Asia Pac J Clin Nutr 2014;23(1):159-166

159

Original Article

What factors were important for dietary improvement
in emergency shelters after the Great East Japan
Earthquake?
Nobuyo Tsuboyama-Kasaoka PhD, RD1,2, Yuko Hoshi RD3, Kazue Onodera RD4,
Shoichi Mizuno PhD5, Kazuko Sako RD 2
1

Section of the Dietary Reference Intakes, Department of Nutritional Epidemiology, National Institute of
Health and Nutrition, Tokyo, Japan
2
The Japan Dietetic Association, Tokyo, Japan3
Department of Public Health and Welfare, Miyagi prefectural Government, Miyagi, JapanAt the time of the study; Kesennuma Public Health Center, Miyagi, Japan
4
Department of Health and Welfare, Kesennuma City Office, Miyagi, Japan
5
Center for International Collaboration and Partnership, National Institute of Health and Nutrition, Tokyo,
Japan

The Great East Japan Earthquake of 2011 left many evacuees with insufficient food and emergency shelter. However, there is no evidence concerning the factors affecting dietary circumstances in emergency shelters after disasters. To clarify the factors that influenced the provision of meals, we reanalyzed a data set from a dietary survey
conducted in emergency shelters one month after the Great East Japan Earthquake (2011). Among the 69 sheltersin “city A,” 53 (79.1%) had food shortages. The possibility of cooking in the emergency shelter improved theprovision of meals to evacuees. When comparing emergency shelters with and without cooking equipment, theshelters with cooking equipment provided more meals, as well as more dishes containing grains and vegetables.
When there was a gas supply, the twice per day provision of “balanced” meals (containing grains, vegetables, andmeat/fish) was more frequent than when there was no gas supply. Interestingly, neither the water supply nor theelectricity supply affected the provision of balanced meals. Further, emergency shelters with larger numbers ofevacuees had a lower possibility of cooking and lower availability of gas supply. Our results demonstrate that early improvements to post-disaster meal provision may maintain the health of evacuees. Such improvements could
be achieved by 1) the speedy restoration of the gas supply to enable cooking, and 2) limiting the number of evacuees per emergency shelter.

Key Words: disaster, emergency shelter, gas, cooking, meals

INTRODUCTION
Large-scale natural disasters frequently result in massevacuations. During these evacuations, nutrition care may
be crucial for sustaining the lives of evacuees. However,
little research has been undertaken to investigate the nature of diets in emergency shelters or its effects on evacuees.
Only a few studies have been reported on dietary circumstances and nutrition care after disasters. However,available results suggest that the meals provided at emergency shelters have an important effect on evacuee’s
health and physical condition. For example, immediately
following the 1999 Greek earthquake,1 researchers studied meals provided at two camps and, using the 24-hour
recall method, and found a significant lack in dietary intake for adults (particularly the elderly). After the Great
Hanshin-Awaji Earthquake in Japan, food supply distributed to emergency shelters consisted mainly of carbohydrate-rich foods, such as rice balls, bread, and instantnoodles, to provide energy.2 However, supplies of fresh
food were poor.3 Indeed, a study conducted about twomonths after the Great Hanshin-Awaji Earthquake foundthat lower intake of green vegetables was associated withmore reports of common cold symptoms, coughing,weight loss, gastrointestinal disorders, stress, and irritability.4 This association with health-related complaints was
also found for a lower intake of fish.4 However, we could
find no studies on effective methods for improving meal
Corresponding Author: Dr Nobuyo Tsuboyama-Kasaoka,
Section of the Dietary Reference Intakes, Department of Nutritional Epidemiology, National Institute of Health and Nutrition
1-23-1, Toyama, Shinjuku-ku, Tokyo 162-8636, Japan.
Tel: 81-3-3203-5721; Fax: 81-3-3202-3278
Email: ntsubo@nih.go.jp
Manuscript received 17 June 2013. Initial review completed 8
July 2013. Revision accepted 12 October 2013.
doi: 10.6133/apjcn.2014.23.1.17

