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TCM Dietary Therapy
Chinese Dietary Therapy Concepts and Principles Last Updated: 09/25/2011 |
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CHINESE DIETARY THERAPY Chinese dietary therapy is a standard modality of traditional Chinese medicine. The idea that food is also medicine is deeply rooted in the Chinese culture. Chinese medicine has a unique way to assess foods. Practitioners not only look at nutritional components, but also consider the food's color, taste, texture and shape. Foods with specific colors and tastes nourish specific parts of the body and correct specific imbalances. This article is organized into two parts: traditional Chinese medicine theories, Chinese dietary therapy concepts and principles. The properties of commonly-used foods and their applications, and a selection of classical Chinese dietary recipes may be found here. Traditional Chinese Medicine TheoriesSix concepts or theories are fundamental to an understanding of traditional Chinese medicine. The theories covered here are as follows: Yin and Yang; Five Phases; Fundamental Substances; Meridians; Zang/Fu Organs; and External Pathogens. In Western medicine, specific systems and organs of the body are diagrammed and analyzed in isolation: the circulatory system, the immune system, the liver, etc. In Chinese medicine a basic cosmology or theory of the universe is formed, and mankind is examined and explained as an integral part of this vast system. Yin/Yang theory and Five Phase theory are ways of understanding the laws of nature and interrelationships within nature. Fundamental Substances, Meridian, and Zang/Fu theories explain human physiology and functionality. Pathogenesis, diagnosis and treatment theories explain how and why imbalances develop within us and how to go about restoring balance. Yin and Yang. The universe is equally divided between Yin and Yang. Yin is a philosophical construct representing the aspects of the universe that are dark, receptive, etc. Yang embodies the principles of light, action, etc. Everything that exists in nature can be classified as Yin or Yang, and is generally a mixed balance of Yin and Yang. These two "opposites" are mutually dependent, interdependent, and always in a relative balance with each other. The relationship between Yin and Yang is essentially dynamic, and constantly changing. Yin may change into Yang, and vice versa under certain conditions. In traditional Chinese medicine, the theory of Yin/Yang provides a model of pathology. Yin and Yang are balanced in a healthy body. An excess or deficiency of either Yin or Yang will lead to illness or disease. Five Phases. This is also called the Five Element theory, because in Western thought the five entities involved (Wood, Fire, Earth, Metal, Water) are considered to be "elements" of nature. However, this label does not convey the idea of action, motion, transformation, and cyclical change that is implied in the Chinese word "xing." As with Yin and Yang, all things in nature can be classified as one of the Five Phases, or a blending of them � they are the essential constituents of the material universe. Also as with Yin and Yang, the Five Phases are mutually interdependent, and always in a relative and dynamic balance with each other. The following list of Five Phase correspondences gives some idea of the elaborate nature of this theory as it pertains to every aspect of our lives in space and through time. It is also the philosophical basis of Chinese astrology and the practice of Feng Shui.
In traditional Chinese medicine, the Five Phases are used for explaining the properties of the internal organs (viscera, Zang/Fu) of the human body, including their mutual relations, physiological phenomena and pathological changes. Five Phase theory is also used as a guide for making diagnosis and treatment. Fundamental Substances of the Body. Qi Literally defined as "vital energy," Qi is a Fundamental Substance of the body that is constantly in motion. Qi is the life force of our bodies, and if it slows down or stops, illness will surely result. The concept of "Qi" is very broad, because Qi exists everywhere in the universe, as well as in our bodies. When the Qi of our bodies is considered, it is classified in terms of its function and type. Some major functions of Qi are to protect and warm the body, as well as keeping everything in place. It is also the source of all movement in the body, and the mechanism that transforms the food we eat into "ourselves." The principle types of Qi are: Defensive Qi, which circulates at the level of the skin and protects us from harmful influences; Nutritive Qi, which creates Blood from food and nourishes the body; Organ Qi, which is the Qi of each specific