Asia Pac J Clin Nutr 2014;23(2):321-330

321

Short Communication

Stockpiles and food availability in feeding facilities after
the Great East Japan Earthquake
Miho Nozue PhD, RD1, Kazuko Ishikawa-Takata PhD, RD1, Nobuko Sarukura PhD, RD1,
Kazuko Sako RD2, Nobuyo Tsuboyama-Kasaoka PhD, RD1
12

National Institute of Health and Nutrition, Toyama, Shinjuku, Tokyo, Japan
Japan Dietetic Association, Kanda-jinbocho, Chiyoda, Tokyo, Japan
Food stockpiles and methods of ensuring food availability after the Great East Japan Earthquake of March 11,2011 have been studied. Questionnaires were sent to 1911 registered dietitians and general dietitians who weremembers of the Japan Dietetic Association in August 2012. Four hundred thirty-five dietitians (22.8%) completed
the questionnaire about work involved in feeding facilities, types and administration of meals, and food stockpiles.
Methods of ensuring food availability, preparation, and accommodating food for special dietary uses were recorded for the three-day period immediately following the earthquake, and the period from 4 days to one month after the earthquake. Three days after the earthquake, differences in administration of meals at feeding facilities
providing three meals daily, food stockpiles, organization, contactable facilities, and how to contact them for fooditems were assessed. Sixty-nine percent of all feeding facilities in this study had stockpiles of food before theGreat East Japan Earthquake. Administration of meals in feeding facilities and the possibility of contact with cooperative feeding facilities were found to correlate positively with ensuring the availability of food groups. Foodscores were higher in facilities providing three meals daily by direct administration of meals and with accessible
public administrators, cooperative facilities and suppliers, and facilities that were contactable by landline telephone, mobile phone, fax or email. The necessity for natural disaster-readiness through continuous stockpilingfood at feeding facilities is confirmed. Each prospective feeding facility must be required to plan its stockpiles,
their turnover and replaceability to maximise food security in the face of disaster.

Key Words: stockpile, food supply, dietitian, feeding facility, JapanINTRODUCTION
Ensuring access to water and food during a disaster is aserious problem. Several studies showed that deterioration in nutritional status after the earthquake affected thehealth status of diabetic patients and others.1-3 The Japanese government recommends the stockpiling of foodsufficient for a 2-week duration to deal with emergencies
such as the incidence of new strains of influenza or otherdisasters. The stockpile should include a portable gas
stove and easily cooked food that can last for 3 days if
there is a shortage or lack of electricity, gas, or water, or
restricted transportation.4 Most of the feeding facilities
provide three daily meals in the areas where patients andresidents live. Therefore, it is important to ensure foodavailability for residents and users of facilities. Accordingly, the Ministry of Health, Labour and Welfare(MHLW) required administrative dietitians to support
specified food-service facilities, develop a food-supply
system, and enhance food stockpiles in the event of ahealth-care crisis.5 (The 2008 notification was discarded
following enforcement of the 2013 notification by the
MHLW).5,6 Nevertheless, the specific details of thestockpiles have been left to the responsibility of each facility under present circumstances.
Stockpiles of household food from 14 states were reported

in a United States study.7 In Japan, stockpiled food inhouseholds and municipalities of prefectural centers were
investigated.8-10 The Ministry of Education, Culture,
Sports, Science and Technology studied stockpiles atschools.11 However, reports on food stockpiles at hospital
kitchens and facilities for the elderly are scarce.12 Other
studies have investigated food items and groups at evacuation centers and the food they were unable to obtain.13,14
The food provided at hospitals was reported on; however,there are limited reports on ensuring food availability for
their kitchens during emergencies.15
The objective of this study was to explore food stockpiles and supply after emergencies such as an earthquake.
The findings of this study could be used to solve foodstockpiles and nutrition problems in future disasters. A
questionnaire survey was conducted among registered
Corresponding Author: Dr Kazuko Ishikawa-Takata, National Institute of Health and Nutrition Toyama 1-23-1, Shinjuku, Tokyo, 162-8636, Japan.
Tel: 81-03-3203-5721; Fax: 81-03-3202-3278
Email: kazu@nih.go.jp; kazutak@dream.com
Manuscript received 2 September 2013. Initial review completed 18 September 2013. Revision accepted 28 December
2013.
doi: 10.6133/apjcn.2014.23.2.14

