臺灣博碩士論文加值系統

台灣65歲以上老年人口比率在民國82年即已邁過高齡化社會門檻，並在民國107年正式邁入高齡社會。隨著年歲的增長，長者罹患失智症(Dementia)的可能性就愈高。據估計，民國107年之台灣65歲以上老人約有340萬人，其中失智症患者約有26萬人，故推知老年失智者約有7.86%，且推估老年失智人口數至民國154年時，將以平均每天增加36人，每40分鐘增加1人的速度成長。有研究結果顯示，地中海飲食(Mediterranean diet)加上得舒飲食(DASH diet)所延伸而來的「麥得飲食」(Mediterranean-DASH Intervention for Neuro- degenerative Delay diet; MIND diet)，可有效延緩認知減退，並顯著降低阿茲海默症的發生率。為能透過日常飲食方式來減少失智症發生的風險，因此本研究採用麥得飲食原則，以台灣在地食材為主材料，設計出符合現行「每日飲食指南」及「台版我的餐盤」之內涵，以及「國人膳食營養素參考攝取量」(Dietary Reference Intakes; DRIs)建議值的一週菜單(設定為1800 Kcal/天，三大營養素熱量比例：醣類50~60%、蛋白質10~20%及脂肪20~30%)及食譜，然後進行實作與修正，再利用MIND飲食計分表來驗證設計菜單及食譜內容的合宜性。由計分結果得知，設計菜單及食譜內容在總分15分中獲得14分(只缺少紅酒攝取量)，顯示非常切合MIND飲食原則。此外，整體營養素的含量也都能夠符合設計初衷。其實MIND飲食原則不難遵循，只要在飲食上稍加留意及改變，即可有效防治失智。本設計菜單及食譜內容應可做為一般家庭之健康餐飲，或是長照機構在供餐上的參考。

In March of 2018, Taiwan officially became an “aged society” with people 65 years and older accounted for 14.05% of the country’s total population. As people grow older, they may experience physiological changes that can cause dementia. In 2018, the number of Taiwanese people over 65 years old was estimated to be 3,400,000 and that of elderly population of dementia was about 260,000, which means there were already 7.86% elderly living with dementia. By 2054, the numbe of elderly dementia will rise at an average rate of 36 people per day. In another word, a new case of elderly dementia will be diagnosed every 40 minunites. The MIND diet, a hydrid of the Mediterranean and DASH diets with the goal for neurodegenerative delay, have been demonstrated to slow cognitive decline with aging and reduce incidence of Alzheimer’s disease. In order to decrease the risk of dementia, the MIND diet principles were adopted to develop a one-week meal plan, featuring brain health recipes prepared with local and natural foods. In addition, the related health recommendations from the Taiwaneses version of Daily Food Guide, My Plate, and Dietary Reference Intakes (DRIs) were also considered for menu planning and recipe development. The adequacy of the meal plan and recipes was checked by the table of Mind diet component servings and scoring. The final score for the one-week meal plan was 14 points out a total 15 points and only the red wine was not included. Thus, the menu and recipes were well designed with the MIND diet principles. The contents of other nutrients were also within the range of recommended intake range. The MIND diet pattern is easy to follow. By making beeter food choices and changing eating habits, it will be effective to reduce the risk of dementia. The menu and recipe contents of the Taiwanese MIND diet chould be used as a good cooking reference for the general families or the long-term care institutions.

摘要... I
ABSTRACT ............................ III
目 錄....... IV
表目錄...................... V
圖目錄.................... VII
第一章 前言 ........................ 1
第二章 文獻探討 ....................... 5
第一節 人口老化 .............................5
第二節 糖尿病 .......................... 7
第三節 失智症 .......................... 13
第四節 飲食與失智症 ............... 26
第五節 地中海飲食、得舒飲食及麥得飲食的比較 ........................... 44
第三章 研究材料與方法 ............................................ 46
第一節 研究流程 ...................................................... 46
第二節 麥得菜單及食譜設計 ............................................ 47
第四章 結果與討論 ................................................. 52
第一節 麥得菜單設計 .................................52
第二節 結果與討論 ................................................... 54
第五章 結論與建議 .................................................. 107
參考文獻............................................................ 108

