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æ√»√’ ªØ‘¡“πÿ‡°…¡ √». ¬ÿ∑∏π“ ªí≠≠“ß“¡ √».∑æ.¥√. ¿“§«‘™“‡§¡’ §≥–∑—πµ·æ∑¬»“ µ√å ®ÿÓ≈ß°√≥å¡À“«‘∑¬“≈—¬

∫∑§—¥¬àÕ °“√‡µ‘¡‰Œ‚¥√‡®π∫“ß à«π≈ß„ππÈ”¡—πæ◊™∑”„À⇰‘¥°√¥‰¢¡—π∑√“π å ®“°°“√»÷°…“∑’ºË “à π¡“æ∫«à“ °“√ ∫√‘‚¿§°√¥‰¢¡—π∑√“π å∑’ˉ¥â√—∫®“°Õ“À“√‡ªìπ®”π«π¡“° ·≈–µ‘¥µàÕ°—π‡ªìπ‡«≈“π“π ¡’§«“¡ —¡æ—π∏凙‘ß ∫«°°—∫°“√‡°‘¥‚√§À≈Õ¥‡≈◊Õ¥À—«„® ‚√§°≈â“¡‡π◊ÈÕÀ—«„®µ“¬‡æ√“–¢“¥‡≈◊Õ¥ ·≈–‚√§À≈Õ¥‡≈◊Õ¥·¢Áß ®“° √“¬ß“π°“√ ”√«®ª√‘¡“≥‰¢¡—π∑√“π å„πÕ“À“√Õ∫·≈–∑Õ¥¢Õß ”π—°‚¿™π“°“√ °√¡Õπ“¡—¬ °√–∑√«ß  “∏“√≥ ÿ¢ æ∫«à“ ¡’Õ“À“√‡ªìπ®”π«π¡“°∑’Ë¡’ª√‘¡“≥°√¥‰¢¡—π∑√“π å Ÿß «“ß®”Àπà“¬„π∑âÕßµ≈“¥ ·≈–«—¬ √ÿàπ à«π„À≠à„π‡¡◊ÕßÀ≈«ßπ‘¬¡√—∫ª√–∑“π °“√»÷°…“§√—Èßπ’È®÷ß¡’«—µ∂ÿª√– ß§å‡æ◊ËÕ ”√«®°“√∫√‘‚¿§°√¥‰¢ ¡—π∑√“π å¢Õ߇¥Á°«—¬√ÿàπ°≈ÿà¡Àπ÷Ëß´÷ËßÕ“»—¬Õ¬Ÿà„π°√ÿ߇∑æ¡À“π§√ ‚¥¬ ÿࡵ—«Õ¬à“ß ÿà¡·∫∫ –¥«° ∫—π∑÷° 惵‘°√√¡°“√∫√‘‚¿§Õ“À“√∑’Ë¡’°√¥‰¢¡—π∑√“π å„π‡«≈“ 24 ™—Ë«‚¡ß (24-hour dietary recall) ‡ªìπ‡«≈“ 7 «—𠵑¥µàÕ°—π À“§«“¡·µ°µà“ß√–À«à“ߧ–·ππ‡©≈’ˬ¢Õß惵‘°√√¡°“√∫√‘‚¿§Õ“À“√¢Õß°≈ÿࡵ—«Õ¬à“ߥ⫬ °“√∑¥ Õ∫ ∑’ ∑’Ë√–¥—∫§«“¡‡™◊ËÕ¡—Ëπ√âÕ¬≈– 95 º≈°“√»÷°…“ æ∫«à“ ‡æ»™“¬ (63 §π) ·≈–‡æ»À≠‘ß (137 §π)¡’Õ“¬ÿ‡©≈’ˬ 19.0±1.29 ·≈– 19.5±1.30 ªï ·≈–¥—™π’¡«≈°“¬ 20.9±2.50 ·≈–19.8±2.65 °‘‚≈°√—¡/ µ√.¡. ‡æ»™“¬∫√‘‚¿§°√¥‰¢¡—π∑√“π å‡©≈’ˬ 1.39±0.67 °√—¡µàÕ«—π Ÿß°«à“‡æ»À≠‘ß 0.96±1.30 °√—¡µàÕ«—π Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<.05) ®“°‡°≥±å∑’ËÕߧ尓√Õπ“¡—¬‚≈°·π–π” «—¬√ÿàπ‰∑¬§«√∫√‘‚¿§°√¥‰¢ ¡—π∑√“π å‰¡à‡°‘π 2.0 °√—¡µàÕ«—π æ∫«à“ ‡æ»À≠‘ß√âÕ¬≈– 80.1 ·≈–‡æ»™“¬√âÕ¬≈– 72.3 Õ¬Ÿà„π‡°≥±å·π–π” ‡ª√’¬∫‡∑’¬∫√–À«à“ß«—π¡“‡√’¬π·≈–«—πÀ¬ÿ¥ æ∫«à“ „π«—πÀ¬ÿ¥¡’®”π«πµ—«Õ¬à“ß∑’∫Ë √‘‚¿§°√¥‰¢¡—π∑√“π å¡“°°«à“ 2 °√—¡µàÕ«—π ‡æ‘Ë¡¢÷ÈπÕ¬à“ß¡’π—¬ ”§—≠ ∑—Èß„π°≈ÿࡇ滙“¬·≈–°≈ÿࡇæ»À≠‘ß (p<.05)  √ÿª‰¥â«à“ «—¬√ÿàπ∑’ËÕ“»—¬ Õ¬Ÿà„π°√ÿ߇∑æ¡À“π§√ à«π„À≠à ∫√‘‚¿§°√¥‰¢¡—π∑√“π å‰¡à‡°‘π 2 °√—¡µàÕ«—π ·≈–¡’·π«‚πâ¡®–∫√‘‚¿§°√¥ ‰¢¡—π∑√“π å¡“°¢÷Èπ„π«—πÀ¬ÿ¥¡“°°«à“«—π¡“‡√’¬π

90

¡°√“§¡ - ¡’π“§¡ 2555

°√¡Õπ“¡—¬  à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒


°“√∫√‘‚¿§°√¥‰¢¡—π∑√“π å¢Õß«—¬√ÿàπ‰∑¬°≈ÿà¡Àπ÷Ëß„π°√ÿ߇∑æ¡À“π§√

The Trans Fatty Acids Consumptions among Adolescents Living in Bangkok Pornsri Patimanukaseam Assoc.Prof. Yuttana Panya-ngarm Assoc.Prof.Dr Department of Biochemistry, Faculty of Dentistry, Chulalongkorn University

Abstract Partial Hydrogenation of vegetable oils resulted in trans fatty acids (TFAs) formation. Previous studies demonstrated the relationship between high amount of TFAs consumption and the incidences of coronary artery disease, Myocardial infarction and atherosclerosis. The Bureau of Nutrition, Department of Health Ministry of Public Health reported the amounts of content in many foods available in the market. Most of them are usually consumed by young generations in urban area so the purpose of this study is to determine the TFAs consumption among adolescents living in Bangkok. Subjects were selected by convenience sampling. The intake of foods containing TFAs were daily recorded for 1 week. The difference between the studied variables was performed by t-test at 95% confidence limit. The results revealed that the subjects (63 males; 137 females ) were 19.0±1.29 and 19.5±1.30 years old with BMI = 20.9±2.50 and 19.8±2.65 km/m2 , respectively. The means of TFAs consumption by males and females were 1.39±0.67 and 0.96±1.30 g/ day with significant difference, (p<.05). According to WHO recommendation, TFAs consumption by Thai adolescents should be ≤ 2.0 g/day and there were 80.1% females and 72.3% males in this group. On holiday the percentages of males and females consumed TFAs > 2.0 g/day significantly increased. (p<.05) It was concluded that most adolescents living in Bangkok consumed TFAs within recommended level (2.0 g/day) and they had tendency to consumed higher TFAs on holiday than school day.

