癌症、心血管疾病和糖尿病的預防

The Prevention of Cancer, Cardiovascular Disease and Diabetes Mellitus

10.30026/CJSH.200712.0006

張瑞泰(Ray-Tai Chang)；林健民(Chien-Min Lin)

癌症 ； 心血管疾病 ； 糖尿病 ； 抽菸 ； 肥胖 ； 身體活動量 ； cancer ； cardiovascular disease ； diabetes mellitus ； smoking ； physical activity

學校衛生

51期（2007 / 12 / 01）

89 - 102

繁體中文

癌症、心血管疾病和糖尿病，已為已開發國家的主要死亡原因，2005年佔了國人55%的總死亡人數。這些疾病不僅縮短了生命年數，並且對個人造成病痛、失能，而且對家庭、社會、國家也造成相當的經濟負擔，與競爭力之降低。2005年台灣死亡癌症比例為26.8%，腦血管病變死亡率9.5%，心臟病9.3%，糖尿病死亡率7.6%，高血壓死亡率1.4%，分別佔國人死亡原因之第1、2、3、4和第10名。這些疾病擁有共同的危險因子，也就是抽菸、缺乏身體活動量和肥胖。菸害防治可由藥物治療、設立戒菸專家支援中心、醫師或衛生教育人員的簡短勸導和利用抽菸者住院期間等方面著手。減重的有效策略包含飲食的控制、運動的建議和行為改變等三方面。增加身體活動量的有效策略包括1、發展和健康相關的公共政策；2、把推廣增加身體活動量當成一項公共衛生政策；3、於各都會區和社區創造支持性的增加身體活動量的環境；4、強化社區的運作；和5、教育和協助發展個人的能力。本文綜評這些危險因子，希望能預防或降低上述疾病的發生，及其所帶來的衝擊，以提升生活品質，降低醫療費用，提振國人之整體競爭力。

Cancer, Cardiovascular disease (including stroke, coronary artery disease, and hypertension) and diabetes mellitus were the major leading cause of deaths in our country, counting 55% of the total mortality rate. These diseases cause disabilities, economic burden, and premature deaths. And they share common modifiable risk factors, including: smoking, physical inactivity, and obesity. This review paper describe how these 3 risk factors can effect on these diseases. And discuss how to reduce and/or prevent these diseases, to improve our quality of life, reduce economic burden, and facilitate the competitive capacity of the country.

