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校 輔仁大學
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494445115
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研
究
生 江玫欣
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中
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研
究
生 CHIANG, MEI-HSIN
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英
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論 由抗發炎之觀點探討有助於健康老化之飲食
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論
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Diet which is useful for healthy ageing in the point of anti-inflammatory response
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指
導
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吳文勉
授
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指
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Wen-Mein Wu
授
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文 2010.10.2
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案 封面 謝辭 摘要 目次 第一章 第二章 第三章 第四章 第五章 第六章 第七章 第
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文 中文
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字 老人 健康老化 抗發炎飲食
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關
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字 elderly healthy ageing Anti-inflammation
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摘
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輔仁大學九十八學年度第二學期碩士論文摘要 系(所)別:營養科學系 研究生:
江玫欣 論文名稱: 由抗發炎之觀點探討有助於健康老化的飲食(綜論) 指導教
授:吳文勉 博士 摘要 台灣地區老年人口快速成長，而調查發現台灣老人有高
達八成以上罹患慢性疾病，65 歲以上的老人平均有 2.4 種慢性疾病，老年人
較易罹患的慢性疾病例如:癌症、代謝症候群、心血管疾病等，老年人體內
的 C 反應蛋白(CRP)、發炎細胞激素介白質-6 (IL-6)、或是腫瘤壞死因子
(TNF-α)都明顯升高，此與慢性發炎有密切關係。2002 年世界衛生組織所提
出的健康(活躍)老化之概念，指的是使健康狀態、參與度、和安全達到最適
化機會的過程，以便促進民眾老年時的生活品質，為了呼應 WHO 同時考量
身體、心理、社會三面向，須降低老年人體內親發炎物質的產生，建立抗發
炎的飲食原則: 採限制熱量攝取，降低 8 % 至 25 %熱量攝取，並未降低主要
營養素攝取;充足的蛋白質攝取，減少紅肉攝取且每週增加 2~3 次的魚肉攝
取；增加 ω-3 不飽合脂肪酸且降低 ω-6 不飽合脂肪酸的攝取，避免反式脂
肪酸及油炸食品;多攝取蔬菜、水果、五穀類及黃豆類，以防止維生素及微
量營養素缺乏;養成良好的生活習慣，規律運動的習慣，每週固定有氧運動
四次以上（約 180 分鐘），避免甜食、抽菸及喝酒;可適量補充營養輔助食品
-薑黃素與輔酵素 Q10，以上飲食原則有助老年人減緩因慢性疾病而引起的發
炎現象，協助老年人達到健康老化有助延年益壽。 關鍵詞:老人、健康老
化、抗發炎飲食
摘
要
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英
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論
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目
次
Diet which is useful for healthy ageing in the point of anti-inflammation response
Abstract The population of the elderly is increasing quickly in Taiwan. According to
an investigation, up to 80 % of the elderly suffer from chronic complaints. In Taiwan
senior citizens older than 65-year-old have 2.4 kinds of chronic diseases in average.
Including cancer, metabolic syndromes, and cardiovascular disease and so on.
