飲食控制與運動對山地民眾在體重、腰圍下降之成效探討：社區健康營造計畫的自然實驗

Investigating the combined effects of diet and physical exercise on reducing body weight and waist circumference among mountain-dwelling Taiwanese people:Natural experiment of healthy community project

Background and purpose: Obesity increases morbidity and mortality. Dieting and exercise are the most frequently methods used to decrease body weight. However, the superiority of diet alone, exercise alone, or a combination of the two in reducing body weight is sti11 controversial. We evaluated the role of diet and exercise instruction on decreases in body weight, body mass index (BMI), and waist circumference (WC) among a group of mountain-dwelling Taiwanese. We were particularly interested in how body weight, BMI, WC reduction were associated with diet alone, exercise alone, two activities combined. Method: An intervention study of diet education (2 weeks) and exercise instruction (10 weeks), as part of the healthy community project which served as a natura1 experiment, was conducted with residents of Fushing Township, northem Taiwan. Results:A total of 50 adu1ts participated in the program. The mean BMI was 26.1 kg/m2 and 68% were overweight (BMI≧24 kg/m2)at baseline. After the diet education and exercise program, there were significant reductions in body weight (0.8 kg), BMI (0.3 kg/m2), and WC (l.7 cm). These reductions in body weight (r=-0.42), BMI (r=-0.4 1), and WC (r=-0.53) were most significant1y correlated with tota1 attendance in the diet and exercise activities combined. Condusion: This natural experiment of healthy community project showed that participants' body weight, BMI, and WC reduction were most correlated with overall frequency of attendance in diet and exercise classes combined. 背景與目的:肥胖會增加疾病率及死亡率。飲食控制與運動是最常被用來減重的方法。但是單純採用飲食控制、單純採用運動，或採用合併此兩種方法在減重之效果何種較佳尚無定論。本研究評估山地民眾飲食控制與運動之綜合效果對減重之影響，我們特別對上述方法(單純考慮任一種、同時考慮兩種)在減重之效果作統計分析。材料與方法:本研究為社區健康營造計畫的一部份，可視為一自然實驗，屬單組有前後測的實驗設計。介入活動在機園復興鄉施行，包括飲食控制課程2週及運動課程10週。結果:共50位成人參加活動。活動介入前平均BMI為26.1 kg/m2 ，且有68% 的人屬過重範圍(BMI≧24kg/m2 ) 。經過飲食控制及運動課程的介入後，體重( 0.8公斤)、BMI (0.3 kglm2 ) 、腰圍( l. 7公分)均有明顯的減少。且飲食控制及運動合併與體重、BMI、腰圍下降之相關最強，相關係數分別為-0 .42，-0.41，-0.53。結論:本社區健康營造的自然實驗結果顯示，飲食控制及運動合併對體重、BMI、腰圍下降的效果最佳。