Dietary therapy, also known as food therapy, is a method that utilizes the properties of food to regulate bodily functions under the guidance of TCM theory, aiming to achieve health or prevent and treat diseases. It is commonly believed that food provides various nutrients necessary for human growth, development, and healthy survival. In other words, the primary role of food is nutritional.
However, this is not entirely accurate. TCM has long recognized that food can not only nourish but also treat diseases and expel illnesses. For instance, the modern physician Zhang Xichun pointed out in his work Medical Records of the East and West that food “not only treats diseases but also satisfies hunger”.
History
With the emergence and use of pottery, food preparation expanded beyond simple methods like “fire roasting meat” and “roasting grains on stones”. Cooking methods became increasingly diverse, and food flavors became more palatable. During this period, alcohol also appeared, as recorded in the Records of the Lüshi, where it mentions “Yidi making wine”. Initially, it was limited to naturally fermented beverages made from grains and fruits, later evolving into complex alcoholic and medicinal wines.
The Inner Canon from the Warring States period is the first medical theoretical work in China. The Su Wen: Discussion on the Five Constant Regulations advocates: “Great toxicity treats diseases, removing six out of ten; moderate toxicity treats diseases, removing seven out of ten; mild toxicity treats diseases, removing eight out of ten; non-toxic treatments remove nine out of ten. Grains, meat, fruits, and vegetables should be consumed in moderation, without excess, to avoid harming the body’s balance.” This text highly praises the role of dietary therapy in health preservation, marking a significant advancement in the theory of dietary therapy.
During the Eastern Han dynasty, the famous physician Zhang Zhongjing emphasized the importance of dietary therapy when treating external illnesses, stating that after taking Gui Zhi Tang (Cinnamon Twig Decoction), patients should “drink a bowl of hot thin porridge to assist the medicinal effect”. He also advised against consuming cold, greasy, or spicy foods during treatment, highlighting the importance of dietary health and its auxiliary therapeutic role.
In the Sui and Tang dynasties, many specialized texts on dietary therapy emerged, such as Sun Simiao’s Essential Prescriptions Worth a Thousand Gold, which dedicated a section to food therapy. He advocated that “physicians should understand the source of diseases and know what to avoid, treating them with food first, and only resorting to medicine if food therapy fails”, reflecting the principle of “people-centered” care. Subsequent works like Food Therapy Materia Medica and Food Properties Materia Medica systematically recorded various medicinal foods and dietary prescriptions. The Song dynasty’s Complete Compendium of Sacred Aid established a dedicated section for food therapy, introducing dietary methods for various diseases. Chen Zhi’s Book on Caring for the Elderly focused on health care issues for the elderly, emphasizing the importance of dietary nutrition for health. The Yuan dynasty’s Principles of Dietary Therapy compiled by Hu Sihui inherited the tradition of integrating food, nourishment, and medicine, discussing dietary practices for healthy individuals, and is considered the first nutritional science text in China. The Ming dynasty’s Compendium of Materia Medica by Li Shizhen included over 300 medicinal grains, vegetables, and fruits, and over 400 animal-based medicines, all suitable for dietary therapy. Additionally, works like Lu He’s Materia Medica of Foods, Wang Mengying’s Dietary Records of Suixi Ju, and Fei Boxiong’s Three Types of Dietary Nourishment contributed to the comprehensive development of dietary therapy.
Taboos
It can be said that a low-salt diet is the foundation of dietary therapy for most patients with kidney diseases. A low-salt diet strictly limits sodium intake. Therefore, all foods high in sodium should be restricted. High-sodium foods mainly fall into two categories: first, seasonings like salt, monosodium glutamate, and soy sauce; second, various salted preserved foods such as pickled vegetables, cured meats, and sausages. Daily salt intake should be controlled at 2-3 grams (a medium-sized toothpaste cap is about 1 gram) or 10-15 milliliters of soy sauce. Low-salt diets prohibit the second category of foods. Monosodium glutamate contains half the sodium of table salt and must also be used sparingly. Additionally, various flour products generally contain a certain amount of sodium (baking soda), so they should also be consumed in moderation. Since various natural fresh foods have very low sodium content, it is not difficult to maintain a low-salt diet by limiting the use of seasonings, using less salt, monosodium glutamate, and soy sauce, and more sugar and vinegar. Furthermore, the Chinese herb Qiu Shi (Autumn Stone) and commercially available low-sodium salt can be used to enhance saltiness. However, they mainly consist of potassium chloride, so consultation with a physician is necessary. In cases of oliguria or anuria, or late-stage renal failure, caution should be exercised or they should be avoided to prevent hyperkalemia. A low-salt diet is primarily suitable for patients with nephrotic syndrome, hypertension, and oliguria, and is the most commonly used dietary approach for kidney diseases. However, patients with tubular damage in the kidneys generally should not adopt a low-salt diet, as excessive sodium loss in urine can lead to hyponatremia and insufficient blood volume. Therefore, sodium supplementation should be considered, and high-sodium foods should be consumed.