322

M Nozue, K Ishikawa-Takata, N Sarukura, K Sako and N Tsuboyama-Kasaoka

dietitians and general dietitians of Iwate, Miyagi, andFukushima prefectures where damage was more serious
in the Great East Japan Earthquake of March 11, 2011.
MATERIALS AND METHODS
Study design
Survey questionnaires were sent to 1911 registered dietitians and general dietitians with the Japan Dietetic Association (JDA) in the Iwate, Miyagi, and Fukushima prefectures in August 2012. Letters were to the same dietitians in October 2012 to remind them to complete thesurvey. The objective of the study and the confidentialityof the data were described in the letters. Return of thequestionnaire implied consent of the dietitians (participants) to participate in the study. The study was reviewed
and approved by the ethics committee of the National
Institute of Health and Nutrition in Japan. Questionnaires
were collected by mail at the end of October 2012.
Questionnaire
The questionnaire was self-administered and included
questions on the work involved in feeding facilities, types
and provision of meals, stockpiles (food, prepared food,
food for special dietary uses such as powdered milk for
infants, and meals for sick people), emergency generators,
and operating kitchens with equipment and facilities
damaged by the earthquake. Questions on food availability, possibility of cooking, organization of kitchen facilities, and ensuring facilities were able to be contacted, andwhat methods were used to contact them were included in
the questionnaire. In a contactable facility, public administrators included the prefectural government and healthcenters. Each question was asked for the period from theearthquake to 3 days after the earthquake, and the periodof 4 days to 1 month (period of 1 month) after the earthquake. Gender and age group at the time of the earthquake were also recorded.
Fifteen food items were used for the analysis of foodavailability and related factors in facilities which were
providing three meals daily.
Statistical analysis
Participants were included in the analysis if they answered questions on types of feeding facilities. Hospitals,
facilities for the elderly, and facilities for the disabledwere included in the group of facilities providing threemeals daily. Schools, nursery schools, and others were
included in the others group. Descriptive statistics andcross-tabulations were used to summarize the characteristics, stockpiles, and ensuring food availability at all facilities, facilities providing three meals daily, and others.
The percentage response to each question was calculatedwith the number of valid responses as the denominator.
Ensuring food availability, preparing food, and food forspecial dietary uses, possibility of cooking, organization,
contactable facilities, and how to contact them were analyzed by all feeding facilities, facilities providing threemeals daily, and others. Dietitians would be trying to use
a variety of foods to provide meals and to meet nutritional
requirements in feeding facilities in ordinary times. In thisstudy, from this viewpoint of ensuring the necessary nutrients by using variety of foods, food scores were used to

