研究生: |
鄭小嵐 Hsiao-Lan Cheng |
---|---|
論文名稱: |
高齡者飲食習慣與規律運動對其身體組成及血液、尿液生化指標相關性之探討 The correlations of diet, regular exercise, body composition, and the biomarkers in plasma and urine of the elderly |
指導教授: |
湯馥君
Tang, Fu-Chun |
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: | 2004 |
畢業學年度: | 92 |
語文別: | 中文 |
論文頁數: | 78 |
中文關鍵詞: | 高齡者 、飲食 、規律運動 、身體組成 、生化指標 |
英文關鍵詞: | elderly, diet, regular exercise, body composition, biomarkers |
論文種類: | 學術論文 |
相關次數: | 點閱:218 下載:50 |
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本研究目的在探討高齡者飲食攝取與規律運動習慣,對於身體組成及生理代謝之影響。研究對象為台北市大安區60歲(含)以上,有自主意識及運動能力的居民56人。依性別、運動習慣分為高運動男性13人、低運動男性13人、高運動女性16人、低運動女性14人,共四組。資料收集包括:問卷調查、脈搏、血壓測量、身體組成分析、跟骨廣頻超音波衰減率、握力與腳力之測量,血液及尿液生化分析。所得數據進行差異性測試、相關迴歸及分析。結果顯示高運動男性每日熱量攝取、蛋、豆、魚、肉類攝取量、右手握力及左腳睜眼單腳站立時間顯著高於低運動男性 (p < .05) ,而兩組女性則無顯著差異。同性別之高、低運動組的身體組成、雙腳跟骨廣頻超音波衰減率、尿中排泄物及尿液酸鹼值均無顯著差異 (p > .05) 。高運動男性之血漿支鏈胺基酸濃度顯著低於低運動男性者 (p < .05) ,兩組女性則無顯著差異 (p > .05) 。身體質量指數分別與體脂肪重百分比 (r = .605, p < .0001) 、腰臀比 (r = .795, p < .0001) 、三頭肌皮脂厚 (r = .692, p < .0001) 呈正相關;體脂肪重百分比與腰臀比 (r = .714, p < .0001)、 三頭肌皮脂厚 (r = .973, p < .0001) 亦呈正相關。高齡者之蛋白質攝取量分別與肌肉量百分比 (r = .284, p = .0337)、血漿支鏈胺基酸濃度 (r = .320, p = .0174) 呈現正相關,與尿中三甲基組胺酸濃度則呈負相關 (r = -.311, p = .0196) 。而高運動組之蛋白質攝取量與左 (r = .532, p = .0030) 、右 (r = .470, p = .0100) 手握力呈正相關;低運動組則無此相關。尿鈣排泄量與高齡者之骨量 (r = -.433, p = .0009) 、右腳跟骨廣頻超音波衰減率分別呈現負相關(r = -.307, p = .0212),與尿中羥基脯胺酸濃度則呈正相關 (r = .389, p = .0030) 。骨量與左 (r = .687 , p = .0001)、右(r = .722, p = .0001) 腳跟骨廣頻超音波衰減率均為正相關。而高運動組之骨量與左 (r = .535, p = .0028) 、右 (r = .404, p = .0300) 腳站立時間呈正相關;低運動組則無此相關。因此,建議高齡者應攝取足夠之能量與營養素,並配合規律運動,才能有效地增進握力及腳力、維持骨骼之健全,進而提升生命之品質。
The purpose of the study was to investigate the relationship of diet, regular exercise, body composition, and the biomarkers in the plasma and urine of the elderly. Healthy and free-living older adults (n = 56, ages ≧ 60 years) voluntarily participated in this study. Based on gender and regular exercise time, the elderly were divided into four groups: high exercise males (n = 13), low exercise males (n = 13), high exercise females (n = 16), and low exercise females (n = 14). The habits on diet and exercise were recorded. The parameters including pulse rate, blood pressure, body composition, calcaneus broadband ultrasound attenuation (BUA), grip strength and single leg standing duration; plasma amino acid concentrations; urinary urea nitrogen, 3-methylhistidine (3-MH), hydroxyproline (HP), and calcium excretions, and urinary pH value were measured. The energy, egg, bean, fish and meat consumption, the right hand grip strength and the left leg standing duration of the high exercise males were significantly higher than those of low exercise