Diet
How to Design Meals like Medicinal Formulas
If food is medicine then creating each meal should be a bit like writing your own herbal formula. Whenever possible, it should be as agreeable as possible with our unique physiology, though this is admittedly challenging when cooking for a family where everyone has different body types. Nevertheless, one part of each meal should complement the other parts, either through synergistic benefit or offsetting its potentially detrimental qualities.
As a longstanding, traditional example, any time we get Thai or Mexican food, it is served with cucumber or radishes, respectively, which are there to mitigate the side effects of the spice.
Most foods are good, but almost all of them have “side effects.” Red meat nourishes the body’s blood, yin, and qi, but if it were an herb it would be a bit warm and damp. Too much red meat and/or red meat that is not harmonized by the remainder of the meal can create damp heat, or inflammation in the stomach and intestines. Then again too little red meat can cause a deficiency of blood, yin, and qi. Ideally red meat (and pork) would be consumed alongside steamed vegetables, then followed by hot green tea, either after the meal or the following morning (green tea at other times and/or for vegetarians is thought to have a bit too cooling, or vasoconstrictive effect on the microbiome—for them black teas are preferable).
Carbohydrates are settling for both the stomach and the mind—probably why they give us such immediately pleasure—but they are obviously stickier foods, “damper” foods, which are more difficult to digest. For this reason whenever possible, it is best to eat them warm and cooked, and alongside more acrid spices in the meal, such as basil, rosemary, ginger, garlic, or onion. While I am Jewish and from New York, and love a great tuna on a bagel, there is a remarkable difference in the physiological response to cold tuna on bread versus cooked pasta with garlic and oil, maybe vegetables and cannelini beans. Yum!
Salads. Oh boy, do westerners love salad. Frankly, if you tend to any digestive problems whatsoever, raw foods should be avoided as much as possible, but if you must:
Consume salad more in summer—less in winter—and always alongside some cooked protein and/or ginger tea. The acridity of the ginger should help to warm the stomach to digest the raw foods. The protein should provide warmth, plus some much needed calories, or “qi and yin.”
Cooked vegetables, allergies notwithstanding, are probably the only perfect food that wholly lack side effects, which is probably why they are also the one food that nearly every paradigm of medicine agrees upon. If you don’t consume cooked vegetables daily you are on a dangerous path, in my opinion. They are nearly always harmless and beneficial… yet still ultimately inadequate, as we can only imagine the metabolic fatigue and inevitable illnesses to come were someone to consume exclusively vegetables.
Food is a gentle medicinal. It will neither heal nor destroy us quickly on its own, however it will always do one or the other over time. I’ve seen firsthand, in myself, loved ones, and patients eradicate chronic symptoms by pursuing a more Eastern diet, though it took many months—in my case years! People should not get discouraged by eating well for a particular interim and not feeling dramatically better. Instead, pay attention to whether you feel worse (always a possibility), meanwhile recognizing that without internal medicine, diet alone may take a long time to cure disease. It is up to us to continue to better understand the nature of each food, so that we can wisely design the perfect “herbal formula” three times a day until the end of time.
Pictured above is an imperfect, but still great meal: Breaded chicken cutlet, sauteed spinach, and roasted acorn squash with roasted apples, cinnamon, and maple syrup. What is “imperfect” about it? First, fruit should be consumed at least 15 minutes apart from other foods so as to avoid creating its notoriously mucus-like congestion in the microbiome. Also, “natural” or not, let’s be honest: maple syrup is sugar; and chicken is healthier without breadcrumbs. On the other hand, breadcrumbs make up a very small amount of the meal, the apples are at least cooked, hence easier to digest, and the leafy greens with garlic should help to optimally process the meat and sugars.
Breakfast Idea: Eastern Nutrition
Patients often ask me what they should eat for breakfast. Most Americans are conditioned to either skip breakfast, have something simple and unhealthy like a bagel or toast, or something “healthy” like yogurt or smoothies. While the latter might check off as such within the context of a scientific laboratory, obviously Eastern Medicines hold that uncooked foods are more difficult to digest, thereby ultimately providing us with less nutrients, in spite of having maybe started with more on the grocery shelf.
While going through Chinese Medical school my own microbiome was a minor disaster, and one of my teachers who was treating me at the time requested I eat sweet potatoes (with my eggs) for breakfast.
