title: Evacuation after the Great East Japan Earthquake was associated with poor dietary intake: The Fukushima Health Management Survey.
abstract: BACKGROUND
  Few studies have investigated the relationship between living arrangements and dietary intake among evacuees after disasters.
  
  
  OBJECTIVE
  To 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.
  
  
  METHODS
  73,433 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.
  
  
  RESULTS
  Modified 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan. Electronic address: zhangw09@fmu.ac.jp.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, School of Medicine, Fukushima Medical University, 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.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Abe
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kamiya
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Japan and Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Public Health, School of Medicine, Fukushima Medical University, 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, Fukushima, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Ohtsuru
authors.affiliation: Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan; Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan.
authors.forename: Maeda
authors.initials: M
authors.lastname: Masaharu
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: Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan; 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, School of Medicine, Fukushima Medical University, 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: Michiko
authors.initials: M
authors.lastname: Yuuki
authors.affiliation: Department of Epidemiology, School of Medicine, Fukushima Medical University, 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: 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, School of Medicine, Fukushima Medical University, Fukushima, Japan; Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Nakano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004032:Diet / Q000706:statistics & numerical data*; D004190:Disasters; D055866:Earthquakes; D060447:Emergency Shelter / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Dietary intake; Great East Japan earthquake; Living arrangements