Evacuation after the Great East Japan Earthquake was associated with poor dietary intake: The Fukushima Health Management Survey

Abstract

BackgroundFew studies have investigated the relationship between living arrangements and dietary intake among evacuees after disasters.ObjectivesTo examine the relationship between living arrangements and dietary intake using the data of a large-scale cohort survey of evacuees after the Great East Japan Earthquake in 2011.Methods73,433 residents in evacuation zones responded to the Fukushima Health Management Survey questionnaire. Subjects were excluded if they did not report their living conditions or were missing more than three pieces of information about dietary intake. The data of 52,314 subjects (23,149 men and 29,165 women ≥15 years old) were used for the analyses. Evacuees' living arrangements were characterized into three categories: evacuation shelters or temporary housing, rental houses or apartments, or a relative's home or their own home. Dietary intake was characterized in terms of grains, fruits and vegetables, meat, soybean products, dairy products, and fish. Daily consumption of the third quartile (Q3) or higher for each food group was defined as ‘high consumption’. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were estimated using modified Poisson regression analyses.ResultsModified Poisson regression analyses showed that, compared with respondents living in a relative's home or their own home, the PRs and 95% CIs for the people living in rental apartments of high consumption of fruits and vegetables (non-juice), meat, soybean products, and dairy products were 0.69 (95% CI, 0.61–0.77), 0.82 (95% CI, 0.73–0.91), 0.89 (95% CI, 0.83–0.94), and 0.83 (95% CI, 0.74–0.93) respectively. The corresponding PRs and 95% CIs for people living in evacuation shelters or temporary housing were 0.83 (95% CI, 0.78–0.88), 0.90 (95% CI, 0.86–0.95), 0.94 (95% CI, 0.91–0.97), and 0.91 (95% CI, 0.86–0.96) for high consumption of fruits and vegetables (non-juice), meat, soybean products, and dairy products, respectively.ConclusionThe present study suggests that, after the earthquake, living in non-home conditions was associated with poor dietary intake of fruits and vegetables (non-juice), meat, soybean products, and dairy products, suggesting the need for early improvements in the provision of balanced meals among evacuees living in non-home conditions.

Associations between Dietary Patterns and Cardiometabolic Risks in Japan: A Cross-Sectional Study from the Fukushima Health Management Survey, 2011–2015

“…We analyzed those aged ≥16 years who underwent at least one wave of FFQ diet assessment in 2011, 2012, or 2013 and underwent a health checkup in 2014 or 2015. For those who did not answer some dietary questions (13.0% missed one and 4.4% missed two questions in the 2014 dataset, while 13.2% missed one and 4.4% missed two questions in the 2015 dataset), we replaced the missing values by using the median value of frequency for that food item by survey year and sex [20]. Finally, we enrolled 15,409 participants in 2014 and 14,999 participants in 2015 with dietary and health checkup data into this study ( Figure S1 in Supplementary Materials).…”

“…Finally, we enrolled 15,409 participants in 2014 and 14,999 participants in 2015 with dietary and health checkup data into this study ( Figure S1 in Supplementary Materials). For the frequency of dietary intake of each food group, we used the daily midpoint for the frequency category, for example, we assessed '3-4 times/week' as 0.5 times/day [20].…”

“…With regard to the covariates at the baseline for multivariable adjustment, we selected the first available value of a variable if an individual had participated in more than two diet surveys between 2011 and 2013. We considered the potential confounding factors mainly based on the previous publications of FHMS [4,20]. We classified the education status into elementary, junior high, high school, vocational university, and university and above; smoking history into never, former, and current; and alcohol consumption into never, occasional, and regular.…”

“…We also grouped physical activity into none, 1 time/week, 2-4 times/week, and every day and resident places post-earthquake into living in a shelter or temporary house, an apartment or rental house, and at relatives' or in one's own house. We measured depression using the Japanese version of the Kessler Psychological Distress Scale (K6), with higher scores signifying a worse mental health status (range: 0-24), grouped as low (K6 < 13) or high (K6 ≥ 13) [20].…”

Relationship between death attitude and risk perception of radiation

“…The analyses indicated that Iitate employees tended to fear death and reported less purpose in their lives compared to Tokyo residents. Evacuation zone residents, including Iitate employees, were seriously affected by the GEJE, FDNP, and resulting social/personal confusion from lifestyle changes such as evacuation(Hasegawa et al, 2015;Zhang et al, 2017). This fact may explain the differences in DAs.…”