It’s official – it’s September and we are in the height of the Atlantic hurricane season. Hurricane Florence is poised to be a very dangerous storm for East Coast residents while West Coast residents are still recovering from devastating forest fires. It’s important that we try to prepare ahead of time, as much as possible, for storms and other natural disasters and the damage and anxiety they bring with them. One thing we can do to help ourselves get through these events with our health is make sure our nutrition stays on point even when the rain is pouring, the wind is whipping and the power goes out.

Close-up of empty snack shelf. Credit: Cunaplus M. Faba

If you don’t plan ahead, you might not find many options in the grocery store before a storm. If preparing last minute, grab what you can in unsalted cans of vegetables and no-sugar-added cans of fruit. Credit: Cunaplus M. Faba.

Learning from Hurricane Maria

Aida Nancy Sisco is a Registered Dietitian based in Isabela, a town in northwest Puerto Rico. She has 8 years of experience practicing in the field of nutrition and dietetics, in both a clinical setting and in a community and wellness setting. She is the President of NutriSector, which specializes in developing evidence-based, personalized nutrition strategies for patients with and at risk for chronic diseases.

Over the past year, Aida has been helping Puerto Rico residents affected by Hurricane Maria with their nutritional needs. Many residents are struggling with finances following this “monster storm.” Part of the guidance that Aida provides is busting the myth that eating healthy has to be expensive and helping people learn to cook more balanced meals with the resources available. She has been working in an outpatient clinic in Isabela, Puerto Rico to help lower income individuals manage their nutritional needs.

Hurricane Maria devastated Puerto Rico in 2017. It left many residents with absolutely no forms of communication. “You didn’t even know what was going on in your own town,” Aida said. Hurricane Maria is regarded as being the worst natural disaster on record to affect Dominica and Puerto Rico. It brought with it 175 mile per hour winds and catastrophic flooding.

In helping at an outpatient clinic following the storm, Aida says that she realized how unprepared people were for how long they would be out of power and fresh food.

“I quickly realized that I needed to learn what people did have in their pantry and educate them on how best to store, prepare and use this food,” Aida said.

Aida helps with relief efforts.

For example, Aida found herself educating people on how to decrease their sodium intake at a time that they were relying on canned and dried foods, how to properly filter and treat their water, and how to eat balanced meals that would provide high levels of nutrients and fiber to sustain and satiate without exacerbating chronic health conditions such as hypertension and diabetes.

In Puerto Rico, six of the 10 leading causes of death are related to chronic diseases and nutrition, including diabetes. Following a natural disaster like Hurricane Maria, people may not have regular access to medications they need, such as medications for hypertension and insulin for diabetes management. In such cases, nutrition can play an important role in either exacerbating or helping to manage symptoms.

“Here, people love savory foods,” Aida said. “We use lots of condiments that have a lot of sodium.”

In the aftermath of a hurricane, however, residents can find themselves consuming abnormally high levels of sodium. Aida told residents, for example, that if they had cans of corned beef they wanted to prepare a meal with, they shouldn’t also use highly salted canned foods such as tomato sauce. “With a canned or salted meat, just boil some potatoes to go with it, or prepare rice without oil or salt,” Aida advises.

MREs(Meals-Ready-to-Eat) and other disaster relief food items can also contain massive amounts of salt and lots of calories without substantial fiber content. Beef jerky, crackers, chocolate, potato chips… these meals often have high levels of animal fat, carbs and sodium with little fiber content.

“When you think about it, these are some of the worst things someone can eat when they have a chronic condition,” Aida said. “They are going to make inflammatory processes in your body worse.”

In addition to uncontrolled diabetes exacerbated by inflammatory diets, Aida found that many Puerto Ricans were suffering from leptospirosis, a bacterial infection that spreads from infected animals to humans through contaminated soil and water. Residents were using stream water in mountainous areas and assuming it was safe, but the hurricane had disrupted the ecosystem and caused once safe water sources to become contaminated.

Aida has learned from her experience with Hurricane Maria that people often underestimate the power of nature and overly rely on government and other institutions to help in times of need. Puerto Ricans, just like most of us when hurricanes are barreling towards us, aren’t prepared for months without power, communication, clean water and fresh food.

FEMA recently updated their disaster planning recommendations such that any individual should have food supplies in storage to last them for at least 10 days following a natural disaster.

“It’s imperative to know that preparing for a natural disaster involves work ahead of time, ideally not days before the event,” Aida said.

