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I've been living in Taiwan for a while and have tried to avoid raw food and tap water very carefully (ie. brushing teeth with bottled water, eating at places where I can see that everything is cooked, etc).

However, many people including expats eat raw salads, etc and I know one American woman who drinks the tap water regularly with no ill effect.

Is it possible though that by avoiding raw food and tap water, of any sort, for so long, I now have lost some kind of immunity or similar?

Is it now more risky for me than for people who had eaten raw food and drank tap water from the US or whatever country they previously were?

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    @Itai The Water Department in Taipei claims the tap water is safe to drink. Are they lying? english.water.gov.taipei/… – Tor-Einar Jarnbjo Oct 8 '17 at 17:20
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    @Itai Even in Germany, most locals prefer bottled water and you are not likely to find any kind of establishment serving tap water to their customers. That however, does not mean that tap water is not safe to drink. – Tor-Einar Jarnbjo Oct 8 '17 at 17:33
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    @Itai Perhaps we travel in different universes. Bottled water is ubiquitous and easily available in grocery stores and kiosk in most (if not all) industrialized countries even if the tap water is drinkable. When thinking about it, I don't think I've ever been to a country, where it has been anything but 'very easy' to get bottled water, except perhaps for Norway until some 10-15 years ago. – Tor-Einar Jarnbjo Oct 8 '17 at 19:15
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    Municipal tap water in Taiwan is perfectly safe, assuming your building is in acceptable condition. Not drinking raw tap water is a cultural thing, passed down from decades ago when the water wasn't as good. Some people are used to the taste of bottled or previously-boiled water. The situation is the same in many developed parts of SE Asia, including Hong Kong and Singapore. – user71659 Nov 15 '17 at 22:23
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    I'm kind of amazed this question wasn't closed. The OP is living in a country, which at the very least points this question to being migrated to Expatriates and the question isn't even about travel, but about the conditions of food/drink in the country in which he now lives (not traveling to). – CGCampbell Nov 27 '17 at 17:15
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To the first question, my guess is that yes, you have lost some kind of immunity, but the reasons of this lost may not only lay on your habit of avoiding raw food, and tap water, but in the practices of all the Western culture.
I do not know how to quote properly, but here it is something I found in an article in the New York Times Magazine (May 15 2013):

A handful of microbiologists have begun sounding the alarm about our civilization's unwitting destruction of the human microbiome and its consequences. Important microbial species may have already gone extintc before we have had the chance to learn who they are or what they do. What we think of as an interior wilderness may in fact be nothing of the kind, having long ago been reshaped by unconcious human actions. Taking the ecological methaphor further, the "Westernized microbiome" most of us now carry around is in fact an artifact of civilization, no more a wilderness today than, say, the New Jersey Meadowlands

The title of the article is"Some of my best friends are germs", by Michael Pollan.

The next paragraph of the one I just quoted says:

To obtain a clearer sense of what has been lost María Gloria Dominguez-Bello, a Venezuelan born microbiologist at New York University, has been traveling to remote corners of the Amazon to collect samples of hunter-gatherers who have had little previous contact with Westerners or Western medicine "We want to see how the human microbiota looks before antibiotics, before processed food, before modern birth", she told me. "These samples are really gold".

So, my guess is that not only you, who, I assume, are a Westerner, but a lot of us who live in the Western world, or in places who have the same practices , have a less strong immune system, because of the practices our culture has.

Take this, as an example, also, from the article I cited before:

One bacterium commonly found in the non Wester microbiome, but nearly extinct in ours is a corkscrew-shaped inhabitant of the stomach by the name of Helicobacter pylori. Dominguez-Bello's husband, Martin Blaser, a physician and microbiologist at the N.Y.U., has been styding H. pylori since the mid 1980s and is convinced that it is an endangered species, the extinction of which we may someday rue. According to the "missing microbiota hipothesis," we depend on microbes like H. pylori, to regulate various metabolic and immune functions, and their disapearance is dissordering those systems. The lose is cumulative: "Each generation is passing on fewer of these microbes," Blaser told me, with the result that the Western microbiome is progressively being impoverished.

The article is very interesting and informative.

The answer to the second question, I guess is yes, for the same reasons mentioned in the last sentence I quoted.

Of course, when you, or me, travel, we are at risk. Our immune system, may not respond properly to the microbes found in the new environment. But I believe, this apply also in the opposite sense. We may carry diseases for which the native people's immune system is not properly armed to fight.

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I think I need to answer this question on multiple levels.

