飲食動植物性蛋白質與礦物質來源對兒童生長發展之相關研究
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2013
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近年來世界衛生組織鼓勵飲食多攝取植物性來源食物，對於健康與慢性病的預防相較動物性來源好；而飲食蛋白質與礦物質來源對兒童生長發展亦扮演重要角色。本研究目的為提供本土學齡前兒童動或植物性礦物質鈣、鎂、鐵、鋅與蛋白質來源攝取狀況，並探討其與幼童體位及食物攝取等因素之相關性。
本研究為前瞻性長期世代研究，分別於民國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，並以相同的問卷調查方法收集飲食、健康狀況、體位發展等資料。動植物性礦物質與蛋白質攝取狀況是利用幼童兩日24小時飲食回憶資料進行分析，以獲取平均攝取量及比例，再以SPSS 19.0及 STATA 8.0進行統計分析。
結果顯示，6歲幼童平均一日動植物性鈣攝取各為220±140及108±57毫克，比例介於0.04~11.03 (ratio<1:22%)；動植物性鎂攝取各為46±18及103±36毫克，比例介於0.04~1.45 (ratio<1:96.7%)；動植物性鐵攝取各為4±2及5±2毫克，比例介於0.05~3.81 (ratio<1:58.5%)；動植物性鋅攝取各為3±2及3±1毫克，比例介於0.11~4.20 (ratio<1:61%)；動植物性蛋白質攝取各為26±10及25±7公克，比例介於0.19~3.43 (ratio<1:50.4%)。其中幼童飲食鎂、鐵和鋅攝取以植物性來源較多，鈣攝取以動物性來源為主，蛋白質攝取來源則較為均衡。若與國人膳食營養素參考攝取量(Dietary Reference Intakes, DRIs)比較，幼童飲食不足DRIs的礦物質為鈣；鎂和鋅超過DRIs約1.2倍，鐵約接近DRIs；蛋白質攝取則超過DRIs約1.7倍。
食物攝取方面，幼童飲食動物性礦物質來源以牛奶、奶粉及豬肉居多，植物性礦物質以白飯、麵條及豆製品占多數。而蛋類、乳製品類及肉類，深色蔬菜及水果類分別與動物和植物性礦物質及蛋白質呈顯著正相關。此外，經控制性別和出生體型後，幼童於6歲時體重與鎂和鐵總攝取量有顯著相關；身高與植物性礦物質攝取有顯著相關；BMI則與動物性蛋白質有相關性存在。多元迴歸分析結果顯示體重以出生體重、鎂和鐵總攝取量具影響力；身高以出生身長及植物性礦物質較具影響力。
本研究亦合併兩世代嬰幼兒出生至6歲(n=123)的資料，依出生體重第25及第75百分位分為相對低出生體重(relative low birth 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，追蹤至幼童6歲之身高、體重及BMI於三組間達顯著差異(p<0.05)，以rHBW組保持最高，rLBW組保持最低；且三組之BMI於1~5歲呈逐年下降，於5~6歲時有微幅上升的情形。此外，三組幼童0~6歲之體型增加倍數、增加百分比亦有顯著差異存在(p<0.05)。6歲幼童平均熱量攝取為1484大卡，醣類、蛋白質及脂質分別為218、53及45公克，各占總熱量58%、14%及27%；膳食纖維攝取仍不足建議量的一半。
整體而言，本研究6歲幼童飲食除了鈣攝取不足DRIs外，鎂、鐵、鋅和蛋白質攝取皆符合或超過建議量。本研究乃國內首次以橫斷性研究設計進行幼童飲食動植物性礦物質攝取狀況及其與體位和食物攝取來源之相關性探討，未來如欲推廣至兒童營養教育仍需更多長期追蹤的資料進行分析，以釐清整體相關性。
Dietary intake of plant foods rather than animal foods is currently encouraged by World Health Organization (WHO) for a better health and prevention of chronic disease. Therefore, dietary intake and food sources of protein or minerals play an important role on children’s diet. The purpose of this study is to investigate the dietary intake of animal and plant minerals calcium, magnesium, iron, zinc and protein among local pre-school children aged 6 years old, and to examine its association with children’s anthropometric status, food sources intake and other relevant factors. This research is a prospective cohort studies, which included the first cohort of 151 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 methodology and questionnaire content adopted in two cohorts are identical. The intakes of dietary animal and plant minerals or protein are calculated by using the 2-day 24-hours recall to obtain the average daily intake and its ratio. The software of SPSS 19.0 and STATA 8.0 are used for the statistical analysis. The results indicate that dietary animal and plant calcium intake are 220±140 mg and 108±57 mg, its ratio ranged from 0.04~11.03 (ratio<1:22%). Dietary animal and plant magnesium intake are 46±18 mg and 103± 6 mg, its ratio ranged from 0.04~1.45 (ratio<1:96.7%). Dietary animal and plant iron intake each 4±2 mg and 5±2 mg, its ratio ranged from 0.05~3.81 (ratio<1:58.5%). Dietary animal and plant zinc intake are 3±2 mg and 3±1 mg, its ratio ranged from 0.11~4.20 (ratio<1:61%). Dietary animal and plant protein intake each 26±10 g and 25±7 g, its ratio ranged from 0.19~3.43 (ratio<1:50.4%). It’s showed that plant foods contribute mainly to dietary intake of minerals magnesium, iron and zinc among these children, while animal foods contribute to dietary intake of calcium, and the dietary protein’s food sources intake are considered balanced. Compare to the Dietary Reference Intakes (DRIs), calcium intake is inadequacy and below the DRIs, magnesium and zinc are about 1.2 times more than DRIs, iron intake is approaching DRIs, while protein intake is about 1.7 times more than DRIs. The main food sources of animal minerals are milk, milk powder and pork, while plant minerals are rice, noodles and soy products among children’s diet. In addition, dark green vegetables and fruits consumption are positively associated with plant minerals and protein intake, while eggs, dairy products and meat products are associated with dietary animal minerals and protein intake. Besides, after controlling for gender and birth size, children’s weight at age 6 is significantly associated with total magnesium and total iron intake, height is associated with plant minerals intake, while BMI is associated with animal proteins intake. Futher by multiple regression analysis result showed that birth weight, total magnesium and total iron intake are the better predictor for children’s weight at age 6, while birth length and plant minerals play an influential factors on children’s height. This study combined two cohorts’ children age ranging from birth to 6 year old data (n=123). These children are divided into 3 groups according to the 25th and 75th birth weight 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 results show that the growth indicators (weight, height and BMI) are significant different from age 0 to 6 among the three groups (p<0.05). The rHBW group still maintains higher means for weight, height and BMI, while the rLBW group is smallest among the three groups. Children’s BMI from aged 1 to 5 is declining, while slightly rebound at the age of 6. 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 mean daily calorie intake of 6-year-old children is 1484 Kcal, and the average dietary intakes of carbohydrate, protein and fat are 218 g, 53 g, and 45 g respectively. The total energy is made up by 56% from carbohydrates, 14% from protein, and 29% from fat. The mean dietary fiber intake is still less than the half of the IOM reference. Overall, dietary intake of minerals magnesium, iron, zinc, and protein meet the DRIs while calcium intake is inadequate among 6-year-old children. However, the present study is the first time to investigate the association between dietary intake of animal or plant minerals and protein with children’s anthropometric status and food sources intake. Thus, it’s required more long-term data to clarify its overall correlation.