More than three months after Hurricane Maria struck, an area resident collects water from a pipe bringing untreated water from the mountainside just outside town. Essential services remain at a fraction of their pre-storm capacities throughout the island. Utuado, Puerto Rico – Dec. 14, 2017. Credit: Vichinterlang.

Plan Ahead for When the Worst Happens

With hurricane season upon us, there are things you can do to prepare. Perhaps most important, reach out. Get in contact with your neighbors and create a community pantry – share information about your collective resources and make emergency plans.

If you don’t have a hurricane barreling towards you at the moment, plan ahead by stocking up your food supplies. If you have a gas stove, you might even be able to continue cooking when your power is out (just be careful that none of your gas lines are compromised from storm damage, otherwise you might need to turn your gas off. Keep a carbon monoxide detector with batteries handy).

If you are in the possible path of Hurricane Florence this week, prepare as best you can by creating a food menu of at least three different meals (at least breakfast, lunch and dinner), and three snacks. This might end up being a time of natural caloric restriction, so you want to be prepared with balanced meals combining multiple different food groups. Each of your planned meals should combine at least three different food groups, and snacks should combine two. For example, a lunch could combine rice, legumes and canned  green beans. A breakfast could combine oatmeal, unsalted almonds and raisins. A snack could combine bread or wheat crackers, carrots and homemade hummus – chickpeas, onions, olive oil, garlic whipped or mashed together if you don’t have electricity.

“Stock up and cook only what you are going to eat so that your leftovers don’t go bad,” Aida said. Your meal leftovers should be thrown out after four hours on the countertop if you don’t have power.

Here are some items that should be on your grocery list heading into a hurricane or other natural disaster:

Water. You’ll need a gallon of clean water per day per person in your home. Bottled water is best. If you are having trouble finding bottled water at the store ahead of a storm, you might even try your local boating supply store for a large drinking container than you can fill up at your house with clean water ahead of time. You can even fill your bathtubs before a storm so that you can still flush your toilets and don’t expend drinking water.

Starches and Whole Grains. Focus on whole grains that keep on the shelf. You can stock up on dry pasta, starchy vegetables such as potatoes, high fiber dry cereal (at least 3 grams per serving), high fiber and low sodium crackers and oats. Do look at the amount of sugar in the grains and cereals that you purchase – try to keep the sugar content below 10 grams of sugar in a serving.

“You are looking for foods that will provide high levels of satiety without lots of sugar and salt,” Aida said.

You can make homemade hummus easily with chickpeas, garlic, olive oil and paprika. It's fiber-rich and anti-inflammatory. Credit: 49'F this morning..feels, Flickr.com.
You can make homemade hummus easily with chickpeas, garlic, olive oil and paprika. It’s fiber-rich and anti-inflammatory. Credit: 49’F this morning..feels, Flickr.com.

Plant-based Protein. Focus on beans, pulses (peas, chickpeas, lentils) and legumes, which have high levels of plant-based protein as well as fiber and vitamins. If you are going for canned legumes or animal proteins like tuna, look for items canned in water instead of oil, ideally in low-sodium water. Unsalted nuts and nut butters (try almonds) are also great disaster supply foods that aren’t inflammatory and contain protein, fat, fiber and other important nutrients.

Vegetables and Fruits. Yes, you can eat vegetables in the wake of natural disasters! They might be canned, but you should have supplies to be able to eat 1-2 cups of vegetables every day. You can stock up on unsalted canned vegetables. Corn, carrots, cabbage and celery are also vegetables you can purchase ahead of a storm that will do well in the absence of power for refrigeration.

For fruits, stock up on things like peaches, pineapple, pears, etc. canned in their own juice (no added sugars), and single serving boxes of 100% fruit juice. It’s also important to think ahead in terms of food preparation and storage – if you don’t have power, large containers of canned fruit, meats, etc. will likely spoil before you can finish them. Go for single serving fruit cups and other smaller cans of food if possible. You can also stock up on dried fruit like raisins, apricots, etc., but avoid sugary and salty trail mixes.

You should have enough fruits and vegetable supplies to be able to eat a half cup of vegetables and a half cup of fruit per meal. A serving of fruit can look like a half cup of canned fruit, a 4oz individual fruit cup, or 2 tablespoons of dried fruit.

If you aren’t able to eat the daily recommended servings of fruits and vegetables during a time of natural disaster, you might consider at least taking a multivitamin during this time.

Combine dry or canned lentils with carrots, celery and herbs, all foods that keep well when you don't have power. Cook on a gas or camping stove. Credit: Ella Olsson, Flickr.com.
Combine dry or canned lentils with carrots, celery and herbs, all foods that keep well when you don’t have power. Cook on a gas or camping stove. Credit: Ella Olsson, Flickr.com.

