素食與定期運動：對臺灣成年人高密度脂蛋白膽固醇的影響

研究目的：探討臺灣成人的運動及素食習慣對高密度脂蛋白膽固醇 (High-Density Lipoprotein Cholesterol , HDL-C)之影響。研究材料與方法：本研究為橫斷式研究(cross-sectional study)，資料取自中央研究院臺灣人體生物資料庫(Taiwan Biobank)，在2008-2015年間共有9,588位年齡介於30-70歲參與者納入研究分析(女性5,162人、男性4,426人)。本研究透過飲食習慣將參與者分成三組，分別是雜食、曾經吃素及素食食用者(包含蛋奶素及全素)，再進一步以是否有規律運動習慣進行分層分析(Stratified analysis)，使用多變項線性迴歸模式(Multiple linear regression model)探討運動與飲食習慣對HDL-C的影響。所有模式中皆調整年齡、生活習慣、體位測量指標及生化檢驗值等干擾因子。研究結果：本研究共有4,025位規律運動者及5,563位非規律運動者納入研究。調整干擾因子後，規律運動者之HDL-C濃度顯著高於非規律運動者，且與雜食者相比，素食者帶有較低的HDL-C(β = -4.0433; p = <.0001)、曾經吃素者則為(β = -0.3056; p = 0.5065)，達劑量效應關係(P<0.001)。透過運動分層分析後，也發現運動及素食習慣對HDL-C具有拮抗型交互作用(p =0.009)。結論與建議：規律運動與素食的結合會導致HDL-C濃度降低更多，且規律運動可能會預防素食者HDL-C濃度的增加。

Objective: We investigated the effect of diet plus exercise on HDL-C levels in Taiwanese adults.Material and Methods: Data were collected from 9588 participants (5162 women and 4426 men) aged 30-70 years using Taiwan Biobank. Participants were categorized as omnivores, former vegetarians, lacto-ovo vegetarians, and pure. Further stratifications were made based on exercise status. Associations of HDL-C with diet and exercise were determined using multiple linear regression analysis.Results: Overall, 4,025 exercisers and 5,563 non-exercisers were recruited. After adjusting for covariates, HDL-C levels were significantly higher in exercisers compared to non-exercisers. Compared with omnivores, pure vegetarians had the lowest levels of HDL-C (β = -5.6827; p =0.0008) followed by lacto-ovo vegetarians (β = -3.8944; p<0.001) and former vegetarians (β= -0.3057; p=0.5064). The test for trend was significant (p <0.001). After categorization based on exercise status, the β values were -13.9835 (p <0.001) for pure vegetarians, -4.4188 (p <0.001) for lacto-ovo vegetarians, and -1.8640 (p =0.019) for former vegetarians, respectively. Further analyses showed a significant antagonistic interaction between diet and exercise (p =0.0099).Conclusion: We found that regular exercise in conjunction with vegetarian diet resulted in greater reductions in HDL-C levels. In light of this study, we conclude that regular exercise might prevent an increase in the concentration of HDL-C among vegetarians.