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研究生: 吳映卿
Ying-Ching Wu
論文名稱: 以素食和運動為主的生活型態改變對成年人心血管疾病危險因子影響之探討
Effects of Vegan Diet and Exercise-Based Lifestyle on the CVD Risk Factors of Adults
指導教授: 吳文惠
Wu, Wen-Huey
學位類別: 碩士
Master
系所名稱: 人類發展與家庭學系
Department of Human Development and Family Studies
論文出版年: 2007
畢業學年度: 95
語文別: 中文
論文頁數: 131
中文關鍵詞: 新起點全素食運動強度心血管疾病同半胱胺酸高敏感性C反應蛋白
英文關鍵詞: NEWSTART, Vegan Die, exercise intensity, CVD, high Sensitivity C-reactive Protein(hsCRP), Homocysteine(Hcy)
論文種類: 學術論文
相關次數: 點閱:222下載:25
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  • 改變飲食及運動等生活型態以改善或促進健康的預防醫學蔚為風潮。本研究目的探討以新起點(NEWSTART)素食和運動為主的生活型態介入對傳統心血管疾病危險因子:空腹血糖、血壓、總膽固醇(TC)、三酸甘油酯(TG)高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、TC/ HDL-C;及新的獨立危險因子:高敏感性C反應蛋白( high sensitivity C-reactive protein, hsCRP),同半胱胺酸(Homocysteine﹐Hcy)的影響及成效評估。採立意取樣共收個案86位,以參加新起點(NEWSTART)13 天計畫的學員59位為實驗組平均年齡57.46±10.69歲,另招募沒有參加新起點的27位男女為對照組,平均年齡51.9±7.8歲;收集基本資料、生活型態史、飲食與運動強度評估、血液生化值等資料。實驗組實驗前、後比較,不論是全體、或男性組、女性組的BMI、血壓、空腹血糖、TG及TC等血脂值顯著下降,而BMI下降差值與TG呈正相關;HDL-C、hsCRP在全體及女性組呈顯著下降;Hcy濃度在男性組上升呈顯著差異。將實驗組依危險程度分高危險組、低危險組,NEWSTART介入後高危險組的血糖、低危險組的LDL-C、hsCRP呈顯著下降。將實驗組依熱量攝取與計畫相較,分偏少、正常、偏多3組,與實驗前比較,血壓、hsCRP下降僅在偏少組顯著;將實驗組依運動強度分中強度組、低強度2組,中強度組hsCRP下降較顯著;將實驗組依大於或小於50歲分2組,小於50歲組的血壓、LDL-C下降幅度大,大於50歲組Hcy濃度顯著較多。介入後與對照組比較,男性組的BMI,全體或男性組的收縮壓、舒張壓,血糖,全體的TG 、LDL-C,全體或女性組的TC、HDL-C均顯著低於對照組;但Hcy濃度在全體及女性組顯著上升。總結上述結果,以素食和運動為主的生活型態對心血管疾病的預防應有所裨益,但Hcy的上升需進一步研究。
    關鍵詞:新起點、全素食、心血管疾病、運動強度、同半胱胺酸、
    高敏感性C反應蛋白

    Abstract
    Lifestyle changes have been a recent trend in preventive medicine for health improvement. The purpose of this study was to investigate the effect of “NEWSTART” intervention including vegan diet and exercises on the traditional and new risk factors of coronary artery disease. A total of 86 subjects participated in this study by purposive sampling model. The experimental group consisted of 59 participants in a 13-day NEWSTART program and was 57.5±10.7 years old, whereas the control group included 27 healthy subjects and was 51.9±7.9 years old. The general information, and blood biochemical markers of all subjects were collected before and after the program. At the end of the NEWSTART program, BMI, systolic pressure, diastolic pressure, triglycerides (TG) and total cholesterol (TC) were significantly decreased in whole group, and male or female subgroups. The degrees of decreased BMI were positively correlated with that of TG. HDL-C and high sensitivity C-reactive protein (hsCRP) were significantly decreased in whole group and female subgroup; concentration of Homocysteine (Hcy) was significantly increased in male subgroup. When the experimental subjects were categorized by risk factors, the fasting plasma glucose (FPG) decreased only in high-risk subgroup, and LDL-C、hsCRP decreased only in low-risk subgroup. When the experimental subjects were categorized by caloric intakes, blood pressure and hsCRP were significantly decreased only in subgroup with calorie intake less than the planned amount. When the experimental subjects were categorized by exercise intensity, diastolic pressure, and hsCRP decreased only in subgroup with higher intensity exercise. When the experimental subjects were categorized by age, the decreases in diastolic pressure and LDL-C were larger and the increase in Hcy was smaller in subjects under 50’s than over 50 years old. When compare with control group, the BMI in males of experimental group, systolic pressure, diastolic pressure, blood sugar, and TG in experimental group and its male subgroup, TC and HDL-C in experimental group and its female subgroup, were significantly decreased. However, concentration of Hcy was significantly increased in experimental group and its female subgroup. In conclusion, a lifestyle with vegan diet and exercise is crucial for the prevention of cardiovascular disease. However, the elevated level of Hcy needs further investigation.

