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肥胖與健康 PowerPoint PPT Presentation


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肥胖與健康. 李啟澤 醫師. 前言 -- 肥胖的問題的由來. 拜經濟繁榮、物質富庶所賜 飲食型態逐漸西化 肉類奶製品攝取量增加 高熱量飲食店 ( 如速食店、 牛排館 ) 雨後春筍般快速成長 外食人口增加 國人普遍缺乏運動。. 何謂肥胖. 肥胖的定義. 是指身體脂肪過度堆積而 超過正常比例 所造成的狀況。 是 長時間 的 熱量攝取 超過 熱量消耗 所產生的結果。 過多的熱量 就以 脂肪組織 的形式儲存起來。 簡單的說就是 吃的太多,運動太少 。 主要是由於 不正常的飲食習慣 所致 。. 體脂肪. 每一個人都需要一定量的體脂肪來儲存能量、產生熱能。

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肥胖與健康

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--

  • ()







    • Body Mass IndexBMI

    • Waist-to-Hip Ratio


1.

  • 85

  • 43mm58mm


2.

  • 80 0.7

  • 70 0.6

  • 10

  • 20

  • 10045Kg

  • 0.9


  • 3. (BMI)

    • BMI = 2

    • 35

      • 35BMI 25

      • 35BMI 27

      • BMI 30


    (BMI)


    BMI

    • 22

    • 10%

    • 10%~20%

    • 20%


    4. Waist-to-Hip Ratio


    • ()



    • 0.90.8






    • 210-14

    • 2




    • 2 10-14










    • ()




    • 80%

    • 40%

    • 7~10%


    ob gene

      • ob gene(leptin)


    • --neuropeptide Y ()

    • --3 - adrenergic receptor


    • ()


    • (Adenovirus) 36




    • 40%






    1.

    2.

    3.

    4.


    1.


    2.


    3.


    4.



      • ;

      • ;


    1.


    • 10%20%

    • 10%

      • 6.5 mmHg

      • 12 mg/dl

      • 2 mg/dl


    2.

    • 6

      • 5%~15%70%;

      • 15%


    3.


    • 0.7%

    • BMI3010

    • (NIDDM)80%


    4. ()


    5.

    • 6

      • 2

      • 3


    6.


    7.

    • 30%


    8.

    • ()


    9.

    • 30%2.5


    10.


    11.


    12.


    13.

    • 2


    14.


    15.


    16.


    17.




    --


    --

    • ()

    • /


    --


    :




    • 5-15%

      1)10-15%

      2)35-50%

      3)(5-15%)



    • BMI


    ()

    • 1200


    • 0.5 ~1.0

    • 20% 30%


      • .


    • .


    • 800-1200 kCalday

    • < 800 kCalday


    < 800 kCalday


    • (BMI) 30

    • 50


    • ()

    • C B

    • 3000 cc








    (60)



    • ()




    (:200g)


    (:60g)


    (:100g)


    (:15g)


    (:100g)














    • )





    ()



    1.

    • 30


    2.

    • 3

    • 30

      • 1030


    3.


    • ,




      • 355

    • 30


    (/()/)



    100kcal

    • ()60

    • ()46

    • ()40

    • 27

    • 35

    • (16070)15


    150kcal

    • 53

    • (10)53

    • ()23

    • 38

    • ()60

    • 45


    300

    • 30~50

    • 1~75

    • 1~l

    • 30~40

    • 45~1

    • 30~40


    ()


    1.


    2.


    3.


    4.


    ()


    (1)

    • (a) Adrenergic

      (b) Serotonergic

      (c)


    (a) Adrenergic

    • norepinephrine /epinephrine

      • benzphetamine,

      • phendimetrazinde,

      • phentermine,

      • mazindol,

      • diethylpropion

      • Phenylpropanolamine(PPA)


    • phentermine

    • phenylpropanolamine(PPA)


    (b) Serotonergic

    • serotonergic systemserotonin

    • fenfluramine,

    • dexfenfluramine,

    • fluoxtine ,

    • Sertraline

    • SSRIs


    • fenfluramine,dexfenfluramineFDA

    • fluoxetine, sertralineSSRIs


    (c)

    • neuropeptide Y

    • St John's Wort

      • -endophin,

      • opiate peptide antagonist(naloxone),

      • cholecystokine(CCK),

      • NPY antagonist


    (2)

    • Orlistat (Xenical)

    • Benzocaine

    • Fiber

    • Sucrose polyester


    (3)

    • BRL26830A (3-receptor agonist)

    • Ro16-87l4

    • Thyroid hormone

    • Ephedrine with caffeine

    • Growth hormone


    • Sibutramine hydrochloride(Meridia)

    • Orlistat(Xenical)


    Sibutramine hydrochloride(Meridia)

    • norepinephrineserotonin dopaminefenfluraminephentermineneurotransmine


    • 4-5/1- 3mmHg

    • MAO inhibitorSSRInarrow-angle glaucoma


    Orlistat (Xenical)

    • 1/3

    • 6-128-10%2

    • orlistat


    • ADEK


    ()


    ()


    ()

    • BMI40

    • 25%-35%

    • (10%1-1.5%)



    • (Gastric restriction)

    • (Gastric bypass)


    (1)(Gastric restriction)

    • 40%-50%


    (2)(Gastric bypass)

    • 50%-60%




    • 1.(330)

      2.(1)

      3.

      4.(1)

      5.

      6.


    • ()







    • 50







    • 24




    • ()

      • ()

      • ()



    ()

    • ()

    • ()


    ()

    • ""


    ()




    • ()


    • 15-30%












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