examine the meals provided. Food scores were calculated
as total number of 15 food items (water, rice, bread, noodles, potatoes, pulses, nuts and seeds, vegetables, fruits,mushrooms, algae, fishes and shellfishes, meats, eggs anddairy products) that feeding facilities had provided.
The statistical significance of differences in food scores
between providing meals in feeding facilities, stockpilesof food, and contactability at the period of 3 days were
tested by Mann-Whitney U test. Differences between
facilities and electricity/gas damaged by the earthquake
were examined for statistical significance using the chisuare test. A p value of p<0.05 (two-tailed) was considered to be significant. All statistical analysis was performed with SPSS software (version 18.0; IBM SPSS,Tokyo, Japan).
RESULTS
Questionnaires were sent to 1911 dietitians and 435 completed the questionnaire (response rate, 22.8%). Twohundred seventy-eight (63.9%) participants were involvedin feeding facilities at the moment of the earthquake.
Seven (2.5%) answered about multiple feeding facilities
and we could not distinguish between the responses forfacilities in relation to the provision of three meals daily
or other arrangements; therefore these were excluded
from the analysis. Of the study participants, 90.8% were
women. Participants in their 30s made up 28.4% of the
population, 27.7% were in their 40s, and 26.9% were in
their 50s. In facilities providing three meals daily, 50.7%
were hospitals, 41.3% were facilities for the elderly, and8.0% were facilities for the disabled. In other facilities,
58.6% were schools, 29.3% were nursery schools, and12.1% were others (Table 1). Direct administration ofmeals was performed in 49.3% of all feeding facilities.
Food was stockpiled at 69% of all feeding facilities, including 80.3% of facilities providing three meals daily,and 25.5% of other facilities. Food for special dietary
uses was stockpiled at 56.3% of facilities providing threemeals daily and 23.2% of other facilities. Emergency
generators, portable gas stoves, or water were not stockpiled at 9.4% of facilities providing three meals daily. On
the other hand, these items were not stockpiled at 48.3%
of other facilities. Damage at all feeding facilities included 62.3% with some damage of the facilities, 59.8%
lacked a water supply, and 64.2% lacked electricity
and/or gas. In the facilities providing three meals daily,
82.4% of hospitals and 76.1% of facilities for the elderly
had stockpiles of food and 65.7% of hospitals and 48.8%
of facilities for the elderly had stockpiles of food for special dietary uses. Stockpiles at schools included food(6.3%), emergency generators (8.8%), portable gas stoves(11.8%), and water (23.5%).
Responses on ensuring food availability at 3 days and 1
month after the earthquake are shown in Table 2. In all
feeding facilities, 70.5% could ensure water availability,
and 76.5% of facilities providing three meals daily could
ensure water 3 days after the earthquake.
Three days after the earthquake, facilities providing
three meals daily ensured food availability of fishes andshellfishes (47.4%), meats (49.3%) and eggs (46.9%).
One month after the earthquake, these facilities ensured
food availability of fishes and shellfishes (60.6%), meats

Stockpiles and food availability in feeding facilities

323

Table 1. Types of food provision, stockpiles, and damage in facilities after the earthquake

Administration ofmeals

Direct administration
Partly consignment
Completely consignment

Food stockpiles

Yes
No
In stock¶

Food for special
dietary uses

Yes
No
No needEmergency generator
Portable gas stove
Water
None of the above

Other stockpiles‖

Facilities damagedby the earthquake
Equipment damagedby the earthquake‖

DamagedPartly damaged
No damage
Water supply
Electricity/gas
Cooking facility
Cooking machinery
Tableware
Dishwasher
Elevator
There was no damage
above

All feeding
facilities†
n
%
n=270
133
49.3
65
24.1
72
26.7
n=268
185
69.0
37
13.8
46
17.2
n=264
130
49.2
110
41.7
24
9.1
94
34.7
145
53.5
180
66.4
48
17.7
n=244
5
2.0
152
62.3
87
35.7
162
59.8
174
64.2
47
17.3
67
24.7
32
11.8
84
31.0
104
38.4
50
18.5

Facilities providing
three meals daily‡
n
%
n=213
91
42.7
54
25.4
68
31.9
n=213
171
80.3
9
4.2
33
15.5
n=208
117
56.3
78
37.5
13
6.3
87
40.8
128
60.1
157
73.7
20
9.4
n=193
4
2.1
119
61.7
70
36.3
133
62.4
140
65.7
29
13.6
55
25.8
26
12.2
76
35.7
99
46.5
38
17.8

