Associations Between Lifestyle Factors and Constipation Among Survivors After the Great East Japan Earthquake: A 9-year Follow-up Study.

BACKGROUND: Disaster survivors experience deterioration in lifestyles and an increase in constipation. After the Great East Japan Earthquake in 2011, some survivors were evacuated for a long term, even after moving to temporary housing and public reconstruction housing. However, annual changes in constipation and the association between lifestyles and constipation among the survivors are still unknown. METHODS: Overall, 9,234 survivors aged 18 years or older participated in this 9-year follow-up survey after the disaster. Information about the prevalence of constipation and lifestyle factors (diet, physical activity, and mental health) was collected using a self-reported questionnaire. Their dietary intake was categorized into the following two dietary patterns: prudent (fish and shellfish, soybean products, vegetables, fruits, and dairy products) and meat (meat and eggs). Odds ratios for constipation according to lifestyle factors were calculated using a generalized linear mixed model. RESULTS: In women, the prevalence of constipation was the highest at baseline (8.7%) and remained around 5% afterward. In both men and women, older age, poor mental health, and poor physical activity were significantly associated with higher odds ratios of constipation. Moreover, a lower frequency of meals and a lower prudent dietary score were significantly associated with women's constipation. CONCLUSION: The prevalence of constipation was the highest at baseline and remained around 5% in women. Lifestyle factors, such as poor mental health, physical inactivity, and low frequency of meals were associated with constipation. Our findings suggest continuous support for the survivors with constipation for medium- to long-term after disasters.

[The effect of lunch box provision and mass feeding on energy and nutrient supply at emergency shelters after the Great East Japan Earthquake].

Objectives　Improvement in the quality of meals provided after a disaster is an important issue. We reanalyzed the data obtained from the dietary survey of emergency shelters in Miyagi Prefecture 2 and 3 months after the Great East Japan Earthquake in 2011 to improve the quality of meals at emergency shelters.Methods　We performed a secondary analysis of the data from the dietary survey conducted by the Miyagi prefectural government. Two hundred and forty-one and 49 emergency shelters participated in the 1-day dietary survey in May 2011 and June 2011, respectively. We targeted emergency shelters that had no missing data and provided 3 meals a day. As a result, we targeted 216 emergency shelters in May and 49 in June. We examined the amounts of nutrients (i.e. energy, protein, vitamin B1, vitamin B2, and vitamin C) and food groups (i.e. cereal, potatoes, meat, seafood, eggs, dairy, vegetables, fruits, and fats) in meal portions provided in lunch boxes, rationing, and mass feeding.Results　We found significant differences in the amounts of energy and nutrients in the meals provided at the emergency shelters 2 months after the Great East Japan Earthquake but found no significant differences 3 months after the disaster. The amounts of energy, protein, seafood, and fats were high, and those of vitamins B1 and C, potatoes, and vegetables were low, at the emergency shelters where lunch boxes were provided. The amounts of potatoes, meat, and vegetables were high at the emergency shelters where mass feeding was conducted.Conclusion　Two months after the Great East Japan Earthquake, the provision of lunch boxes at emergency shelters may have increased the amounts of energy, protein, and seafood in meals served to survivors, whereas the amounts of vitamins B1 and C have remained low. These results indicate that providing lunch boxes at an early stage in the event of a disaster can improve energy and protein supply. We believe a combination of lunch box and mass feeding will improve the nutrient supply at emergency shelters.

The effects of changes in the meal providing system on emergency shelter menus following the Great East Japan Earthquake.