“You want me to eat Thanksgiving for breakfast?” I asked. He laughed and asked if I’d ever had eggs with hash browns or french fries. Of course I had, countless times.
He rhetorically asked me what the difference was —if I chopped sweet potatoes in the same way as hash browns, even adding onions to my liking. For years to follow sweet potatoes became my daily breakfast. And many of my health issues gradually improved during that time.
I became perpetually more educated in health and self-care, also about food itself. I learned that sweet potatoes are not in season for the majority of the year, which means during those periods they are, a) not as much what my body needs, and b) likely lacking in their maximum nutrients. From yams it was an easy transition to exploring other vegetables as side dishes with breakfast, which I realized was a good way to get in some daily recommended portions of greens from the start.
For many years now my breakfast has been eggs with a cooked, in-season vegetable, and would struggle to imagine starting the day any other way. In the Winter we eat a variety of root vegetables—whether roasted potatoes, carrots, radishes, or turnips—in Summer it’s more leafy greens. As for the ongoing, raging egg debate, now reignited by many functional medicine docs, all I can say is I’ve eaten eggs every single day for decades. I don’t doubt some peoples’ allergies to them, in which case they should surely avoid until that allergy is rectified. For the rest of us eggs provide invaluable nutrients in a very light, easily metabolized way. In Chinese Medicine they are said to nourish the blood, so much so that the yolk is even an ingredient in the herbal formula, “Huang Lian E Jiao Tang,” which is used to clear inflammatory heat that exists as a result of healthy systemic fluid deficiency. This “blood” benefit is probably why eggs are so highly recommended by many holistic fertility doctors.
EGGS AND “ZUCCH” (as my daughter calls it)
- Pre-heat oven to 375
- Slice squash however you like it, leave all of the slices on the cutting board, and lightly sprinkle them with salt. Let them rest for about 10 minutes (or longer) so that their excess water gets sweated out, then pat them dry.
- Add to pan with olive oil, sprinkle with salt, pepper, and whatever seasonings you like.
- Cook for 15-20 minutes, turning them over once in the middle to roast both sides
- Once almost finished cook your eggs to your liking.
- Drizzle a nice olive oil on top of them once plated
Thirst, Sweat, & Urine: What is Normal?
In contrast to the requisite ruling out of red flags by most nurses in conventional medical settings, the reason Chinese Medical practitioners ask about almost every system in your body is because we are diagnosing based on complete patterns—not just symptoms.
For example, if someone comes in for acid reflux, we cannot know their prescriptions until we know how often they urinate or poop, what each one is like, whether they experience headaches or dizziness, which part of the head they get their headaches in, how is their appetite, how thirsty they are during the day versus in the evening, etc. etc. This is because we are one of the only true forms of holistic medicine.
So, what is normal?
A normal amount of urination is approximately 6 times a day (yes, this includes waking at night). Much less than that and you are likely either retaining, or not drinking enough water in the first place. More than 6 indicates either a weakness in the urogenital microbiome, or excessive inflammation in the urogenital microbiome, which over time can lead to local weakness by putting strain on it. The remainder of the intake questions will determine which of the two is the case.
People should sweat, but not excessively so. Chinese Medicine is critical of HIIT or marathon training, hot yoga, and sauna therapy in most cases. While these might all feel great in the short-term and/or be proven to offer certain isolated benefits in the short-term, we believe they ultimately deplete the body’s healthy metabolic fluids. On the other hand, never sweating (exercising) at all is obviously just as harmful.
While some people barely break a sweat even when they exercise, others are drenched by the time they finish their morning commute, especially triggered by certain climates or seasons. The former can either indicate body fluid depletion or a malfunction of the immunological “qi.” The latter can either indicate inflammation, fluid retention, or also a malfunction of the immunological “qi.” This is where diagnoses and prescriptions get tricky.
Many western doctors have now begun to recognize the health benefits of the Chinese herb, astragalus, which on one hand is great. On the other hand, their recognition by way of empirical studies poses the challenge of having no comprehension of Chinese Medicine. If you give astragalus to the former example of a “cold-body person” with a simple immunological malfunction they will feel amazing and sing your praises. If you give it to someone with both immunological malfunction AND fluid deficiency it will do almost nothing. Worse, if you give it to a “hot-body person” with inflammation and fluid retention they will feel much worse.
