退化性關節炎病人之飲食調查：健康膳食與營養素建議攝取量之遵從情形

許多國外研究指出飲食型態，如地中海型飲食或得舒飲食對健康有益，然而目前鮮少研究了解退化性關節炎病人的飲食和營養素攝取狀況，故本研究目的為進行退化性關節炎病人之飲食調查，了解其對健康膳食與營養素建議攝取量之遵從情形。本研究招募100位退化性關節炎病人與100位無退化性關節的中老年人當成對照組，利用24小時飲食回憶了解受試者飲食種類與份量，透過御廚皇軟體計算營養素攝取量。研究結果發現，在六大類食物與巨量營養素攝取量方面，退化性關節炎受試者攝取豆魚蛋肉類食物攝取份數（p = 0.02）及蛋白質攝取量（p = 0.03）顯著低於中老年人；脂肪佔總熱量攝取比例顯著高於飲食指南建議攝取比例（35% vs. 30%），其中次亞麻油酸攝取量顯著低於中老年人（p = 0.02）；另在維生素攝取方面則發現，退化性關節炎受試者於β-胡蘿蔔素（p = 0.03）及葉酸（p = 0.04）攝取量顯著高於中老年人。與衛福部的各年齡每日飲食指南六大類食物份數建議攝取量及第八版國人膳食營養素參考攝取量比較發現，退化性關節炎與中老年人有半數以上受試者在攝取全穀根莖類、乳品類、蔬菜及水果類食物攝取份數皆未達飲食指南建議數值；營養素方面則發現，有半數以上受試者在菸鹼酸、維生素B-6、葉酸及礦物質（鈣、磷、鎂、鐵、鋅）未達膳食營養素建議攝取值。故我們建議營養師應對退化性關節炎病人更加注重均衡飲食攝取，透過每一種類食物的建議攝取量以達完整之營養素攝取。

Many studies have demonstrated that dietary patterns such as the Mediterranean diet or DASH (Dietary Approaches to Stop Hypertension diet) is good for health. However, few studies have investigated compliance with the healthy dietary pattern and recommended daily nutrients reference intake in patients with osteoarthritis. Therefore, the purpose of this study is to investigate the food and nutrients intake of patients with osteoarthritis. This study recruited 100 patients with osteoarthritis and 100 middle-aged and elderly people without degenerative joints as a control group. A 24-hour diet recall was conducted to understand the dietary habits of the subjects, and using E-kitchen software to calculate the values of nutrients intake. The results showed that the servings for protein food (p = 0.02) and the protein intake (p = 0.03) were significantly lower in patients with osteoarthritis than the control group. The ratio for the fat intake of total calories was higher than the recommended values (35% vs. 30%). In addition, α-linolenic acid intake was significantly lower in patients with osteoarthritis than in the control group (p = 0.02). Regarding vitamin intakes, β-carotene (p = 0.03) and folic acid (p = 0.04) intake were significantly higher in patients with osteoarthritis than the control group. After comparing with the Daily Dietary Guidelines in elderly and the Dietary Reference Intakes of the Ministry of Health and Welfare in Taiwan, we found that over 50% of the subjects did not meet the recommended servings of grains, dairy, vegetables, and fruits, as well as in the recommended values for vitamins and minerals, such as niacin, vitamin B-6, calcium, phosphate, magnesium, iron, and zinc. As a result, we suggest that dietitians should educate and encourage patients with osteoarthritis to consume a variety of foods to meet their nutritional needs.