Skip to main content
SpringerLink
Log in

Post-Disaster Mental Health and Dietary Patterns among Older Survivors of an Earthquake and Tsunami

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Research suggests that cardiometabolic disease risks are elevated among survivors of natural disasters, possibly mediated by changes in diet. Using the Brief Dietary History Questionnaire, we examined (1) dietary patterns among older survivors of the 2011 Great East Japan Earthquake and Tsunami, and (2) the contribution of posttraumatic stress symptoms (PTSS)/depressive symptoms, as well as relocation to temporary housing on dietary patterns and (3) gender differences in the associations.

Design, Setting and Participants

Data came from a prospective cohort study of 1,375 survivors aged 65–89 years (44.6% male).

Measurements

PTSS/depression onset was evaluated in 2013, 2.5 years after the disaster. Dietary data was collected with a self-administered brief-type diet history questionnaire in 2020. A principal component analysis identified three posterior dietary patterns.

Results

Diet 1 consisted of high intake of vegetables, soy products, and fruits; Diet 2 consisted of carbohydrate-rich foods and snacks/sweets; Diet 3 consisted of high intake of alcoholic beverages, meat, and seafood. Least-squares linear regression revealed that individuals with PTSS/depression were less likely to exhibit Diet 1, while individuals with PTSS were more likely to exhibit Diet 2&3. Especially, males who had depression showed an unhealthy dietary pattern. Those who have lived in a trailer-style temporary housing reported less consumption of Diet 3.

Conclusion

Survivors of disaster with symptoms of mental illness tended to exhibit less healthy dietary patterns after 9 years. Diet varied by type of post-disaster mental illness, gender, and current social circumstances. We lacked pre-disaster BDHQ data, which is a limitation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Bazoukis G, Tse G, Naka KK, et al. Impact of major earthquakes on the incidence of acute coronary syndromes — A systematic review of the literature. Hellenic J Cardiol. 2018;59(5):262–267. doi: https://doi.org/10.1016/j.hjc.2018.05.005

    Article  PubMed  Google Scholar 

  2. Ghazanchaei E, Khorasani-Zavareh D, Aghazadeh-Attari J, Mohebbi I. Identifying and Describing Impact of Disasters on Non-Communicable Diseases: A Systematic Review. Iran J Public Health. 2021;50(6):1143–1155. doi: https://doi.org/10.18502/ijph.v50i6.6413

    PubMed  PubMed Central  Google Scholar 

  3. Shiba K, Hikichi H, Aida J, Kondo K, Kawachi I. Long-Term Associations Between Disaster Experiences and Cardiometabolic Risk: A Natural Experiment From the 2011 Great East Japan Earthquake and Tsunami. American Journal of Epidemiology. 2019;188(6):1109–1119. doi: https://doi.org/10.1093/aje/kwz065

    Article  PubMed  PubMed Central  Google Scholar 

  4. Armenian HK, Melkonian AK, Hovanesian AP. Long term mortality and morbidity related to degree of damage following the 1998 earthquake in Armenia. Am J Epidemiol. 1998;148(11):1077–1084. doi: https://doi.org/10.1093/oxfordjournals.aje.a009585

    Article  CAS  PubMed  Google Scholar 

  5. Nakagawa I, Nakamura K, Oyama M, et al. Long-term effects of the Niigata-Chuetsu earthquake in Japan on acute myocardial infarction mortality: an analysis of death certificate data. Heart. 2009;95(24):2009–2013. doi: https://doi.org/10.1136/hrt.2009.174201

    Article  CAS  PubMed  Google Scholar 

  6. Rubeis VD, Lee J, Anwer MS, et al. Impact of disasters, including pandemics, on cardiometabolic outcomes across the life-course: a systematic review. BMJ Open. 2021;11(5):e047152. doi: https://doi.org/10.1136/bmjopen-2020-047152

    Article  PubMed  PubMed Central  Google Scholar 

  7. Babaie J, Pashaei Asl Y, Naghipour B, Faridaalaee G. Cardiovascular Diseases in Natural Disasters; a Systematic Review. Arch Acad Emerg Med. 2021;9(1):e36. doi: https://doi.org/10.22037/aaem.v9i1.1208

