Dietary therapy

The practice of using food to treat illness. Dietary therapy can be used alone or in conjunction with other therapies.

Food versus Medicine (食物与药物 shí wù yǔ yào wù)

In Chinese culture, the line is thinly drawn between food and medicine. Food is for sustenance and pleasure. Medicine is for treating illness; most of it is taken orally like food. Chinese medicinals, like food, are mostly vegetable and animal products. In China, many medicinals are regularly used as food or in the preparation of food, e.g., fresh ginger, scallions, garlic, Sìchuān peppercorns, fennel seed, star anise, cinnamon, pepper, fermented soybeans, mung beans, adzuki beans, and coix (Job’s tears).

All foodstuffs, like medicinals, are analyzed in terms of their flavor (the five flavors) and their nature (hot, warm, cool, cold). For example, the famous Chinese bitter melon (also called balsam pear) is bitter and cold like huáng qín (Scutellariae Radix) and has a similar effect on the body. Because of this, careful selection of foodstuffs according to the same principles as are applied in the selection of medicinals can be used to create a daily diet that can treat illness or at least provide support for therapy. When we have a hot condition, we can use cold-natured foods to counteract it. When we have a cold condition, we can use hot-natured foods or medicine to help restore the balance.

Chinese doctors will prescribe medicine for their patients, but they usually also tell them what foods to eat or avoid. For example, they tell patients with yīn-biased constitutions and cold conditions to increase their intake of warming foods like lamb, ginger, scallions, and garlic, and try not to eat too many cold and raw foods and green vegetables. Chinese patients usually have an inkling about the hot and cold nature of foods, because Chinese medicine is part of their culture.

Medicinal Cookery (药膳 yào shàn)

China has a tradition of using medicinals in cookery as part of dietary therapy or for the pleasure of the palate. Medicinal cookery differs from regular medicinal therapy not only by the use of regular foodstuffs but also by limiting medicinals to those whose flavors combine well with foodstuffs and are pleasant to the palate. Since these mostly fall within the category of supplementing medicinals, medicinal cookery tends to be used to supplement insufficiencies rather than eliminating evils. Supplementing medicinals, whether they supplement qì, blood, yīn, or yáng, tend to be sweet in flavor, and hence highly suited for use in the preparation of pleasantly tasting dishes.

The medicinals most commonly used in medicinal cookery are huáng qí (Astragali Radix) and dà zǎo (Jujubae Fructus), which boost qì, and cooked shú dì huáng (Rehmanniae Radix Praeparata) and gǒu qǐ zǐ (Lycii Fructus), which supplement blood and yīn. All these are sweet and pleasant-tasting. When they are added to a soup of chicken, pork, or fish, they create a delightful centerpiece to a hearty, healthy meal.

Rén shēn (Ginseng Radix) is often used in medicinal cookery for its powerful supplementing qualities and its unique flavor. The fine roots are often used for economy. Ginseng is very often combined with dà zǎo (Jujubae Fructus) and chicken to made Ginseng and Jujube Chicken (rén shēn dào zǎo jī).

Medicinal cookery is, however, not by any means limited to supplementing medicinals. Yì yǐ rén (Coicis Semen), for example, looks and tastes very much like barley, although it is slightly larger. Coix has properties and actions similar to those of fú líng (Poria) but tends to be used more commonly in medicinal cookery because it can be eaten. It is used as a foodstuff; it often appears in sweetened gruels made of multiple grains and seeds, such as Eight Gem Gruel (bā bǎo zhōu).

Dāng guī (Angelicae Sinensis Radix), which is used both to supplement and quicken the blood, is prized in medicinal cookery not only for its excellent medicinal qualities but, like ginseng, also for its unique flavor. Chinese angelica notably appears in combination with shú dì huáng (Rehmanniae Radix Praeparata), bái sháo yào (Paeoniae Radix Alba), and chuān xiōng (Chuanxiong Rhizoma) in the above-mentioned sì wù tāng (Four Agents Decoction), which is an effective remedy for blood vacuity and blood stasis, as well as a popular way of cooking chicken.

The main topic of this section, however, is not medicinal cookery, but the use of regular foodstuffs in the treatment of illness.

Dietary Balance

According to Chinese (as well as Western) nutrition theory, the key to healthy eating lies in balance, which is achieved through variety. Foodstuffs are fairly well distributed between hot and cold, and in general foodstuffs tend to be on the warm or the cool side, and only rarely cold or hot. By ensuring a variety of different foods, it is easy to keep in good health. For the Chinese (except those living in very poor areas), variety is not a problem. Chinese culture is a food culture. The Chinese adore good food and variety in food. A middle-class Chinese family meal invariably includes two or even three kinds of animal protein (pork, duck, and fish, for example), and very often a tofu dish. Chinese markets offer a much greater variety of vegetables, and in specific a greater range of green leafy vegetables. A meal is barely complete without a green vegetable.

Most Chinese cooks compose meals without thinking very much about the hot and cold balance. They don’t have to, because their love of variety in food usually ensures balance. When they are sick and are given instructions about what to eat and not to eat, they become more sensitive to the yīn-yáng balance.

The Nature of Foodstuffs (食物的性质 shí wù de xìng-zhì)

Foodstuffs are analyzed in terms of flavor and nature just as Chinese medicinals.

Western practitioners wishing to tell their patients about food values in Chinese medicine have a harder task because patients are generally less familiar with the Chinese view of nutrition. The best thing to do is to give them printed information, ringing the items that are good for them and crossing the items that are bad for them.

In general, the following three points provide a rule of thumb.

Balanced: Grains, many meats, certain vegetables (mainly root crops).

