On kidney and other organ issues in Taiwan. With emphasis on diet

Life Health & Fitness
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It would be a worthy long term, in depth conversation to have on organ issues here. As they are rampant in Taiwan. In this thread I would prefer to stick to a diet based conversation, but we can certainly.mention ither environmental factors when relevant, as these things are incredibly variable and rarely a 1 reason fits all issue.

Deep, but let’s keep it respectful towards each other. shit on the point all day, but not each other :slight_smile:

So, from the “Taiwanese food sucks” thread, Taiwanese food sucks! - #2385 by Explant

I brought up the point that I feel we eat too much sodium in Taiwan. others disagree. let’s discuss :slight_smile:
@Mtl @user86 @tt etc.

everyone has their own food preference, but what is healthy?

My point is that Taiwan has very very serious organ issues, especially kidney, heart, liver etc. The food here “sucks” more based on quality and ingredients rather than just tasty metrics. I feel most food here has sodium and sugars intertwined with their ingredients, and as a daily average we are mostly probably consuming far too much.

It was the opinion of others, which can post their opinions here if they so wish, that we do not. probably based on food seeming too bland to their tastes.

My argument is the levels are not too low, rather too high. Not based on a this burger is too salty or too bland, but that everything we eat has loads and on the daily we are probably mostly consuming more than our body needs/wants. I want to learn about the health risks, if any, that may be connected to such food intakes. Especially sodiums and sugars. Too many people seem quite strongly against my.perspective. So it’s time for me to reevaluate with more modern knowledge. or them.
Let’s discus :slight_smile:

My current stance on food here is that it has lots of sodium and sugar, in my opinion.

Doctors here always mention all the ailments of both and always say to cut down. I am quite aware of the lack lustre quality of doctors here though, so I am not bias in my opinion that we should cut down (I do think we should, however ). That said, the earth used to be flat and we thought herbalists were witches. so it is worth understanding what we know is certainly going to be at least improved upon in the future, if not completely rejected. So, a grain .of salt with every opinion :innocent:

here are some international research links to support what pretty much every doctor I have heard from has repeated to the end of the earth.

not an actual research article, but more a simple overview from Harvard. Read the drop downs and check the references.

"In most people, the kidneys have trouble keeping up with excess sodium in the blood. As sodium accumulates, the body holds onto water to dilute the sodium. This increases both the amount of fluid surrounding cells and the volume of blood in the bloodstream. Increased blood volume means more work for the heart and more pressure on blood vessels. Over time, the extra work and pressure can stiffen blood vessels, leading to high blood pressure, heart attack, and stroke. It can also lead to heart failure. There is some evidence that too much salt can damage the heart, aorta, and kidneys without increasing blood pressure, and that it may be bad for bones, too. Learn more about the health risks and disease related to salt and sodium:
Cardiovascular disease
Chronic Kidney Disease
Osteoporosis
Cancer [stomach]
"
To be fair, stomach cancer, and other cancers, seem more likely linked to secondary issues that align with high sodium intake, but that’s just my opinion not their point.

"
Abstract

The relation of salt to hypertension and kidney disease had been well known at the turn of the last century, but the importance of salt has been grossly neglected more recently. There is a close link between salt intake and hypertension, as well as partially blood pressure-independent target organ damage including renal disease. In the general population, high salt intake is associated with hypertension and cardiovascular events. Salt loading also increases albuminuria in individuals without primary renal disease and raises excretion of albumin and protein in patients with renal disease. It aggravates proteinuria and glomerulosclerosis and accelerates progression in most animal models of renal damage. The effect of salt restriction cannot be reproduced by treatment with diuretics. Inappropriate increase of intrarenal angiotensin II and increased reactive oxygen species are the major culprits responsible for salt-related renal damage.
"
Salt and dehydration go hand in hand. Taiwan is hot, people are addicted to various chemicals and narcotics on a society level which promotes dehydration (eg. tea, coffee) as well as many environmental conditions that may not compliment less hydration and high sodium intake.

in this type of environmental/lifestyle situation, this sort of thing gets relevant quickly:

https://www.sciencedirect.com/science/article/abs/pii/B9780128185407000380

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It would be interesting to know if the Taiwanese population suffer more from organ damage compared to the Chinese and US populations.

I say this because I believe American food in general is way more sodium-heavy compared to Taiwanese, simply based on the fact that I moved here from the US and my food suddenly became less salty. Also, Chinese food is even more sodium-heavy than both American and Taiwanese food (undisputed fact), especially the food from Central China.

