心肺適能結合BMI 對健康體位之影響評估

Assessment of the combined effects of cardiorespiratory fitness and BMI on healthy body weight

據世界衛生組織的統計，全世界的肥胖人口不斷的增加，不只是成人，兒童及青少年過重或肥胖的比例也是逐年提高。自1990年起，世界衛生組織提倡全世界應落實並推動健康促進學校，在臺灣已推動了近二十年，身體質量指數就是評估學生健康體位的主要指標，但也常被家長、學生及老師質疑是否真的能被準確的評估體位。文獻回顧顯示心肺適能亦是評估人體健康的重要指標之一，良好的心肺適能可降低罹患各種疾病與死亡的風險。因此，經BMI評估為過重及肥胖體位的兒童與青少年，再輔以心肺適能作為健康體位判別的輔助指標，應可及早介入輔導，以達早期改善兒童青少年肥胖之效。目前，花蓮縣教育處在111學年度花蓮縣國民中小學健康促進學校計畫中，試辦將學生心肺適能納入作為評估健康體位的輔助指標，行政執行面有87.9%的比例，實務面則有76.4%比例，認同將健康體位結合心肺適能指標分類，能提升學生整體健康狀態。因此，建議未來我國執行健康促進學校的計畫，可將心肺適能作為輔助指標，協助BMI來評估學生健康體位，讓健康體位評估更佳精準，並進一步的強化健康促進計畫之成效，讓更多學童受惠。

According to the World Health Organization (WHO), the global prevalence of obesity continues to rise steadily, affecting not only adults but also children and adolescents. Since 1990, the WHO has promoted the health promoting schools (HPS) framework worldwide, and Taiwan has implemented this initiative for nearly two decades. Body mass index (BMI) remains the primary indicator used to assess students’healthy body weight; however, its accuracy is frequently questioned by educators, students, and parents due to its limitations in distinguishing body composition. Emerging research underscores the importance of cardiorespiratory fitness (CRF) as a complementary health indicator, as higher CRF levels are associated with reduced risks of chronic disease and premature mortality. For children and adolescents categorized as overweight or obese by BMI, incorporating CRF into the assessment process may enable earlier identification of health risks and facilitate timely interventions. In the 2022 academic year, Hualien County launched a pilot program integrating CRF as a supplementary indicator to BMI within the HPS framework. The program received strong support, with 87.9% of respondents endorsing its administrative feasibility and 76.4% affirming its practical value. Most school personnel reported that combining BMI and CRF allowed for more accurate identification of at-risk students and more effective targeting of health promotion resources. This study recommends that future implementations of the HPS program in Taiwan formally incorporate CRF as a supplementary indicator to BMI. Doing so would enhance the precision of student health assessments and strengthen the overall impact of health promotion initiatives across school settings.