| Summary: | 碩士 === 國防醫學院 === 公共衛生學研究所 === 90 === Human being’s eating behavior is a complex and multi-dimensional phenomenon. The traditional single-food or single-nutrient approach cannot completely explain the actual relationship between the overall dietary quality and the risk of disease. The present study aims to develop an overall dietary quality index, Overall Dietary Index (ODI), based on the ROC’s Food Guide, the ROC’s Food Guidelines, and dietary variety. The researcher linked ODI to the risk factors for major chronic diseases: hypertension, hyperglycemia, hyperlipidemia and hyperuricemia. The study subjects were between the ages of 19 and 64, non-vegetarians, and attended a regular physical check-up program of MJ Health-Screening Institute during the years of 1996-1998. Totally 57,477 (females: 52.89%) and 6003 (females: 67.45%) were eligible for the cross-sectional and longitudinal analyses, respectively. Information regarding subjects’ characteristics, lifestyle-related factors (smoking, alcohol drinking, etc.), and dietary data from a 25-item simplified semi-quantitative food frequency questionnaire were completed by the examinees upon registration for health check-up. Anthropometric measurements, blood pressures, blood glucose and blood lipids were obtained during check-up. ODI has 11 components, which include the consumption of milk, meats, vegetables, fruits, and staples, the moderation of dietary lipids (total fat, saturated fat, and cholesterol), salt, sugar, and dietary variety. Respondents received a score ranging from 0 to 10 for each component, except for salt and sugar, whose ideal scores are both 5. ODI of individual subject ranges from 0 to 100. The mean ODI score was 65.4 for the study population. In the cross-sectional analysis, the researcher used multiple regressions and multiple logistic regressions to appraise the correlation between the ODI score and the risk factors for major chronic diseases in the year 1998. Compared to the lowest quintile, the OR of hyperglycemia of females in the highest quintile was 0.76. Males and females in the highest ODI quintile, when compared to those in the lowest quintile, had a 13% and 11% lower risk of hyperlipidemia, respectively. The association between ODI and serum uric acid has the same pattern as serum lipids. To sum up, respondents in the highest ODI quintile had lower blood sugar, serum lipids, and uric acid. The researcher was unable to include the important risk factor of blood pressure as an ODI component; consequently, ODI cannot be used to predict the risk of hypertension. In the longitudinal prevalence and incidence analyses, the researcher used dietary quality in the year 1996 to assess the impact of diet on four risk factors for major chronic diseases of year 1998. Maybe due to the lack of power of the cohort, the researcher cannot get significant effect of ODI on the chronic disease risk factors, except for blood lipids. Though the study subjects may not be fully represented the general population, the findings of the present study offer the epidemiologic evidence and reference for the relationship between overall dietary quality and risk factors for major chronic diseases in Taiwan.
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