1. Below are various drug and food compatibility taboos listed by different editors:
(1) Generally, diaphoretic drugs should avoid cold foods; digestive tonics should avoid greasy foods; anti-edema and qi-regulating drugs should avoid legumes; cough suppressants should avoid fish; and anti-diarrheal drugs should avoid melons and fruits.
These taboos mainly include: pork with Wu Mei (Mume), Jie Geng (Platycodon), Huang Lian (Coptis), Huai Shan (Chinese Yam), Bai He (Lily), Cang Zhu (Atractylodes); lamb with Ban Xia (Pinellia), Chao Pu (Acorus), avoiding copper and cinnabar; dog meat with Shang Lu (Sichuan Pepper), avoiding almonds; crucian carp with Hou Po (Magnolia Bark), avoiding Mai Dong (Ophiopogon); pig’s blood avoiding Di Huang (Rehmannia), He Shou Wu (Fo-Ti); pig’s heart avoiding Wu Zhu Yu (Evodia); carp avoiding Zhu Sha (Cinnabar); sparrow meat avoiding Bai Zhu (Atractylodes) and plums; scallions avoiding Chang Shan (Dichroa), Di Huang, He Shou Wu, honey; garlic avoiding Di Huang, He Shou Wu; radish avoiding Di Huang, He Shou Wu; vinegar avoiding Fu Ling (Poria); Tu Fu Ling (Smilax) and Wei Ling Xian (Clematis) avoiding tea, etc.
(2) The ancients also had some taboos regarding food combinations, although the reasoning may not be sufficient, they can serve as references in medicinal cuisine applications.
These taboos include: pork avoiding buckwheat, pigeon meat, crucian carp, and soybeans; lamb avoiding vinegar; dog meat avoiding garlic; crucian carp avoiding mustard greens and pig liver; pig’s blood avoiding soybeans; pig liver avoiding buckwheat, bean paste, and carp intestines; carp avoiding dog meat; turtle meat avoiding amaranth, wine, and fruits; eel avoiding dog meat and dog blood; sparrow meat avoiding pig liver; duck eggs avoiding mulberries and plums; chicken meat avoiding mustard, glutinous rice, and plums; turtle meat avoiding pork, rabbit meat, duck meat, amaranth, and eggs. The application of these taboos mainly aims to prevent qi stagnation, wind generation, sores, and disease onset.
2. Seasonal dietary recommendations
Seasonal dietary adjustments involve adapting one’s diet according to the changes in nature throughout the four seasons. This perspective is based on the holistic view of health preservation in TCM. Diet is one aspect of the body’s connection with the external environment, so dietary practices should also adapt to the seasonal climate changes.
In spring, the liver qi is dominant, so it is advisable to reduce sour and increase sweet flavors to prevent excessive liver qi generation, especially for those with a tendency towards hyperactivity of liver yang, as spring is a time when relapses are most likely. Therefore, in addition to dietary adjustments, it is best to use medicinal prevention, such as consuming sweet foods to nourish the spleen qi.
In summer, the climate is hot, and digestive functions decline, so it is advisable to eat light and easily digestible foods, particularly rich in nutrients like vegetables and fruits.
As summer involves more sweating and relative fluid loss, it is advisable to consume moderate amounts of cold drinks like green bean soup to replenish fluids and clear heat. However, excessive cold drinks should be avoided, as they can be harmful.
Since ancient times, the Chinese have had the habit of drinking tea to relieve summer heat. Modern research has shown that tea contains not only coarse fiber, mucilage, and chlorophyll but also alkaloids, flavonoids, tannins, vitamins, ergosterol, volatile oils, and small amounts of niacin, thiamine, folic acid, proteins, and minerals. Drinking tea can refresh the mind, relieve fatigue, and enhance memory. Therefore, drinking tea in summer is more effective than cold drinks for cooling off.
In autumn, gastrointestinal diseases are more prevalent, so special attention should be paid to dietary hygiene to prevent “diseases from entering through the mouth”. Additionally, after the beginning of autumn, one should not indulge in cold drinks and foods to avoid harming the spleen and stomach.