Other facilities§
n

%
n=57

42
11
4

73.7
19.3
7.0
n=55

14
28
13

25.5
50.9
23.6
n=56

13
32
11
7
17
23
28

23.2
57.1
19.6
12.1
29.3
39.7
48.3
n=51

1
33
17
29
34
18
12
6
8
5
12

2.0
64.7
33.3
50.0
58.6
31.0
20.7
10.3
13.8
8.6
20.7

†

All feeding facilities (n=271)
Hospitals, facilities for the elderly, facilities for the disabled (n=213)§
Facilities providing less than two meals daily. Schools, nursery schools, offices, other facilities (n=58)‖
Multiple answered. Denominator of each feeding facility. All feeding facilities: 271, facilities providing three meals daily: 213, otherfacilities: 58.
‡(63.4%) and eggs (63.8%). Availability of dairy productsin facilities providing three meals daily was the lowest
among the food groups with 34.7% at the period of 3 days
and 43.2% at the period of 1 month. In 61.5% of facilities
providing three meals daily, canned food was still available 3 days after the earthquake. Calorie-dense food, concentrated liquid diet, and dietary supplements were major
foods for special dietary uses that were available in all
feeding facilities 3 days and 1 month after the earthquake.
In all feeding facilities, 63.1% ensured food availability
from their suppliers and stores, but 10% were unable toensure a supply of food from anywhere and 14.4% were
not able to cook at 3 days after the earthquake.
In facilities providing three meals daily, 51.2% could
contact their suppliers at 3 days after the earthquake, next,
cooperating facilities (33.8%) and public administrators(30.5%). Direct contact was the best way to contact feeding facilities (45.4% for all feeding facilities and 47.9%
for facilities providing three meals daily) at 3 days after
the earthquake. Landline telephone (70.1% for all feeding
facilities and 71.4% for facilities providing three meals
daily) and mobile phone (58.3% for all feeding facilities
and 59.2% for facilities providing three meals) were themain ways to contact feeding facilities at 1 month after
the earthquake. In the facilities providing three meals
daily, 25.0% of hospitals and 37.5% of facilities for theelderly were in contact with public administrators at 3days after the earthquake. In addition, 25.9% of hospitals
and 43.2% of facilities for the elderly had contact withcooperating facilities at 3 days after the earthquake.
The relationship between providing meals, food stockpiles, contactability, and food scores at 3 days after theearthquake are shown in Table 3. The food scores werehigher in facilities providing three meals daily by direct
administration of meals than in those partly or completely
through consignment (p<0.05).
Subjects who were able to contact public administrators, cooperating facilities, and suppliers had higher foodscores than those who could not (p<0.05). Subjects who
were able to use landline telephones, mobile phones, faxes, and email had higher food scores than those who did
not have access to communication technology (p<0.05).
No significant difference was found in food scores in regard to contactability by facilities damaged by the earthquake. But electricity/gas damaged by the earthquake wasrelated to possible contactability by landline telephone(<0.001) and fax (<0.001).
DISCUSSION
This study examined the food-supply conditions at feeding facilities after the Great East Japan Earthquake andfound that food stockpiles and contactability affected the324

M Nozue, K Ishikawa-Takata, N Sarukura, K Sako and N Tsuboyama-Kasaoka

Table 2. Ensuring food availability and contactability in feeding facilities at 3 days and 1 month after the earthquake

Food groups‖

Food for special
dietry uses‖

†

Water
Rice
Bread
Noodles
Potatoes
PulsesNuts and seeds
Vegetables
FruitsMushrooms
Algae
Fishes and shellfishes
Meats
Eggs
Dairy products
Calorie dense food
Low calorie food
Low protein foodProtein dense food
Low protein, calorie dense food
Concentrated liquid diet
Powdered milk
Solid foodAll feeding facilities†
From the earthquake
4 days to 1
to 3 days after (%)
month (%)
70.5
74.5
67.9
76.4
27.7
48.7
21.4
43.2
42.4
62.0
28.0
48.3
25.1
43.5
55.0
70.1
38.4
60.9
29.5
49.4
32.8
45.0
40.2
57.6
43.2
61.3
41.0
60.9
30.3
42.4
21.4
28.8
6.6
10.7
7.0
11.8
8.5
14.0
5.5
10.3
32.5
47.6
3.7
6.6
2.6
5.9

