臺灣博碩士論文加值系統

背景:研究證實烹飪課程融入營養教育有助於提升學童對蔬果的喜好度，
並進一步提高其攝取量，但目前尚未有研究探討烹飪依不同時間順序
(不同時序)融入營養教育，是否能強化介入之成效。
目的:探討烹飪課程依不同時序融入營養教育對國小學童營養知識、蔬果
選擇態度、蔬果攝取行為、蔬果喜好度之影響。
方法:以高雄市某區國小3-4 年級學童90 位為對象。隨機分為兩組，以交
叉試驗將烹飪課程及營養教育課程依先後不同順序介入八週課程，即先
進行烹飪課程，後介入營養教育課程的CN 組，及先進行營養教育，後介
入烹飪課程的NC 組。並評估介入前(W0)、中(W4)、後(W8)及後後測(W10)，
以經過評定信效度之問卷，進行介入前、中、後及後後測的測驗。
結果:本研究結果顯示，烹飪課程融入營養教育確實可有效提升介入成效，
並有效提升其營養知識、蔬果選擇態度、蔬果攝取行為及蔬果喜好度，且
也會受到時序不同而有所影響。其結果如下: (1) CN 組學童於蔬果喜好度
的得分明顯提升，且態度方面得分明顯高於NC 組(p < .05)。(2)男、女生
相較下，CN 組女生態度明顯高於NC 組。(3)於後後測結果顯示：CN 組
學童不僅可有效維持知識、態度及喜好度，更可有效提高蔬果攝取行為。
(4) CN 組一週晚餐攝取水果天數比例，於後測結果，明顯高於期中測驗，
但晚餐攝取蔬菜及晚餐外食天數比例，則無明顯差異。
結論:烹飪課程融入營養教育可有效地提高學童營養知識、蔬果選擇態度
及蔬果攝取行為，如此未來可將烹飪課程應用於營養教育策略中，以達建
立學童良好飲食習慣之目的。

Background: Earlier studies have demonstrated that cooking integrated with
nutrition education could enhanced children’s preference and intakes of
vegetable and fruit (VF). However, little investigation on the effect of different
intervention sequence of cooking and nutrition education integration toward
children’s nutritional knowledge (NK), attitude toward VF selecting (AT) and
behaviors on VF consuming (BE) and VF preferences (VFP).
Objective: This study will investigate the effects on different intervention
sequence cooking and nutrition education in elementary students. Participants’
NK, AT, BE, VFP would be assessed.
Methods: This study was conducted in a crossover-trial design, 90 children of
Grade 3-4 graders were recruited in a electuary school, and were assigned into
two groups randomized.
The group which was intervened with cooking then nutrition education was
named as CN group; the other group was named as NC group, alternatively.
Participants’ NK, AT, BE, VFP from the CN and NC groups will be assessed
pretest (W0), midterm test (W4), posttest (W8), and follow-up test (W10).
Results:
The results showed that cooking integrate nutrition education in a different
sequence could significantly improve NK, AT, BE, VFP.
The results showed that (1) CN group has improved significantly in the VFP
and AT significantly higher than NC group.
(2) Compare boys and girls, CN group of girls’ attitude was significantly
enhanced than NC group.
vi
(3) The follow-up test results show, CN group not only could keep the
knowledge, attitudes and preferences, but also could improve behavior.
(4) The midterm and posttest were significantly different in dining intake of
fruits frequency, but there no significantly in intake of vegetable and eating-out
frequency.
Conclusion:
“The group which was intervened with cooking then nutrition education” could
effectively improve children’s nutritional knowledge, attitude toward
vegetables and fruit selecting and behaviors on vegetable and fruit consuming
and vegetable and fruit preferences.
The future may apply cooking to nutrition education strategies will achieve the
purpose of establishing healthy eating habits.