∫∑π” Õ“À“√‰¢¡—πª√–°Õ∫¥â«¬°√¥‰¢¡—π 2 ™π‘¥ §◊Õ °√¥‰¢¡—π™π‘¥Õ‘Ë¡µ—« (saturated fatty acids) ´÷Ëßæ∫„π‰¢¡—π®“° —µ«å πÈ”¡—π¡–æ√â“«·≈–πÈ”¡—𠪓≈å¡ ·≈–°√¥‰¢¡—π™π‘¥‰¡àÕ‘Ë¡µ—« (unsaturated

fatty acids) ´÷ßË æ∫„ππÈ”¡—πæ◊™µà“ßÊ ‡™àπ ¡–°Õ° ¢â“«‚æ¥ ‡¡≈Á¥¥Õ°∑“πµ–«—π ∂—«Ë ‡À≈◊Õß ·≈–√”¢â“« πÕ°®“°π’È ¬—ßæ∫¡“°„ππÈ”¡—π®“°∂—Ë«‡ª≈◊Õ°·¢Áß ‡™àπ ∂—Ë«≈‘ ß Õ—≈¡Õπ¥å «Õ≈π—∑ ‡ªìπµâπ1 °√¥‰¢¡—π™π‘¥‰¡àÕ‘Ë¡µ—«∑’Ëæ∫„π∏√√¡™“µ‘

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

January - March 2012

91


∫ ∑ «‘ ∑ ¬ “ ° “ √ µ√ß∫√‘‡«≥∑’Ë¡’æ—π∏–§Ÿà (double bond) ¡—°®–¡’ °“√‡√’¬ßµ—«¢Õ߉Œ‚¥√‡®π„π∑‘»∑“߇¥’¬«°—π ‡√’¬° «à “ °“√‡√’ ¬ ßµ— « ·∫∫´‘   (cis-form) ·µà „ π ¢∫«π°“√º≈‘µÕ“À“√„π‡™‘ßÕÿµ “À°√√¡ ®–¡’°“√

‡µ‘¡‰Œ‚¥√‡®π∫“ß à«π (partial hydrogenation) ≈ß„ππÈ”¡—πæ◊™ ´÷Ëß®–∑”„À⇰‘¥°“√‡√’¬ßµ—«¢Õß ‰Œ‚¥√‡®π‡ªìπ§π≈–¥â“π¢Õßæ—π∏– ‡√’¬°«à“ °“√ ‡√’¬ßµ—«·∫∫∑√“π å (trans-form) (√Ÿª∑’Ë 1)

√Ÿª∑’Ë 1 ‚§√ß √â“ß∑“߇§¡’¢Õß°√¥‰¢¡—π∑’Ëæ∫„πÕ“À“√

πÈ”¡—πæ◊™∑’˺à“π°√–∫«π°“√‡µ‘¡‰Œ‚¥√‡®π ∫“ß à«π ®–¡’ª√‘¡“≥°√¥‰¢¡—π∑√“π å‡°‘¥¢÷Èπ ª√–¡“≥√âÕ¬≈– 40 ¢Õߪ√‘¡“≥‰¢¡—π∑—ßÈ À¡¥2 °“√ ‡√’¬ßµ—«¢Õ߉Œ‚¥√‡®π„π≈—°…≥–π’È πÕ°®“°®– ∑”„Àâ√“§“µâπ∑ÿπ°“√º≈‘µ≈¥≈ß·≈â« ¬—ß∑”„Àâ πÈ”¡—π¡’§«“¡§ßµ—« ·≈–¡’Õ“¬ÿ°“√‡°Á∫π“π¢÷Èπ (long shelf life) ®÷ ß ‡ªì π ∑’Ë π‘ ¬ ¡π”‰ª„™â „ π Õÿµ “À°√√¡°“√º≈‘µÕ“À“√ ‡™àπ ‡π¬‡∑’¬¡ ‰¢¡—π ”À√—∫∑Õ¥Õ“À“√ ·≈–‰¢¡—π ”À√—∫∑” ¢π¡µà“ßÊ ¥—ßπ—Èπ Õ“À“√ª√–‡¿∑∑Õ¥ À√◊Õ Õ∫ °√Õ∫∑’«Ë “ߢ“¬„π∑âÕßµ≈“¥ ‡™àπ ¡—πΩ√—ßË ·ºàπ∑Õ¥ ¢π¡‡§â° §ÿâ°°’È ‰°à∑Õ¥ œ≈œ ®÷߇ªìπÕ“À“√∑’Ë¡’°√¥ ‰¢¡—π™π‘¥∑√“π å§àÕπ¢â“ß¡“° πÕ°®“°π’È ‡¥Á°„π ‡¡◊ÕßÀ≈«ß®–π‘¬¡√—∫ª√–∑“πÕ“À“√·∫∫µ–«—π µ°´÷Ëß¡’ à«πª√–°Õ∫‡ªìπ‡π¬ (butter) ‡π¬‡∑’¬¡ (margarine) ·≈–‡π¬¢“« (shortening) ´÷Ëß ¡— ° ®–¡’ ª √‘ ¡ “≥°√¥‰¢¡— π ∑√“π å  Ÿ ß °«à “ Õ“À“√ 92

¡°√“§¡ - ¡’π“§¡ 2555

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·∫∫‰∑¬ 3 ¥— ß π—È π „π·µà ≈ –«— 𠇥Á ° «— ¬ √ÿà π „π °√ÿ߇∑æ¡À“π§√Õ“®‰¥â√—∫ª√‘¡“≥°√¥‰¢¡—π™π‘¥ ∑√“π å‡ªìπ®”π«π¡“° ®“°º≈°“√»÷ ° …“¢Õß Mensick ·≈– Katan 4 æ∫«à “ À“°°‘ π Õ“À“√∑’Ë ¡’ ° √¥‰¢¡— π ™π‘¥∑√“π å ª√–¡“≥√âÕ¬≈– 10 ¢Õßæ≈—ßß“π∑’Ë §«√‰¥â√—∫„π 1 «—π ®–∑”„Àâª√‘¡“≥·Õ≈¥’·Õ≈§Õ‡≈ ‡µÕ√Õ≈ (LDL-cholesterol) À√◊Õ§Õ ‡≈ ‡µÕ√Õ≈™π‘¥‰¡à¥’ (bad cholesterol) „π‡≈◊Õ¥ ‡æ‘¡Ë ¢÷πÈ „π¢≥–∑’ªË √‘¡“≥‡Õ™¥’·Õ≈-§Õ‡≈ ‡µÕ√Õ≈ (HDL-cholesterol) À√◊Õ§Õ‡≈ ‡µÕ√Õ≈™π‘¥¥’ (good cholesterol) „π‡≈◊Õ¥≈¥≈ß °“√»÷°…“∑“ß√–∫“¥«‘∑¬“ ´÷Ëß∑”°“√‡°Á∫ ¢âÕ¡Ÿ≈®“°ª√–™“°√ 7 ª√–‡∑»5  √ÿª‰¥â«“à ª√‘¡“≥ °√¥‰¢¡— π ∑√“π å ∑’Ë ‰ ¥â √— ∫ ®“°Õ“À“√¡’ § «“¡  —¡æ—π∏凙‘ß∫«°°—∫°“√‡°‘¥‚√§À≈Õ¥‡≈◊Õ¥À—«„® (coronary artery disease) πÕ°®“°π’È ¬—ß¡’


°“√∫√‘‚¿§°√¥‰¢¡—π∑√“π å¢Õß«—¬√ÿàπ‰∑¬°≈ÿà¡Àπ÷Ëß„π°√ÿ߇∑æ¡À“π§√

°“√»÷ ° …“∑’Ë ·  ¥ß„Àâ ‡ ÀÁ π «à “ ª√‘ ¡ “≥°√¥ ‰¢¡—π∑√“π å∑’ˉ¥â√—∫®“°Õ“À“√·≈– – ¡Õ¬Ÿà„π ‡π◊ÈÕ‡¬◊ËÕ‰¢¡—π (adipose tissue) ¡’§«“¡ —¡æ—π∏å ‡™‘ß∫«° °—∫°“√‡°‘¥‚√§°≈â“¡‡π◊ÈÕÀ—«„®µ“¬‡æ√“– ¢“¥‡≈◊Õ¥ (myocardial infarction)6 ·≈–‚√§ À≈Õ¥‡≈◊Õ¥·¢Áß (atherosclerosis)7 ®“°°“√»÷°…“¢Õß Kavanagh ·≈–§≥–8 ‚¥¬„Àâ≈‘ß„π°≈ÿà¡∑¥≈Õß°‘πÕ“À“√∑’Ë¡’°√¥‰¢¡—π ∑√“π å√âÕ¬≈– 8 ¢Õßæ≈—ßß“π∑—ÈßÀ¡¥ ‡ª√’¬∫ ‡∑’¬∫°—∫≈‘ß„π°≈ÿࡧ«∫§ÿ¡∑’Ë°‘πÕ“À“√æ≈—ßß“π ‡∑à“°—π·µà‰¡à¡°’ √¥‰¢¡—π∑√“π å ‡ªìπ‡«≈“π“π 6 ªï æ∫«à“ ≈‘ß„π°≈ÿà¡∑¥≈Õß¡’πÈ”Àπ—°µ—«¡“°°«à“ ¡’ °“√ – ¡‰¢¡—π¿“¬„π™àÕß∑âÕß¡“°°«à“·≈–¡’°“√ „™âπÈ”µ“≈„π√à“ß°“¬™â“≈߇æ√“–¡’§«“¡∑πµàÕÕ‘π  ÿ≈‘π‡æ‘Ë¡¢÷Èπ (insulin resistance) ªí®®ÿ∫—π À≈“¬ª√–‡∑»„À⧫“¡ ”§—≠¢Õß ª√‘¡“≥°√¥‰¢¡—π∑√“π å„πÕ“À“√¡“°¢÷È𠇙àπ  ¡“§¡À—«„®¢Õß À√—∞Õ‡¡√‘°“ (The American Heart Association) ·π–π”«à“ ª√–™“™π§«√‰¥â √—∫ª√‘¡“≥°√¥‰¢¡—π∑√“π å ‰¡à‡°‘π√âÕ¬≈– 1.0 ¢Õß æ≈—ßß“π∑—ÈßÀ¡¥∑’˧«√‰¥â√—∫9 ·≈– ”π—°ß“π§≥– °√√¡°“√Õ“À“√·≈–¬“ ¢Õß À√—∞Õ‡¡√‘°“ (The US Food and Drug Administration) ‰¥â ª √–°“»„Àâ µ‘ ¥ ©≈“°· ¥ßª√‘ ¡ “≥°√¥ ‰¢¡— π ∑√“π å „ πÕ“À“√ ”‡√Á ® √Ÿ ª ∑’Ë ¡’ ° √¥‰¢ ¡—π∑√“π å¡“°°«à“ 0.5 °√—¡µàÕ 1 Àπ૬∫√‘‚¿§ µ—Èß·µà«—π∑’Ë 1 ¡°√“§¡ æ.».2551 ‡ªìπµâπ‰ª10 ‡¡◊ËÕ ºŸâ º ≈‘ µ Õ“À“√√–∫ÿ «à “ Õ“À“√π—È π ¡’ ª √‘ ¡ “≥°√¥ ‰¢¡—π∑√“π å°’Ë°√—¡ ®–™à«¬„À⺟â∫√‘‚¿§ “¡“√∂ ª√–¡“≥‰¥â«à“ „π·µà≈–«—π‰¥â√—∫°√¥‰¢¡—π∑√“π å ¡“°πâÕ¬‡æ’¬ß„¥ À√◊Õ‰¥â√—∫°√¥‰¢¡—π∑√“π å¡“° °«à“ª√‘¡“≥∑’Ë·π–π”À√◊Õ‰¡à ·¡â Õ ß§å ° “√Õπ“¡— ¬ ‚≈° (The World Health Organization; WHO) ®–·π–π”

