社區長者營養指導介入後飲食蛋白質攝取量與肌力改善之探討

Dietary Protein Intake and Muscle Strength Improvement Following a Nutritional Guidance Intervention Among Older Adults in the Community

目的
評估長者營養攝取與肌耐力狀況，營養指導的介入，蛋白質飲食攝取量和肌力改善之間相關性。
方法
社區65歲以上長者30位，為期三個月時間，由營養師介入營養指導，長者依據飲食紀錄圖示，攝取足量蛋白質。於首次及最後一次營養指導介入，使用迷你營養評估表單評估長者蛋白質攝取量指標。於首次及最後一次運動課程，運用上肢30秒肱二頭肌手臂屈舉次數與下肢30秒坐站測試次數測試肌耐力，運用握力測試器，測試肌力。
結果
使用配對樣本t檢定做分析，數值以平均值±標準差呈現，統計顯著標準為p<0.05；營養指導介入前後測：蛋白質攝取量指標分數（0.8±0.3分vs.1±0.1分；p<0.05），營養不良指標分數（25.3±2.5分vs.25.4±2.4分；p<0.05）。肌耐力與肌力前後測：慣用手30秒肱二頭肌手臂屈舉（4.83±0.38次vs.5±0次；p<0.05），非慣用手30秒肱二頭肌手臂屈舉（4.7±0.53次vs.4.93±0.25次；p<0.05），下肢30秒坐站測試（3.9±0.99次vs.4.2±0.96次；p<0.05），優勢手握力（21.47±7.12公斤vs.21.88±7.35公斤；p<0.05）。
結論
綜合上述分析，社區的長者在營養指導介入蛋白質攝取量與運動肌耐力訓練，在蛋白質量攝取增加與提升肌耐力表現，有正向顯著差異，有助於維持老化生理健康，預防延緩失能目標。

Purposes
The aim of this study was to evaluate the nutritional intake and muscle endurance status of older adults, the effect of a nutritional guidance intervention, and the correlation between protein intake and muscle strength improvement.
Methods
Thirty older adults over the age of 65 residing in the community received nutritional guidance from dieticians for 3 months, and were required to consume an adequate amount of protein according to a food tracking diagram. At the first and last nutritional guidance interventions, the participants’protein intake indicators were evaluated using the Mini Nutritional Assessment. During the first and last exercise classes, participants’muscle endurance was assessed using the 30-second bicep curl test for the upper limbs and the 30-second sit-to-stand test for the lower limbs. The participants’muscle strength was assessed using a hand grip dynamometer.
Results
Statistical analysis was performed using a paired-samples Student’s t test, and the data are presented as the mean±standard deviation. p<0.05 indicated statistical significance. Pre- and post-testing of the nutritional guidance intervention showed that the protein intake index scores were 0.8±0.3 vs.1±0.1(p<0.05), and the malnutrition index score was 25.3±2.5 vs.25.4±2.4(p<0.05). Pre- and post-testing of muscle endurance and muscle strength indicated 4.83±0.38 vs.5±0(p<0.05) 30-second bicep curls with the dominant hand and 4.7±0.53 vs.4.93±0.25(p<0.05) with the non-dominant hand. the number of 30-second sit-to-stand movements was 3.9±0.99 vs.4.2±0.96(p<0.05) and the grip strength of the dominant hand was 21.47±7.12kg vs.21.88±7.35kg(p<0.05).
Conclusions
In conclusion, providing older adults in the community with a nutritional guidance intervention on protein intake and muscle endurance training had a significant positive impact on increasing protein intake and improving muscle endurance performance, which can contribute to maintaining physiological health during aging and preventing and delaying functional decline.