males (p < .05). Within the same gender, there was no significant difference in body composition measurement, BUA, urinary excretions and pH value between the high exercise and low exercise groups. The plasma branched-chain amino acid concentrations of high exercise males were significantly lower than that of low exercise males (p < .05). Body mass index was positively correlated with percentage of body fat mass (r = .605, p < .0001), waist-to-hip ratio (r = .795, p < .0001), and triceps skinfold thickness (r = .692, p < .0001). Percentage of body fat mass was positively correlated with waist-to-hip ratio (r = .714, p < .0001) and triceps skinfold thickness (r = .973, p < .0001). Daily protein intake was positively correlated with percentage of body muscle mass (r = .284, p = .0337) and plasma BCAA concentrations (r = .320, p = .0174); and negatively correlated with urinary 3-MH excretion (r = -.311, p = .0196). There were significant correlations between the daily protein intake and left hand grip strength (r = .532, p = .0030), and right hand grip strength (r = .470, p = .0100) of the high exercise group, but not the low exercise group. Urinary calcium was negatively correlated with bone mass (r = -.433, p = .0009) and right calcaneus BUA (r = -.307, p = .0212); and positively correlated with urinary HP excretion (r = .389, p = .0030). Bone mass was positively correlated with left (r = .687, p < .0001) and right (r = .722, p < .0001) calcaneus BUA. There were significant correlations between the bone mass and left leg standing duration (r = .535, p = .0028), and right leg standing duration (r = .404, p = .0300) of the high exercise group, but not the low exercise group. In conclusion, with adequate intakes of energy and nutrients, regular exercise enhanced muscle strength and bone homeostasis in the elderly.
一、中文部分
王順正(1993)。運動訓練對骨骼肌蛋白質的影響-以尿中3甲基組胺酸的變化來評量,中華體育,25,54-64。
內政部統計處(2000)。中華民國八十九年老人狀況調查報告。臺北市:內政部統計處。
甘龍醫用生理學下冊(白禮源等譯)(1995)。臺北:藝軒。(原著出版年:1991)
行政院統計室(2003)。衛生統計動向-90年人口與家庭。臺北市:行政院統計室。民92年9月1日,取自:http://www.doh.gov.tw/statistic/index.htm
行政院衛生署(1997)。每日飲食指南。臺北市:行政院衛生署。
行政院衛生署(1998)。臺灣常見食品營養圖鑑(編號:016099860023)。臺北市:行政院衛生署。
行政院衛生署(1999)。國民營養現況1993-1996國民營養健康狀況變遷調查結果(修訂版)。臺北市:行政院衛生署。
行政院衛生署(2001)。國人每日營養素建議攝取量。臺北市:行政院衛生署。
李世代(1998)。臺灣老人(醫)學研究之現況與展望。載於詹火生(主編),迎接高齡社會的挑戰(261-278頁)。臺北市:厚生基金會。
李志緯(2001)。利用超音波技術評估骨頭機械特性。國立成功大學醫學工程研究所碩士論文,未出版,臺南。
李宗派(2003)。老人保健與生活科技之學術研究。民92年9月1日,取自:http://www.usc.edu.tw/college/GRC/btr05/btr05-1.htm
李雅雯(2002)。臺灣地區老年人飲食品質相關因素研究。國立臺灣師範大學家政教育研究所碩士論文,未出版,臺北。
言穆仁(1990)。衰老信號與對策。臺北市:科技圖書。
林興中(1995)。骨質疏鬆症之成因。臺灣醫界,38,34-38。
林正常(1989)。老人的運動。臺北市:中華日報出版部。
林以勤、蕭寧馨、邱正芬、林盟喬與潘文涵(2003)。國人骨質健康與營養狀況之關聯-國民營養健康狀況變遷調查1999-2000老人調查結果(摘要)。載於中華民國營養學會學術研討會手冊(28-29頁)。臺北。