1. Annual smoking-attributable mortality, years of potential life lost, and economic costs(2002).United States, 1995-1999.Morbidity Mortality weekly Report,51,300-303.
2. Blair S. N.,Jackson A. S.(2001).Physical fitness and activity as separate heart disease risk factors: a meta-analysis.M­­edicine and Science in Sports and Exercise,33,762-764.
3. Bullen C.,Whittaker R.,McRobbie H.,Fagerstrom K.(2007).A Clinical Imperative: Assisting patients who smoke to reduce their risk of cardiovascular disease.Preventive Cardiology,10(2suppl 1),5-9.
4. Calle E. E.,Rodriguez C.,Walker-Thurmond K.(2003).Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults.New England Journal of Medicice,348,1625-1638.
5. Calle E. E.,Thun M. J.,Petrelli J. M.(1999).Body-mass index and mortality in a prospective cohort of U.S. adults.New England Journal of Medicine,341,1097-1105.
6. Centers for Disease Control and Prevention(2004).Guide to Community Preventive Services.Atlanta, Ga:Centers for Disease Control and Prevention.
7. Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC): Adult SAMMEC and Material and Child Health (MCH) SAMMEC software
8. Chow W. H.,Gridley G.,Fraumeni J. F.(2000).Obesity, hypertension, and the risk of kidney cancer in men.New England Journal of Medicine,343,1305-1311.
9. Chuahirun T.,Wesson D. E.(2002).Cigarette smoking predicts faster progression of type 2 established diabetic nephropathy despite ACE inhibition.American Journal of Kidney Disease,39,376-382.
10. D`Zurilla T. J.(1971).Problem solving and behavior modification.Journal of abnormal psychology,78,107-126.
11. Dattilo A. M.,Kris-Etherton P. M.(1992).Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis.American Journal of Clinical Nutrition,56,320-328.
12. Doll R.,Peto R.(1981).The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today.Journal of National Cancer Institute,66,1191-1308.
13. Eckel R. H.(1997).Obesity and heart disease: a statement for health care professionals from the Nutrition Committee, American Heart Association.Circulation,96,3248-3250.
14. Fletcher G. F.,Balady G.,Blair S. N.(1996).Statement on exercise: benefits and recommendations for physical activity programs for all American: a statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association.Circulation,94,857-862.
15. Goldstein L. B.,Adams R.,Becker K.(2001).Primary prevention of ischemic stroke: a statement for healthcare professionals from the Stroke Council of the American Heart Association.Circulation,103,163-182.
16. Grundy S. M.,Pastermak R.,Greenland P.(1999).Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology.Circulation,100,1481-1492.
17. Helmrich S. P.,Ragland D. R.,Leung R. W.,Paffen-barger R. S.(1991).Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus.New England Journal of Medicine,325,147-152.
18. Hu F. B.,Manson J. E.,Stampfer M. J.(2001).Diet, lifestyle, and the risk of type 2 diabetes mellitus in women.New England Journal of Medicine,345,790-797.
19. Hubert H. B.,Feinleib M.,McNamara P. M.(1983).Obesity as an independent risk factor for cardiovascular disease: a 26-yaer follow-up of participants in the Framingham Heart Study.Circulation,67,968-977.
20. Hughes J. R.,Stead L. F.,Lancaster T.(2007).Antidepressants for smoking cessation.Cochrane database system Review.
21. Jakicic J.,Wing R.,Winters C.(1999).Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women.Journal of American Medical Association,282(16),1554-1560.
22. Jeffery R.W.,Wing R.R.(1998).Use of personal trainers and financial incentives to increase exercise in a behavioral weight-loss program.Journal of Consult Clinical Psychology,66,777-783.
23. Jeffery R.W.,Wing R.R.(2001).The effects of an enhanced exercise program on long-term weight loss.Obesity Research,9(suppl 3),100.
24. Jemal A.,Tiwari R. C.,Murray T.,American Cancer Society(2004).Cancer statistics, 2004.CA-A Cancer Journal For Clinicians,54,8-29.
25. Kawakami N.,Takatsuka N.,Shimizu H.(1997).Effects of smoking on the incidence of non-insulin-dependent diabetes mellitus: replication and extension in a Japanese cohort of male employees.American Journal of Epidemiology,145,103-109.
26. Knowler W. C.,Barrett-Connor E.,Fowler S. E.(2002).Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.New England Journal of Medicine,346,393-403.
27. Kuczmarski R. J.,Flegal K. M.(2002).Criteria for definition of overweight in transition: background and recommendations for the United States.American Journal of Clinical Nutrition,72,1074-1081.
28. Lancaster T.,Stead L. F.(2005).Individual behavioural counseling for smoking cessation.Cochrane Database of Systematic Review.
29. Lancaster T.,Stead L. F.(2004).Physician advice for smoking cessation.Cochrane Database of Systematic Review.
30. Lee I. M.,Paffenbarger R. S.,Hennekens C. H.(1997).Physical activity, Physical fitness and longevity.Aging (Milano),9,2-11.
