進階搜尋


  查詢北醫館藏
系統識別號 U0007-2501201700493300
論文名稱(中文) 台灣地區食品營養成份資料庫磷與蛋白質比值分析暨美國食品成份資料庫比較
論文名稱(英文) Dietary phosphorus to protein ratio analysis from the databases of food composition in Taiwan and comparison with USDA Food Composition Databases
校院名稱 臺北醫學大學
系所名稱(中) 保健營養學研究所
系所名稱(英) Graduate Institute of Nutrition and Health
學年度 105
學期 1
出版年 106
研究生(中文) 敖立燕
研究生(英文) Li-Yen Au
學號 G556102012
學位類別 碩士
語文別 中文
口試日期 2017-01-04
論文頁數 81頁
口試委員 指導教授-趙振瑞
委員-呂旭峰
委員-簡怡雯
中文關鍵字 慢性腎臟病  飲食磷與蛋白質比值  台灣地區食品營養成份資料庫  飲食蛋白質  飲食磷 
英文關鍵字 chronic kidney disease  dietary phosphorus to protein ratio  Taiwanese food composition databases  dietary protein  dietary phosphorus 
學科別分類
中文摘要 為使慢性腎臟病人獲得適當的蛋白質攝取,同時達成控制飲食磷含量的目標,KDOQI建議參考食物的磷與蛋白質比值,但台灣目前缺乏較完整的相關資料,因此本研究希望提供本土食物的每份磷含量、磷與蛋白質比值資料供臨床工作者使用。研究方法以衛生福利部最新的台灣地區食品營養成份資料庫 (2015版) 為基礎,按照食物代換表分析常見食物的每份磷含量、磷與蛋白質比值,同時比較美國農業部食品成份資料庫 (United States Department of Agriculture Food Composition Databases) 的相同品項以提供更具參考價值的資料。結果顯示,台灣常見食物每份磷含量平均值乳品類為214.5 mg;豆魚肉蛋類的魚肉蛋類為73.1 mg,豆類與其製品 (含高蛋白麵製品) 為86.5 mg,高蛋白麵製品小於5 mg;全榖根莖類為37.8 mg,低蛋白澱粉類小於15 mg;油脂與堅果種子類為31.5 mg,烹調用油接近0 mg;蔬菜與水果類分別為41.3 mg與20.7 mg。全部的乳品類、雞蛋黃、豬腦、冷凍鱈魚丸、無糖豆漿及三角油豆腐是台灣資料庫中磷與白質比值較高的蛋白質來源食物,雞蛋白則是磷與蛋白質比值最低的蛋白質來源食物。台灣與美國的資料庫在部份植物性食品與加工食品呈現較大的含磷量差距。臨床工作者可將本研究結果應用於慢性腎臟病人的飲食計畫,粗估未經調整的一日飲食磷含量,再參考各類食物磷與蛋白質比值、每份食物磷含量挑選合適的食物,搭配符合個別化目標的控磷飲食。
英文摘要 Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend the use of phosphorus to protein ratio for proper dietary protein intake and restriction of dietary phosphorus, but there’s lack of intact food phosphorus to protein ratio and phosphorus data in Taiwan. The objective of this study was to provide phosphorus to protein ratio and phosphorus content per serving of Taiwanese foods to clinical workers for further application. Phosphorus to protein ratio and phosphorus content per serving from the newest databases of food composition in Taiwan were analyzed and compared with those from the United States Department of Agriculture Food Composition Databases for more reliable references. The results showed that Taiwanese common food’s average phosphorus content per serving was 214.5 mg for milk and dairy products, 73.1 mg for fish, meat, poultry and egg, 86.5 mg for bean products (including high protein flour products), less than 5 mg for high protein flour products, 37.8 mg for cereals and starchy roots, less than 15 mg for low protein flour products, 31.5 mg for oils, fats and nuts, near 0 mg for cooking oil, 41.3 mg for fruits, and 20.7 mg for vegetables. All dairy products, egg yolk, pork brain, frozen codfish ball, sugar-free soy milk and oil-fried bean curd were high-protein foods with higher phosphorus to protein ratio, whereas egg white was a high-protein food with the lowest phosphorus to protein ratio. Phosphorus content in certain foods from plant foods and processed foods were remarkably varied between Taiwanese and American food databases. The data of this study can be a useful tool for assessing daily total phosphorus intake, and further for designing a personalized phosphorus-restricted diet with the reference of phosphorus to protein ratio to have appropriate dietary management in the patients with chronic kidney disease.
