Discrepancy in Nutrition Knowledge of Hyperlipidemic Risk and Lipid Levels Among Health Check-Up Population in Taiwan

●臺灣健康受檢者高脂血相關飲食知識與血脂值之差異研究

10.6288/TJPH2005-24-01-05

簡國龍(Kuo-Liong Chien)；陳珮蓉(Pey-Rong Chen)；蘇大成(Ta-Chen Su)；賴鴻褚(Hong-Shiee Lai)；陳明豐(Ming-Fong Chen)；李源德(Yuan-Teh Lee)

脂質 ； 營養知識 ； 問卷 ； 高脂血症 ； lipids ； nutrition knowledge ； questionnaire ； hyperlipidemia

台灣公共衛生雜誌

24卷1期（2005 / 02 / 01）

52 - 63

英文

目標：高脂血症營養知識可能與高脂血症危險性有關，本研究之目的係以橫斷式族群探討營養知識及血脂質之間的關係。方法：以自1998年四月到九月共1787位至台大醫院接受健康檢查的民眾，並完成高脂血問卷為研究對象。營養知識問卷共15題，經因素分析定義出四組因數。第一組為高膽因醇或高飽和脂肪食物；第二組為高油脂或低飽和脂肪食物；第三組為高纖維食物；第四組為高能量或高碳水化合物食物。結果：女性教育程度較低，但比男性有較高的營養知識分數。教育程度與營養知識分數呈正相關性，但在高能量營養知識則例外，即教育程度並未能提高對高能量食物之認知。收入狀況與高膽因醇、高脂食物知識呈正相關性。血三酸甘油酯值與高能量食物營養知識分數呈正相關性；身體質量指數亦與高能量食物營養知識分數呈正相關性。經年齡、性別及身體質量指數、社經地位調整之後，所有血脂質與營養知識分數並無相關性。結論：高脂血症相關營養知識分數與血脂質並不一效，此可作為高脂血症飲食阻介計畫之參考。

Objectives: A cross-sectional study was conducted to investigate the association between nutrition knowledge and hyperlipidemia, Methods: A total of 1787 Taiwanese adults completed hyperlipidemic knowledge questionnaires during their health check-ups in a tertiary hospital from April 1998 to September 1998. Knowledge-based 4 sets were defined and the exploratory factor analysis results were used to confirm the grouping. Set 1 was defined as high cholesterol or high saturated fat foods; Set 2 as high fat or low saturated fat foods; Set 3 as high fiber foods and Set 4 as high energy or high carbohydrate foods. Results: Women had lower educational levels but better knowledge scores than men. Years of education had a positive correlation with nutrition knowledge scores, except for the set of high energy foods. This implied that even people with high educational levels had incomplete knowledge concerning high energy foods. Income was associated positively with high cholesterol and high fat food knowledge. Total cholesterol, HDL cholesterol and LDL cholesterol levels were not significantly associated with knowledge of hyperlipidemia. Furthermore, triglyceride levels were positively associated with scores from high energy foods. Body mass index was significantly positively associated with high energy food knowledge scores. After adjusting for age, gender, body mass index, income and education years, no lipid levels could be predicted by any knowledge scores of hyperlipidemia. Conclusions: The discrepancy between nutritional knowledge of hyperlipidemia and lipid profiles should be taken into consideration when planning for behavior intervention for hyperlipidemia during the health check-ups of the population of Taiwan.