160

N Tsuboyama-Kasaoka, Y Hoshi, K Onodera, S Mizuno and K Sakoprovision in emergency shelters. Further, there is also no
evidence on factors that might affect dietary circumstances in emergency shelters.
One recent example of a natural disaster requiring
evacuation was the Great East Japan Earthquake, which
occurred on March 11, 2011. This magnitude 9 earthquake generated an enormous tsunami that resulted in thedestruction of houses, roads, and countless infrastructure.
An estimated 450,000 evacuees were temporarily housedin over 2400 emergency shelters. These evacuees lived
together in the shelters for periods of up to four months ormore.3,5 Although emergency care was the first priority, it
quickly became clear that nutrition care was essential tosustain lives. Three weeks after the earthquake, the Japan
Dietetic Association (JDA) dispatched 1588 volunteer
registered and general dietitians to the affected areas.
Their five-month-long tasks were to support and improvethe essential food supply and provide nutrition care toprotect the lives of nutritionally vulnerable evacuees.6
In the present study, we report dietary supply circumstances at emergency shelters after the Great East Japan
Earthquake. Data were provided by the JDA and our aim
was to elucidate the important factors that influenced theprovision of meals to evacuees.
METHODS
Data source
We analyzed data collected from April 4 (post-quake Day24) to April 5 (Day 25), 2011; the Japan Dietetic Association permitted our use of the data. Data were collectedusing a cross-sectional survey of the all emergency shelters in city “A,” one of the most damaged areas. The survey was conducted as part of a nutrition support programadministered by the Japan Dietetic Association and local
governments. The survey consisted of three components:
1) a questionnaire about conditions in the emergency
shelters (number of evacuees, presence of nutritionallyvulnerable or high risk individuals, possibility of cooking,availability of services for cooking); 2) a questionnaire
about food supplies (eg, excess foods, lack of foods); and3) a dietary record for meals provided. Nutritionally vulnerable individuals were defined as those who needed
nutrition care with a special diet (ie, infants needing formula or a diet of soft foods, elderly persons including
those with aphagia, and individuals with food allergies,
pressure ulcers, or other health conditions). Data about
the availability of services for cooking included information about the availability of electricity, gas, and water.
Gas and electricity were supplied by regular utility services and by portable gas canisters and emergency generators, respectively. Water was supplied by regular utilities(eg, by faucet) and by tank truck and bottled sources.
Data collection
The survey originally included 81 emergency shelters
open to the public as of March 31, 2011 in city A. The
response rate was 100%. However, data from 12 shelters
were excluded because incomplete answers were provided for the dietary record. Thus, we analyzed data from 69
emergency shelters in total. Questionnaires were delivered by teams of two or three dietitians to the food service
managers who were in charge of providing meals in eachof the emergency shelters. The 24-hour recall, one-day
dietary record we used in this study was the dietary menu
as reported by each emergency shelter. Menus for eachmeal were then categorized into six food types: grains(carbohydrate-rich foods), vegetables (vegetable-based
dishes including soup), meat and fish (main protein-baseddish), fruit, and milk or other dairy products. We also
focused on balance of the diet. A diet was defined as“balanced” if two or more meals per day contained grains,vegetables, and meat or fish.
Statistical analyses
Data were analyzed by the size of the shelter (ie, thenumber of evacuees). Shelters were classified into threegroups according to the tertile of the number of evacuees
accommodated: T1 (<25 evacuees), T2 (25–80 evacuees),
and T3 (>80 evacuees). Statistical comparisons among
the emergency shelters were performed using the Trend
test and Fisher’s exact test. The Trend test was used forcomparisons of 2×3 or 2×4 contingency tables for frequency of meal provision or shelter size. Fisher’s exact
test was used for comparisons of 2×2 contingency tables
obtained from all categorical variables. For all tests, thesignificance level was set at p<0.05. Statistical analyses
were performed using the SPSS software, version 16.0
(SPSS® Inc, Chicago, Ill).
Ethical considerations
The present analysis was approved by the institutional
ethics committee of the National Institute of Health andNutrition, Japan (approval number: 20120711-01).
RESULTS
Characteristics of emergency shelters
Included in the survey were 69 emergency shelters, housing a total of 7423 evacuees. The largest shelter housed
1100 evacuees, while the smallest housed only 2 evacuees.
The median was 50 evacuees per shelter.
There were nutritionally vulnerable individuals (n=194)
housed in 24 (34.8%) of the emergency shelters, as shownin Table 1. Among these vulnerable individuals, most fell
into one of three groups: 1) infants, 2) elderly with aphagia, and 3) people with other health conditions (hypertension, diabetes mellitus, and renal disease).
Table 2 shows the adequacy of food distribution fromwarehouse to emergency shelters. Among the 69 emergency shelters, 53 (79.1%) had food shortages and 24(35.8%) had excess food. Notable types of shortage were:milk and dairy products, meat, vegetables, beans, fish,and shellfish. Seasonings (eg, ketchup, mayonnaise, instant stock base, sauces, and pepper) were also reported
as insufficient at eight shelters. Among the excess foods,
cereals were reported in excess at 17 shelters.
Meal provision
As shown in Table 3, in the first month after the earthquake, one emergency shelter still provided a meal only
once daily and four shelters still provided meals only
twice daily. Shelters with the possibility of cooking, both
frequency of meals and provision of grains and vegetables were significantly greater than in shelters with nocooking equipment or access to cooking facilities. Possi-

