碩士 / 國防醫學院 / 公共衛生學研究所 / 102 / Fish is a good source of protein, but also a major source of n-3 polyunsaturated fatty acids. The American Heart Association recommends at least weekly intake of 2 servings of fish to reduce cardiovascular disease incidence. Results of the relationship between fish intake and type 2 diabetes are inconsistent. Studeis of Europe and America found that fish intake increase the risk of type 2 diabetes, however, studies of China and Singapore found that fish intake may prevent type 2 diabetes incidentce. This thesis used a cohort study design to explore the associations of fish intake and that type 2 diabetes, cardiovascular disease incidences, mortality and all-cause mortality in adults (30-64 years), and the aged (65 years of age or older). Data for analyses were obtained from the 1993-1996 National Nutrition and Health Survey in Taiwan for adults and from the 1999-2000 National Nutrition and Health Survey in Taiwan for the older adults. These data have been linked to the National Health Insurance database and national death registration to obtain information of participants’ disease incidence and cause of death. Data were weighted and adjusted by SUDAAN to consider the survey deisng effect on sampling. The relative riks of fish intake on the study outcomes were assessed by using Cox proportional-hazards regression analysis. Participants’ fish intake frequencyes were classified into four groups, namely: do not eat, up to twice a week, 2-4 times a week and at least four times a week. Results showed that , regardless age, women, the aged, live in Hakka or mountainous areas, less educated, unmarried who ate less frequent fish. Those who ate more fish, those whose dietary diversity scores (DDS) were higher. Adjust for possible confounding factors, fish intake frequency can reduce the risks of type 2 diabetes, cardiovascular disease and all-cause mortality in adults aged 30-64 years. Compared to the reference group (intake up to twice a week), the risk of death of the highest fish intake group (intake of at least 4 times a week) was 20% significantly lowere (95% CI: 0.66-0.97). In the sensitivity analyses, excluded those who died within a year after follow-up, the risk of death was even lower 26% (95% CI : 0.60-0.90). Stratified analyses by gender, only women have significantly lower risk of death for fish intake. For the older adults, fish intake can significantly reduce the risk of type 2 diabetes incidence. Excluded those who died within a year of follow-up and adjused possible confounders, the highest fish intake group had a 42% (95% CI: 0.37-0.93) lower risk of type 2 diabetes incidence, compared to the reference group. Stratified analyses by gender, the protective effect on type 2 diabetes incidence was only found in women. In conlusion, we found that adults ate fish at least four times a week were at lower risk of all-cause mortality; for the older adults, higher frequency fish intake can lower the risk of type 2 diabetes incidence.
| Identifer | oai:union.ndltd.org:TW/102NDMC0058035 |
| Date | January 2014 |
| Creators | Hsu, Ya-Ting, 許雅婷 |
| Contributors | Lee, Meei-Shyuan, 李美旋 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 116 |
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