Foundations of Food Therapy.
There is nothing more fundamental to gastro-intestinal – a.k.a. general health - than an appropriately balanced diet. Unfortunately, for many people in today’s world, a confusing and conflicting jumble of fads, marketing ploys and false information often incorrectly influence the idea of a “healthy diet”. Not only this, but food travels for miles and miles from where it is actually grown, chemicals and preservatives are added, and with the rise of GMOs, food is in many cases no longer “real food”.
Traditional Chinese Medicine recognises that people with different constitutions and health problems require unique dietary solutions. The structure and content of the diet can be manipulated to help correct pathological imbalances in most instances. In all patients, the aim of diet therapy is to gradually move from whatever dietary approach is suitable to correct a particular imbalance, towards a “Spleen and Stomach” qi strengthening diet. NOTE: In Chinese Medicine, we say Spleen and Stomach, which in modern medical terms is stomach, pancreas and small intestine function or ‘gut health’. This type of diet optimizes digestive function and capabilities and assists absorption and transportation of nutrients throughout the body. A healthy Spleen and Stomach function is necessary for all aspects of life and health, including tissue growth and repair, metabolism, defence and reproduction. Maintenance of healthy Spleen and Stomach function is central to the treatment and management of all internal disorders, as well as emotional health, as more and more research connects the digestive tract and neurochemicals.
The goal of Food Therapy is to balance what is not currently balanced and then move towards a long-standing, preventative approach, which means:
Maintaining digestive fire
Not overwhelming the gut with dampness.
These are the two main factors most likely to impair digestive health and lead to lack of wellness. Here is a quick breakdown of the digestion process according to TCM:
The stomach is like a cooking pot. Our own body’s digestive fire, known as our yang (function), must break everything down, transport it through the intestines, absorbing and assimilating nutrients, filtering out the wastes, and draw into the body what is needed to make energy and tissue, and eliminate the leftover waste.
The analogy of the fire is important. Fire transforms things. It takes wood and turns it to ash and smoke. The metaphorical fire in our gut is suppose to transform food and drink into energy / qi and blood to provide the functional and material basis for all bodily processes and workings. Without this fire, the digestive system becomes sluggish leading to a whole host of discomforts and disease, if left like this for a prolonged period of time.
When digestive fire is strong we can digest most foods, feel comfortable after eating, and eliminate efficiently and regularly.
When food or lifestyles choices (or a constitutional weakness of digestive fire) impair this vigour and heat inherent to this part of the body we will feel fullness, bloating, constipation or diarrhea, abdominal pain, weakness in the body, low energy, and more. Food is not broken down properly and the pathological bi product of this is called “dampness or phlegm” or “garbage”.
Eating foods that are not good quality, or foods that are very rich, will also lead to excessive dampness or phlegm. We may have a combined cold sluggishness as well as an encumbered gut by dampness with leading to many more problems.
It is because of this above process that we highly advise against drinking ice water with meals or eating lots of cold or chilled foods in general. Everything we advise is to ultimately preserve digestive function / fire and keep the body free from overwhelming dampness or phlegm.
The Basics: To ease the work load for your digestive track
Chew your food thoroughly.
Eat slowly.
Eat clean and well-prepared food.
Do not drink cold drinks with meals – NO ICE WATER!
Do not watch TV, or be in a emotional or intense discussion while eating.
Be mindful and present with your food.
There are two main aspects of diet to be considered: the type of food ingested and the way it is consumed.
1. THE TYPE OF FOOD INGESTED
There is no single diet that is appropriate for everyone. Different constitutional types and pathological patterns require different types of food.
There are three general groups of foods that we are concerned with in TCM: carbohydrates, proteins, and fruits and vegetables. Each group is composed of diverse items with their own unique functions and flavours, but each group as a whole has a specific nutritional and energetic activity.
Carbohydrates are sweet and warm, and strengthen the spleen and build qi.
Proteins nourish qi, blood, yin and jing, and tend to be warmer than other food
groups.
Fruits and vegetables tend to be cooling and clearing in nature, providing balance to the supplementing and building elements of the previous two groups.