organ (Zang/Fu); Meridian Qi, which flows through the meridians and blood vessels; and Pectoral Qi, that gathers in the chest and regulates the Heart and Lungs. The main functions of Qi are to nourish, regulate and defend the body. Blood. Blood is a Yin substance that circulates primarily in the blood vessels, but also in the meridians. Blood transports nutrients to the entire body, and nourishes the internal organs. Traditional Chinese medicine also believes that Blood is the material basis for mental activities. (The brain is considered to be a type of bone marrow, and mental activity is ascribed to the Spleen and Heart, and to the Fundamental Substance, Shen). Jing. Jing is commonly translated as "Essence." We are conceived as a result of the combination of our parents' Jing, and this aspect of Jing (Prenatal Jing) is close to the Western concept of genetic inheritance. Jing is the core Fundamental Substance, and directs all aspects of our growth through time � conception, growth, maturity, reproduction, and aging. It is the depletion of Jing over time that brings about aging. After we are born, we replenish our Jing (Postnatal Jing) with the purified essence of the food we eat. Shen. Shen is best translated as "spirit," and its home base is the Heart. Shen manifests as human consciousness; as awareness; as the "life" that shines out of our eyes and faces. When someone seems depressed or confused, with dull eyes, he is said to "lack Shen." When someone is in a manic state, out-of-control, or psychotic, then his Shen is "wandering." When the Heart's energy (Qi) or Yin (Blood) are depleted, then Shen does not have a secure home, and we are likely to experience anxiety, palpitations, insomnia, inability to concentrate, and other signs of unease. In Chinese medicine and philosophy, Qi, Jing, and Shen are called "the three treasures." Fluids. Fluid refers to the body fluids, including saliva, stomach fluids, synovial fluids and tissue fluids, but excluding Blood. Fluid moistens the skin, flesh and internal organs, lubricates the joints, and nourishes the brain and bone marrow. Meridians. Currently, Western science does not recognize the existence of discrete "energy vessels" in the body that are analogous to blood vessels; but to the Chinese the meridians that carry Qi are actual anatomical structures that can be palpated and treated. The function of meridians is to transport Qi and Blood, connect the internal organs, and provide pathways between the inside and outside of the body. The meridian system consists of twelve principal meridians which correspond to the five Yin and five Yang organs, plus the Pericardium (Yin) and Triple Burner (Yang). So there is a meridian for the Heart, Lungs, Liver, Spleen, and Kidneys (Zang), and for their paired organs, the Small Intestine, Large Intestine, Gall Bladder, Stomach, and Urinary Bladder (Fu). There are also eight "extraordinary" meridians, a system of tendino-muscular meridians close to the surface of the skin, a system of "divergent" meridians, and "luo" channels that connect paired Yin and Yang meridians.Through the meridians, every part of the body is connected to the whole: the internal organs communicate between themselves and have access to the surface of the body; the skin, muscles, and extremities have networks of secondary meridians that circulate energy on the surface and also tap into deeper levels. Each principal meridian is associated with a group of symptoms that appear when the meridian is not functioning properly. For example, cough, dyspnea, asthma, sore throat, and a feeling of fullness in the chest are associated with Lung meridian dysfunction. The meridian system is used in several ways in the diagnosis and treatment of disease. Sometimes the problem is with the meridian itself, as in the case of simple tendonitis, muscle strain, or an atrophied area of tissue. These are generally viewed as local problems, and are treated locally to the injury. In other cases, the problem is an imbalance or disease of an internal organ, and the meridian system is utilized as an avenue to the seat of the problem. For example, a digestive problem would be treated by using acupuncture points along the Spleen and Stomach meridians, since these meridians connect directly to "their" organs. Chinese medicinal herbs and foods are also tied into this system because they are classified by taste (Five Phase theory), property (Yin/Yang theory), and by which meridians they enter (and therefore which internal organs they affect). Five Zang Organs. The internal organs of the body (viscera) are counted as twelve in number, and each is assigned one of the twelve principal meridians. There are six Yin and six Yang organs, and they are paired into six Yin/Yang partnerships. Of the twelve