論文目次 中文摘要 I
英文摘要 III
目錄 V
表目次 VI
縮寫對照表 VII
第一章 緒論 1
第二章 文獻回顧 3
第一節 慢性腎臟病與磷代謝異常 3
第二節 維持磷平衡的策略 5
第三節 限磷飲食 7
第四節 磷與蛋白質比值 9
第五節 飲食文化差異 10
第六節 台灣地區食品營養成份資料庫 11
第三章 研究目的 13
第四章 材料與方法 14
第一節 資料來源及分類 14
第二節 蛋白質比值分組與表格呈現與磷 14
第五章 結果 16
第一節 食物品項基本資料 16
第二節 六大類食物各品項每份食物之磷含量、磷與蛋白質比值 18
第六章 討論 47
第一節 六大類食物每份食物磷含量平均值 47
第二節 乳品類 48
第三節 豆魚肉蛋類 49
第四節 全穀根莖類 52
第五節 油脂與堅果種子類 53
第六節 蔬菜與水果類 54
第七節 磷與蛋白質比值的應用 55
第八節 研究優勢與限制 59
第七章 結論 62
第八章 參考文獻 63
參考文獻 一、中文參考文獻
王強生、劉大江 (1987) 大豆營養要素之累積與分布。中華農業研究。36: 29-40。
吳紅蓮 (2014) 腹膜透析病患高血磷飲食治療之策略—黃豆蛋白之應用。腎臟與透析。26: 269-275。
孫嘉玲、葉秀美、蕭燕燕、陳琇麗、王麗玲、林秀琴、林姿儀、李良怡 (2007) 運用行為修正改善血液透析病患高血磷症之成效。健康管理學刊。5: 49-59。
黃文德、朱柏齡、許育瑞 (2014) 磷結合劑在慢性腎臟疾病病人運用的新進展。內科學誌。25: 184-94。
楊智媛 (2005) 採收成熟度及採後處理對酪梨品質之影響。中興大學園藝系碩士論文。
潘文涵、吳幸娟、葉志嶸、莊紹源、張新儀、葉乃華、謝耀德 (2009)台灣人飲食與健康之趨勢:1993-1996與 2005-2008營養健康調查之比較。2005-2008台灣營養健康調查。17-40。
劉慧瑛、黃菊美、張庚鵬、朱戩良 (1998) 磷肥施用量對水耕小白菜化學成份之影響。土壤與環境。1: 237-248。
衛生福利部中央健康保險署 (2015) 95-103年臺灣透析相關數據。衛生福利部中央健康保險署,主題專區,慢性腎臟病防治。http://www.nhi.gov.tw。
衛生福利部食品藥物管理署 (1998) 台灣地區食品營養成分資料庫(舊版)。衛生福利部食品藥物管理署,台灣地區食品營養成分資料庫,分析項目及分析方法。https://consumer.fda.gov.tw/FoodAnalysis。
衛生福利部食品藥物管理署 (2015) 台灣地區食品營養成分資料庫(2015版)。衛生福利部食品藥物管理署,業務專區,食品,食品營養。http://www.fda.gov.tw。
謝明哲、葉松鈴、蔡雅惠、邱琬淳 (2015) 膳食療養學實驗,一零四年三月修訂再版,第 1-9頁。臺北醫學大學保健營養學系。

二、外文參考文獻
Barril-Cuadrado G., Puchulu M.B., Sanchez-Tomero J.A. (2013) Table showing dietary phosphorus/protein ratio for the Spanish population. Usefulness in chronic kidney disease. Nefrologia 33:362-71.
Benini O., D'Alessandro C., Gianfaldoni D., Cupisti A. (2011) Extra-phosphate load from food additives in commonly eaten foods: a real and insidious danger for renal patients. J Ren Nutr 21:303-8.
Block G.A., Klassen P.S., Lazarus J.M., Ofsthun N., Lowrie E.G., Chertow G.M. (2004) Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol 15:2208-18.
Caldeira D., Amaral T., David C., Sampaio C. (2011) Educational strategies to reduce serum phosphorus in hyperphosphatemic patients with chronic kidney disease: systematic review with meta-analysis. J Ren Nutr 21:285-94.
