“Eating a balanced diet” would be viewed by most of us as sound advice. But what does this mean? What are we balancing? In this article I will be exploring what light Chinese nutritional theory throws on the question.
From a western viewpoint a balanced diet might be seen as one which balances protein, fat, carbohydrate, vitamins and minerals. In the UK, for example, an NHS website suggests we look at food as consisting of five main groups:
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- Fruit and vegetables.
- Starchy foods, such as rice, pasta, bread and potatoes.
- Meat, fish, eggs and beans.
- Milk and dairy foods.
- Foods containing fat and sugar.
We are recommended to eat “five a day” from the fruit and vegetable group to protect us against degenerative diseases. Wholegrain is advocated over refined grain to improve bowel movement and regulate blood sugar. Lean meats and oily fish are particularly recommended. Low fat milks and cheeses are preferred, saturated fats are discouraged and intake of refined, sugary and processed foods is to be kept low.
This sort of advice is fairly standard. It is founded on modern research and has the support of both government and the medical profession. If followed, it is certainly a broadly healthy common sense approach that will move the nation away from its addiction to fast, denatured foods and reduce the load on our health system of the consequences of poor eating habits.
Chinese medicine, although it might reach some of the same conclusions, views the issue of balance through a different lens. Balance is understood to be the skillful blending and inclusion of the “five flavours” and the balance of “thermal natures”. The question of balance also includes balancing the person with their environment, eating in harmonious relationship with the climate, weather and season. A balanced diet is also one which is individually tailored according to a person’s constitution, condition and lifestyle.
We begin with the notion of the “five flavours”. Whereas in the West we assign nutritional values to food based on their chemical composition (this much vitamin A, that much potassium) and calorific value, the Chinese assign value based on a food’s effect on our body after digestion. Foods are described as heating or cooling, as possessing certain flavours, as taking certain routes and as having various actions.
Although the modern scientific view no longer describes foods in these terms, such an understanding of food has characterized western thought until very recently. In “Regimen in Health” written in the fifth century BC, Hippocrates, who we recognize as a father of western medicine, outlined guidelines for healthy eating which profoundly influenced western though for two millennia. Later classified by Galen in the second century AD, the system describes foods according to their natures (Hot, cold, dry, damp and so on) and advocates that we eat to balance the nature of the prevailing season as well as according to our own temperament (a system of four elements and their corresponding “humour”).
Winter, therefore, which is cold and wet, is balanced by eating a drying and warming diet. A person is also encouraged to eat to balance their own innate tendencies toward imbalance. The “phlegmatic” person, for example, would be encouraged to avoid too much cold and damp food because of their tendency to accumulate phlegm and become heavy. Using four elements to the Chinese five, the approach is nevertheless broadly similar.
In Chinese thought the five flavours (sweet, pungent, salty, sour and bitter) are a literal description of a food’s taste as well as indicators of a food’s effects. Each flavour, for example, moves the body’s energy in various directions. Sweet foods moisten, harmonise and nourish; pungent foods move energy from the centre to the surface, stimulate circulation, disperse stagnation and tend to be drying; salty foods sink, moisten and detoxify; sour foods are contractive, move energy inwards and tone the body’s tissues; bitter foods have a drying action and tend to move downward.
“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 energy. 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 balanced diet, therefore, seeks to include all flavours in appropriate proportions.
Balance may also be considered in terms of temperature. Each food has an inherent temperature, warming or cooling the body. Melon, cucumber and yoghurt are cooling; chicken, oats and onion are warming. In a condition of health the overall thermal effect of our diet should be neutral. When a person is exhibiting too much heat or coldness then balance is restored by favouring foods of an opposing temperature. In a balanced diet the overuse of extreme temperatures is avoided.
Let’s see how this works in practice. Most meats are considered to be warming. So is alcohol and excessive sugar. Deep frying is considered to be a hot cooking method. A diet, therefore, of hamburgers, deep fried foods and coca cola with a tendency to heavy drinking is likely to create heat. This may show as a red complexion, restlessness and bad temper or as an inflamed liver, constipation or virulent acne. The remedy here would be to increase vegetables and fruits which are mostly cooling and to use cooking methods such a s steaming or stirfry which are less heating.
Both temperature and flavor are also adjusted according to season. Whereas a warming diet of casseroles and roasts washed down with plenty of red wine is appropriate for the winter months to protect the body against cold, the same diet in summertime would risk overheating and damaging the body. A balanced diet is one which keeps us in harmony with our environment.
A balanced diet therefore adjusts with the season. In Spring we need to decongest after a winter of densely nourishing and warming foods. To not do this creates a conflict in the body between the rising, vigorous and warming nature of Spring and the residual heaviness and latent heat from our wintry diet. Appropriate foods for Spring include all the emergent green shoots and leaves such as nettles, spring greens and asparagus which cleanse the blood, a move towards less hot cooking methods such a stirfry and steaming, and the reduction of wintry favourites such as the roast meat and red wine. Summer sees an increasing lightness in our diet with more fresh fruits and vegetables, more fluids, lighter proteins such as fish and Autumn foods include root vegetables and squash, nuts and seeds and so on.
As well as seeking to include all five flavours, balancing the hot and cold natures of foods and responding to seasonal changes, Chinese medicine also recognizes that “one person’s meat is another’s poison”. In other words there is no one size fits all diet and what we eat is one of the ways we bring our own natures into balance.
Our internal balance is described in the language of climate. The forces of cold, heat, moisture and dryness need to be properly regulated. Imbalance is described as an excessive dominance of one or more of these forces. Our internal climate depends in turn on the vitality of the body’s essential substances – its Qi, Blood and Essence – and a balanced diet seeks to sufficiently nourish these.
So, someone who has a dislike of cold weather, whose metabolism is slow, who is prone to loose stools and frequent clear urination, who lacks energy and finds it hard to get up in the morning would be described as “Yang deficient”. The Yang is the body’s internal fire. This person would bring their body into balance by eating more warm and hot natured foods, avoiding very cold foods such as salads and tropical fruits, using oven based cooking methods, eating more fat and meat and using warming spices such as ginger and cinnamon.
Someone who has a dislike of hot weather, is prone to inflammation, scant urination and a tendency to constipation, who tends to be restless and irritable would be described as showing “excess heat”. Their way of coming back into balance would be to eat more fruit and vegetables with some juices and salad, to favour cooler cooking methods such as steaming, to eat less meat and more vegetable protein and to use cooling herbs and spices such as mint, coriander and marjoram.
It is here, in the realm of differential diagnosis, that Chinese medicine can offer us a deeper insight into the notion of balance. The advice from the NHS quoted at the beginning of this article will certainly do more good than harm but it does not offer guidelines that are tailored to an individual’s needs. So, I believe we can go deeper than the broad common sense approach of the NHS. The future of dietary therapy may well be a fusion of eastern and western principles.
Finally, I feel it is important to remember that what we eat, though obviously important, is not the most powerful determinant of our health. Our sense of purpose and belonging has more impact on our health than our diet. For this reason I include the context of our eating as part of the picture. Meals eaten in isolation or without joy or following highly restrictive rules are less nourishing than those eaten together as part of the celebration and bonding of our family and cultural lives.
In fact I will go one step further and say that our diet, as well as supporting our own internal balance, cannot be truly balanced unless it also supports the balance of our planet’s ecology. So local and organic become high priorities. Nor can our diet be truly balanced if we buy foods in such a way that we perpetuate social injustice. So supporting small scale shops and markets and reaching for the Fairtrade label is also part of our consideration of what is a balanced diet. And this, if I don’t stop here, will take us into another article altogether.