長期追蹤臺灣北部青少年營養攝取及飲食品質與生長速度的相關性
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2022
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青少年正值兒童至成人期的轉換階段，此階段飲食營養需供應青春期的生長及發育，同時也奠定成年後的飲食習慣及健康基礎。良好的飲食品質滿足個體的營養需求也會影響到學童的生長速度，因此本研究欲從飲食品質的層面探討青少年飲食與生長速度的表現。前瞻性世代研究設計，分析臺灣北部 129 名青少年11–18 歲間每年所收集之 2 日 24 小時飲食回憶資料，共有 530 份有效問卷，並根據年齡分為小學高年級、國中生及高中生時期，以加權平均值(weighted average)方式計算其營養素及食物份數，為更符合本土的飲食習慣及建議，本次將以臺灣每日飲食指南為基礎改良飲食品質指數：師大版台灣健康飲食指數(THEI-NTNU)，並以其評估青少年飲食品質。結果顯示同一群青少年於追蹤期間熱量攝取量維持穩定，醣類攝取量隨年齡增加而減少，蛋白質與脂質隨年齡增加而增加，為增加肉類及蛋類攝取量，減少水果類及乳品類攝取量。青少年歷年平均營養素充足比 0.7-0.8，未有營養素攝取缺乏(< 70% DRIs)的情形，但一些營養素及平均營養素充足比隨年齡越高而不理想的情況。青少年歷年平均飲食品質分數 48.3 ± 2.3，且隨年齡上升顯著變差，以未精製穀類、深綠色蔬菜類及水果類得分最低。飲食品質與多數營養素攝取量及營養素充足比呈顯著正相關(r =0.19-0.55, p < 0.05)，但與身高年變化量及體重年變化量無相關性(r =- 0.07-0.11 , p > 0.05)，且青春期早期飲食品質分數對青春期早期及青春期晚期的體位或體位年變化無顯著相關性(p > 0.05)，僅與青少年最新一次體重(平均 16 歲)呈顯著負相關(r =- 0.25, p < 0.01)。本研究為長期追蹤同一群青少年從小學高年級至高中生時期的觀察性研究，利用我國飲食指南改良之飲食品質指數評青少年估飲食品質，亦分析體位及營養
素之變化，本次研究發現台灣北部青少年的飲食品質及平均營養素充足性表現逐年變差，並確定 THEI-NTNU 是反映微量營養素充足性的良好指標，可能成為評估飲食品質與營養素缺乏相關的指標工具，但飲食品質與生長速度或體位之間無發現相關性，未來 THEI-NTNU 與青少年的生長速度的相關性，並需確認飲食品質對兒童和青少年的生長速度的影響。
Objectives: Adolescence is the period of transition between childhood and adulthood and serves the critical foundation of dietary habit and health development. High dietary quality can meet individual nutritional requirements, promote growth in childhood. The aims of study are to estimate dietary quality and dietary nutrient of adolescents, and to examine the correlations between dietary quality, dietary nutrient and anthropometric measurements. Methods: Total 129 adolescents in north Taiwan participated in our prospective cohort studies and provided 530 questionnaires including 2 day 24-hour dietary recalls from 11 to 18 years old. Our dietary nutrient and food consumption are calculated as weighted averages, and furthermore, we constructed a dietary quality indices based on current Taiwan dietary guidelines. In this study, we used Taiwan Healthy Eating Index- National Taiwan Normal University (THEI-NTNU) to examine overall dietary performance for adolescents. Results: The calorie intake remained stable during the follow-up period, mean carbohydrate intake decreased with age, andmean protein and lipid intake increased with age. One of the main reasons to increase the consumption of meat and eggs, reduce the consumption of fruit and dairy. The mean adequate ratio (MAR) was 0.7-0.8 from 11 to 18 years old for adolescents. Although the results indicated that most of them had not a problem about nutrient inadequacy (< 70% DRIs), some nutrients and average nutrient adequacy ratios (MAR) are not ideal with age. The scores of dietary quality of means and standard deviations were 48.3 ± 2.3 for THEI-NTNU, and the scores of dietary quality declined significantly for adolescents from 11 to 18 years old (p for trend < 0.01). We observed that the scores of unrefined grain, green vegetables and fruits intake were particularly low. We found that a dietary quality scores had significantly positive correlations (r=0.19-0.55, p < 0.05) with most nutrient intakes and nutrient adequacy ratio scores. Moreover, dietary quality score had a significantly negative correlation (r=-0.25, p < 0.01) with the latest weight (average age 16 years). However, we found that the dietary quality scores had not significantly correlations (p > 0.05) with annual height velocity and weight velocity for adolescents. The dietary quality score of early adolescence had not significantly correlations (p > 0.05) with the height, weight, annual height velocity and annual weight velocity of early adolescence or late adolescence. Also, dietary quality score of early adolescence had not significantly correlations (p> 0.05) with the annual height velocity and weight velocity of calendar year. Conclusion: Our observational study is a longterm tracking of the diet quality and body position of the adolescents in north Taiwan from 11 to 18 years old. The diet quality score of adolescents assessed by THEI-NTNU, and to analyze the changes in growth status and dietary nutrient. The results found that THEI-NTNU can be used as an indicator to assess the sufficiency of micronutrients, because it can reflect the ideal the intake of nutrients. It may be an indicator tool to assess the correlation between diet quality and dietary nutrient deficiency. However, there is no correlation between the diet quality and growth velocity or growth status. The effect of diet quality on growth velocity in children and adolescents needs to be confirmed in the future.
