食物熱量與體重控制講課教案

1、食物熱量與體重控制容易計(jì)算且不需儀器的方法體體重身高重身高對(duì)對(duì)照表照表(weight-for-height tables)體質(zhì)指標(biāo)(body mass index; BMI)體體重身高重身高對(duì)對(duì)照表照表肥胖的定肥胖的定義義 身體質(zhì)量指數(shù) (Body Mass Index; BMI) BMI= BMI= 體體重重(kg) / (kg) / (身高身高;m);m)2 2 例如: 身高160公分，體重50公斤， BMI: BMI: 501.61.619.5 肥胖: BMI 27行政院衛(wèi)生署91年4月公告國人成年人體重過重及肥胖的定義 分類BMI (kg/m2 )體重過輕 18.5正常18.5 BMI

2、 24體體重重過過重重24 BMI 27肥胖肥胖 27年年齡齡男生男生女生女生正常範(fàn)圍正常範(fàn)圍(BMI介於介於)過重過重 (BMI)肥胖肥胖(BMI)正常範(fàn)圍正常範(fàn)圍(BMI介於介於)過重過重 (BMI)肥胖肥胖(BMI)215.2-17.717.719.014.9-17.317.318.3314.8-17.717.719.114.5-414.4-17.717.719.314.2-514.0-17.717.719.413.9-613.9-17.917.919.713.6-714.7-18.618.6

3、21.214.4-18.018.020.3815.0-19.319.322.014.6-18.818.821.0915.2-19.719.722.514.9-19.319.321.61015.4-20.320.322.915.2-1115.8-21.021.023.515.8-20.920.923.11216.4-21.521.524.216.4-21.621.623.91317.0-17.0-1417.6-22.722.725.217.6-22.722.725.11518.2-18.0-22.72

4、2.725.31618.6-23.423.425.618.2-22.722.725.31719.0-23.623.625.618.3-22.722.725.31819.2-23.723.725.618.3-22.722.725.3兒兒童童與與青少年肥胖定青少年肥胖定義義行政院衛(wèi)生署91年4月公告國人成年人肥胖的定義性別中圍 (公分)男性90 公分女性80 公分決定肥胖的因素 遺傳 (Genetics) 環(huán)境 (Environment) 生理因素 (Physical factors) 心理因素 (Psychological factors) 內(nèi)分泌因素 (Endocrine disorders)

5、Obesity TherapyObesity / Energy Balance Energy requirement = 30kcal x Wt Net energy = Energy intake Energy expenditure 500 calories per day weight 0.51 kg per week體重控制的方法 飲飲食控制食控制 運(yùn)動(dòng)運(yùn)動(dòng) 生活型生活型態(tài)態(tài)改改變變 藥藥物物 外科手外科手術(shù)術(shù) 其他其他飲食控制 減少熱量攝取 選擇低油的烹調(diào)方式 選擇低熱量食物 選擇高纖食物 避免含糖飲料兒童熱量需求計(jì)算以理想體重計(jì)算100 x 10 + 50 x (20-10) +

6、20 x (wt-20)例: 理想體重為35公斤 100 x 10 + 50 x (20-10) + 20 x (35-20) =1800 (大卡)成年人熱量需求計(jì)算以輕度工作者為例:30 卡 x 理想體重=熱量需求另可依目前體重狀況與活動(dòng)量調(diào)整體重過輕理想範(fàn)圍體重過重輕度工作353025中度工作403530現(xiàn)代人的文明病l肥胖l心臟血管疾病l腦血管疾病l糖尿病l高血壓l高脂血l痛風(fēng)體重控制減減少少熱熱量量攝攝取取( (飲飲食控制食控制) ) 增加增加熱熱量量消耗消耗( (運(yùn)動(dòng)運(yùn)動(dòng)) )熱量計(jì)算u 1 公克 醣醣類類( (碳水化合物碳水化合物) ) = 4 大卡u 1 公克 蛋白質(zhì) = 4 大

7、卡u 1 公克 油脂油脂 = 9 大卡u 1 公克 酒精酒精 = 7 大卡u 1 公克 水 = 0 大卡含700卡熱量食物含800卡熱量食物運(yùn) 動(dòng)Sedentary = BMR X 1.2 (little or no exercise, desk job)Lightly active = BMR X 1.375 (light exercise/sports 1-3 days/wk)Mod. active = BMR X 1.55 (moderate exercise/sports 3-5 days/wk)Very active = BMR X 1.725 (hard exercise/spor