„Àâª√–™“™π∫√‘‚¿§°√¥‰¢¡—π∑√“π å ‰¥â‰¡à‡°‘π √â Õ ¬≈– 1 ¢Õßæ≈— ß ß“π∑—È ß À¡¥∑’Ë § «√‰¥â √— ∫ „π ·µà≈–«—π11 ·µà®“°√“¬ß“π°“√ ”√«®°“√∫√‘‚¿§ °√¥‰¢¡—π∑√“π å¢Õß™“«µ–«—πµ°12-13 æ∫«à“  à«π „À≠à ¬—ß∫√‘‚¿§°√¥‰¢¡—π∑√“π å Ÿß°«à“ª√‘¡“≥∑’Ë Õߧ尓√Õπ“¡—¬‚≈°·π–π” ‡™àπ  À√—∞Õ‡¡√‘°“ æ∫ «à“¡’°“√∫√‘‚¿§°√¥‰¢¡—π∑√“π å Ÿß∂÷ß 5.8 °√—¡ µàÕ«—π À√◊Õ ‰Õ´å·≈π¥å ∫√‘‚¿§°√¥‰¢¡—π∑√“π å 5.4 °√—¡µàÕ«—𠇪ìπµâπ ¥—ß√“¬≈–‡Õ’¬¥„πµ“√“ßµàÕ‰ªπ’È

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°√¥‰¢¡—π∑√“π å (°√—¡/«—π) 5.8 5.4 4.3 4.1 4.0 2.8 2.3 2.6 2.2 2.1 1.6 1.6

‡æ◊ËÕ„Àâª√–™“™π∫√‘‚¿§°√¥‰¢¡—π∑√“π å πâÕ¬≈ß Àπ૬ߓπ¥â“π ÿ¢¿“æª√–‡∑»·§π“¥“ (Health Canada) ®÷ ß ‰¥â ¢ Õ„Àâ ºŸâ ª √–°Õ∫ Õÿµ “À°√√¡Õ“À“√≈¥ª√‘¡“≥°√¥‰¢¡—π∑√“π å „ππÈ”¡—πæ◊™ ·≈–‡π¬‡∑’¬¡„ÀâµË”°«à“√âÕ¬≈– 2.0 ·≈– „πÕ“À“√™π‘¥Õ◊Ëπ„Àâ¡’ª√‘¡“≥µË”°«à“√âÕ¬≈– 5.0 ¢Õߪ√‘¡“≥‰¢¡—π∑—ßÈ À¡¥14 ·µà ”À√—∫ª√–‡∑»‰∑¬ °“√√≥√ߧå„Àâª√–™“™πµ√–Àπ—°∂÷ßÕ—πµ√“¬¢Õß

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

January - March 2012

93


∫ ∑ «‘ ∑ ¬ “ ° “ √ °√¥‰¢¡—π∑√“π å¬—ߧàÕπ¢â“ßπâÕ¬ Õ’°∑—È߬—߉¡à¡’ °ÆÀ¡“¬∑’Ë ® –°”Àπ¥„Àâ ºŸâ º ≈‘ µ √–∫ÿ ª √‘ ¡ “≥°√¥ ‰¢¡— π ∑√“π å „ πÕ“À“√ ·≈–®“°√“¬ß“π°“√  ”√«®ª√‘¡“≥‰¢¡—π∑√“π å„πÕ“À“√Õ∫·≈–∑Õ¥ ®”π«π 65 µ—«Õ¬à“ß ®“°Àâ“ß √√æ ‘π§â“·≈– µ≈“¥∑—Ë«‰ª3 · ¥ß„Àâ‡ÀÁπ«à“¡’Õ“À“√‡ªìπ®”π«π ¡“°∑’Ë¡’ª√‘¡“≥°√¥‰¢¡—π∑√“π å Ÿß ·≈– à«π„À≠à ‡ªìπÕ“À“√∑’ˇ¥Á°„π«—¬‡√’¬π·≈–«—¬√ÿàππ‘¬¡∫√‘‚¿§ ‡ªìπª√–®”

«—µ∂ÿª√– ß§å°“√»÷°…“ °“√»÷°…“§√—Èßπ’È ¡’«—µ∂ÿª√– ß§å‡æ◊ËÕ ”√«® °“√∫√‘‚¿§°√¥‰¢¡—π∑√“π å¢Õ߇¥Á°«—¬√ÿàπ°≈ÿà¡ Àπ÷Ëß´÷ËßÕ“»—¬Õ¬Ÿà„π°√ÿ߇∑æ¡À“π§√

«‘∏’°“√»÷°…“ °“√«‘ ®— ¬ ·∫∫æ√√≥𓇙‘ ß ‡ª√’ ¬ ∫‡∑’ ¬ ∫ (comparative descriptive research) §√—Èßπ’È ª√–™“°√‡ªìπ‡¥Á°«—¬√ÿπà ‰∑¬∑’¡Ë Õ’ “¬ÿ√–À«à“ß 15-20

ªï ´÷ËßÕ“»—¬Õ¬Ÿà„π°√ÿ߇∑æ¡À“π§√ ‰¡àπâÕ¬°«à“ 5 ªï ∑”°“√‡°Á∫¢âÕ¡Ÿ≈¥â«¬«‘∏’‡≈◊Õ° ÿà¡·∫∫ –¥«° (convenience sampling) ‚¥¬·®°·∫∫ Õ∫∂“¡ ·≈–‡°Á∫¢âÕ¡Ÿ≈ µ—ßÈ ·µà«π— ∑’Ë 1 惻®‘°“¬π 2553 ®π ‰¥â·∫∫ Õ∫∂“¡ àß°≈—∫¡“§√∫ 200 §π ‡§√◊ËÕß¡◊Õ∑’Ë„™â„π°“√«‘®—¬§◊Õ ·∫∫ Õ∫∂“¡ ¢â Õ ¡Ÿ ≈  à « π∫ÿ § §≈ ·∫∫∫— π ∑÷ ° 惵‘ ° √√¡°“√ ∫√‘‚¿§Õ“À“√∑’Ë¡’°√¥‰¢¡—π∑√“π å¬âÕπÀ≈—ß 24 ™—«Ë ‚¡ß (24-hour dietary recall) ¢Õß∑ÿ°«—𠇪ì𠇫≈“ 7 «—𠵑¥µàÕ°—π ‚¥¬‡√‘Ë¡µâπ«—π„¥°Á‰¥â ∑—Èßπ’È Õ“ “ ¡— § √‰¥â √— ∫ §”·π–𔇰’Ë ¬ «°— ∫ «‘ ∏’ ∫— π ∑÷ ° ª√‘¡“≥Õ“À“√‡ªìπÀπ૬∫√‘‚¿§∑’Ë√–∫ÿ‰«â®π‡¢â“„® ¥’·≈â«®÷ß√—∫·∫∫ Õ∫∂“¡‰ª∑”°“√∫—π∑÷° (¥—ß · ¥ß√“¬≈–‡Õ’ ¬ ¥„πµ“√“ß∑’Ë 1) ‡¡◊Ë Õ ‰¥â ·∫∫ Õ∫∂“¡°≈—∫¡“·≈â«®÷ß√«∫√«¡·≈–§”π«≥ ‡ªìπª√‘¡“≥‰¢¡—π∑√“π å∑’Ë∫√‘‚¿§‡ªìπÀπ૬°√—¡ µàÕ«—π «‘‡§√“–Àå¢Õâ ¡Ÿ≈‚¥¬„™â ∂‘µ‡‘ ™‘ßæ√√≥π“ ·≈– À“§«“¡·µ°µà “ ß√–À«à “ ߧ–·ππ‡©≈’Ë ¬ ¢Õß

