盧立卿Lyu, Li-Ching陳采蘋Chen, Cai-Ping2023-12-082024-08-312023-12-082023https://etds.lib.ntnu.edu.tw/thesis/detail/180fa836b55e59092f263ab7091cb4a7/http://rportal.lib.ntnu.edu.tw/handle/20.500.12235/121899流行病學研究發現出生體重影響著兒童日後的生長狀況，並與成年後慢性疾病發生的風險有關。此外，飲食與生長和健康發展的關係也密不可分，在成年之前，兒童與青少年期維持良好的營養狀況是也是奠定生長發育和健康的重要基礎。故本研究欲探討本土不同出生體重兒童在兒童與青少年期之飲食營養攝取是否具有差異及對其生長發展之影響。本研究為世代研究，研究對象來自民國91及93年所招募之2個長期追蹤世代。將受試者以出生體重之第25及75百分位為切點分為3組：相對低出生體重(relative low birth weight, rLBW)、相對適當出生體重(relative adequate birth weight, rABW)及相對高出生體重(relative high birth weight, rHBW)，每年定期以電話訪問收集24小時飲食回憶、體位等資料，持續追蹤兒童至16歲 (n=80)。統計軟體使用SPSS 23.0 進行分析。追蹤兒童至16歲，發現到不論身高、體重及BMI，rLBW、rABW及rHBW三組兒童之間歷年體位均達顯著差異。16歲時rHBW兒童之體位為最高，而rLBW為最低。兒童生長速度觀察到，0-2歲時rLBW與rHBW兒童之身高變化量顯著大於rABW兒童；rHBW兒童在出生-1歲及9-10歲之體重變化量顯著高於rLBW兒童。兒童長期營養攝取變遷發現，16年來全體兒童在熱量、三大營養素與多數微量營養素攝取皆隨年齡增加呈顯著增加趨勢；而醣類佔總熱量百分比、鈣及維生素D攝取則是隨年齡增加呈顯著下降趨勢 (p for trend<0.001)。歷年來兒童之膳食纖維及維生素D皆有攝取不足情形，鈣則於4歲後開始攝取不足。比較不同出生體重兒童歷年營養素攝取差異，發現16歲時rABW兒童在熱量、三大營養素顯著高於rLBW與rHBW兒童。 不同時期營養素攝取與16歲體位之相關性分析中發現，控制性別與出生體重後，13歲之維生素B1、16歲之鉀、鈣、鎂、維生素B1、B2與16歲身高呈顯著正相關；6歲鎂、16歲維生素D、維生素K、維生素B1、維生素C和1歲維生素C與16歲體重呈顯著正相關；6歲鐵、1歲維生素B12以及1歲和16歲之維生素C與16歲BMI呈顯著正相關。綜合以上，出生體重雖影響兒童16歲之體位分佈，但後天適當的微量營養素攝取亦對青少年時期之生長發育相當重要。Epidemiological studies have found that birth weight has impact on the growth and is associated with the risk of developing chronic diseases in adulthood. Additionally, the relationship between diet, growth and health development is closely intertwined. Maintaining good nutritional status during childhood and adolescence lays a crucial foundation for growth, development and health before adulthood. Therefore, this study aims to explore whether there are differences in dietary nutrient intakes among children with different birth weights group and its influence on their growth development during childhood in a local population.This longitudinal study consists of the two long-term follow-up cohorts recruited in 2002 and 2004. The participants were divided into three groups based on the 25th and 75th percentiles of birth weight cut points: relative low birth weight (rLBW), relative adequate birth weight (rABW), and relative high birth weight (rHBW). Data on 24-hour dietary recalls, anthropometry, and other relevant information were collected through regular telephone interviews every year, and the children were followed until 16 years old (n=80). The data for this study was analyzed using IBM SPSS Statistics software version 23.0.Following up the children until 16, significant differences in anthropometry were observed among the three groups (rLBW, rABW, and rHBW), regardless of height, weight, or BMI. At the age of 16, rHBW children had the highest anthropometric measures including height, weight and BMI, while rLBW children had the lowest. On the growth velocity, it was observed that from 0 to 2 years old, rLBW and rHBW children had significantly greater changes in height than rABW children. Additionally, rHBW children showed significantly higher changes in weight than rLBW children during the period from birth to 1 year and at the ages of 9 to 10.Regarding the long-term dietary nutrient intake changes in children, it was found that over the 16 years, all children exhibited a significant increase in energy and macronutrient intakes, as well as most micronutrients, with increasing age. However, the percentage of carbohydrates of total energy intake, and the intakes of calcium and vitamin D, showed a significant decreasing trend with age (p for trend<0.001) Throughout the years, inadequate intakes of dietary fiber and vitamin D were observed in children, and calcium intake started to be inadequate after the age of 4. Comparing the differences in nutrient intakes among children with different birth weights, it was found that at the age of 16, rABW children had significantly higher energy and macronutrient intakes compared to rLBW and rHBW children. The correlation analysis between nutrients intake at different stages and anthropometry at theage of 16, after adjusting for gender and birth weight, it was found that vitamin B1 at the age of 13, potassium, calcium, magnesium, vitamin B1, B2 at the age of 16 were significantly positively correlated with height at the age of 16. Magnesium at the age of 6, vitamin D, vitamin K, vitamin B1, vitamin C at the age of 16 were significantly positively correlated with weight at the age of 16. Iron at the age of 6, vitamin B12 at the age of 1, and vitamin C at the ages of 1 and 16 were significantly positively correlated with BMI at the age of 16.In conclusion, birth weight indeed influences the distribution of anthropometric measures at the age of 16 in children, but proper consumption of micronutrients during adolescence is also crucial for growth development.出生體重生長發育營養攝取生長速度前瞻性世代研究birth weightgrowth developmentnutrition intakegrowth rateprospective cohort studyetd