8、ts 6-7 days/wk)Extr. active = BMR X 1.9 (hard daily exercise/sports & physical job or 2X day training, i.e marathon, contest etc.)Men: BMR = 66 + (13.7 X wt in kg) + (5 X ht in cm) - (6.8 X age in years)Women: BMR = 655 + (9.6 X wt in kg) + (1.8 X ht in cm) - (4.7 X age in years)Light Activity (

9、50 to 200 KCals per hour) Lying or Sleeping (80 kcals/hour) Desk Work (110 kcals/hour) Driving (120 kcals/hour) Fishing (130 kcals/hour) Sitting (100 kcals/hour) Standing (140 kcals/hour) Housework (180 kcals/hour) Moderate Activity (200 to 350 KCals per hour) Bicycling - Pace: 5.5 mph (220 kcals/ho

10、ur) - Pace: 11 mph (440 kcals/hour) - Pace: 16.5 mph (660 kcals/hour) Bowling (270 kcals/hour) Golf - Golf cart: 150 kcals/hour - Walking: 300 kcalks/hour Swimming at 0.25 mph (300 kcals/hour) Walking (approximately 100 calories per mile) Pace: 2 mph (150 kcals/hour) Pace: 4 mph (330 kcals/hour) Str

11、enuous Activity (over 350 kcals/hour) Dance - Slow Step: 300 kcals/hour - Square Dancing: 350 kcals/hour - Fast Step (Aerobic): 490 kcals/hour Racquet Sports - Badminton (350 kcals/hour) - Racquetball Singles (775 kcals/hour) - Squash or Handball (600 kcals/hour) - Tennis Singles (420 kcals/hour ) R

12、unning (approximately 100 calories per mile) - Jogging: 5 mph (640 kcals/hour ) - Moderate: 6 mph (750 kcals/hour) - Fast: 10 mph (1200 kcals/hour ) Shoveling (400 kcals/hour) Skating at 10 MPH (400 kcals/hour ) 適當(dāng)運(yùn)動(dòng)建議的決定與實(shí)行美國公共衛(wèi)生局建議：在1週中多數(shù)的日子，甚至每天累積30分鐘或更長時(shí)間的中度運(yùn)動(dòng)中度運(yùn)動(dòng) A每小時(shí)快走3-4英哩被認(rèn)為是中度運(yùn)動(dòng)，而散步則不是 A中度運(yùn)

13、動(dòng)中度運(yùn)動(dòng)包括：步行、游泳、騎腳踏車、割草、打掃房子和修理房子。A日常生活中累積中度運(yùn)動(dòng)的策略包括：爬樓梯、步行取代短程的交通工具、看電視時(shí)踩固定式腳踏車及清掃庭院的落葉。運(yùn)動(dòng)的建議應(yīng)強(qiáng)調(diào)頻率的重要性 診斷(評(píng)估)治療(介入)體重控制流程效果效果(評(píng)價(jià)評(píng)價(jià))肥胖肥胖行行為為環(huán)環(huán)境境教育教育流行病流行病診斷診斷行行為與環(huán)為與環(huán)境境診斷診斷教育教育診斷診斷診斷(評(píng)估)行行為與環(huán)為與環(huán)境之境之診斷診斷晚上一定吃完宵夜才睡覺 (B)找不到適當(dāng)?shù)牟蛷d吃低熱量食物(E)常吃油炸食物如炸雞腿等(B)家裡的伙食太油膩(E)教育程度(E)不覺得肥胖會(huì)對(duì)健康影響很大(B)覺得自己有點(diǎn)胖但不是太胖(B)想減肥但不知

14、道那裡有辦減肥班?(E)教育的教育的診斷診斷nPredisposing factors (內(nèi)內(nèi)在在, ,傾傾向向) knowledge, attitudes, beliefs, values, motivation, self-efficacy, psychological domain, socio-demographic factors.nEnabling factors (能力能力) Availability, accessibility and affordabilitynReinforcing factors (增增強(qiáng)強(qiáng)) Social support, peer influence

15、, advice and feedback by health care providers, physical consequences of behavior. 教育的教育的診斷診斷不知道那些食物含熱量高(Knowledge)無法改變家裡的伙食(Enabling)應(yīng)酬太多(Enabling)不知道如何製作低熱量食物(Skills)缺乏醫(yī)療人員支持與建議(Reinforcing)不覺得減重可改善健康狀況(Predisposing)沒有錢付減重班的學(xué)費(fèi)(Enabling)治治療療( (介入介入) )Educational Setting High risk population in comm

16、unity/institution High risk population at hospital General population for obesity preventionEducational Programs (duration, F/U) Individual/group teaching Individual nutrition counseling/assessment Individual behavioral/psychosocial counseling Support groupEducational materials (教材教材) Types of mater

