台灣社區老人之飲食行為與其營養健康狀況改變之研究

The effects of dietary behaviors and related factors on health status change among the elderly in Taiwan

本研究在探討台灣社區老人之飲食行為及其影響因子，再分析老人飲食行為與其營養相關健康情形改變的相關性。研究對象是以全台分層抽樣的方式，抽出1999年2,828名居住於社區之老人為樣本，並於2003年追蹤同一世代中的2,131名老人。研究重點先探討老人之飲食內容、飲食狀況及是否攝取營養補充品的重要相關因子，再分析此三項飲食行為對其四年後之營養相關健康狀況改變的影響。研究結果發現，老人每日的進食以米飯類（98.7%）及蔬菜類（90.1%）的比率最高，奶類（42.3%）最低；平均進食2.96次、攝取3.6類食物。老人中有98.8%覺得份量足夠、80.8%有陪同進食者、81.7%覺得食慾好、39.9%有攝取營養補充品。社會互動網絡較多、有情感性支持的老人，其「飲食內容」與「飲食狀況」較佳的比率及有「攝取營養補充品」的比率皆較高。邏輯斯迴歸結果顯示，有情感性支持之老人，其「飲食內容」與「飲食狀況」較佳的發生比皆較高；縱貫分析發現，有攝取營養補充品、每天進食水果的老人，其門診次數、BMI不變或變好的比率較高。因為居家老人的飲食行為受個人特質及家庭、社會支持系統之影響甚鉅，故建議未來應針對老人的個人狀況與家庭需求進行改善以促進老人營養相關的健康狀況。

The objectives of this study were discussed the dietary behaviors among the elderly in Taiwanese communities and the impact factors. Then, we analyzed the correlation between dietary behaviors and nutrition-related health changes of the elderly. Used the method of stratified samples throughout Taiwan to select out a total of 2,828 elderly people and living in the communities in 1999 and tracked a total of 2,131 elderly people in the same generation in 2003. The study focused on, firstly, discussing the important relevant factors of the three dietary behaviors --content of diet, dietary situation and consumption of dietary supplements. Then, further analysis of the effects of this three eating behaviors on the nutrition-related health change after 4 years. The results showed: The elderly people’s daily consumption of rice (98.7%) and vegetables (90.1%) were of the highest rates and milk (42.3%) was of the lowest. The average daily intake was of 2.96 times and 3.6 foods were taken. 98.8% of them felt the food intake was enough, 80.8% was accompanied while eating, 81.7% felt that they had a good appetite, and 39.9% took dietary supplements. The result also showed that the elderly people who have more social interactive network and better emotional support had a higher rate of “better dietary content”, “better dietary situation”, and “taking dietary supplements” . The result of logistic regression revealed that the elderly people with emotional support were more often to have better “dietary content” and “dietary situation”. The longitudinal analysis discovered that those elderly people who took dietary supplements and took the fruit everyday had more frequencies of seeking for medical advice and a higher rate to keep their BMi the same or get better. Dietary behaviors of the elderly are significantly influenced by their individual characters and family or social supports. Therefore, we recommend that in the future, for the purpose of improving the nutrition-related health conditions of the elderly, it should focus on the improvement of personal conditions and family needs of the elderly.