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更年期肥胖防治

更年期肥胖防治. 撰稿：蘇美禎 曹麗英 報告日期： 101 年 10 月 26 日. 前言.

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更年期肥胖防治

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  1. 更年期肥胖防治 撰稿：蘇美禎 曹麗英 報告日期：101年10月26日

  2. 前言 • 臺灣婦女平均自然停經年齡為49.33.8歲（張、周、陳、張，1995），平均壽命為82.65歲(行政院衛生署， 2011)，這些資料顯示台灣婦女，與西方國家一樣會有三分之一的人生時間是在停經之後度過。更年期是全球性的，但每個人之更年期經驗並不盡相同。從轉變(transition)的觀點，更年期婦女在其生活中面臨各方面的轉變包含：中年期發展、身體健康、家庭及不可預期之情境轉變等。如︰事業的瓶頸或再度就業、更年期症狀、空巢期或滿巢期等（曹、蘇，2009）。這些轉變均會對婦女生活造成相當衝擊，因此容易發生肥胖的情形(Lovejoy, 2003; Teede, Lombard, & Deeks, 2010; Torng et al., 2002)。預防中年體重增加及確保健康的老年生活須從更年期做起，婦女在更年期有自我調整能力，成為自己健康的主宰者，將擁有尊嚴及活力的老年期生活(Jones & Sutton, 2008)。

  3. 流行病學 • 根據2005-2008年國民營養健康狀況變遷調查國人肥胖及過重狀況：女性在青年、壯年、中年及老年的過重盛行率分別則為9.8%、12.1%、27.6%及32.0%，過重情況隨著年齡增加而上升；且男女性年齡別代謝症候群盛行率曲線於45歲交叉，意即女性於45歲後盛行率逐漸高於男性(Yeh, Chang, & Pan, 2011) 。

  4. 台灣現況與關鍵問題 更年期婦女過重盛行率隨年齡增加而上升， 罹患慢性病風險增加

  5. 台灣現況與關鍵問題(2) 肥胖對停經婦女骨骼關節的影響

  6. 台灣現況與關鍵問題(3) 面臨空巢期或家庭結構改變時的生活 型態變化

  7. 台灣現況與關鍵問題(4) 更年期婦女易有認知的迷思，導致容易 忽略自我健康照護

  8. 策略相關文獻回顧 更年期肥胖防治觀念與其相關疾病的影響

  9. 策略相關文獻回顧(2) 修正生活型態，與預防更年期肥胖的關係

  10. 策略相關文獻回顧(3) 家庭及社會支持對於婦女健康的影響

  11. 策略相關文獻回顧(4) 社區介入及政策制定，對於更年期肥胖的影響

  12. 更年期肥胖防治目標設定及策略 營造正確的更年期肥胖防治與迎接健康 老化的健康素養(A)

  13. 更年期肥胖防治目標設定及策略(2) 全民更年期健康飲食(A)

  14. 更年期肥胖防治目標設定及策略(3) 中老年人健康運動習慣的養成(A)

  15. 更年期肥胖防治目標設定及策略(4) 提高空巢或滿巢期時，個人及家庭的正向思維(D)

  16. 更年期肥胖防治目標設定及策略(5) 更年期肥胖防治明確列於國家健康政策(C)

  17. 監測指標

  18. 政策立法建議

  19. 參考資料 • 李建明、黃素妃、陳政友、羅應嘉、林昭光、游麗惠、潘佩君（2007）•健走運動對改善更年期婦 女骨密度與健康體適能之研究•北市醫學雜誌，4（3），235-244。 • 邱淑娟、彭雪英（2010）•社區生活型態介入計畫對中年婦女之代謝危險因子的成效•臺灣醫學，14， 496-508。 • 葉美玲、王佩棋、林昭庚、林宜信、陳興夏（2011）•運動改善更年期身體組成之成效-系統性回 顧暨統合分析•護理暨健康照護研究，7(1)，35-44。 • 曹麗英、蘇美禎（2009）•婦女重要的人生過渡期：更年期面面觀。於王秀紅、曾綺華總校閱：婦 女健康理論與實務(二版，9-1~9-50頁) •台北：禾楓。 • 曹麗英（2004）•更年期婦女健康照護研究近況分析•中華民國更年期協會。 • Blanck, H. M., McCullough, M. L., Patel, A. V., Gillespie, C., Calle, E. E., Cokkinides, V. E., et al. (2007). Sedentary behavior, recreational physical activity, and 7-year weight gain among postmenopausal U.S. women. Obesity (Silver Spring), 15(6), 1578-1588. • Bond, G. E., Burr, R., Wolf, F. M., Price, M., McCurry, S. M., & Teri, L. (2007). The effects of a web-basedintervention on the physical outcomes associated with diabetes among adults age 60 and older: a randomized trial. Diabetes TechnolTher, 9(1), 52-59. • Carroll, S., Borkoles, E., & Polman, R. (2007). Short-term effects of a non-dieting lifestyle intervention program on weight management, fitness, metabolic risk, and psychological well-being in obese premenopausal females with the metabolic syndrome. ApplPhysiolNutrMetab, 32(1), 125-142.