µ“√“ß∑’Ë 1 ª√‘ ¡ “≥‰¢¡— π ∑√“π å ¢ ÕßÕ“À“√∑’Ë „ Àâ Õ “ “ ¡— § √∑”°“√∫— π ∑÷ ° „π·∫∫∫— π ∑÷ ° 惵‘°√√¡°“√∫√‘‚¿§Õ“À“√∑’Ë¡’°√¥‰¢¡—π∑√“π å¬âÕπÀ≈—ß 24 ™—Ë«‚¡ß µ—«Õ¬à“ßÕ“À“√

Àπ૬∫√‘‚¿§

Trans fat (¡‘≈≈‘°√—¡)

‡§â°‡π¬ ‡§â°°≈⫬ÀÕ¡ ‡§â°º≈‰¡â ‡§â° Õ¥‰ â§√’¡ (‡™àπ ¬Ÿ‚√) §ÿâ°°’È ·§√°‡°Õ√å Õ¥‰ â§√’¡ 擬 ·¬¡‚√≈

80 °√—¡ (2 ™‘Èπ) 80 °√—¡ (1 ™‘Èπ) 80 °√—¡ (1 ™‘Èπ) 75 °√—¡ (1 ™‘Èπ)

320 248 189 97

30 °√—¡ (3 ™‘Èπ) 30 °√—¡ (3 ™‘Èπ) 55 °√—¡ (1 ™‘Èπ) 55 °√—¡ (1 ™‘Èπ)

101 58 241 150

1. 2. 3. 4. 5. 6. 7. 8.

94

¡°√“§¡ - ¡’π“§¡ 2555

°√¡Õπ“¡—¬  à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒

µ—«Õ¬à“ßÕ“À“√ 9. 10. 11. 12. 13.

‡Õ·§≈√å ‚¥π—∑‰¡à¡‰’  â ‚¥π—∑‰ â§√’¡ ∫√“«π’ ‡«‡øÕ√凧≈◊Õ∫ ™Õ§‚°·≈µ 14. ¢π¡ªíß∑“‡π¬ (Õ∫°√Õ∫) 15. ¢π¡ªíß‡π¬ ¥

Àπ૬∫√‘‚¿§

Trans fat (¡‘≈≈‘°√—¡) 55 °√—¡ (3 ™‘Èπ) 130 55 °√—¡ (1 ™‘Èπ) 97 55 °√—¡ (1 ™‘Èπ) 455 30 °√—¡ (1/2 ™‘Èπ) 94 30 °√—¡ (3™‘Èπ) 131 30 °√—¡ (5 ™‘Èπ)

69

50 °√—¡ (1.5 ™‘Èπ)

56


°“√∫√‘‚¿§°√¥‰¢¡—π∑√“π å¢Õß«—¬√ÿàπ‰∑¬°≈ÿà¡Àπ÷Ëß„π°√ÿ߇∑æ¡À“π§√

µ“√“ß∑’Ë 1 ª√‘ ¡ “≥‰¢¡— π ∑√“π å ¢ ÕßÕ“À“√∑’Ë „ Àâ Õ “ “ ¡— § √∑”°“√∫— π ∑÷ ° „π·∫∫∫— π ∑÷ ° 惵‘°√√¡°“√∫√‘‚¿§Õ“À“√∑’Ë¡’°√¥‰¢¡—π∑√“π å¬âÕπÀ≈—ß 24 ™—Ë«‚¡ß(µàÕ) µ—«Õ¬à“ßÕ“À“√

Àπ૬∫√‘‚¿§

16. ¢π¡ªí߉ â°√Õ° 50 °√—¡ (1 ™‘Èπ) 17. ·´π«‘ ·Œ¡™’  55 °√—¡ (1 ™‘Èπ) 18. ·´π«‘ ∑Ÿπà“ 55 °√—¡ (1 ™‘Èπ) 19. ·Œ¡‡∫Õ‡°Õ√åÀ¡Ÿ 135 °√—¡ (1 ™‘Èπ) 20. ·Œ¡‡∫Õ‡°Õ√å‡π◊ÈÕ 200 °√—¡ (1 ™‘Èπ) 21. ·Œ¡‡∫Õ‡°Õ√剰à 150 °√—¡ (1 ™‘Èπ) 22. æ‘´´“ 176 °√—¡ (1 ™‘Èπ) 23. ‰°àªÖÕ∫ 40 °√—¡ (5 ™‘Èπ) 24. π—°‡°Áµ 40 °√—¡ (2 ™‘Èπ) 25. ‰°à∑Õ¥·∫∫‰∑¬ 80 °√—¡(1 ™‘ÈππàÕß) 26. ‰°à∑Õ¥·∫∫Ω√—Ëß 80 °√—¡(1 ™‘ÈππàÕß) 27. À¡Ÿ∑Õ¥ 40 °√—¡ (5 ™‘Èπ) 28. ª≈“µ—«‡≈Á°∑Õ¥ 5 °√—¡ (1 ™µ.) 29. ‡π◊ÈÕ∑Õ¥ 40 °√—¡ (5 ™‘Èπ) 30. ª“∑àÕß‚°ã 27 °√—¡ (1 §Ÿà) 31. ´“≈“‡ª“ 40 °√—¡ (™‘Èπ )

Trans fat (¡‘≈≈‘°√—¡) 95 142 110 324 466 198 200 102 73 217 173 142 21 118 53 62

惵‘°√√¡°“√∫√‘‚¿§Õ“À“√¢Õß°≈ÿ¡à µ—«Õ¬à“ßÕ‘ √– 2 °≈ÿࡥ⫬°“√∑¥ Õ∫ ∑’ (independent t-test) ∑’Ë√–¥—∫§«“¡‡™◊ËÕ¡—Ëπ√âÕ¬≈– 95

º≈°“√»÷°…“ ºŸâ‡¢â“√à«¡°“√«‘®—¬ ®”π«π 200 §π ‡ªìπ ‡æ»™“¬ 67 §π·≈–‡æ»À≠‘ß 163 §π ¡’Õ“¬ÿ‡©≈’ˬ 19.0±1.29 ·≈– 19.5±1.30 ªï §à“¥—™π’¡«≈°“¬ (Body mass index; BMI) ¢Õß°≈ÿࡵ—«Õ¬à“ß ‡æ»™“¬ (20.9±2.50 °‘‚≈°√—¡/µ√.¡.)  Ÿß°«à“ ‡æ»À≠‘ß (19.8±2.65 °‘‚≈°√—¡/µ√.¡.) Õ¬à“ß¡’ π—¬ ”§—≠∑“ß ∂‘µ‘ (p<.05) (µ“√“ß∑’Ë 2)

µ—«Õ¬à“ßÕ“À“√ 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43.

¢π¡‡°≈’¬« ¢π¡¥Õ°®Õ° ¢π¡‰¢àÀß å ´“≈“‡ª“∑Õ¥ ·∫∫‰∑¬ ‰ â∂—Ë« ¢π¡ªíπô ¢≈‘∫∑Õ¥ °≈⫬·¢° ¢â“«‚æ¥∑Õ¥ ‡µâ“ÀŸâ∑Õ¥ ‡º◊Õ°∑Õ¥ ∂—Ë«≈‘ ß∑Õ¥·∫∫ ·ºàπ°≈¡ ¡—πΩ√—Ëß·ºà𠇙àπ ‡√¬å, æ√‘߇°‘≈ ¡—πΩ√—Ë߇ âπ∑Õ¥ (‡ø√âπ´åø√“¬)

Àπ૬∫√‘‚¿§

Trans fat (¡‘≈≈‘°√—¡) 10 °√—¡ (1 ™‘Èπ) 11 10 °√—¡ (1 ™‘Èπ) 31 25 °√—¡ (1 ™‘Èπ) 4 40 °√—¡(1 ™‘Èπ) 11 5 °√—¡ (1 ™‘Èπ) 40 °√—¡ (1 ™‘Èπ) 40 °√—¡ (1 ™‘Èπ) 57 °√—¡ (™‘Èπ) 40 °√—¡ (1 ™‘Èπ) 12 °√—¡ (1 ™‘Èπ)

11 96 95 115 98 16

45 °√—¡ (1 ∂ÿß)

3,000

71 °√—¡ (1 ∂ÿß)

5,500

‡¡◊ËÕ®”·π°¢âÕ¡Ÿ≈µ“¡§à“¥—™π’¡«≈°“¬ ‡ªìπ °≈ÿà¡∑’ËÕ¬Ÿà„π√–¥—∫ºÕ¡ (skinny) §à“ BMI < 18.5 °‘‚≈°√—¡/µ√.¡. °≈ÿà¡∑’ËÕ¬Ÿà„π√–¥—∫ª°µ‘ (normal) §à“ BMI= 18.5-22.9 °‘‚≈°√—¡/µ√.¡. ·≈–°≈ÿà¡ ∑’ÕË ¬Ÿ„à π√–¥—∫πÈ”Àπ—°‡°‘π (overweight) §à“ BMI> 22.9 °‘‚≈°√—¡/µ√.¡. æ∫«à“ ®”π«π‡æ»™“¬∑’ËÕ¬Ÿà „π‡°≥±åºÕ¡ ¡’‡æ’¬ß√âÕ¬≈– 17.9 ´÷ËßπâÕ¬°«à“ ‡æ»À≠‘ß´÷Ëß¡’®”π«π∂÷ß√âÕ¬≈– 39.1 Õ¬à“ß¡’π—¬  ”§—≠∑“ß ∂‘µ‘ (p<.05) „π¢≥–∑’Ë®”π«π‡æ» ™“¬∑’Ë Õ ¬Ÿà „ π‡°≥±å ª °µ‘ (√â Õ ¬≈– 65.7) ·≈– ‡°≥±åπÈ”Àπ—°‡°‘π (√âÕ¬≈– 16.4) ¡“°°«à“‡æ» À≠‘ß (√âÕ¬≈– 48.9 ·≈– 12.0) Õ¬à“ß¡’π—¬ ”§—≠