In winter, with the dominance of yin and the decline of yang, it is a good time for those with weakness to replenish. The key to winter nourishment is food supplementation, with many nourishing options available, tailored to individual needs.
For those with qi deficiency, presenting symptoms like fatigue, shortness of breath, dizziness, and spontaneous sweating, Ren Shen (Ginseng) chicken soup can be beneficial; for those with blood deficiency, showing pale complexion, dizziness, and numbness in hands and feet, consuming more Hong Zao (Red Dates), Gui Yuan (Longan), and animal blood and liver can be helpful; for those with yin deficiency, foods like Tuan Yu (Round Fish), turtle, and Dan Cai (Mussels) are recommended; for those with yang deficiency, foods like beef, lamb, and dog meat that warm the body and nourish the blood are suitable.
Misconceptions in Dietary Therapy
What are misconceptions in dietary therapy?
Blindly supplementing
Incorrect supplementation direction. Some people feel their bodies are weak and often use tonics like ginseng wine, astragalus yam soup, or ginseng astragalus essence, thinking they are harmless. However, these substances are not suitable for those with yin deficiency (pale complexion, palpitations, low fever, night sweats, thirst, red tongue with little coating, insomnia with vivid dreams), as they can further deplete yin fluids and worsen symptoms. The aforementioned tonics are effective for those with qi deficiency, who may experience shortness of breath, dizziness, and prolapse of internal organs (such as gastric, renal, or uterine prolapse, or rectal prolapse). Therefore, it is essential to supplement according to the symptoms. For example, many elderly patients with chronic bronchitis often exhibit symptoms of lung yin deficiency (coughing without phlegm or with scanty thick phlegm, sometimes with hemoptysis, tidal fever, night sweats, hot palms and soles, dry mouth and throat). If they use overly sweet and warming red ginseng, it may worsen their condition; instead, Xi Yang Shen (American Ginseng) or Sha Shen (Glehnia) should be used to tonify qi, nourish yin, and clear heat. For this type of yin deficiency cough, consuming fresh Di Zhu (Earth Rice) porridge or candied lily can be beneficial.
Excessive supplementation. The elderly often have weak digestive power and spleen-stomach deficiency. If they consume large amounts of nourishing foods like longan meat, cooked rehmannia, or donkey-hide gelatin, it can weaken their digestive capacity, reduce appetite, and lead to symptoms like abdominal distension and diarrhea. Therefore, excessive richness is a common mistake in supplementation. If elderly individuals are indeed yin deficient, they should use cooked rehmannia or donkey-hide gelatin in small amounts, avoiding overly rich foods. Consuming appropriate amounts of rock candy and Huang Jing (Polygonatum) soup or Yi Pin Huai Shan (One-Grade Yam) is also a good choice. Lu Rong (Deer Antler) can indeed tonify essence and assist yang, being a well-known yang tonic, but if used in large amounts suddenly, it can lead to symptoms of heat excess such as nosebleeds, red eyes, dizziness, etc. Therefore, it is crucial to start with small amounts.
Assuming supplementation. Some people believe that vitamins are supplements and can be used without restraint. For example, fish liver oil contains vitamins A and D. When the body lacks vitamin A, it can lead to dry eye disease and night blindness, while a deficiency of vitamin D can cause rickets. However, in reality, obtaining vitamin A from food is sufficient for physiological needs, and only in cases of chronic hepatitis, pancreatitis, or diarrhea will vitamin A deficiency occur. In such cases, treatment should target the underlying cause while appropriately supplementing vitamin A. Blindly taking large amounts can lead to toxicity, resulting in symptoms like headaches, nausea, vomiting, hair loss, and skin itching. Long-term excessive use of vitamin D can cause low fever, irritability, loss of appetite, liver enlargement, kidney damage, and bone hardening. Other vitamin supplements should also not be used blindly as tonics; for instance, excessive long-term use of vitamin C can lead to kidney, ureter, and bladder stones, while excessive use of vitamin B1 can cause headaches, irritability, arrhythmias, edema, and nervous exhaustion.