  20. 參考資料(2) • Cicero, A. F., Dormi, A., D‘Addato, S., Gaddi, A. V., & Borghi, C. (2010). Long-term effect of a dietary education program on postmenopausal cardiovascular risk and metabolic syndrome: the Brisighella Heart Study. J Womens Health (Larchmt), 19(1), 133-137. • Col, N. F. (2007). Using Internet technologies to improve and simplify counseling about menopause: the WISDOM website. Maturitas, 57(1), 95-99. • Compston, J. E., Watts, N. B., Chapurlat, R., Cooper, C., Boonen, S., Greenspan, S., et al. (2011). Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med, 124(11), 1043-1050. • Cumming, G. P., & Currie, H. (2005). The Internet and the menopause consultation: menopause management in the third millennium. J Br Menopause Soc, 11(3), 103-108. • Davis, S. R., Castelo-Branco, C., Chedraui, P., Lumsden, M. A., Nappi, R. E., Shah, D., et al. (2012). Understanding weight gain at menopause. Climacteric, 15(5), 419-429. • Dubnov, G., Brzezinski, A., & Berry, E. M. (2003). Weight control and the management of obesity after menopause: the role of physical activity. Maturitas, 44(2), 89-101. • Eliassen, A. H., Colditz, G. A., Rosner, B., Willett, W. C., & Hankinson, S. E. (2006). Adult weight change and risk of postmenopausal breast cancer. JAMA, 296(2), 193-201. • Frank, L. L., Sorensen, B. E., Yasui, Y., Tworoger, S. S., Schwartz, R. S., Ulrich, C. M., et al. (2005). Effects of exercise onmetabolic risk variables in overweight postmenopausal women: a randomized clinical trial. Obes Res, 13(3),615-625. • Hooven, F. H., Adachi, J. D., Adami, S., Boonen, S., Compston, J., Cooper, C., et al. (2009). The Global Longitudinal Study of Osteoporosis in Women (GLOW): rationale and study design. OsteoporosInt, 20(7), 1107-1116.

  21. 參考資料(3) • Huerta, R., Mena, A., Malacara, J. M., & de Leon, J. D. (1995). Symptoms at the menopausal and premenopausal years: their relationship with insulin, glucose, cortisol, FSH, prolactin, obesity and attitudes towards sexuality. Psychoneuroendocrinology, 20(8), 851-864. • Jones, G. L., & Sutton, A. (2008). Quality of life in obese postmenopausal women. Menopause Int, 14(1), 26-32. • Keitt, S. K., Resnick, E. M., Simon, V. R., Iskikian, S. O., & Marts, S. A. (2008). Behavior and obesity in women across the life span: a report by the Society for Women's Health Research. J Investig Med, 56(6), 830-842. • Kuller, L. H., Kinzel, L. S., Pettee, K. K., Kriska, A. M., Simkin-Silverman, L. R., Conroy, M. B., et al. (2006). Lifestyle intervention and coronary heart disease risk factorchanges over 18 months in postmenopausal women: the Women On the Move through Activity and Nutrition (WOMAN study) clinical trial. Womens Health (Larchmt), 15(8), 962-974. • Lovejoy, J. C. (2003). The menopause and obesity. Prim Care, 30(2), 317-325. • Lumsden MA, Pitkin J, Panay N, Abernethy K, Ayres J, G. S., Mander T, et al. (2011). Modernizing the NHS: observations and recommendations from the British Menopause Society. Menopause Int, 17(2), 41-43. • Malacara, J. M., Huerta, R., Rivera, B., Esparza, S., & Fajardo, M. E. (1997). Menopause in normal and uncomplicated NIDDM women: physical and emotional symptoms and hormone profile. Maturitas, 28(1), 35-45. • Mastorakos, G., Valsamakis, G., Paltoglou, G., & Creatsas, G. (2010). Management of obesity in menopause: diet, exercise, pharmacotherapy and bariatric surgery. Maturitas, 65(3), 219-224.

  22. 參考資料(4) • Neve, M., Morgan, P. J., Jones, P. R., & Collins, C. E. (2010). Effectiveness of web-based interventions in achieving weight loss and weight loss maintenance in overweight and obese adults: a systematic review with meta-analysis. Obes Rev, 11(4), 306-321. • Simkin-Silverman, L. R., Wing, R. R., Boraz, M. A., & Kuller, L. H. (2003). Lifestyle intervention can prevent weight gain during menopause: results from a 5-year randomized clinical trial. Ann Behav Med, 26(3), 212-220. • Teede, H. J., Lombard, C., & Deeks, A. A. (2010). Obesity, metabolic complications and the menopause: an opportunity for prevention. Climacteric, 13(3), 203-209. • Teixeira, P. J., Going, S. B., Houtkooper, L. B., Cussler, E. C., Metcalfe, L. L., Blew, R. M., et al. (2006). Exercise motivation, eating, and body image variables as predictors of weight control. Med Sci Sports Exerc, 38(1), 179-188. • Torng, P. L., Su, T. C., Sung, F. C., Chien, K. L., Huang, S. C., Chow, S. N., et al. (2002). Effects of menopause on intraindividual changes in serum lipids, blood pressure, and body weight--the Chin-Shan Community Cardiovascular Cohort study. Atherosclerosis, 161(2), 409-415. • Tsao, L. I., Su, M. C., Hsiao, P. J., Gau, Y. M., An, C., & Lin, K. C. (2007). The longitudinal effects of a perimenopausal health education intervention on the mid-life women in Taiwan. Maturitas, 57(3), 296-305.

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