Dietary improvement after disaster

161

Table 1. Proportion of nutritionally vulnerable individuals in emergency shelters (n=69) after the Great East Japan
Earthquake (2011)

Nutritionally vulnerable individuals

Presence
AbsenceUnknown

All emergency shelters (n=69)
n†
(%)‡
24
(34.8)
42(60.9)
3(4.3)

Number of individuals
194

Infants

Presence
AbsenceUnknown

12
56
1(17.4)(81.2)(1.4)

40

Elderly with aphagia

Presence
AbsenceUnknown

7
57
5(10.1)(82.6)(7.2)

38

Food allergy

Presence
AbsenceUnknown

7
57
5(10.1)(82.6)(7.2)

11

Pressure ulcers

Presence
AbsenceUnknown

7
57
5(10.1)(82.6)(7.2)

20

Other health problem

Presence
AbsenceUnknown

8
58
3(11.6)(84.1)
(4.3)

85

†

n = the number of emergency shelters (total = 69).
Numbers in parentheses indicate percentage of emergency shelters according to type of nutritionally vulnerable individuals.
Note. Column numbers may not sum to 100% due to rounding.
‡

Table 2. Adequacy of food distribution from thewarehouse to emergency shelters (n=67) after theGreat East Japan Earthquake (2011)

Total Food
Food groups§
Cereals
Instant noodle
Sweet buns
Potatoes and starches
Vegetables
FruitsFish and shellfish
Meats
Eggs
Beans
Milk and dairy products
Fats and oils
Seasonings and spices

All emergency shelters(n† = 67)
Shortage
Excessn†(%)‡ n†(%)‡
53(79.1) 24 (35.8)
2
0
0
0
16
5
11
17
7
13
29
2
8

(3.0)
(0.0)
(0.0)
(0.0)
(23.9)(7.5)(16.4)(25.4)(10.4)(19.4)(43.3)(3.0)(11.9)

17
5
11
0
0
0
1
0
0
1
0
0
0

(25.4)(7.5)(16.4)
(0.0)
(0.0)
(0.0)
(1.5)
(0.0)
(0.0)
(1.5)
(0.0)
(0.0)
(0.0)

†

n=number of emergency shelters (total=69). Data for two shelters was missing.
‡Numbers in parentheses indicate percentage of emergency
shelters for each category of food.
§Multiple answers were allowed.

bility of cooking was associated with a significant increase in the provision of meat and fish dishes by Trend
test, but not by Fisher’s exact test. When comparing
emergency shelters according to restoration of services,
the shelters with gas and water supply provided the possibility of cooking whereas restoration of electricity was
not associated with the possibility of cooking (Table 4).
In the case of balanced meals, availability of gas supply