viscera, the five Zang, or Yin, organs, Heart, Liver, Spleen, Lung, Kidney, are generally considered to be the most significant in terms of pathology, diagnosis, and treatment. In addition to being in a Yin/Yang relationship with its paired Fu organ, each Zang organ is also assigned to one of the Five Phases. Even though the names of these Zang are the same as the Western names, their functions are markedly different from the Western paradigm, and they can more accurately be considered as "energetic manifestations" rather than as masses of tissue. The functions of the heart are to regulate the circulation of Blood; house the Shen (e.g. regulate mental and emotional activities), and direct speech. The face and the tongue reflect the state of the Heart. The Liver is responsible for storing Blood and causing it to flow smoothly, regulating the smooth flow of emotions, regulating the smooth flow of all Fundamental Substances, controlling the joints and tendons, and regulating digestion. The eyes and the fingernails reflect the state of the Liver. The Spleen transports nutrients for the body, "transforms" food so it will be readily absorbed into cells, assists in making Blood, assists with fluid metabolism, and controls muscles and the four limbs. The Lungs regulate Qi in the body (especially Defensive Qi), regulate fluid metabolism, regulate and disseminate Air Qi in the body, assist the Heart in creating and regulating Blood, and regulate the voice. The skin and body hair reflect the state of the Lungs. The Kidneys store Jing (genetic constitution) and control birth, development, and maturation. They also guide water metabolism and excretion, rule the bones and produce marrow, nourish the brain, and assist the Lungs with the breathing process. The ears, bones (including teeth) and head hair reflect the state of the Kidneys. External Pathogens. The external factors which lead to disease originate in nature. They invade the body via the skin, mouth and nose. The leading external pathogens include Wind, Cold, Heat, Dampness and Dryness. Wind. Wind attacks the Yang aspects of the body, namely the upper limbs, torso, head, and the skin. Wind produces a sudden onset of symptoms such as edema and skin irritation with itching. Wind-caused diseases are often accompanied by abnormal movements such as dizziness, tremors, and convulsions. Cold. Cold damages the Yang Qi of the body. The nature of Yang is to be warm, active, and expansive. When it is damaged by climatic Cold there may be cold, stagnation, and contraction in the body leading to sharp pains, muscular contractions, spasms and limb rigidity. If Spleen Yang is damaged, for example, it leads to abdominal coldness and pain. Heat. Heat is a Yang pathogenic factor. Heat causes the depletion of Body Fluids and manifests with such symptoms as dry mouth, scanty urine and constipation. When Heat moves upward, it causes symptoms such as headache, ringing in the ears (tinnitus), and a swollen throat. Heat can damage the Blood and cause it to move "recklessly," leading to nosebleed, blood in the urine, and excessive menses. Heat can interfere with mental activity and cause anxiety or even coma. Dampness. Dampness impairs Yang Qi. If Spleen Yang is impaired, it can lead to diarrhea, scanty urine and edema. Dampness-related problems such as edema, gummy eyes, sticky loose stools, and eczema are characterized by heaviness and turbidity. Accumulation of Dampness produces excess phlegm which can lead to many problems � not just profuse sputum production, but also gallstones, strokes, and mental illness in extreme circumstances. Dryness. Dryness is a Yang pathogenic factor. Dryness-related conditions deplete Body Fluids. Dryness especially attacks the Lungs and the Kidneys. Constipation, scanty urine, lusterless hair and dry skin are characteristic symptoms of Body Fluid depletion.It is the balance and harmony of these various factors that promote health and well-being. If Yin and Yang are in balance; if the generation and control cycles of the Five Phases are in harmony; if the meridians and Zang/Fu are functioning freely and delivering sufficient Qi and Blood to every part of the body, then we are healthy. When these systems become imbalanced through climatic assault, emotional imbalance, improper diet, excessive sexual activity, overwork, etc., our Fundamental Substances are damaged and we fall ill. Chinese Dietary Therapy Concepts and Principle Treating illness and maintaining health through dietary therapy is central to the philosophy and practice of Chinese medicine. It is thought that many, if not most, of our health problems are related to imbalances in our diet. As you may have noticed in the discussion of Chinese medical theory, balance is really the most important aspect