國人的肥胖盛行率有逐年增加之趨勢，同樣的在國軍部隊肥胖情形亦逐年攀升，本研究藉由營養教育或運動方式介入後，探討肥胖者減重後體重、血壓、血液生化值、運動習慣、體重控制認知之改變狀況，以期作為國軍未來在制定體重控制計畫之參考。研究對象為76名20~45歲、BMI>24kg/m2的志願役軍士官。依照個人意願自行參與(1)營養教育組（29人）(2)運動組（23人）(3)營養教育配合運動組（24人）；各組進行為期12週的體重控制課程。營養教育組採取均衡低熱量飲食，每週一個半小時營養教育課程，運動組為每週一次每次一小時的有氧運動課程，並要求每人另外自行每週三次每次至少半小時以上的運動，營養教育配合運動組則兩種課程皆參加。介入前後均進行體位及血壓測量、血液生化值分析包含總膽固醇、三酸甘油酯、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、尿酸與血糖，並利用問卷收集飲食攝取量、身體活動量、體重控制認知等資料進行統計分析。
研究結果顯示運動或營養教育介入後，營養教育配合運動組在體重、身體質量指數、腰圍、腰臀比、收縮壓、舒張壓有顯著的下降，營養教育組及運動組在臀圍有顯著增加。在血液生化值方面，營養教育配合運動組之高密度脂蛋白有顯著上升，血糖在運動組也有顯著的下降。而體重控制認知方面，營養教育組及營養教育配合運動組，在食物分類與份量項目、烹調方式選擇項目及認知項目總分顯著地比運動組高，不過三組在介入後總熱量攝取皆顯著地降低。運動消耗量方面，營養教育配合運動組在運動消耗量有顯著增加。總熱量攝取改變量、醣類攝取改變量、蛋白質攝取改變量、脂肪攝取改變量與體重改變呈正相關。由本研究可以發現，對整體減重成果而言，單獨以營養教育或運動介入其效果小於以營養教育配合運動一起介入進行體重控制。

The purpose of this study was to assess the differences on body weight, blood pressure, blood biochemical measurements as well as body control cognition for an obese group in soldiery. The 76 subjects were BMI>24 and 20-45 years old. The were divided into three groups according to various interventions: nutritional education group（N，n＝29）;exercise group（E，n＝23）and nutritional education combine exercise group（NE，n＝24）for 12 weeks. The “N” group was instructed to take a balance , low calorie diet and 1.5 hours of nutritional education per week . The “E” group was asked to take 1 hour exercise class and three times of voluntary exercise per week . The “NE” group was instructed to take both of the above. The anthropometric examination, blood pressure, blood biochemical tests and questionnaire were evaluated before and after intervention.
We find that（1）there were statistically significant decreases in the body weight, BMI, waist circumference, waist hip ratio, systolic pressure, diastolic pressure（P＜0.05）in NE group. The hip circumference were significantly higher in N and E groups.（2）Mean blood glucose concentration in E group was significantly decreased, whereas the mean HDL values was increased in NE group.（3）the dietary questionnaire showed that the score of food kinds and methods of cooking as well as total scores were significantly higher in N and NE group. The calorie intake was significantly lower after intervention in all three groups.（4）The exercise output was significantly increase in NE group. It were positively correlated to the changes in intakes of calorie, carbonhydrate, protein, and fat change in body weight. The result of this study demonstrated that the effect in NE group was better than N or E group.

中文摘要.................................................3英文摘要.................................................5

第一章 文獻回顧………………………………………………………6
一、前言……………………………………………………………….6二、流行病學………………………………………………………….6
（一）成人肥胖定義………………………………………………….6（二）肥胖盛行率…………………………………………………….8
三、致病危險因子…………………………………………………….9
（一）造成肥胖的因素……………………………………………….9
（二）肥胖對健康的影響……………………………………………11
四、體重控制策略……………………………………………………12
（一）控制熱量攝取…………………………………………………12
（二)加強運動訓練………………………………………………….12
五、減重對健康的好處………………………………………………13

第二章 動機與目標………………………………………………….15

第三章 方法………………………………………………………….16
一、研究架構…………………………………………………………16
二、研究對象、時間及流程…………………………………………16
（一）研究對象………………………………………………………16
（二）研究時間………………………………………………………16
（三）研究流程………………………………………………………16
三、介入之課程內容………………………………………………..19
（一）營養教育課程………………………………………………..19
（二）運動課程………………………………………………………19
四、問卷研究…………………………………………………………19
五、體位及血壓測量…………………………………………………20
六、血液生化值………………………………………………………21
七、統計分析…………………………………………………………24

第四章 結果………………………………………………………….25
一、受試者基本資料…………………………………………………25
二、體重控制成效之比較……………………………………………26

第五章 討論………………………………………………………….29
一、體位測量值………………………………………………………29
二、血液生化值………………………………………………………30
三、體重控制認知與飲食攝取量……………………………………31
四、活動量……………………………………………………………32
五、研究限制…………………………………………………………32
六、結論………………………………………………………………33
•圖表……………………………………………………………34

第六章 參考文獻…………………………………………………….44

第七章 附錄………………………………………………………….52

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