    Key words:NEWSTART、Vegan Diet、exercise intensity、cardiovascular disease(CVD)、high Sensitivity C-reactive Protein(hsCRP)、Homocysteine(Hcy)

    論 文 目 次 誌謝……………………………………………………………….….. i 中文摘要………………………………………………………….….. ii Abstract………………………………………………………….….. iii 目錄………………………………………………………….……….. iv 表目錄………………………………………………………….…….. vi 第一章 緒論………………………………………………….…….. 1 第一節 研究背景與動機………………………………………… 1 第二節 研究目的………………………………………….……… 4 第三節 名詞釋義…………………………………………………. 5 第二章文獻探討………………………………………………….….. 6 第一節 心血管疾病危險因子之探討及評估方法……………… 6 第二節 新興的心血管疾病危險因子…………………………… 13 第三節 生活型態與心血管疾病………………………………… 22 第四節 NEWSTART Lifestyle program介入對心血管疾病危險因子之影響……………………………………………… 36 第三章 研究設計………………………………………………….… 49 第一節 研究架構………………………………………………… 49 第二節 研究對象………………………………………………… 50 第三節 實驗流程………………………………………………… 51 第四節 血液生化值檢體處理方法……………………………… 57 第五節 資料處理分析方法………………………………………. 59 第四章 研究結果………………………………………………… 61 第一節基本資料分析……………………………………………… 61 第二節NEWSTART介入前生活習慣因子與心血管疾病危險因子…………………………………………………………… 62 一、運動與心血管危險因子…………………………………… 62 二、喝酒與心血管疾病危險因子……………………………… 62 三、咖啡因與心血管疾病危險因子…………………………… 62 四、抽菸與心血管危險因子…………………………………… 62 第三節NEWSTART介入後對生理指標、生化因子的影響……….. 63 壹、生理指標檢測………………………………………………… 63 一、身體質量指數……………………………………………… 63 二、血壓……………………………………………………… 63 貳、生化分析……………………………………………………… 63 一、一般血液生化值分析………………………………………… 63 (一)、空腹血糖………………………………………………. 63 (二)、三酸甘油酯…………………………………………… 64 (三)、總膽固醇………………………………………………… 64 (四)、高密度脂蛋白膽固醇…………………………………… 65 (五)、總膽固醇/高密度脂蛋白膽固醇……………………… 65 (六)、低密度脂蛋白膽固醇…………………………………… 65 二、 新興心血管疾病危險因子………………………………… 65 (一)、 高敏感性C反應蛋白…………………………………… 65 (二)、 同半胱胺酸…………………………………………… 65 第四節 NEWSTART介入後對高危險組與正常組心血管疾病危險因子的影響…………………………………………… 66 第五節 NEWSTART介入後對不同飲食熱量組心血管疾病危險因子的影響……………………………………………… 67 第六節 NEWSTART介入後對不同運動強度的心血管疾病危險因子的影響……………………………………………… 68 第七節NEWSTART介入後對不同年齡族群心血管疾病危險因子的影響………………………………………………….. 69 第八節 實驗組藥物服用處理狀況……………………………… 69 第五章 討論……………………………………………………… 86 第一節NEWSTART介入前之生活習慣因子與心血管疾病危險因子的探討……………………………………………… 86 第二節NEWSTART介入後對生理指標的影響……………………………………………………… 89 第三節NEWSTART介入後血液生化值分析………………………. 91 一、一般血液生化值分析…………………………………… 91 二、新興心血管疾病危險因子分析……………………… 91 第四節 NEWSTART介入後對高危險組與正常組心血管疾病危險因子的影響…………………………………………… 96 第五節 NEWSTART介入後對不同飲食熱量組心血管疾病危險因子的影響……………………………………………… 97 第六節 NEWSTART介入後對不同運動強度組心血管疾病危險因子的影響……………………………………………… 98 第七節NEWSTART介入後對不同年齡族群心血管疾病危險因子的影響………………………………………………… 99 第八節 NEWSTART介入後實驗組藥物服用資料處理……….. 100 第九節 研究限制…………………………………………………. 101 第六章 結論與建議……………………………………………… 102 參考文獻………………………………………………… 104 附表目錄……………………………………………….. 120 表目錄 表4-1 基本資料 70 表4-2-1 生活習慣因子-運動與心血管疾病危險因子 71 表4-2-2 生活習慣因子-喝酒與心血管疾病危險因子 72 表4-2-3 生活習慣因子-咖啡因飲料與心血管疾病危險因子 73 表4-2-4 生活習慣因子-抽菸與心血管疾病危險因子 74 表4-3 生理指標檢測 75 表4-4-A BMI 分佈 76 表4-4-B BMI下降差值與心血管疾病危險因子的相關性 76 表4-5 一般血液生化分析 77 表4-6 心血管疾病獨立危險因子分析 79 表4-7 NEWSTART介入實驗組前後測比較 80 表4-8 NEWSTART介入對照組前後測比較 81 表4-9 NEWSTART介入對高危險組與正常組CVD危險因子之影響 82 表4-10 NEWSTART介入期熱量攝取差異對CVD危險因子的影響 83 表4-11 NEWSTART介入對不同運動強度組CVD危險因子的影響 84 表4-12 NEWSTART介入對不同年齡組CVD危險因子的影響 85 附表目錄 附錄一 受試同意書……………………………………………….120 附錄二 對照組(葷食者)收案流程…………………………….121 附錄三.1 民國九十四年台灣地區十大死因統計表……………..122 附錄三.2 民國九十四年台灣地區男性十大死因統計表………..123 附錄三.3 民國九十四年台灣地區女性十大死因統計表………..124 附錄四 參加 NEWSTART前生活型態及健康史問卷………….125 附錄五 個人飲食計劃表………………………………………….126 附錄六 運動頻率與強度記錄……………………………………..127 附錄七 新起點13日班課程表(範例)…………………………….128 附錄八 同半胱胺酸代謝圖…………………………………….…131

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    (三)、網路參考資料
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    王治元(2002)新陳代謝症候群。台灣。http://www.femh.org.tw/active/1101act3.aspx

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