    PubMed  PubMed Central  Google Scholar 

  8. Ohira T, Nakano H, Nagai M, et al. Changes in Cardiovascular Risk Factors After the Great East Japan Earthquake: A Review of the Comprehensive Health Check in the Fukushima Health Management Survey. Asia Pac J Public Health. 2017;29(2_suppl):47S–55S. doi: https://doi.org/10.1177/1010539517695436

    Article  PubMed  Google Scholar 

  9. Hall KS, Hoerster KD, Yancy WS Jr. Post-Traumatic Stress Disorder, Physical Activity, and Eating Behaviors. Epidemiologic Reviews. 2015;37(1):103–115. doi: https://doi.org/10.1093/epirev/mxu011

    Article  PubMed  Google Scholar 

  10. Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters: a systematic review. Psychol Med. 2008;38(4):467–480. doi: https://doi.org/10.1017/S0033291707001353

    Article  CAS  PubMed  Google Scholar 

  11. Beaglehole B, Mulder RT, Frampton CM, Boden JM, Newton-Howes G, Bell CJ. Psychological distress and psychiatric disorder after natural disasters: systematic review and meta-analysis. The British Journal of Psychiatry. 2018;213(6):716–722. doi: https://doi.org/10.1192/bjp.2018.210

    Article  PubMed  Google Scholar 

  12. van den Berk-Clark C, Secrest S, Walls J, et al. Association between Posttraumatic Stress Disorder and lack of exercise, poor diet, obesity and co-occuring smoking: A Systematic Review and Meta-analysis. Health Psychol. 2018;37(5):407–416. doi: https://doi.org/10.1037/hea0000593

    Article  PubMed  PubMed Central  Google Scholar 

  13. Flórez KR, Dubowitz T, Ghosh-Dastidar MB, Beckman R, Collins RL. Associations between depressive symptomatology, diet, and body mass index among participants in the supplemental nutrition assistance program. J Acad Nutr Diet. 2015;115(7):1102–1108. doi: https://doi.org/10.1016/j.jand.2015.01.001

    Article  PubMed  PubMed Central  Google Scholar 

  14. Eng PM, Kawachi I, Fitzmaurice G, Rimm EB. Effects of marital transitions on changes in dietary and other health behaviours in US male health professionals. J Epidemiol Community Health. 2005;59(1):56–62. doi: https://doi.org/10.1136/jech.2004.020073

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lee S, Cho E, Grodstein F, Kawachi I, Hu FB, Colditz GA. Effects of marital transitions on changes in dietary and other health behaviours in US women. Int J Epidemiol. 2005;34(1):69–78. doi: https://doi.org/10.1093/ije/dyh258

    Article  PubMed  Google Scholar 

  16. Vesnaver E, Keller HH, Sutherland O, Maitland SB, Locher JL. Food Behavior Change in Late-Life Widowhood: A Two-Stage Process. Appetite. 2015;95:399–407. doi: https://doi.org/10.1016/j.appet.2015.07.027

    Article  PubMed  PubMed Central  Google Scholar 

  17. Middle-Aged Japanese Men and Their Expectations of Homemade Meals. nippon, com. Published July 29, 2019. Accessed February 23, 2022. https://www.nippon.com/en/japan-data/h00499/middle-aged-japanese-men-and-their-expectations-of-homemade-meals.html

  18. Hikichi H, Aida J, Kondo K, Tsuboya T, Kawachi I. Residential relocation and obesity after a natural disaster: A natural experiment from the 2011 Japan Earthquake and Tsunami. Sci Rep. 2019;9(1):1–11. doi: https://doi.org/10.1038/s41598-018-36906-y

    Article  CAS  Google Scholar 

  19. Nishi N, Yoshimura E, Ishikawa-Takata K, et al. Relationship of Living Conditions With Dietary Patterns Among Survivors of the Great East Japan Earthquake. Journal of Epidemiology. 2013;23(5):376–381. doi: https://doi.org/10.2188/jea.JE20130025

    Article  PubMed  Google Scholar 

  20. Uemura M, Ohira T, Yasumura S, et al. 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. BMJ Open. 2016;6(7):e011534. doi: https://doi.org/10.1136/bmjopen-2016-011534

