膳食脂肪品質指數與臺灣成人體圍之相關性研究

Abstract

目的：近年來，過重與肥胖人口逐年上升，其帶來的不良健康影響如高血壓、高血脂及心血管疾病等，更對全球帶來健康及經濟上的負擔與壓力。造成肥胖的原因相當多，除遺傳、運動習慣外，另一個重要因素便是飲食。其中，飽和脂肪與反式脂肪因被認為與心血管疾病發生風險有關，而被視為對身體較有害的脂肪酸，因此本研究欲探討在此觀念衍伸出的膳食脂肪品質指數 (fat quality index, FQI) 與台灣成人體位、體圍之相關性。方法：利用本研究室研發之食材為主飲食頻率問卷 (food and ingredients-based food frequency questionnaire, FIFFQ) 及24小時飲食回憶法 (24-hour dietary recall, 24HDR) 收集297份20－60歲台灣成年人飲食及非飲食資料，再經由本研究室自行研發之師大食品營養素資料庫 (National Taiwan Normal University Food and Nutrition Management System 2, NUFOOD.2) 運算出各營養素一日總攝取量後，探討不同分位之FQI與營養素、食物類別、體位、體圍等之相關性。 結果：FIFFQ-FQI分數範圍Q1為<1.5、Q2為1.51-1.79、Q3為1.8-2.04、Q4為2.05-2.35、Q5為2.36-3.27。24HDR-FQI分數範圍Q1為<1.7、Q2為1.71-2.07、Q3為2.08-2.40、Q4為2.41-2.84、Q5為2.85-4.48。營養素方面，兩方法學皆有共同趨勢的為維生素B2、PUFA隨FQI上升而顯著增加攝取，反之視網醇、鈣及飽和脂肪則下降。食物類別部分，隨著24HDR-FQI上升，精緻穀類 (p trend = 0.003)、蔬菜 (p trend = 0.003)及魚類、水產類 (p trend = 0.001)隨FQI上升攝取增加，乳製品 (p trend <0.001)則下降。體圍方面，FIFFQ-FQI在控制性別、年齡、教育年限、社經地位分類、酒精攝取量、吸菸、疾病史、動態活動量及總熱量攝取前，與腰臀比呈現正相關 (r = 0.012，p =0.038)，但在控制干擾因子後，FIFFQ-FQI與所有體圍皆無相關性。而24HDR-FQI則在控制前後皆與所有體圍無顯著相關性。比較兩方法學蒐集之飲食資料互有差異，與國民營養調查雖多有低估，且與第八版DRIs相比發現本研究受訪者熱量攝取低於適度活動量之熱量需求，但三大營養素攝取充足。結論：FQI能反應受訪者飲食攝取狀況，但不適合作為體位圍參考指標。

Objective: In recent years, the prevalence of overweight and obesity has been increasing, leading to adverse health effects such as hypertension, hyperlipidemia, and cardiovascular diseases, which impose significant health and economic burdens globally. The causes of obesity are multifaceted, including genetic factors and exercise habits, with diet being another critical factor. Among dietary factors, saturated and trans fats are considered more harmful due to their association with cardiovascular disease risk. This study aims to investigate the relationship between the dietary fat quality index (FQI) and body measurements among Taiwanese adults, a concept derived from these health considerations. Methods: This study collected dietary and non-dietary data from 297 Taiwanese adults aged 20-60 using a food and ingredients-based food frequency questionnaire (FIFFQ) and a 24-hour dietary recall (24HDR). The total daily nutrient intake was calculated using the National Taiwan Normal University Food and Nutrition Management System 2 (NUFOOD.2). We then explored the correlation between FQI and various nutrients, food categories, body mass index (BMI), and body measurements across different quartiles. Results: The FIFFQ-FQI scores ranged as follows: Q1< 1.5, Q2 = 1.51-1.79, Q3 = 1.8-2.04, Q4 = 2.05-2.35, Q5 = 2.36-3.27. The 24HDR-FQI scores ranged as follows: Q1 < 1.7, Q2 = 1.71-2.07, Q3 = 2.08-2.40, Q4 = 2.41-2.84, Q5 = 2.85-4.48. In terms of nutrients, both methodologies showed a significant increase in vitamin B2 and PUFA intake with higher FQI, whereas retinol, calcium, and saturated fats decreased. For food categories, as the 24HDR-FQI increased, the intake of refined grains (p trend = 0.003), vegetables (p trend = 0.003), and fish/seafood (p trend = 0.001) increased, while dairy product consumption (p trend< 0.001) decreased. FIFFQ-FQI was positively correlated with waist-to-hip ratio (r = 0.012, p = 0.038) before controlling for gender, age, education, socioeconomic status, alcohol intake, smoking, disease history, physical activity, and total calorie intake. However, no significant correlations were found after controlling for these confounding factors. Similarly, 24HDR-FQI showed no significant correlation with body measurements both before and after adjustment. The dietary data collected by the two methods showed some differences. Despite the general underestimation in comparison with national nutrition surveys, the intakes of the three major nutrients were adequate, though the mean of caloric intake of the respondents was below the requirements for moderate physical activity. Conclusion: While FQI reflects the dietary intake status of respondents, it is not suitable as a reference index for body measurements.