Facilities providing three meals daily‡
From the earthquake
4 days to 1
to 3 days after (%)
month (%)
76.5
77.0
75.1
81.2
29.1
47.4
23.9
43.2
46.5
63.8
30.0
49.3
26.3
42.3
62.9
73.2
42.7
61.5
33.3
50.7
35.7
45.1
47.4
60.6
49.3
63.4
46.9
63.8
34.7
43.2
27.2
36.2
8.0
13.1
8.9
15.0
10.3
17.4
7.0
13.1
41.3
60.1
1.9
3.8
0.9
2.8

All feeding facilities (n=271)
Hospitals, facilities for the elderly, facilities for the disabled (n=213)§
Facilities providing less than two meals daily. Schools, Nursery schools, Offices, Other facilities (n=58)‖
Multiple answered. Denominator of each feeding facilities. All feeding facilities: 271, facilities providing three meals daily: 213, other facilities: 58.
¶
Prefectural government and health center‡

Other facilities§
From the earthquake
4 days to 1
to 3 days after (%)
month (%)
48.3
65.5
41.4
58.6
22.4
53.4
12.1
43.1
27.6
55.2
20.7
44.8
20.7
48.3
25.9
58.6
22.4
58.6
15.5
44.8
22.4
44.8
13.8
46.6
20.7
53.4
19.0
50.0
13.8
39.7
0.0
1.7
1.7
1.7
0.0
0.0
1.7
1.7
0.0
0.0
0.0
1.7
10.3
17.2
8.6
17.2

Stockpiles and food availability in feeding facilities

325

Table 2. Ensuring food availability and contactability in feeding facilities at 3 days and 1 month after the earthquake (cont.)

Food for special dietaryuses‖

How to ensure food‖Possibility of cooking
Contactable facilities‖†

Lactose free foodAllergy free food
Food for elderly and dysphagia
Low sodium foods
Drink for hydration
Dietary supplement
Enriched rice
None of the above was needed
Suppliers/stores
Public administration
Stockpile of supply alliance
Cooperation facilities
Neighborhood
Volunteer
Couldn't ensure foodPossible
Possible with the assistance
Impossible
Public administrators¶
Cooperating facilities
Suppliers
Prefectural Dietetic Association
Japan Dietetic Association
Council of feeding facilities

All feeding facilities†
From the earthquake
4 days to 1
to 3 days after (%)
month (%)
0.0
1.1
1.5
3.0
15.1
23.2
0.7
3.7
10.7
22.9
23.2
36.2
5.2
6.3
8.9
8.1
63.1
70.1
18.5
31.7
14.8
18.5
9.6
16.6
17.0
15.9
6.3
11.1
10.0
2.2
73.4
74.2
2.6
3.0
14.4
3.7
36.2
44.3
31.7
38.7
47.6
57.6
0.7
6.6
0.0
1.1
2.6
4.8

Facilities providing three meals daily‡
From the earthquake to 3
4 days to 1 monthdays after (%)
(%)
0.0
1.4
0.9
2.3
18.8
29.1
0.9
4.7
12.2
27.7
28.2
44.6
6.1
6.6
4.2
4.7
71.4
75.6
19.7
35.7
17.8
22.1
10.8
20.2
19.2
19.7
7.5
12.7
7.5
0.9
81.7
79.8
2.3
3.3
10.3
1.9
30.5
41.3
33.8
40.8
51.2
59.2
0.9
6.1
0.0
1.4
2.8
4.7

All feeding facilities (n=271)
Hospitals, facilities for the elderly, facilities for the disabled (n=213)§
Facilities providing less than two meals daily. Schools, Nursery schools, Offices, Other facilities (n=58)‖
Multiple answered. Denominator of each feeding facilities. All feeding facilities: 271, facilities providing three meals daily: 213, other facilities: 58.
¶
Prefectural government and health center‡

Other facilities§
From the earthquake
4 days to 1
to 3 days after (%)
month (%)
0.0
0.0
3.4
5.2
1.7
1.7
0.0
0.0
5.2
5.2
5.2
5.2
1.7
5.2
25.9
20.7
32.8
50.0
13.8
17.2
3.4
5.2
5.2
3.4
8.6
1.7
1.7
5.2
19.0
6.9
43.1
53.4
3.4
1.7
29.3
10.3
56.9
55.2
24.1
31.0
34.5
51.7
0.0
8.6
0.0
0.0
1.7
5.2

326

M Nozue, K Ishikawa-Takata, N Sarukura, K Sako and N Tsuboyama-Kasaoka

Table 2. Ensuring food availability and contactability in feeding facilities at 3 days and 1 month after the earthquake (cont.)

