Advice From APHA Experts: How to create a healthy emergency stockpile

Q&A with Capt. Laura A. McNally, MPH, RD, FADA, a dietitian with the U.S. Public Health Service

Much has been written in the media lately about the threat of pandemic flu. The flu virus that causes a pandemic can spread easily from person to person and may cause large numbers of people to become ill and die. In the event of pandemic flu or other natural disaster, your local officials might advise you to shelter in place, which is a precaution that aims to keep you and your family safe in your home. To prepare for such an emergency, you’ll need to have created — in advance — an emergency stockpile of healthy foods.

To help you make the healthiest choices when planning what will go into your stockpile, the American Public Health Association recently sought advice from Capt. Laura A. McNally, MPH, RD, FADA. McNally is a dietitian officer in the U.S. Public Health Service and chair of the Emergency Preparedness Task Force for the American Dietetic Association.

Capt. Laura A. McNally

When it comes to stockpiling, many of the obvious foods that come to mind, such as canned soups and vegetables, are high in sodium. How can we pack foods that are healthy?

There are many options available today. The low-sodium, low-fat canned foods that are available are ideal for stockpiling. Things such as canned soups – Healthy Choice makes one option or Campbell’s makes another low-sodium option — these are good choices. Other good choices for canned foods are those foods that are packed in their own juices, such as canned fruits. You can buy vegetables that are low in sodium, and those also would make very good options. So when you are looking for low-sodium foods, there are many options now available in canned products.

How about crackers and chips?

Crackers and chips tend to have more sodium. Given that you  potentially would have a limited water supply or juice supply, you will want to stay away from salty items such as crackers, nuts and chips, although we recognize that those are comfort foods and may be the kinds of foods that many, children in particular, will want to have. You don’t have to avoid them totally but you can buy non-salted nuts, you can buy low-sodium crackers and you can also buy low-sodium or no-salt chips, so it’s not impossible to have those in your stockpile.

How much water should we plan on including in our emergency stockpile?

The recommendation for water is that we have one gallon of water per person per day. This is for food, drinking and personal use, such as brushing your teeth. You can possibly have water supply in your home at that time, but you do want to make sure that you also have an extra stockpile. So at very minimum the one gallon of water per person per day is recommended, for at least a three-day supply, and for pandemic flu it may be much longer.

How often should you rotate your water supply?

Your water supply does need to be rotated because bacteria will build up in it. Water is stamped with a date on it, and what I recommend is that you actually (use) stickers. Whether it is for water or other foods in your emergency supply kit, take a sticker and put the date on it that you put it in there and then if you use a regular rotation schedule, you will be able to look at the date that it went in, and make sure that at six months you look at the expiration date that’s been stamped on it. And also with canned goods, inspect for any signs of bulging or anything like that on the lids, to be sure that the product has not gone bad on you. But it is important that you rotate your water on a regular schedule.

How often should foods be rotated?

It is a good recommendation, just as you would change the batteries in your smoke alarms every six months along with (changing your clocks, to rotate) your emergency food supply — your foods and your water. It’s a good idea to put that  as part of your practice…that way you would have a trigger point and you would be able to remember to rotate these foods and if you put the sticker on it with the date that you put in it, you know how long it’s been in your kit, and you might even put a trigger in there, “Needs to be removed at six months,” or “Okay for one year.” But many of our food products now have expiration dates on them, and that will help us make sure that we’re not storing foods that go bad on us. Peanut butter is one that can go rancid, so it is important to rotate your foods.

For storing your stockpile, what kinds of containers work best?

There is no particular container that we are recommending, however I do think it’s a good idea to store your food in maybe a big, plastic bin that has a lid that is secure, because you want to make sure if you’re storing it, particularly in the basement or in the garage or in a location where there is  potential for rodents or bugs to get into it, that the lid is sealed tight and will prevent anything from getting in there. The other thing you want to do is make sure that you store it in a place where the temperature is pretty stable, and that you don’t have extremes of hot or cold, which may impact the quality of your food.

What are some of the healthy foods we should include in our stockpile?

We recommend things that require no refrigeration, little or no preparation, no cooking and that require little or no water added to them, because you don’t want to take your water supply and use it with your foods. Many chicken, tuna (products), things like that, come in these vacuum-packed sealed containers, which are much easier to store than canned products. But for proteins I usually recommend canned meats or chicken, canned tuna, salmon -- those kinds of things. Canned beans make an excellent source of protein. They generally are low in sodium and require no cooking and can be added to many things, so I always recommend various kinds of canned beans, as well as your canned fruits packed in water and vegetables with no added salt. Along with this I would recommend protein and fruit bars. These are especially important for children because it gives them something sweet to eat, but make sure you are buying ones that have some nutritional value, not just (those with) chocolate and other added things that don’t give it as much value. Other things would include dry cereals…granola — that is something that is important for your kids. Peanut butter is always a very good staple, and dried fruits or trail mix. Nuts, as long as you buy the unsalted variety, are good for snacking as well as a protein source.  (Also) low-sodium crackers, your canned juices, and you always want to make sure that you have some kind of non-perishable pasteurized milk or dried powdered milk available. And vitamins, because your nutrients in your foods will not be necessarily what you would get if you were on a regular diet.

