P. S., Lai, P., Guy, D., Knight, J., Jackson, M., & Nielsen, A. L. (2012). Diet, physical activity, weight status, and culture in a sample of children from the developing world. J Nutr Metab, 2012, 242875. doi: 10.1155/2012/242875
    Gidding, S. S., Dennison, B. A., Birch, L. L., Daniels, S. R., Gilman, M. W., Lichtenstein, A. H., . . . Van Horn, L. (2005). Dietary Recommendations for Children and Adolescents A Guide for Practitioners: Consensus Statement From the American Heart Association. Circulation, 112(13), 2061-2075.
    Hampl, J. S., Betts, N. M., & Benes, B. A. (1998). The 'age+5' rule: comparisons of dietary fiber intake among 4- to 10-year-old children. J Am Diet Assoc, 98(12), 1418-1423. doi: 10.1016/S0002-8223(98)00320-4
    Ishida, H., Suzuno, H., Sugiyama, N., Innami, S., Tadokoro, T., & Maekawa, A. (2000). Nutritive evaluation on chemical components of leaves, stalks and stems of sweet potatoes Ipomoea batatas poir. Food Chemistry, 68(3), 359-367.
    Kranz, S., Mitchell, D. C., Siega-Riz, A. M., & Smiciklas-Wright, H. (2005). Dietary fiber intake by American preschoolers is associated with more nutrient-dense diets. J Am Diet Assoc, 105(2), 221-225. doi: DOI 10.1016/j.jada.2004.11.005
    Lee, Y., Lee, H.-J., Lee, H.-S., Jang, Y.-A., & Kim, C.-i. (2008). Analytical dietary fiber database for the National Health and Nutrition Survey in Korea. Journal of Food Composition and Analysis, 21, S35-S42.
    MacArtain, P., Gill, C. I., Brooks, M., Campbell, R., & Rowland, I. R. (2007). Nutritional value of edible seaweeds. Nutrition reviews, 65(12), 535-543.
    Martone, D., Roccaldo, R., Censi, L., Toti, E., Catasta, G., D'Addesa, D., & Carletti, C. (2013). Food consumption and nutrient intake in Italian school children: results of the ZOOM8 study. International journal of food sciences and nutrition, 64(6), 700-705.
    McCleary, B. V. (2003). Dietary fibre analysis. Proceedings of the Nutrition Society, 62(01), 3-9.
    Mitchell, M. K. (2003). Nutrition across the life span: WB Saunders.
    Murakami, K., Miyake, Y., Sasaki, S., Tanaka, K., & Arakawa, M. (2011). Dietary glycemic index and glycemic load in relation to risk of overweight in Japanese children and adolescents: the Ryukyus Child Health Study. Int J Obes, 35(7), 925-936.
    Nicklas, T., & Hayes, D. (2008). Position of the American Dietetic Association: nutrition guidance for healthy children ages 2 to 11 years. J Am Diet Assoc, 108(6), 1038.
    Ramulu, P., & Udayasekhara Rao, P. (2003). Total, insoluble and soluble dietary fiber contents of Indian fruits. Journal of Food Composition and Analysis, 16(6), 677-685.
    Roseman, M. G., Yeung, W. K., & Nickelsen, J. (2007). Examination of weight status and dietary behaviors of middle school students in Kentucky. J Am Diet Assoc, 107(7), 1139-1145.
    Ruottinen, S., Lagström, H. K., Niinikoski, H., Rönnemaa, T., Saarinen, M., Pahkala, K. A., . . . Simell, O. (2010). Dietary fiber does not displace energy but is associated with decreased serum cholesterol concentrations in healthy children. The American journal of clinical nutrition, 91(3), 651-661.
    Sette, S., Le Donne, C., Piccinelli, R., Arcella, D., Turrini, A., & Leclercq, C. (2011). The third Italian National Food Consumption Survey, INRAN-SCAI 2005–06–part 1: nutrient intakes in Italy. Nutrition, Metabolism and Cardiovascular Diseases, 21(12), 922-932.
    Williams, C. L. (2006). Dietary fiber in childhood. Journal of Pediatrics, 149(5), S121-S130. doi: DOI 10.1016/j.jpeds.2006.06.066
    Williams, C. L., & Bollella, M. (1995). Is a high-fiber diet safe for children?. J Pediatri, 96(5), 1014-1019.
    Williams, C. L., Bollella, M., & Wynder, E. L. (1995). A new recommendation for dietary fiber in childhood. J Pediatri, 96(5), 985-988.
    Zanovec, M., O'Neil, C. E., Cho, S. S., Kleinman, R. E., & Nicklas, T. A. (2010). Relationship between whole grain and fiber consumption and body weight measures among 6-to 18-year-olds. J Pediatr, 157(4), 578-583.

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