臺灣博碩士論文加值系統

中文摘要
行政院衛生署國民健康局大力推動母乳哺育之下，國內目前母乳哺育率也大幅提升，因此母乳提供之營養成分對嬰兒生長發育佔極重要的地位。長鏈多元不飽和脂肪酸；AA、DHA等，除了於出生第一年會快速累積於腦部外，亦是嬰兒的正常的生長發育必須的營養素。人體乳汁中營養成份源自母親的飲食攝取及身體組織儲存，乳汁中的營養組成與含量可能受個人代謝狀況與飲食攝取等外在因子影響。因此本研究以設籍臺北市都會型態之信義行政區之出生嬰兒簡單隨機採樣50份樣本，以問卷及分析母親乳汁營養成份方式探討影響母乳營養成份之因子。
本研究中外籍母親（含大陸、越南等）佔了16％，外籍移入居民與本國國籍之居民於基本特質、懷孕前生活習慣、懷孕期生活習慣、懷孕前飲食頻率、懷孕期飲食習慣、哺乳期飲食頻率、24小時飲食回憶…等，有不同之趨勢。外國籍哺乳婦女飲食攝取較高的熱量、醣類、蛋白質、脂肪、飽和脂肪酸、油酸及膽固醇。從乳汁成份分析中發現，外國籍哺乳婦女有較高的膽固醇含量及飽和脂肪酸百分比，n-3/n-6比較低且具統計差異。而EPA、DHA、LCPUFA、MUFA百分比和蛋白質含量較低。
此外由母乳營養成分與母親取乳前24小時飲食攝取之營養素分析，發現飲食中熱量、脂肪、醣類之攝取與乳汁中脂肪或C18:0脂肪酸之百分比成正相關，而飲食中蛋白質攝取量與乳汁中營養成份則無相關性。綜合以上結果推測哺乳婦女飲食攝取內容會明顯影響乳汁的脂肪酸組成。
Key word： AA、EPA、DHA、n-3、n-6、SFA、LCPUFA、MUFA

Abstract
Because the Bureau of health department put vigorous effort in promoting breast feeding, the breast feeding rate has increased conspicuously in Taiwan. Furthermore, the nutrients in breast milk are very important to infant’s growth. Long-Chain polyunsaturated fatty Acid; arachidonic acid and docosahexaecoic acid accumulate in infant’s brain in the first year after birth and they are important to normal baby growth. The nutrient composition of breast milk maybe influenced by mother’s dietary intake and personal metabolic status. Therefore, this study was to investigate the influences of demographic characteristics and dietary intakes on the nutrients of human milk. The results could be served as a major reference for educating lactation women about their dietary intakes. A total of 50 subjects from Xinyi District of Taipei were collected human mature milk, and the 24 hours dietary intakes before sampling were recorded and questionnaire was surveyed.
In this research, the subject from China and Vietnam constitutes 16% of the study population. New immigrants and residents of Taiwan are different in their demographic characteristics, living habits before and after pregnancy, dietary intake frequency before pregnancy, dietary intake during pregnancy, dietary intake frequency during lactation period, and 24-hour diet recall. New immigrants of lactation women’s diet contains higher calories, carbohydrates, proteins, lipids, saturated fatty acid , oleic acid and cholesterol. It is also found that higher cholesterol content and higher saturated fatty acid in the milk of lactation immigrant women, however, their n-3/n-6 is lower and eicosa-pentaenoic acid, long-chain polyunsaturated fatty Acid , monounsaturated fatty Acid percentage and protein are lower, too.
In addition, when we analyzed 24-hour dietary intake before sampling and the nutrients in human milk, it is found that calories, lipids, and carbohydrates are positively correlated to C18:0 fatty acid. However, there seems no correlation between protein intake and the nutrients in breast milk. In summary, we concluded that the dietary intake would influence the fatty acid composition of the human milk.
KEY WORD: AA , EPA , DHA , N-3 , N-6 , SFA , LCPUFA , MUFA

