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學校名稱輔仁大學
系所名稱食品營養學系
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學號491445114
研究生(中)彭惠鈺
研究生(英)Hui-Yu Peng
論文名稱(中)糖尿病患之骨質疏鬆相關營養知識及飲食 行為調查
論文名稱(英)TE survey of osteoporosis-related knowledge and dietary intake in diabetes
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指導教授(中)王果行
指導教授(英)Ivy Wang
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學位類別碩士
畢業學年度94
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關鍵字(中)糖尿病 骨質疏鬆 鈣 身體質量指數
關鍵字(英)DIABETES osteoporosis calcium BMI
摘要(中)本研究採用問卷調查方式探討糖尿病患之骨質疏鬆及營養知識及相關營養素攝取情形。問卷調查內容包括基本資料、飲食頻率問卷、24小時飲食回憶、骨質疏鬆及營養知識問卷,並於收案當日由病歷中收集最近一次血液生化值AC、A1C等項目的數據。研究對象以臺大醫院糖尿病病變篩檢診第2型糖尿病患為主,共116人參與此研究。參與研究糖尿病人之平均年齡為52.5±7.3歲;罹患糖尿病時間平均為8.3±5.1年, BMI平均值為25.5±3.5,肥胖率為30.2%、過重佔30.2%,空腹血糖平均值為148±42.2 mg/dl,糖化血色素平均值為7.8±1.4%。受試者BMI值與收縮壓和血中三酸甘油酯數值成正相關。結果顯示受試者骨質疏鬆知識問卷以百分計得分平均為75.7±16.6分,營養知識問卷得分平均為61.3±20.4分,對於營養相關知識顯著低於骨質疏鬆認知。男、女每日平均攝取熱量分別為1537±530 kcal及1200±322 kcal。男性及女性三大營養素醣類、蛋白質、脂肪平均攝取量佔總熱量之53.2%、15.7%、30.7%及54.2%、16.4%、30.5%。鈣質攝取男性為407±242毫克,女性為451±280毫克,皆未達國人營養素攝取參考量(每日1000毫克)。主要鈣食物來源依序為蔬菜、牛奶、黃豆製品。糖尿病患者熱量攝取較一般人低,可能是害怕血糖控制不良所致。鈣攝取量也低於國人鈣之平均量。另外,鎂的攝取也未達建議量。因此建議糖尿病患衛教上應加強含鈣、鎂食物的介紹,除了改善血糖控制外,亦應注意預防糖尿病人骨質疏鬆症的發生。 關鍵字﹕糖尿病、骨質疏鬆、鈣、BMI
摘要(英)The survey of osteoporosis-related knowledge and dietary intake in diabetes Hui–Yu Peng Abstract This study used questionnaire to investigate DM patient’s daily nutritient intake and knowledge about osteoporosis and nutrition. The questionnaire included patient’s demographic data, food frequency questionnaire, 24 hr dietary recall, knowledge questionnaire of osteoporosis and nutrition. Laboratory data was collected from patient’s chart. One hundred sixteen subjects were recruited from DM screening clinics. All subjects had DM with average duration of 8.3 ± 5.1 years. Patient’s age, BMI, AC sugar, and A1C were 52.5 ± 7.3 years old, 25.5 ± 3.5, 148 ± 42.2 mg/ dL, and 7.8 ± 1.4%, respectively. Obesity and overweight rate was 30.2% and 30.2%, respectively. BMI and TG level showed positive correlation and SBP was positively correlated with blood TG level. The results showed that patient’s score about osteoporosis knowledge was 75.7 ± 16.6 and the score of nutrition knowledge was 61.3 ± 20.4. The score of nutrition knowledge out of 100 was lower than osteoporosis knowledge score. For men and women, the daily energy intake was 1537 ± 530 and 1200 ± 322 Kcal, respectively. For men, daily intake of carbohydrate, protein, and fat was 53.2%, 15.7%, and 30.7%, respectively. For women, daily intake