脂質関連栄養素の適性摂取を目標とした地域住民に対する個人栄養教育の介入効果  [in Japanese] EFFECTS OF NUTRITION EDUCATION FOR RESIDENTS ON INTAKE OF LIPID-RELATED NUTRIENTS  [in Japanese]

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Abstract

<b>目的</b> 地域住民を対象に個別健康教育が多く行われつつあるが,その介入効果に関する研究は意外と少ない。本研究は,脂質関連栄養素の適正摂取を目標とした個別栄養教育が栄養素摂取量に与える介入効果を検討することを目的としたものである。<br/><b>方法</b> 奈良県 A 町の40歳以上の住民を対象に実施された基本健康診査の受診者の中から40歳以上65歳未満の女性のうち,血清総コレステロールが220 mg/d<i>l</i> 以上300 mg/d<i>l</i> 未満で,本研究に対するインフォームド・コンセントを提出し,ベースライン健診を受けた79人を対象とした。対象者を前期介入群42人と後期介入群37人に分け,前期介入群には前半の24週間は介入を加え,後半の24週間は自己管理期間として介入せず,後期介入群は前半24週を待機期間として介入せず,後半24週間に介入を加えた。介入内容は,ほぼ 8 週間おき計 3 回の栄養士による個別食事指導と,一定期間ごとに求めた日記帳形式の「三日間の食事記録」,「ヘルシーライフ手帳」の自己記録等である。各種栄養素摂取量の推定は上島・岡山が開発した食物摂取頻度調査票を用い,摂取エネルギー量で調整した栄養素摂取量の介入期間前後の変化を効果判定の指標とした。<br/><b>成績</b> 前期介入群42人のうち 3 人が介入期間中に,さらに 2 人が自己管理期間中に脱落し,後期介入群37人については 6 人が待機期間中に,さらに 3 人が介入期間中に脱落した。前期に介入を受けた39人と後期に介入を受けた28人を加えた介入期間群67人の摂取エネルギー量調整摂取量は,介入を受けなかった待機期間群31人の結果と異なり,脂質に加えコレステロール・飽和脂肪酸が有意に低下するとともに,PS 比が有意に上昇していた。また,前期に介入を受け後期は自己管理となった37人の主たる脂質関連栄養素摂取量は,自己管理期間中には変化なく,48週全体を通した時,ベースライン時よりも有意な低下が示された。また,脂質関連栄養素の望ましいと思われる摂取パターン,すなわち脂肪エネルギー比率25%以下かつコレステロール摂取量300 mg 以下かつ PS 比 1 以上の者の割合は,介入期間群が待機期間群に比べ24週間で有意に増加していることも示された。<br/><b>結論</b> 以上の結果は,個別栄養教育が脂質関連栄養素摂取量を有意に低下させること,その効果は介入終了後24週間は持続することを示唆するものである。

<b>Objectives</b> Health education for residents is now common, but only a few studies of its effects have been made. The purpose of this study was to investigate the effects of nutrition education for residents on intake of lipid-related nutrients.<br/><b>Methods</b> A total of 79 females (40-64 years) who underwent a health examinatio for residents in a town, Nara Prefecture and were found to have total serum cholesterol levels between 220 mg/d<i>l</i> and 300 mg/d<i>l</i> were divided into two groups. In the first group, nutrition education was performed during the first 24 weeks and no education was performed during the second 24 weeks as the self-control period. In the second group, no education was given during the first 24 weeks as the waiting period but was performed during the second 24 weeks. During the education period, dietary intervention for individual subjects was performed 3 times at intervals of 8 weeks by trained dietitians. The intake of nutrients was estimated by the food frequency questionnaire developed by Ueshima and Okayama, and changes in the intake of nutrients adjusted for total energy were used for evaluation of the effects of the education.<br/><b>Results</b> In the first froup of 42 subjects, three discontinued during the education period and two during the self-control period, and in the second group of the 37 subjects, six discontinued during the waiting period and three during the education period. At the end of the education period, for the total of 67 subjects (39 and 28 in the first and second groups, respectively), the total energy adjusted intake of lipid, cholesterol and saturated fatty acid were significantly lower and the PS ratio was significantly higher than in the second group during the waiting period. During the self-control period after the education, the adjusted intake of lipid-related nutrients remained nuchanged in the 37 subjects of the first group who had been given the nutrition education in the first 24 weeks, and it was significantly lower at the end of the 48-week test period than at the baseline examination. The percentage of the subjects showing a desirable intake pattern of major lipid-related nutrients increased significantly after the education period.<br/><b>Conclusions</b> These results indicate that the intake of lipid-related nutrients can be decreased by educating individual subjects about nutrition and the effects are maintained for at least 24 weeks.

Journal

  • Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH)

    Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH) 49(4), 332-343, 2002-04-15

    Japanese Society of Public Health

References:  23

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008647303
  • NII NACSIS-CAT ID (NCID)
    AN00189323
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    05461766
  • NDL Article ID
    6158154
  • NDL Source Classification
    ZS17(科学技術--医学--衛生学・公衆衛生)
  • NDL Call No.
    Z19-216
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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