Association between evacuation and becoming overweight after the Great East Japan Earthquake: a 7-year follow-up of the Fukushima Health Management Survey

M Nagao; K Okazaki; T Ohira; H Nakano; F Hayashi; M Shimabukuro; A Sakai; M Hosoya; J J Kazama; A Takahashi; M Maeda; H Yabe; H Ohto; K Kamiya; S Yasumura

doi:10.1016/j.puhe.2024.04.029

Association between evacuation and becoming overweight after the Great East Japan Earthquake: a 7-year follow-up of the Fukushima Health Management Survey

Public Health. 2024 Jul:232:170-177. doi: 10.1016/j.puhe.2024.04.029. Epub 2024 May 23.

Authors

M Nagao¹, K Okazaki², T Ohira³, H Nakano³, F Hayashi³, M Shimabukuro⁴, A Sakai⁵, M Hosoya⁶, J J Kazama⁷, A Takahashi⁸, M Maeda⁹, H Yabe¹⁰, H Ohto¹¹, K Kamiya¹², S Yasumura¹³

Affiliations

¹ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan. Electronic address: nagaom@fmu.ac.jp.
² Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan; Department of Physical Therapy, Fukushima Medical University School of Health Sciences, Fukushima, Japan.
³ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁴ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Diabetes, Endocrinology and Metabolism, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁵ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁶ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁷ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁸ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan.
⁹ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan.
¹⁰ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Mind and Brain Medicine, Fukushima Medical University, Fukushima, Japan.
¹¹ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.
¹² Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Radiation Effects Research Foundation, Hiroshima, Japan.
¹³ Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan; Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan.

PMID: 38788493
DOI: 10.1016/j.puhe.2024.04.029

Abstract

Objectives: Disaster evacuation increases the risk of becoming overweight or obese owing to lifestyle changes and psychosocial factors. This study evaluated the effect of evacuation on becoming overweight during a 7-year follow-up among residents of Fukushima Prefecture during the Great East Japan Earthquake.

Study design: This was a prospective cohort study.

Methods: We analysed data collected from 18,977 non-overweight Japanese participants who completed the 'Comprehensive Health Checkup Program' and 'Mental Health and Lifestyle Survey', as part of the Fukushima Health Management Survey, between July 2011 and November 2012. An evacuation was defined as the moving out of residents of municipalities designated as an evacuation zone by the government or having a self-reported experience of moving into shelters or temporary housing. Follow-up examinations were conducted in March 2018 to identify patients who became overweight. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using a Cox proportional hazards regression model.

Results: Among 15,875 participants (6091 men and 9784 women; mean age 63.0 ± 11.1 years) who received follow-up examination (mean follow-up, 4.29 years), 2042 (856 men and 1186 women) became overweight. Age-, baseline body mass index-, lifestyle-, and psychosocial status-adjusted HRs (95% CIs) for becoming overweight after evacuation were 1.44 (1.24-1.66) for men and 1.66 (1.47-1.89) for women.

Conclusion: Evacuation was associated with the risk of becoming overweight 7 years after the disaster. Thus, maintaining physical activity, healthy diet, and sleep quality and removing barriers to healthy behaviour caused by disasters, including anxiety concerning radiation, may prevent this health risk among evacuees.

Keywords: Earthquake; Evacuation; Nuclear accident; Overweight; Psychosocial factors; Risk factors.

MeSH terms

Aged
Body Mass Index
Disasters
Earthquakes*
Female
Follow-Up Studies
Fukushima Nuclear Accident
Health Surveys
Humans
Japan / epidemiology
Life Style
Male
Middle Aged
Overweight* / epidemiology
Prospective Studies
Risk Factors