for cooking was associated with a significant increase in
the twice-daily provision of balanced meals (Table 5).
Further, both cooking and availability of gas supply wereassociated with shelter size (Table 6). Emergency shelterswith larger numbers of evacuees had a lower possibilityof cooking and lower availability of gas supply than did
shelters with smaller numbers of evacuees.
DISCUSSION
The present study revealed the generally poor dietarycircumstances in emergency shelters after the Great East
Japan Earthquake and found that the opportunity forcooking and the availability of gas significantly affected
the provision of meals to evacuees. When cooking was
not possible, meal provision tend to be inadequate. Further among the important services, the availability of gas
for cooking was associated with a marked improvement
in an emergency shelter’s ability to provide twice-dailybalanced meals. In fact, some emergency shelters could
not serve food such as instant noodles because of the lackof gas to boil water. Previous studies reported that local
governments generally stockpile not only food but also
cooking utensils.7 However, not many heat sources wereavailable even in local government. In order to improvedietary and nutritional conditions in emergency shelters,
we suggest that it will be necessary to provide a regular
gas utility to shelters as quickly as possible and stockpile
heat sources such as portable gas canisters. Furthermore,
shelter size may be an important factor toward improving
dietary conditions. Early post-disaster improvements inmeal provision were best achieved when the numbers ofevacuees per shelter were lower and by speedy restorationof the gas supply to provide a cooking environment.

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N Tsuboyama-Kasaoka, Y Hoshi, K Onodera, S Mizuno and K Sako

Table 3. Meal provision in emergency shelters by the possibility of cooking (n=69) after the Great East Japan Earthquake
All shelters
Provided frequency/day

Cookingn† (%)‡

Shelters where
possible, n=52n † (%)‡

n=69

Shelters where
impossible, n=17n† (%)‡

p for
trend

p for Fisher’s
exact test

Meals

None
Once
Twice
3 times0 (0.0)1 (1.4)4 (5.8)64 (92.8)

0 (0.0)0 (0.0)1 (1.9)51 (98.1)

0 (0.0)1 (5.9)3 (17.6)
13 (76.5)

0.003

0.012

Grain dishes

None
Once
Twice
3 times0 (0.0)1 (1.4)5 (7.2)63 (91.3)

0 (0.0)0 (0.0)2 (3.8)50 (96.2)

0 (0.0)1 (5.9)3 (17.6)
13 (76.5)

0.009

0.029

Vegetable dishes

None
Once
Twice
3 times

5 (7.2)20 (29.0)
34 (49.3)
10 (14.5)

1 (1.9)14 (26.9)
28 (53.8)
9 (17.3)

4 (23.5)
6 (35.3)
6 (35.3)
1 (5.9)

0.005

0.041

Vegetable dishes(including soup)

None
Once
Twice
3 times

2 (2.9)11 (15.9)
43 (62.3)
13 (18.8)

0 (0.0)9 (17.3)
31 (59.6)
12 (23.1)

2 (11.8)
2 (11.8)
12 (70.6)
1 (5.9)

0.066

0.722

Meat and fish dishes

None
Once
Twice
3 times

5 (7.2)20 (29.0)
34 (49.3)
10 (14.5)

2 (3.8)14 (26.9)
27 (51.9)9 (17.3)

3 (17.6)
6 (35.3)
7 (41.2)
1 (5.9)

0.035

0.146

Fruit

None
Once
Twice
3 times23 (33.3)
37 (53.6)
9 (13.0)0 (0.0)15 (28.8)
29 (55.8)8 (15.4)
0 (0.0)8 (47.1)
8 (47.1)
1 (5.9)0 (0.0)

0.13

0.236

Milk and dairy products

None
Once
Twice
3 times58 (84.1)
11 (15.9)
0 (0.0)0 (0.0)41 (78.8)
11 (21.2)
0 (0.0)0 (0.0)17 (100.0)
0 (0.0)0 (0.0)0 (0.0)0.054†

n = number of emergency shelters (total=69).
Numbers in parentheses indicate percentage of emergency shelters for each meal category and for meal category according to shelter
type.
Note. Column numbers may not sum to 100% due to rounding. The Trend test was used for 2×3 and 2×4 tables. Categorical variables,
frequency of meal provision, and cooking possibility (2×2) were analyzed using Fisher’s exact test. Meals: ≤twice vs 3 times, Graindishes: ≤twice vs 3 times, Vegetable dishes: ≤once vs twice, Meat and fish dishes: ≤once vs twice, Fruits: none vs once, Milk anddairy products: none vs once.
‡