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH

January - March 2012

95


∫ ∑ «‘ ∑ ¬ “ ° “ √ µ“√“ß∑’Ë 2 ¢âÕ¡Ÿ≈ à«π∫ÿ§§≈¢Õß°≈ÿࡵ—«Õ¬à“ß ¢âÕ¡Ÿ≈∑’»Ë °÷ …“ 1. ®”π«π (§π) 2. Õ“¬ÿ‡©≈’¬Ë (ªï) 3. ¥—™π’¡«≈°“¬ (°‘‚≈°√—¡/µ√.¡.) 4. °≈ÿࡵ—«Õ¬à“ß®”·π°µ“¡§à“¥—™π’¡«≈°“¬ (√âÕ¬≈–) ‡°≥±åºÕ¡ (¥—™π’¡«≈°“¬ <18.5 °°/¡2) ‡°≥±åª°µ‘(¥—™π’¡«≈°“¬ 18.5-24.5 °°/¡2) ‡°≥±åπÈ”Àπ—°‡°‘π (¥—™π’¡«≈°“¬ >24.5 °°/¡2) 5. °≈ÿࡵ—«Õ¬à“ß®”·π°µ“¡∑’Ëæ—°Õ“»—¬ (√âÕ¬≈–) Õ¬Ÿà°—∫∫‘¥“¡“√¥“ Õ¬Ÿà°—∫≠“µ‘ Õ¬ŸàÀÕæ—°

™“¬

˭ԧ

67 19.0 (1.29) 20.9 (2.50)

163 19.5 (1.30) 19.8 * (2.65)

17.9 76.2 5.9

39.1* 48.9* 12.0*

56.7 4.5 38.8

53.4 5.3 41.3

( ) = §à“‡∫’ˬ߇∫π¡“µ√∞“π (S.D.) * = ¢âÕ¡Ÿ≈§Ÿà∑’Ë·µ°µà“ßÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (significant difference (p<.05))

∑“ß ∂‘µ‘ ‡™àπ°—π (p<.05) (µ“√“ß∑’Ë 2) °“√®”·π°°≈ÿࡵ—«Õ¬à“ßµ“¡∑’ËÕ¬ŸàÕ“»—¬æ∫ «à“ °≈ÿࡵ—«Õ¬à“ß à«π„À≠àÕ“»—¬Õ¬Ÿà°—∫∫‘¥“¡“√¥“ (√âÕ¬≈– 56.7 ¢Õ߇滙“¬ ·≈–√âÕ¬≈– 53.4 ¢Õß ‡æ»À≠‘ß) √Õß≈ß¡“§◊Õ ÀÕæ—°  à«π∑’ËÕ“»—¬°—∫ ≠“µ‘§àÕπ¢â“ßπâÕ¬ °“√«‘‡§√“–Àå∑“ß ∂‘µ‘æ∫«à“∑’Ë Õ¬ŸàÕ“»—¬¢Õß°≈ÿࡇ滙“¬·≈–À≠‘߉¡à·µ°µà“ß°—π Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (µ“√“ß∑’Ë 2) °“√«‘ ‡ §√“–Àå ª √‘ ¡ “≥‰¢¡— π ∑√“π å ∑’Ë ∫√‘‚¿§®“°∫—π∑÷°æƒµ‘°√√¡°“√∫√‘‚¿§Õ“À“√∑’Ë¡’ °√¥‰¢¡—π∑√“π å„π‡«≈“ 24 ™—Ë«‚¡ß ‡ªìπ‡«≈“ 7 «— 𠵑 ¥ µà Õ °— π æ∫«à “ °≈ÿà ¡ ‡æ»™“¬¡’ §à “ ‡©≈’Ë ¬ ª√‘¡“≥‰¢¡—π∑√“π å∑’Ë∫√‘‚¿§ (1.39±0.67 °√—¡ µàÕ«—π) ¡“°°«à“°≈ÿࡇæ»À≠‘ß (0.96±1.30 °√—¡ µàÕ«—π) Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<.05) ·≈– 96

¡°√“§¡ - ¡’π“§¡ 2555

°√¡Õπ“¡—¬  à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒

‡¡◊Ë Õ ‡ª√’ ¬ ∫‡∑’ ¬ ∫°“√∫√‘ ‚ ¿§§à “ ‡©≈’Ë ¬ ª√‘ ¡ “≥ ‰¢¡—π∑√“π å∑’Ë∫√‘‚¿§„π√–À«à“ß«—π∑’Ë¡“‡√’¬π ·≈– «—πÀ¬ÿ¥ æ∫«à“ ‡æ»™“¬∫√‘‚¿§‰¢¡—π∑√“π å¡“° °«à“‡æ»À≠‘ßÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<.05) °“√»÷°…“§√—Èßπ’È æ∫«à“ ª√‘¡“≥‰¢¡—π∑√“π å  Ÿß ÿ¥∑’Ë∫√‘‚¿§„π«—π¡“‡√’¬π·≈–«—πÀ¬ÿ¥ §◊Õ 8.1 ·≈– 9.2 °√—¡µàÕ«—π„π‡æ»™“¬ ·≈– 6.1 ·≈– 7.7 °√—¡µàÕ«—π„π‡æ»À≠‘ß (µ“√“ß∑’Ë 3) ‡π◊ËÕß®“°Õߧ尓√Õπ“¡—¬‚≈° ·π–π”„Àâ ª√–™“™π∫√‘‚¿§°√¥‰¢¡—π∑√“π å ‰¥â‰¡à‡°‘π√âÕ¬≈– 1 ¢Õßæ≈—ßß“π∑—ÈßÀ¡¥∑’˧«√‰¥â√—∫„π 1 «—π·≈–  ”π—°‚¿™π“°“√ °√¡Õπ“¡—¬ °√–∑√«ß “∏“√≥ ÿ¢ ·π–π”„Àâ«—¬√ÿà𠉥â√—∫æ≈—ßß“π®“°Õ“À“√«—π≈– 2,000 °‘‚≈§“≈Õ√’15 °“√»÷°…“§√—Èßπ’È®÷ß„™âª√‘¡“≥ °√¥‰¢¡—π∑√“π å 2.0 °√—¡µàÕ«—π‡ªìπ‡°≥±å„π


°“√∫√‘‚¿§°√¥‰¢¡—π∑√“π å¢Õß«—¬√ÿàπ‰∑¬°≈ÿà¡Àπ÷Ëß„π°√ÿ߇∑æ¡À“π§√

µ“√“ß∑’Ë 3 ª√‘¡“≥‡©≈’ˬ°√¥‰¢¡—π∑√“π å∑’Ë∫√‘‚¿§®”·π°µ“¡‡æ» (°√—¡/«—π)

ª√‘¡“≥‡©≈’ˬ∑’Ë√—∫ª√–∑“π„π 1  —ª¥“Àå ª√‘¡“≥‡©≈’ˬ∑’Ë√—∫ª√–∑“π„π«—π¡“‡√’¬π ª√‘¡“≥∑’Ë√—∫ª√–∑“π Ÿß ÿ¥„π 1 «—π ª√‘¡“≥‡©≈’ˬ∑’Ë√—∫ª√–∑“π„π«—πÀ¬ÿ¥ ª√‘¡“≥∑’Ë√—∫ª√–∑“π Ÿß ÿ¥„π 1 «—π

™“¬

˭ԧ

1.39 (0.67) 1.31 (1.58) 8.1 1.61 (1.80) 9.2

0.96 * (1.30) 0.87 * (1.22) 6.1 1.14 * (1.15) 7.7

( ) = §à“‡∫’ˬ߇∫π¡“µ√∞“π (S.D.) * = ¢âÕ¡Ÿ≈§Ÿà∑’Ë·µ°µà“ßÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (significant difference (p<.05))