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kondo K, Rosenberg M, World Health Organization. Advancing Universal Health Coverage through Knowledge Translation for Healthy Ageing: Lessons Learnt from the Japan Gerontological Evaluation Study. World Health Organization; 2018. Accessed April 9, 2021. https://apps.who.int/iris/handle/10665/279010

  22. Hikichi H, Aida J, Tsuboya T, Kondo K, Kawachi I. Can Community Social Cohesion Prevent Posttraumatic Stress Disorder in the Aftermath of a Disaster? A Natural Experiment From the 2011 Tohoku Earthquake and Tsunami. Am J Epidemiol. 2016;183(10):902–910. doi: https://doi.org/10.1093/aje/kwv335

    Article  PubMed  PubMed Central  Google Scholar 

  23. Dietary Reference Intakes for Japanese 2010: Energy. Accessed May 4, 2022. https://www.jstage.jst.go.jp/article/jnsv/59/Supplement/59_S26/_article/-char/ja/

  24. Kobayashi S, Asakura K, Suga H, Sasaki S. High protein intake is associated with low prevalence of frailty among old Japanese women: a multicenter cross-sectional study. Nutr J. 2013;12:164. doi: https://doi.org/10.1186/1475-2891-12-164

    Article  PubMed  PubMed Central  Google Scholar 

  25. Fujii S, Kato H, Maeda K. A Simple Interview-Format Screening Measure for Disaster Mental Health: An Instrument Newly Developed after the 1995 Great Hanshin Earthquake in Japan- The Screening Questionnaire for Disaster Mental.; 2007.

  26. Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologjst: The Journal of Aging and Mental Health. 1986;5(1–2): 165–173. doi: https://doi.org/10.1300/J018v05n01_09

    Google Scholar 

  27. Niino N. A Japanese translation of the Geriatric Depression Scale. Clin Gerontol. 1991;10:85–87.

    Google Scholar 

  28. Sugishita K, Sugishita M, Hemmi I, Asada T, Tanigawa T. A Validity and Reliability Study of the Japanese Version of the Geriatric Depression Scale 15 (GDS-15-J). Clin Gerontol. 2017;40(4):233–240. doi: https://doi.org/10.1080/07317115.2016.1199452

    Article  PubMed  Google Scholar 

  29. Nyunt MSZ, Fones C, Niti M, Ng TP. Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging Ment Health. 2009;13(3):376–382. doi: https://doi.org/10.1080/13607860902861027

    Article  PubMed  Google Scholar 

  30. Lyness JM, Noel TK, Cox C, King DA, Conwell Y, Caine ED. Screening for depression in elderly primary care patients. A comparison of the Center for Epidemiologic Studies-Depression Scale and the Geriatric Depression Scale. Arch Intern Med. 1997;157(4):449–454.

    Article  CAS  PubMed  Google Scholar 

  31. Sasaki S, Yanagibori R, Amano K. Self-administered diet history questionnaire developed for health education: a relative validation of the test-version by comparison with 3-day diet record in women. J Epidemiol. 1998;8(4):203–215. doi: https://doi.org/10.2188/jea.8.203

    Article  CAS  PubMed  Google Scholar 

  32. Kobayashi S, Murakami K, Sasaki S, et al. Comparison of relative validity of food group intakes estimated by comprehensive and brief-type self-administered diet history questionnaires against 16 d dietary records in Japanese adults. Public Health Nutr. 2011;14(7): 1200–1211. doi: https://doi.org/10.1017/S1368980011000504

    Article  PubMed  Google Scholar 

  33. Kobayashi S, Honda S, Murakami K, et al. Both comprehensive and brief self-administered diet history questionnaires satisfactorily rank nutrient intakes in Japanese adults. J Epidemiol. 2012;22(2): 151–159. doi: https://doi.org/10.2188/jea.je20110075

    Article  PubMed  PubMed Central  Google Scholar 

  34. Yatsuya H, Ohwaki A, Tamakoshi K, et al. Reproducibility and validity of a simple checklist-type questionnaire for food intake and dietary behavior. J Epidemiol. 2003;13(5):235–245. doi: https://doi.org/10.2188/jea.13.235