誌謝……….……………………………………………………………….i
中文摘要………………………………………………………………….iii
英文摘要………………………………………………………………….v
目錄………………………………………………………………………vii
表目錄……………………………………………………………………..x
圖目錄……………………………………………………………………xii
第一章 緒論.................................................1
第一節 研究背景與動機.......................................1
第二節 研究目的.............................................5
第三節 名詞界定.............................................6
第二章 文獻探討.............................................7
第一節 各國學童過重與肥胖盛行率.............................7
第二節 蔬菜水果對人體的益處、攝取量與肥胖盛行率之相關性....11
第三節 各國學童營養教育計劃及其成效評估....................16
第四節 食物烹飪課程融入營養教育介入成效之相關研究..........23
第五節 學童學習與認知發展過程的理論基礎之探討..............27
第三章 研究方法............................................30
第一節 研究架構............................................30
第二節 研究設計............................................32
第三節 研究對象............................................34
第四節 課程內容............................................34
第五節 研究工具與問卷設計..................................35
第六節 統計分析............................................46
第七節 研究倫理............................................47
第四章 結果................................................48
第一節 學童基本資料........................................48
第二節 烹飪課程及營養教育課程依不同時序介入之成效..........50
第三節 烹飪及營養教育課程介入對學童體位之變化..............55
第四節 介入後對一週晚餐攝取「水果」、「蔬菜」、及「外食」天數影響.56
第五章 討論................................................57
第一節 學童背景基本資料分析................................57
第二節 烹飪課程及營養教育課程依不同時序介入之變化評估......58
第三節 一週晚餐攝取「水果」、「蔬菜」、及「外食」天數變化評估.63
第六章 結論................................................64
第七章 研究限制............................................65
參考文獻...................................................66
附件一 課程內容....................................………..103
附件二 專家效度審查委員名單......................……………111
附件四 人體試驗審查委員會同意書..............…………………116
附件五 預試問卷............................…………………..117

Bere, E., Brug, J., & Klepp, K. I. (2008). Why do boys eat less fruit and vegetables than girls? Public Health Nutr, 11(3), 321-325.

Bisset, S. L., Potvin, L., Daniel, M., & Paquette, M. (2008). Assessing the Impact of the Primary School-based Nutrition Intervention Petits cuistots Canadian Journal of Public Health / Revue Canadienne de Sante'e Publique, 99(2), 107-113.

Bradlee, M. L., Singer, M. R., Qureshi, M. M., & Moore, L. L. (2010). Food group intake and central obesity among children and adolescents in the Third National Health and Nutrition Examination Survey (NHANES III). Public Health Nutr, 13(6), 797-805.

Caraher, M., Seeley, A., Wu, M., & Lloyd, S. (2013). When chefs adopt a school? An evaluation of a cooking intervention in English primary schools. Appetite, 62, 50-59.

Chico, H. (2013). On Japan's school lunch menu: A healthy meal, made from scratch. Retrieved from Washington Post: https://www.washingtonpost.com/world/on-japans-school-lunch-menu-a-healthy-meal-made-from-scratch/2013/01/26/5f31d208-63a2-11e2-85f5-a8a9228e55e7_story.html

Contento, I. R. (2011). Nutrition education: Linking research, theory, and practice. 2nd ed.: Jones & Bartlett Learning.

Cooke, L. (2007). The importance of exposure for healthy eating in childhood: a review. J Hum Nutr Diet, 20(4), 294-301.

Cooking Matters. (2013). COOKING MATTERS
2013 ANNUAL REVIEW. Retrieved from Washington DC, 20005: http://cookingmatters.org/sites/default/files/CookingMatters_2013_AnnualReview_FOR_WEB.pdf

Cunningham-Sabo, L., & Lohse, B. (2013). Cooking with Kids positively affects fourth graders' vegetable preferences and attitudes and self-efficacy for food and cooking. Child Obes, 9(6), 549-556.

Cunningham-Sabo, L., & Lohse, B. (2014). Impact of a school-based cooking curriculum for fourth-grade students on attitudes and behaviors is influenced by gender and prior cooking experience. J Nutr Educ Behav, 46(2), 110-120.

De Meester, F., van Lenthe, F. J., Spittaels, H., Lien, N., & De Bourdeaudhuij, I. (2009). Interventions for promoting physical activity among European teenagers: a systematic review. Int J Behav Nutr Phys Act, 6, 82.

Dougherty, K., & Silver, C. (2007). Chef–Nutritionist Teams Spark Enjoyment and Learning in Cooking Education Series for 8- to 12-year-olds. J Nutr Educ Behav, 39(4), 237-238.

Eastwood, M., & Kritchevsky, D. (2005). Dietary fiber: how did we get where we are? Annu Rev Nutr, 25, 1-8.

Freedman, M. R., & Fulgoni, V. L., 3rd. (2015). Canned Vegetable and Fruit Consumption Is Associated with Changes in Nutrient Intake and Higher Diet Quality in Children and Adults: National Health and Nutrition Examination Survey 2001-2010. J Acad Nutr Diet.