Dry Herbs and Spices. Oregano, pepper, Italian herbs, garlic – dry herbs and spices are a great purchase because they can help you flavor your food without adding salt at a time when you might be on clean water rations following major flooding from a hurricane, for example.

Powdered Milk. You can still have dairy for your cereals and cooking during and after the storm – just purchase powdered milk that you can mix with water, individual serving unrefrigerated cartons of milk, or soy or cashew milk with no added sugar.

Leave the highly processed and junk food and chips at the grocery store. Especially if you suffer from a chronic disease such as diabetes, these foods aren’t going to help you, and will likely lead you to overeat. A natural disaster is already stressful enough – try to avoid stressing your body with inflammatory, high sugar and high fat junk foods.

“You aren’t going to eat just one potato chip,” Aida said.

Medications. Try to stock up on your medications before a storm or natural disaster if at all possible and if you have enough warning. Always carry your medications on you in the wake of a natural disaster, especially things like an EpiPen if you have food allergies.

“As most adults are on one or more prescription meds, it’s particularly important to establish a reserve of medications and to consider all meds and supplements when planning, including possible emergency substitutions, how that might affect dietary choices, and vice versa,” says Jeff Rubin, Emergency Manager at Tualatin Valley Fire & Rescue. “This is easily one of the most important individual preparedness steps – having even basic healthcare access disrupted, whether outpatient procedures like dialysis, or loss of meds, is a huge factor in post-disaster death and injury.”

Jeff also suggests alternatives to MREs. “My Own Meals offers meal pouches similar in use to MRE entrees (heat and eat, or eat cold), but with various combinations of vegetarian, gluten-, soy-, dairy-, egg-, and peanut-free options and a caloric load similar to a healthy frozen entrée (200-350 kcal).” Contact Jeff for questions about disaster preparedness.

More information:

Coast Guard Petty Officer 2nd Class Kenneth Krowel drops a box of MRE’s to locals from a Coast Guard MH-65 Dolphin helicopter Tuesday, October 3, 2017, near Utuado, Puerto Rico. The locals were stranded after Hurricane Maria by washed out roads and mudslides. U.S. Coast Guard photo by Petty Officer 3rd Class Eric D. Woodall.

Food Safety During and After Natural Disaster

Food safety is another critical component of healthy living post-disaster.

“After a storm or other natural disaster, we have to be very careful about how we manage, store and prepare our foods, to avoid getting sick,” Aida said.

Be mindful of the following food safety tips:

Wash food cans in soapy water before opening. Especially if your food has been in storage for a long time, you don’t know what has been crawling on these cans or who has handled them.

Check expiration dates. Don’t open or buy cans that are dented, rusted or swollen, even if they are half price. They could contain spoiled food and deadly levels of harmful bacteria.

If you lose power, your freezer, if closed, should keep food safe for 48 hours. To maximize this time, stock your freezer with zip-lock bags of water (they will turn into ice) before the storm and pack food tightly together to avoid air gaps that will lead to things warming up more quickly. Ideally, put thermometers in your fridge and freezer to monitor their temperatures. Once your refrigerator is turned off or the temperature rises to over 40 degrees F., food that need to be refrigerated will only last for four hours.

Wash your hands. Before any food preparation, and especially if you’ve been cleaning up storm or flooding damage, scrub your hands with soap vigorously for at least 20 seconds.

Keep any generators or other petrol products away from your living and food area.

Store your disaster food supplies high and in waterproof containers to avoid losing your food stores to flooding.

Frozen + thawed meats should be cooked and eaten right away, not stored.

Sanitize your cooking surfaces, especially if they have been subjected to debris or other storm conditions.

Sanitize your water. If you have to use rain water or water from your faucets that you don’t know is safe for cooking, it’s important that you sanitize this water. You can sanitize water by adding a small amount of clear (no aroma) bleach to it, and/or hard boiling it for at least 20 minutes. For a gallon of water, add 8 drops of bleach product with a controlled dropper if your bleach product contains 5.25% bleach (e.g. Clorox). If you use a more concentrated bleach product such as a pool bleach, you will need to reduce the amount of drops accordingly.

Finally, it’s important to know when it’s time to leave your home and evacuate the area. If your area is flooding, it’s best to check with local officials and head to higher, safer ground.

More information:

Stay safe, eat safe, and stay healthy this hurricane season!