Nutrition and Constitution

Nutrition From the Perspective of Chinese Medicine

                                                                                    Stewart Cohen, Ph.D., L.Ac.

**Oriental Medicine recognizes individual differences with nutrition.

The most significant aspect of nutrition in Oriental Medicine is that individual differences are considered. Instead of overall prescriptions for health based on statistical analysis of groups, quantities of calories, protein, fat, etc., the overall balance of yin and yang is the goal for each person.

**Nutrition is viewed by looking at a persons constitutional tendencies.

With individual differences in mind, people are often grouped within a constitutional type.  There are a variety of schemes for constitutional typing, and none of them should be held up as an absolute.  People may also exhibit characteristics of one or more types within a scheme. One of several paradigms that are used in Chinese Medicine will be presented here.

**Foods have a variety of tastes and properties that are responsible for their actions on the body.

This idea is very important in analyzing foods, and their effects on the person. I have included a short section on properties and tastes that help exemplify actions in the body, but I have not listed the properties of the individual foods.

**Different foods influence the health differently, depending on the constitution of the person.

This last idea links up the second and third to yield dietary guidelines specific for each type.  In addition, there are specific foods which may be applicable for certain disorders.

**There are some ideas about eating that apply to most everyone.  It is self-evident that the overall health of the digestive system is necessary for proper digestion of the foods to achieve the desired balance in each person. The following are generalities that can help our digestive health.

-Wait until being hungry to eat, but waiting too long injures the stomach qi.  Eat some breakfast.

-One should not get too full or eat too much.

-One should drink when thirsty, but not too excessively.

-Frequent small meals are better than fewer large meals.

-Eating too much food injures the qi, because the fullness obstructs the circulation of qi.

-One should not sleep immediately after eating or eat too much food at night.

-All meats should be thoroughly cooked.

-Make eating a time for eating. Respect your stomach!  Try to eat in peace, and avoid working, arguing, driving, or walking around during your meals.  The way you eat often matters more than what you eat.

THE THEORY OF TASTES OR FLAVORS

Classically, there are five flavors: sour, sweet, bitter, salty and pungent. If a food lacks all of the above flavors, it is considered to be bland, and also has specific properties. The pungent taste is the sharp or acrid taste present in foods like peppermint, onions and cayenne.  Note that cayenne and peppermint are both pungent, but cayenne is hot, and peppermint is cool. [It is interesting to note that while we have identified the salty, bitter, sweet and sour flavors in classical taste research, recent taste research in Japan has identified a brain region specific to the taste of “Umami,” which is pungent.]

A. The Pungent or Acrid Flavor: This flavor enters the lungs, is Yang in nature, disperses and expands the qi. Consuming an excess of pungent food will injure the qi, and eventually cause contraction (a yang/yin reversal).

B. The Sweet Flavor: This flavor enters the Spleen/Pancreas, is Yang in nature, tonifies and harmonizes the qi, and slows down the mind/heart. Overconsumption leads to stagnation of qi and mental sluggishness.  This can cause injury to the bones and teeth, as well as hair loss.

C. The Bitter Flavor: This flavor enters the Heart, is Yin in nature, draining heat downward and drying dampness. Excess consumption leads to excess dryness.

D. The Sour Flavor: This flavor enters the Liver, is Yin in nature, and is astringent. Excess consumption leads to thickening of the skin and contraction of the tendons.

E. The Salty Flavor: This flavor enters the Kidneys, is Yin in nature, cleanses the body, softens hardness (like tumors and cysts) and nourishes the yin.  Excess consumption injures and clouds the blood vessels, causing clogging. Eventually, over consumption can lead to hypertension, which is a yin/yang reversal.

F. The Bland Flavor:  This flavor is Yang in nature, promotes urination and leeches out dampness.

TEMPERATURES

This category of properties includes the classifications of cold, cool, neutral, warm and hot. Sometimes the property of aromatic is included as well.

EIGHT CONSTITUTIONS

A constitution is a tendency.  This concept is similar to what is called a miasma in homeopathy.  Constitution is often hereditary, while disease is not.  A constitution is not an illness, but when a person is sick, they will tend to accent their constitution.  Logically, constitutions are often defined partially by how someone gets sick when they do.  For instance, some people get headaches with colds, some get fatigued, some have copious phlegm, and some get hot sinus infections.  These all reflect their constitutions to some extent, as well as the nature of the pathogen.  Each person may be described by one or more of these constitutions, and can have varying amounts of each.