  1. Sorry to say so but you have succumbed to a series of urban myths. Neither is drinking tap water or eating raw food in Taiwan a threat to your health, nor is eating "processed food" (the term is meaningless from a scientifc or medical perspective ).
  2. Tap water is safe in pretty much every civilized country. Since disinfectant agents and regular scanning for bacteria have become commonplace hygienic problems related to tap water have become very very rare. In fact more people catch bacteria from taking showers than from drinking tap water. Why? The hot water boiler, when poorly maintained and run at too low temperatures can become a breeding ground for bateria. So are air-conditions systems. I therefore recommend to not use the airconditioning and avoid showering in Taiwan.
  3. Eating raw and not perfectly hygienic food is not a health risk (except for some food and countries with specifics parasites). When you chance to a different country, in a different climate zone and diferent types of food the bacteria in your gut will eventually adapt to the change in circumstances. That is diffrent strains of bacteria will settle in. This can temporarily cause diary but after a few days you will be just fine. You can delay but not avoid this effect.
  4. One aspect of the narrative is largely true, although the science behind it is a bit convoluted. When you always eat cooked food, disinfect your hands, avoid dirt etc. you will not ingest gut bacteria and the eco-systems in your guts will be, lets say, "underdeveloped". Note that gut bacteria are not only harmless but neccessary for your body to function properly. This effect has been suspected for a long time, but could only be quantified with genetic analysis techniques in the last few years. E.g Native people living in natural environment have ~2x the variety in gut bacteria than the average civilized person. It has also been proven that certain types of gut bacteria contribute to the regulation of our immune system.

So in short the recommendation is: "eat some shit" :-). In more scientific terms: Your paranoia of avoiding unhygienic food and tap water indeed has a chance of creating a deficient intestinal flora, which could potentially impair your immune systeme. But worst of all, you are missing out on a lot of fun Taiwan.

  • What is a "civilized" country (your point #2)? I've been several places (eg Myanmar) that I would consider civilized but where the tap water was undrinkable. – Roddy of the Frozen Peas Nov 24 '17 at 22:53
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    I see your intent, so I will tease you with Latin. Frequent travellers tend to use "civillized" in its literal meaning: "A place with well working civil infrastructure". – Michael Renper Nov 25 '17 at 21:05
  • No my intent is to point out that the word "civilized" appears -- at minimum -- ambiguous, arbitrary and without clear definition, which leaves your second point equally unclear. – Roddy of the Frozen Peas Nov 25 '17 at 21:30
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    @MichaelRenper "Developed" might be a more appropriate term. – Johns-305 Nov 27 '17 at 15:02
  • Disagree with “unavoidable” in point three. Six adults and 31 teenagers in Guadalajara for two weeks. One (me) did not get sick. And I know another person in a similar group who was also a hold-out. She hypothesizes her success was due to drinking vinegar after every meal. Hypothesis for me is that I was rather careless about germ-risks in my early years. But “data” is not the plural of “anecdote.” – WGroleau Jan 1 '18 at 7:16
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You should avoid raw meats.
Sea food fresh under cooked is very bad. You can get flukes from it. Both liver & kidney. They are easy to treat in the early stages.
Water you need know location. Much is just filtered & treated tap water. The big thing here is minerals in the water. Lead arsenic etc. Well water even treated can be bad. Even boiling will not remove arsenic or lead.

Next how is your small intestine?
Look at it as a storage area for bacteria. The more you travel the more different ones you have there in storage. They are released as needed in each area you travel. Stored when not needed. Why world travelers become immune to local food much more so than newbe's.
We have the bacteria need in storage.
You need develop it for each new area you are in.

So enjoy.
Travel, build imunety you do not have.

If in areas were well water is drank. Bring a clear jug. Get your water set in sunlight for 2 hours. It is now about as safe as bottled water. except minerals. Add a few drops of bleach. You now have treated water. Let settle or boil if you wish some minerals to settle from the water.

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    Seafood is safe if it has been frozen. OP is staying in Taiwan, not traveling around. So your answer is only partly fitting. – Willeke Nov 25 '17 at 8:46
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This article suggests that it can. Children from Finnish Karelia and Russian Karelia were observed, similar with regards to genetics but former leading much more urbanized life style. It turns out they have much greater incidence of autoimmune diseases.

However, you better start imunnizing yourself while young. I'm not sure that making a U turn in this regard is safe. Better change your habits slowly.

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The tap water in Taiwan isn't clean as in US, people often boil the water first to drink, mostly to avoid the worms and diseases. Brushing teeth or ordinary uses is fair enough to use tap water.

I think you shouldn't try raw food since these dishes aren't clean, even Taiwan people sometimes get sick for eating raw foods. https://halong-bay-cruise.com

If you don't live in a glass house, don't worry about your immune system's getting weak since the air has contained enough bacteria for your body to resist

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