Frerichs, L., Brittin, J., Sorensen, D., Trowbridge, M. J., Yaroch, A. L., Siahpush, M., Huang, T. T. (2015). Influence of school architecture and design on healthy eating: a review of the evidence. Am J Public Health, 105(4), e46-57.

Gay, L. R. A., P. (2000). Educational research: Competencies for analysis and application Educational research: Competencies for analysis and application. New Jersey: Prentice-Hall.

George, D., & Mallery, P. (2003). SPSS for Windows step by step: A simple guide and reference. 11.0 update. Allyn & Bacon. Boston, USA.


Gidding, S. S., Nehgme, R., Heise, C., Muscar, C., Linton, A., & Hassink, S. (2004). Severe obesity associated with cardiovascular deconditioning, high prevalence of cardiovascular risk factors, diabetes mellitus/hyperinsulinemia, and respiratory compromise. J Pediatr, 144(6), 766-769.

Glaser, R., & De Corte, E. (1992). Preface to the assessment of prior knowledge as a determinant for future learning. . In F.J.R.C. Dochy (Ed.), Assessment of prior knowledge as a determinant for future learning (pp. 1-2).Utrecht/ London; Lemma B.V./ Jessica Kingsley Publishers.

Grosso, G., Marventano, S., Yang, J., Micek, A., Pajak, A., Scalfi, L., Kales, S. N. (2015). A Comprehensive Meta-analysis on Evidence of Mediterranean Diet and Cardiovascular Disease: Are Individual Components Equal? Crit Rev Food Sci Nutr.

Hernandez-Alonso, P., Salas-Salvado, J., Baldrich-Mora, M., Juanola-Falgarona, M., & Bullo, M. (2014). Beneficial effect of pistachio consumption on glucose metabolism, insulin resistance, inflammation, and related metabolic risk markers: a randomized clinical trial. Diabetes Care, 37(11), 3098-3105.

Hersch, D., Perdue, L., Ambroz, T., & Boucher, J. L. (2014). The impact of cooking classes on food-related preferences, attitudes, and behaviors of school-aged children: a systematic review of the evidence, 2003-2014. Prev Chronic Dis, 11, E193.

HSCIC. (2009-2014). National Statistics National Child Measurement Programme - England, 2009-14 school year. Retrieved from http://www.hscic.gov.uk/article/2021/Website-Search?productid=13778&q=the+rate+of+obesity+among+child&sort=Relevance&size=10&page=6&area=both#top

Jamie Oliver Food Foundation. (2015). Childhood Obesity Strategy. jamie oliver food foundation. jamie oliver food foundation. Retrieved from http://www.jamieoliverfoodfoundation.org.uk/

Jaworowska, A., Blackham, T., Davies, I. G., & Stevenson, L. (2013). Nutritional challenges and health implications of takeaway and fast food. Nutr Rev, 71(5), 310-318.

Kaiser, H. (1974). An index of factorial simplicity. Psychometrika, 39(1), 31-36.

Kawato. (1989). Questions of nutrition from the viewpoint of school lunch programs and awaiting tasks. School Health, 31, 558-562.

Kim, S. A., Moore, L. V., Galuska, D., Wright, A. P., Harris, D., Grummer-Strawn, L. M., Rhodes, D. G. (2014). Vital signs: fruit and vegetable intake among children—United States, 2003–2010. MMWR Morb Mortal Wkly Rep, 63(31), 671-676.

Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development.

Krebs-Smith, S. M., Guenther, P. M., Subar, A. F., Kirkpatrick, S. I., & Dodd, K. W. (2010). Americans do not meet federal dietary recommendations. J Nutr, 140(10), 1832-1838.

Lai Yeung, W. L. (2010). Gender perspectives on adolescent eating behaviors: a study on the eating attitudes and behaviors of junior secondary students in Hong Kong. J Nutr Educ Behav, 42(4), 250-258.

Langellotto, G. A., & Gupta, A. (2012). Gardening increases vegetable consumption in school-aged children: A meta-analytical synthesis. HortTechnology, 22(4), 430-445.

Lee, J. S., & Kim, J. (2010). Vegetable intake in Korea: data from the Korean National Health and Nutrition Examination Survey 1998, 2001 and 2005. Br J Nutr, 103(10), 1499-1506.

