Biomedical science has reduced foods to the sum of their calories and micronutrients. While it is important to understand the biochemistry of what we eat, it is also important to realize that the qualities, colors, textures of our foods and the ways they are cooked play just as much
of a role as their "nutrient content" in influencing our health. Traditional Chinese medicine has much to teach us on this subject.
Traditional Chinese Medicine (TCM) has much to teach us about how food influences health. The language of TCM may sound more like poetry than science, but is grounded in careful observation of human function and detailed study of the plants and animals that make up our diets.
The lens of biomedical science has reduced foods to aggregations of calories, vitamins, minerals, fats and other micronutrients, and this view governs how most of us think about nutrition. Blueberries are "good" because they have anthocyanidins. Soy is "healthy" because it contains isoflavones. Fish are vehicles for giving us omega-3s. There are dozens of diets calling for people to eat more of this or that food, because it contains this or that nutrient.
The idea that foods are nothing more than the sum of their biochemical parts has contributed to our culture's near-obsession with calorie counting, fat-finding, and nutrient content measurement. At one extreme, people are so overwhelmed or so lacking in education that they don't pay attention to the health value of their food at all; at the other extreme, people worry constantly about the amount of fiber in their diet, or whether they're getting the right omega-3 to omega-6 ratio, or whether they should drink more wine to get more resveratrol.
It is important to be mindful of the nutrient content of what we eat, and it is great when we can apply the knowledge of biochemistry to understand how foods influence health. But there is another approach, an ancient way of looking at foods qualitatively in terms of their "energies" and healing properties that can balance the reductionistic view.
The Nei Jing Classic of Internal Medicine (aka, the Inner Canon of Huangdi or the Yellow Emperor's Inner Canon) compiled over 2,000 years ago, may be the first known Chinese writings on the dynamic relationship between health and food. Like other traditional systems from around the world, TCM posits that we humans are intricately connected with and are fundamentally part of nature, and that our individual health is a reflection of the care we give to our environment, to others, and to our earth—an expanding spiral of inter-connections.
Yin, Yang, Qi, Shen
The TCM approach to nutrition is a rich, nuanced combination of art and science that takes years of study and practice. But if you get a grasp of a few basic concepts, you can really open the door to a new way of looking at food and counseling your patients.
In Asian Medicine, Yin and Yang are the two complementary yet antagonistic forces or principles that make up all aspects and phenomena of life. Yin describes all that is earthy, feminine, dark, wet, cool, passive, receptive and absorbing; Yang describes that which is "heavenly" or celestial, masculine, bright, active, expansive, dry, hot, and penetrating. Together they express the interdependence of opposites.
In relation to diet, fruits and vegetables are more Yin compared to meats and dairy foods which are considered more Yang. The balance of Yin and Yang in one's body and environment is essential to one's health.
Qi (pronounced "chi") is another core concept, used to mean the circulation of energy in the body-mind that gives rise to our vitality. TCM identifies what is called our "pre-natal Qi," as the baseline constitution with which we are born, and "post-natal Qi," as the energy our systems are constantly creating to maintain our present physiologic state. In a sense, pre-natal Qi is our "nature" while the quality and vitality of post-natal Qi corresponds to "nurture," and is highly dependent on our ability to digest and transform food.
When a Chinese medicine practitioner speaks of "stagnant Qi," it refers to situations in which the Qi that nourishes a specific organ, muscle, body part, or meridian is being blocked and not flowing smoothly. In TCM, health is all about smooth and harmonious flow of Qi within and between the systems that comprise a human being.
Two other important classical Chinese medical concepts are: Jing, a person's core essence, which, when strong gives potential for longevity; and Shen, often defined as "spirit," and thought to represent the synergy of emotional, mental and physical health. Shen is sometimes referred to as "Heart/Mind."
Location & Season
The idea of "eating locally" has had a lot of buzz recently. But it is really nothing new. Asian dietary philosophies have long suggested that we embrace, as much as is possible, native foods locally grown, and eat what is in season. When we over-consume food imported from very different climates or regions, we may lose adaptability to our immediate surroundings. This is especially true when someone living in a temperate or cold climate eats a lot of tropical or semitropical foods.
