| 摘要: | 因飲食西風東漸，近年來，肥胖的盛行率有日益增加的趨勢。在許多的國家，肥胖已成為嚴重的公共衛生問題。而台灣歷年來的十大死因中，除自殺死亡以外，幾乎都與肥胖有相當大的關係。而且，肥胖所引起的包括糖尿病，腎臟病等，在全民健保醫療上的支出已日益增加。
民國 90 年中央健康保險局資料顯示，台灣所有健保人口中，有 2.5% 被歸為糖尿病；而根據健保局民國 87 年的資料顯示，糖尿病患者之醫療花費佔所有醫療費用的 11.5%。
本研究針對台灣南部某健康減重中心，採取經由非侵入性治療，而由均衡飲食、控制熱量之減重計畫學員共 125 位為研究對象。另設計相同問卷給予 56 位有定期做健康檢查及腰圍紀錄之群眾作為對照組。評估其家族疾病史、生活習慣、生化檢驗值以及曲線測量，來多方面了解這些變項對肥胖及疾病的影響做統計分析研究。區別於以往的研究，此次研究，專業營養師團隊介入，去做一個有效減重計畫。經過二年期間分批收集藉由熱量限制飲食進行減重控制學員的資料，經統計後發現：1. 遺傳家族性糖尿病、高血壓或其它疾病者，易肥胖比例較高。2. 在生活習慣方面：（1）不運動；（2）三餐外食；（3）腸胃功能差，對肥胖的影響最為深鉅。3. 在生化檢驗值方面：實驗組與對照組介入後變化比較，實驗組的轉胺（GOT 與 GPT）、三甘油酯（TG）、膽固醇（CHO）、高密度脂蛋白（HDL）、尿酸（UA）、飯前血糖（AC glucose）及體脂肪率都有顯著差異。4. 在體位測量(曲線)方面，包括胸圍、胃圍、腰圍及臀圍測量介入後皆有顯著下降。
接著再進一步將實驗組分為三個子群，分別為體重平均每月增減 0.5㎏ （當作對照族群）、平均月減 1~2 ㎏ 以及平均月減 2㎏ 以上者。進而探討各種體重下降可能因子的影響力，作為日後減重規劃之參考依據。結果顯示：1. 減重者的年紀越大則減重效果越小。2. 體重80公斤以上或身體質量指數（BMI）大於 30（kg/m2）者減重成效較高。3. 在生化檢驗值方面，必需要平均月減達 2㎏ 以上才會明顯改善生化檢驗值之危害程度。4. 而在身體曲線方面，實驗組的三個子群中，都有顯著性的改善。
經由本研究顯示，減重對於慢性疾病、新陳代謝症候群都有非常明確的改善。藉由此實驗可提高國人對預防醫學的重視。而能做到預防勝於治療的重要性以及減低國家健保的支出。
ABSTRACT
In recent years, the prevalence of obesity is increasing due to the culture of dietary of West Country influencing. It has been an important public healthy problem in many countries.
Over the years, among the top 10 factors which causing the death in Taiwan, excepting suicide, there are all associated with obesity nearly. Moreover, the complications of obesity are diabetes, kidney disease…etc, has been causing expenditure of National Health Insurance loading year by year!
According to a report shown from National Healthy Insurance Administration in 2001; in Taiwan, among those people who had healthy insurance, 2.5% has classified diabetes. At meanwhile, the indication of administration; medication insurance costs of diabetes had occupied 11.5% in 1998.
A main objectives of this study was aim to healthy weight management center in south of Taiwan which is adopting noninvasive therapies. Balancing their diets and managing calories were the methods of this study. There were 125 members attended this study. Besides was designed the control group 56 participants for this study who were had taken body examination routinely and waist hip ratio records and had the same questionnaire with experimental group.
The items of assessment for this study were including: family history, life style, biochemical examination, and anthropometry. In order to analysis among those items-relation and make a statically analysis. The feature of this study we were interfere a specialty group of dietitians for weight management effectively plans. The reports of controlling under calories restricted plan were collected within two years, there were some significant observations after statistical examination:
1. Having the inherited diseases of diabetes and hypertension tends to being obesity easily.
2. People are relative to obesity that has those situations: without regular exercise, eating out and gut disorder
3. The comparison of experimental to control group from their biochemical exam report, we found that the level of GOT, GPT, UA, TG, CHO, AC glucose and body fat ratio were more significantly than control group.
4. The bust, stomach , waistline and hip of the body shape were reduced significantly than control group, too.
Furthermore, the experimental group was divided into three sub-groups for average weight reducing monthly; ±0.5 kg (as control), 1 to 2 kg and over 2 kg respectively. We investigated the effect on probable factor(s) of weight reducing as a reference of weight management. Two significant observations were：1. The efficacy of weight reduction was decreased when the age increased; 2. For person with body weight higher than 80 kg or body mass index (BMI) larger than 30 (kg/m2), the efficacy was improved significantly; 3. In biochemical exam report, we found it could be improved obviously, if weight reduction was higher than 2 kg/month；4. In all groups, the waist hip ratio of anthropometry item improved significantly.
According to the results shown in this research; losing weight is definitely way improving for chronic diseases. We may rising people draw more and more attention to preventive medicine through this study due to reducing expenditure of healthy insurance and the importance of prevention is better than cure. |