Finally, it is normal to be thirsty, for 6-9 cups of water per day. A lack of thirst tells us there is fluid retention in the microbiome, signaling to the brain that it’s got plenty of liquid down here—no need to hydrate! This is dangerous, and better to fake it ‘til you make it in acquiring thirst. On the other pole are those who are ravenously or insatiably thirsty, which informs us of inflammatory heat in either their respiratory microbiome, gastrointestinal microbiome, or both, drying out their fluids. As always, the most complicated patterns are those who are generally unthirsty followed by sudden bouts of desperate thirst. This is a combination pattern that requires more thought, trial, and error.
I hope this was interesting and informative. One of western medicine’s shortcomings is its reliance on tests and labs to determine whether we are healthy or normal. While these are undeniably valuable, they tell only part of the story, which is why so many diseases get caught too late. Chinese Medicine is more brilliant in its neurotic recognition of pathologies in any abnormality, any imbalance, as something to rectify before it spirals into disease.
How Much Animal Protein Should I/We/U Eat?
I got some great feedback from last week’s newsletter, not the least of which in the form of an inquiry and idea for elaboration on what is a “mindful” amount of animal protein for one to consume. Obviously, this is a subject of great debate—as are most dietary recommendations—and one Chinese medicine has strong opinions on.
Ironically, it was “The China Study” (2005) that prompted even greater popularity for vegetarianism, in spite of my understanding its conclusion was predicated on the assumption that if less is good, then none must be great. Traditional Chinese Medicine does not agree.
It would be impossible to know exactly how much animal protein is advisable for any one individual, but relatively easy to offer some general guidelines:
- Eat only wild fish, grass-fed or grass-finished meats, sans hormones or antibiotics. I recommend Whole Foods, Vital Choice, or Butcher Box.
- Eat more animal protein in winter and less in summer—approximately once a day in winter (in addition to eggs is fine, since eggs are light and easily digestible in the absence of any specific sensitivity) and 2-4 times a week in summer.
- Women should eat more red meat on their menses.
- Women should eat more red meat before, during, and after pregnancy.
- Elderly people need more animal protein than younger people.
- Everyone needs more animal protein after surgery, or after something like a marathon—basically any physical trauma.
- Animal protein should make up the smallest portion of food on your plate. In no way does this mean it should not appear on your plate, nor that its appearance is that of an allowable indulgence. Just that if each meal could be looked at as an herbal formula, the most beneficial dosage of steak would be smaller than that of broccoli.
- It is a kind gesture to say a quick prayer and thank the animal before consumption.
- People with a great deal of systemic “damp heat” should eat less animal protein than those with systemic “cold” and “blood deficient” constitutions. The challenge of course lies in that damp heat can dry out our body fluids and create blood deficiency, which causes us to require more meat. Also cold, over time, can create damp heat in the typical manifestation of inflammation as result of weakness.
How do you know who you are? It’s tough.
“Cold people” tend to have lesser appetites, more digestive complaints, and more frequent bowel movements. They’re rarely thirsty and rarely sweat, but they tend to sleep great.
“Damp heat people” tend to huge appetites, iron stomachs, and less frequent bowel movements, which doesn’t seem to bother them at all. They’re more likely ravenously thirsty and sleep is a great challenge.
Obviously, there are exceptions to these rules, but mostly as a result of one pathology lingering chronically for long enough to complicate the pattern by engendering its opposite. This is what makes real medicine so challenging. In school we learn case studies as if people are one or the other—either warm or cold-bodied—then we get into practice and quickly realize if only it were so simple. People are complex. So are our bodies, which means so should be its fuel sources.
I love my vegan friends, I respect vegetarianism for ethical reasons, but per usual, I believe that Chinese Medicine’s more moderate and discerning perspective on diet is most logical.
Food as Medicine
Mama Always Said: You Are What You Eat
Maybe mom really did know best when it came to nutrition. As research has shown, what we eat can actually impact our health profoundly. Over the years, we have learned that our dietary choices can influence our risk of disease. And some have made it a profitable business to teach us new ways to look at food (anti-inflammatory diet, Keto, heart healthy, etc.). continue reading