Contactable facilities‖

How to contact‖†

Medical institution
OthersDidn't have contact
Landline telephone
Mobile phone
Fax
Email
Internet
Direct contact
None of the above

All feeding facilities†
From the earthquake to
4 days to 1
3 days after (%)
month (%)
2.2
5.5
1.1
2.2
15.1
9.6
39.1
70.1
32.8
58.3
10.3
44.3
10.7
26.9
5.2
24.4
45.4
31.4
8.5
1.1

Facilities providing three meals daily‡
From the earthquake
4 days to 1
to 3 days after (%)
month (%)
2.3
6.6
0.9
2.8
16.0
10.3
40.8
71.4
33.8
59.2
10.8
44.6
10.8
25.4
6.6
23.5
47.9
33.3
7.5
0.9

All feeding facilities (n=271)
Hospitals, facilities for the elderly, facilities for the disabled (n=213)§
Facilities providing less than two meals daily. Schools, Nursery schools, Offices, Other facilities (n=58)‖
Multiple answered. Denominator of each feeding facilities. All feeding facilities: 271, facilities providing three meals daily: 213, other facilities: 58.
¶
Prefectural government and health center‡

Other facilities§
From the earthquake
4 days to 1
to 3 days after (%)
month (%)
1.7
1.7
1.7
0.0
12.1
6.9
32.8
65.5
29.3
55.2
8.6
43.1
10.3
32.8
0.0
27.6
36.2
24.1
12.1
1.7

Stockpiles and food availability in feeding facilities

327

Table 3. Food scores on stockpiles and contactability in facilities that provide three meals daily† at 3 days after theearthquake
Administration of meals

Food stockpiles
Contactability: public
administrators‡
Contactability: cooperating
facilities
Contactability: suppliers
Contactability: landline
telephoneContactability: mobile phone
Contactability: fax
Contactability: email

Direct administration
Partly/completely
consignment
Yes/in stockNo
Possible
Impossible
Possible
Impossible
Possible
Impossible
Possible
Impossible
Possible
Impossible
Possible
Impossible
Possible
Impossible

n
91

Mean
7.5

SD
5.1

Median8.0

25, 75 percentile
2.0, 12.0

122

5.9

4.8

5.0

2.0, 10.0

204
9
65
148
72
141
109
104
87
126
72
141
23
190
23
190

6.7
4.9
7.8
6.1
7.6
6.1
7.9
5.3
8.4
5.4
7.6
6.1
10.7
6.1
8.7
6.3

5.0
4.1
4.9
5.0
5.2
4.9
4.7
5.0
5.2
4.5
4.9
5.0
5.0
4.8
5.0
5.0

6.0
5.0
7.0
5.0
8.0
6.0
8.0
4.0
9.0
4.0
8.0
5.0
13.0
6.0
9.0
6.0

2.0, 11.0
1.5, 8.5
3.5, 12.5
2.0, 10.8
2.0, 12.0
2.0, 10.0
3.5, 12.0
1.0, 10.0
4.0, 13.0
1.0, 9.0
3.0, 11.8
2.0, 11.0
8.0, 15.0
2.0, 10.0
5.0, 13.0
2.0, 11.0

p value
0.030

0.324
0.020
0.040
<0.001<0.001
0.039<0.001
0.034

SD: Standard Deviation
Differences in food scores between category at the period of 3 days were tested by Mann-Whitney U test
Food scores were calculated as total number of 15 food items (water, rice, bread, noodles, potatoes, pulses, nuts and seeds, vegetables,
fruits, mushrooms, algae, fishes and shellfishes, meats, eggs and dairy products) that feeding facilities had provided.
†
Hospitals, facilities for the elderly, facilities for the disabled (n=213)‡
Prefectural government and health center