Table 4. The effects of service restoration on the possibility of cooking in emergency shelters (n=69) after the Great
East Japan Earthquake (2011)
Shelters where possiblen†(%)‡

Cooking
Shelters where impossiblen†(%)‡

p for Fisher’s exact test

Water for cooking

Available
Unavailable

493(80.3)(37.5)

125(19.7)(62.5)

0.018

Gas for cooking

Available
Unavailable

520(85.2)(0.0)

98(14.8)(100.0)0.000

Electricity for cooking

Available
Unavailable

33
19(71.7)(82.6)

134(28.3)(17.4)

0.387†

n=the number of emergency shelters (total=69).
Numbers in parentheses indicate percentage of emergency shelters according to service type.

‡Dietary improvement after disaster

163

Table 5. The effects of the possibility of cooking and of service restoration on the provision of balanced meals inemergency shelters (n=69) after the Great East Japan Earthquake
Balanced meal provided
n†
(%)‡
30
(57.7)
6(35.3)

Unbalanced meal provided
n†
(%)‡
22
(42.3)
11(64.7)

p for Fisher’s exact test

Cooking

Possible
Impossible

0.162

Water for cooking

Available
Unavailable

342(55.7)(25.0)

276(44.3)(75.0)

0.140

Gas for cooking

Available
Unavailable

351(57.4)(12.5)

267(42.6)(87.5)

0.024

Electricity for cooking

Available
Unavailable

24
12(52.2)(52.2)

2211(47.8)(47.8)

1.000†

n = the number of emergency shelters (n=69).
Numbers in parentheses indicate the percentage of emergency shelters according to type of service restored and type of meal provided.
Note. Column numbers may not sum to 100% due to rounding.
‡

Table 6. The effects of availability of cooking, service restoration, and balanced meals according to the number of
evacuees in emergency shelters after the Great East Japan Earthquake
Number of evacuees in shelter
T2T3
25-80 evacuees>80 evacuees
n†
(%)‡
n†
(%)‡
19
(36.5)
13(25.0)
6(35.3)
9(52.9)

Cooking

Possible
Impossible

T1<25 evacuees
n†
(%)‡
20
(38.5)
2(11.8)

Water for cooking

Available
Unavailable

193(31.1)(37.5)

223(36.1)(37.5)

202(32.8)(25.0)

0.640

Gas for cooking

Available
Unavailable

220(36.1)(0.0)

23
2(37.7)(25.0)

166(26.2)(75.0)

0.005

Electricity for cooking

Available
Unavailable

157(32.6)(30.4)

1312(28.3)(52.2)

184(39.1)(17.4)

0.341

Balanced meal

Provided
Not provided

148(38.9)(24.2)

1213(33.3)(39.4)

1012(27.8)(36.4)

0.231

p for
trend
0.015

†

n = the number of emergency shelters (total = 69).
Numbers in parentheses indicate percentage of emergency shelters according to cooking, service, and meal categories.
Note. Column numbers may not sum to 100% due to rounding.
‡

Another important reason for inadequate provision ofmeals was shortages of food in the emergency shelters.
Indeed, more than three quarters of the shelters surveyedreported some form of food shortage. Consequently, each
emergency shelter had to decide on its own menus according to the limited food distribution. For example, one
shelter provided a sweet bun and coffee for breakfast, asweet bun and instant noodles for lunch, and fried chicken, cabbage, and instant miso soup for dinner. This isconsistent with previous research showing that foodstockpiles tend to be carbohydrate rich.8 Therefore, meal
provision is likely to be improved both by increasing foodsupply and by the building of balanced food stockpiles.
The current survey also found that there were many
evacuees, particularly the elderly and chronically ill, at
nutritional risk.9 This finding may be related to the finding that after the Great East Japan Earthquake, there weresignificant increases in the occurrence of cardiovascular disease.10 Further, to prevent the deterioration ofhealth conditions such as hypertension,11 a low sodium
diet is necessary but is not freely available in emergency
shelters. Indeed, many food supplies provided after theearthquake were preserved in salt (eg, instant noodles,