°“√®”·π°°≈ÿà ¡ µ— « Õ¬à “ ߇ªì π °≈ÿà ¡ ∑’Ë ∫ √‘ ‚ ¿§°√¥ ‰¢¡—π∑√“π åÕ¬Ÿà„π‡°≥±å ·≈–¡“°°«à“‡°≥±å∑’Ë ·π–π” º≈°“√®”·π° æ∫«à“ „π°≈ÿà¡∑’Ë∫√‘‚¿§ ‰¢¡—π∑√“π åÕ¬Ÿà„π‡°≥±å∑’Ë·π–π” ¡’®”π«π‡æ» À≠‘ß (√âÕ¬≈– 80.1) ¡“°°«à“‡æ»™“¬ (√âÕ¬≈– 72.3) Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<.05)  à«π„π °≈ÿ¡à ∑’∫Ë √‘‚¿§‰¢¡—π∑√“π å¡“°°«à“‡°≥±å∑·’Ë π–π” ¡’®”π«π‡æ»™“¬√âÕ¬≈– 27.7 ¡“°°«à“‡æ»À≠‘ß ∑’Ë¡’®”π«π‡æ’¬ß√âÕ¬≈– 19.9 Õ¬à“ß¡’π—¬ ”§—≠ ∑“ß ∂‘µ‘ (p<.05) (µ“√“ß∑’Ë 4) °“√«‘‡§√“–À凪√’¬∫‡∑’¬∫§«“¡·µ°µà“ß ¢Õß°“√∫√‘‚¿§°√¥‰¢¡—π∑√“π å„π«—π¡“‡√’¬π ·≈–«—πÀ¬ÿ¥¢Õß°≈ÿࡵ—«Õ¬à“߇滇¥’¬«°—π æ∫«à“ „π°≈ÿ¡à ∑’∫Ë √‘‚¿§‰¢¡—π∑√“π å‰¡à‡°‘π 2.0 °√—¡µàÕ«—π ª√‘¡“≥‰¢¡—π∑√“π å∑’Ë∫√‘‚¿§„π«—π¡“‡√’¬π·≈– «— π À¬ÿ ¥ ·µ°µà “ ß°— π πâ Õ ¬¡“°®π‰¡à ª √“°Øπ— ¬  ”§—≠∑“ß ∂‘µ‘ ·µà„π°≈ÿà¡∑’Ë∫√‘‚¿§‰¢¡—π∑√“π å ¡“°°«à“ 2.0 °√—¡µàÕ«—π ª√‘¡“≥‰¢¡—π∑√“π å∑’Ë ∫√‘‚¿§„π«—π¡“‡√’¬π·≈–«—πÀ¬ÿ¥·µ°µà“ß°—πÕ¬à“ß

¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<.05) (µ“√“ß∑’Ë 4) °“√«‘‡§√“–À姫“¡∂’Ë¢Õß°“√∫√‘‚¿§Õ“À“√ ‰∑¬ ·≈–Õ“À“√µ–«—πµ°∑’Ë¡’ª√‘¡“≥‰¢¡—π∑√“π å  Ÿß ÿ¥ 5 Õ—π¥—∫·√° æ∫«à“ À¡Ÿ∑Õ¥ ‡ªìπÕ“À“√ ‰∑¬∑’¡Ë ‰’ ¢¡—π∑√“π å ßŸ  ÿ¥ §◊Õ 0.36 °√—¡/100 °√—¡ ¡’°≈ÿࡇ滙“¬·≈–‡æ»À≠‘ß ∫√‘‚¿§¥â«¬§«“¡∂’Ë ‡©≈’ˬ 20.6 ·≈– 8.7 §√—ÈßµàÕ —ª¥“Àå  à«π¡—πΩ√—Ëß ‡ âπ∑Õ¥ (French fries) ´÷Ë߇ªìπÕ“À“√µ–«—πµ° ∑’Ë¡’‰¢¡—π∑√“π å Ÿß ÿ¥ §◊Õ 7.7 °√—¡/100 °√—¡ ¡’ °≈ÿ¡à ‡æ»™“¬·≈–‡æ»À≠‘ß ∫√‘‚¿§¥â«¬§«“¡∂’‡Ë ©≈’¬Ë 10.9 ·≈– 5.9 §√—ÈßµàÕ —ª¥“Àå Õ“À“√‰∑¬∑’Ë¡’ §«“¡∂’Ë„π°“√∫√‘‚¿§ Ÿß ÿ¥ §◊Õ ‰°à∑Õ¥ ´÷Ëß¡’ ª√‘¡“≥‰¢¡—π∑√“π å 0.27 °√—¡/100 °√—¡ ¡’°≈ÿà¡ ‡æ»™“¬·≈–‡æ»À≠‘ß ∫√‘‚¿§¥â«¬§«“¡∂’ˇ©≈’ˬ 20.7 ·≈– 27.7 §√—ÈßµàÕ —ª¥“Àå  à«πÕ“À“√µ–«—π µ°∑’Ë¡’§«“¡∂’Ë„π°“√∫√‘‚¿§ Ÿß ÿ¥ §◊Õ ¡—πΩ√—Ëß·ºàπ ∑Õ¥ ´÷ßË ¡’ª√‘¡“≥‰¢¡—π∑√“π å 6.7 °√—¡/100 °√—¡ ¡’°≈ÿࡇ滙“¬·≈–‡æ»À≠‘ß ∫√‘‚¿§¥â«¬§«“¡∂’Ë ‡©≈’ˬ 16.4 ·≈– 14.5 §√—ÈßµàÕ —ª¥“Àå (µ“√“ß∑’Ë 5)

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∫ ∑ «‘ ∑ ¬ “ ° “ √ µ“√“ß∑’Ë 4 √âÕ¬≈–¢Õß°≈ÿࡵ—«Õ¬à“ß®”·π°µ“¡‡°≥±åª√‘¡“≥°√¥‰¢¡—π∑√“π å∑’Ë·π–π”‚¥¬ Õߧ尓√Õπ“¡—¬‚≈°

∑—Èß°≈ÿà¡ ™“¬ À≠‘ß

«—π¡“‡√’¬π 72.3 27.7 73.7 26.3 81.8 18.2

‰¡à‡°‘π 2.0 °√—¡/«—π ¡“°°«à“ 2.0 °√—¡/«—π ‰¡à‡°‘π 2.0 °√—¡/«—π ¡“°°«à“ 2.0 °√—¡/«—π ‰¡à‡°‘π 2.0 °√—¡/«—π ¡“°°«à“ 2.0 °√—¡/«—π

«—πÀ¬ÿ¥ 80.1 19.9 68.7 31.3 * 75.9 24.1*

* = ¢âÕ¡Ÿ≈§Ÿà∑’Ë·µ°µà“ßÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (significant difference (p<.05))

µ“√“ß∑’Ë 5 §«“¡∂’¢Ë Õß°“√∫√‘‚¿§Õ“À“√‰∑¬·≈–Õ“À“√µ–«—πµ°∑’¡Ë ª’ √‘¡“≥‰¢¡—π∑√“π å ßŸ  ÿ¥ 5 Õ—π¥—∫·√° (‡√’¬ß≈”¥—∫µ“¡ª√‘¡“≥‰¢¡—π∑√“π å)

Õ“À“√

Õ“À“√‰∑¬ À¡Ÿ∑Õ¥ ‰°à∑Õ¥ °≈⫬·¢° ª“∑àÕß‚°ã ´“≈“‡ª“∑Õ¥ Õ“À“√µ–«—πµ° ¡—πΩ√—Ë߇ âπ∑Õ¥ ¡—πΩ√—Ëß·ºàπ∑Õ¥ ‚¥π—∑‰ â§√’¡ ·Œ¡‡∫Õ‡°Õ√å‡π◊ÈÕ æ‘´´“

98

¡°√“§¡ - ¡’π“§¡ 2555

ª√‘¡“≥‰¢¡—π∑√“π å (°√—¡/100 °√—¡)