吳忠芳、王順正(2001)。基礎代謝。運動生理週訊電子報,第101期。民92年9月10日,取自:運動生理學網站http://epsport.ccu.edu.tw/epsport/week/newspaper.asp?repno=28
吳麗貞(2001)。運動介入對社區老年人健康體能之影響。國立臺北護理學院護理研究所碩士論文,未出版,臺北。
姚維仁(2003)。國人骨密度之偵測與分析(摘要)。載於中華民國營養學會學術研討會手冊(27頁),臺北。
高美丁、曾明淑、葉文婷、張瑛韶、潘文涵(1998)。台灣地區居民體位及肥胖狀況。載於國民營養現況1993-1996國民營養健康狀況變遷調查結果(143-171頁),行政院衛生署。
陳秀珠(1998)。老人運動行為及其相關因素研究-以台北市基督長老教會松年大學五十五歲以上學員為例。國立臺灣師範大學衛生教育研究所碩士論文,未出版,臺北。
陳美齡(2002)。長期運動介入對社區50-75歲中老年人體適能之成效探討。國立臺北護理學院護理研究所碩士論文,未出版,臺北。
梁煥國(主編)(1994)。中國老年百科全書(生理、心理、長壽卷)。北京:寧夏人民。
彭駕騂(1999)。老人學。臺北市:揚智文化。
湯馥君(1994)。飲食中鈣含量與運動對攝食氯化銨之成年雌鼠骨質疏鬆及新陳代謝之影響。臺北市:文景。
楊文山(1999)。臺灣地區老人醫療與照護問題及其因應對策。臺灣社會問題研究學術研討會論文,12,29-30。
董氏基金會(2000)。吸煙率參考資料。民92年9月12日,取自:http://www.jtf.org.tw/JTF06/06-02.htm
臺灣省政府社會處(1999)。臺灣獨居老人生活狀況及對社會福利需求調查報告(編號:012033)。臺灣省政府社會處:南投縣中興新村。
蔡佳良(2000)。不同慣用腳定義在靜態平衡、對地反作用力和速度之比較。國立體育學院運動科學研究所碩士論文,未出版,臺北。
蔡美月(1995)。臺北市某活動中心六十歲以上老人運動行為及其影響因素之研究。國立臺灣師範大學衛生教育系碩士論文,未出版,臺北。
劉兆惠(1998)。不同體脂肪測量法評估高中女生身體組成之研究。國立臺灣師範大學體育研究所碩士論文,未出版,臺北。
劉樹泉(1991)。老人學與老人醫學。臺北市:合記。
蕭淑芬(2003)。中老年人運動行為與醫療就診記錄關係之研究。國立臺灣師範大學體育學系在職進修碩士論文,未出版,臺北。
二、西文部分
Amarantos, E., Martinez, A., & Dwyer, J. (2001). Nutrition and quality of life in older adults. Journals of Gerontology, 56A (Special issue II), 54-64.
Anderson, J. J. B. (2000). The important role of physical activity in skeletal development: how exercise may counter low calcium intake. The American Journal Clinical Nutrition, 71, 1384-1386.
Baumgartner, R. N., Waters, D. L., Gallagher, D., Morley, J. E., & Garry, P. J. (1999). Predictors of skeletal muscle mass in elderly men and women. Mechanisms of Ageing and Development, 107(2), 123-136.
Bischoff, H., Stahelin, H. B., Vogt, P., Friderich, P., Vonthein, R., Tyndall, A., & Theiler, R. (1999). Immobility as a major cause of bone remodeling in residents of a long-stay geriatric ward. Calcified Tissue International, 64, 485-489.
Booth, C. J., Naidoo, D., Rosenberg, A. R., & Kainer, G. (1999). Elevated creatinine after ingestion of model aviation fuel: interference with Jaffe reaction by nitromethane. Journal of Paediatrics and Child Health, 35, 503-504.
Caballero, B., Gleason, R. E., & Wurtman, R. J. (1991). Plasma amino acid concentrations in healthy elderly men and women. The American Journal Clinical Nutrition, 53, 1249-1252.
Carrieri, M., Trevisan, A., & Bartolucci, G. B. (2001). Adjustment to concentration-dilution of spot urine samples: correlation between specific gravity and creatinine. International Archives of Occupational and Environmental Health, 74, 63-67.
Cetin, A., Gokce-Kutsal, Y., & Celiker, R. (2001). Predictors of bone mineral density in healthy males. Rheumatology International, 21, 85-88.
