靜態作息與肥胖－－臺灣2002年「國民健康促進知識、態度與行為調查」之研究

Inactivity Status and Obesity in Taiwan– 2002 Survey on Knowledge, Attitude, and Practice of Health Promotion

目地：本研究利用大型的全國性健康問卷調查資料，來探討成人肥胖相關因素。本文在控制住其他影響肥胖的因素下，特別針對靜態作息中坐著及睡眠時間的因素進行分析，希望透過適當的體重控制衛教，達到減少肥胖成長的目的。方法：本文採用2002年台灣「國民健康促進知識、態度與行為調查」的全國性資料，18歲以上成人樣本共有23,809個受訪者，其中男性12,241人，女性11,568人。問卷內容包括個人基本資料、健康狀態和健康行為。本研究依據身體質量指數為依變項，以27公斤／公尺2為切點分為「肥胖」與「非肥胖」，進行邏輯斯複迴歸分析。結果：成人肥胖在靜態作息中的坐著時間，以≦4小時為控制組，發現隨著時間增多，肥胖的風險逐漸升高，男性與女性分別以久坐8-12小時及≧12小時的族群，肥胖風險明顯增加（勝算比＝1.24，95%信賴區間＝1.05-1.45；勝算比=1.27，95%信賴區間＝1.07-1.86）。靜態作息中的睡眠時間與肥胖呈現U型的關係，以≦5小時為控制組，可發現睡眠約7小時的受訪者，肥胖風險最低［男性：勝算比0.78（95%信賴區間＝0.66-0.92）；女性：勝算比0.89（95%信賴區間＝0.74-0.96）］。超過7小時後，肥胖風險又逐步上升；對女性而言，甚至超過8小時者，肥胖的機率持續上升（8小時：勝算比＝1.05，95%信賴區間＝1.02-1.12；≧9小時：勝算比＝1.07，95%信賴區間＝1.01-1.15）。結論：本文利用國內大型的調查資料，發現靜態作息中的坐著時間及睡眠時間與肥胖呈現相關性：隨著坐的時間增多，肥胖的風險逐漸升高，在男性以8-12小時，而女性則以≧12小時的族群最明顯。睡眠時間與肥胖則呈現U字型的風險分佈，在睡眠7小時的肥胖風險最低，且在男女性別均有統計上明顯差異。因此本文的結論可提供公共衛生施政參考，針對教育程度較低的民眾加強預防肥胖之衛教，建議除了注意飲食的攝取、適量運動外，減少靜態作息中的久坐時間及足夠的睡眠，也是同樣重要。

Objectives: We studied the causes of adult obesity by use of data from a large-scale health survey of Taiwanese patients, focusing on the relationship between inactivity status (sitting time and sleeping time) and obesity. Our ultimate aim was to improve weight control education in order to reduce the prevalence of obesity. Methods: There were 23,809 Taiwanese patients (12,241 males and 11,568 females) surveyed in the National Survey on Knowledge, Attitude, and Practice of Health Promotion 2002 (2002 HPKAP). This questionnaire considered socioeconomic data, health status, and health behavior. For statistical analysis, we used a multiple logistic regression model and classified patients as ”obese” or ”non-obese”. Results: Increased sitting time was associated with a greater risk of obesity. Compared with those who sat less than 4 h per day, males who sat 8-12 h per day and females who sat more than 12 h per day had significantly higher risk of obesity (OR=1.24, 95% CI: 1.05-1.45; OR=1.27, 95% CI: 1.07-1.86, respectively). There was also a U-shaped association between obesity and sleeping time. In particular, patients who slept 5 h per day had a higher risk of obesity than those who slept 7 h per day (males: OR=0.82, 95% CI: 0.66-0.92; females: OR=0.89, 95% CI: 0.72-0.92). Patients who slept 8 h or ≧9 h per day had a higher risk for obesity than those who slept 7 h per day, especially females (8 h per day: OR=1.05, 95% CI: 1.02-1.12; ≧9 h per day: OR=1.07, 95% CI: 1.01-1.15). Conclusions: This study suggests an association between inactivity Statns (sitting time and sleeping time) and obesity. Increased sitting time was associated with greater risk of obesity, especially for males who sat 8-12 h per day and females who sat more than 12 h per day. There was a U-shaped association between obesity and sleeping time, with the lowest obesity in patients who slept 7 h per day. From a public health standpoint, this paper reinforces the need to provide education programs to reduce obesity. In addition to modifications of diet and lifestyle, we suggest that patients be urged to decrease sitting time and to obtain adequate continuous sleep to reduce the likelihood of obesity.