Food Therapy Part 2

TRADITIONAL CHINESE MEDICINE DIET:
USED BY MILLIONS

In China, doctors regularly exhort their patients to eat "a balanced diet." But they mean something quite different than American physicians dispensing the same advice.

According to Traditional Chinese Medicine, a balanced diet isn't one that includes selections from four basic food groups. Rather, it's a diet that balances yin and yang, universal complementary opposites. (For an illustrated explanation of yin and yang, see page 278.)

"To enjoy good health, you must balance yin and yang," says Henry C. Lu, Ph.D., doctor of Traditional Chinese Medicine, principal of the International College of Traditional Chinese Medicine in Vancouver and author of Chinese System of Food Cures.

Think of yin and yang as two complementary sets of qualities. While yin is cool, watery, dark and contracting, for instance, yang is warm, dry, light and expansive. In the traditional Chinese view, everything in the universe--including you and every bite of food you eat--is yin or yang, to a greater or lesser degree.

Since yang is warm, foods that have a warming effect on the body, such as chili peppers, are predominantly yang. Watermelon and other foods that cool the body are predominantly yin, because yin is cool, explains Maoshing Ni, Ph.D., vice-president of Yo San University of Traditional Chinese Medicine and author of The Tao of Nutrition. Foods that neither warm nor cool the body, like brown rice, buckwheat, peas and lettuce, are neutral--no more yin than yang.

A balanced diet can include foods that are predominantly yin and yang as well as foods that are neutral, says Dr. Ni. But it includes them in such proportions that the yin and yang foods balance one another--and keep you in balance.

"Generally speaking, such a diet is heavy on grains and vegetables; uses a lot of beans and soy products; includes some fruits, nuts and seeds; and uses protein, like red meat, poultry and fish as a condiment," says Dr. Ni. In essence, it's the diet that most Chinese have been eating for thousands of years.

A Different Balance

Have the flu? Painful menstrual periods? Hemorrhoids? PMS? High blood pressure? Trouble conceiving? A Traditional Chinese Medicine doctor would advise you to check your plate.

According to the Traditional Chinese Medicine theory, diet not only contributes to but can also help alleviate virtually any health problem.

Most women with PMS, for instance, are too yang, Dr. Lu says. Cooling yin foods, such as celery, can help alleviate their symptoms. Hemorrhoids are usually associated with excess yang as well and respond to cooling yin foods like ripe bananas, he says.

While proper nutrition alone won't prevent every illness, good health is pretty much impossible without it, Dr. Lu explains. And while dietary change is rarely enough to treat severe illness--traditional Chinese doctors usually use acupuncture and herbs with hard-core cases--there's no curing someone who won't eat properly.

Yin Women Need Yang Foods

In keeping with the tenets of Traditional Chinese Medicine, everyone should eat a balanced diet. But that's not to say that everyone should eat exactly the same diet, Dr. Ni points out. That's because everything in the universe--every person, climate, lifestyle, season--is yin or yang to some degree.

To maintain balance, you need to fine-tune your diet, taking into account whether you're constitutionally more yin than yang; what your gender, age and activity level is; what kind of climate you live in; what you do for a living and what season it is, Dr. Ni explains. "If you tend to be more yin, eat more yang foods, and vice versa."

Women, who are generally more yin than yang, should choose more yang foods like yams, green onions and chicken, to even things out, Dr. Ni advises. When it's cold (yin) outside, we should all eat more of these warming (yang) foods. And if your job requires a lot of physical exertion or yang energy, you should also eat more yang foods to replenish that energy. That's for everyday maintenance. If you're sick, you'll need to adjust your diet again.

"Let's say that you have high blood pressure," Dr. Lu says. "There are different types with different causes, but one type is due to the liver being too yang." In that case, Dr. Lu might recommend eating more eggplant, which is not only yin but also can prevent arteriosclerosis.

Firsthand Research

Studies find that the traditional Chinese diet--mostly grains and vegetables; smaller quantities of legumes and fruit; occasional servings of meat, poultry and fish; and very little fat--is extremely healthy. The China-Cornell-Oxford Diet and Health Project, a research undertaking that has been gathering information on the eating habits and health of 10,000 Chinese since 1983, finds lower rates of heart disease, cancer, diabetes and obesity in China than in the United States.