31. Lynch, J.,Helmrich S. P.,Lakka T. A.(1996).Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in mid-dle-aged men.Archives of Internal Medicine,156,1307-1314.
32. Manson J. E.,Ajani U. A.,Liu S.(2000).A prospective study of cigarette smoking and the incidence of diabetes mellitus among US male physicians.American Journal of Medicine,109,539-542.
33. Manson J. E.,Nathan D. M.,Krolewski A. S.,Stampfer M. J.,Willett W. C.,Hennekens C. H.(1992).A Prospective study of exercise and incidence of diabetes among US male physicians.The Journal of American Medical Association,268,63-67.
34. Marlatt G. A.,Gordon J. R.(1985).Relapse prevention: maintenance strategies in addictive behavior change.New York:Guilford.
35. McCrory M.,Fuss P.(1999).Dietary variety within food groups: association with energy intake and body fatness in men and women.American Journal of Clinical Nutrition,69,440-447.
36. Michaud D. S.,Giovannucci E.,Willett W. C.(2001).Physical activity, obesity, height, and the risk of pancreatic cancer.The Journal of American Medical Association,286,921-929.
37. Mitchell B. D.,Hawthome V. M.,Vinik A. I.(1990).Cigarette smoking and neuropathy in diabetic patients.Diabetes Care,13,434-437.
38. Mokdad A. H.,Ford E. S.,Bowman B. A.(2000).Diabetes trends in the U.S.: 1990-1998.Diabetes Care,23,1278-1283.
39. Muhlhauser I.,Bender R.,Bott U.(1996).Cigarette smoking and progression of retinopathy and nephropathy in type 1 diabetes.Diabetic Medicine,13,536-543.
40. Ogden C. L.,Flegal K. M.,Carroll M. D.(2002).Prevalence and trends in overweight among US children and adolescents, 1999-2000.The Journal of American Medical Association,288,1728-1732.
41. Oster G.,Thompson D.,Edelsberg J.(1999).Life time health and economic benefits of weight loss among obese persons.American Journal of Public Health,89,1536-1542.
42. Rodriguez B. L.,D`Agostino R.,Abbott R. D.(2002).Risk of hospitalized stoke in men enrolled in Honolulu Heart Program and the Framingham Study: a comparison of incidence and risk factor effects.Stroke,33,230-236.
43. Rowell K. E.,Thompson P. D.,Caspersen C. J.(1987).Physical activity and the incidence of coronary heart disease.Annual Review of Public Health,8,283-287.
44. Sherwin R. S.,Anderson R. M.,Buse J. B.(2004).The prevention or delay of type 2 diabetes. American Diabetes Association and the National Institute of Diabetes and Digestive and Kidney Disease.Diabetes Care,27,47-54.
45. Silagy C.,Lancaster T.,Stead L. F.(2004).Nicotine replacement therapy for smoking cessation.Cochrane Database of Systematic Review.
46. Sowers J. R.(2003).Obesity as a cardiovascular risk factor.American Journal of Medicine,115(suppl 8A),37-41.
47. Stead L. F.,Lancaster T.(2005).Group behavior therapy programs for smoking cessation.Cochrane Database of Systematic Review.
48. Steinberger J.,Daniels S. R.(2003).Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in Young Committee(Council on Cardiovascular Disease in the Young)and the Diabetes Committee(Council on Nutrition, Physical Activity, and Metabolism).Circulation,107,1448-1453.
49. Stuart R. B.(1967).Behavioral control of overeating.Behaviour research and therapy,5,357-365.
50. Tuomilehto J.,Lindstrom J.,Eriksson J.(2001).Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.New England Journal of Medicine,344,1343-1350.
51. The Health Benefits of Smoking Cessation: A Report of the Surgeon General
52. US Preventive Services Task Force(2004).Guide to Clinical Preventive Services.Washington, D.C.:Agency for Healthcare Research and Quality.
53. Wannamethee S. G.,Shaper A. G.,Perry U.,British Regional Heart Study(2001).Smoking as a modifiable risk factor for type 2 diabetes in middle-aged men.Diabetes Care,24,1590-1595.
54. Will J. C.,Galuska D. A.,Ford E. S.(2001).Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study.International Journal of Epidemiology,30,540-546.
55. Williams K. V.,Kelley D. E.(2000).Metabolic consequences of weightloss on glucose metabolism and insulin action in type 2 diabetes.Diabetes Obesity & Metabolism,2,121-129.
56. Wing R. R.,Hill J. O.(2001).Successful weight loss maintenance.Annual Review of Nutrition,21,323-341.
57. World Health Organization(1992).Ottawa Charter for health promotion 1986.WHO regional Europeans Series publication,44,1-7.
58. Young L. R.,Nestle M.(2002).The contribution of expanding portion sizes to the US obesity epidemic.American Journal of Public Health,92(2),246-249.
59. Zhu S. H.,Anderson C. M.,Tedeschi G. J.(2002).Evidence of real-world effectiveness of a telephone quitline for smokers.New England Journal of Medicine,347,1087-1093.

1. 黃健富、林貴福(2010)。職場健康生活形態面向之分析。輔仁大學體育學刊，9，274-284。
2. 黃健富、林貴福(2010)。職場健康生活形態面向之分析。輔仁大學體育學刊，9，274-284。
3. 蘇榮立、黃素珍、張世沛、祁崇溥(2011)。有氧舞蹈與體適能瑜珈對運動健身成效評估。文化體育學刊 ，12，19-28。
4. 謝佳容、李光武、王信淵(2015)。各類減重方式成效之探討。海峽兩岸體育研究學報，9(2)，101-111。
5. 葉清華(2009)。減重課程介入實施成效分析與追蹤評估。大專體育學刊，11(1)，93-104。
6. 應立志、陳儷月、李福春、李淑真、王萬琳(2013)。戒菸門診病人對戒菸誘因與戒菸服務之滿意度調查。臺灣家庭醫學雜誌，23(4)，177-188。