從城市社區老人營養狀態與肌少症風險評估，規劃以活躍老化為核心的營養健康策略

From Assessing the Nutritional Status and Sarcopenia Risk of Elderly in Urban Communities, Planning a Nutrition and Health Strategy Centered Around Active Aging

王弘仁(Hung-Jen Wang)；劉嘉茹(Chia-Ju Liu)；吳靜宜(Ching-Yi Wu)；梁子明(Tzu-Ming Liang)；徐硯怡(Yen-I Hsu)；顏嘉均(Jia-Jun Yan)

活躍老化 ； 營養照護 ； 肌少症 ； 肥胖 ； 人工智慧 ； Active aging ； nutritional care ； sarcopenia ； obesity ； artificial intelligence

城市學學刊

14卷（2024 / 09 / 01）

1 - 34

繁體中文;英文

全球老化問題日益嚴重，成為醫療和社會領域的重要挑戰，許多國家正面臨著老年人口比例快速增長的壓力。根據世界衛生組織（WHO）的判斷，當65歲及以上人口占總人口比例達到7％時，即被視為「高齡化社會」；14％時則是「老年社會」；而若達到20％則被歸類為「超高齡社會」。台灣自1993年起已進入高齡化社會階段，預計於2025年迎來超高齡社會的挑戰。本研究旨在調查高雄市社區中老年人的營養狀況和肌少症風險，並提出以活躍老化為核心的營養健康策略。研究發現，儘管大多數老年人的營養狀況良好，但超過一半的老年人存在體重過重和肥胖問題，且約有44.7%的老年人面臨肌少症風險。這些結果顯示，在臺灣城市社區中，營養不均衡和攝取熱量過量是需要關注的問題。活躍老化是由世界衛生組織於2002年提出的概念，旨在提高老年人的生活品質，使其能夠在整個生命週期中實現身體、社會和心理的健康福祉。為實現這一目標，需採取有效的健康促進和疾病預防策略，包括均衡飲食、定期運動和健康篩查等措施。針對老年人的體重管理應包括均衡飲食和適度運動，以維持肌肉質量和功能，並避免過度減重或增加體重。研究指出，老年人BMI與死亡率之間存在U型關係，即過低和過高的體重都會增加死亡風險。此外，針對患有肌少症型肥胖的老年人，建議攝取高蛋白質飲食、適量熱量攝取及抗炎營養素補充。蛋白質是肌肉合成的基礎，對維持和增加肌肉質量至為重要。透過實地研究和文獻分析，本研究提出針對老年人營養與健康的策略建議，強化社區營養中心角色，例如定期舉辦社區健康活動、進行營養評估和體適能測試，以早期發現高風險老年人並進行適時介入。同時，強調未來社區營養照護的人工智慧應用潛力，例如透過大數據分析提供精確的營養評估及個人化的營養建議。為因應即將到來的超高齡社會，維護老年人的健康、促進他們的活躍老化對於個人、家庭和整個社會都至為重要。實現這一目標需要政府、社區和個人共同努力，透過綜合性的營養健康策略來達成。

Global aging poses significant challenges as populations rapidly age, with many nations experiencing dramatic shifts in demographics. The World Health Organization declares an "aged society" occurs when those over 65 comprise 7% of the total, an "elderly society" at 14%, and a "super elderly society" reaches 20%, as projected for Taiwan by 2025 after becoming an aged society in 1993. This study explores nutritional status and sarcopenia risk among middle-aged and elderly individuals in Kaohsiung City, proposing an active aging strategy centered on nutrition and health. Findings reveal while most seniors enjoy good nutrition, over half face overweight and obesity issues, with approximately 44.7% at risk of sarcopenia. These results indicate urban Taiwanese communities must address nutritional imbalance and excessive calorie consumption concerns. Active aging, an idea introduced by the WHO in 2002, aims to enhance quality of life for older persons by supporting physical, social, and mental well-being throughout life. Achieving this requires effective health promotion and disease prevention strategies, including balanced diets, regular exercise, and health screenings. Regarding weight management for seniors, a balanced diet and moderate physical activity can maintain muscle mass and function while avoiding excessive weight loss or gain, as research links both low and high BMI to higher mortality rates in a U-shaped pattern. Furthermore, for elderly with sarcopenic obesity, diets high in protein and appropriate calories plus supplements addressing inflammation are advisable. Proteins underpin muscle synthesis and preservation of mass crucial for function. This study proposes strategic recommendations for senior nutrition and health through community research and literature review, such as regular health activities, nutritional assessments, and fitness testing to early identify at-risk elders for timely intervention. It also emphasizes artificial intelligence's future role in community nutrition care through precise assessments and personalized recommendations leveraging big data. In conclusion, maintaining senior health and promoting active aging is essential for individuals, families, and society facing high longevity, necessitating cooperation across government, communities, and persons through comprehensive nutrition and healthcare strategies.