營養教育對過重成人自我效能和飲食行為改變

Effects on Nutritional Education of Self-Efficacy and Eating Behaviors in Overweight Adults

肥胖（obesity）會促發許多慢性疾病，而減重有助預防罹患慢性疾病。許多研究發現實際上減重較容易，但維持正常體重困難，許多研究發現，經由營養教育，可讓病患得到高度的自我效能和良好的飲食行為是維持體重的有效方法，為探討個別和團體營養教育介入對於自我效能、飲食行為與體重維持的差異，本研究將65 位過重成人受試者隨機分為對照組（n=20）、營養教育個別組（n=22）以及團體組（n=23），研究時程共計8 個月，包括2 個月減重之營養教育課程以及6 個月追蹤體重的維持；受試者在第0 個月、第2 個月後以及第8 個月後接受身體組成、自我效能及飲食行為的檢測。本研究結果顯示，各組在營養教育介入前自我效能和飲食行為並無差異，而分析營養教育介入2 個月後數值發現，相較於對照組，個別組和團體組的自我效能及各項飲食行為皆有明顯增加（p＜0.05）；個別組修正脂肪、醣類、正向、負向等飲食行為的程度顯著高於團體組。本研究接續的維持期，共實施6 個月，結果對照組、個別組、團體組持續減重者比例分別是35%、68%、57%，顯示個別組或團體組持續減重及減重程度明顯高於對照組。本研究說明個別和團體營養教育課程對減重和維持減重後體重皆有效益，可提升自我效能和健康飲食行為，比較兩組營養教育，個別組在減重期可修正較多的飲食行為；在維持期較能持續進行減重。

Obesity is related to the development of many chronic diseases. It is well-known that body weight (BW) reduction can be beneficial for the prevention against several chronic diseases. In general, it's easily practical to reduce BW, but maintaining the reduced-BW is difficult. Many studies have suggested that it can be the way to maintain the BW by having higher self-efficacy and good eating behaviors, which were acquired probably through the nutritional education. To investigate the differences of self-efficacy, eating behaviors, and the BW maintain between the individualized and the group nutritional educations, sixty-five overweight subjects were randomly divided into three groups, the control (n=20) group, the INE (individual nutritional education, n=22) group, and the GNE (grouping nutritional education, n=23) group. The entire study had 8-months duration including 2-months course for weight-reduction and the 6-months follow-up for bodyweight maintenance. Subjects' body composition, self-efficacy and eating behaviors were analyzed at 0 (baseline), 2 (weight-reduction), and 8 (the follow-up) months. The data showed that there were no significantly difference in baseline self-efficacy and eating behaviors among these three groups. The INE and the GNE groups have higher degree of self-efficacy and good eating behaviors at 2 month while compared with that at baseline (P＜0.05). Compared to the GNE group, the INE group had higher healthy degrees of lipid, carbohydrate, positive and negative eating behaviors. After the follow-up, the observation which the percentages of lasting weight-reduction in the control, the INE, and the GNE groups were 35%, 68%, and 57% showed the INE group or the GNE group is more easy to keep the BW reduced when compared to the control group. This study suggested that the INE and the GNE both benefit to gain self-efficacy and healthy eating behaviors, to reduce BW, and to keep the BW reduced. While compared to the GNE, the INE had higher degree of healthy eating behaviors in the duration of weight-reduction and more practical to keep the BW reduced in the duration of maintenance.