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研究生:侯沂錚
研究生(外文):Yi-Cheng Hou
論文名稱:以加鈣米介入學童營養午餐為增加學童鈣質攝取量良好方式之探討
論文名稱(外文):Using Calcium fortified rice in lunch program increases calcium intake in school children
指導教授:楊淑惠楊淑惠引用關係
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:保健營養學研究所
學門:醫藥衛生學門
學類:營養學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:102
中文關鍵詞:加鈣米學童營養午餐成本利益分析成本效益分析
外文關鍵詞:calcium fortified riceschool childrenschool lunchcost benefit analysiscost effectiveness analysisbenefit analysiscost
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本研究為評估學童在鈣質攝取不足情況下,藉由主食米飯營養強化鈣質方式為增加飲食鈣之攝取量良好方式。針對市售營養強化鈣質食品包含市售加鈣點心與市售加鈣米及市售鈣錠劑共三種不同類別增加鈣質攝取之方式,以市售佔有率配合文獻回顧生物利用率方式分析內容物鈣化合物型式並配合成本利益、成本最小值及可近性分析,結果顯示鈣含量較種類為重要,又以市售加鈣米一碗80克得304毫克鈣量且為必需之正餐熱量來源為理想營養強化鈣食品。進一步評估加鈣米是否經過清洗和烹煮的過程有鈣流失情形及口感接受度,故取得目前市售兩種廠牌S加鈣米及C加鈣米,委託食品工業研究所以感應耦合電漿原子發射光譜儀 (Inductirely coupled plasma atomic emission spectrometer, ICPAES) 進行鈣定量分析分析,得到加鈣米經過清洗和烹煮的過程中能保留98.36% ~ 93.71%的鈣含量,顯示輕微洗米過程中不會有太多鈣質流失;由台北醫學大學保健營養學系師生共33人,平均年齡24.7 ± 1.2歲進行S加鈣米及C加鈣米官能品評試驗,得S加鈣米較C加鈣米、白米在外觀、香味、口味、黏性、總評部份皆有較佳之接受度,以S加鈣米進行介入試驗。
由台北市37所具中央廚房國民小學中以隨機抽樣方式挑選螢橋國小四年級及五年級各一班進行營養午餐介入。使用飲食頻率問卷和3天飲食日記、輔以24小時回憶法進行飲食評估結果受試男童、女童鈣質攝取占10~12歲國人膳食營養素參考攝取量 (Dietary reference intakes, DRI’s ) 41%~45%,乳品攝取部份每日平均攝取為0.64份,顯示受試學童確實有鈣攝取不足之情形。加鈣米介入期間,定量學童米飯進食量,結果S加鈣米和一般供應的米食並沒有顯著差異。每碗S加鈣米可獲鈣量占10~12歲DRI’s 30.4%,分別占受試男、女童現況鈣攝取量的68%、74%,以加鈣米進食後,飲食鈣低於DRI’s 1000毫克男童由96% 降低至77.2%、女童由92%降低至87.5% ,考量在最高鈣攝取量的學童增加608毫克的鈣,結果皆未超過鈣質上限攝取標準2500毫克。分別以五年級、四年級營養午餐實際進食日數117日、81日除以一年365天計算,加鈣米平均單日平均花費1.25元、0.87元,單日提供熱量90大卡、63大卡,為正餐熱量攝取。除進食量之外,進一步於加鈣米推廣因素分析學童對加鈣米攝取利益、障礙及重要他人支持部分顯示學童對攝取加鈣米意圖正向,且在家人、老師支持下以學童營養午餐介入可近性高。綜合結論藉由加鈣米介入學校營養午餐可有效且便利增加學童鈣質攝取量。
The purpose of this study is used to assess the fortified of calcium through food (mainly rice) to increase the calcium intake of school children. Literature reviews were used to identify the optimal method of forming calcium chemical by investigating the cost-benefit analysis (CAB), cost effectiveness analysis (CEA), cost-minization analysis (CMA) and accessibility analysis of commercial calcium supplement, calcium fortified snacks, calcium fortified rice from market products. In this study, we obtained 304mg of calcium quantity per 0.91NT of 80 grams for calcium fortified rice since there was no additional source of calories was the optimal food to fortified with calcium. Using the commercial sold S brand and C brand calcium fortified rice to evaluate the calcium reserve during the cooking process by Inductively Coupled Plasma Atomic Emission Spectrometer (ICPAES) at the Institute of Food Industry, found out that in the process of cleaning and cooking, calcium fortified rice was able to retain 98.36% ~ 93.71% of calcium, indicating a low calcium loss. A total of 33 students and faculty members from school of Public Health, Taipei Medical University with an average age of 24.7 ± 1.2 gave an sensory evaluation of S calcium fortified rice, C calcium fortified rice and milled rice including the appearance, smell, taste, viscosity, and overall evaluation. S calcium fortified rice have better acceptable so we choose that to intervene in school luch program to increase dietary calcium intake.
Out of 37 kitchen equipped elementary schools, ying-giao elementary schools one calss for fifth graders and fourth graders respectively was randomly selected to have its school lunch intervened. Using food questionnaires and 3 day dietary records supported by 24-hour recall. for food evaluation, the average calorie intake was found to be 1920 ± 59 kcal for boys and 1921 ± 84 for girls. The Calcium intake was 41%~45% of the Dietary Refernece Intakes (DRI’s ) and the daily dairy intake was 0.64 portions for 10-12 year olds During the period of intervention, no significant difference between milled rice and brand S rice; the calcium obtained from each bowl of brand S rice was 30.4% of the DRI’s . There was 68% and 74% form boys and girls for daily calcium intake individually. After using calcium fortified rice as the main meal, the percentage of calcium intake less than 1000mg dropped from 96% to 77.2% for boys and 92% to 87.5% for girls, without exceeding the limit of 2500mg. Using the actual consumption days of the school lunch for fifth graders (177 days) and fourth graders (81 days), the daily average calorie provided by calcium fortified rice was 90 kcal per 1.25NT and 63 kcal per 0.87 NT without the increase in calorie intake, there is no concern for weight gain. The calcium fortified rice in school lunch was successful probably due to the support of parents and teachers.
In conclusion, using calcium fortified rich in school lunch in elementary schools is a very effective and convenient way to increase calcium intake.
目錄
中文摘要 I
英文摘要 III
致 謝 V
目錄 VI
表目錄 X
圖目錄 XII
第一章 緒論 1
第一節 研究動機 1
第二節 研究目的 4
第二章 文獻回顧 5
第一節 學童飲食鈣質、乳品攝取現況 5
第二節 學童適當鈣質補充之好處及超過上限攝取量之影響 6
第三節 增加學童鈣質攝取適當之 時機、鈣源 及介入方式 8
第四節 增加學童營養素攝取之方式:營養富化或營養強化 10
第五節 學童營養午餐辦理、介入情形 12
第六節 學童飲食攝取評估 14
第七節 評值分析 15
第八節 加鈣食品推廣因素分析 17
第三章 研究方法 19
第一節 研究架構 19
第二節 研究設計 20
壹、第一階段:飲食中適合添加鈣化合物之方式探討 21
貳、第二階段:加鈣食品介入試驗 27
第三節 研究工具編制 31
第四節 統計分析 34
第四章 結果與討論 35
第一節 飲食中適合添加鈣化合物之方式探討 35
壹、鈣化合物型式及生物利用率 35
貳、鈣錠劑、加鈣點心、加鈣米之成本利益分析、成本最小值分析 35
參、鈣定量分析 38
肆、官能品評 38
第二節 加鈣米介入試驗 39
壹、學童背景資料 39
貳、飲食評估 41
參、飲食中添加鈣之進食量評估 43
肆、上限攝取量評估 43
伍、成本利益分析、可近性分析 44
陸、加鈣食品推廣因素分析 47
第五章 結論 49
第六章 參考文獻 61
中文部份: 61
英文部份: 64
附錄 74
附錄1、加鈣米與白米試食評分表 74