of life, both in regard to our health, and also in respect to our ability to live harmoniously in the world. It is in the area of diet and food preparation that this concept of balance is most concretely expressed. In the first place, there is an aversion in Chinese thought to any kind of excess � Chinese philosophers would be in complete agreement with the Greek philosopher who said, "Nothing too much." Food fads and extreme diets of any sort are contrary to Chinese dietary principles. There is not a philosophical bias toward a purely vegetarian diet, as there would be in Hinduism. Neither do Chinese people sit down to eat huge slabs of meat. In Chinese cuisine, small amounts of animal protein and seafood are combined with generous amounts of vegetables and grains in endless variation. After the extremes are discarded, attention turns to balancing Yin and Yang and the Five Phases. Two major dietary principles which relate to balancing Yin and Yang are the "Four Energies" or "Four Properties" of food (cold, cool, warm, and hot), and the direction, or "bearing," that the food's energy takes in the body (upward or downward). The "Five Tastes" of food, the seasonal aspects of food, and the "meridian propensities" of food are tied to Five Phase theory. The specific functions that foods can have to tonify, cleanse, and regulate the body are based on these principles and on direct experience. Traditional Chinese medicine focuses on treating the root cause of diseases, rather than just wallpapering over the symptoms. The root cause of any disease ultimately involves excess, deficiency, or imbalance of the Fundamental Substances, including Yin and Yang. Dietary therapy is used to balance Yin and Yang, nourish Qi and Blood, and restore the normal functioning of the organs and meridians. In the following paragraphs, we will discuss Chinese dietary therapy principles in more detail, with examples of how they affect our health. Dietary modifications and other lifestyle considerations are always discussed by Chinese medicine practitioners with their patients for optimum health maintenance and prevention of disease. The Five Tastes of Food. The "five taste" principle in Chinese herbal medicine pertains also to Chinese dietary therapy. If you review the Five-Phase chart near the beginning of this article, you will see that the five tastes of sour, bitter, sweet, pungent, and salty correspond to colors and to the internal organs and their respective meridians. The correspondences are guidelines, rather than inflexible rules, and they are applied to foods in the same way that they are applied to medicinal herbs. For example, salty-tasting foods such as seaweed enter the Kidney meridian and affect the Kidney, as do certain black-colored foods such as black sesame seeds and black mushrooms. Orange and yellow-colored foods like yams and carrots are often sweet-tasting, and they are used to strengthen the Spleen.More specifically, each taste has a functional effect, and these effects are taken into account when recommending foods or types of food. Sour-tasting foods have the function of constraining sweating, stopping cough, and relieving diarrhea. Bitter foods have the function of causing Qi to flow downwards, drying dampness, expelling toxicity, purging fire, and clearing heat. Sweet foods have the function of harmonizing and tonifying, and relieving both pain and spasms. Pungent foods have the function of dispersing, moving Qi, and invigorating Blood. Salty foods soften masses and nourish both Blood and Yin. In addition to the traditional five tastes, there is a category of "aromatic" foods such as mint and cilantro. These have the function of moving Qi, expelling dampness, strengthening the Spleen, increasing the appetite, clearing the mind, and enhancing the spirit. The Four Energies of Food. The Four Energies (Si Qi) of Chinese herbal medicine are Cold, Cool, Warm and Hot. There is also a category of "Neutral" for foods which have no energetic temperature property. For practical purposes, traditional Chinese medicine practitioners classify Chinese foods into three energetic groups: Cold/Cool foods; neutral foods; and Warm/Hot foods. Cold/Cool foods, such as watermelon and salad greens, have the medicinal functions of clearing heat and fire, cooling the blood, and eliminating toxins. Warm/Hot foods such as garlic and chicken have the medicinal functions of warming meridians, strengthening Yang, invigorating Blood, opening collateral meridians, and eliminating cold. Neutral foods are used to serve as bridges, harmonizers, or neutralizers to bring about a balanced state.It is easy to see how the Four Energies of food can be used to achieve balance in the body. If a person suffers from a Cold-induced condition, he will be advised