Li, M., Fan, Y., Zhang, X., Hou, W., & Tang, Z. (2014). Fruit and vegetable intake and risk of type 2 diabetes mellitus: meta-analysis of prospective cohort studies. BMJ Open, 4(11), e005497.

MEXT. (2013). Overview of the Ministry of Education, Culture, Sports, Science and Technology 2013. Japan.

Miyoshi, M., Tsuboyama-Kasaoka, N., & Nishi, N. (2012). School-based ＂Shokuiku＂ Program in Japan: Application to Nutrition Education in Asian Countries. Asia Pacific journal of clinical nutrition, 21(1), 159-162.

Official Sponsor. (2016). What is British Food Fortnight? Love British Food Fortnight. Retrieved from http://www.lovebritishfood.co.uk/british-food-fortnight/what-is-british-food-fortnight?

Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA, 307(5), 483-490.

Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA, 311(8), 806-814.

Oguntibeju, O. (2014). Antioxidant-Antidiabetic Agents and Human Health: inTech.

Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: theory, research & practice, 19(3), 276.

Prochaska, J. O., & Velicer, W. F. (1997). The Transtheoretical Model of Health Behavior Change. American Journal of Health Promotion, 12(1), 38-48.

Reverdy, C., Chesnel, F., Schlich, P., Köster, E. P., & Lange, C. (2008). Effect of sensory education on willingness to taste novel food in children. Appetite, 51(1), 156-165.

Tanaka, N., & Miyoshi, M. (2012). School Lunch Program for Health Promotion among Children in Japan. Asia Pacific journal of clinical nutrition, 21(1), 155-158.

Thompson, R. A., & Zamboanga, B. L. (2004). Academic Aptitude and Prior Knowledge as Predictors of Student Achievement in Introduction to Psychology. Journal of educational psychology, 96(4), 778.

USDA&HHS. (2010). Dietary Guidelines for Americans Washington, DC: U.S. Government Printing Office, 7th 23.

Wall, D. E., Least, C., Gromis, J., & Lohse, B. (2012). Nutrition Education Intervention Improves Vegetable‐Related Attitude, Self‐Efficacy, Preference, and Knowledge of Fourth‐Grade Students. Journal of School Health, 82(1), 37-43.

WHO. (2013). Global Targets 2025 : childhood overweight policy brief World Health Organization. Retrieved from http://www.who.int/nutrition/global-target-2025/en/

World Obesity Federation. (2016). Obesity prevalence worldwide - Boys. world obesity federation. Retrieved from http://www.worldobesity.org/resources/world-map-obesity/?map=overview-boys#country=TWN

Wu, S., Pan, W., Yeh, N., & Chang, H. (2007). Dietary nutrient intake and major food sources: the Nutrition and Health Survey of Taiwan Elementary School Children 2001-2002. Asia Pacific journal of clinical nutrition, 16, 518.

Yngve, A., Wolf, A., Poortvliet, E., Elmadfa, I., Brug, J., Ehrenblad, B., Klepp, K. I. (2005). Fruit and vegetable intake in a sample of 11-year-old children in 9 European countries: The Pro Children Cross-sectional Survey. Ann Nutr Metab, 49(4), 236-245.

 
小野尚美 （2007）。 Introduction to the review of Article 2 of the School Lunch Implementation Standard。Journal of humanities and social sciences（23），頁 86-72。

內閣府（2015）。 平成27年版食育白書。 內閣府。取自 http://www8.cao.go.jp/syokuiku/data/whitepaper/2015/pdf-honbun.html

文部科学省（2004）。 学校給食実施状況調査。 文部科学省。取自 http://www.mext.go.jp/b_menu/toukei/001/index24a.htm

王明傑、陳玉玲 （2002）。 教育心理學-理論與實務。台北: 學富.(原出版年代 1986)。

王馨慧（2013）。營養教育介入對過重或肥胖學童體重控制之成效評估與影響因子之分析。輔英科技大學保健營養系碩士班，高雄市。

何縕琪（2000）。 先備技能。 教育大辭書[Online]。取自 http://terms.naer.edu.tw/detail/1304375/

吳幸娟、潘文涵、葉乃華、張新儀 （2006）。 台灣國小學童營養健康狀況調查 2001-2002 以 24 小時飲食回顧法評估國小學童膳食營養狀況。行政院衛生署。