    Article  PubMed  Google Scholar 

  35. Akter S, Nanri A, Pham NM, Kurotani K, Mizoue T. Dietary patterns and metabolic syndrome in a Japanese working population. Nutrition & Metabolism. 2013;10(1):30. doi: https://doi.org/10.1186/1743-7075-10-30

    Article  CAS  Google Scholar 

  36. Koyano W, Shibata H, Nakazato K, Haga H, Suyama Y. Measurement of competence: reliability and validity of the TMIG Index of Competence. Arch Gerontol Geriatr. 1991;13(2):103–116. doi: https://doi.org/10.1016/0167-4943(91)90053-s

    Article  CAS  PubMed  Google Scholar 

  37. van den Hoonaard DK. Experiences of Living Alone: Widows’ and Widowers’ Perspectives. Housing Studies. 2009;24(6):737–753. doi: https://doi.org/10.1080/02673030903203015

    Article  Google Scholar 

  38. Sterne JAC, White IR, Carlin JB, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393. doi: https://doi.org/10.1136/bmj.b2393

    Article  PubMed  PubMed Central  Google Scholar 

  39. Browne J, Morey MC, Beckham JC, et al. Diet quality and exercise in older veterans with PTSD: a pilot study. Transl Behav Med. 2021;11(12):2116–2122. doi: https://doi.org/10.1093/tbm/ibab116

    Article  PubMed  PubMed Central  Google Scholar 

  40. Talbot LS, Maguen S, Epel ES, Metzler TJ, Neylan TC. Posttraumatic Stress Disorder Is Associated With Emotional Eating. Journal of Traumatic Stress. 2013;26(4):521–525. doi: https://doi.org/10.1002/jts.21824

    Article  PubMed  Google Scholar 

  41. Zellner DA, Loaiza S, Gonzalez Z, et al. Food selection changes under stress. Physiol Behav. 2006;87(4):789–793. doi: https://doi.org/10.1016/j.physbeh.2006.01.014

    Article  CAS  PubMed  Google Scholar 

  42. Debell F, Fear NT, Head M, et al. A systematic review of the comorbidity between PTSD and alcohol misuse. Soc Psychiatry Psychiatr Epidemiol. 2014;49(9): 1401–1425. doi: https://doi.org/10.1007/s00127-014-0855-7

    Article  PubMed  Google Scholar 

  43. Kim Y, Roberts AL, Rimm EB, et al. Posttraumatic stress disorder and changes in diet quality over 20 years among US women. Psychol Med. 2021;51(2):310–319. doi: https://doi.org/10.1017/S0033291719003246

    Article  PubMed  Google Scholar 

  44. Edmondson D, von Känel R. Posttraumatic Stress Disorder and Cardiovascular Disease. Lancet Psychiatry. 2017;4(4):320–329. doi: https://doi.org/10.1016/S2215-0366(16)30377-7

    Article  PubMed  PubMed Central  Google Scholar 

  45. Hardy DS, Garvin JT, Xu H. Carbohydrate quality, glycemic index, glycemic load and cardiometabolic risks in the US, Europe and Asia: A dose-response metaanalysis. Nutrition, Metabolism and Cardiovascular Diseases. 2020;30(6):853–871. doi: https://doi.org/10.1016/j.numecd.2019.12.050

    Article  CAS  PubMed  Google Scholar 

  46. Suzuki T, Miyaki K, Tsutsumi A, et al. Japanese dietary pattern consistently relates to low depressive symptoms and it is modified by job strain and worksite supports. J Affect Disord. 2013;150(2):490–498. doi: https://doi.org/10.1016/j.jad.2013.04.044

    Article  PubMed  Google Scholar 

  47. Elstgeest LEM, Visser M, Penninx BWJH, Colpo M, Bandinelli S, Brouwer IA. Bidirectional associations between food groups and depressive symptoms: longitudinal findings from the Invecchiare in Chianti (InCHIANTI) study. British Journal of Nutrition. 2019;121(4):439–450. doi: https://doi.org/10.1017/S0007114518003203

    Article  CAS  PubMed  Google Scholar 

  48. Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J. A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. The American Journal of Clinical Nutrition. 2014;99(1):181–197. doi: https://doi.org/10.3945/ajcn.113.069880