The point is that patterns of illness, according to TCM, are linked to seasonal climatic changes. For example, disorders of "Wind invasion" often come in the Spring, manifesting in stiff neck, headaches, or the symptom patterns Western medicine classifies as "colds and flu." Heat-related symptoms such as heat stroke and overexertion occur in Summer.
"Damp," phlegm-related symptoms arise in late Summer, manifesting as colds, mucus in the chest, sluggish digestion and sinus problems. Symptoms related to "Dryness" occur in Autumn causing dry skin, dry cough, and difficulty eliminating from the colon. "Cold" syndromes in Winter show up as stiffness in the back and lower back, constipation, and difficulty in keeping warm.
A core principle of TCM-based nutrition is that one should eat to optimize the body's adaptability to these seasonal changes. For example, in Spring and Summer, when physical activity tends to increase, Yang Qi flows outwards to the body's surface, and a person's internal Yang Qi may become depleted, thus requiring replenishment in the warm weather. At the same time, it is good to increase consumption of cooling Yin foods.
In the colder and dryer climates of Fall and Winter, it is important to keep warmer and prevent dryness, and we want to eat foods for nourishing Yang and warmth, building Yin, dispelling mucus and phlegm, and enhancing building the circulation of Qi energy, blood and bodily fluids for the present and coming seasons.
Health imbalances can result from the over-consumption of heavy animal-based foods in warm climates, since this quality of food is more suited to the colder regions. On the other hand, not having enough of these kinds of foods in cold climates can also be detrimental.
Taste & Cooking Style
In Chinese nutritional practice, the primary taste of a food is an essential aspect of its nutritional content. This is because the specific tastes send signals through the energy meridians—specific pathways of Qi in the body related to corresponding organs.
Sweet foods, which nourish the spleen and stomach, include: grains, millet, squashes, onions, sweet fruits, bananas, blueberries, oranges, figs, dates, honey, molasses, barley malt. Ideally, these are prepared by steaming, boiling, or Nishimi-style—a Japanese/macrobiotic slow-cooking method done over a low heat. (See accompanying recipe for "waterless" vegetable stew.)
Sour foods, which nourish the liver and gallbladder, include: tomatoes, barley, vinegar, green apples, lemons, grapefruit, and other sour fruits. These are best prepared by pickling, steaming, and in pressed salads. A pressed salad is made by layering very thinly cut vegetables (e.g., Chinese cabbage, daikon root, onion, leek) either in a "pickle press" or in a fairly deep dish, adding in a little pinch of sea salt and rice vinegar (optional) with each layering. Then put a second dish containing a heavy object over the contents thus pressing the veggies down.
After an hour or up to 3–4 hours, you will have a lot of excess water, which should be poured off. What you have now is a pressed salad, which has digestive enzymes from this partial pickling method. It is recommended to have a small portion accompanying a meal while savoring the fragrance and taste of the salad.
Pungent foods include onions, garlic, ginger, daikon, peppers, cayenne and other sharp, spicy foods. They are thought to nourish the lungs and large intestines. Optimal cooking methods include sauté, pressure-cooking and Kinpira, a Japanese method similar to braising. (See accompanying recipe for Kinpira burdock root.)
Bitter foods nourish the heart and small intestine, and include kale, lettuce, dandelion, broccoli, arugula, endive, collard greens, and most other leafy greens. These are best eaten raw, pressed, stir fried or blanched.
Salty foods like fish, miso, eggs, burdock root, sea vegetables (wakame, arame, hiziki, kombu, kelp), tofu and aduki beans (even though they are not salty) are thought to nourish the kidneys and bladder. These are best prepared via stewing, frying, or Nabe-style (cooked in a ceramic pot, prepared at the table).
Generally, in colder seasons one should lean toward longer cooking times and more salt. In warmer weather, lighter cooking methods and less salt is healthier. Steaming, poaching and blanching-boiling help alter the nature of the food for more of a Yin-cooling effect. At the other end of the spectrum, deep-frying, stir frying and roasting and pressure cooking alter foods for more Yang-heating and body insulation effect.