Dietary intake of plant foods rather than animal foods is currently encouraged by World Health Organization (WHO) for a better health and prevention of chronic disease. Therefore, dietary intake and food sources of protein or minerals play an important role on children’s diet. The purpose of this study is to investigate the dietary intake of animal and plant minerals calcium, magnesium, iron, zinc and protein among local pre-school children aged 6 years old, and to examine its association with children’s anthropometric status, food sources intake and other relevant factors. This research is a prospective cohort studies, which included the first cohort of 151 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 methodology and questionnaire content adopted in two cohorts are identical. The intakes of dietary animal and plant minerals or protein are calculated by using the 2-day 24-hours recall to obtain the average daily intake and its ratio. The software of SPSS 19.0 and STATA 8.0 are used for the statistical analysis. The results indicate that dietary animal and plant calcium intake are 220±140 mg and 108±57 mg, its ratio ranged from 0.04~11.03 (ratio<1:22%). Dietary animal and plant magnesium intake are 46±18 mg and 103± 6 mg, its ratio ranged from 0.04~1.45 (ratio<1:96.7%). Dietary animal and plant iron intake each 4±2 mg and 5±2 mg, its ratio ranged from 0.05~3.81 (ratio<1:58.5%). Dietary animal and plant zinc intake are 3±2 mg and 3±1 mg, its ratio ranged from 0.11~4.20 (ratio<1:61%). Dietary animal and plant protein intake each 26±10 g and 25±7 g, its ratio ranged from 0.19~3.43 (ratio<1:50.4%). It’s showed that plant foods contribute mainly to dietary intake of minerals magnesium, iron and zinc among these children, while animal foods contribute to dietary intake of calcium, and the dietary protein’s food sources intake are considered balanced. Compare to the Dietary Reference Intakes (DRIs), calcium intake is inadequacy and below the DRIs, magnesium and zinc are about 1.2 times more than DRIs, iron intake is approaching DRIs, while protein intake is about 1.7 times more than DRIs. The main food sources of animal minerals are milk, milk powder and pork, while plant minerals are rice, noodles and soy products among children’s diet. In addition, dark green vegetables and fruits consumption are positively associated with plant minerals and protein intake, while eggs, dairy products and meat products are associated with dietary animal minerals and protein intake. Besides, after controlling for gender and birth size, children’s weight at age 6 is significantly associated with total magnesium and total iron intake, height is associated with plant minerals intake, while BMI is associated with animal proteins intake. Futher by multiple regression analysis result showed that birth weight, total magnesium and total iron intake are the better predictor for children’s weight at age 6, while birth length and plant minerals play an influential factors on children’s height. This study combined two cohorts’ children age ranging from birth to 6 year old data (n=123). These children are divided into 3 groups according to the 25th and 75th birth weight 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 results show that the growth indicators (weight, height and BMI) are significant different from age 0 to 6 among the three groups (p<0.05). The rHBW group still maintains higher means for weight, height and BMI, while the rLBW group is smallest among the three groups. Children’s BMI from aged 1 to 5 is declining, while slightly rebound at the age of 6. 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 mean daily calorie intake of 6-year-old children is 1484 Kcal, and the average dietary intakes of carbohydrate, protein and fat are 218 g, 53 g, and 45 g respectively. The total energy is made up by 56% from carbohydrates, 14% from protein, and 29% from fat. The mean dietary fiber intake is still less than the half of the IOM reference. Overall, dietary intake of minerals magnesium, iron, zinc, and protein meet the DRIs while calcium intake is inadequate among 6-year-old children. However, the present study is the first time to investigate the association between dietary intake of animal or plant minerals and protein with children’s anthropometric status and food sources intake. Thus, it’s required more long-term data to clarify its overall correlation.
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學齡前兒童, 鈣, 鎂, 鐵, 鋅, 蛋白質, 世代研究, preschoolers, calcium, magnesium, iron, zinc, protein, cohort study