Chan, Y. C., Suzuki, M., & Yamamoto, S. (1999). A Comparison of Anthropometry, Biochemical Variables and Plasma Amino Acids among Centenarians, Elderly and Young Subjects. Journal of the American College of Nutrition, 18(4), 358-365.
Cooper, C., Barker, D. J. P., & Wichham, C. (1988). Physical activity, muscle strength, and calcium intake in fracture of the proximal femur in Britain. British Medical Journal, 297(6661), 1443-1446.
Castell, L. M., & Newsholme, E. A. (2001) The relation between glutamine and the immunodepression observed in exercise. Amino Acids, 20, 49-61.
Deyhim, F., Stoecker, B. J., Brusewitz, G. H., & Arjmandi, B. H. (2003). The effects of estrogen depletion and isoflavones on bone metabolism in rats. Nutrition Research, 23, 123-130.
DiPietro, L. (2001). Physical activity in aging: changes in patterns and their relationship to health and function. Journals of Gerontology, 56A (Special issue II), 13-22.
Dresner-Pollak, R., Parker, R. A., Poku, M., Thompson, J., Seibel, M. J., & Greenspan1, S. L. (1996). Biochemical markers of bone turnover reflect femoral bone loss in elderly women. Calcified Tissue International, 59, 328-333.
Drewnowski, A., & Evans, W. J. (2001). Introduction. Journals of Gerontology, 56A (Special issue II), 5.
Drews, R. E. (2003). A primer on anemia evaluation with case presentations. Primary Care Update Ob/Gyns, 10(4), 151-160.
Elia, M., Carter, A., Bacon, S., Winearls, C.G., & Smith, R. (1981). Clinical usefulness of urinary 3-methylhistidine excretion in indicating muscle protein breakdown. British Medical Journal, 282(6261), 351-354.
Evans, W. J., & Cry-Campbell, D. (1997). Nutrition, exercise, and healthy aging. Journal of the American Dietetic Association, 97(6), 632-638.
Ferrando, A. A., Paddon-Jones, D., & Wolfe, R. R. (2002). Alterations in protein metabolism during space flight and inactivity. Nutrition, 18(10), 837-841.
Georgobiani, A. N., Volkov, V. T., & Vorob’ev, M. O. (2002). Effect of annealing in oxygen radicals on luminescence and electrical conductivity of ZnO:N films. Semiconductors, 36(3), 265-269.
Gerrior, S. A. (2002). The nutrient and anthropometric status oh physically active and inactive older adults. Journal of Nutrition Education and Behavior, 34 (S1), S5-S13.
Giangregorio, L. & Blimkie, C. T. R. (2002). Skeletal adaptations to alterations in weight-bearing activity: a comparison of models of disuse osteoporosis. Sports Medicine, 32(7), 459-476.
Glick, Z. (1995). Energy balance. In J. E. Morly, Z. Glick & L. Z. Ribenstein (Eds.), Geriatric nutrition (pp. 15-24). New York: Raven.
Goodpaster, B. H., Carlson, C. L., Visser, M., Kelley, D. E., Scherzinger, A., Harris, T. B., et al. (2001). Attenuation of skeletal muscle and strength in the elderly: the health ABC study. Journal of Applied Physics, 90, 2157-2165.
Grodsky, G. M. (1983). Chemistry and function of the hormones: IV. Pituitary and hypothalamus. In D. W. Martin, P. A. Mayes, & V. W. Rodwell (Eds.), Harper’s Review of Biochemistry (pp. 523-534). Lange.
Gunby, M. C., & Morley, J. E. (1995). Calcium, vitamin D, and osteopenia. In J. E. Morly, Z. Glick & L. Z. Ribenstein (Eds.), Geriatric nutrition (pp. 107-114). New York: Raven.
Harper, A. E., Block, K. P., & Cree, T. C. (1983). Branched-chain amino acids: nutritional and metabolism interrelationships. In M. Arnal, R. Pion & D. Bonin (Eds.), Protein Metabolism Nutrition 4th International Symposium (pp. 159-181). Paris.
Hartman, C., Brik, R., Tamir, A., Merrick, J., & Shamir, R. (2004). Bone quantitative ultrasound and nutritional status in severely handicapped institutionalized children and adolescents. Clinical Nutritrion, 23, 89-98.