§«“¡∂’Ë¢Õß°“√∫√‘‚¿§ (§√—Èß/ —ª¥“Àå) ™“¬ À≠‘ß

0.36 0.27 0.24 0.20 0.16

20.6 20.7 5.4 2.7 6.9

8.7 27.7 7.3 8.7 10.3

7.7 6.7 0.83 0.23 0.11

10.9 16.4 2.7 13.7 4.1

5.9 14.5 5.9 8.7 4.4

°√¡Õπ“¡—¬  à߇ √‘¡„Àâ§π‰∑¬  ÿ¢¿“楒


°“√∫√‘‚¿§°√¥‰¢¡—π∑√“π å¢Õß«—¬√ÿàπ‰∑¬°≈ÿà¡Àπ÷Ëß„π°√ÿ߇∑æ¡À“π§√

«‘®“√≥å ®“°º≈°“√®”·π°°≈ÿà ¡ µ— « Õ¬à “ ßµ“¡§à “ ¥—™π’¡«≈°“¬®–‡ÀÁπ‰¥â«à“ ‡æ»À≠‘ß´÷Ëß¡’§à“¥—™π’ ¡«≈°“¬Õ¬Ÿ„à π√–¥—∫ºÕ¡ ¡’®”π«π Ÿß∂÷ß√âÕ¬≈– 39.1 „π¢≥–∑’ˇ滙“¬¡’®”π«π‡æ’¬ß√âÕ¬≈– 17.9 ´÷Ëß º≈∑’ˉ¥â„π°“√»÷°…“§√—Èßπ’È Õ¥§≈âÕß°—∫√“¬ß“π °“√«‘®—¬¢Õß Taylor ·≈–§≥–16 ∑’Ë°≈à“««à“ ‡¥Á° «— ¬ √ÿà π ‡æ»À≠‘ ß  à « π„À≠à ¡— ° ®–¡’ πÈ” Àπ— ° µË” °«à “ ‡°≥±åª°µ‘ ‡π◊ËÕß®“°Õ‘∑∏‘æ≈®“° ◊ËÕµà“ßÊ  àߺ≈ „À⇥Á°«—¬√ÿàπ‚¥¬‡©æ“–‡æ»À≠‘ßÕ¥Õ“À“√‡æ◊ËÕ„Àâ ¡’√Ÿª√à“ߺա‡À¡◊Õπ¥“√“¿“æ¬πµ√å π—°√âÕß À√◊Õ π“ß·∫∫∑’˵π™◊Ëπ™Õ∫ ´÷ËßÕ“®∑”„À⇥Á°∫“ߧπÕ¬Ÿà „π¿“«–πÈ”Àπ—°µË”°«à“¡“µ√∞“π (underweight) πÕ°®“°π’È °“√»÷°…“‡°’ˬ«°—∫Õ—πµ√“¬®“°°“√≈¥ πÈ”Àπ—°¢Õß«—¬√ÿàπ æ∫«à“‡¥Á°∑’˧‘¥«à“µ—«‡ÕßÕâ«π®– Õ¥Õ“À“√µàÕ‡π◊ËÕß ®π∫“ߧ√—Èß°àÕ„À⇰‘¥Õ—πµ√“¬ ‡¡◊ËÕ‡¢â“ Ÿà¿“«–‚¿™π“°“√¢“¥·§≈π17 °“√«‘ ‡ §√“–Àå À “ª√‘ ¡ “≥‡©≈’Ë ¬ ¢Õß°√¥ ‰¢¡— π ∑√“π å ∑’Ë ∫ √‘ ‚ ¿§„π‡«≈“ 1  — ª ¥“Àå ¢ Õß °≈ÿà ¡ µ— « Õ¬à “ ß æ∫«à “ ª√‘ ¡ “≥‡©≈’Ë ¬ ¢Õß°√¥ ‰¢¡—π∑√“π å∑’Ë∫√‘‚¿§¢Õß°≈ÿࡇ滙“¬·≈–‡æ» À≠‘ß ‡∑à“°—∫ 1.39±0.67 ·≈– 0.96±1.30 °√—¡ µàÕ«—π ´÷Ë߇ªìπª√‘¡“≥∑’ËπâÕ¬‡¡◊ËÕ‡ª√’¬∫‡∑’¬∫°—∫ À≈“¬ª√–‡∑»∑“ßµ–«—πµ° ·µà¬—ß Ÿß°«à“√“¬ß“π °“√»÷°…“„πª√–‡∑»≠’˪ÿÉπ´÷Ëß∑”°“√«‘‡§√“–Àå°“√ ∫√‘‚¿§°√¥‰¢¡—π∑√“π å¢Õßπ—°»÷°…“¡À“«‘∑¬“≈—¬ ®”π«π 118 §π æ∫«à“ °≈ÿࡇ滙“¬ 57 §π ¡’§à“ 0.39-0.45 °√—¡µàÕ«—π ·≈–°≈ÿà¡À≠‘ß 61 §π ¡’§à“ 0.49-0.73 °√— ¡ µà Õ «— π 18 Õ¬à “ ߉√°Á µ “¡ ·¡â ª√‘¡“≥‡©≈’ˬ¢Õß°√¥‰¢¡—π∑√“π å∑’Ë°≈ÿà¡«—¬√ÿàπ ∫√‘ ‚ ¿§¬— ß ‰¡à ‡ °‘ π ‡°≥±å ∑’Ë Õ ß§å ° “√Õπ“¡— ¬ ‚≈° ·π–π”„Àâª√–™“™π∫√‘‚¿§ ·µà°Á§«√¡’°“√√≥√ß§å „Àâª√–™“°√«—¬√ÿàπ‰¥âµ√–Àπ—°∂÷ßÕ—πµ√“¬¢Õß°“√ ‰¥â √— ∫ °√¥‰¢¡— π ∑√“π å ® “°Õ“À“√¡“°‡°‘ 𠉪

µ‘¥µàÕ°—π‡ªìπ‡«≈“π“π ‡æ√“–®–∑”„À⇰‘¥‚√§ À≈Õ¥‡≈◊Õ¥À—«„® ‚√§°≈â“¡‡π◊ÕÈ À—«„®¢“¥‡≈◊Õ¥ ·≈– ‚√§À≈Õ¥‡≈◊Õ¥·¢Á߇¡◊ËÕ‡¢â“ Ÿà«—¬ºŸâ„À≠à ‚√§¥—ß °≈à “ «‡ªì π ‚√§∑’Ë ¡’ § «“¡√ÿ π ·√ßµ—È ß ·µà ∑”„Àâ ‡ ªì π Õ—¡æƒ°…å Õ—¡æ“µ ®π∂÷߇ ’¬™’«‘µ‰¥â °“√®”·π°°≈ÿࡵ—«Õ¬à“߇ªìπ°≈ÿà¡∑’Ë∫√‘‚¿§ °√¥‰¢¡—π∑√“π åÕ¬Ÿà„π‡°≥±å ·≈–¡“°°«à“‡°≥±å ∑’Ë·π–π” æ∫«à“ ‡æ»À≠‘ß à«π„À≠à®–Õ¬Ÿà„π°≈ÿà¡∑’Ë ∫√‘‚¿§°√¥‰¢¡—π∑√“π å„π‡°≥±å·π–π” ·µà‡æ» ™ “ ¬  à « π „ À ≠à ® – Õ ¬Ÿà „ π ° ≈ÿà ¡ ∑’Ë ∫ √‘ ‚ ¿ § ° √ ¥ ‰¢¡—π∑√“π å Ÿß°«à“‡°≥±å·π–π” πÕ°®“°π’È ‡¡◊ËÕ »÷°…“惵‘°√√¡°“√∫√‘‚¿§‡ª√’¬∫‡∑’¬∫√–À«à“ß «—πÀ¬ÿ¥·≈–«—π¡“‡√’¬π ®–‡ÀÁπ‰¥â«à“ „π«—πÀ¬ÿ¥∑—Èß ‡æ»™“¬·≈–‡æ»À≠‘ß¡’·π«‚πâ¡∑’Ë®–√—∫ª√–∑“π Õ“À“√∑’Ë¡’°√¥‰¢¡—π∑√“π å¡“°°«à“„π«—π¡“‡√’¬π ‚¥¬‡©æ“–°≈ÿà ¡ ∑’Ë ∫ √‘ ‚ ¿§°√¥‰¢¡— π ∑√“π å ¡ “° °«à“‡°≥±å·π–π”Õ¬Ÿà·≈â« «—πÀ¬ÿ¥®–√—∫ª√–∑“π Õ“À“√∑’Ë¡’°√¥‰¢¡—π∑√“π å‡æ‘Ë¡¢÷ÈπÕ¬à“ß¡“°‡¡◊ËÕ ‡ª√’¬∫‡∑’¬∫«—π¡“‡√’¬πÕ¬à“ß™—¥‡®π °“√«‘‡§√“–À凪√’¬∫‡∑’¬∫™π‘¥¢ÕßÕ“À“√ ‰ ∑ ¬ · ≈ – Õ “ À “ √ µ – «— π µ ° ∑’Ë ¡’ ª √‘ ¡ “ ≥ ° √ ¥ ‰¢¡—π∑√“π å Ÿß ÿ¥ 5 Õ—π¥—∫·√° ®–‡ÀÁπ«à“ Õ“À“√ ‰∑¬¡’ ª √‘ ¡ “≥°√¥‰¢¡— π ∑√“π å µË” °«à “ Õ“À“√ µ–«—πµ°¡“° ‡™àπ À¡Ÿ∑Õ¥ ´÷Ëß¡’°√¥‰¢¡—π∑√“π å  Ÿß ÿ¥„π°≈ÿ¡à Õ“À“√‰∑¬ ¡’ª√‘¡“≥‡æ’¬ß 0.36 °√—¡ µàÕ 100 °√—¡ „π¢≥–∑’Ë¡—πΩ√—Ë߇ âπ∑Õ¥´÷Ëß¡’°√¥ ‰¢¡— π ∑√“π å  Ÿ ß  ÿ ¥ „π°≈ÿà ¡ Õ“À“√µ–«— π µ° ¡’ ª√‘¡“≥ Ÿß∂÷ß 7.7 °√—¡µàÕ 100 °√—¡  à«πÕ“À“√ ‰∑¬∑’Ë°≈ÿà¡«—¬√ÿàπ∫√‘‚¿§∫àÕ¬∑’Ë ÿ¥ §◊Õ‰°à∑Õ¥ ¡’ °√¥‰¢¡—π∑√“π å‡æ’¬ß 0.27 °√—¡µàÕ 100 °√—¡„π ¢≥–∑’Ë¡—πΩ√—Ëß·ºàπ∑Õ¥ ´÷Ë߇ªìπÕ“À“√µ–«—πµ°∑’Ë °≈ÿ¡à «—¬√ÿπà ∫√‘‚¿§∫àÕ¬∑’ Ë ¥ÿ ¡’°√¥‰¢¡—π∑√“π å 6.7 °√—¡µàÕ 100 °√—¡ ¥—ßπ—Èπ ∂÷ß·¡â«à“°≈ÿà¡«—¬√ÿàπ ®– √—∫ª√–∑“π‰°à∑Õ¥∫àÕ¬°«à“¡—πΩ√—Ëß·ºàπ∑Õ¥ ·µà°Á

