This article is about how I am becoming more of a simpleton as I get older. It essentially states the obvious, or perhaps what is obvious to me. But because something is obvious we should not stop saying it. Below are some reflections on what is important when we look at the question of what constitutes healthy eating. The lens through which this question is viewed is that of Chinese medicine which has informed my work for the last three decades.
These days this is the single most important piece of advice I give to my clients. I mean it. In Chinese medicine we understand that emotions and states of mind impact our Qi. Worry, the emotion associated with the Spleen, knots the Qi. This manifests as tension in the digestive system and inhibits our ability to digest clearly. When Chinese medicine says “Anxiety damages the Blood” it is describing this process. So worry, especially about food, is damaging. In fact I would go further and say that today worrying about food, overwhelmed as we are by too much often contradictory information and stimulation, has become a pathology.
Related to this is the state of the body when receiving the food. In the words of the bard “Unquiet meals make ill digestion” (Shakespeare, Comedy of Errors).
Relaxation and enjoyment are key and are part of the ‘yin’ aspect of digestion. A relaxed body will digest food more easily and enjoying our food is how we open to nourishment. Digestion begins even before we put the food into our mouths. The sight and smell of the food on our plate begins the production of digestive enzymes. Therefore, taking time to appreciate food before we put it in our mouths is part of healthy eating. If I achieve nothing else with a client beyond convincing them to slow down, stop worrying and enjoy their food I am happy with the session.
Less is More
A cook once held out her cupped hands to me and said “Look, this is the size of your stomach”. It was significantly smaller than the amount of food most of us put on our plates, including me. So this brings me to the issue of quantity. Perhaps the most radical thing we can do in support of our health is limit how much we eat. Now this sounds hard and ascetic but consider: all scientific studies have shown how limiting the intake of food has extended lifespan, brought about freedom from most diseases such as heart disease and cancer, and extended reproductive life. And it is clear, surely, that over-consumption is a prime cause of many of our modern ills. So when the Chinese say “Eat til you are two thirds full” they were on to something.
Let’s unpack this a little further. In Chinese medicine there is a concept of foods possessing a balance of Wei and Qi. Wei is the dense nutritious aspect of food which builds structure. Qi is the dynamic energetic aspect which assists with the processes of digestion and absorption, with transit through the system. We balance these according to our needs. For example, someone carrying excessive weight with sluggish digestion and signs of Heat may do well to eat more foods that are high in Qi and less that are high in Wei. Someone struggling to maintain weight and vigour showing signs of Deficiency may do well to do the opposite.
An overburdened digestive system becomes sluggish and is unable to keep pace with detoxification and elimination. Cultivating the (difficult) habit of stopping before we are full and ensuring we eat sufficient foods high in Qi i.e. fresh vegetables, fruits and whole grains will support the health of the digestive system.
If reducing the sheer quantity of what we consume is helpful it must be balanced by increasing the quality. Here again is a radical step. Simply upgrading the quality of our food, from chemically to organically grown, from old to fresh, from distant to local will have the effect of increasing our health, helping us to be more satisfied by our food (and therefore inclined to eat less).
Eating food with good flavour increases satisfaction and improves digestion. And the flavours are the nutritious essences of food. Dean Ornish, an American doctor and heart specialist, once said “As human beings we need a certain amount of gratification, and if we don’t get it in quality we tend to make up for it in quantity.” I like him for this. If food tastes good, and we are slowed down enough to appreciate this, we will eat less. Simple.
Then comes the issue of timing. Chinese medicine recognises that the body’s systems display a tidal movement of energy symbolised by the Chinese clock. Digestion is strongest in the morning and weakest in the evening. The implication here is that we should attend to breakfast. The Chinese clock is supported culturally by sayings such as “eat breakfast like a king, lunch like a merchant and supper like a pauper”. It is supported also by modern science. Many studies have shown how the habit of eating breakfast gives us the best chance of regulating our weight, avoiding diabetes and managing our energy levels through the day. Similarly studies have also shown how the timing and quantity of supper affects weight management – lighter and earlier suppers best supporting those who are attempting to regulate their weight.
Although making breakfast the biggest meal of the day may not work for most of us (it doesn’t for me), the important message here is that distributing nutrients more evenly through the three meals of the day and both reducing the quantity and lateness of the evening meal is pivotal in supporting our health. A recent study on weightloss showed that the “Big Breakfast Diet” i.e. a diet involving some fat and protein for breakfast was significantly more successful in achieving weightloss than a lighter carbohydrate based breakfast despite an overall higher consumption of calories by the Big Breakfast group throughout the day. As they say in Spain “Better lose a supper than have a hundred physicians.”