of carbohydrate, protein, and fat was 54.2%, 16.4%, and 30.5%, respectively. Daily calcium intake did not achieve the level of DRI (1000 mg). Calcium intake for men and women was 407 ± 242 and 451 ± 280 mg, respectively. The main dietary sources of calcium were vegetables, milk, and beans. Energy intake of DM patients was lower than general population, possibly due to fear of poor blood sugar control. Calcium intake was lower than the average Taiwanese population calcium intake. Additionally, magnesium intake did not achieve DRI. In the future, to introduce of calcium- and magnesium- rich foods in the diet is needed to be especially emphasized in the nutrition education to prevent osteoporosis and improve blood sugar control among DM patients. Key word: diabetes, osteoporosis, calcium, BMI
論文目次目錄 中文摘要…………………………………………………………………Ⅰ 英文摘要…………………………………………………………………Ⅱ 誌謝………………………………………………………………………Ⅲ 目錄………………………………………………………………………Ⅳ 表目錄……………………………………………………………………Ⅵ 圖目錄……………………………………………………………………Ⅶ 第一章 前言…………………………………………………………… 1 第二章 文獻回顧…………………………………………………………3 第一節 糖尿病飲食……………………………………………………3 第二節 鈣和骨質疏鬆…………………………………………………11 第三節 糖尿病和骨質疏鬆……………………………………………14 第四節 飲食評估………………………………………………………16 第三章 研究目的…………………………………………………………21 第四章 材料及方法………………………………………………………22 第一節 研究架構………………………………………………………22 第二節 研究對象………………………………………………………23 第三節 研究工具………………………………………………………24 第四節 研究設計………………………………………………………29 第五節 資料處理與統計分析…………………………………………29 第五章 結果………………………………………………………………31 第一節 糖尿病患基本資料……………………………………………31 第二節 糖尿病患生活型態的情形……………………………………32 第三節 糖尿病患其他疾病罹患情形…………………………………33 第四節 體位測量情形…………………………………………………33 第五節 糖尿病患者生化值分布情形…………………………………… 33 第六節 糖尿病患者骨質疏鬆及營養知識認知問卷答題分布的情形 34 第七節 糖尿病患者營養素攝取情形………………………………… 35 第八節 飲食鈣攝取與骨質疏鬆及營養知識、BMI和營養素攝取與血液生 化值相關性……………………………………………………37 第六章 討論………………………………………………………………38 第一節 糖尿病患生活型態及慢性疾病罹患情形…………………… 38 第二節 糖尿病患骨質疏鬆及營養相關知識………………………… 39 第三節 營養狀況之探討……………………………………………… 40 第四節 24小時回憶與飲食頻率問卷相關性的探討………………… 42 第五節 鈣的食物來源的探討………………………………………… 43 第六節 飲食控制與血糖、血脂肪的相關性探討…………………… 44 第七節 研究限制 45 第七章 結論與建議 47 第一節 結論 47 第二節 建議 48 參考文獻 中文參考文獻 69 英文參考文獻 70 附錄 附錄一 糖尿病病人基本照護資料表 61 附錄二 骨質疏鬆症及營養知識認知問卷 62 附錄三 飲食頻率問卷 63 附錄四 24小時飲食回憶 64 附錄五 各種類食物使用不同烹調方法之用油比例 65 表目錄 表2-1 糖尿病飲食 三大營養素佔每日總熱量的百分比(%) 5 表2-2 飲食評估方法之適用情形與優缺點比較 20 表5-1 糖尿病受試者基本資料 49 表5-2 男、女糖尿病患生活型態比較 50 表5-3 糖尿病患其他疾病罹患情形 51 表5-4 糖尿病患體位測量情形 52 表5-5 糖尿病患男、女性血液生化值比較 53 表5-6 糖尿病患骨質疏鬆及營養知識問卷測試得分情形 54 表5-7 骨質疏鬆症及營養知識認知問卷 55 表5-8 糖尿病患男女營養素攝取情形 56 表5-9 糖尿病患不同食物來源鈣攝取量 57 表5-10 飲食鈣攝取與骨質疏鬆及營養知識相關性 58 表5-11 BMI和營養素攝取與血液生化值相關性 59 圖目錄 圖1 :研究流程 22 圖2 :半球狀食物模式 24
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