Meanwhile, the substances in their bodies such as C-reactive protein (CRP), cytokines
interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) are rising in a
significant incidence, which are closely related to chronic inflammations. WHO’s
healthy ageing refers to the process that maximizes the optimum opportunities to make
people have health and safety, and enhance motivation for participation, in order to
improve their life quality when they are getting senile. In response to WHO’s
considering of physical, psychological, and social aspects, we have to reduce the
generation of pro-inflammation in their bodies and build a diet discipline of antiinflammatory：limiting their consumption to 8% ~ 25% of calories restriction, such a
method would little reduce the ingestion of major nutrients by obtaining sufficient
protein, cutting down on fatty food, and getting fish as a diet supplement two or three
more times a week. elderly should also ingest less w-6 unsaturated but more w-3
unsaturated, and stay away from trans fatty acid as well as fried food. As a matter of
fact, it will be better for them to eat more vegetable, fruit, grains, and soybean
products. Additionally, cultivating a good living habit and physical activities is also
essential. A healthy elderly should do aerobic exercise regularly four times a week
(approximately 180 minutes)and avoid desserts, smoking nor drinking . Properly
ingesting nutritional supplementary food with curcumin, coenzyme Q10 is highly
recommended. All the mentioned suggestions could help elderly reduce the
inflammation responses incurred by chronic diseases, and live long and happy with a
healthy senile aging. Keywords: elderly、healthy ageing、Anti-inflammation
目錄 第一章 緒論 ……………………………………………… 1 第二章 老
年人常見之疾病與飲食型態……………………2 第一節 老年人常見之慢性
疾…………………………… 2 第二節 台灣老年人之飲食調查結
果………………… 4 2.2.1 老年人之熱量與三大營養素攝取………… 4 2.2.2
膳食纖維…………………………………… 5 2.2.3 維生素方
面………………………………… 5 2.2.4 礦物質方
面………………………………… 7 第三節 台灣老年人罹患代謝不良症候群
之情形…… 8 2.3.1 高血壓……………………………………… 8 2.3.2 糖尿
病……………………………………… 9 2.3.3 高血脂
症…………………………………… 10 第四節 老年人常見的疾病多數為發炎
相關之疾病… 11 2.4.1 老年人罹患慢性疾病隨年齡而增加……… 11 2.4.2 慢
性疾病與發炎…………………………… 11 第三章 為何老年人的免疫系統常
呈現慢性發炎之狀況…20 第一節 老化個體免疫系統之變
化…………………… 20 3.1.1 先天免疫反應……………………………… 20
3.1.2 適應性免疫反應…………………………… 23 第二節 發炎影響老化與年
齡相關的各種疾病……… 25 3.2.1 血管粥狀硬化症……………………………
26 3.2.2 肥胖、第二型糖尿病與代謝症候群……… 27 3.2.3 癌
症………………………………………… 30 第三節 以藥物控制發炎反
應………………………… 33 第四章 飲食對調節發炎反應之作
用…………………… 42 第一節 營養素缺乏引起發炎反應……………………
42 4.1.1 蛋白質類…………………………………… 42 4.1.2 油脂
類……………………………………… 44 4.1.3 維生素與礦物
質…………………………… 45 4.1.4 蔬果
類……………………………………… 50 第二節 促發炎與抗發炎物質之前趨
物……………… 52 4.2.1 發炎反應與慢性發炎……………………… 52 4.2.2
親發炎與抗發炎物質之前趨物…………… 53 第三節 抗發炎飲食之定
義…………………………… 56 第四節 親發炎的生活方
式…………………………… 58 4.4.1 肥
胖………………………………………… 59 4.4.2 抽