Abuse of medicinal foods
In recent years, “medicinal foods” have become popular. However, the abuse of these “medicinal foods” can be very harmful. They can disrupt normal physiological activities in the body and even cause diseases. For instance, products like “ginseng gummies”, “deer antler gummies”, “ginseng milk powder”, and “ginseng cookies” can promote the secretion of gonadal hormones. If children consume these so-called “medicinal foods” indiscriminately, it may lead to precocious puberty, such as the development of facial hair and pubic hair. Some “medicinal foods” (like certain beverages) contain caffeine and other stimulants, and excessive use can disrupt the body’s biological rhythms and harm health. Additionally, some people make their own “medicinal foods”. For example, some believe that licorice is harmless and beneficial, and due to its sweet taste, they brew licorice in water as tea. This is very dangerous. Prolonged consumption of this “licorice tea” can produce side effects similar to adrenal cortex hormones, reducing sodium excretion and increasing potassium excretion, leading to hypernatremia and calcium deficiency seizures. Prolonged use of licorice can also lead to adrenal cortex function decline, which can be quite troublesome, as some patients may need to take corticosteroids like prednisone for life to maintain their health.
Not distinguishing suitability and taboos
In the process of dietary therapy, it is crucial to distinguish the suitability and taboos of foods for different individuals. For instance, many people believe that fish is suitable for everyone. However, this is not the case. Fish oil primarily contains eicosapentaenoic acid, which inhibits platelet aggregation and is beneficial for preventing and treating coronary heart disease and cerebral thrombosis. However, because it reduces platelet aggregation, it can lead to spontaneous bleeding, including cerebral hemorrhage. Research has shown that the Inuit people, who primarily consume fish, have a very low incidence of coronary heart disease and cerebral thrombosis, but cerebral hemorrhage is a significant cause of death among them. Therefore, individuals with a tendency towards cerebral hemorrhage or those with a history of cerebral hemorrhage should not consume fish indiscriminately.
Precautions
Adhering to dietary therapy principles is beneficial for health and disease prevention. Conversely, failing to follow these principles can be detrimental, even harmful. The following are some important precautions:
Avoid dietary bias
A reasonable diet first requires dietary diversity. TCM uses the five flavors to represent various foods and their characteristics, and it also believes that the intake of various foods should not be biased; if one has a long-term preference for certain foods, it can affect normal physiological states and even lead to diseases. For example, the Huang Di Nei Jing states: “Excessive sourness can damage liver qi, leading to deficiency of spleen qi; excessive saltiness can exhaust the bones and shorten muscles, suppressing heart qi; excessive sweetness can cause heart qi to flutter, leading to dark complexion and imbalance of kidney qi; excessive bitterness can dry the spleen qi, thickening stomach qi; excessive spiciness can obstruct the meridians, leading to mental fatigue.” It repeatedly emphasizes this issue.
A reasonable diet also requires a balance of coarse and fine foods, and a coordination of meat and vegetables, especially avoiding diets high in saturated fatty acids from animal sources. Excessive saturated fatty acids can increase cholesterol levels in the blood for most people, leading to atherosclerosis and inducing coronary heart disease. Ancient TCM also pointed out that “rich and heavy foods” can lead to illness.
In daily life, some people do have a preference for spicy foods, fried and greasy foods, or alcoholic beverages; children often prefer snacks and meat. These habits are detrimental to health. Among flavor preferences, a love for overly sweet or salty foods is harmful. Sweet foods, primarily sugars or sugar-containing foods, are positively correlated with the incidence of dental caries, so it is advisable to reduce sugar and sweet foods to protect teeth. Salty foods, which contain sodium and chloride, are also linked to the incidence of hypertension, so salt intake should be limited. To prevent hypertension, it is advisable for each person to consume no more than 10 grams of salt daily. Patients with hypertension should especially limit their salt intake. As for consuming high-proof liquor without restraint, it can reduce appetite and food intake, leading to nutritional deficiencies, and in severe cases, can cause alcoholic liver cirrhosis. Therefore, it is advisable to drink less or avoid alcohol, especially high-proof liquor. Pregnant women and children should avoid alcohol altogether.
Additionally, the Huang Di Nei Jing states: “Diet should not be excessively hot or cold”. The Jin Gui Yao Lue also mentions: “Food should be moderated in temperature”. This indicates that one should not excessively consume cold, raw fruits and vegetables, nor should one eat foods that are too hot or spicy. The former can easily damage the yang qi of the spleen and stomach, leading to symptoms like reduced appetite, diarrhea, or menstrual irregularities in women; the latter can lead to heat accumulation in the intestines and stomach, damaging yin and fluids, causing thirst, dry throat, or abdominal pain and constipation, and is also a significant factor in inducing esophageal cancer.