• Grains and meats tend to be balanced in nature.
• Meats are largely balanced, e.g., pork and beef (chicken and lamb are warm).
• Vegetables: white cabbage, potato, carrot, and turnip.

Warm-hot: Alliums (onions, garlic, etc.), spices, certain meats.

• The most commonly used fresh condiments in Chinese cooking are scallions, ginger, garlic, chili, and coriander leaf; they are all warm in nature. In general, all species of the genus allium, including garlic, onions, shallots, scallions (spring onions), garlic chives, and chives are warm in nature.
• Fermented soybeans and hot bean paste are also warm in nature, as also are most dried spices, such as Sìchuān peppercorns, pepper, dried chili, star anise, and cinnamon bark. Chinese wine used in cooking is also warm.
• Chicken, and especially lamb, dog meat, and venison are warm.
• Alcoholic beverages are warm-hot. The higher the alcohol content, the hotter they are. Chinese rice wine used in cooking is also warm.

Cold-cool: Tofu, green vegetables, and salt.

• Tofu (bean curd), the Chinese vegetarian’s main source of protein, is cool in nature, because the heat-clearing medicinal gypsum (shí gāo) is added to coagulate soybean milk, although some varieties now commercially available are made with other coagulants.
• Green leafy vegetables are cold in nature.
• Gourds according to Chinese sources are mostly cool-cold. This is because gourds with a fresh green skin, such as Asian cucumber, luffa gourd, and bottle gourd most commonly appear on the Chinese table. Regular cucumber and zucchini (courgettes) fall into this category. However, pumpkin and many American squashes that have colored skins and keep well are warm.
• Salt is cold in nature. Soy sauce, which has a high salt content, is also cool in nature.

Patients with a strong preference for meat over vegetables or a partiality for highly spiced meat dishes may have a diet that is too warm in nature. If they go for hamburger, steak and French fries or rich cheesy dishes, they may have a similarly over-warm diet. Spicy hot fatty and sweet foods and alcoholic beverages, especially the stronger kind, tend to create excess heat in the body that also often gives rise to dampness.

According to Western nutrition, such patients have a diet with insufficient fiber, which is a major single dietary cause of numerous unhealthy conditions. Patients eating mostly Western food must control their intake of meat, cheese, and fried foods. Patients who eat mostly Chinese, as well as other East Asian, food are likely to be eating less meat, but more oil and spice. The solution in both cases is more vegetables and fruit. In Western theory, that means more fiber; in Chinese theory, it means more coolness.

People who avoid meat and tend to rely on tofu or have a partiality for green vegetables have a diet that diet may be on the cold side. This can be compensated by adding warm and hot spices to their food. Generally, people with a predilection for bland, cool-natured foods are less common than people who tend towards an overly warm diet. Nevertheless, people who are not overweight, but have a fetish for keeping their weight down, tend to suffer from an overly cool diet.

The following list of foodstuffs and their warm-cool values is compiled from several reliable Chinese sources. Many of these items are available in China but not in the West; certain items commonly eaten by Westerners do not appear in the list. However, by studying this list, you will get a general idea of the classification system. Certain items are classified differently in different source texts. This is because any classification is based on experience of what effects a food item produces on the body rather than on constituents, and experience of effects produced may vary.

Postpartum Recuperation: Sitting Out the Month (坐月子 zuò yuè zǐ)

In Chinese culture, women rest up for several weeks after giving birth, usually for about 30 days. In Chinese, this is called 坐月子 zuò yuè zi, sitting out the month. Traditionally, they do not bathe or wash their hair for fear of catching cold. They avoid excessive fluid intake to prevent water swelling. They also follow a strict diet. The proscriptions about washing have become less stringent with the advent of hot running water and central heating. However, many women still follow a strict diet, which includes many dishes cooked with black sesame oil, which is sweet and cool, moistens dryness, free the stool, resolves toxin, and promotes the growth of flesh, thus aiding recovery after childbirth. Here are instructions that some Chinese doctors give.

First week: For the first week, a diet based on chicken, pork, or fish soups is recommended. These foods are regularly given to the sick and convalescent in China because they are easy to digest and don’t overburden the spleen.

Second week: In the second week, the patient should eat dishes with black sesame oil, such as pork livers stir-fried with black sesame oil, pork kidneys stir-fried with black sesame oil, dried longans stir-fried with black sesame oil, and Eucommia and Kidney Soup.

Third week: Starting from the 14th day after delivery, the patient can eat a diet based on Sesame Oil Chicken (recipe below). This is the classic dish eaten by Chinese women after childbirth. However, since chicken is quite fatty, it is best not to start taking it until the third week.

To be avoided: Throughout the postpartum recuperation period, the mother should avoid raw foods, cold foods, and cool- or cold-natured foods (as given above); deep-fried foods, highly spiced foods (chili, curry), pickled foods, excessive use of salt, and excessive use of acid foods (vinegar, lemons, etc.) are also contraindicated. If her wounds of childbirth have not heeled and there is redness and swelling, she should avoid sesame oil and crab.

Sesame Oil Chicken: This is a nourishing dish that you can enjoy even if you have not just had a baby.

Ingredients: 1 chicken chopped into chunks, 10 slices of old ginger, 6 tablespoons of black sesame oil, 1 bottle of yellow rice wine.

Method: Heat the black sesame oil in the wok and fry the sliced ginger over a low flame until it starts to frazzle. Then add the chicken chunks, stirring all the time until they start to turn a golden brown. Then add the yellow rice wine and enough water to cover the chicken. Bring to a boil. Then cover and simmer for 20–40 minutes depending on how soft you like the meat.