| 摘要: | 研究目的：(1)探討客觀測量睡眠與身體活動量之間的因果關係，(2)探討睡眠與身 體活動量對肥胖風險與憂鬱風險之影響，(3)開發與評估針對睡眠和身體活動(以健康信念模式理論為基礎)之預防肥胖和憂鬱的健康促進方案。 研究背景：台灣民眾的肥胖率日漸上升，據 2010報告指出台灣十大死因中有六項 與肥胖有關。研究證實肥胖與憂鬱症狀有關，憂鬱症是現代社會的一大隱憂，嚴重患者有自殺傾向。了解更多影響肥胖與憂鬱症的因素可供未來健康政策的制定。運動為常見影響肥胖與憂鬱之因子，相較運動介入已被大量運用於衛生介入，睡眠此一被證實與肥胖和憂鬱相關的因子則較少被探討。調查指出睡眠不足和缺乏運動為台灣大學生兩大健康危害行為。過去相關研究較少同時記錄全天的活動量和睡眠、 較少以客觀方式測量、也多限制於橫斷式設計。因此難以決定睡眠與活動量間的因果關係；兩者間也可能存在交互作用再進而影響肥胖與憂鬱。材料與方法：分兩階段縱向追蹤研究進行，第一階段目標為以一年縱向追蹤(3次測量)診斷身體活動量、睡眠、與肥胖和憂鬱相關之生化指標(胰島素、血糖、血脂肪、 荷爾蒙)之因果關係。此階段將選取 150位 20歲以上之大學生參與研究，進行問 卷填寫和抽取血液。第二階段將根據上一階段的結果(如:睡眠影響活動量、活動量影響睡眠)設計為期 12 週之健康促進方案。此階段將第一階段之受試者隨機分配成介入組(75人)和控制組(75人)，於介入前後各測一次前測與後測。本階段目的為評 估大學生在參與介入前後之睡眠與身體活動量改變量是否能改善與肥胖和憂鬱相關之生化指標、降低肥胖和憂鬱風險。 預期成效:透過了解睡眠和活動量對於肥胖和憂鬱之路徑機制，本研究結果將可供衛生單位擬定肥胖相關慢性疾病以及憂鬱症和其相關自殺率的本土化衛教策略，以增進大學生之健康促進行為。期盼大學生將健康生活型態延伸至成年階段以達成疾病預防之長期效果。
Objectives: (1) Identify the causal associations between sleep and activity levels based on objective data, (2) Investigate influences of sleep and activity levels on risks of obesity and depression, (3) Design and evaluate the effectiveness of a theory-based intervention program (based on the Health Belief Model) targeting sleep and activity levels in lowering the risks of obesity and depression. Background: Obesity prevalence has increased in Taiwan. According to the 2010 statistics, six out the top ten causes of death are perceived as obesity-related health complications. Depression has been found to be related to obesity, severe depression carries a high risk of suicide. Understanding determinants of obesity and depression could inform health policy making. Activity levels is an established correlates of obesity and depression and has been widely addressed in health interventions, on the other hand, sleep, has been less emphasized in obesity and sleep-related interventions. In Taiwan, physical inactivity and lack of sleep are the top two unhealthy behaviors among undergraduate students. Majority of the prior literatures did not study sleep and activity levels simultaneously, did not based on objective data, and was confined to cross-sectional design. Hence, the causality between sleep and activity levels could not been correctly determined. Methods: We will achieve our research goals through two stages. In the first stage, we will assess activity levels, sleep, physiological correlates of obesity and depression, and risks of obesity, and depression for three times over 12 months. Pathways linking activity levels, sleep, obesity, and depression will be determined. A total of 150 college students (≧20 years old) will be recruited; research tools include questionnaires and blood draws. In the second stage, based on the findings from previous stage (e.g., sleep predicts activity levels, or, activity levels predicts sleep), we will conduct a randomized intervention to promote healthy sleep habits/an active lifestyle for 12 weeks. Effectiveness of the intervention will be evaluated by assessing whether or not the change score of pre- and post- data on sleep/activity level reduces risks of obesity and depression. Expected research contributions: Identifications of the pathways linking sleep, activity behavior, and risks of obesity as well as depression could assist health policy making on preventing obesity-related chronic diseases, lowering depression rates, and reducing depression-related suicides. Study results could guide future health programs to promote habitual activity and healthy sleep patterns among undergraduate students and have beneficial influences on decreasing future risks of obesity and depression during adulthood. |