How about infants and children? Any special considerations for them?

If you have infants or very young children, you need to make sure that you include the infant formula as well as extra water for reconstitution, or better yet, cans that are already constituted. And for young children, foods that they are interested in eating, (such as) finger foods, your canned fruits, vegetables…Vienna sausage even may be more appealing to a young child. And then last of all, your comfort and stress snack foods, because we’re going to need those. Those are a little harder to plan. You don’t want to put chocolate in there if there is a potential for it to melt. But make sure that you do put comfort foods, especially for pandemic flu, because you may be confined to your home for longer than a three-day period and you’ll want to make sure that you have foods that your family will be able to eat during periods of high stress.

How about a can opener?

Fortunately the sealed packages don’t require a can opener and many of our cans do have pop lids, but absolutely a can opener is an essential element to have.

When creating our stockpile, for how many days should we plan?

The recommendation is a three-day supply, however, as I said, with pandemic flu and having to shelter in place, it may be that you need to realistically plan to have food for at least a week. If (officials) do recommend sheltering in place, the schools will be closed, day care will be closed, after-school programs will be closed and you may find yourself with your family at home for a much longer period of time.

Any special concerns for people with special health issues such as diabetes or high blood pressure?

The main thing to consider with those kinds of health issues is that they have adequate supplies of their medications, whether it be insulin or pills, and that they have any other health supplies that they need for their particular condition. Obviously, the kinds of foods that they would stockpile would be those that they can eat, in other words low-sodium kinds of items. With diabetes they want to make sure that the protein and fruit bars that they choose are not those that are high in sugar — there are many that are made for diabetics. Dried fruit or trail mix may not be a high option for them, whereas nuts might be fine. So I think the diet that they eat on a regular basis is the same kind of recommendation that they’ll need for stockpiling.

Should antibiotics be included in your emergency stockpile?

Antibiotics are a prescription item. You don’t really want to stockpile an antibiotic because you don’t know which antibiotic you are going to need for a particular condition. If you are already on an antibiotic, then by all means you should make sure that you take that with you (if you are told to evacuate), but as a general rule, no, antibiotics are not an item that should be in your emergency stockpile because you don’t know which one you need for any particular condition.

What kinds of foods should pregnant mothers have in their stockpile?

The kinds of foods that pregnant mothers would want would be the same as the general population. They have no special requirements other than an increased caloric requirement. That’s making sure that they have adequate kinds of proteins, adequate fluids. They may want to ensure that they have a higher load of fruit juices and water in their stockpile to ensure that they have adequate hydration.

Any tips for making it fun for kids to get involved in creating a stockpile?

There is a wonderful Web site called Ready.gov, and there is a children’s portion that helps children learn what they need to do to create their family’s emergency stockpile, which includes, of course, things beyond food and water…also clothing and those kinds of items. I recommend that all families take a look at that. But in addition to that, they can also prepare their own perhaps small side stockpile with some of the kinds of foods that they like, so that they know that in the event that something occurs, they have the kinds of foods that are important to them, and they may have their own utensils that make them feel better…children-size utensils…and you need to make sure that when you are packing your stockpile that you do include not only that can opener but knives and forks and spoons and paper plates and paper bowls. Paper is probably better because you will not have the ability to do dishwashing. And so with your kids you want to pack things that are familiar to them, and again, the fruit bars and maybe the Vienna sausage…it depends on what stage that child is at as to the kinds of foods that are going to be their favorites.

Is there anything else you’d like to add?

When we are looking at fluids, probably our better choice, of course, is water, and there are a number of small one-serving things where you change water to lemonade or you can change it to iced tea, or things like that. But I would really recommend that you not stockpile soda. Soda contains no nutrients and all it contains is sugar and calories, and that’s not going to be a good option when you are trying to shelter in place or in an emergency stockpile  because there is no value added to having any kind of soda. You really want to stick with your water and your juice, which is going to add for your hydration, and avoid those foods that are going to also make you very thirsty.

— Q&A conducted and condensed by Teddi Dineley Johnson, The Nation's Health

APHA wishes to thank the Food and Nutrition Section for helping to make this feature possible.