背景與目的：健康生活是預防代謝異常及慢性疾病的重要策略，其關鍵在健康飲食及保持適當體重及體適能。此策略常被運用於社區民眾的健康促進，但其成效未被證實。本研究探討此策略運用於社區有代謝異常民眾的成效。
方法：2010年臺中縣21個社區全面推動減糖減脂健康促進班，招募體位過重、肥胖或三高(高血糖、高血壓、高血脂)的民眾為對象進行類實驗介入研究。其中隨機選1社區為對照組，其他社區為介入組。所有社區都提供圖文單張並鼓勵學員執行自我健康管理；但介入社區又運用各社區衛生人員給予標準化營養衛教課程，且定期討論、激勵及追蹤，以突破障礙及養成健康飲食及運動行為。以t檢定分析減重及代謝改善成效，並以邏輯回歸分析影響因子。
結果：經16週，介入組個案(553人)的體重減1.76 kg， BMI降0.70 kg/m2，腰圍減2.67 cm；而對照組(30人)分別減0.75 kg，0.32 kg/m2，及0.18 cm (二組間的差異皆p<0.05)。介入組的收縮壓亦降4.15 mmHg，舒張壓降2.36 mmHg，三酸甘油酯減8.73 mg/dL，血清膽固醇減6.85 mg/dL，皆顯著(p<0.001)低於啟始點。迴歸分析顯示減重的顯著因子是多運動，降低膽固醇是多運動及多吃蔬菜，改善血糖及血壓是多吃水果。
結論：健康飲食及多運動可經由有組識有系統的健康促進方法推廣到社區且可有效的改善中老年人的代謝異常現象。本縣所採用的模式應可適用於其他縣市。

Objectives: To determine the effectiveness of healthy diet and physical exercises on reducing the risk of metabolic abnormalities in community-living adults.
Methods: Taichung Health Bureau and Asia University partnered to design a program and trained field workers to carry out a health-promoting project in summer 2010. Twenty-one community groups totaling 583 adults participated in the project and one group was randomly chosen to serve as controls. All participants received graphic leaflets on healthy living but treatment groups received class sessions on healthy eating and exercise activities for the first four weeks. Field workers empowered group leaders to organize and choose appropriate group activities. Group leaders served as role models and helped break learning barriers. Participants shared progress and experiences of action-learning at monthly meetings.
Results: After 16 weeks, significant (all p<0.05) treatment effects were observed in body weight, BMI and waist circumference. The net changes from baseline were -0.75 vs. -1.74 kg for weight, -0.32 vs. -0.70 kg/m2 for BMI, -0.18 vs. -2.67 cm for waist circumference for control and treatment groups, respectively. Logistic regression analyses suggested that weight reduction was significantly associated with greater physical activity; cholesterol lowering with physical exercise and eating more vegetables; and improved blood glucose and blood pressure with eating more fruits.
Conclusions: Empowerment of local group leaders was an effective strategy in promoting healthy eating and physical activity to reduce the risk of metabolic disorders in community-living adults. The program can serve as a model of community health-promotion in other counties.

目錄
前言 1
相關研究 1
研究方法 4
結果 9
討論 11
結論 14
參考文獻 16

表目錄
表一、標準化課程內容 7
表二、參與者之基本資料 21
表三、對照組及介入組個案的體位、代謝指標於研究啟始點、終點及其淨差異與差異顯著性22
表四、邏吉斯迴歸及模式A, B, C, 及D分別呈現體重減2公斤、血壓降2 mmHg、血膽固醇降2 mg/dL、及血糖降5 mg/dL的關聯因子25
附錄、原始問卷---中老年減糖減脂班追蹤表及關懷問卷 27

圖目錄
圖一、行為治療理論 3
圖二、研究架構 5
圖三、研究流程 8
圖四、健康生活方式介入對個案體位指標的影響 23
圖五、健康生活方式介入對個案血壓及血液生化指標的影響 24

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