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Long-term follow-up study of sugar sweetened beverages, snacks and desserts, and refined sugar consumption among preschoolers aged 2 to 5 years
snacks and desserts
本研究屬前瞻性之長期追蹤世代研究，於民國91及93年間於台北市立婦幼醫院及台大醫院招募151及150位嬰兒（簡稱民91世代與民93世代），兩世代皆以問卷調查法收集飲食、健康狀況、體位發展等資料。本研究則利用24小時飲食回憶資料計算幼兒2~5歲含糖飲料及糕餅點心攝取量，並估計其精製糖百分比，進一步獲得幼兒平均每日攝取自含糖飲料及糕餅點心之精製糖量，續而以SPSS 19.0及STATA 8.0版進行描述性及相關性分析。
本研究亦合併兩世代嬰幼兒出生至5歲(n=132)之資料，依出生體重第25及第75百分位分成相對低出生體重(relative lowbirth weight infants, rLBW)、相對適當出生體重(relative adequate birth weight infants, rABW)、相對高出生體重(relative high birth weight infants, rHBW)三組。結果顯示，幼兒追蹤至5歲之體型（體重、身高及BMI）於三組間達顯著差異(p<0.05)，仍以rHBW組保持最高，rLBW組保持最低；但相對適當出生體重組(rABW)與其他兩組間之差異性已漸趨微小。另幼兒追蹤至5歲之體型增加倍數、增加百分比則也具出生組別差異(p<0.05)，rLBW組幼兒之生長速度較rHBW組快速。營養素攝取方面，全體5歲幼兒平均熱量攝取約為1366大卡，蛋白質、脂質及醣類攝取約48、45、192公克，各占總熱量攝取14%、29%及56%；鈣質攝取（319毫克）僅達DRIs一半，膳食纖維攝取（8克）尚不及建議量一半。
The status of diet, nutrition and health of early childhood is essential for children’s growth, development, and establishment of good dietary patterns. The purpose of this study is to investigate the consumption of sugar-sweetened beverages, snacks, and desserts among local pre-school children aged two to five years old, to assess the intake of refined sugar by developing methodology method, and to examine its association with parents’ socio-demographic characteristics, figure status, and nutrient intakes as well as health status. This research aims to be a prospective cohort study, including the first cohort of 130 children and the second cohort of 150 children recruited from the Taipei Municipal Women’s and Children’s Hospital and the National Taiwan University Hospital in 2002 and 2004. The intake of food and nutrient as well as the health status and body measurements are assessed by questionnaire. The intake of sugar-sweetened beverages, snacks, and desserts among children aged two to five years old are calculated by using the 24-hour recalls in the study. An estimated percentage of refined sugar is used in order to obtain the average daily intake of refined sugar from sugar-sweetened beverages, snacks, and desserts. The SPSS 19.0 and STATA 8.0 statistical program are used for all analysis. The consumption of sugar-sweetened beverages among reported children increases with age. Among the sugar-sweetened beverages, “flavored and fermented milk” contributes to the highest percentage among children aged from two to five years old, while the “whole grains drinks” shows an increasing trend in years. Among the different category of drinks, “tea” has the most significant increase in its consumption. For sacks and desserts, “biscuits” contribute to the highest percentage among children age range from two to four years old, with “Chinese sweet soup” showing an upward trend by years while having the highest increasing percentage. It also becomes the highest among children aged five years old. The intakes from refined sugar are 5%, 6%, 9% and 8% respectively of their total energy among children aged 2 to 5 years old. After controlling the gender, refined sugar consumptions of children at age 5 and the intakes at age 2 to 4 years old are positively associated (p<0.05). After controlling the gender and birth-size (weight and height), refined sugar intakes of children at age 4 are positively associated with body weight and height at age 5(p<0.05), and the association with BMI of 5-year-old children by gender and birth BMI variable controlled is not significant (p>0.05). Five-year-old children are divided into three categories according to the percentile of refined sugars intakes and are named low, medium and high intake groups (n = 44,43,45). The averageintake of refined sugar is approximately 11,26,48 grams. The results show that no parents’ socio-demographic characteristics, parents figures status, or health status difference of various types of consumers (p>0.05). There are significant differences in height, intakes of eggs, calories, carbohydrates, and a lot of nutrients among the three groups (p<0.05). Those in the highest category of refined sugars intake also have higher figure, higher intake of eggs, total calories, carbohydrates, and a lot of nutrients than low-consumers who have lower intake of dairy products (no significant). Five-year-old children are also divided into two categories according to the total energy intake of refined sugars. The results show that the group with excessive-intake (>10% of total calories, n = 46) also has significantly lower intake of cereals and dairy products than the group with adequate-intake (p<0.05) and lower intake of calcium (no significant). The analysis combined two cohorts’ studies consisting a total of 132 subjects age ranging from newborn to 5 years old. These participants are divided into three groups according to the 25th and 75th percentile cut-points: relative low birth weight infants group (rLBW), relative adequate birth weight infants group (rABW), and relative high birth weight infants group (rHBW). The result indicates that the growth indicators (weight, height and BMI) of infants between the three groups are significantly different from age 0 to 5(p<0.05). The rHBW group has higher means for weight, height and BMI, while the rLBW group is still the smallest of the three groups. However, the differences between the rABW and rLBW group become smaller. The assessments of the growth rates by multiplier of figures, weight/height gain percentages indicate that the growth speed is also significantly different among the three groups (p<0.05). The rLBW group has faster growth speed than the rHBW group. The mean daily caloric intake of 5-year-old children is 1366 Kcal, and the average dietary intakes of protein, fat and carbohydrate are 48g, 45g, and 192g respectively. The total energy is made up by 14% from protein, 29% from fat, and 56% from carbohydrates. The mean calcium intake is 319 mg compared to the DRIs of 600 mg, and the mean dietary fiber intake is 8 g compared to the IOM of 25 g. In this study, the average intake of refined sugar is still in line with the Department of Health recommendations (<10% of total calories) among children aged 2 to 5 years old. Yet over one-third of 5-year-old children have over 10% calories intakes from refined sugar, which may affect the cereals and dairy products consumption. Children should have good eating habits and a balanced diet in order to facilitate normal growth and development. This study assesses the intake of refined sugars by using rough estimate method. Further studies are needed to confirm these findings by renewing our refine sugar database with local or other countries’ Food and Nutrition Composition Database.
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