As TCM practitioners, our aim is to construct the right combination of these components to suit our patients’ specific need. We can customize our recommendations by varying the proportions to achieve different outcomes. Patients with deficiencies will benefit from a diet based on more supplementing foods: the carbohydrates and proteins. The balance of carbohydrate and protein can be varied depending on the type of deficiency.
Qi deficiency will benefit from more carbohydrates, whereas blood deficiencies benefits from a higher proportion of animal protein.
Those people tending to excess patterns will benefit from more fruits and vegetables in their diet. Vegetables and fruits can be modified or enhanced in their clearing action depending on how they are prepared.
In general, the average diet of the developed world is animal protein rich and thus overly supplementing, especially to blood and yin. The negative effect of excessive supplementation is the development of accumulations like dampness and phlegm, and then heat can come. These accumulations of food, phlegm, or dampness can be deposited in various locations in the body and leads to various diseases.
Balance is important. A meat and protein rich diet will be too supplementing for some people and can generate and or aggravate dampness and phlegm. Too many sweet foods weaken the spleen and create dampness. Large quantities of carbohydrates can congest qi movement. Excessive heating or pungent dispersing foods can dry and damage the lungs and stomach and weaken qi. An overly salty diet weakens the blood and kidneys. Too much raw food damages yang. Too little protein leads to blood deficiency.
Raw or Cooked?
In the Western world, with the many influences from the European naturopathic movement, a so-called healthy diet has come to be associated with one based on raw foods and juices and avoidance of meat. TCM practitioners often find themselves going against this trend, advising cooked foods and animal proteins, especially if their patients have deficient conditions.
Eating foods that are already at body temperature saves the spleen and stomach qi for the demanding process of digestion, rather than using it to warm food in the stomach before the foods can be processed. Digestive enzymes (or spleen or stomach qi) only work at physiological temperatures - this is one reason why drinking iced water at meal times is strongly advised against. In addition, the cooking process begins the breakdown of vegetable materials and softens tough cell walls to make their contents more available.
Any nutrients lost in the cooking process will be made up again in preserving the spleen qi, enabling better and more efficient digestion overall.
Chinese medicine does not prohibit raw food completely though. Robust, hot, yang constitutions require these cooling and cleansing actions made available to us through the consumption of raw foods. In hot weather some cooling and raw foods are also desirable, even for those with some spleen qi deficient, but never for those with spleen yang deficiency.
Quality of Ingredients:
It goes without saying that what we put into our bodies determines the quality of qi, blood and tissues. All produce should be the best quality available. Where health and vitality are concerned, it never pays to cut corners and quality ingredients do not always cost more than processed foods. All meat should be as chemical, hormone and antibiotic free as possible. Food should appeal to the senses, being vibrant in color and aroma, bursting with vitality and qi. Locally grown and seasonal produce is better than that grown artificially in hothouses in a distant locations or country.
Vegetarian or Meat Diet?
The TCM practitioner may recommend a vegetarian diet (which is considered yin) to those with a hot or damp heat constitution or yang condition. This diet is unsuitable for those with blood and or yin deficiency though as getting adequate protein is essential to these people. Being strictly vegetarian and meeting all nutritional needs presents certain challenges in the modern world. The major consideration is getting
sufficient protein and an adequate supply of vitamin B12. It is also common for those eating a vegetarian diet to consume higher quantities of sugar and various other carbohydrates. This can lead to fullness, bloating, and dampness conditions with an underlying blood weakness. If you eat a vegetarian, or even more importantly a vegan diet, please ensure you take the time to prepare your foods to have a balanced protein source.
Thermal nature and flavours of food
The thermal nature and the flavours of food are a way of describing the properties of foods and their effects upon the body. The actual oral sensation and tastes of some foods do not necessarily correspond to their designated thermal nature or flavour. For example, beef and chicken are classified as sweet, lettuce and broccoli as bitter.
Foods that warm the body
Warm and hot natured foods warm the body, encourage the ascent of qi, promote circulation, stimulate yang, and increase metabolism. Cooking increases the warmth of foods especially prolonged stewing, roasting and deep-frying. Warms foods are suitable for deficiency and cold conditions while too much can aggravate heat or excess patterns.