1. (2001).Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High blood Cholesterol in Adults (Adult Treatment Panel III).JAMA.
2. (1997).Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure..The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure,157,2413-46.
3. (1992).Council for Economic Planning and Development, Executive Yuan.Taiwan Statistical Data Book.
4. (1988).SAS Institute Inc.SAS Procedure Guide.
5. (1996).Directorate-General of Budget, Accountant and Statistics, Executive Yuan.Annual Statistics
6. (1992).Council for Economic Planning and Development, Executive Yuan.Taiwan Statistical Data Book,279
7. Abbott RD,Wilson RWF,Kannel WB,Castelli WP(1988).High density lipoprotein cholesterol total cholesterol screening and myocardial infarction: the Framingham study.Arteriosclerosis.
8. Abbott RD,Wilson RWF,Kannel WB,Castelli WP.(1988).High density lipoprotein cholesterol total cholesterol screening and myocardial infarction: the Framingham study.Arteriosclerosis.
9. Anderson JW,Gustafson NJ(1988).Hypocholesterolemic effects of oat and bean products.Am Clin Nutr.
10. Anderson JW,Gustafson NJ.(1988).Hypocholesterolemic effects of oat and bean products.Am Clin Nutr.
11. Anderson JW,Johnstone BM,Cook-Newell ME(1995).Metaanalysis of the effects of soy protein intake on serum lipids.N Engl J Med.
12. Anderson JW,Johnstone BM,Cook-Newell ME.(1995).Meta-analysis of the effects of soy protein intake on serum lipids.N Engl J Med,333,276-82.
13. Anderson KM,Castelli WP,Levy D(1987).Cholesterol and mortality 30 years of follow-up from the Framingham study.JAMA.
14. Assmann G,Schulte H,Eckardstein AV(1996).Hypertriglyceridemia and elevated lipoprotein(a) are risk factors for major coronary events in middle-aged men.Am J Cardiol.
15. Assmann G,Schulte H,Eckardstein AV.(1996).Hypertriglyceridemia and elevated lipoprotein (a) are risk factors for major coronary events in middle-aged men.Am J Cardiol,77,1179-84.
16. Austin MA,Hokanson JE,Edwards KL(1998).Hypertriglyceridemia as a cardiovascular risk factor.Am J Cardiol.
17. Austin MA,Hokanson JE,Edwards KL.(1998).Hypertriglyceridemia as a cardiovascular risk factor.Am J Cardiol,81,7B-12B.
18. Caballero AE.(2003).Endothelial dysfunction in obesity and insulin resistance: a road to diabetes and heart disease.Obesity Res.
19. Caballero AE.(2003).Endothelial dysfunction in obesity and insulin resistance: a road to diabetes and heart disease.O besity Res,11,1278-89.
20. Chisholm A,Mann J,Skeaff M(1998).A diet rich in walnuts favourably influences plasma fatty acid profile in moderately hyperlipidaemic subjects.Eur J Clin Nutr,52,12-6.
21. Chisholm A,Mann J,Skeaff M(1998).A diet rich in walnuts favourably influences plasma fatty acid profile in moderately hyperlipidaemic subjects.Eur J Clin Nutr.
22. Clarke R. Frost C,ollins R(1997).Dietary lipids and blood cholesterol: quantitative meta-analysis of metabolic ward studies.BMJ.
23. Crouse JR,Grundy SM(1984).Effects of alcohol on plasma lipoproteins and cholesterol and triglyceride metabolism in man.J Lipid Res,25,486-9.
24. Crouse JR,Grundy SM.(1984).Effects of alcohol on plasma lipoproteins and cholesterol and triglyceride metabolism in man.J Lipid Res.
25. Crouse JR,Grundy SM.(1984).Effects of alcohol on plasma lipoproteins and cholesterol and triglyceride metabolism in man.J Lipid Res.
26. Crouse JR,Grundy SM.(1984).Effects of alcohol on plasma lipoproteins and cholesterol and triglyceride metabolism in man.J Lipid Res,25,486-96.
27. Dattilo AM,Kris-Etherton PM(1992).Effects of weight reduction on blood lipids and lipoproteins: a metaanalysis.Am J Clin Nutr.
28. Dattilo AM,Kris-Etherton PM.(1992).Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis.Am J Clin Nutr.