內容目錄
謝誌------------------------------------------------------------------------------------ i
中文摘要------------------------------------------------------------------------------ii
英文摘要------------------------------------------------------------------------------iii
內容目錄------------------------------------------------------------------------------v
表目錄---------------------------------------------------------------------------------ix
圖目錄---------------------------------------------------------------------------------x
第一章前言 1
壹、研究動機 5
一、人口密度： 5
二、出生人口數： 5
三、自然增加率： 5
四、人口結構情況： 6
五、健康狀況： 6
六、環境： 6
貳、研究目的 8
參、名詞解釋 9
肆、研究架構圖 12
伍、實驗流程圖 13
第二章、文獻探討 14
壹、母乳介紹 14
一、母乳的特性 14
二、母乳製造及來源 14
三、母乳階段及營養成份的變化 15
四、母乳的分泌量 15
貳、母乳的成分 15
一、醣類 15
二、脂肪 16
三、蛋白質 16
四、維生素 17
五、礦物質 17
參、母乳營養成分對嬰兒生理功能之影響 17
一、醣類 17
三、蛋白質 19
（一）乳清蛋白(WHEY)： 19
（二）酪蛋白(CASEIN)： 20
（三）非蛋白含氮物質(NON-PROTEIN NITROGEN) 20
肆、母親飲食與母乳脂肪酸成分之相關性 21
一、脂肪酸的來源 21
二、哺乳婦血漿磷脂質與乳汁脂肪酸之相關性 21
三、飲食脂肪對母乳脂肪酸之影響 21
伍、母乳蛋白質組成成分分析 22
一、哺乳動物母乳中營養素比較 22
二、人類乳汁分泌時期營養素變化 22
三、甲型乳白蛋白(α-lactalbumin) 23
四、乳鐵蛋白(lactoferrin) 23
五、母乳中游離胺基酸含量及生理功能 23
陸、其它影響因素 24
第三章材料與方法 25
壹、樣本取得 25
一、母乳樣品收集方法 25
二、飲食調查方法 25
貳、母乳分析 25
一、脂肪分析 25
二、總膽固醇(total cholesterol)測定 26
三、蛋白質分析 27
四、水分及灰分測定 27
參、儀器設備 27
肆、統計分析 28
一、母乳分析統計方法 28
二、問卷統計方法 28
伍、研究限制 29
一、哺乳婦樣本取得 29
二、飲食調查部分 29
三、補充劑認知不足 29
第四章結果 30
壹、受試者基本資料 30
一、本研究哺乳婦女及嬰兒之基本資料 30
二、本研究哺乳婦女乳汁營養成份 30
三、本研究哺乳婦女24小時飲食回憶營養素攝取量 30
貳、個人特質之影響 31
一、母親特質對乳汁營養成份之影響 31
二、嬰兒特質對乳汁營養成份之影響 31
參、妊娠期生活習慣對乳汁營養成份之影響 32
一、營養補充劑之影響 32
二、魚油補充劑之影響 33
三、媽媽奶粉之影響 33
四、吸菸之影響 33
肆、母親懷孕前飲食習慣對乳汁營養成份之影響 34
一、使用烹調油之影響 34
二、外食習慣之影響 34
三、各類食物攝取頻率之影響 34
肆、母親哺乳期食頻率對乳汁營養成份之影響 34
一、肉類攝取頻率之影響 34
二、豆類攝取頻率之影響 34
三、魚類攝取頻率之影響 34
四、主食類攝取頻率之影響 35
伍、移入人口群之差異 35
一、外來人口與本土人口個人特質之差異性 35
二、外來人口與本土人口妊娠期生活習慣之差異性 35
三、外來人口與本土人口懷孕前飲食習慣之差異性 35
四、外來人口與本土人口哺乳期飲食頻率之差異性 35
五、外來人口與本土人口乳汁營養成份之差異性 35
六、外來人口與本土人口24小時飲食回憶所攝食營養成份之差異性 35
陸、24小時飲食攝取營養素與乳汁營養素之相關性 36
一、飲食熱量攝取與乳汁營養成份之相關性 36
二、飲食蛋白質攝取與乳汁營養成份之相關性 36
三、飲食脂質攝取與乳汁營養成份之相關性 36
四、飲食醣類攝取與乳汁營養成份之相關性 36
五、飲食飽和脂肪酸攝取與乳汁營養成份之相關性 36
六、飲食油酸攝取與乳汁營養成份之相關性 36
第五章討論 37
壹、臺北市信義行政區哺乳婦乳汁成份 37
貳、哺乳婦的六大類食物攝取狀況及營養成分分析與衛生署之膳食建議攝取量比較。 38
參、影響臺北市信義行政區哺乳婦乳汁成份之因子 38
一、個人特質之影響 38
二、妊娠期生活習慣之影響 39
三、母親懷孕前飲食習慣 40
四、母親哺乳期食頻率 41
肆、臺北市信義行政區哺乳婦24小時飲食攝取營養素與乳汁營養素之相關性 41
伍、移入人口群之差異 41
第六章結論 43
第七章參考文獻 44
【英文部分】 44
【中文部分】 50
附表 52
附圖 83
附件 89