Carrigan A., Klinger A., Choquette S.S., Luzuriaga-McPherson A., Bell E.K., Darnell B., Gutierrez O.M. (2014) Contribution of food additives to sodium and phosphorus content of diets rich in processed foods. J Ren Nutr 24:13-9, 19e1.
Cunningham J., Danese M., Olson K., Klassen P., Chertow G.M. (2005) Effects of the calcimimetic cinacalcet HCl on cardiovascular disease, fracture, and health-related quality of life in secondary hyperparathyroidism. Kidney Int 68:1793-800.
Cupisti A., D'Alessandro C., Baldi R., Barsotti G. (2004) Dietary habits and counseling focused on phosphate intake in hemodialysis patients with hyperphosphatemia. J Ren Nutr 14:220-5.
Cupisti A., Gallieni M., Rizzo M.A., Caria S., Meola M., Bolasco P. (2013) Phosphate control in dialysis. Int J Nephrol Renovasc Dis 6:193-205.
Cupisti A., Kalantar-Zadeh K. (2013) Management of natural and added dietary phosphorus burden in kidney disease. Semin Nephrol 33:180-90.
D'Alessandro C., Piccoli G.B., Cupisti A. (2015) The "phosphorus pyramid": a visual tool for dietary phosphate management in dialysis and CKD patients. BMC Nephrol 16:9.
Fouque D., Roth H., Pelletier S., London G.M., Hannedouche T., Jean G., Bouchet J.L., Drueke T. (2013) Control of mineral metabolism and bone disease in haemodialysis patients: which optimal targets? Nephrol Dial Transplant 28:360-7.
Fouque D., Vennegoor M., ter Wee P., Wanner C., Basci A., Canaud B., Haage P., Konner K., Kooman J., Martin-Malo A., Pedrini L., Pizzarelli F., Tattersall J., Tordoir J., Vanholder R. (2007) EBPG guideline on nutrition. Nephrol Dial Transplant 22 Suppl 2:ii45-87.
Goraya N., Simoni J., Jo C.H., Wesson D.E. (2013) A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate. Clin J Am Soc Nephrol 8:371-81.
Goto S., Nakai K., Kono K., Yonekura Y., Ito J., Fujii H., Nishi S. (2014) Dietary phosphorus restriction by a standard low-protein diet decreased serum fibroblast growth factor 23 levels in patients with early and advanced stage chronic kidney disease. Clin Exp Nephrol 18:925-31.
Hruska K.A., Saab G., Mathew S., Lund R. (2007) Renal osteodystrophy, phosphate homeostasis, and vascular calcification. Semin Dial 20:309-15.
Hussain A., Larsson H., Kuktaite R., Johansson E. (2010) Mineral composition of organically grown wheat genotypes: contribution to daily minerals intake. Int J Environ Res Public Health 7:3442-56.
Isakova T., Gutierrez O., Shah A., Castaldo L., Holmes J., Lee H., Wolf M. (2008) Postprandial mineral metabolism and secondary hyperparathyroidism in early CKD. J Am Soc Nephrol 19:615-23.
Isakova T., Wahl P., Vargas G.S., Gutierrez O.M., Scialla J., Xie H., Appleby D., Nessel L., Bellovich K., Chen J., Hamm L., Gadegbeku C., Horwitz E., Townsend R.R., Anderson C.A., Lash J.P., Hsu C.Y., Leonard M.B., Wolf M. (2011a) Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney Int 79:1370-8.
Isakova T., Xie H., Yang W., Xie D., Anderson A.H., Scialla J., Wahl P., Gutierrez O.M., Steigerwalt S., He J., Schwartz S., Lo J., Ojo A., Sondheimer J., Hsu C.Y., Lash J., Leonard M., Kusek J.W., Feldman H.I., Wolf M. (2011b) Fibroblast growth factor 23 and risks of mortality and end-stage renal disease in patients with chronic kidney disease. JAMA 305:2432-9.
Jean G., Terrat J.C., Vanel T., Hurot J.M., Lorriaux C., Mayor B., Chazot C. (2008) Evidence for persistent vitamin D 1-alpha-hydroxylation in hemodialysis patients: evolution of serum 1,25-dihydroxycholecalciferol after 6 months of 25-hydroxycholecalciferol treatment. Nephron Clin Pract 110:c58-65.