29. Denke MA,Sempos CT,Grundy SM(1994).Excess body weight: An under-recognized contributor to dyslipidemia in white American women.Arch Intern Med.
30. Denke MA,Sempos CT,Grundy SM(1993).Excess body weight. An under-recognized contributor to high blood cholesterol levels in white American men.Arch Intern Med.
31. Denke MA,Sempos CT,Grundy SM.(1993).Excess body weight. An under-recognized contributor to high blood cholesterol levels in white American men..Arch Intern Med,153,1093-103.
32. Denlce MA,Sempos CT,Grundy SM.(1994).Excess body weight: An under-recognized contributor to dyslipidemia in white American women.Arch Intern Med,154,401-10.
33. Department of Health, Executive Yuan(1998).Nutrition and Health Survey in Taiwan (1993-1996).
34. Department of Health,Executive Yuan(1998).Nutrition and Health Survey in Taiwan (1993-1996).
35. Directorate-General of Budget(1996).Accountant and Statistics, Executive Yuan.Annual Statistics.
36. Ford ES,Giles WH,Dietz WH(2002).Prevalence of the metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination survey.JAMA.
37. Friedewald WT,Levy RI,Fredrickson DS(1972).Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.Clin Chem.
38. Friedewald WT,Levy RI,Fredrickson DS.(1972).Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.Clin Chem,18,499-502.
39. Glore SR,Van Treeck D,Knehans AW(1944).Soluble fiber and serum lipids: a literature review.J Am Diet Asso.
40. Glore SR,Van Treeck D,Knehans AW(1994).Soluble fiber and serum lipids: a literature review.J Am Diet Asso.
41. Grundy SM.,Shils ME,O1-son JA,Shike M,Ross AC(1999).Nutrition and diet in the management of hyperlipidemia and atherosclerosis.Modern nutrition in health and disease.
42. Grundy SM.,Shils ME,Olson JA,Shike M,Ross AC(1999).Nutrition and diet in the management of hyperlipidemia and atherosclerosis.Modern nutrition in health and disease.
43. Grundy SM,Denke MA.(1990).Dietary influences on serum lipids and lipoproteins.J Lipid Res,31,1149-72.
44. Grundy SM,Denke MA.(1990).Dietary influences on serum lipids and lipoproteins.J Lipid Res.
45. Grundy SM,Denke MA.(1990).Dietary influences on serum lipids and lipoproteins.J Lipid Res.
46. Grundy SM,Denke MA.(1990).Dietary influences on serum lipids and lipoproteins.J Lipid Res,1,1149-72.
47. Hegsted DM,McGandy RB,Myers ML(1965).Quantitative effects of dietary fat on serum cholesterol in man.Am J Clin Nutr,17,281-95.
48. Hegsted DM,McGandy RB,Myers ML(1965).Quantitative effects of dietary fat on serum cholesterol in man.Am J Clin Nutr.
49. Hubert HB,Feinleib M,McNamara PM(1983).Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study.Circulation.
50. Joint National Committee on Prevention,Detection,Evaluation,Treatment of High Blood Pressure(1997).The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.Arch Intern Med.
51. Judd JT,Clevidence BA,Muesing RA(1994).Dietary trans fatty acids: effects on plasma lipids and lipoproteins of healthy men and women.Am Clin Nutr.
52. Judd JT,Clevidence BA,Muesing RA(1994).Dietary trans fatty acids: effects on plasma lipids and lipoproteins of healthy men and women.Am Clin Nutr,59,861-8.
53. Kannel WB.(1988).Cholesterol and risk of coronary heart disease and mortality in men.Clin Chem,34,B53-9.
54. Kannel WB.(1988).Cholesterol and risk of coronary heart disease and mortality in men.Clin Chem.
55. Kristal AR,Abrams BF,Thornquist MD(1990).Development and validation of a food use checklist for evaluation of community nutrition interveotions.Am J Public Health.
56. La Rosa JC.(1997).Triglycerides and coronary risk in women and the elderly.Arch Int Med.
57. La Rosa JC.(1997).Triglycerides and coronary risk in women and the elderly.Arch Int Med,157,961-8.
58. Lopes-Virella M,Stone P,Ellis S,Colwell JA(1977).Cholesterol determination in high-density lipoproteins separated by three different methods.Clin Chem.