17、ials Factors in choosing materialsEducational methods (方法方法)Educational Materials (教材)Types of material Videotapes Slide/tapes Booklets/Books Programmed instruction Audiotapes,Computer-assisted instruction TV/Radio,Newspaper, Newsletters, Posters Brochures/FlyersFactors in choosing material Applicab

18、ility Ease of use Reading level Ease of obtaining CostEducational Methods (方法)Individual skill sessionsIndividual counseling sessionsIndividual content sessionSmall-group content sessionsSmall-group skill sessionsSupport groupsLarge-group discussionlectures治治療療( (介入介入) )健康飲食觀念(knowledge)熱量計(jì)算(knowled

19、ge)低熱量食物烹調(diào)( skills)記錄飲食(self-monitoring)行為修正(behavior modification)設(shè)定目標(biāo)(set realistic goal)回饋(reward)行行為為改改變變的治的治療療ComponentExamplesSelf-Monitoring記錄記錄食物食物, ,與與造成多吃的情造成多吃的情緒與環(huán)緒與環(huán)境境Stimulus control遠(yuǎn)離遠(yuǎn)離高油脂的食物高油脂的食物, , 在固定的食在固定的食間間與與地地點(diǎn)進(jìn)點(diǎn)進(jìn)餐餐Contingency Management若若達(dá)達(dá)到目到目標(biāo)標(biāo), ,則給則給予予獎(jiǎng)勵(lì)獎(jiǎng)勵(lì)Changing behavior

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33、H5D2A+x*u$qZnWkShPeMaJ7F4C1z)w&t!pYmUjRgOcL9I6E3B+y(v%r#oXlTiQeNbK8G5D2A-x*t$qZnVkShPdMaI7F4C0z)w&s!pYmUjRfOcL9H6E3B+y(u%r#oWlTiQeNbJ8G5D1A-x*t$qYnVkSgPdMaI7F3C0z)v&s!pXmUiRfOcK9H6E2B+x(u%rZoWlThQeNbJ8G4D1A-w*t$qYnVjSgPdLaI7F3C0y)v&s#pXmUiRfNcK9H5E2B+x(u$rZoWkThQeMbJ7G4D1z-w*t!qYmVjS

34、gOdLaI6F3B0y)v%s#pXlUiRfNcK8H5E2A+x(u$rZnWkThPeMbJ7G4C1z-w&t!qYmVjRgOdL9I6F3B0y(v%s#oXlUiQfNbK8H5D2A+x*u$qZnWkShPeMaJ7G4C1z)w&t!pYmVjRgOcL9I6E3B0y(v%r#oXlTiQfNbK8G5D2A-x*u$qZnVkShPdMaJ7F4C0z)w&s!pYmUjRfOcL9H6E3B+y(v%r#oWlTiQeNbK8G5D1A-x*t$qZnVnVkSgPdMaI7F4C0z)v&s!pXmUjRfOcK9H6E2B+y(u

35、%rZoWlThQeNbJ8G4D1A-w*t$qYnVjSgPdLaI7F3C0y)v&s#pXmUiRfOcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1z-w*t!qYnVjSgOdLaI6F3C0y)v%s#pXlUiRfNcK8H5E2A+x(u$rZnWkThPeMbJ7G4C1z-w&t!qYmVjSgOdL9I6F3B0y)v%s#oXlUiQfNcK8H5D2A+x*u$rZnWkShPeMaJ7G4C1z)w&t!pYmVjRgOcL9I6E3B0y(v%r#oXlTiQfNbK8H5D2A-x*u$qZnWkShPdMaJ7F4C1z)

36、w&s!pYmUjRgOcL9H6E3B+y(v%r#oWlTiQeNbK8G5D1A-x*t$qZnVkSgPdMaI7F4C0z)w&s!pXmUjRfOcL9H6E2B+y(u%r#oWlThQeNbJ8G5D1A-w*t$qYnVkSgPdLaI7F3C0z)v&s#pXmUiRfOcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1A-w*t!qYnVjSgPdLaI6F3C0y)v&s#pXlUiRfNcK9H5E2A+x(u$rZoWkThPeMbJ7G4D1z-w&t!qYmVjSgOdL9I6F3B0y)v%s#pXlUiQfN

37、cK8H5E2A+x*u$rZnWkThPeMaJ7G4C1z-w&t!pYmVjRgOdL9I6E3B0y(v%s#oXlTiQfNbK8H5D2A-x*u$qZnWkShPeMaJ7F4C1z)w&t!pYmUjRgOcL9I6E3B+y(v%r#oXlTiQeNbK8G5D2A-x*t$qZnVkShPdMaI7F4C0z)w&s!pXmUjRfOcL9H6E2B+y(u%r#oWlTiQeNbJ8G5D1A-x*t$qYnVkSgPdMaI7F3C0z)v&s!pXmUiRfOcK9H6E2B+x(u%rZoWlThQeMbJ8G4D1A-w*t!qYn