availability of foods.
The percentage of food stockpiles in this study was
higher than a previous study.12 In all feeding facilities,
69% had food stockpiles before the Great East Japan
Earthquake. A study on feeding facilities in Kagoshima
prefecture in 2004 found that 37% of the study subjects
had food stockpiles.12 Comparing this study and the previous one has limitations because the circumstances
around these study sites and years are different. However,the previous study mentioned that the number of feeding
facilities with stockpiles had increased after the Great
Hanshin-Awaji Earthquake in 1995.12 The present study
was conducted in 2012 and it meant the Niigata-Chūetsu
earthquake (2004) and Niigata Chūetsu-Oki earthquake(2007) were already occurred.
In the present study, schools stockpiled food (6.3%)
and water (23.5%). A nationwide survey which targeted
public and private schools after the Great East Japan
Earthquake conducted by the Ministry of Education, Culture, Sports, Science and Technology reported that
schools stockpiled food (30.2%) and water (33.7%).11
Generally, schools do not provide meals three times daily,
but do play an important role as evacuation centers according to previous disasters.16 Therefore, improving
stockpiles in schools is recommended.
Our findings suggest that dairy products are one of thefood groups that are hard to keep available after a disaster.
In this study, food availability of most food groups wasmore than 60%; however, dairy products were 40% for all
feeding facilities and facilities providing three meals daily
1 month after the earthquake. Dairy products are an essential food source of calcium, of which it is recommended to ingest adequate amounts at developmental stages inwhich bone mass accumulation rates are highest such asadolescence. In this regard, if evacuation is prolonged,
attention should be paid to ensure that food sources ofthis nutrient are available to those who need it most.17
Therefore, measures to ensure dairy products are available must be considered. Food for special dietary uses wasstockpiled by 65.7% of hospitals, which are considered tohave the highest need for them. The average stockpiles offood for special dietary uses at facilities providing threemeals daily was 56.3%. In particular, 60.1% of facilities
providing three meals daily could ensure availability ofconcentrated liquid diet and 36.2% could ensure availability of calorie-dense food. People who need these kinds
of foods experience difficulties substituting other foods
that they can absorb nutrients from thus once stockpilesof these special dietary uses are depleted, other substitutes
must be offered continuously.
The Ministry of Health, Labour and Welfare recommends that the nutritional reference quantities for energy,
protein, vitamin B1, vitamin B2 and vitamin C be adequate for up to 3 months after a disaster.18 But the resultsof food availability in this study demonstrated difficulties
in ensuring sources of protein and vitamins. Therefore
each feeding facility should be required to consider how it
would ensure food stocks to meet reference amounts for
citizens, including patients.
The importance of solidarity was shown in this study.
Providing meals in feeding facilities and being able tocontact cooperating facilities was strongly related to ensuring food groups were available. The operation of anationwide support network between hospitals outside thedisaster area to relieve hospitals in the disaster area
played an important role for the early procurement offood for hospitals after the Great Hanshin-Awaji Earthquake.15 Additionally, this study demonstrated that the328