Moderation in diet
Moderation in diet or appropriate hunger and fullness refers to the need for dietary intake to be moderate, neither too little nor too much. This is one of the essential components of a reasonable diet. Generally, when appetite is satisfied, caloric needs can be met, which is one of the standards for maintaining a healthy body weight. Eating too little can lead to weight loss, while eating too much can lead to obesity, both of which are undesirable.
In ancient China, there was significant attention to the harm caused by overeating. The Huang Di Nei Jing states that dietary intake should not be excessive, as it can harm the body’s balance. First, “excessive eating can damage the intestines and stomach”. Furthermore, it can lead to certain diseases. Regarding the severe consequences of overly rich diets, the Shou Shi Bao Yuan states: “Indulging in gluttony, pursuing the beauty of flavors, and exhausting the joy of eating, even if the body is plump and the complexion is radiant, the intense qi will erode the organs, leading to spiritual depletion!”
How to maintain moderation in diet? The Principles of Dietary Therapy states, “Those who are good at nurturing their nature eat when hungry, and do not overeat; drink when thirsty, and do not overdrink. Appetite should be moderate and not excessive at once.” This remains very applicable today.
Dietary considerations during illness
As early as the Han dynasty, the Jin Gui Yao Lue stated: “The flavors of food can either be beneficial or harmful to the body; if suitable, they benefit the body, if harmful, they cause disease.” This indicates that dietary choices should be made based on the disease and symptoms, as dietary suitability varies with different diseases and conditions. For example, for those with spleen and stomach cold deficiency, experiencing diarrhea and abdominal pain, it is advisable to consume easily digestible foods that can warm the spleen, such as those containing Shan Yao (Chinese Yam), Lian Zi (Lotus Seed), Hong Zao, Sha Ren (Amomum), and Huo Jiao (Pepper). Cold, raw fruits and overly rich foods like ice pops, cold drinks, watermelon, glutinous rice, sea cucumbers, and fatty meats should be avoided. For those with yin deficiency and internal heat, presenting symptoms like fever, irritability, and thirst, it is advisable to consume foods that nourish yin and clear heat, such as those containing watermelon, tomatoes, celery, lotus seed heart, and Mai Dong (Ophiopogon); spicy, warming, and stimulating foods like ginger, chili, lamb, strong tea, alcohol, and coffee should be avoided. Diabetic patients should consume foods that help lower blood sugar, such as those containing Shan Yao, Mai Dong, Stevia, and Huang Qi (Astragalus); refined sugars and their products should be avoided. Generally, during illness, it is advisable to consume foods that are mild in nature, easily digestible, and nutritionally balanced, while avoiding hard, sticky, foul-smelling, and overly greasy foods.
In the early stages of recovery from illness, when appetite is just returning, it is advisable to start with porridge and not abruptly return to regular meals or rich foods, as this can be difficult to digest, burden the spleen and stomach, and even lead to incomplete recovery or relapse of the illness. This is especially common with gastrointestinal diseases.
Aside from the above, general dietary hygiene is also worth noting.
Dietary Therapy for Diseases
Dietary Therapy for Psoriasis
Fresh Sophora Flower Porridge
Method: Combine 30 grams each of fresh sophora flowers and Tu Fu Ling (Smilax) in a pot, add an appropriate amount of water, and boil for half an hour. Strain to obtain the liquid, then add 60 grams of glutinous rice and cook into porridge, sweeten with an appropriate amount of brown sugar before consumption. This porridge should be consumed once daily for a duration of 10 days as a treatment course. It has the effects of clearing heat, cooling blood, and relieving itching, effectively alleviating psoriasis symptoms.
Dietary Therapy for Pelvic Inflammation
Three-Character Classic of Dietary Therapy
Author: Li Baokun
Eat raw pears, good for phlegm. Ginger scallion soup, treats colds.
Rich in iodine, kelp is wonderful. Boil green beans, detoxifying is clever.
For insufficient milk, eat pig trotters. Mushrooms help tumors dissolve.
Eat tomatoes for a youthful appearance. Grapes keep one from aging.
For black hair, eat walnuts. Want to lose weight? Cucumbers are good.
For gastroenteritis, garlic is wonderful. Eat winter melon to promote urination.
For unblocking meridians, purple eggplant is good. To detoxify, cabbage is excellent.
Eat cauliflower to reduce cancer risk. Eat tangerine peel to dissolve phlegm.
For cholesterol, beer is wonderful. Eat poultry eggs to improve memory.
To generate saliva, dried plums are clever. To suppress cancer, kiwi is effective.
For lung nourishment, honey is good. Eat Yin Er (Tremella) to prevent aging.