Diet
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
Red Meat and Foxglove Root as Medicine
In my last weekend roundtable of case discussions with my group in Beijing, my teacher reminded us of the importance of sometimes inquiring how patients feel while digesting red meat. Whether they feel good, bloated, constipated, or otherwise, can inform us of the strength of the microbiome.
Red meat, like all foods in Chinese Medicine, is medicinal, but like any medicinal it is not perfect. Although there is no better food for building and nourishing the blood and body fluids, plus warming the overall gut, red meat is obviously a heavy material, more difficult to digest than most foods, and therefore should be dosed and prescribed mindfully.
This reminded me precisely of how we think of “shu di huang,” a Chinese herbal medicinal that is better known in the west as foxglove root. Foxglove root is one of the most important herbs in our pharmacopeia for building and nourishing blood—especially when the lack of blood has led to internal heat in the body.
The problem is if you look at raw foxglove root it looks like a stale old chocolate brownie. It is dense, heavy, and sticky, invaluable to certain patient patterns, but also difficult to digest; we are continuously reminded to not prescribe unless and until patients’ microbiome functionality is fully, or close to fully restored. It’s a rather simple connection: If someone feels bloated or distended after eating red meat they cannot yet handle foxglove root. If we make the mistake of prescribing it, they’ll likely come back complaining of worse digestive issues and no improvement of symptoms. We always must first rectify the gut before rebuilding blood. This is Chinese herbal medicine in a nutshell—or a stale brownie if you will.
We are now entering the time of year where red meat is most advisable, utilizing its sweet warming properties to balance the bitter cold of winter, as well as its fatty lubrication to counteract the dryness most evidenced on our skin or chapped lips.
However, it is important to dose properly—also whenever possible to intelligently design the remainder of each “formula,” which is to say plate of food. Since something like salmon is relatively easy to digest it can be consumed alongside more carbs and/or potatoes. On the other hand, red meat is better harmonized by cooked greens and light vegetables to aid in its downward movement. Beer and white bread will obviously have the opposite effect.
By all means take the following Eastern recommendations with a grain of salt (or pinch of sea salt atop your filet mignon this holiday season):
- Ideally, red meat should make up the smallest portion of food on your plate. When it doesn’t it’s important the following day to drink plenty of mint, barley, and/or ginger tea to help with its processing and digestion.
- Red meat might be consumed about once a week in summer months and three times a week in winter months.
- Red meat should be consumed more by people over the age of 60, women on their menses, and people with relatively “cold constitutions,” that tend more to anemia, hypotension, hypothyroid, and almost “hypo” anything.”
- People with warmer body types with tendencies to “hyper” conditions, or dealing with serious hemorrhoids or intestinal inflammation should mostly avoid red meat until said symptoms are resolved.
- Red meat can be consumed with reckless abandon by any woman less than six months post-partum and almost any woman trying to get pregnant. If it bothers your stomach I would advise starting with very tiny portions and gradually increasing the dose, as unlike foxglove root, red meat should strengthen the microbiome enough to tolerate more of it.
If you are a meat-eater and have never been to Quality Meats in Manhattan I’d highly recommend! My father always preferred The Palm II on 2nd Avenue, but I believe he was guilty of nostalgic attachment, as it was located a few blocks from his office of several decades.