Seasonally too our diet needs to be responsive. More foods high in wei for the winter and foods with warming energy; more foods high in Qi and generally cooler in the summer. This is not news. However, it is when we go counter to the seasons that we invite trouble. For example, it took me a long time to realise that if I followed the natural offering of Spring – more greens, less heating foods and a bit of a Spring clean – my summer hayfever was significantly better.
Digestion is a warm process dependent on the Yang of the Spleen and ultimately the Kidneys. Healthy eating means looking after this fire. If we continuously fill the body with chilled foods and cold energy foods we weaken this fire. If we eat a mostly warm, cooked diet we support it. The extent to which we need to do this will depend on our constitution. Eating raw (cold) foods can also be buffered by the use of warming ingredients in dressings such as mustard, black pepper, horseradish and vinegar and by chewing well to warm and break down the food on the mouth.
This notion is pivotal to Chinese medicine’s understanding of nutrition. “Sui Ren (Fire Man) invented fire by drilling wood and instructed the people to take cooked food to prevent digestive diseases.” (The Book of Rites, 11th century BC). Although the inclusion of some raw food in our diet is certainly supportive to health, the current vogue of raw food fundamentalism is misguided. It is the head leading the body. I have seen enough clients to know that, in almost all cases, a raw food diet is both unsustainable and ultimately damaging to health. Supporting the digestive fire is fundamental to healthy eating.
The Qi of the Cook
So, what about the fire in the heart of the cook? Working as we do with Qi, it will be apparent to us that the Qi of the cook enters the food. I often tell the story of how, when I was gathering recipes for my book, I met a pizza chef who made the best pizzas in town. I used to hang out in his pizza joint and chat with him as he multi-tasked with complete equanimity, warm and humorous with all his clients, relaxed in the busy environment of the kitchen. When I asked him for his pizza recipe he smiled and said “Oh, it’s the same as Jo’s down the road”. I was not convinced. His pizza was extraordinary, Jo’s was not. “It’s not the ingredients,” he went on, “it’s the dance”. And he’s right. And not just the cooking but the growing and transporting and selling all leaves its Qi imprint. So I tell you this story and do with it what you will.
“Eating a balanced diet” would be viewed by most of us as sound advice. But what does this mean? Balance in diet may be looked at as the balance of wei and qi as discussed earlier. A diet too heavy in wei will impede the dispersal and transformation process and a diet too high in Qi may be too light, failing to provide a sufficient ground of nourishment.
It may also be looked at in the balance of all five flavours. “If people pay attention to the five flavours and blend them well, their bones will remain straight, their muscles will remain tender and young, breath and blood will circulate freely, the pores will be fine in texture, and consequently breath and bones will be filled with the Essence of life.” Huang Di, Yellow Emperor’s Classic of Internal Medicine, 2500BC. The flavours all have functions in the regulation of digestion and the habitual omission of a flavour or its overuse has consequences.
To take an example, the sour flavour has the function of supporting the digestion of fat, toning the body’s tissues through its astringent nature and encouraging movement of Liver Qi. Its omission may make the liver sluggish, encourage loss of tone and prolapse of body tissues, and fail to regulate the Stomach’s appetite. Its overuse may exacerbate the retention of Dampness.
One of the values of the bitter flavour is illustrated by the Maasai diet. The Maasai, whose diet is high in milk, eat a soup rich in bitter bark and roots which lower cholesterol and counter the congesting effect of the dairy. Urban Maasai, who don’t have access to the bitter plants, tend to develop heart disease.
A Five Element approach might encourage a “rainbow” diet balancing all the colours which, incidentally, provides a full range of anti-oxidants. Balance may also be considered as the balance of different foods on the plate i.e. the proportion of grains, vegetables, proteins etc. For example, a more meaty diet is best balanced with higher intake of vegetables and fruits/less grains and a more vegetable protein diet is complemented by a higher intake of grains.
We must be careful not to form rigid views about food. Human beings are adaptable and there is no perfect diet. Even the notion of balance must be considered thoughtfully. An Eskimo may eat a diet high in protein and fat, a Maasai may consume vast amounts of milk, a Seventh Day Adventist may follow a vegetarian diet: all three are very healthy populations. Each of these populations has two things in common: a knowledge of how to balance the potentially negative impact of their staple foods and a strong supportive culture.
So, some simple notions: don’t worry, enjoy, eat less, eat better, consider the rhythms of nature, have fun in the kitchen and eat an inclusive, broad diet. In my view we need to address these broad issues of how we relate to food before we enter the nitty gritty of what particular foods support our health. Actually all foods can support health. The critical factor, as Paracelsus says, is quantity. Meat nourishes our Blood and provides warmth. How much we should eat depends on the individual’s constitution and condition and will also depend on what other foods are being consumed. And this is where this article ends. The field of differential diagnosis and how we translate this into more specific individual recommendations is a different article.
Better to end with the wise voice of the comedian Fran Lebowitz “Food is an important part of a balanced diet.”