Kalantar-Zadeh K. (2013) Patient education for phosphorus management in chronic kidney disease. Patient Prefer Adherence 7:379-90.
Kalantar-Zadeh K., Gutekunst L., Mehrotra R., Kovesdy C.P., Bross R., Shinaberger C.S., Noori N., Hirschberg R., Benner D., Nissenson A.R., Kopple J.D. (2010) Understanding sources of dietary phosphorus in the treatment of patients with chronic kidney disease. Clin J Am Soc Nephrol 5:519-30.
Kalantar-Zadeh K., Kovesdy C.P. (2009) Clinical outcomes with active versus nutritional vitamin D compounds in chronic kidney disease. Clin J Am Soc Nephrol 4:1529-39.
Kalantar-Zadeh K., Kuwae N., Regidor D.L., Kovesdy C.P., Kilpatrick R.D., Shinaberger C.S., McAllister C.J., Budoff M.J., Salusky I.B., Kopple J.D. (2006) Survival predictability of time-varying indicators of bone disease in maintenance hemodialysis patients. Kidney Int 70:771-80.
Karp H., Ekholm P., Kemi V., Hirvonen T., Lamberg-Allardt C. (2012a) Differences among total and in vitro digestible phosphorus content of meat and milk products. J Ren Nutr 22:344-9.
Karp H., Ekholm P., Kemi V., Itkonen S., Hirvonen T., Narkki S., Lamberg-Allardt C. (2012b) Differences among total and in vitro digestible phosphorus content of plant foods and beverages. J Ren Nutr 22:416-22.
Kendrick J., Chonchol M. (2011) The role of phosphorus in the development and progression of vascular calcification. Am J Kidney Dis 58:826-34.
Kirkpantur A., Balci M., Gurbuz O.A., Afsar B., Canbakan B., Akdemir R., Ayli M.D. (2011) Serum fibroblast growth factor-23 (FGF-23) levels are independently associated with left ventricular mass and myocardial performance index in maintenance haemodialysis patients. Nephrol Dial Transplant 26:1346-54.
Kung C.-W. (2010) Milk Alternatives. J Ren Nutr 20:e7-e15.
Lee M.S., Wahlqvist M.L., Peng C.J. (2015) Dairy foods and health in Asians: Taiwanese considerations. Asia Pac J Clin Nutr 24 Suppl 1:S14-20.
Lin J., Fung T.T., Hu F.B., Curhan G.C. (2011) Association of dietary patterns with albuminuria and kidney function decline in older white women: a subgroup analysis from the Nurses' Health Study. Am J Kidney Dis 57:245-54.
Lou-Arnal L.M., Caverni-Munoz A., Arnaudas-Casanova L., Vercet-Tormo A., Gimeno-Orna J.A., Sanz-Paris A., Caramelo-Gutierrez R., Alvarez-Lipe R., Sahdala-Santana L., Gracia-Garcia O., Luzon-Alonso M. (2013) The impact of processing meat and fish products on phosphorus intake in chronic kidney disease patients. Nefrologia 33:797-807.
McGraw N.J., Krul E.S., Grunz-Borgmann E., Parrish A.R. (2016) Soy-based renoprotection. World J Nephrol 5:233-57.
Moe S.M., Zidehsarai M.P., Chambers M.A., Jackman L.A., Radcliffe J.S., Trevino L.L., Donahue S.E., Asplin J.R. (2011) Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clin J Am Soc Nephrol 6:257-64.
Moore L.W., Nolte J.V., Gaber A.O., Suki W.N. (2015) Association of dietary phosphate and serum phosphorus concentration by levels of kidney function. Am J Clin Nutr 102:444-53.
National Kidney Foundation (2003) K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 42:S1-201.
Noori N., Kalantar-Zadeh K., Kovesdy C.P., Bross R., Benner D., Kopple J.D. (2010a) Association of dietary phosphorus intake and phosphorus to protein ratio with mortality in hemodialysis patients. Clin J Am Soc Nephrol 5:683-92.
Noori N., Sims J.J., Kopple J.D., Shah A., Colman S., Shinaberger C.S., Bross R., Mehrotra R., Kovesdy C.P., Kalantar-Zadeh K. (2010b) Organic and inorganic dietary phosphorus and its management in chronic kidney disease. Iran J Kidney Dis 4:89-100.