菸………………………………………… 59 4.4.3 飲食模
式…………………………………… 60 第五章 有助於緩解老年相關慢性發
炎疾病之飲食…… 69 第一節 熱量限制……………………………………… 69
5.1.1 熱量限制飲食對延年益壽影響…………… 69 5.1.2 熱量限制飲食對老化
相關疾病的影響…… 70 第二節 熱量限制對氧化壓力的調節…………………
72 5.2.1 老化與氧化壓力…………………………… 72 5.2.2 氧化壓力誘導氧化
還原不平衡…………… 73 第三節 熱量限制飲食對發炎反應的影
響…………… 74 5.3.1 老化與發炎反應…………………………… 74 5.3.2 熱
量限制能夠調節老化時期的發炎反應… 75 5.3.3 熱量限制、運動對發炎的調
節……………… 77 第六章 世界各地成功老化長者的飲食…………………
89 第一節 成功老化……………………………………… 89 6.1.1 成功/活躍老
化之定義……………………… 89 6.1.2 老化軌道的變
化…………………………… 90 第二節 比較東方與西方之成功老化長者的飲
食…… 91 6.2.1 日本沖繩飲食……………………………… 91 6.2.2 地中海飲
食………………………………… 92 6.2.3 素
食………………………………………… 94 第三節 抗發炎相關的營養補充
品…………………… 95 6.3.1 薑黃素……………………………………… 95
6.3.2 輔酵素 Q10 ………………………………… 97 第七章 總
結……………………………………………… 118 第八章 參考文
獻……………………………………… 119 表目錄 表一、1994 年台灣地區老
年人口主要死亡原因………………………13 表二、2008 年台灣地區老年人
口主要死亡原因…………………‥…14 表三、台灣地區 50 歲以上中老年
「自述曾經醫師診斷之慢性病盛行率」……15 表四、台灣地區 50 歲以上中
老年「自述曾經醫師診斷之慢性病盛行率」……16 表五、台灣地區 65 歲以
上老人每天各種營養素攝取狀況……………17 表六、台灣地區 50 歲以上中
老年「自述曾經醫師診斷之慢性病項目數」 … 18 表七、老化對各種先天性
免疫細胞之影響…………………………… 35 表八、老化相關之全身適應性
免疫反應……………………………… 36 表九、因氧化壓力大而增加罹癌風
險之疾病………………………… 37 表十、抗發炎藥物的副作
用…………………………………………… 38 表十一、補充不同劑量抗氧化
劑對血漿中黏著分子濃度的影響…… 62 表十二、長期熱量限制對囓齒動
物、靈長類、非肥胖人之老化標誌影響…80 表十三、熱量限制時粒線體自
由基生成與 DNA 氧化損傷下降比率…………81 表十四、長期熱量限制影響
粒線體自由基生成速率………………… 82 表十五、影響發炎反應的相關因
素………………………………… 83 表十六、熱量限制飲食對抗發炎的影
響……………………………… 84 表十七、素食與葷食組血液中三酸甘油
酯、膽固醇的比較…………101 表十八、素食者與葷食者之低密度膽固醇在
體外產生氧化的情形…102 表十九、素食組與葷食組各項血液分析結
果…………………………103 表二十、人體組織輔酵素 Q10 與氧化還原的分
佈狀態……………104 表二十一、輔酵素 Q10 因老化在人體降低的情
形……………………105 表二十二、肝臟參
數……………………………………………………106 表二十三、比較罹患代
謝症候群患者之血清中 C-反應蛋白和 輔酵素 Q10 之平均
值…………………………………………107 圖目錄 圖一、台灣地區老人各種
營養素攝取與 DRIs 比較…………………19 圖二、動脈粥狀硬化症發炎反應
機制……………………………… 39 圖三、飲食、肥胖、發炎與胰島素抗性
之關聯 ……………………40 圖四、發炎反應產生之自由基分子對細胞層次
之影響 ……………41 圖五、營養與疾病–營養儲備狀況對身體因應壓力反
應的影響 ……63 圖六、老化之分子發炎學
說 …………………………………………64 圖七、必需脂肪酸在體內轉換的
代謝途徑 …………………………65 圖八、N-3 與 N-9 不飽和脂肪酸對於生成
脂質發炎介質代謝物的 影
響………………………………………………………………66 圖九、EPA 的
攝取量影響嗜中性白血球的呼吸爆作用………………67 圖十、N-3 不飽和脂
肪酸協同藥品治療之抗發炎功效機制圖……68 圖十一、哺乳類動物因熱量
限制之飲食而產生的生理反應變化 …85 圖十二、親發炎分子參與老化及老
化相關疾病的途徑………86 圖十三、年輕或是老年鼠施以熱量限制飲食對
肝臟氧化壓力的影
響……………………………………………………………87 圖十四、熱量限
制與運動對於發炎之病理過程所造成的影響……88 圖十五、構成成功老化
的要素……………………………………… 108 圖十六、三種老化的模
式…………………………………………… 109 圖十七、地中海飲食金字塔模
型…………………………………… 110 圖十八、地中海飲食補充 n-3 不飽和
脂肪酸對血清中 IL-18 的 影
響 ……………………………………………………… 111 圖十九、薑黃素的化
學結構與相關衍生物 ……………………… 112 圖二十、薑黃素及其代謝物對
花生四烯酸釋放的影響 ………… 113 圖二十一、薑黃素對 COX-1 與 COX-2
不同的影響 ……………… 114 圖二十二、輔酵素 Q10 氧化還原反
應 …………………………… 115 圖二十三、在八週內餵養小鼠不同的飲食對
發炎反應與氧化壓 力的影響 ………………………………………………116 圖
二十四、在八週內餵養小鼠不同的飲食對發炎反應與氧化壓 力的影
響 ………………………………………………117
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文
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獻
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參
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