Ho, S. C., Chen, J. L. F., Leung, S. S. F., Lam, T. H., & Janus, E. D. (2001). Sodium is the leading dietary factor association with urinary calcium excretion in Hong King Chinese adults. Osteoporosis International, 12, 723-731.
Holm, G., Sullivan, L., Jagenburg, R., & Bjorntorp, P. (1978). Effects of physical training and lean body mass on plasma amino acid in man. Journal of Applied Physiology, 45, 177-181.
Hunter, G. R., Wetzstein, C. J., Fields, D. A., Brown, A., & Bamman, M.M. (2000). Resistance training increases total energy expenditure and free-living physical activity in older adults. Journal of Applied Physiology, 89, 977-984.
Jakes, R. W., Khaw, K. T., Day, N. E., Bingham, S., Welch, A., Oakes, S., et al. (2001). Patterns of physical activity and ultrasound attenuation by heel bone among Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk): population based study. British Medical Journal, 322, 1-5.
Jeevanandam, M., Young, D. H., Ramias, L., & Schiller, W. R. (1990). Effect of major trauma on plasma free amino acid concentrations in geriatric patients. Am J Clinical Nutrition, 51, 1040-1045.
Jorgensen1, H. L., Warming, L., Bjarnason, N. H., Andersen, P. B., & Hassager, C. (2001). How does quantitative ultrasound compare to dual X-ray absorptiometry at various skeletal sites in relation to the WHO diagnosis categories? Clinical Physiology, 21 (1), 51-59.
Kaiser, F. E. (1995). Nutrition and diabetes mellitus in the elderly. In J. E. Morly, Z. Glick & L. Z. Ribenstein (Eds.), Geriatric nutrition (pp. 211-218). New York: Raven.
Karlsson, M.K., Duan, Y., Ahlborg, H., Obrant, K. J., Gohnell, O., & Seeman, E. (2001). Age, Gender, and fragility fractures are associated with differences in quantitative ultrasound independent of bone mass density. Bone, 28, 118-122.
Kemper, H. C. G. (2000). Skeletal development during childhood and adolescence and the effects of physical activity. Pediatric Exercise Science, 12(2), 198-216.
Kikuchi, M., Inagaki, T., & Shinagawa, N. (2001). Five-year survival of older people with anemia: variation with hemoglobin concentration. Journal of the American Geriatrics Society, 49, 1226-1228.
Larsson, L., & Ramamurthy, B. (2000). Aging-related changes in skeletal muscle: mechanisms and interventions. Drugs and Aging, 17 (4), 303-316.
Logan, P., Moore, J. (2004). Hypertension: getting back to basics. Nursing, 34(Supplement Hypertension), 1-7.
Mickell, J. J. (2001). Urea nitrogen in critically III children. Pediatrics 70(6), 949-955.
Mooradian, A. D. (1995). Theories of aging. In J. E. Morly, Z. Glick & L. Z. Ribenstein (Eds.), Geriatric nutrition (pp. 5-14). New York: Raven.
Morley, J. E. (2001). Decreased food intake with aging. Journals of Gerontology, 56A (Special issue II), 81-88.
Murray, L. A., Reilly, J. J., Choudhry, M., & Durnin, J. V. (1996). A longitudinal study of changes in body composition and basal metabolism in physically active elderly men. European Journal of Applied Physiology and Occupational Physiology, 72(3), 215-218.
Newsholme, E. A., Blomstrand, E., & Ekblom, B. (1992). Physical and mental fatigue: metabolic mechanisms and importance of plasma amino acids. British Medical Bulletin, 48, 477-495.
Patel, S., Coupland, C. A. C., Stone, M. D., & Hosking, D. J. (1995). Comparison of methods of assessing response of Paget's Disease to biphosphonate therapy. Bone, 16(2), 193-197.
Poehlman, E. T., Melby, C. L., & Badylack, S. F. (1991). Relation of age and physical exercise status on metabolic rate in younger and older healthy men. Journals of Gerontology, 46 B, 54-58.
Poehlman, E. T., Turturro, A., Bodkin, N., Cefalu, W., Heymsfield, S., Holloszy, J., et al. (2001). Caloric restriction mimetics: physical activity and body composition changes. Journals of Gerontology, 56A (Special issue I), 45-54.