Foods that cool the body
Cold and cold thermal natured foods cool the body and clear heat. They tend to direct qi inwards and downwards, an in general slowdown metabolic processes. Raw foods are the coolest, but some cooking methods, such as quick stir-frying, steaming and blanching, preserve more of the cool nature of foods while making them Spleen friendly and easy to digest. Cooling foods are indicated in heat patterns, but too much can weaken yang and create stagnation.
Sweet
Sweet flavours are yang and have an affinity for the spleen. In proper amounts sweet flavours are stimulating and beneficial to the digestive processes and relax spasm in smooth muscles. Sweet, warm flavours are on the whole strengthening and tend to supplement qi and yang and build yin and blood. Sweet cool flavours tend to be moistening and cleansing.
An overly sweet diet causes accumulation of dampness and phlegm and may aggravate tissue proliferation, as occurs in obesity and various growths, plaques, and tumours. Many root vegetables, grains, and meats are sweet and warm or
sweet and neutral; fruit tends to be sweet and cool. Sweet flavours are emphasised in deficiency patterns.
Sour
Sour flavours are yin, contracting and astringing, and tend to be cooling. Sour flavours benefit the liver and assist in toning and tightening tissues, and stopping fluid leakage as in sweating and frequent urination. An excessively sour diet can retard the metabolism and expulsion of pathogens, so sour food should be used sparingly when dampness or lingering pathogens are present. Too much sour flavour may cause dryness and injure the tendons. Many fruits are sour, as are tomato, lemon, leek, yogurt, sourdough bread, vinegar, pickles, and wine.
Salty
Salty flavours are yin, cooling and moistening and tend to focus their effects inward and downward. Salty flavours have a descending and contracting tendency with a special effect on the kidney system. They also soften areas of hardness such as masses and nodules. An overly salty diet can aggravate dampness, damage the bones and blood and disrupt fluid metabolism. Foods with a salty flavour include most seafood, kelp and other seaweed, fermented soy products, millet parsley and of course salt.
Pungent
Pungent flavours are yang, dispersing and direct qi upwards and out towards the surface. They are particularly beneficial to the lungs and assist the spleen in the digestion and processing of rich supplementing foods. Pungent flavours promote sweating, help break up phlegm, invigorate the circulation of qi and blood, and assist in dispersing stagnation of qi and blood.
An excessively pungent diet will tend to dissipate qi and yin and cause dryness, especially of the lungs and stomach. Large quantities are not suitable for deficiency states. Pungent foods can be warm or cool. Pungent warm foods are the onion family, chilli, ginger, pepper, cinnamon and many kitchen spices. Examples of pungent cooling foods are radish, watercress, cabbage, celery and peppermint. Cooking diminishes pungency. When this aspect is desired, light cooking or no cooking is appropriate.
Bitter
Bitter flavours are yin, drying, descending, often cooling and specifically aligned with the heart. Bitter flavours dry dampness and in small amounts assist the spleen and encourage stomach qi to descend. As a component of diet, bitter flavours help maintain the qi mechanism. Bitter cool foods are good for clearing heat and damp
hear, while bitter warm flavours dry damp. An overly bitter diet, while uncommon, can weaken the spleen, damage yin, and blood and cause dryness. Bitter flavours include coffee, tea, oats, and rye, lettuce, bamboo shoots, broccoli and bitter melon.
2. THE WAY FOOD IS COMSUMED:
Chinese medicine recognises that the way food is prepared and consumed is as important as the food itself. Eating a nutritious and well balanced diet will not guarantee healthy qi or health in general if the spleen and stomach are compromised by other factors that affect their performance. There are several factors, which influence the efficiency of digestion.
Timing of Eating
According to their own internal cycle, the spleen and stomach, in association with the liver, prepare themselves to receive and process foods at specific times. They work best on a schedule or routine. If meals are missed frequently or the timing of eating is erratic (as commonly occurs in shift workers) the function of the spleen and stomach can be severely compromised.
The optimum times of eating will vary from person to person. Larger and more carbohydrate rich meals should be consumed earlier in the day to provide a steady supply of yang qi for the day’s activities. The best time for the main carbohydrate meals is between 7 am and 11 am, which is when the spleen and stomach are strongest. Smaller meals are recommended towards the end of the day, as the transition from the yang active phase of the day proceeds into the quieter phase, and the body prepares for rest.