    Article  CAS  PubMed  Google Scholar 

  49. Jacka FN, Cherbuin N, Anstey KJ, Butterworth P. Does reverse causality explain the relationship between diet and depression? Journal of Affective Disorders. 2015;175:248–250. doi: https://doi.org/10.1016/j.jad.2015.01.007

    Article  PubMed  Google Scholar 

  50. Payne ME, Steck SE, George RR, Steffens DC. Fruit, Vegetable, and Antioxidant Intakes Are Lower in Older Adults with Depression. Journal of the Academy of Nutrition and Dietetics. 2012;112(12):2022–2027. doi: https://doi.org/10.1016/j.jand.2012.08.026

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Nozue M, Nishi N, Tsubota-Utsugi M, et al. Combined associations of physical activity and dietary intake with health status among survivors of the Great East Japan Earthquake. Asia Pac J Clin Nutr. 2017;26(3):556–560. doi: https://doi.org/10.6133/apjcn.042016.08

    PubMed  Google Scholar 

  52. Shiba K, Aida J, Kondo K, et al. Mediation of the relationship between home loss and worsened cardiometabolic profiles of older disaster survivors by post-disaster relocation: A natural experiment from the Great East Japan earthquake and tsunami. Health & Place. 2020;66:102456. doi: https://doi.org/10.1016/j.healthplace.2020.102456

    Article  Google Scholar 

  53. Tsubota-Utsugi M, Yonekura Y, Tanno K, et al. Association between health risks and frailty in relation to the degree of housing damage among elderly survivors of the great East Japan earthquake. BMC Geriatr. 2018;18(1):133. doi: https://doi.org/10.1186/s12877-018-0828-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

None reported.

Author information

Authors and Affiliations

  1. Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave., Boston, MA, 02115, USA

    Aki Yazawa, S. S. Okuzono & I. Kawachi

  2. Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan

    Aki Yazawa

  3. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA

    K. Shiba

  4. Division of Public Health, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan

    H. Hikichi

  5. Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

    J. Aida

  6. Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan

    K. Kondo

  7. Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan

    K. Kondo

  8. Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan

    S. Sasaki

Authors
  1. Aki Yazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Shiba
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Hikichi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. S. Okuzono
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Aida
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K. Kondo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Sasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. I. Kawachi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aki Yazawa.

Ethics declarations

Conflicts of interest: None.

Ethical standards: The study was approved by the Human Subjects Committee of the Harvard T.H. Chan School of Public Health (CR-23143-09), and the Institutional Review Boards of Chiba University (protocol #3442), and Tokyo Medical & Dental University (D2021-025).

Additional information

Financial support: This study used data from JAGES (the Japan Gerontological Evaluation Study). This study was supported by a grant from the National Institutes of Health (R01 AG042463), Japan Society for the Promotion of Science (JSPS) (KAKENHI Grant Number JP22390400, JP22592327, JP24390469, JP15H04781, JP15H01972, JP16H05556, JP19H03860, JP21J01171), Health Labour Sciences Research Grant (H28-Choju-Ippan-002), Japan Agency for Medical Research and Development (AMED) (JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP21lk0310073, JP21dk0110037), Open Innovation Platform with Enterprises, Research Institute and Academia (OPERA, JPMJOP1831) from the Japan Science and Technology (JST), a grant from Innovative Research Program on Suicide Countermeasures (1–4), a grant from Sasakawa Sports Foundation, a grant from Japan Health Promotion & Fitness Foundation, a grant from Chiba Foundation for Health Promotion & Disease Prevention, the 8020 Research Grant for fiscal 2019 from the 8020 Promotion Foundation (adopted number: 19-2-06), grants from Welfare and the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology (29–42, 30–22, 20–19, 21–20), a grant from Meiji, Obirin University, and Niimi University (1915010). AY is financially supported by JSPS Research Fellowship for Young Scientists.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yazawa, A., Shiba, K., Hikichi, H. et al. Post-Disaster Mental Health and Dietary Patterns among Older Survivors of an Earthquake and Tsunami. J Nutr Health Aging 27, 124–133 (2023). https://doi.org/10.1007/s12603-023-1887-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-023-1887-z

Key words

Search

Navigation