Praneet, P., Bungsunn, T., Benjaluck, P., Niyomsri, V., Pornrutsami, J., Seevika, V., et al. (2000). Activity, dietary intake, and anthropometry of an informal social group of Thai elderly in Bangkok. Archives of Gerontology and Geriatrics, 30, 245-260.
Pratt, C. A., Woo, V., & Chrisley, B. (1996). The effects of exercise on iron status and aerobic capacity in moderately exercising adult women. Nutrition Research, 16(1), 23-31.
Rejeski, W. J., & Mihalko, S. L. (2001). Physical activity and quality of life in older adults. Journals of Gerontology, 56A (Special issue II), 23-35.
Ronsky, J. L., Nigg, B. M., & Fisher, V. (1995). Correlation between physical activity and the gait characteristics and ankle joint flexibility. Clinical Biomechanics, 10, 41-49.
Starling, R. D. (2001). Energy expenditure and aging: effects of activity. International Journal of Sport Nutrition and Exercise Metabolism, 11, s208-s217.
Steen, B., Isaksson, B., & Svanborg, A. (1979). Body composition at 70 and 75 years of age: a longitudinal population study. Journal of Clinical and Experimental Gerontology, 1, 185-192.
Stewart, A. D., Stewart, A., & Reid, D. M. (2002). Correcting calf girth discriminates the incidence of falling but not bone mass by broadband ultrasound attenuation in elderly female subjects. Bone, 31(1), 195-198.
Swaminathan, R. (2001). Biochemical markers of bone turnover. International Journal of Clinical Chemistry and Applied Molecular Biology, 313, 95-105.
Tang, F. C., Kung, I. L., Hsieh, S. Y., Sheu, W. H. H., & Chang, J. B. (1995). Effects of a very-low-calorie diet and aerobic exercise on the metabolism of skeletal muscle. Journal of Chinese Nutrition Society, 20(3), 239-248.
Tang, F. C. (1996). Plasma branched-chain amino acid changes during energetic stress. Journal of Chinese Nutrition Society, 21(1), 27-36.
Tang, F. C. (2003). Effect of branched-chain amino acid supplementation on body composition measured with SBIA: an advanced BIA. Journal of Chinese Nutrition Society, 28(2), 65-73.
Thoren, P., Floras, J. S., Hoffmann, P., & Seals, D. R. (1990). Endorphins and exercise: physiological mechanisms and clinical implications. Medicine and Science in Sports and Exercise, 22, 417-428.
Tipton, K. D. (2001). Muscle protein metabolism in the elderly: influence of exercise and nutrition. Canadian Journal of Applied Physiology, 26(6), 588-606.
Trichopoulou, A., Gnardellis, C., Lagiou, A., Benetou, V., Naska, A., & Trichopoulos D. (2001). Physical activity and energy intake selectively predict the waist-to-hip ratio in men but not in women. The American Journal Clinical Nutrition, 74, 574-578.
Vaughan, L., Zurlo, F., & Ravussin, E. (1991). Aging and energy expenditure. The American Journal Clinical Nutrition, 53, 821-825.
Visser, M., Pahor, M., Tylavsky, F., Krtichevsky, S. B., Cauley, J. A., Newman, A. B., et al. (2003). One- and two- year change in body composition as measured by DXA in a population-based cohort of older men and women. Journal of Applied Physiology, 94, 2368-2374.
Voorbij, A. I. M., & Steenbekkers, L. P. A. (2001). The composition of a graph on the decline of total body strength with age based on pushing, pulling, twisting and gripping force. Applied Ergonomics, 32, 287-292.
Walker, M., Klentrou, P., Chow, R., & Plyley, M. (2000). Longitudinal evaluation of supervised versus unsupervised exercise programs for the treatment of osteoporosis. European Journal of Applied Physiology, 83, 349-355.
Westerterp, K. R., & Meijer, E. P. (2001). Physical activity and parameters of aging: a physiological perspective. Journals of Gerontology, 56A (Special issue II), 7-12.
Williams, M. H. (Ed.). (2002). Nutrition for health, fitness and sport (6th ed.). New York: McGraw-Hill.