臺灣北中南地區婦女懷孕期間之飲食差異及植化素攝取情形

Abstract

研究背景與目的 近年來臺灣衛生福利部推行彩虹飲食，均衡攝取多彩蔬果，獲得不同的植化素以降低國人罹患慢性疾病及癌症之風險。臺灣各個鄉鎮因地理位置及歷史背景，而擁有自己獨特的飲食文化，但目前國內缺乏統合多地區針對女性及母嬰飲食健康飲食差異性的探討。本研究為一前瞻性研究，探討臺灣北中南三區婦女懷孕期間飲食差異及初步瞭解臺灣國人植化素攝取情形。

研究方法 自民國98年11月至100年10月分別於於臺北市立聯合醫院婦幼院區、臺中市中山醫學大學附設醫院及高雄市義大醫院的產科門診，招募451位懷孕20週以內的健康婦女，利用面對面、電話訪談、郵寄及電子郵件等方式收集相關資料，包括孕婦基本資料、24小時飲食回憶問卷及新生兒基本資料。參考美國農業部網站及國內植化素分析研究，更新及補遺本研究室研發之營養素運算系統NUFOOD中植化素資料，進行營養素計算，利用統計軟體SPSS 21.0及STATA 8.0版進行統計分析。

研究結果 扣除中途退出者，研究分析以335位(北區122位、中區104位、南區109位)孕婦，平均年齡31歲，招募時懷孕週數為6~20週，平均身高160公分，孕前平均體重56公斤，平均BMI為22公斤/公尺2。北區及中區孕婦高社經地位及教育程度大學以上的人數比例高於南區孕婦。 以24小時飲食回憶分析營養素攝取情形，孕婦懷孕第一、二、三期平均熱量攝取分別為1627、1939、2007大卡，醣類、蛋白質、脂質三大營養素比例分別為15~16%、30~32%、53~54%。孕婦的熱量、蛋白質；脂質、單元不飽和脂肪酸、多元不飽和脂肪酸、飽和脂肪酸、膽固醇、動物性蛋白質、動物性脂質、植物性脂質、維生素A、維生素E、維生素K、維生素B1、維生素B2、維生素B6、維生素C、泛酸、生物素、葉酸、鉀、鈣、鎂、磷、鐵等營養素有顯著地區性差異存在(p<0.05)，大部分營養素攝取量是中區顯著高於其他兩區。 孕婦植化素平均攝取量，異黃酮類:total isoflavone 22.9mg、daidzein 9.8mg、genistein 12.4mg、glycitein 1.1mg；類胡蘿蔔素:α-carotene 276.4µg、β-carotene 3442.1µg、β-cryptoxanthine 181.8µg 、lutein+zeaxanthin 7487.8µg、lycopene 1269.0µg；類黃酮:quercetin 10.3mg、kaempferol 2.6mg、myricetin 1.3mg、isorhamnetin 0.3mg、luteolin 1.1mg、apigenin 0.5mg、hesperetin 10.4mg、naringenin 5.1mg、eriodictyol 0.5mg。大部分植化素平均攝取量略高於國內外植化素研究，但仍低於達蔬果攝取建議之族群。主要食物來源: 異黃酮類以黃豆及其製品為主；類胡蘿蔔素:α-carotene、β-carotene來源為深色蔬菜類、β-cryptoxanthine為水果類、lutein+zeaxanthin為深色蔬菜類、lycopene為水果類；類黃酮:quercetin主要食物來源為水果類、kaempferol為深色蔬菜類、myricetin為深色蔬菜類、isorhamnetin為深色蔬菜類、luteolin為水果類、apigenin為淺色蔬菜類，hesperetin、naringenin及eriodictyol皆由水果類所提供。 探討植化素與孕期體重增加量及新生兒出生體重、身長、頭圍、胸圍之相關性發現，並未發現顯著相關性。