表目錄
表2-1 老人(65 歲以上)自述經醫師診斷罹患慢性病數百分比 .................. 6
表2-2 台灣失智人口推估(以中推計人口為準) ............................. 15
表2-3 地中海飲食原則 .............................................................. 29
表2-4 麥得飲食組成分份量及計分表 .................................... 43
表2-5 地中海飲食、得舒飲食及麥得飲食的比較 ........................... 45
表3-1 平日份量分配(一).........................................48
表3-2 平日份量分配(二).............. 48
表3-3 周末份量分配(一)............... 49
表3-4 周末份量分配(二)............... 49
表4-1 麥得飲食一週菜單 ........... 52
表4-2 麥得飲食設計菜單選用食材 ........................................... 53
表4-3 第一天菜單之熱量及營養素總表 ................................. 54
表4-4 第一天菜單之早餐食譜 ........................................ 55
表4-5 第一天菜單之午餐食譜 .......................................... 57
表4-6 第一天菜單之晚餐食譜 ........................................................ 59
表4-7 第二天菜單之熱量及營養素總表 ................................. 61
表4-8 第二天菜單之早餐食譜 ............................................... 62
表4-9 第二天菜單之午餐食譜 ............................................... 64
表4-10 第二天菜單之晚餐食譜 .............................................. 67
表4-11 第三天菜單之熱量及營養素總表 .................................. 69
表4-12 第三天菜單之早餐食譜 ............................................... 70
表4-13 第三天菜單之午餐食譜 ............................................. 72
表4-14 第三天菜單之晚餐食譜 .......................................... 74
表4-15 第四天菜單之熱量及營養素總表 ................................ 76
表4-16 第四天菜單之早餐食譜 .......................................... 77
表4-17 第四天菜單之午餐食譜 .....................................79
表4-18 第四天菜單之晚餐食譜 ........................................... 82

表4-19 第五天菜單之熱量及營養素總表 ................................. 84
表4-20 第五天菜單之早餐食譜 ........................................... 85
表4-21 第五天菜單之午餐食譜 ........................................... 87
表4-22 第五天菜單之晚餐食譜 ......................................... 89
表4-23 第六天菜單之熱量及營養素總表 .............................. 91
表4-24 第六天菜單之早餐食譜 .......................................... 92
表4-25 第六天菜單之午餐食譜 ......................................... 94
表4-26 第六天菜單之晚餐食譜 ........................................ 96
表4-27 第七天菜單之熱量及營養素總表 .................................. 98
表4-28 第七天菜單之早餐食譜 .......................................... 99
表4-29 第七天菜單之午餐食譜 ......................................... 101
表4-30 第七天菜單之晚餐食譜 ......................................... 103
表4-31 麥得菜單得分表 ............................................... 105
圖目錄
圖2-1 阿茲海默症與糖尿病的共同機制 ................................. 12
圖2-2 台灣失智症總人口數推估 ........................................ 14
圖2-3 地中海飲食原則金字塔 ........................................ 27
圖2-5 台版地中海飲食 ............................................ 33
圖2-6 得舒飲食5 原則 ................................................ 40
圖3-1 研究流程 .................................................. 46
圖3-2 每日飲食指南 ..................................................... 50
圖3-3 台版我的餐盤......................................... 51
圖4-1 第一天早餐餐盤照 ............................................ 56
圖4-2 第一天午餐：A.餐盤照、B 餐盒照。 .............................. 58
圖4-3 第一天晚餐：A.餐盤照、B 餐盒照。 ............................ 60
圖4-4 第二天早餐餐盤照 ............................................... 63
圖4-5 第二天午餐：A.餐盤照、B 餐盒照。 ................................ 66
圖4-6 第二天晚餐：A.餐盤照、B 餐盒照。 ............................... 68
圖4-7 第三天早餐餐盤照 .......................................... 71
圖4-8 第三天午餐：A.餐盤照、B 餐盒照。 ................................ 73
圖4-9 第三天晚餐：A.餐盤照、B 餐盒照。 ................................ 75
圖4-10 第四天早餐餐盤照 ............................................ 78
圖4-11 第四天午餐：A.餐盤照、B 餐盒照。 ............................ 81
圖4-12 第四天晚餐：A.餐盤照、B 餐盒照。 ........................... 83
圖4-13 第五天早餐餐盤照 ................................................. 86
圖4-14 第五天午餐：A.餐盤照、B 餐盒照。 ........................... 88
圖4-15 第五天晚餐：A.餐盤照、B 餐盒照。 ............................ 90
圖4-16 第六天早餐餐盤照 .............................................. 93
圖4-17 第六天午餐餐盤照 ............................................ 95
圖4-18 第六天晚餐餐盤照 .............................................. 97
圖4-19 第七天餐早餐盤照 ........................................... 100
圖4-20 第七天餐午餐盤照 ............................................... 102
圖4-21 第七天餐晚餐盤照 ............................................ 104

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