59. Lopes-Virella M,Stone P,Ellis S,Colwell JA.(1977).Cholesterol determination in high-density lipoproteins separated by three different methods.Clin Chem,23,382.
60. Men sink RP,Katan MB.(1990).Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects.N Engl J Med.
61. Men sink RP,Katan MB.(1990).Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects.N Engl J Med,323,439-45.
62. MRFIT Investigator group(1990).Mortality rates after 101/2 years for participants in the Multiple Risk Factor Intervention Trial.Findings related to a prior hypothesis of the Trial.
63. MRFIT Investigator group(1990).Mortality rates after 10 1/2 years for participants in the Multiple Risk Factor Intervention Trial.Findings related to a prior hypothesis of the Trial. Circulation,82,1616-28.
64. Pownall HJ,Ballantyne CM,Kimball KT(1999).Effect of moderate alcohol consumption on hypertriglyceridemia: a study in the fasting state.Arch Int Med.
65. Pownall HJ,Ballantyne CM,Kimball KT(1999).Effect of moderate alcohol consumption on hypertriglyceridemia: a study in the fasting state.Arch Int Med,159,981-7.
66. SAS Institute Inc.(1988).SAS Procedure Guide. 6.03 ed.
67. Shepherd J,Cobbe SM,Ford I(1995).Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia.N Engl J Med,333,1301-7.
68. Shepherd J,Cobbe SM,Ford I(1995).Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia.N Engl J Med.
69. Stevens J.(1996).Applied Multivariate Statistics for the Social Sciences.
70. Stevens J.(1996).Applied Multivariate Statistics for the Social Sciences.
71. Strychar IM,Potvin L,Pineault R(1993).Changes in knowledge and food behaviour following a screening program held in a supermarket.Can J Public Health.
72. Strychar TM,Potvin L,Pineault R(1993).Changes in knowledge and food behaviour following a screening program held in a supermarket.Can J Public Health,84,382-8.
73. The Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) Study Group(1998).Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.N Engl J Med.
74. The Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) Study Group(1998).Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels.N Engl J Med,339,1349-57.
75. Wahle KW,James WP.(1993).Isomeric fatty acids and human health.Eur J Clin Nutr,47,828-39.
76. Wahle KW,James WP.(1993).Isomeric fatty acids and human health.Eur J Clin Nutr.
77. Yamasaki R,Miyoshi T,Imaki M(1994).Evaluation of the effects of various factors on the serum triglyceride level in young adults.Tokushima J Experimental Med,41,17-30.
78. Yamasaki R,Miyoshi T,Imaki M(1994).Evaluation of the effects of various factors on the serum triglyceride level in young adults.Tokushima J Experimental Med.
79. Yu-Poth S,hao G,Etherton T(1999).Effects of the National Cholesterol Education Programs Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis.Am J Clin Nutr.
80. Yu-Poth S,Zhao G,Etherton T(1999).Effects of the National Cholesterol Education Program´s Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis.Am J Clin Nutr,69,632-46.
81. Zambon D,Sabate J,Munoz S(2000).Substituting walnuts for monounsaturated fat improves the serum lipid profile of hypercholesterolemic men and women.A randomized crossover trial.
82. Zambon D,Sabate J,Munoz S.(2000).Substituting walnuts for monounsaturated fat improves the serum lipid profile of hypercholesterolemic men and women.A randomized crossover trial.
83. Zock PL,Katan MB.(1992).Hydrogenation alternatives: effects of trans fatty acids and stearic acid versus linoleic acid on serum lipids and lipoproteins in humans.J Lipid Res.
84. Zock PL,Katan MB.(1992).Hydrogenation alternatives: effects of trans fatty acids and stearic acid versus linoleic acid on serum lipids and lipoproteins in humans.J Lipid Res,33,399-410.

1. 黃艾君、江界山(2006)。運動與高血脂症。大專體育，87，191-197。