結論 綜上所述，本研究初步探討臺灣北中南地區婦女於懷孕期間飲食結果存在地區性差異，植化素攝取多以深色蔬菜為主。基於植化素能降低癌症及慢性疾病風險之功效，建議國人每天均衡攝取各種顏色的蔬果，以攝取不同類別的植化素，滿足不同的生理需求。Background & purpose In recent years, promoting having a balanced diet and intake multicolored food by The Ministry of Health and Welfare in Taiwan. By choosing a variety of colour in the diet, we can get different phytochemicals to prevent and reduce the risk of cancer and chronic diseases. There are many studies evaluate dietary intakes, but the lack of studies investigate about diatary intakes of pregnant women in different areas.The purpose of this study is to collect and evaluate the current diatary and phytochemicals intakes of pregnant women of Taiwan by a prospective study..

Study method We recruited 451 health pregnant women less than 20 weeks from the Taipei City Hospital, Chung Shan Medical University Hospital and E-Da Hospital from Nov. 2009 to Oct. 2011. The basic characteristics, five 24 hour dietary recalls and the neonatal information by using face-to-face, telephone, mail and e-mail. Phytochemicals values of food in the NUFOOD system were based on The United States Department of Agriculture (USDA) and domestic databases. Statistical analyses were conducted using SPSS 21.0 and STATA 8.0 software.

Result The final analyses included total 335 women and their newborns ,the northern Taiwan (n=122), the central Taiwan (n=104) and the southern Taiwan (n=109). Before pregnancy, the average age was 31 years old, height was 160 cm, weight was 56 kg, BMI was 22 kg/m2. The results showed that The northern and central Taiwan proportion of high social-economic backgrounds and education is higher than higher than the southern of pregnant women. The results of the 24-hour dietary recalls evaluation indicated that the participants’ average daily calorie intake of three trimesters were 1627 Kcal, 1939 Kcal and 2007 Kcal, respectively. The percentage of energy was 15~16% of protein, 30~32% of fat, and 53~54% of carbohydrate.The women from the central Taiwan consumed more nutrients than those from the northern Taiwan and the southern Taiwan. The the results of the 24-hour dietary recalls evaluation indicated that the participants’ average daily phytochemaicals intake were slightly higher than other researches: total isoflavone 22.9mg, daidzein 9.8mg, genistein 12.4mg, glycitein 1.1mg, α-carotene 276.4µg, β-carotene 3442.1µg, β-cryptoxanthine 181.8µg, lutein+zeaxanthin 7487.8µg, lycopene 1269.0µg, quercetin 10.3mg, kaempferol 2.6mg, myricetin 1.3mg, isorhamnetin 0.3mg, luteolin 1.1mg, apigenin 0.5mg, hesperetin 10.4mg, naringenin 5.1mg, eriodictyol 0.5mg. Analysis showed that women’s main food sources of isoflavone (total isoflavone, daidzein, genistein, glycitein), carotenoid (α-carotene and β-carotene, β-cryptoxanthine, lutein+zeaxanthin, lycopene) and flavonoid (quercetin, kaempferol, myricetin, isorhamnetin, luteolin, apigenin, hesperetin, naringenin, eriodictyol) are soy products, dark-colored vegetables vegetable and fruits, and light-colored vegetables, dark-colored vegetables vegetable and fruits, respectively. However, the maternal phytochmeicals intakes didn’t show relationships with the gestational weight gain and birth outcomes by partial correlation analysis.

Conclusion The above results showed that there are difference of dietary and phytochemicals intakes between different areas of Taiwan during pregnancy. maternal dietary preferences do affect the nutrient intakes. However, the dietary preferences during pregnancy did not show relationships with the gestational weight gain and birth outcomes . Since an appropriate phytochemicals intake can reduce the risks of cancer and chronic diseases, for people phytochemicals intake below the recommended value of the vegetable and fruit, it is recommended to promote public increased intake of multicolored food, and increase rich in phytochemicals used to protect people's health. Key words：nutrition intake in pregnancy, phytochemicals, isoflavone, carotenoid, flavonoid