附錄2、學童飲食紀錄單 75
附錄3、飲食頻率問卷 79
附錄4、每份乳品運算份數表 80
附錄5、問卷效度專家名單 81
附錄6、乳品攝取量表問卷空白問卷 82
附錄7、乳品攝取量表原始資料數據檔案譯碼簿 85
附錄8、知識部份難度鑑別度分析 87
附錄9、量表信度調查結果 87
附錄10、加鈣食品推廣因素分析 88
附錄11、加鈣食品推廣成功因素分析原始資料數據檔案譯碼簿 90

表目錄
表 1、市售鈣錠劑成本分析 50
表 2、市售加鈣點心成本分析 51
表 3、白米與市售三種加鈣米成本利益及成本最小值分析 52
表4、鈣錠劑、加鈣點心、加鈣米、白米與全脂奶成本利益、成本最小值 52
表5、加鈣米烹煮過程鈣定量分析 53
表6、加鈣米官能品評評估 53
表7、學童背景資料 54
表8、學童飲食資料 55
表9、學童乳品攝取分析 56
表10、加鈣米、白米介入學童午餐可近性分析 57
表11、S加鈣米提供鈣量之成本利益分析及上限攝取量評估 57
表12、評估三種不同進食日數365日、117日、81日對於鈣錠劑、加鈣點心、加鈣米、白米、全脂奶之可近性分析 58
表 13、加鈣米推廣傾向因素分析:自覺健康狀況分布情形 59
表 14、加鈣米推廣傾向因素分析:鈣營養知識分布情形 59
表 15、加鈣米推廣傾向因素分析:知覺攝取加鈣米利益分布情形 59
表 16、加鈣米推廣傾向因素分析:知覺攝取加鈣米障礙分布情形 60
表 17、加鈣米推廣增強因素分析:重要他人支持分布情形 60
表 18、加鈣米推廣促成因素分析:訊息管道分布情形 60









圖目錄

圖 1、研究目的 4
圖 2、研究架構 19
圖 3、研究步驟 20
圖 4、米飯官能評鑑位置圖 27
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