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This is going to require government regulation. Either that or you grow your own food/buy from wet market. A lot of work, and for working class people in Taiwan is impossible. Furthermore the trash collection time in most of Taiwan literally require you to take a day off just so trash doesn’t pile up. It means a working class person will make sure they don’t have ANY trash at all. This makes cooking your own meal even less tenable.

You know poor health will further burden NHI and so it really is in the government’s interest to start regulating lunchbox places a lot more.

I’m not convinced lunchbox food is any worse than wet market ingredients though, because they all come from the wet market, but perhaps the amount of sugar/sodium can be regulated. Or very little salt in the food and issue salt packets to salt it to the customer’s liking.

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Quick post. just in case the original thread is locked to editing. I will use this post to edit and compile any research links provided by anyone just in case the thread gets long :slight_smile:

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mohw reccomends not to eat more than 2.4g of sodium, but average taiwanese eat about twice of the upper limit.

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I feel like I’m not all that sensitive to salt, and I haven’t noticed much of a difference while eating in restaurants in Taiwan or any of the other countries I’ve lived. It’s rare that I find that food someone else has prepared is too salty or needs more salt (I think I’m quite bad at judging this actually), and when I’m cooking for myself, which is most of the time these days, I don’t use very much (in my opinion).

There are a couple of recipes I regularly make where I’ve found I prefer using less salt than dictated in the recipe, like bread (I tend to use around 1.0–1.4% of the flour weight, compared with the 2% that’s pretty standard) and Thai basil chicken (I often omit the salt entirely and also use low-sodium soy sauce). I’m not sure what my overall consumption is, but it’s possible that I make up for those reductions in stuff where the salt content is more hidden, like ketchup and the occasional danbing.

So whereabouts exactly is it in Taiwan where people literally have to take days off work to deal with the trash? That sounds inconvenient, especially if it’s having knock-on effects on preventing them from cooking. :thinking:

What proportion of the population do you estimate are affected by this troubling problem? Fortunate for us we live in Taipei and have good trash collection and enough free time, eh? We can cook all we want. :blush:

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Trash in my area is 3pm and 6pm. Those are the only time. You will either be at work or on the way from work, you won’t make trash collection time either way. I think there may be trash collection nearby at 8pm but it’s quite a walk.

I have no idea how sodium level works because the “recommended” amount is very restrictive. Since damn near everything has sodium, you will eat half the sodium budget just eating bland food, and you can easily go over if you want even a little bit of flavor in it.

I have no idea how to deal with the “too much sodium” level except drink enough water to offset them.

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There’s a hormone-mediated control loop inside your body referred to as the renin-angiotensin-aldosterone system. It’s a fearsomely complex, MIMO system that manages all sorts of things including electrolyte balance and blood pressure and volume, and interlocks with calcium regulation. I’m not going to pretend to understand even half of how it works (and I don’t think anybody actually does) but broadly speaking, you can rely on two principles:

  • If you need more of something - water, salt, whatever - you’ll feel inclined to ingest it.
  • It’s easier to excrete stuff that you don’t need than to magic it out of thin air.

There was a study done a couple of decades ago - don’t ask me to root it out - in which people were told to just add salt ad lib to their meals. It turned out that they were adding the ideal physiological requirement … what a surprise. I’m not sure why anyone expected anything different.

The idea that you can somehow overwhelm either your kidneys or the control system itself by eating a gram or two of extra salt is … a bit unlikely, frankly, and there doesn’t seem to be any evidence that it happens in practice. The article’s suggestion of kidneys somehow struggling to excrete sodium would not, in fact, result in a small persistent offset; the control system would simply dial it out. That’s what control systems do.

If you are chronically sodium-deficient, it will result in (among other things) potassium depletion because of the need to maintain Na/K balance within a certain range. If you observe some level of sodium, or some Na/K ratio, that you believe to be physiologically “abnormal”, the default assumption should be that the RAAS system is responding to an abnormal system disturbance (and that the observed levels are correct for the context), not that it is malfunctioning.

I’m really not sure why salt is such a recurring bogeyman for dietitians and researchers. I suspect it’s partly because it’s a nice simple thing that everyone can understand, and control, and feel virtuous about; mainly, though, I think nobody really knows why everyone is getting so disastrously sick, and the experts feel like they ought to come up with some sort of halfway plausible explanation, even if it’s wrong, in order to maintain their status as experts.