表目錄

表一 本研究哺乳婦女及嬰兒之基本資料 52
表二 本研究與先前台北地區、英國、德國成熟乳營養成份之比較 53
表三 本研究哺乳婦女每飲食攝取量與衛生署國人膳食建議之比較 54
表四、母親個人特質(年齡)對成熟乳營養素組成之影響 55
表五、母親個人特質(年齡)對成熟乳營養素組成之影響 56
表六、母親哺乳期飲食習慣(素食)對成熟乳營養素組成之影響 57
表七、嬰兒個人特質(週齡)對成熟乳營養素組成之影響 58
表八、乳汁分泌時期(樣品取得時間)對成熟乳營養素組成之影響 59
表九、嬰兒個人特質(出生體重)對成熟乳營養素組成之影響 60
表十、嬰兒個人特質(出生頭圍)對成熟乳營養素組成之影響 61
表十一、母親妊娠期間之生活習慣(脂溶性維生素)對成熟乳營養素組成之影響 62
表十二、母親妊娠期間之生活習慣(魚油補充劑)對成熟乳營養素組成之影響 63
表十三、母親妊娠期間之生活習慣(媽媽奶粉)對成熟乳營養素組成之影響 64
表十四、母親妊娠期間之生活習慣(抽煙)對成熟乳營養素組成之影響 65
表十五、母親懷孕前飲食習慣(使用沙拉油為烹調油)對成熟乳營養素組成之影響 66
表十六、母親懷孕前飲食習慣(晚餐外食)對成熟乳營養素組成之影響
67
表十七、母親懷孕前飲食習慣(宵夜外食)對成熟乳營養素組成之影響
68
表十八、母親懷孕前飲食習慣(每日吃肉類之頻率-不含魚)對成熟乳營養素組成之影響 69
表十九、母親哺乳期食頻率(每日吃肉類之頻率-不含魚)對乳汁營養成份組成之影響 70
表二十、母親哺乳期食頻率(每日吃豆類之頻率)對乳汁營養成份組成之影響 71
表二十一、母親哺乳期食頻率(每日吃魚類之頻率)對乳汁營養成份組成之影響 72
表二十二、母親哺乳期食頻率(每日吃主食類之頻率)對乳汁營養成份組成之影響 73
表二十三、外來人口與本土人口基本特質之差異性 74
表二十四、教育程度對哺乳婦女營養素攝取之影響 75
表二十五、外來人口與本土人口妊娠期間生活習慣之差異性 76
表二十六、外來人口與本土人口懷孕前外食習慣之差異性 77
表二十七、外來人口與本土人口懷孕前飲食習慣（各類食物攝取頻率）之差異性 78
表二十八、外來人口與本土人口哺乳期間飲食各類食物攝取頻率之差異性 79
表二十九、外來人口與本土人口哺乳期間飲食習慣(進補習貫)之差異性 80
表三十、外來人口與本土人口哺乳婦女成熟乳營養素組成之差異性81
表三十一、外來人口與本土人口哺乳婦女營養素攝取之差異性 82


圖目錄

圖一、母親飲食攝取之熱量與乳汁脂質含量之相關性 83
圖二、母親飲食攝取之熱量與乳汁中C18:0脂肪酸含量百分比之相關性 84
圖三、母親飲食攝取之脂質量與乳汁脂質含量之相關性 85
圖四、母親飲食攝取之醣類與乳汁中C18:0脂肪酸含量百分比之相關性 86
圖五、母親飲食攝取之飽和脂肪酸量與乳汁中蛋白質量之相關性 -87
圖六、母親飲食攝取之油酸量與乳汁中蛋白質量之相關性------------ 88

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