探討膳食中蛋白質攝取與臺灣成人體圍相關性

Abstract

目的：近十年亞洲富裕地區國家之營養調查結果顯示，膳食中總蛋白質攝取量增加，而腰圍、臀圍及肥胖比例有逐年攀升趨勢，但是也有研究發表高蛋白飲食有助於體重控制。因此本研究目的為透過飲食及體圍問卷所分析之結果，使用國際膳食指南所創立之最新健康餐食蛋白質品質指標 (Healthy plate protein source quality index, HPPQI)，探討臺灣成人膳食中蛋白質攝取與體圍之相關性。方法：收集282份之20–59歲臺灣成人飲食問卷資料，三種HPPQI指數經由本研究室之資料庫相關營養素分析後計算而得，HPPQIa多增加穀物類、蛋類以及乳製品之食物類別，HPPQIb則是多增加乳製品；體圍及體位則是經由體圍問卷資料進行整理及計算後而得，使用三種HPPQI指數五分位探討蛋白質攝取與體圍之相關性。結果：本研究以FIFFQ計算HPPQI、HPPQIa及HPPQIb五分位，受訪者平均每日熱量攝取1871 kcal，碳水化合物231 g (占總熱量50%)，蛋白質71g (占總熱量15%)，其中HPPQI分數越高，植物性蛋白質有顯著增加趨勢 (每日平均攝取29g)，相較HPPQI及HPPQIb，多數維生素及礦物質於HPPQIa五分位間呈增加趨勢。在體圍方面，多數體圍在HPPQIa及HPPQIb呈減少趨勢，而HPPQI則無觀察到顯著趨勢。在蛋白質食物類別與體圍相關性分析結果中，植物性蛋白質來源的精緻穀物攝取量越高，多項體圍增加；豆類攝取量越高，中臂圍及腰臀比增加。在動物性蛋白質來源的蛋類攝取量越高，臀圍、腰高比增加；魚類與海鮮類攝取量越高，上胸圍減少；乳製品攝取量越高，上胸圍、腰圍及腰臀比減少；於未精緻穀物、家畜類、加工肉類、全脂乳、低脂乳、起司及堅果類皆無觀察到與體圍之相關性。在胺基酸與體圍相關性分析中發現，多數胺基酸則與腰圍及腰臀比呈顯著負相關。結論：本研究發現雖然HPPQI指數與體圍沒有顯著相關性，但經由納入全穀物、雞蛋及乳製品等食物類別考量後的調整HPPQIa及HPPQIb模型發現與多數體圍呈現負相關，其中精緻穀物及蛋類攝取量攝取過量可能導致體圍增加，相較之下海鮮、魚類及乳製品的攝取可能與較低的體圍相關，因此綜觀上述，不同蛋白質來源食物種類的選擇會影響體型的表現。Objective: In the past decade, nutritional survey results from the affluent regions of Asia have shown an increase in the total dietary protein intake, along with a gradual rise in the waist circumference, hip circumference, and obesity rates. However, some studies have suggested that a high-protein diet can aid in weight control. Therefore, the aim of this study is to investigate the correlations between the dietary protein consumptions and body measurements in Taiwanese adults, using the results analyzed from dietary and body measurement questionnaires and the latest Healthy Plate Protein Source Quality Index (HPPQI) established by international dietary guidelines. Methods: We collected dietary questionnaire data from 282 Taiwanese adults aged 20-59. Three types of HPPQI indices were calculated based on the nutrient analysis from food composition databases. HPPQIa included a higher variety of grains, eggs, and dairy products, while HPPQIb included more dairy products. Body measurements were organized and calculated using the body measurement questionnaire data. We used the quintiles of the three HPPQI indices to explore the relationship between the protein consumptions and body measurements. Results: This study used the FIFFQ to calculate HPPQI, HPPQIa, and HPPQIb quintiles. Participants had an average daily calorie intake of 1871 kcal, with carbohydrates at 231 g (50% of total calories) and protein at 71 g (15% of total calories). Higher HPPQI scores were associated with a significant increase in daily intake of plant-based protein (average 29 g). Compared to HPPQI and HPPQIb, most vitamins and minerals showed an increasing trend in the HPPQIa quintile. Regarding anthropometric measures, most measurements decreased in the HPPQIa and HPPQIb quintiles, with no significant trends observed in HPPQI. In the analysis of protein food source categories and anthropometrics, higher intake of refined grains from plant-based sources was associated with several anthropometric increases. Increased legume consumption was linked to increased mid-arm circumference and waist-hip ratio. Among animal-based protein sources, higher egg intake was associated with increased hip circumference and waist-height ratio. Increased consumption of fish and seafood was associated with decreased upper chest circumference. Higher dairy intake was associated with decreased upper chest circumference, waist circumference, and waist-hip ratio. No correlation was observed between the anthropometrics and consumption of unrefined grains, livestock, processed meats, whole milk, low-fat milk, cheese, or nuts. Most dietary amino acids showed a significant negative correlation with waist circumference and waist-hip ratio. Conclusion: Although HPPQI scores showed no significant correlation with anthropometrics, adjusted models for HPPQIa and HPPQIb, including whole grains, eggs, and dairy products have showed a negative association with most anthropometric measures. Excessive intake of refined grains and eggs may lead to increased anthropometrics, whereas consumption of seafood, fish, and dairy products may be associated with lower anthropometrics.