長期追蹤婦女及嬰幼兒飲食營養世代研究

Abstract

此三年之研究目的為延續前兩項國科會研究「生命起始期營養狀況:探索台北地區孕產婦 飲食及新生兒健康影響因素」及「嬰幼兒飲食營養長期追蹤研究:由懷孕到孩童期」 所追 蹤的二組出生世代，將持續探討參加研究婦女及其子女的飲食營養攝取及相關因素對生 長髮育及健康狀態之關係。第一組世代為民國九十一年開始由台北市立婦幼醫院所招募 正常懷孕之婦女(民91 世代，n=181)，第二組世代由民國九十三年開始(民93 世代， n=150)，招募地點也包括台大醫院，對像為相對低出生體重(n=74)及相對高出生體重 (n=76)之新生兒。資料收集為嬰兒(infants)一歲前為每個月，一歲後收集兒童及母親資料 時間點為一歲半，二歲，二歲半及三歲，之後為四歲及五歲幼兒(toddlers)時期。此三年 研究將執行四項假說檢驗研究及三項方法學研究，並持續增加改進研究所使用食品成分 資料庫內容及提供及管理參加者網路部落格聯誼。 第一項研究將探討懷孕前、懷孕期間，及產後之飲食營養攝取及相關因素對新生兒體型 包括出生體重(birth weight)及母親體重保留(weight retention) (n=317)之影響。第二項研 究將持續完成民91 世代母親及兒童四歲及五歲長期追蹤之資料收集(出生時n=132, 一 歲時n=122, 二歲時n=111, 三歲時n=101)。第三項研究將持續追蹤民93 世代包括相對 低(n=74, 已流失2 位)與相對高出生體重(n=76, 已流失12 位)之母親及嬰幼兒至三歲， 未來至五歲。兩組世代資料也將合併比較生長追上(catch-up)或下降(catch-down)分析。 第四項研究將開始追蹤民國九十六學年度搬遷後新設師大附設幼稚園所有入學兒童及 其家庭(每年三班n=90/year)，以學校為基礎收集飲食營養及生長發育之長期資料。三項 研究相關方法學研究將包括：1. 研發昇糖指數(glycemic index: GI)及昇糖負荷(glycemic load: GL)於24 小時回憶法及中式食物頻率問卷(Chinese food frequency questionnaire:CFFQ)之運算方法。2.研發3-5 歲兒童飲食營養評估施測方法學。3. 研發婦女及兒童有 關膳食補充劑(dietary supplements)資料及相關資料處理之方法學。研究分析會使用多種 長期追蹤資料分析統計分法來描述發現及檢定假說。研究團隊持續長期追蹤參加研究者 並成功管理小規模之母親、嬰幼兒及兒童世代，我們收集並分析珍貴之本土前驅性飲食 營養資料。由於良好的飲食起源於兒童時期，相關研究將提供基礎及長期追蹤資料來進 行多項本土假說驗證。

This 3-year grant will continue our endeavor to examine diet and nutrition status for women and their children to understand the interrelationships between nutrition-related factors with growth and health status by collecting longitudinal data. Since 2002, we conducted two NSC grants entitled 「Nutrition assessment in early life span: examination of maternal diets, infant health outcomes and related factors in Taipei」 and 「A longitudinal study of feeding and nutrition for infants and toddlers: from pregnancy to childhood」, we have been able to built two birth cohorts, first cohort was recruited from Taipei MunicipalWomen and Children Hospital between Oct 2002 and Feb 2004 (民91 cohort, n=181) and the second was also recruited from National Taiwan University Hospital between Feb 2005 and July 2006 (民93 cohort, n=150) which consisting of relatively low (n=74) and high (n=76) birth weight infants. The data collected includes detailed monthly dietary and growth information between birth and 12 month, then at 1.5, 2, 2.5, and 3 years old, later will collect maternal and toddlers』 information at 4 and 5 years old. We plan to conduct four hypothesis testing studies and three related methodology studies, as well as maintain our food composition databases and build a web blog network to provide communication services for our participants in the future 3 years. The first study will analyze nutritional status before pregnancy, during pregnancy and postpartum for mothers (n=317) and examine the impact of various maternal lifestyle factors on birth outcomes and weight retentions. The second study will collect information from mothers and children at 4 and 5 years old from the 民91 cohort (n=132 at birth, n=122 at 1 year old, n=111 at 2-years old. n=101 at 3-years old) in order to complete the longitudinal data collection. The third study will continue our follow-ups for the low (n=74, loss 2 until present) and high (n=76, loss 12 until present) birth weight cohort (民93 cohort) until 5-years old to examine their growth patterns such as catch-up and/or catch down growth related to feeding practices.We also will combine data from 2 cohorts for further analyses for comparison purposes. The four study is to recruit all children and their families (n=90 each year) at our relocated university kindergarten (師大附幼) since fall semester 2007 to build a new cohort to examine diet and nutrition status on growth and development based on schools. The three related methodology studies include: 1. The first is to develop calculation system for glycemic index (GI) and glycemic load (GL) for 24-hour recalls and compared to our meal-based Chinese food frequency questionnaire (CFFQ). 2. The second study is to examine the differences among administration methods to collect nutrition related data for toddlers between 3 and 5 years old. 3. The third methodology study is to understand the logics and develop questionnaires to collect data on dietary supplements and related data processing procedures from women and their children. Various statistical methods suitable for longitudinal data analyses will be utilized and performed to test our findings. Our continuous efforts to collect prospective diet and nutrition data and manage small cohorts for women, infants and children have been successful and generate valuable longitudinal data. Eating better diets have roots in childhood, our studies will provide fundamental and follow-up data for testing various hypothesis.