Climate and Diet

Situated off the east coast of Asia and surrounded by warm ocean currents, Taiwan represents an oceanic and subtropical monsoon climate. Summers are long with high humidity; winters are short and rather mild, snowfalls are possible in high mountains. In lowlands the temperature rarely approaches zero degree. Mean monthly temperatures range from 15°C to 20°C in winter to around 28°C in summer. The highest and lowest

19 Chu CY, Yu R., 2010, Understanding Chinese Families: A Comparative Study of Taiwan and Southeast China. New York: Oxford University Press, p.66

20 Chu CY, Yu R., 2010, Understanding Chinese Families: A Comparative Study of Taiwan and Southeast China. New York: Oxford University Press, p.78

21 Taiwan Statistical Data Book 2010 (electronic publication), Council for Economic Planning and Development, Executive Yuan, R.O.C.; source:

http://www.cepd.gov.tw/att/0014212/0014212_1.pdf, accessed 20 may 2011

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urban temperatures were recorded in Taitung (40.2 degrees Celsius in May 2004) and Taichung (-1.0 degree Celsius in February 1901))²².

One of Taiwan public health highlights is NAHSIT- a Nutrition and Health Survey carried out in 1993-1996.²³ Although Chinese herbs and nutrient supplements were not included in the calculation of dietary intakes, the survey results are interesting: it reveals that the levels of percent calorie from fat and protein were higher, but that of carbohydrate was lower than the ideal values. The survey results shows that mean dietary intakes of vitamin E and calcium in men and women and iron in women were not above the values of the recommended daily nutrient allowances (RDNA). Dietary intakes of vitamin A and ascorbic acid were much beyond RDNA. Women aged 13-24 and men aged 13-15 had the lowest values in % RDNA of several vitamins and minerals among all age-sex groups. If consider only an example factor- the iron level- according to NAHSIT- iron deficiency rate for males and females was respectively 2.1 and 10.7%, and 2.1% of Taiwanese women older than 4 years, displayed clinical symptoms of anemia which may have an impact on their general health status as well as fertility-related issues.

According to WHO²⁴, iron deficiency in childbearing women increases maternal mortality, prenatal and perinatal infant loss, and prematurity. Forty percent of all maternal perinatal deaths are linked to anemia. Favorable pregnancy outcomes occur 30-45% less often in anemic mothers, and their infants have less than one-half of normal iron reserves.

22 The Republic of China Yearbook 2010 (electronic publication), Taipei: Government

Information Office; source: http://www.gio.gov.tw/taiwan-website/5-gp/yearbook/contents.htm, accessed 20 may 2011

23 Pan W, Chang Y, Chen J, Wu S, Tzeng M, Kao M. 1999, Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996: Dietary Nutrient Intakes Assessed by 24-Hour Recall. 臺灣營養學會雜誌 (Nutritional Sciences Journal)24(1):11-39.

24 WHO, UNICEF, UNU. 2001. Iron deficiency anaemia: assessment, prevention, and control.

WHO/NHD/01.3. Geneva, Switzerland: World Health Organization. Source:

http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf, accessed 22 june 2011

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Such infants require more iron than is supplied by breast milk, at an earlier age, than do infants of normal birth weight. Moreover, if pregnancy-induced iron deficiency is not corrected, women and their infants suffer all the consequences mentioned above.

There are factors specific for Taiwan nutrition, such as high prevalence of vegans and vegetarians (cultural factor), postpartum confinement that may result in vitamin D deficiency²⁵, or supplementation with Traditional Chinese Medicinal. There are reports on such medicinal utilization during pregnancy and postpartum:²⁶ Chinese herbal medicine was used by 33.6% and 87.7% of pregnant and postpartum Taiwanese women, respectively. Most common medicinal used during pregnancy was An-Tai-Yin (安胎飲), Pearl powder (珍珠粉) and Huanglian (黃連). Shen-Hua-Tang (生化湯) and Si-Wu-Tang (四物湯) were the most commonly used by postpartum women.

The usage of herbs during pregnancy and postpartum was positively correlated with respondent‘s higher education, and is more common for primiparous women.

It is difficult to assess the safety and outcome of Chinese medicine usage, especially during pregnancy and breastfeeding period. For such long tradition of Chinese herbs usage, there is no historical evidence for its teratogenic or other adverse effect. The pharmacokinetics of these is a subject of contemporary research, and thus, such possibility cannot be excluded, especially with consideration on constantly shifting environment and new chemical substances that are absorbed by human bodies and may interact with these herbs.

One of ―Zuo Yuezi‖-related foods is the sesame-chicken soup (麻油雞): a dish prepared with rice alcohol-(there is no lactation-related alcohol taboo in Taiwan). As the negative impact of ethyl alcohol on developing mammals is widely known, the alcohol levels in human milk were measured ²⁷ after consumption of ―sesame chicken‖: Alcohol

25 M Strand, J Perry, J Guo, J Zhao, C Janes Doing the month: rickets and post-partum convalescence in rural China, Midwifery, 25( 5), 588-596

26 Chuang, C.H., Chang, P.J., Hsieh, W.S., Tsai, Y.J., Lin, S.J., & Chen, P.C. , 2009. Chinese herbal medicine use in Taiwan during pregnancy and the postpartum period: a population-based cohort study. International Journal of Nursing Studies, 46(6), 787-795

27 Chien Y, Liu J, Huang Y, Hsu C, Chao J. 2005, Alcohol levels in Chinese lactating mothers

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levels in blood and in milk reaches a plateau roughly at 20–40 min after ingestion and then decreases, reaching zero level after three hours. So, theoretically there is no risk for alcohol-caused development impairment for the baby, when the breastfeeding is postponed to 3 hours after alcoholic soup intake. Their another research in this matter²⁸, however, it ends with the conclusion that ―Consumption of ―sesame chicken‖ affects not only the composition of maternal blood and milk, but also lactation performance‖, and they suggest that an alcoholic diet should be avoided during lactation.