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∫ ∑ «‘ ∑ ¬ “ ° “ √ ®–‰¥â√—∫ª√‘¡“≥‰¢¡—π∑√“π åπâÕ¬°«à“¡“° ®÷ߧ«√ „À⧫“¡√Ÿâ‡°’ˬ«°—∫ª√‘¡“≥‰¢¡—π∑√“π å„πÕ“À“√ µ–«—πµ° ‡æ◊ËÕ„Àâ°≈ÿà¡«—¬√ÿàπ≈¥°“√∫√‘‚¿§Õ“À“√ ‡À≈à “ π’È À √◊ Õ √— ∫ ª√–∑“π„Àâ πâ Õ ¬∑’Ë  ÿ ¥ ‡æ√“– πÕ°®“°®–¡’‰¢¡—π Ÿß·≈â« ∫“ß™π‘¥¬—ß¡’§ÿ≥§à“ ∑“ß‚¿™π“°“√πâÕ¬Õ’°¥â«¬ ‡™àπ ¡—πΩ√—Ëß∑Õ¥ À√◊Õ ‚¥π—∑‰ â§√’¡ ‡ªìπµâπ ·¡â „ πÀ≈“¬ª√–‡∑» ‡™à 𠷧𓥓  À√—∞Õ‡¡√‘°“ ‰¥â°”Àπ¥„Àâ√–∫ÿª√‘¡“≥‰¢¡—π ∑√“π å (Trans Fat) „π©≈“°‚¿™π“°“√19 ·µà ª√–‡∑»‰∑¬ ¬—߉¡à¡’¢âÕ°”Àπ¥¥—ß°≈à“« ¥—ßπ—Èπ ª√–™“™π®÷߉¡àÕ“®∑√“∫‰¥â«à“Õ“À“√∑’Ë∫√‘‚¿§¡’ ª√‘¡“≥‰¢¡—π∑√“π å¡“°πâÕ¬‡æ’¬ß„¥ º≈°“√ «‘®—¬§√—Èßπ’ÈÕ“®· ¥ß„Àâ‡ÀÁπ«à“ «—¬√ÿàπ°≈ÿà¡Àπ÷Ëß„π °√ÿ ß ‡∑æ¡À“π§√¡’ · π«‚πâ ¡ ∑’Ë ® –∫√‘ ‚ ¿§‰¢¡— π ∑√“π å ®”π«π¡“°®“°Õ“À“√ª√–‡¿∑¡— π Ω√—Ë ß ∑Õ¥™π‘ ¥ ·ºà π ´÷Ë ß  à « π„À≠à ‡ ªì π Õ“À“√ ”‡√Á ® √Ÿ ª ∫√√®ÿ´Õß ¥—ßπ—ÈπÀ“°°”Àπ¥„ÀâÕ“À“√ ”‡√Á®√Ÿª ‡À≈à“π’È√–∫ÿª√‘¡“≥‰¢¡—π∑√“π åÕ¬à“ß™—¥‡®π Õ“® ™à«¬„À⺟â∫√‘‚¿§≈¥°“√∫√‘‚¿§Õ“À“√‡À≈à“π’ȉ¥â

 √ÿª «— ¬ √ÿà π °≈ÿà ¡ Àπ÷Ë ß ´÷Ë ß Õ“»— ¬ Õ¬Ÿà „ π°√ÿ ß ‡∑æ ¡À“π§√  à«π„À≠à∫√‘‚¿§°√¥‰¢¡—π∑√“π åÕ¬Ÿà„π ‡°≥±å∑·’Ë π–π”‚¥¬Õߧ尓√Õπ“¡—¬‚≈° §◊Õ ‰¡à‡°‘π 2.0 °√— ¡ µà Õ «— π Õ¬à “ ߉√°Á µ “¡ „π«— π À¬ÿ ¥ ¡’ ®”π«π§π∑’Ë∫√‘‚¿§°√¥ª√‘¡“≥‰¢¡—π∑√“π å Ÿß °«à“‡°≥±å·π–π”¡“°°«à“„π«—π¡“‡√’¬π

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‡Õ° “√Õâ“ßÕ‘ß 1. Fern_ndez-San Juan PM.Trans fatty acids (tFA): sources and intake levels, biological effects and content in commercial Spanish food. Nutr Hosp 2009;24(5):515-20. 2. Ascherio A, Willett WC. Health effects of trans fatty acid. Am J Clin Nutr. 1997; 66(suppl) :S1006S10. 3. π—π∑¬“ ®ß„®‡∑» ¿—∑∏‘√“ ¬‘Ë߇≈‘»√—µπ–°ÿ≈ ªî¬π—π∑å ‡ºà“¡à«ß «“√’∑‘æ¬å æ÷Ëßæ—π∏å. ª√‘¡“≥‰¢¡—π∑√“π å„πÕ“À“√ Õ∫·≈–∑Õ¥. Available from http://nutrition.anamai.moph.go.th/  ◊∫§âπ«—π∑’Ë 19 /10/2009 4. Mensink RPM, Katan MB. Effect of dietary trans fatty acids on high-density and low density lipoprotein cholesterol levels in healthy subjects. N Eng J Med. 1990;323:439-410. 5. Kromhout D, Menotti A, Bloemberg B, et al. Dietary saturated and trans fatty acids and cholesterol and 25-year mortality from coronary heart disease: the Seven Countries Study. Prev Med. 1995;24(3):308-15. 6. Thomas LH, Winter JA, Scott RG. Concentration of 18:1 and 16:1 transunsaturated fatty acids in the adipose body tissue of decedents dying of ischaemic heart disease compared with controls: analysis by gas liquid chromatography. J Epidemiol Community Health. 1983;37(1):16-21.

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7. Siguel EN, Lerman RH.Trans-fatty acid patterns in patients with angiographically documented coronary artery disease. Am J Cardiol. 1993;15;71(11):916-20. 8. Kavanagh K, Jones KL, Sawyer J, Kelley K, Carr JJ, Wagner JD, Rudel LL. Trans fat diet induces abdominal obesity and changes in insulin sensitivity in monkeys. Obesity (Silver Spring). 2007;15(7):1675-84. 9. Lichtenstein AH, Appel LJ, Brands M, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006;114(1):82-96. 10. http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/ FoodLabelingNutrition/ucm053479.htm Page Last Updated 05/19/2009. ◊∫§âπ«—π∑’Ë 12/09/2011 11. World Health Organization. Diet, nutrition and the prevention of chronic disease. Geneva; 2003. (WHO Technical Report Series, 916). 12. Allison DB, Egan SK, Barraj LM, Caughman C, Infante M, Heimbach JT. Estimated intakes of trans fatty and other fatty acids in the US population. J Am Diet Assoc. 1999 Feb;99(2):166-74; quiz 175-6. 13. Hulshof KF, van Erp-Baart MA, Anttolainen M, et al. Intake of fatty acids in western Europe with emphasis on trans fatty acids: the TRANSFAIR Study. Eur J Clin Nutr. 1999 Feb;53(2):14357. 14. Ratnayake WM, L'Abbe MR, Farnworth S, et al. Trans fatty acids: current contents in Canadian foods and estimated intake levels for the Canadian population. J AOAC Int. 2009;92(5):1258-76. 15. §Ÿà¡◊Õ∏ß‚¿™π“°“√ ®—¥∑”‚¥¬ §≥–∑”ß“π®—¥∑”¢âժؑ∫—µ‘°“√°‘πÕ“À“√‡æ◊ËÕ ÿ¢¿“æ∑’Ë¥’¢Õߧπ‰∑¬ °Õß‚¿™π“°“√ °√¡Õπ“¡—¬ °√–∑√«ß “∏“√≥ ÿ¢. °√ÿ߇∑æ¡À“π§√. ‚√ßæ‘¡æåÕߧ尓√ ß‡§√“–Àå∑À“√ºà“π»÷°; 2542. 16. Taylor CB, Sharpe T, Shisslak C, et al. Factors associated with weight concerns in adolescent girls. Int J Eat Disord 1998;24:31-42. 17.  ¡„® «‘ ™— ¬ ¥‘ … ∞. ªí ≠ À“‚¿™π“°“√„π«— ¬ √ÿà π Õ— π µ√“¬®“°°“√≈¥πÈ” Àπ— ° ¢Õß«— ¬ √ÿà π . °‘ π ‡æ◊Ë Õ  ÿ ¢ ¿“æ. °√ÿ߇∑æ¡À“π§√.∫√‘…—∑ª√–¬Ÿ√«ß»åæ√‘π∑嵑Èß ®”°—¥; 2541Àπâ“ 115-118 18. Kawabata T, Shigemitsu S, Adachi N, et al. Intake of trans fatty acid in Japanese university students. J Nutr Sci Vitaminol. 2010;56(3):164-70. 19.  ”π— ° ß“π¡“µ√∞“π ‘ π §â “ ‡°…µ√·≈–Õ“À“√·Àà ß ™“µ‘ Available from:http://www.acfs.go.th/km/ trans_fat_nutrition_labeling_us.php  ◊∫§âπ«—π∑’Ë 12/09/2011 HEALTH

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