to avoid cold (and raw) foods, and to eat warming foods. The opposite advise would be given to a person with too much Heat in his system. One of the commonest conditions a Chinese medicine practitioner sees is a pattern called Spleen Qi Deficiency. It can produce symptoms of fatigue, poor appetite, poor concentration, loose stools, cold hands and feet, and is often accompanied by weight gain and water retention. The natural fire and "cooking ability" of the Spleen has been overwhelmed by cold and dampness. To treat this condition, the Spleen must be gently warmed and drained of dampness. The worst kinds of food to eat in this case are cold and raw foods and liquids because they force the Spleen to expend its dwindling reserves of energy on the process of warming and "cooking" the food inside the body. Lightly-cooked, warming foods, and liquids that are room-temperature or warmer are what the Spleen requires to regain its strength. Four Energies theory also explains why alcohol, sugar, and greasy fried foods are so bad for us. These are very Yang foods. When they are consumed in excess over a period of time, they deplete the Yin of our bodies, drying up the body fluids and producing a pattern called Yin Deficient Empty Heat. Meridian Propensities of Food. Medicinal herbs and foods, because of their intrinsic nature, have an affinity for, or propensity toward, specific energy meridians. Some herbs and foods have an affinity for one particular meridian; others may enter several meridians. The therapeutic implication of this is that specific foods, or classes of food, can be used to treat the internal organ system that is out of balance by using the organ's associated meridian as a conduit to the organ itself (Zang/Fu).Meridian propensities are an aspect of Five Phase theory. In Chinese medicine, sour-tasting and/or green-colored foods are associated with the Liver and Gallbladder meridians; bitter-tasting and/or red-colored foods are associated with the Heart and Small Intestine meridians; sweet-tasting and/or yellow-colored foods are associated with the Spleen and Stomach meridians; pungent-tasting and/or white-colored foods are associated with the Lung and Large Intestine meridians; and salty and/or black-colored foods are associated with the Kidney and Urinary Bladder meridians. If meridian propensities are combined with the Four Energies, specific therapeutic results may be achieved (refer to the following chart on properties of common foods). Pears can be used to clear Heat from the Lungs because pears are cool-property and enter the Lung and Stomach meridians. Bananas are cold-property and enter the Stomach and Large Intestine meridians, so they are given to relieve lower-intestinal heat (hot diarrhea, foul-smelling stool, hard dry stool, etc.). Walnuts are an example of a food with several meridian propensities. They are associated with the Lung, Liver, and Heart meridians, and are used to relieve asthma, nourish Blood, and enhance mental function. Bearing of Food. The bearing of a food refers to the direction of that food's medicinal actions in the body. Besides the two principle directions of upbearing (ascending to the upper body), and downbearing (descending to the lower body), there are also "floating," which designates an effusive or dissipating activity, and "sinking," which indicates a draining activity, similar to clearing a clogged drainpipe. Upbearing and floating foods, which move upward and outward, have the medicinal functions of raising Yang, releasing the exterior, and dispersing cold. Downbearing and sinking foods, which move downward and inward, have the medicinal functions of subduing Yang, clearing heat, stopping cough, and draining and percolating dampness. As a general rule, light foods are upbearing, aromatic foods are floating, and heavy, strong-tasting foods are downbearing and sinking. Seasonal Diet. Chinese medicine developed in a society that was largely agricultural, and in a region of the world that experiences pronounced seasonal changes. Chinese medicine theory follows Taoist thought in believing that the closer we stay to the rhythms and cycles of nature, the healthier and more balanced we will be. Even though the inhabitants of industrialized countries have distanced themselves from nature in many ways, it is a mistake to think that natural cycles have ceased to be important. The effect of millions of years of evolving within nature cannot be erased in a few decades. The natural seasonal rhythm of Qi in our bodies follows a predictable pattern: Qi rises and migrates outward in spring; it circulates freely at the surface of the body in summer; it migrates inward and downward in autumn; and it gathers in the core of the body in winter. An optimum diet takes this seasonal flow