retort-packed food, and canned food) suggesting that salt
intake was high in the shelters. Reports published after
the Great Hanshin-Awaji Earthquake also revealed theimportance of managing the diet of diabetic individuals,
given the marked effect that food intake has on blood
sugar levels.12-14 The importance of the quantity of meals
for individuals with diabetes was also reported after the
Noto Peninsula Earthquake in Japan.15 One possible solution is to follow a trend established in the United States,
where individual households are encouraged to store nonperishable foods in case of disaster.16
There were several limitations to the present study.
First, the sample size was relatively small. Second, we
could not investigate data on the portion sizes of themeals provided. This was in part because there were concerns on the support of the evacuees, and therefore tried
to reduce the burden on food service managers. Third, themeal provision data for each emergency shelter was collected for only one day of meal provision. Therefore, ourresults may not reflect typical diet in emergency shelters
because of a lack of data for variations in day-to-day meal
provision. In particular, the types of food arriving fromthe warehouse may differ daily. In addition, the dietary

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N Tsuboyama-Kasaoka, Y Hoshi, K Onodera, S Mizuno and K Sako

intake level of individual evacuees is unknown because
data on food consumption could not reasonably be collected. Furthermore, the present study could not directly
evaluate the effect of improvements in early food supply
on nutritional status of the evacuee population. In theacute phase after a disaster, it would be difficult to obtainthe necessary data.
In conclusion, our analysis suggests early improvements in the provision of meals at emergency shelters
could be achieved by 1) having adequate and balanced
stockpiles of food, 2) speedy restoration of gas supplies tofacilitate cooking, and 3) limiting the number of evacuees
per emergency shelter. Improvements to cooking facilities
could be achieved in part by advance preparation for disasters; therefore, it is hoped that local governments andauthorities will act now and implement such measures toprepare for future disasters.
ACKNOWLEDGEMENTS
The data for this survey were collected with the assistance of theregistered and general dietitians dispatched by the Japan Dietetic Association as volunteers on a disaster relief mission under
the city office. We are indebted to Ms Kana Iwabuchi, Ms
Akina Izumi from Kesennuma City Office, and Mr Chotoku
Saitoh, Mr Kazuhiro Nishimura, Mr Yuichi Ishikawa, and Ms
Shinobu Kaji from the Japan Dietetic Association for their assistance with survey planning and data collection. We are also
grateful to Dr Hidemi Takimoto, Dr Nobuo Nishi, Dr Miho
Nozue, and Dr Megumi Tsubota-Utsugi from the National Institute of Health and Nutrition for their advice regarding data analysis and to Dr Teiji Nakamura, Dr Tatsushi Komatsu, and Dr
Yasuhiro Kido from the Japan Dietetic Association for theirsupport regarding data providing.
AUTHOR DISCLOSURES
None of the authors had any personal or financial conflict ofinterest to declare.
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Dietary improvement after disaster165

Appendix.
Meals and types of food provided according the numbers of evacuees in emergency shelters after the Great East Japan Earthquake.
All shelters

Number of evacuees in shelter
T2,
T3,
25–80 evacuees>80 evacueesn = 25n = 22
n†
(%)‡
n†
(%)‡
0
(0.0)
0
(0.0)
0
(0.0)
1
(4.5)
1
(4.0)
3
(13.6)
24(96.0)
18(81.8)

None
Once
Twice
3 timesn† (%)
0 (0.0)1 (1.4)4 (5.8)64 (92.8)

T1,<25 evacueesn = 22
n†
(%)‡
0
(0.0)
0
(0.0)
0
(0.0)
22
(100.0)Grain dishes

None
Once
Twice
3 times0 (0.0)1 (1.4)5 (7.2)63 (91.3)

0
0
1
21

(0.0)
(0.0)
(4.5)
(95.5)

0
0
1
24

(0.0)
(0.0)
(4.0)
(96.0)

0
1
3
18

(0.0)
(4.5)
(13.6)(81.8)

0.084

Vegetable dishes

None
Once
Twice
3 times

5 (7.2)20 (29.0)
34 (49.3)
10 (14.5)

1
6
10
5

(4.5)
(27.3)(45.5)(22.7)

2
7
12
4

(8.0)
(28.0)(48.0)(16.0)

