| Abstract: | 背景：因為宗教、健康、環境保護...等的因素，世界各地的素食人口有越來越多的趨勢。研究顯示素食飲食可降低高血壓、心血管疾病、第二型糖尿病、以及某些癌症的發生率。然而，素食飲食可能會有某些營養素缺乏的危險，例如維生素B-12。維生素B-12缺乏會造成血漿同半胱胺酸濃度升高，進而增加發生心臟血管疾病的潛在危險。
研究目的：比較素食與非素食幼兒及其父母之飲食攝取、營養狀況、維生素B-12與血漿同半胱胺酸濃度。進一步探討血漿同半胱胺酸、維生素B-12濃度之相關性。
研究方法：本研究共募集56位非素食者（28位幼兒及他們的其中一位父母）與42位素食者（21位幼兒， 18位蛋奶素食、3位蛋素食；21位父母，16位蛋奶素食、2位蛋素食、1位奶素、2位全素食）。體位測量包括身高、體重、三頭肌皮下脂肪厚度，並計算身體質量指數和重高指數。以三天飲食記錄計算營養素攝取量。收集受測者空腹靜脈血液，分析血液生化值、血漿同半胱胺酸、以及維生素B-12濃度。
結果：素食與非素食者幼兒與父母之的身高、體重、身體質量指數、和三頭肌皮下脂肪厚度皆無差異。素食幼兒與父母的脂肪攝取顯著低於非素食幼兒與父母，但是膳食纖維攝取顯著高於非素食幼兒與父母。素食幼兒的蛋白質攝取顯著低於非素食幼兒，而維生素C攝取顯著高於非素食幼兒，素食父母的鐵和維生素A攝取顯著低於非素食父母。不論素食幼兒與父母或是非素食幼兒與父母平均鈣攝取量都低於台灣膳食營養素參考攝取量的75％。所有組別的平均血液生化數值都在正常範圍。素食幼兒與父母的平均血液膽固醇濃度和血漿鐵蛋白濃度顯著低於非素食幼兒與父母。素食幼兒與父母的血漿同半胱胺酸濃度在正常生理範圍，雖然其濃度微高於非素食幼兒與父母，但並無顯著差異。非素食幼兒與父母的飲食維生素B-12攝取顯著高於素食幼兒與父母，但是血漿維生素B-12濃度兩組並無顯著差異。在調整年齡、性別、身體質量指數、血清肌酸酐等干擾因子之後，非素食父母之血漿同半胱胺酸濃度與血清葉酸（p = -0.15）和維生素B-12 （p = -0.05）攝取呈顯著負相關。
結論：素食與非素食幼兒皆有正常的生長與充足的營養狀況。所有父母與幼兒受測者的飲食平均鈣攝取量是不足的，當幼兒期正處於生長發育的階段，若飲食鈣攝取不足時可能會影響骨骼牙齒的發育與健康。素食幼兒與父母飲食維生素B-12的攝取低於非素食幼兒與父母，然而血漿維生素B-12的濃度兩者並無顯著差異。素食者之血漿維生素B-12的濃度正常，且維生素B-12濃度與血漿同半胱胺酸沒有相關性。只要用心規畫素食飲食，不論幼兒或父母都可以滿足營養需要，且有正常的生長發育、營養狀況、以及血漿維生素B-12濃度。
Background: For ethical, health or environmental reasons, there are an increasing number of vegetarians in worldwide. Vegetarian diets have been shown a lower incidence of hypertension, coronary artery disease, type II diabetes, and certain cancer. However, vegetarians may be at risk of having certain nutrient deficiencies particular of vitamin B-12. Vitamin B-12 deficiency may increase plasma homocysteine concentration and then potentially increase the risk of cardiovascular disease.
Objective: The aim of this study was to assess and compare dietary intakes, nutritional status, plasma homocysteine and vitamin B-12 status between vegetarian and omnivorous preschool children and their parents. In addition, the association between homocysteine and vitamin B-12 concentration was also examined.
Methods: Fifty-six omnivores (28 preschool children and one of their parents), 42 vegetarians (21 preschool children with 18 lacto-ovo-vegetarians and 3 ovovegetarians; 21 parents with 16 lacto-ovo-vegetarians, 2 ovo-vegetarians, 1 lacto-vegetarian, and 2 vegans) were recruited in this study. Anthropometric measurements were taken; body mass index and weight-for-height index (WHI) were calculated. Nutrient intake was recorded using 3-day dietary records. Fasting venous blood samples were obtained to estimate hematological parameters, plasma homocysteine, and vitamin B-12 concentrations.
Results: The height, weight, body mass index, WHI, and triceps skinfold thickness values were not different between omnivores and vegetarians in both parent and child groups. Both vegetarian parent and their children had significantly lower fat and higher fiber intakes than omnivorous parents and their children. Vegetarian children had significantly lower protein and higher vitamin C intakes than omnivorous children, whereas vegetarian parents had significantly lower vitamin A and iron intakes than omnivorous parents. Vegetarians and omnivores in both parent and child groups had mean calcium consumption less than 75% of the Taiwan dietary reference intake. All subjects’ mean hematologic and biochemical status indicators were within the normal range. However, both vegetarian parents and children had significantly lower mean total cholesterol and serum ferritin concentrations than those of omnivorous parents and children. Mean plasma homocysteine concentration of vegetarian parents and their children was in the physiological range, and they had slightly but not significantly higher plasma homocysteine levels than omnivores. Omnivorous parents and their children had significantly higher vitamin B-12 intake but similar serum vitamin B-12 concentrations than vegetarian subjects. Plasma homocysteine concentration was only significantly and negatively associated with serum folate levels (B = -0.15) and dietary vitamin B-12 intake (B = -0.05) in the omnivorous parents after adjusting for age, gender, body mass index and serum creatinine.
Conclusion: Our vegetarian and omnivorous preschool children had normal growth and adequate nutritional status. However, both parents and children had inadequate calcium intakes, which may potentially affect bone health, especially for preschool children in the growing stage. Vegetarian parents and their preschool children had a lower vitamin B-12 intake but similar plasma vitamin B-12 concentration than omnivorous parents and their preschool children, and plasma vitamin B-12 concentration was not associated with plasma homocysteine levels. As long as carefully plan vegetarian diet for vegetarian children and parent, vegetarian diets can meet dietary requirements and have normal growth, nutritional status, and normal vitamin B-12 levels as omnivorous. |