So the diet seems to prevent health problems. But can it cure them?

There are no Western-style clinical studies to answer the question definitively, says Dr. Ni. Thousands of years of success stories, however, suggest that the diet has therapeutic power. "Each food has been researched for its therapeutic value for several thousand years," Dr. Ni says.

Customize the Diet

If you want to give Traditional Chinese Medicine's nutrition a try, experts suggest these steps.

Determine whether you're more yin than yang. People who are predominantly yang are usually outgoing, sometimes aggressive. They're more likely to feel warm and suffer from yang-type illnesses, such as stress, congestion, musculoskeletal pain, constipation, headaches, high blood pressure and heart disease, Dr. Ni says.

Yin people, on the other hand, are more collected and contemplative. They're more sensitive to cold and more vulnerable to problems such as fatigue, overweight and diarrhea.

Consider your lifestyle. If you run around a lot, you use up a lot of yang energy, so you need extra yang food, like beans and ham. If you sit at a desk, you'll want a more yin diet, with extra vegetables and grains, Dr. Ni says.

Accommodate the climate. "In tropical places where the weather is typically more hot and humid, you want to eat foods that are more cooling and foods that regenerate body fluid. You'll also want foods that are a little drying, so that the humidity and dampness does not accumulate in your body," Dr. Ni says. Extra fruits and vegetables are good choices.

In northern climates where the weather is cool, windy and dry, you should eat foods that are warming and hydrating, he says. You'd eat more chicken soup, for instance, than you would in the tropics.

Change menus with the seasons. By the same token, summer months are warm, or yang, so you should eat more cooling, yin foods during the dog days, Dr. Ni says. And winter months are yin, so choose more yang foods, like lamb and shrimp.

Eat less than you'd like. Unlike Western therapeutic diets, Traditional Chinese Medicine doesn't specify how much food you should eat. A good rule of thumb, says Dr. Ni, is to eat 80 percent of what you'd like to eat. That way you won't overdo it. When you sit down to eat, fill 70 percent of your plate with grains and vegetables; 25 percent with "condiments" like meat, nuts, seeds and legumes; and 5 percent with fruit.

Talk to your doctor or consult a nutritionist. For complicated health conditions, such as infertility, you're better off seeing a professional, fully qualified Traditional Chinese Medical doctor (T.C.M.). Chinese nutritional theory is extremely complicated, and doctors take into account all sorts of variables beyond your constitution, lifestyle and locale when prescribing a diet for a particular problem. If the symptoms are severe, you may need herbal remedies and acupuncture as well, Dr. Lu says.

MACROBIOTICS: THE JAPANESE PRESCRIPTION

For breakfast one winter morning, Beth Saito is having miso soup with seaweed, brown rice with adzuki beans and greens, and pickled fermented cabbage.

She doesn't always eat this way. When the weather is warmer, she might have some steamed whole-grain bread and cold fermented soybeans with grated radishes for breakfast. Not your average coffee-and-muffin morning routine.

Saito follows a macrobiotic diet, a carefully prescribed, low-fat, nearly vegetarian regimen that aims for balance amid constant change. Depending on the season, where she is and how she feels, she adjusts the menu for optimal health.

"I feel much better eating this way," says Saito, a New York restaurant manager who has been following a macrobiotic diet for over a decade.

Like Traditional Chinese Medicine and the philosophy on which it's based, macrobiotics seeks a healthful balance of yin and yang. The idea is to steer clear of extremely yin foods like sugar and extremely yang foods like red meat and eat a combination of moderately yin or yang ones, like brown rice and vegetables. Overall, your diet might be slightly yin or yang, depending where you live, the season and how you're feeling, since all those things are either yin, yang or somewhere in between.

In temperate climates like the United States, brown rice and other whole grains--considered the most balanced of foods--make up about 50 percent of a macrobiotic diet. Vegetables, which are moderately yin or yang, make up 25 to 30 percent. Sea vegetables and beans, also moderately yin or yang, make up another 5 to 10 percent, as do soups made with vegetables, grains and beans.

