title: Association between psychological distress and dietary intake among evacuees after the Great East Japan Earthquake in a cross-sectional study: the Fukushima Health Management Survey.
abstract: Psychological distress is generally associated with poor dietary intake, but this has never been investigated among residents after a major disaster. We attempted to reveal the associations between dietary intake and non-specific mental health distress as well as traumatic symptoms among evacuees after the Great East Japan Earthquake of 2011.
  
  
  
  In this cross-sectional analysis of 63 047 evacuees (27 901 men, 35 146 women) who responded to The Fukushima Health Management Survey in 2012, non-specific mental health distress was assessed using the Kessler-6 (K6) scale, while traumatic symptoms were evaluated using the Post-traumatic Stress Disorder (PTSD) Checklist-Stressor-Specific Version (PCL-S). The outcome was 'low frequency'-meaning a daily consumption in the 25th centile or less according to the food frequency questionnaire (FFQ)-of 19 targeted food items. Logistic regression analysis was used to estimate ORs and 95% CIs adjusted for demographic, lifestyle-related and disaster-related factors.
  
  
  
  Of the participants, 14.7% suffered non-specific mental health distress, and 21.2% exhibited traumatic symptoms. Multivariable adjusted logistic regression analysis showed that the former were likely to have a low intake frequency of certain foods, such as rice and bread, fish, meat, vegetables or fruit (non-juice), soya bean products, milk, and yogurt or lactobacillus drinks; the latter were also likely to have a low intake frequency of certain foods, including rice and bread, fish, meat, vegetables (non-juice), milk and yogurt or lactobacillus drinks, but conversely consumed vegetable and fruit juices more often. These associations between dietary intake and non-specific mental health distress, as well as traumatic symptoms, were predominantly observed in women.
  
  
  
  Psychological distress after the Great East Japan Earthquake among evacuees was associated with a low intake frequency of certain foods, and the association was predominantly observed in women.
authors.affiliation: Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Uemura
authors.affiliation: Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ohira
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Otsuru
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Maeda
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Harigane
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Horikoshi
authors.affiliation: National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Hirooki
authors.initials: H
authors.lastname: Yabe
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Nagai
authors.affiliation: Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Nakano
authors.affiliation: Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Hirosaki
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Abe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004032:Diet; D004190:Disasters; D055866:Earthquakes; D004435:Eating / Q000523:psychology*; D060447:Emergency Shelter; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D062406:Fukushima Nuclear Accident; D006306:Health Surveys; D006798:Housing; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: DIET; EPIDEMIOLOGY; GREAT EAST JAPAN EARTHQUAKE; MENTAL HEALTH