M Nozue, K Ishikawa-Takata, N Sarukura, K Sako and N Tsuboyama-Kasaoka

use of landline telephones, mobile phones, faxes, andemail made a difference in ensuring food availability. But
facilities where electricity/gas supplies were damaged by
the earthquake were less likely to be contactable by landline telephone or fax. Thus, there is a need to improve
communication methods to enhance cooperation between
facilities and suppliers in the event of a disaster.
In this study, no significant difference was found infood scores between those with food stockpiles and those
without. One of the explanations may be that we did not
ask about the kind of stockpiles. From Table 2, it can beseen that 76.5% could ensure water and 75.1% could ensure rice in facilities which provided three meals daily forthree days after the earthquake. Understandably, this was
problematic where stockpiles comprised only water andrice.
One of the limitations of this study was that only
22.8% of the distributed questionnaires were returned.
However, the return rate was similar to another survey
whose subjects were JDA members.19 This questionnaire
was distributed to registered dietitians who were themembers of the Dietetic Association of one of three prefectures. However, the disaster damage did not occur inthe whole prefecture, and only affected part of the prefecture. Therefore, it is possible that dietitians who did notbelong to the disaster area did not answer the questionnaire.
Another limitation was that we asked the subjects to
identify the food and prepared food that could be kept
available. Accordingly, the foods not chosen were thosethat could not be kept available. However, it is possiblethat foods that were not chosen included foods that were
not necessary to keep available. Food scores were used toassess meal provisions but we could not assess amount offood or nutritional quality, particularly whether it was
fresh or canned. We also could not establish the capacityof the feeding facilities which did or did not receive
evacuees. It is possible that this information would haveaccounted for some of the differences observed. In addition, the availability of registered dietitians in three prefectures and transportation issues could have affected thedifferences in availability and variety of food between
prefectures. Limited sample size meant we could not analyze the intra-prefectural availability of foods.
In conclusion, in the Great East Japan Earthquake, theprovision of meals in feeding facilities and the ability tocommunicate between cooperating facilities were factors
in ensuring food availability and variety. Therefore, eachfacility which may be called upon in a natural disasterneeds to plan for meal provision in feeding facilities
which can communicate with other food support facilities.
Guidelines should be established in ways which promoteand maintain solidarity between facilities.
ACKNOWLEDGMENTS
The authors wish to express their deepest appreciation for the
study participants. The authors sincerely appreciate the effortsof Ms. Sekiko Ito, former chair of the Dietetic Association of
Iwate prefecture, Ms. Fumiko Ishikawa, chair of the Dietetic
Association of Miyagi prefecture, and Ms. Keiko Nakamura,chair of the Dietetic Association of Fukushima prefecture forassistance in preparing the questionnaire and their dedicatedsupport. The authors express their thanks to the JDA for theirfull support. This study was supported by The Japanese Societyof Nutrition and Dietetics Research Grant: Research on supportof nutrition improvement activities after the Great East Japan
Earthquake.
AUTHOR DISCLOSURES
None of the authors had a personal or financial conflict of interest.
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M Nozue, K Ishikawa-Takata, N Sarukura, K Sako and N Tsuboyama-Kasaoka

Short Communication

Stockpiles and food availability in feeding facilities
after the Great East Japan Earthquake
Miho Nozue PhD RD1, Kazuko Ishikawa-Takata PhD RD1, Nobuko Sarukura PhD RD1,
Kazuko Sako RD2, Nobuyo Tsuboyama-Kasaoka PhD RD1
1
2

National Institute of Health and Nutrition, Toyama, Shinjuku, Tokyo, Japan
Japan Dietetic Association, Kanda-jinbocho, Chiyoda, Tokyo, Japan

日本东部大地震后用餐设施库存和食品供应本课题研究了日本 2011 年 3 月 11 日东部大地震之后的食品库存以及确保食品
供应的方法。2012 年 8 月研究人员将问卷发给了日本营养师协会的 1911 名注册营养师和普通营养师。435 名营养师(22.8%)完成了关于食品用具、类型、饭
菜的处理和食品的储存情况的问卷。研究记录了震后三天内以及从震后第四天到一个月之间确保食物供应的方法、食物的准备和一些特殊用途食物的储存。
地震三天后，对供餐点提供每日三餐、食物的储存、组织和管理、以及如何能
联系到供餐点进行了评估。本研究中，在日本东部大地震之前 69%的供餐点
都有食物贮备。供餐点食物的供给和与供餐点有合作关系的食物集团现存食物成正相关。能直接提供一日三餐、公众容易找到、提供有有线电话、手机、传
真和电子邮件的供餐点的评分较高。本研究证实了为自然灾害在供餐点贮备食
物的必要性。必须要求每个未来供餐点规划它的食物贮备、定期更换和可替代性，以最大限度地提高在灾难面前的粮食安全。
关键词：物资储备ヽ食品供应 ヽ营养师 ヽ食品用具 ヽ日本