吳明隆（2007）。SPSS統計應用學習實務 問卷分析與應用統計（第2007.8冊）。台北縣(現新北市):加樺國際：黃世陽。

厚生労働省（2009-2013）。 国民健康・栄養調査。 厚生労働省。取自 http://www.mhlw.go.jp/bunya/kenkou/kenkou_eiyou_chousa.html

厚生労働省（2013）。 平成27年-国民健康・栄養調査。 厚生労働省。取自 http://www.mhlw.go.jp/bunya/kenkou/kenkou_eiyou_chousa.html

施桂梅、范純美、熊夢萍 （2012）。 營養教育對過重與肥胖國小學童之成效。台灣營養學會， 201209 (37:3期)，頁 102-109。

祝年豐 （2002）。 第二次國民營養健康狀況變遷調查: 台灣國小學童肥胖及其相關合併症流行病學。台北市: 行政院衛生署補助計畫執行報告，頁 284-296。

祝年豐（2010）。台灣國小學童營養健康狀況調查 2001-2002 台灣國小學童肥胖及其相關合併症流行病學。衛生福利部食品藥物管理署。

國家衛生研究院（2008）。 論壇健康促進與疾病預防委員會文獻回顧研析計畫—兒童之肥胖問題與對策。 臺北市：財團法人國家衛生研究院。取自 http://www.npf.org.tw/particle.php?sid=4094&topic=2http://www.doh.gov.tw/CHT2006/other/ShowCopy.aspx?doc_no=80211&class_no=25.

張文哲 （2005）。 教育心理學-理論與實際。台北市: 學富文化事業.(原作 1998 出版)。

教育部統計處（2012）。 國小學生體位趨勢。 教育部統計處。取自 http://www.edu.tw/pages/detail.aspx?Node=3973&Page=20272&WID=31d75a44-efff-4c44-a075-15a9eb7aecdf#a

辜樹仁（2013）。「新廚師運動」發源地。天下雜誌，519期，頁 116-118。

黃有才（2013）。 日本與韓國學校午餐的啟示。 行政院農業委員會。取自 http://www.coa.gov.tw/view.php?catid=2500506

楊忠斌 （2015）。 Piaget「基模」理論的哲學基礎－從Kant到Hegel[A Study on Philosophical Foundation of Piaget's Theory of Schema-From Kant to Hegel]。教育科學期刊， 14（1），頁 1-17。

劉介宇、洪永泰、莊義利、陳怡如、翁文舜、劉季鑫等人 （2006）。 台灣地區鄉鎮市區發展類型應用於大型健康調查抽樣設計之研究。健康管理學刊， 4（1），頁 1-22。

衛生福利部-統計處（2015）。 103年度國人死亡原因統計。 衛生福利部。取自 http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=5488

衛生福利部國民健康署（2007）。 肥胖防治要從小紮根。 衛生福利部國民健康署。取自 http://www.hpa.gov.tw/BHPNet/Web/News/News.aspx?No=200712250291

衛生福利部國民健康署（2011）。 3-6年級學童一日飲食建議量。 衛生福利部國民健康署.肥胖防治網。取自 http://obesity.hpa.gov.tw/TC/downloadList.aspx?pn=2&cid=80

衛生福利部國民健康署（2013）。 兒童及青少年生長身體質量指數（BMI）建議值。 衛生福利部國民健康署.肥胖防治網。取自 http://obesity.hpa.gov.tw/TC/downloadList.aspx?cid=82

衛生福利部國民健康署（2014）。 守護親子健康，醫院暑期減重活動開跑 國小及國中學童近3成過重及肥胖。 衛生福利部國民健康署。取自 http://www.hpa.gov.tw/bhpmobile/Mobile/Code/News/NewsDetail.aspx?NO=201505200001

學校營養午餐工作要點（2013）。桃園縣-學校午餐工作手冊。桃園縣：教育局。

蕭寧馨（2011）。透視營養學（第第二版冊）。：麥格羅希爾出版。

賴苡汝、廖梨伶 （2011）。 學童蔬果攝取教育介入計畫之發展與評價－社會行銷輪轉模式之應用。臺灣營養學會雜誌， 36（3），頁 58-67。

鐘素梅 （2003）。 Ausubel 有意義的學習理論之探討。取自: http://www. nani. com. tw/juniordoc/thesis/thesis15. doc。