38、VjSgPdLaI7F3C0y)v&s#pXmUiRfNcK9H5E2B+x(u$rZoWkThQeMbJ7G4D1z-w*t!qYmVjSgOdLaI6F3B0y)v%s#pXlUiQfNcK8K8H5E2A+x*u$rZnWkThPeMaJ7G4C1z-w&t!qYmVjRgOdL9I6F3B0y(v%s#oXlUiQfNbK8H5D2A+x*u$qZnWkShPeMaJ7F4C1z)w&t!pYmUjRgOcL9I6E3B+y(v%r#oXlTiQfNbK8G5D2A-x*u$qZnVkShPdMaJ7F4C0z)w&s!pYmUjRfOcL9H6E3B+

39、y(u%r#oWlTiQeNbJ8G5D1A-x*t$qYnVkSgPdMaI7F3C0z)v&s!pXmUjRfOcK9H6E2B+y(u%rZoWlThQeNbJ8G4D1A-w*t$qYnVjSgPdLaI7F3C0y)v&s#pXmUiRfNcK9H5E2B+x(u$rZoWkThQeMbJ8G4D1z-w*t!qYnVjSgOdLaI6F3C0y)v%s#pXlUiRfNcK8H5E2A+x(u$rZnWkThPeMbJ7G4C1z-w&t!qYmVjRgOdL9I6F3B0y)v%s#oXlUiQfNcK8H5D2A+x*u$rZnWkShPeMaJ7G4C

40、1z)w&t!pYmVjRgOcL9I6E3B0y(v%r#oXlTiQfNbK8G5D2A-x*u$qZnVkShPdMaJ7F4C1z)w&s!pYmUjRgOcL9H6E3B+y(v%r#oWlTiQeNbK8G5D1A-x*t$qZnVkSgPdMaI7F4C0z)v&s!pXmUjRfOcK9H6E2B+y(u%r#oWlThQeNbJ8G5D1A-w*t$qYnVkSgPdLaI7F3C0z)v&s#pXmUiRfOcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1z-w*t!qYnVjSgOdLaI6F3C0y)v&s#pXlUi

41、RfNcK9H5E2A+x(u$rZoWkThPeMbJ7G4D1z-w&t!qYmVjSgOdL9I6F3B0y)v%s#oXlUiQfNcK8H5D2A+x*u$rZnWkThPeMaJ7G4C1z-w&t!pYmVjRgOdL9I6E3B0y(v%s#oXlTiQfNbK8H5D2A-x*u$qZnWkShPdMaJ7F4C4C1z)w&s!pYmUjRgOcL9H6E3B+y(v%r#oWlTiQeNbK8G5D2A-x*t$qZnVkShPdMaI7F4C0z)w&s!pXmUjRfOcL9H6E2B+y(u%r#oWlThQeNbJ8G5D1A-w*

42、t$qYnVkSgPdLaI7F3C0z)v&s!pXmUiRfOcK9H6E2B+x(u%rZoWlThQeMbJ8G4D1A-w*t!qYnVjSgPdLaI6F3C0y)v&s#pXlUiRfNcK9H5E2A+x(u$rZoWkThPeMbJ7G4D1z-w*t!qYmVjSgOdLaI6F3B0y)v%s#pXlUiQfNcK8H5E2A+x*u$rZnWkThPeMaJ7G4C1z-w&t!pYmVjRgOdL9I6E3B0y(v%s#oXlUiQfNbK8H5D2A+x*u$qZnWkShPeMaJ7F4C1z)w&t!pYmUjRgOcL9I6E

43、3B+y(v%r#oXlTiQeNbK8G5D2A-x*t$qZnVkShPdMaJ7F4C0z)w&s!pYmUjRfOcL9H6E3B+y(u%r#oWlTiQeNbJ8G5D1A-x*t$qYnVkSgPdMaI7F3C0z)v&s!pXmUiRfOcK9H6E2B+x(u%rZoWlThQeNbJ8G4D1A-w*t$qYnVjSgPdLaI7F3C0y)v&s#pXmUiRfNcK9H5E2B+x(u$rZoWkThQeMbJ7G4D1z-w*t!qYmVjSgOdLaI6F3C0y)v%s#pXlUiRfNcK8H5E2A+x(u$rZnWkThPeMbJ7