Seasonal fruit and small quantities of roasted nuts and seeds are included in the diet several times a week. Lean white fish, such as cod, is included one to three times a week, if desired. A small amount of vegetable oil may be used in cooking.

Flexibility Rules

Macrobiotics made a name for itself in the United States in the 1960s when the counterculture made the diet its own. Unfortunately, macrobiotics got noticed for all the wrong reasons. Some people who adopted the diet, then known as Zen Macrobiotics, developed severe nutritional deficiencies. A few died.

"It was very easily misunderstood--and in a very drastic way," says Michio Kushi, who introduced macrobiotics to the United States from Japan after World War II. To distinguish the new version from the old, he clarified the basic principles of macrobiotics and dropped the "Zen" from the name.

Contrary to popular belief, macrobiotics was never meant to be, and isn't, rigid, says Kushi, who has also published dozens of books on macrobiotics and runs the Kushi Institute, a macrobiotics center in Becket, Massachusetts. "The macrobiotic way of eating is not a set pattern. It's flexible, depending on climate, season and personal need."

Extremely yin or yang foods--red meat, sugar, dairy products, animal fats, caffeinated drinks, chocolate, alcohol, eggs, processed foods, poultry, hot spices and tropical fruits--are usually off-limits, for example. But if you're hankering for ice cream on your birthday or a slice of turkey at Thanksgiving, you should enjoy it, Kushi says.

And, while tropical fruits such as pineapple are considered too yin for temperate climates like the United States, they're allowable in the tropics, where they grow naturally. Similarly, red meat, which is very yang, is permitted in cold climates like Alaska, which is very yin. Again, it's a matter of balance.

Achieving balance means making other adjustments on a regular basis. In summer, when the weather is hot, or yang, in most of the United States, you should eat more raw vegetables, which are yin, Kushi says. In the dead of winter, which is more yin, you should eat more yang foods--a little more white fish, for instance. If you have menstrual cramps (usually a sign that you've been overdoing it with yang food), you should forgo the fish for a month or two until things come back into balance.

Of course, simply adjusting your diet isn't always enough to establish balance, Kushi notes. You need to strike a balance among work and relationships, relaxation, exercise and meditation, too. But diet is an important part of the equation.

Curative Powers?

According to macrobiotic theory, a diet that balances yin and yang can help prevent and relieve illness.

Headaches, skin problems, allergies, fatigue, menstrual problems and sexual and reproductive problems can all be averted and usually alleviated with a macrobiotic diet, says Kushi. In many cases, so can heart disease, diabetes, arthritis and cancer, he adds.

Like the Pritikin plan and Traditional Chinese Medicine diet, the macrobiotic diet is essentially a low-fat, high-fiber vegetarian diet very similar to what most rural Chinese people eat. And Chinese population studies have shown that people who eat this way have lower rates of heart disease, obesity, diabetes and cancer, including breast cancer.

"It's a very healthy diet, and it reflects the dietary traditions of countries that tend to have much better health profiles than we do here," says Neal Barnard, M.D., president of Physicians' Committee for Responsible Medicine in Washington, D.C., and author of Eat Right, Live Longer.

Some studies have investigated macrobiotics' power, but not as many have been done as for other types of diets, Dr. Neal Barnard says. But research has shown that the diet can lower blood pressure and blood cholesterol levels profoundly.

In her book Women's Bodies, Women's Wisdom, Dr. Northrup recounts the story of a woman who found relief from fibroid tumors after switching to the diet. An adherent of macrobiotics herself, Dr. Northrup notes that such low-fat, high-fiber diets may also lower your risk of other women's health problems--notably breast cancer and other gynecological problems, such as PMS and endometriosis.

Whether the diet can treat cancer isn't yet clear. Some cancer patients who have pulled through after making the switch to macrobiotics, including baby doctor Benjamin Spock, credit the diet with their recoveries. Anecdotal evidence suggests that those who switch to the diet live longer than those who eat standard American fare.

When you're talking about something like breast cancer, these examples make a lot of sense, says Dr. Neal Barnard. "Low-fat diets are associated with longer survival in women with breast cancer," he notes.