I don’t have any answers either. Certainly bad food is part of the problem, but I don’t think it makes sense to dissect everything into carbs and fat and protein and assorted chemicals, and then point to this or that component and say, aha! It’s that thingy there! It’s just … all of it. Bad food. Food that isn’t food. But I still don’t think that’s the whole reason why cancer is the #2 cause of death, or why fertility rates are dropping through the floor, or why people are developing so many mysterious chronic diseases. With my tinfoil hat on, I suspect someone does know the reason, but they’re not telling us.

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Fertility rate is dropping through the floor, because of industrialization. When you’re too busy working, and kids costs money you don’t have, you don’t want them.

Before industrialization you’d be lucky to have 2 out of 10 babies survive their first year, and so people had lots of babies. Then as medicine gets better there’s a population explosion, followed by a population decline. This happens in every, single, industrialized countries. The problem with China is they took the population explosion as bad, read too much of Malthus’s work, and implemented the one child policy with forced abortion and stuff, and we all know how that is now working for China. Now people are having one child even if the government is trying to get more people to have more babies… just the natural order of thing. Improved nutrition will actually cause populations to decrease, odd as that might sound. Remember not too long ago people mostly starved.

I really don’t understand how dieticians and researchers base thing, because salt is bad, and so is fat, and everything’s bad. Like I said the “recommended” sodium level is far too restrictive and it’s not hard to exceed that just eating normally. By the way the current 2,300mg of sodium corresponds to about 5 or so grams of salt per day, and that’s salt from all sources. It may not even be that healthy to eat at the recommended level of sodium…

If food is too bland for you, then add salt.

There’s a reason why in Roman times employees were paid in salt, and also why “salary” literally means salt (and why Jesus talks about “salt of the earth” in the Bible).

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Kidney and liver issues are likely from Chinese medicine.

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Oh give it a rest TL, I’m not buying it.

There are Saturdays, and leaving work on time once or twice a week for those working 9–5, and walking a bit to the later collection, and dumping a small bag in a public trashcan on occasion when necessary. And anyway, from what I gather you’re still unemployed and prior to that were running your shop with not enough customers to keep you very busy. I guarantee that most of the people here have more to do in a given day than going to Yangmingshan for the cooler weather (I know I do), and somehow we can manage it.

If you choose not to cook because you’re too lazy/don’t enjoy it/don’t want to/prefer processed food/whatever, any of those are totally fine and your prerogative, but that’s a choice you’re making – the reason you’re not cooking isn’t the bloody garbage schedules. :roll:

If only you could find a way to invest the energy you expend on finding excuses and problems into finding solutions instead, I think it’d be pretty good for you.

(We can stop derailing @Explant’s thread now. :bowing:)

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It’s weird. If you’re an active person you actually need more salt. It’s an important part of hydration.

This is my opinion. The 2 main culprits of kidney disease are hypertension and diabetes (which is related to high sugar intake)

I don’t think salt is the main culprit. It can make hypertension worse if you have it but there’s not really much evidence that it will give you hypertension if you’re healthy.

Taiwanese are inactive which can cause hypertension. So in my opinion the main culprit is the lack of exercise added with things like sugary drinks. The food itself isn’t an issue. Those drinks have so much more sugar in them and to intake it in a liquid form immediately is just awful.

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Fantastic inputs, cheers. especially ona new term for me: renin-angiotensin-aldosterone system. I get the base root words, but no idea the definition but am quite keen to read in a out your post.

To clarify, I am not talking about just a little more salt is no issue. I am talking about the food we eat in Taiwan can easily go over the [let’s just say generally accepted range of ]1.5~3g Nacl daily dose most things I have read seem to agree on. I will soon. post some nutrition labels and examples when I have time to.use the computer and edit images as my phone is frustrating to use. But I highly doubt that the vast majority of organ issues reported…key word, reported… early on are not associated with high prevalenceof dietary issues. not trying to blame the sodium group for everything, but I think it is fairly observable that Taiwan suffers from both dehydration (combination of climate, environment, diet and habit). ibsuspect the blanket doctor response of less sodium might perhaps be more well intentioned because they are aware of the lifestyle reality here rather than a temperature controlled experimental group. both are relevant though.