into account, and foods are emphasized which pertain both to the Five Phase correspondences and the Four Energies. Spring, the windy season, is associated with the Liver. Foods that are nourishing to the Liver and Blood while eliminating Wind are most beneficial. The nature of summer is to be hot, which depletes energy and body fluids. Cool-property fruits and vegetables are most helpful. The Lungs are associated with autumn, which is cool and dry. Neutral foods can be used to moisten the dryness this season brings. Winter, the storage season, is cold and is most closely associated with the Kidneys. In winter it is essential to tonify the Kidneys, which tend to become more depleted with age. Yang should be tonified for Kidney Yang deficiency, whereas Yin should be tonified in cases of Kidney Yin deficiency. Tonifying, Cleansing and Regulating. When foods and herbs are used in accordance with the principles of Chinese medicine, they can achieve therapeutic effects in the body. The commonest therapeutic benefits of foods and herbs are to: tonify and nourish; clear and purge; and regulate the flow of Fundamental Substances. A list of the possible beneficial effects include: nourishing Qi, Blood, Yin or Yang; promoting the production of body fluids; generating Essence (Jing); releasing the Exterior; clearing Heat and fire; drying dampness; promoting urination; resolving phlegm; eliminating toxicity; invigorating or cooling Blood; relieving Blood stasis; balancing Yin and Yang; and harmonizing the internal organs. A few specific examples of food therapy would be using chicken soup to treat chronic fatigue in elderly women, mutton soup to treat Blood deficiency after childbirth, garlic for dysentery, hawthorn for food stagnation, and Job's tears for dampness. Food/Herb Combinations. In China, the principles of Chinese medicine are widely accepted and practiced by the general population. Medicinal herbs are stocked as a matter of course in every household's kitchen, and the concept of using foods therapeutically is well understood. When foods and/or herbs are combined, five concepts are utilized: strengthening; assisting; reducing; subsiding; and counteracting. Strengthening (Xiang Xu) is when two foods or herbs enhance each other's medicinal function. Example: watermelon juice and tomato juice together strengthen each other's function of clearing heat. Assisting (Xiang Shi) is when one food or herb assists the main food or herb's function. Example: adding wine to ginger/egg soup to assist ginger's function of warming the Middle Burner and eliminating Cold. Reducing (Xiang Wei) is when the side effect of one food or herb can be lessened by another food or herb. Example: the odor and allergic reaction from crab and shrimp can be reduced by using ginger/vinegar. Subsiding (Xiang E) is when one food or herb's function can be mitigated by another food or herb. Example: when ginseng's function of tonifying Qi is reduced by daikon radish's function of invigorating Qi. Counteracting (Xiang Fan) is when two foods or herbs in combination produce an undesirable effect, and should not be used together at all. Example: carrot and Fo-ti counteract one another when taken simultaneously. ReferenceThe Tao of Nutrition, by Maoshing Ni, The Shrine of the Eternal Breath of Tao, 1987. Between Heaven and Earth: A Guide to Chinese Medicine, by Harriet Beinfield and Efrem Korngold, Ballantine Books, New York, 1991. Chinese Dietary Therapy, by Liu Jilin and Gordon Peck, Churchill Liverstone 1995. Eating Your Way to Health: Dietotherapy in Traditional Chinese Medicine, by Cai Jingfeng, Foreign Language Press, Beijing, 1996. Chinese Herbs with Common Foods, by Henry C. Lu, Kodansha International, Tokyo, 1997. Chinese System of Food Cures: Prevention & Remedies, by Henry C. Lu, Sterling Publishing Co., Inc. New York, 1986. Chinese Dedicated Diet, ed. Zhang Enqin, Publishing House of Shanghai College of Traditional Chinese Medicine, Shanghai, 1988. Staying Healthy with the Seasons, by Elson M. Haas, Celestial Arts, Berkeley, California, 1981. A Diet for All Seasons, by Elson M. Haas, Celestial Arts, Berkeley, California, 1995. Chinese Healing Foods, by Rosa LoSan and Suzanne LeVert, Pochet Books, New York, 1998. The Tao of Balanced Diet: Secrets of A Thin & Healthy Body, by Stephen Chang, Tao Publishing, San Francisco, 1987. Chinese Herbal Medicine: Materia Medica, by Dan Bensky & Andrew Gamble, Eastland Press, Seattle, Washington, 1993. Chinese Herbal Medicine: Formulas & Strategies, by Dan Bensky & Randall Barolet, Eastland Press, Seattle, Washington, 1991 Healing with Whole Foods: Oriental Traditions and Modern Nutrition, by Paul Pitchford, North Atlantic Books, Berkeley, California, 1993.
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