Objectives: Adolescence is the period of transition between childhood and adulthood and serves the critical foundation of dietary habit and health development. High dietary quality can meet individual nutritional requirements, promote growth in childhood. The aims of study are to estimate dietary quality and dietary nutrient of adolescents, and to examine the correlations between dietary quality, dietary nutrient and anthropometric measurements. Methods: Total 129 adolescents in north Taiwan participated in our prospective cohort studies and provided 530 questionnaires including 2 day 24-hour dietary recalls from 11 to 18 years old. Our dietary nutrient and food consumption are calculated as weighted averages, and furthermore, we constructed a dietary quality indices based on current Taiwan dietary guidelines. In this study, we used Taiwan Healthy Eating Index- National Taiwan Normal University (THEI-NTNU) to examine overall dietary performance for adolescents. Results: The calorie intake remained stable during the follow-up period, mean carbohydrate intake decreased with age, andmean protein and lipid intake increased with age. One of the main reasons to increase the consumption of meat and eggs, reduce the consumption of fruit and dairy. The mean adequate ratio (MAR) was 0.7-0.8 from 11 to 18 years old for adolescents. Although the results indicated that most of them had not a problem about nutrient inadequacy (< 70% DRIs), some nutrients and average nutrient adequacy ratios (MAR) are not ideal with age. The scores of dietary quality of means and standard deviations were 48.3 ± 2.3 for THEI-NTNU, and the scores of dietary quality declined significantly for adolescents from 11 to 18 years old (p for trend < 0.01). We observed that the scores of unrefined grain, green vegetables and fruits intake were particularly low. We found that a dietary quality scores had significantly positive correlations (r=0.19-0.55, p < 0.05) with most nutrient intakes and nutrient adequacy ratio scores. Moreover, dietary quality score had a significantly negative correlation (r=-0.25, p < 0.01) with the latest weight (average age 16 years). However, we found that the dietary quality scores had not significantly correlations (p > 0.05) with annual height velocity and weight velocity for adolescents. The dietary quality score of early adolescence had not significantly correlations (p > 0.05) with the height, weight, annual height velocity and annual weight velocity of early adolescence or late adolescence. Also, dietary quality score of early adolescence had not significantly correlations (p> 0.05) with the annual height velocity and weight velocity of calendar year. Conclusion: Our observational study is a longterm tracking of the diet quality and body position of the adolescents in north Taiwan from 11 to 18 years old. The diet quality score of adolescents assessed by THEI-NTNU, and to analyze the changes in growth status and dietary nutrient. The results found that THEI-NTNU can be used as an indicator to assess the sufficiency of micronutrients, because it can reflect the ideal the intake of nutrients. It may be an indicator tool to assess the correlation between diet quality and dietary nutrient deficiency. However, there is no correlation between the diet quality and growth velocity or growth status. The effect of diet quality on growth velocity in children and adolescents needs to be confirmed in the future.
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Keywords
青少年, 飲食品質, 營養素充足, 生長速度, 前瞻性世代研究, adolescent, dietary quality, nutrient adequacy, growth velocity, prospective cohort study