Odermatt A. (2011) The Western-style diet: a major risk factor for impaired kidney function and chronic kidney disease. Am J Physiol Renal Physiol 301:F919-31.
Prie D., Urena Torres P., Friedlander G. (2009) Latest findings in phosphate homeostasis. Kidney Int 75:882-9.
Rebholz C.M., Crews D.C., Grams M.E., Steffen L.M., Levey A.S., Miller E.R., 3rd, Appel L.J., Coresh J. (2016) DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. Am J Kidney Dis 68:853-61.
Schwarz S., Trivedi B.K., Kalantar-Zadeh K., Kovesdy C.P. (2006) Association of disorders in mineral metabolism with progression of chronic kidney disease. Clin J Am Soc Nephrol 1:825-31.
Scialla J.J., Appel L.J., Wolf M., Yang W., Zhang X., Sozio S.M., Miller E.R., 3rd, Bazzano L.A., Cuevas M., Glenn M.J., Lustigova E., Kallem R.R., Porter A.C., Townsend R.R., Weir M.R., Anderson C.A. (2012) Plant protein intake is associated with fibroblast growth factor 23 and serum bicarbonate levels in patients with chronic kidney disease: the Chronic Renal Insufficiency Cohort study. J Ren Nutr 22:379-388 e1.
Shinaberger C.S., Greenland S., Kopple J.D., Van Wyck D., Mehrotra R., Kovesdy C.P., Kalantar-Zadeh K. (2008) Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease? Am J Clin Nutr 88:1511-8.
Shinaberger C.S., Kilpatrick R.D., Regidor D.L., McAllister C.J., Greenland S., Kopple J.D., Kalantar-Zadeh K. (2006) Longitudinal associations between dietary protein intake and survival in hemodialysis patients. Am J Kidney Dis 48:37-49.
Sigrist M., Tang M., Beaulieu M., Espino-Hernandez G., Er L., Djurdjev O., Levin A. (2013) Responsiveness of FGF-23 and mineral metabolism to altered dietary phosphate intake in chronic kidney disease (CKD): results of a randomized trial. Nephrol Dial Transplant 28:161-9.
Stubbs J., Liu S., Quarles L.D. (2007) Role of fibroblast growth factor 23 in phosphate homeostasis and pathogenesis of disordered mineral metabolism in chronic kidney disease. Semin Dial 20:302-8.
Sullivan C., Sayre S.S., Leon J.B., Machekano R., Love T.E., Porter D., Marbury M., Sehgal A.R. (2009) Effect of food additives on hyperphosphatemia among patients with end-stage renal disease: a randomized controlled trial. JAMA 301:629-35.
Tucker K.L., Qiao N., Maras J.E. (2010) Simulation with soy replacement showed that increased soy intake could contribute to improved nutrient intake profiles in the U.S. population. J Nutr 140:2296s-2301s.
Uribarri J. (2007) Phosphorus homeostasis in normal health and in chronic kidney disease patients with special emphasis on dietary phosphorus intake. Semin Dial 20:295-301.
Uribarri J., Calvo M.S. (2003) Hidden sources of phosphorus in the typical American diet: does it matter in nephrology? Semin Dial 16:186-8.
United States Department of Agriculture (2016) USDA Food Composition Databases. https://ndb.nal.usda.gov/ndb
United States Renal Data System (2015) 2015 USRDS annual data report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. https://www.usrds.org/2015/view
Wen C.P., Cheng T.Y., Tsai M.K., Chang Y.C., Chan H.T., Tsai S.P., Chiang P.H., Hsu C.C., Sung P.K., Hsu Y.H., Wen S.F. (2008) All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan. Lancet 371:2173-82.
Williams C., Ronco C., Kotanko P. (2013) Whole grains in the renal diet--is it time to reevaluate their role? Blood Purif 36:210-4.
Wu S.J., Pan W.H., Yeh N.H., Chang H.Y. (2011) Trends in nutrient and dietary intake among adults and the elderly: from NAHSIT 1993-1996 to 2005-2008. Asia Pac J Clin Nutr 20:251-65.
論文全文使用權限
  • 同意授權瀏覽/列印電子全文服務,於2017-02-08起公開。


  • 若您有任何疑問,請與我們聯絡!
    臺北醫學大學 圖書館 簡莉婷
    E-mail:etds@tmu.edu.tw
    Tel:(02) 2736-1661 ext.2519
    Fax:(02) 2737-5446