Patients with deficient qi may find that they need to eat small amounts more frequently, every 2-3 hours, not to overload the stomach at any one time. Eating large meals late at night can be particularly taxing to the spleen and may disrupt sleep.
Eating in a relaxed state
Digestion is an energy demanding process. If qi is diverted from the spleen and stomach by an emotional stimulus or being busy with some other activity such as driving or working, there is less qi available for the transformation of raw materials into qi and blood. Even doing seemingly benign activities while eating, such as reading or watching TV, can have an impact on the digestive function by diverting
qi from the spleen and stomach to the liver and eyes; especially if there is something exciting or scary going on in the story which will activate the body’s nervous system at the same time. Energy intensive activities such as breakfasts on the run, working through lunch, and late or rushed dinners while debriefing a stressful day, can have significant negative impact on the function of the spleen.
Enjoyment
An essential feature of good digestion is the enjoyment of food. Flavours and textures of food should be pleasing to the palate, while color, variety and presentation should be pleasing to the eye. Even the most nutritious and well balanced diet will fail if eating is a chore or merely tolerated. A healthy diet should not be a chore. It is particularly important for patients with spleen deficiency patterns to note, as they can tend to become obsessive about diets. Very rigid or restrictive diets will feed the spleen imbalance and can create a destructive cycle of food obsession and further weakness. Pleasure in eating a fine healthy meal settles the liver, eases the stomach, and facilitates the whole digestive process.
Overeating
In the developed world we tend to eat too much for our predominantly sedentary lives. It is estimated that an average, 30% excess calories per day are consumed. It was traditional wisdom to leave the table feeling like we could eat a little more, but that rarely occurs now. For many people, especially those with excess patterns, reducing the amount of food eaten is helpful. This can be achieved by having smaller meals, having two meals per day rather than the usual three, using smaller utensils and plates, or by an occasional fast.
Slow down while eating and chew thoroughly to help the process of digestion and to monitor the amount of food being eaten more effectively. Breathe, rest, enjoy!
Undereating / Dieting
Skipping meals or severely restricting calorie intake in an attempt to lose weight can easily damage spleen qi and yang. Chinese medicine advocates eating sufficient amounts of the right foods at the right time, in combination with appropriate activity, to maintain the ideal weight. When our spleen qi is strong we will have more efficient digestion and metabolism, which will support healthy weight management.
Fasting
Fasting is not a common practice among the Chinese, but can have therapeutic value in some situations. Fasting is beneficial for people with excessive robust conditions. Fasting here is usually defined as no solid foods; however vegetable juices and light broths are acceptable. This type of fast is quite different in intent and is usually carried out by those pursuing spiritual goals.
In general, fasting is not recommended for multiple days, but a day’s fast every now and then or on a regular routine such as once a week or month, can accelerate the elimination of pathogens.
Fasting is not recommended at all for patients with deficiency patterns, and in fact can contribute significantly to an aggravation of the problem. There can be damage done to spleen qi and yang after extensive cleansing and fasting in the deficient body. Rather than the hoped weight loss or detoxification, there is often an increase in fluid retention, fatigue, diarrhea or constipation, and digestive weakness. Patients with mixed deficiency and excess patterns may tolerate a mild fast now and then. Fasting is not recommended during cold weather, for children, during pregnancy, or when lactating.
Modifying a Diet
Food plays many social roles in addition to its main nutritional roles. It is a social lubricant, used in ritual and celebration and for emotional comfort. Major changes in a diet cannot, and should not, happen too suddenly. Modifications, additions and subtractions to the diet should be made gradually to allow time for both physical and mental adaptation. Not only will slowing down the process of change help your body to adapt, but it also helps the modifications to become more engrained in your life and way of being in the world.
Being that food, next to exercise, is the best way to impact your health, do what you can to make the changes stick. Slow and steady for you and your body.
Keep in mind that fundamental changes to the diet often contribute to digestive symptoms while the system adjusts.
Adapted From: Maclean, Will and Jane Lyttleton. (1998) Clinical Handbook of Internal Medicine. MacArthur, University of Western Sydney.