Color and Signature
In TCM practice, the color of a food plays a role in its function. TCM also adheres to the doctrine of signatures: the idea that there is a synergy between the appearance of a food and the organs or parts of the body.
For example, red foods like apples and red peppers, which somewhat resemble a human heart in shape, are thought to nourish the heart, as well as the small intestine. The apple also nourishes the spleen because of its sweet taste, and the kidneys when it is baked and lightly salted.
A carrot, when sliced cross-wise, resembles an eye and is thought to be nourishing to the eyes. Lotus root, pale in color and containing many hollow
tubular passages, somewhat resembles the lungs and bronchi and in TCM nutritional theory it is thought to nourish the lungs.
A bitter green vegetable like kale will nourish the heart because of its bitter taste; will also nourish the liver because of its green color, and the kidney and the bones, because of its rich minerals.
Recognizing Individual Needs
There are a few general principles that apply to everybody: eat in moderation, eat what is in season, cook for optimal nutritional value and great taste, eat mindfully and enjoy meals with appreciation. But TCM recognizes that every individual is unique, and that nutritional needs change over time.
A good nutritional evaluation takes into consideration a person's present physical, mental, emotional and spiritual status, his or her baseline constitution, the current and the upcoming season; present dietary habits; social environment; personal desires; and the individual's health condition and goals.
Like any other knowledge base, TCM describes many "textbook" patterns of imbalance. At the same time it admonishes us constantly to realize that in the real world, we are rarely dealing with pure patterns of imbalance that fit into neat packages. There is no "one-size-fits-all" approach to nutrition!
By taking into consideration how our health is affected by qualities and properties of various foods, as well as the methods by which they're prepared, we can learn new ways to apply nutrition in clinical practice. This approach adds color and flavor and makes healthy-eating a joy, rather than a worry-ridden chore full of calorie-counting and fretting over package labels.
Nishimi "Waterless" Vegetable Stew
This is a warming dish—strengthens the Spleen, Stomach, Intestines. Nishimi is restorative in times of fatigue & low vitality; it also strengthens digestion. Use organically-grown vegetables whenever possible.
Kombu or Hiziki Sea Vegetable
1 Burdock Root (scrubbed but not peeled)
2–3 Carrots (scrubbed, not peeled)
1 Winter Squash
1 Head of Broccoli
Miso (fermented soybean paste) or Soy Sauce
1. Cut all veggies into large pieces.
2. In a pot, boil approx. 1" of water, layer the vegetables in the order listed above lower the heat and cook for 30–45 min. Do not stir. Add a bit of miso or soy sauce near the end for flavor and digestive enzymes. Tofu, "Snow" tofu (i.e., dried, frozen tofu) or Tempeh can be added halfway through the cooking, if you desire more protein.
3. When Nishimi is finished there should be almost no water in the pot.
1 Burdock Root (scrubbed, not peeled)
1 Tablespoon Olive or Sesame Oil
1 Tablespoon Mirin (sweet Japanese rice wine) (optional)
or 1 Tablespoon Barley Malt
1/2 tablespoon Organic Miso
3 Tablespoons Water
3 Tablespoons Ground Toasted Sesame Seeds
2 Scallions or 1/3 Bunch of Watercress
1. Cut the Burdock into thin matchstick-sized pieces. Soak the matchsticks in water until you're ready to cook them.
2. Heat the oil in a pot until hot. Sauté the burdock for a few minutes. Add the mirin or barley malt and stir. Add the miso and water, stirring until the miso is dissolved. Cover, turn down the heat, and simmer for a few more minutes. If you want the burdock to be soft, cook it for 5–10 minutes. When it's cooked, add the ground toasted sesame seeds, scallions or watercress and stir before serving.
3. To toast sesame seeds, add them to a pan on low heat stirring the seeds with a wooden spoon, moving them at all times. They will smell like sesame when it's done. To grind use a spice grinder, a pepper mill, a food processor, or you can grind the traditional way by using a mortar and pestle.