If a woman has breast cancer that has spread to other parts of her body, her risk of dying from the disease increases 40 percent for every 1,000 grams of fat that she consumes monthly, according to a study from the State University of New York in Buffalo. While low-fat diets like macrobiotics contribute about 400 grams of fat a month, Dr. Neal Barnard points out, the typical American diet packs a whopping 1,500 grams a month. (A tablespoon of butter, lard, oil or other fat contains an average of 13 grams of fat.)

Macrobiotics Simplified

If you're pregnant or nursing, be sure to talk to an expert before switching to a macrobiotic diet, says Dr. Fuhrman. Whether macrobiotic diets are nutritionally adequate for children is a matter of debate, so check with your pediatrician or a nutritionist before changing your children's diets. If you get the green light, here's how to proceed.

Stock up. Certain foods that originated in Asia, like miso soup, are staples in a macrobiotic diet because they're considered well-balanced. So if you're going to go macrobiotic, you'll need to stock up on these perennial players in macrobiotic fare, available at your local health food store: short- and long-grain brown rice; millet; whole-grain barley; whole-wheat noodles; soy products like miso soup and tofu; lentils; chick-peas; adzuki, pinto and navy beans; split peas; seaweed; sea salt; barley-malt syrup; brown-rice syrup; brown-rice vinegar; sunflower, sesame and pumpkin seeds; grain teas; grain-based coffee substitutes and organically grown seasonal produce.

Take your time. A macrobiotic diet is a major departure from standard American eating. So take your time making the switch, suggests Gale Jack, macrobiotic counselor and cooking instructor at the Kushi Institute.

Phase out meat and prepared foods. First, wean yourself from extremely yin and yang foods. Over a period of two to three months, phase out meat, poultry, dairy products, sugary desserts and prepared foods, including frozen and canned stuff.

More rice, beans and veggies. While you're jettisoning meat and prepared foods, says Jack, phase in more brown rice, beans and fresh cooked vegetables to your diet. Try stir-frys and casseroles--dishes that include less meat and more grains and vegetables, she suggests.

Eat local fruits and vegetables. Unless you live in the tropics, fruits such as papaya and mangos are too yin for most areas of the United States, especially during the cold-weather months.

Forgo the microwave. To truly adhere to macrobiotic theory, you should cook over an open flame or a gas stove and avoid electric stoves and microwaves, says Jack, since the latter affects the food in a way that makes it more yin. Likewise, you should cook with wooden utensils.

Know when to see a pro. If you have a minor illness--a cold, for instance--you can try macrobiotic foods to alleviate the symptoms, says Kushi. But if you're seriously ill, you should see a macrobiotic counselor. Coming up with the appropriate dietary changes for complex health problems is a complex process and requires expertise, he says. If necessary, a counselor may refer you to a medical doctor.

THE ASIAN FOOD PYRAMID:
A SMART OPTION FOR WOMEN

From piquant and spicy Tandoor to fiery Korean and complex, surprising Vietnamese, Asian cuisine includes a wide array of distinct culinary traditions. Even so, all of these traditions share some notable similarities: Most are low-fat, verging-on-vegetarian affairs. Typical meals are primarily grains, vegetables, beans and fruits, garnished with meat or dairy, nuts and seeds.

As a rule, Asian cuisines are also very healthy--healthier than the standard American diet.

"When you look at lung, breast and colon cancer rates, those are much higher in the United States than in countries like China," says Banoo Parpia, Ph.D., senior researcher with the China-Cornell-Oxford Diet and Health Project, centered at Cornell University in Ithaca, New York.

Obesity, diabetes and heart disease are also less common in countries like China than in the United States, notes Dr. Parpia. Among Chinese women ages 35 to 64, the heart disease rate is roughly 10 per 100,000. In the United States, The researchers calculated a staggering 56 per 100,000.

Would American women be better off eating like the Chinese or, for that matter, the Thais?

Absolutely, says Lawrence Kushi, Sc.D., associate professor of public health, nutrition and epidemiology at the University of Minnesota School of Public Health in Minneapolis.