肥胖性肌少症的營養照護

10.6666/ClinMed.201811_82(5).0116

許薰云；邱哲琳；楊雀戀

肥胖性肌少症（sarcopenic obesity） ； 白胺酸（leucine） ； 亞洲肌少症小組（AWGS）

臨床醫學月刊

82卷5期（2018 / 11 / 30）

637 - 641

繁體中文

肥胖性肌少症盛行率隨著高齡人口上升逐漸增加，其與許多代謝性疾病以及失能、跌倒和活動限制有關，進而增加社會及醫療成本，是目前高齡社會所關注的健康議題之一。肥胖性肌少症的發生多與發炎、內分泌因素及生活型態等因素有關。肥胖性肌少症的改善目標為保持身體肌肉質量及改善肌肉強度，並減少脂肪質量，因此，介入措施的評值不能只有體重變化，必須同時評估身體組成和身體功能之變化。營養照護上，適度減少熱量攝取200~750大卡/天，並視患者飲食及營養情況補充微量營養素，避免採用可能導致營養不良的極低熱量飲食，此外，建議攝取充足的蛋白質，每天至少1.5公克/公斤體重，且平均分配於每餐，並多攝取富含白胺酸（leucine）的食物以增加蛋白質合成效率。對血液維生素Ｄ濃度低的老年人，建議補充700-800IU/天以改善肌肉功能。執行飲食控制的同時，也應同步進行運動訓練，可更有效改善肥胖性肌少症。

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