Objectives　To assess the improvement of the menus by the meal providing system in emergency shelters, we reanalyzed the data obtained from the dietary survey at emergency shelters in the Miyagi Prefecture one month after the Great East Japan Earthquake in 2011.Methods　We performed secondary use of the dietary survey conducted by the Miyagi prefectural government. In total, 386 emergency shelters participated in the dietary survey of one day in April 2011. We examined the meal providing system (the frequency of meals per day, the frequency of mass feeding for evacuees per day, and menu creators) and the menus at each emergency shelter (260). We classified menus into the following five groups: staple foods, main dishes, side dishes, dairy products, and fruits, and calculated the frequency of provision per day.Results　There was no emergency shelter that provided zero or one meal per day. Compared with the emergency shelters that provided two meals per day, shelters that provided three had a significantly higher provision frequency of staple foods. However, there were no significant differences in the provision frequencies of the other four food groups between the shelters with two or three meals per day. In emergency shelters with a higher frequency of mass feeding for evacuees, the provision frequency of four food groups (staple foods, main dishes, side dishes, and fruits) was significantly higher compared to shelter with a lower frequency of mass feeding for evacuees. Furthermore, in the emergency shelters where dietitians created menus, the provision frequency for two food groups (dairy products and fruits) was significantly higher compared to shelters without dietitians.Conclusion　A high frequency of mass feeding for evacuees resulted in a high provision frequency of main dishes, side dishes, and fruits, which can be limited in supply after a disaster. Also, in the emergency shelters where dietitians created menus, the provision frequency of dairy products and fruits was higher than in those without dietitians. These results suggested that diets in the emergency shelters may be improved by mass feeding and the involvement of dietitians.

Association between Health Practice and Food Stockpiling for Disaster.

In this study investigated the association between health practices and food stockpiling for disasters in predicted areas with a high risk of food shortage due to the Nankai Trough earthquake. A survey was conducted during 18-20 December 2019 using a self-administered web-based questionnaire. In total, 1200 individuals registered with an online survey company participated in the study. The association between health practices and food stockpiling status was analyzed (n = 998). 59.1% of participants had a poor Breslow's seven health practice scores (BHPS), 32.9% had a moderate score, and 8.0% had a good score. Multivariable logistic regression analysis revealed that higher BHPS had a significantly higher prevalence of food stockpiling. Additionally, the interrupted group had the highest percentage of participants with low BHPS. Lower BHPS was significantly associated with interrupted stockpiled in the adjusted models. Among the seven health practices, the odds ratio of the "eating breakfast" practice was high. There was a significant positive association between higher health practice scores and food stockpiling for disasters in areas with a high risk of food shortage due to the predicted earthquake. Particularly, it was clarified that individuals who had fewer good health practices were associated with ending up interrupting food stockpiling.

Association between personality traits and food stockpiling for disaster.

This study investigated the association between personality traits and food stockpiling for disasters in predicted high-risk areas of food shortages due to the Nankai Trough Earthquake. This survey was conducted between December 18 and 20, 2019, using a web-based questionnaire. The participants were 1,200 individuals registered with an online survey company. This study analyzed the association between the Big Five personality traits and food stockpiling status (n = 1192). The Big Five personality traits assess five basic dimensions of personality (i.e., extraversion, conscientiousness, agreeableness, neuroticism, and openness). To measure theses personality traits, we used the Japanese version of the Ten-Item Personality Inventory (TIPI-J). The Mann-Whitney test and a multivariable logistic regression analysis revealed that none of the Big Five personality traits were significantly associated with having or not having stockpile food. However, interestingly, considering the stages of behavior change regarding stockpiling, high extraversion was significantly positively related to initiating stockpiling. Moreover, high neuroticism was significantly positively related to interrupted stockpiling. Therefore, it is crucial to focus on personality traits (especially low extraversion and high neuroticism) to promote food stockpiling for disasters.

Analysis of Necessary Support in the 2011 Great East Japan Earthquake Disaster Area.

Altogether, 1588 dietitians were dispatched from the Japan Dietetic Association (JDA) to a disaster area for the first time on a nationwide scale following the 2011 Great East Japan Earthquake. Various studies have been conducted based on the activity reports, but the support that the disaster area requested was not documented. The purpose of this study is to identify the support that was needed in the disaster area. Therefore, we investigated the necessary support desired by dietitians who lived in the disaster areas. Questionnaires were sent to 1911 dietitians who were members of the JDA and lived in 3 affected prefectures in August 2012. In total, 435 dietitians (22.8%) completed the questionnaire. Among the questions on the questionnaire, we analyzed answers to the open-ended question: "Please write freely about the support that you wanted at the time of the disaster" (n = 332). Using qualitative descriptive analysis, we extracted data from the answers and categorized and labeled them into similar groups. These groups were divided into four categories: (1) "goods," (2) "establishing a system in advance of a large-scale disaster," (3) "information," and (4) "human resources." To provide "goods," "information," and "human resources" to the disaster area smoothly, it is important to plan a "system" in advance of large-scale disasters.