臺灣博碩士論文加值系統

目標：
肥胖在近年來持續受到重視，飲食型態可能與肥胖相關，而省略早餐與否一直是這方面研究的一大重點。由於每餐的飲食內容會被前一餐的飲食量經由代償或抑制所影響，早餐亦可能有此現象。本研究欲探討在夜間的宵夜飲食型態與隔日早餐飲食型態的相關性。
方法：
本研究採用橫斷性研究，比較同一群人在是否吃宵夜時，隔天是否進食早餐的情形。依據過去研究數據所估算的樣本數為53人(α=0.05；β=0.1)。本研究的研究族群為國立陽明大學校內大於20歲的教職員生，並於2016年10月至2017年01月完成收案，每位參加的受試者皆須完成三次訪談。研究所需的飲食內容資料採用飲食回顧法，讓受試者回憶訪談日及前一日的飲食內容及份量，並由受試者自行定義該次進食為正餐或點心。本研究的操作定義：宵夜定義為晚餐過後到睡前的點心，早餐定義分為3種：受試者自定義之早餐、睡醒2小時內進食、上午9:30前進食。除飲食之外，也記錄受試者的睡眠日誌(sleep log)以及可能的干擾因子：如：情緒健康狀態(使用Depression Anxiety Stress Scales, DASS, 憂鬱、焦慮、壓力量表進行評估)、訪談形式(面訪或電訪)、訪談日(週間或週末)等。由於生理時鐘與飲食型態也有相關，因此也使用清晨-夜晚型問卷(Morningness-Eveningness Questionnaire, MEQ)來檢測受試者的生理時鐘類別。在資料分析上則使用混合效果模型(mixed effect model)評估宵夜進食型態與隔日早餐進食型態的相關性。
結果：
本研究受試者共53人(男性26人、女性27人)，平均年齡分別為22.1歲。依照三次訪談是否有吃宵夜分為3組：三天皆無吃宵夜(2人)、三天中一至二天有吃宵夜(36人)以及三天皆有吃宵夜(15人)。研究族群多屬於BMI正常(18.5-24)、大學在學學生，生理時鐘以中間型為主，在三組間皆無分布上的顯著差異。針對三天中一至二天有吃宵夜的這組依照該次訪談是否進食宵夜分為2組(無吃宵夜為50人次；有吃宵夜為58人次)，兩組在進行面訪、以及訪談日為平日時有較高比例的受訪者回報有吃宵夜；而宵夜進食與否對隔天回報是否有吃早餐時無顯著差異。
從混合效果模型分析結果發現，有吃宵夜相較於未吃宵夜在隔天醒來後2小時內有進食的勝算比(Odds ratio, OR)為0.68 (0.21 - 2.18)，在調整可能的干擾因子後(前一日是否有吃早餐及晚餐、訪談類型、訪談日在週間或週末)，勝算比為0.49 (0.13 - 1.87)，表示有吃宵夜時，隔日醒來2小時內較不容易進食，但此結果為達統計上的顯著意義。
結論：
雖然統計結果未達顯著，但在調整可能的干擾因子後，晚上有吃宵夜時，隔日醒來2小時內較不易進食。由於本研究樣本數較少，未來研究可以擴大樣本數及納入不同種類營養素攝取情形來做更進一步的探討與分析。

Objective:
Prevalence of obesity is being taken seriously in recent decades. Dietary pattern is associate with obesity, especially skipping breakfast. Since each eating episode is affected by the eating episode before, breakfast may be affected by last night eating pattern. Therefore, finding night time eating pattern and the breakfast eating pattern later is the focus in this study.
Subjects and design:
This cross sectional study was conducted in National Yang Ming University during 2016 Oct to 2017 Jan, including 53 subjects. Each subject was asked to finish three interviews. Interview contained dietary recall, sleep log, DASS (depression anxiety stress scales), MEQ (morningness-eveningness questionnaire). Night time snack was defined as snack intake after dinner in subjects’ dietary recall. Breakfast was defined according three different definition: subject self-defined breakfast on the interview day, eating within 2 hours and eating before 9:30AM. Data analysis was using mixed effect model to discover the association between night time snack eating pattern and breakfast eating pattern on the following day.
Results:
A total of 53 adult (26 males and 27 females, average 22.1 years old) took part in this study with three night time snack types: reported no night time snack in 3 recalls (N=2), reported 1-2 day with night time snack in 3 recalls and reported night time snack in all 3 recalls. Most of subjects were health body weight (18.5<BMI<24), college students and early or medium type of chronotype. According to the results of mixed effect model, night time snack intake is associated with less likely to eat within 2 hours after wake up on the following day although there was no statistical significance. (OR = 0.68, 95% CI = 0.21-2.18)
Conclusion:
Even though there is no statistical significance, taking night time snack is associate with less food intake within 2 hour after wake up on the following day. Further study can include more study sample size and take different nutrition intake into consideration to figure out the association between night time snack dietary pattern and breakfast dietary pattern on the following day.

致謝....I
摘要....II
Abstract....IV
目錄....VI
圖目錄....VIII
表目錄....IX
第一章 前言....1
　　第一節 研究背景....1
第二章 文獻回顧....2
　　第一節 進食型態對健康之影響....2
　　第二節 進食型態對後續餐次之影響....4
　　第三節 可能影響進食型態的因素....6
　　第四節 觀察型研究對餐次之定義及其優劣....9
　　第五節 研究概念框架與假說....10
第三章 研究方法....11
　　第一節 研究設計....11
　　第二節 研究對象....11
　　第三節 研究工具....12
　　第四節 研究架構....15
　　第五節 研究變項定義....16
　　第六節 資料分析....18
第四章 研究結果....19
　　第一節 樣本基本特性描述....19
　　第二節 宵夜進食與否之特性描述....21
　　第三節 宵夜進食與否與隔日早餐進食....23
　　第四節 宵夜及早餐進食型態之個人特質分層分析....24
第五章 結果討論....25
　　第一節 樣本數與統計檢定力之探討....25
　　第二節 訪談形式與宵夜進食與否之探討....26
　　第三節 不同早餐定義下，宵夜與早餐相關性之探討....27
　　第四節 宵夜進食與隔日早餐相關性之可能修飾因子(effect modifiers)....29
　　第五節 研究限制....30
　　第六節 研究優點....31
第六章 結論與建議....32
　　第一節 研究結論....32
　　第二節 研究建議....33
參考文獻....34
附錄....42

圖目錄
圖1、研究概念框架....10
圖2、研究架構流程....15
圖3、自定義早餐判別流程圖....17

表目錄
表1、樣本基本特性描述....37
表2、飲食紀錄中宵夜進食與否之特性描述....39
表3、宵夜進食與否當天及隔日之進食及睡眠時間....41
表4、宵夜進食與否與隔日早餐進食之相關性：mixed-effect logistic model....40
表5、宵夜進食與否與隔日早餐進食之相關性：依個人特質進行分層分析(睡醒後2小時內有進食則為早餐(N=36))....41

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