As mentioned intthe other thread, I feel there is a huge difference between a person working hard labor in 30~37C hard labor all day compared to the office worker that needs a jacket in the string AC. sweat is one thing, but other factors persist. I’m not convinced its "income"based as I know many an uneducated farmer and factory worker that grow their own food and cook at home. the ones in my mind now are also experiencing such organ disease and / or failures. some.have died. surely, chemical exposure plays a role as well, but even the organic guys without a dusty workplace are experiencing this. not that this is evidence, just an observation as they (like me) sweat profusely during the day which creates a massive sodium craving/need. I eat salt food too, I crave it. but I just try not to overdo it as I have what looks like soon to be shot kidneys as well a many I know. across industries.

diet seems a common denominator, but that’s still quite subjective. looking to make it more objective. either way.

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This is indeed what seems important with sodium intake. I personally feel lifestyle/climate play a role, but more importantly diet can balance those things. especially sugars.

nothing is as simple as one thing, more or less. everything works together, so it should be addressed as a variable not a black and white.

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Taiwanese diet is bad: instant noodles, soy sauces and many other sauces, Chinese medicine, salty eggs, miso soup, deep fry, sugar a whatever time, chemical japanese curry, kimchi it’s doesn’t seem to be that great.
Korea and Japan have also lot of stomach issues.
Just compare a sauce with fresh ingredients with one of these block of curry they use here.

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yeah, that’s my hunch too. I don’t think it’s the whole story - it doesn’t explain Taiwan’s outlier status in kidney and liver disease - but it probably explains a good fraction of it. Glucose toxicity just rots everything, including your glomeruli.

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I think it’s hard to prove a direct relationship between Chinese medicine and kidney failures (please prove me wrong), specially when other environmental effects also affect.

But, a friend who is doctor here in Taiwan, mentioned how many western medicine doctors here acknowledge that many kidney failures are caused when patients in treatment take western medicine drugs and then also go to the chinese medicine doctor and eat what the chinese doctor tells them on top of that.

Don’t do double drugs

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There has been direct links to specific ones. I suspect there’s more than we know.

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Fermented food like kimchi are great for you. Helped me recover from a deep depression after taking a broad spectrum antibiotics.

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Some potential issues Ihhave seen in my work in regards to chinese medicine.

many plant materials that are GRAS dont go under the same scrutiny as food when importing in regards to testing for things like contaminants, agricultural sprays etc. it is quite astonishing. Ihave a whole issue about the TCM market and FDA here, but that’s a rant for another, not 1am, day :slight_smile: they are treated differently though…

second is the way if actual government enforcement. like with food. they rarely go after the small guys. frying old meat slop at a market or twisting ankles in a hidden backstreet room. much the same. but there are laws. just not followed nor enforced. I view TCM practitioners here the same as I view shamans from abroad. worth listening to and gaining knowledge, but dont touch me and test your voodoo with my body.

there are some interesting things with the FDA I would like to discuss more. Iwas planning to open a new thread just for FDA related issues, as they are broad and beyond retarded. but for now, an example.

Stevia is not allowed here as a food ingredient. only as an extract. to demystify this, this means extracts. you can find whole herb sold (legally) here I. tea bags, but that is exactly because it is extracted, and the bulk leaf isnt ingested. butterfly pea is the same.

interestingly, TCM can sell it just fine and powder it into the mix.

these sorts of logic have plagued peoples trust in the “FDA” which is harshly cracking down on food scandals (eg. apple soda). knee jerks might be a good term to call them little logic, just too little too late so now the laws are extreme and without logic sometimes. the traditional shell ginger.is also on the dont use list, a traditional wrap here for rice dumplings.

I personally noticed the FDA change to idiocy when they tried to ban cinnamon and make it mandatory to be sold via chinese medicine industry. this of course didn’t pan out simply because cinnamon is just far too common a thing, unlike shell ginger, and used traditionally by billions. it is now just required to have a warning stating its risks on every label containing cinnamon. any product not listing this is technically illegal labeling.

Things rarely follow science and logic ,that’s an issue. especially dissapointing if doctors follow this practice of non science based bs. hopefully through more public conversation, thingscan reverse a bit and more logical evidence based decisions will form the regulations.

as an aside, not directly related but worth mentioning.more often.

when it comes to.food permitted for use in products, taiwan follows the USA GRAS system coupled with our own system. Thetaiwan database can be found here, searching either scientific name or chinese. As usual, the website is still jot exactly perfect, so like to search h the genus, not species, then scroll through. 1 species might have multiple entries based on product type (eg. raw, extract, oil etc).

here is the example with stevia, only for extract or beverages is it permitted.

" 限供消費者沖泡飲用，或是將沖泡後之茶湯作為液態飲料供消費者飲用。"

https://consumer.fda.gov.tw/Food/MaterialDetail.aspx?nodeID=160&id=16812

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