2
7
12
1

(9.1)
(31.8)(54.5)
(4.5)

0.191

Vegetable dishes(including soup）

None
Once
Twice
3 times

2 (2.9)11 (15.9)
43 (62.3)
13 (18.8)

0
4
11
7

(0.0)
(18.2)(50.0)(31.8)

1
3
16
5

(4.0)
(12.0)(64.0)(20.0)

1
4
16
1

(4.5)
(18.2)(72.7)
(4.5)

0.078

Meat and fish
dishes

None
Once
Twice
3 times

5 (7.2)20 (29.0)
34 (49.3)
10 (14.5)

1
4
13
4

(4.5)
(18.2)(59.1)(18.2)

1
8
12
4

(4.0)
(32.0)(48.0)(16.0)

38
92(13.6)(36.4)(40.9)
(9.1)

0.062

Fruits

None
Once
Twice
3 times23 (33.3)
37 (53.6)
9 (13.0)0 (0.0)8
122
0(36.4)(54.5)
(9.1)
(0.0)

6
15
4
0

(24.0)(60.0)(16.0)
(0.0)

9
10
3
0

(40.9)(45.5)(13.6)
(0.0)

1.000

Milk and dairy
products

None
Once
Twice
3 times58 (84.1)
11 (15.9)
0 (0.0)0 (0.0)18
4
0
0(81.8)(18.2)
(0.0)
(0.0)

20
5
0
0

(80.0)(20.0)
(0.0)
(0.0)

20
2
0
0

(90.9)
(9.1)
(0.0)
(0.0)

0.605§

Provided frequency/day

Meals

†

n = 69 †n = the number of emergency shelters (total = 69).
Numbers in parentheses indicate percentage of emergency shelters according to frequency of meal and food provided.
Note. Column numbers may not sum to 100% due to rounding.
§This 2×2 table was analyzed by Fisher’s exact test.
‡

p for
trend
0.023

166

N Tsuboyama-Kasaoka, Y Hoshi, K Onodera, S Mizuno and K Sako

Original Article

What factors were important for dietary improvement
in emergency shelters after the Great East Japan
Earthquake?
Nobuyo Tsuboyama-Kasaoka PhD, RD1,2, Yuko Hoshi RD3, Kazue Onodera RD4,
Shoichi Mizuno PhD5, Kazuko Sako RD 2
1

Section of the Dietary Reference Intakes, Department of Nutritional Epidemiology, National Institute of
Health and Nutrition, Tokyo, Japan
2
The Japan Dietetic Association, Tokyo, Japan3
Department of Public Health and Welfare, Miyagi prefectural Government, Miyagi, JapanAt the time of the study; Kesennuma Public Health Center, Miyagi, Japan
4
Department of Health and Welfare, Kesennuma City Office, Miyagi, Japan
5
Center for International Collaboration and Partnership, National Institute of Health and Nutrition, Tokyo,
Japan

東日本大地震後緊急避難所飲食改善有哪些重要因子？
在 2011 年的東日本大地震後，許多災民沒有足夠的食物和緊急避難所。然而，關於災難後在緊急避難所中影響飲食情況的因素目前並無確證。為澄清影響餐食供應的因素，重新分析在東日本大地震一個月後，於緊急避難所進
行的膳食調查資料。在 A 城市中有 69 間避難所，其中 53 間(79.1%)有糧食短
缺的問題。在緊急避難所烹調的可能性，提升膳食供應給避難者。比較有或無烹調設備之緊急避難所，有烹調設備者可以提供較多餐點，及較多包含穀物和蔬菜的菜餚。有天然氣供應的避難所，每天提供兩次“均衡”餐點(包含穀物、蔬菜和肉或魚)的頻率高於沒有天然氣者。特別的是，不論供水或電力供應狀況都不影響提供均衡餐食。再者，多數緊急避難所的難民有較少的烹調
機會及較低的天然氣供應可獲性。本研究結果顯示，即早改善災難後餐食供
應可維持災民的健康。下列舉措可促成這種改善：(1)迅速恢復天然氣供應以提供烹調；(2)限制每個緊急避難所的災民人數。
關鍵詞：災難、緊急避難所、天然氣、烹調、餐點