| Abstract: | 骨質疏鬆症（osteoporosis）及其所引發的骨折被認為是很重要的公共衛生健康的問題。兒童期是骨礦物質累積的重要時期；在此階段若骨量累積不足可能是造成日後低骨量和發生骨質疏鬆症的危險因子之一。本研究目的想了解台灣地區國小學童骨質與生活型態因子之關係。以「2001-2002台灣地區國小學童營養健康狀況調查」中有問卷、體檢資料和有進行骨質檢測的2166位學童為分析對象。以可攜式超音波骨密度測量儀評估腳跟骨質狀況。
分析結果顯示，增加體能活動【包括爬樓梯 (男生β = 0.90, 女生β = 1.04)、運動次數 (男生β = 1.53, 女生β = 1.57)、體育課活動天數 (男生β = 3.33, 女生β = 2.95) 與時間 (男生β = 1.86, 女生β = 2.13)、每週體育課總活動時間（男生β = 0.75女生β = 0.66）和參加運動性社團個數 (男生β = 3.85, 女生β = 4.42)】與男、女生的骨質皆有正向的關聯性 ( p < 0.05)。男生在調整年齡後，沒有發現體能活動和飲食頻率與骨質有關。女生在調整年齡、身高、體重和地區層後，發現運動次數和骨質BUA有關（β = 0.76, p < 0.05）。與骨質相關的營養素（鈣、磷、鈉、鎂、鉀）和學童骨質沒有顯著相關性。經由調整年齡後，男女生牛奶和起司的攝取與骨質仍無顯著的相關性。男女生鈣質攝取量明顯低於DRIs，且每天蔬果類的攝取量也明顯低於建議量。奶類的攝取份數雖有達到建議量，但鈣質攝取量卻未達到DRIs的建議量，可能是其他含鈣食物攝取不夠以致於鈣質總攝取量不足。推測這可能是在本研究未觀察到鈣質攝取和骨質有相關性的原因。
學童體能活動較高者的骨質顯著高於體能活動低者。建議學童增加體能活動時間，應有助於促進骨質的累積且維持骨骼的正常發育。在骨頭發育成熟前達到更高的顛峰骨量，減少在成年期和老年期發生骨折和骨質疏鬆症的危險性。
關鍵詞：學童、骨質、飲食、體能活動
Osteoporosis and related fractures are major public healthy problems. Inadequate bone mass accrual in childhood may result in low bone mass and/or osteoporosis in later life. The current analysis were conducted to investigate the relationships between lifestyle factors and bone mass in the elementary school students in Taiwan. The data was obtained in the “Nutrition and Health Survey in Taiwanese Elementary School Children 2001-2002”, and subjects who had questionnaire data, physical examination, and bone measurement were included in the analyses.
The results showed that higher levels of physical activity [including stories of stair-climbing (β = 0.90 for boys and β = 1.04 for girls), the weekly number of times engaged in exercise (β = 1.53 for boys and β = 1.57 for girls), the weekly number of physical education classes ( β = 3.33 for boys, β = 2.95 for girls) and weekly time length of physical education class (β = 1.86 for boys, β = 2.13 for girls), actual time for exercise in physical education class ( β = 0.75 for boys β = 0.66 for girls), and the number of exercising clubs participated (β = 3.85 for boys, β = 4.42 for girls)] each individually correlated to higher BUA in the children. In boys, no significant relationship between dietary intake, physical activities and bone mass was observed after adjusting for age. In girls, after adjusting for age, height, weight and residing stratum, a positive relationship between the weekly number of times engaged in exercise (β = 0.76, p < 0.05). The nutrients associated with bone mass (calcium, phosphate, sodium, magnesium and potassium) which has no significant correlated to bone mass in the children. The average calcium intake in the children was lower than DRIs, and the servings of the fruits and vegetables were also lower than the recommendation. Although the consumption of milk might have achieved the recommendation, the total amount of calcium intake appeared to lower than the DRIs so that the relationship between the calcium intake and bone mass was not observed.
In conclusion, children who had higher physical activity levels appeared to have better bone mass. Increasing time spent in physical activity may benefit bone mass accumulation and maintain the normal growth of the skeleton so that a higher peak bone mass may be achieved to reduce the risk of osteoporosis and/or fracture in the later stage of life.
Keywords: elementary school students, bone mass, dietary, physical activity |