44、G4C1z-w&t!qYmVjRgOdL9I6F3B0y(v%s#oXlUiQfNbK8H5D2A+x*u$rZnWkShPeMaJ7G4C1z)w&t!pYmVjRgOcL9I6E3B0y(v%r#oXlTiQfNbK8G5D2A-x*u$qZnVkShPdMaJ7F4C0C0z)w&s!pYmUjRfOcL9H6E3B+y(u%r#oWlTiQeNbK8G5D1A-x*t$qZnVkSgPdMaI7F4C0z)v&s!pXmUjRfOcK9H6E2B+y(u%rZoWlThQeNbJ8G4D1A-w*t$qYnVjSgPdLaI7F3C0y)v&s#

45、pXmUiRfOcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1z-w*t!qYnVjSgOdLaI6F3C0y)v%s#pXlUiRfNcK8H5E2A+x(u$rZnWkThPeMbJ7G4D1z-w&t!qYmVjSgOdL9I6F3B0y)v%s#oXlUiQfNcK8H5D2A+x*u$rZnWkShPeMaJ7G4C1z)w&t!pYmVjRgOcL9I6E3B0y(v%s#oXlTiQfNbK8H5D2D2A-x*u$qZnWkShPdMaJ7F4C1z)w&s!pYmUjRgOcL9H6E3B+y(v%r#oWlTiQeNbK8G5D1A-x

46、*t$qZnVkSgPdMaI7F4C0z)v&s!pXmUjRfOcL9H6E2B+y(u%r#oWlThQeNbJ8G5D1A-w*t$qYnVkSgPdLaI7F3C0z)v&s#pXmUiRfOcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1z-w*t!qYnVjSgPdLaI6F3C0y)v&s#pXlUiRfNcK9H5E2A+x(u$rZoWkThPeMbJ7G4D1z-w&t!qYmVjSgOdL9I6F3B0y)v%s#oXlUiQfNcK8H5E2A+x*u$rZnWkThPeMaJ7G4C1z-w&t!pYmVjRgOd

47、L9I6E3B0y(v%s#oXlTiQfNbK8H5D2A-x*u$qZnWkShPdMaJ7F4C1z)w&t!pYmUjRgOcL9I6E3B+y(v%r#oXlTiQeNbK8G5D2A-x*t$qZnVkShPdMaI7F4C0z)w&s!pXmUjRfOcL9H6E2B+y(u%r#oWlThQeNbJ8G5D1A-x*t-w*t$qYnVkSgPdLaI7F3C0z)v&s!pXmUiRfOcK9H6E2B+x(u%rZoWlThQeMbJ8G4D1A-w*t!qYnVjSgPdLaI6F3C0y)v&s#pXlUiRfNcK9H5E2A+x(u$

48、rZoWkThPeMbJ7G4D1z-w*t!qYmVjSgOdLaI6F3B0y)v%s#pXlUiQfNcK8H5E2A+x*u$rZnWkThPeMaJ7G4C1z-w&t!pYpYmVjRgOdL9I6E3B0y(v%s#oXlTiQfNbK8H5D2A-x*u$qZnWkShPeMaJ7F4C1z)w&t!pYmUjRgOcL9I6E3B+y(v%r#oXlTiQeNbK8G5D2A-x*t$qZnVkShPdMaI7F4C0z)w&s!pXmUjRfOcL9H6E3B+y(u%r#oWlTiQeNbJ8G5D1A-x*t$qYnVkSgPdMaI7F3C0z

49、)v&s!pXmUiRfOcK9H6E2B+x(u%rZoWlThQeMbJ8G4D1A-w*t$qYnVjSgPdLaI7F3C0y)v&s#pXmUiRfNcK9H5E2B+x(u$rZoWkThQeMbJ7G4D1z-w*t!qYmVjSgOdLaI6F3B0y)v%s#pXlUiQfNcK8H5E2A+x(u$rZnWkThPeMbJ7G4C1z-w&t!qYmVjRgOdL9I6F3B0y(v%s#oXlUiQfNbK8H5D2A+x*u$qZnWkShPeMaJ7F4C1z)w&t!pYmVjRgOcL9I6E3B0y(v%r#oXlTiQfNbK8G5D2A-x*u$qZnVkShPdMaJ7F4C0z)w&s!pYmUjRfOcL9H6E3B+y(u%r#oWlTiQeNbJ8G5D1A-x*t$qZnVkSgPdMaI7F4C0z)v&s!pXmUjRfOcK9H6E2B+y(u%rZoWlThQeNbJ8G4D1A-w*t$qYnVjSgPdLaI7F3C0y