I. Healthy Constitution.

Good weight, strength, health, abundant hair with luster and moisture. Skin has a radiance, eyes radiate spirit from within. Person feels light and energetic. There is no excessive thirst, and it is easy to tolerate hot and cold. Pulse is harmonious and moderate, has even speed and moderate force. Tongue is pale red with slight white/yellow coat. Even-tempered with healthy appetite, regular bowels, and peaceful sleep. Gets sick by catching colds from external pathogens, or sudden illnesses.  These people will thrive on a balanced diet, and have greater tolerance levels for imbalances than people who have an imbalanced constitution.  There are no special recommendations.

II. Yin Deficiency Constitution.

Tends towards being skinny, may be taller than average. Tongue will be redder with little coat and sometimes cracks. They may manifest flushed cheeks, redness or maybe turbidity in the eyes. Also may have dry scratchy eyes and blurred vision, sometimes with gold floaters. Easily thirsts, prefers cold fluids, has aversion to heat, and sometimes has hot hands and feet. Tends towards dry stools and darker urine. Pulse is thinner, more wiry and faster than normal. Angers more easily than most, and is often anxious or irritable.  Feels more energetic at night, maybe even sleepless. Although this is a constitutional tendency, it can often manifest subsequent to serious illness or blood loss (i.e., menorrhagia) or far too much sex. When sick, this person always develops heat signs and excessive thirst.

Overall climate: Hot and Dry

To avoid: Hot and drying foods and flavors, deep-fried foods, ginger, scallions, garlic, chili and black pepper.

To increase: Cooling and moistening foods. Fruits: bananas, plums, pears, strawberries, lemon, pineapple, watermelon and tomatoes. Meats: eggs, pigeon, duck, pork, rabbit, crab, jellyfish, turtle, clams. Grains: wheat, barley.  Vegetables:  Mung beans, aduki beans, soybean milk, tofu, celery, spinach, radish.  Other: mushrooms, salt and green tea.

III. Yang Deficiency Constitution.

Overweight, face lacks luster or is shiny white, skin is flabby or flaccid, clear eyes, with pale lips. There is often a bland taste in the mouth, aversion to cold with cold extremities, and cold in stomach and back. Easily fatigued, often quiet and introverted. Tongue is pale, moist and flabby with tooth marks and a white coat.  Deep, fine, or forceless pulse, watery stools, clear and profuse urine, prefers warm liquids. Easily becomes sick from cold, and manifests cold signs.

Overall climate: Cool and Damp

To avoid: Oily, rich foods: bananas, milk, too much cold or uncooked foods, large salads.

To increase: Warming and invigorating foods. Rice, peanuts, yams, chives, mustard greens, carrots, chilies, garlic, black pepper, onion, walnuts, chestnuts, pine nuts, betel nuts, ginger, alcohol, cocoa, coffee, goat’s milk, chicken, quail, beef, lamb, shrimp, mussels, fish.

IV. Qi Deficiency Constitution

Could be fat or thin, but more are thin. Face can be pale or yellowish, eyes lack spirit, lips are pale, tongue is pale with tooth marks, but not flabby or moist. Easily fatigued. Has an aversion to both cold and heat.  Prefers quiet and is soft-spoken. Pulse is either deficient or moderate, but not forceful. Prefers sweet foods, and has poor digestion. Stools are normal but feel difficult in that there is a sensation that they still need to go after a bowel movement.  This can be hereditary, part of an illness, or due to long term injury to the digestive system from lifestyle.  This type is often seen with chronic fatigue syndrome.

Overall climate: Cool

To avoid: Cold foods, similar to yang deficiency with the additional adage of avoiding pungent foods that disperse the qi, such as garlic and onions.

To increase: Rice, potatoes, yams, sweet potatoes, mustard greens, radishes, carrots, hawthorn berries, dates, pumpkin, fennel, coffee, cocoa, chicken, goose, quail, beef, lamb, honey, shrimp, oysters, fish.

V. Blood Deficiency Constitution

Thin people, eyes lack spirit and are dry. People may see spots, get dizzy easily and develop palpitations under stress. These people are often absent-minded, quiet, and cannot tolerate cold. Tongue and lips are pale, pulse is thin and empty, nails may be brittle and hair dry.  There may be sleeplessness characterized by an aimlessly wandering mind.  Women will have scanty menses. Can develop from blood loss, poor nutrition, or qi deficiency.

Overall climate: Cool and Dry

To avoid: These people often have qi deficiency as a root, and should follow similar guidelines.

To increase: See qi deficiency, and consider moistening foods as well: spinach, chicken eggs, black sesame, chestnuts, grapes, mulberries, Chinese chives, goat’s milk, pork, lotus root, dangkuei, peanuts. Note that the fruits are not as cool as for yin deficiency.

VI. Blood Stasis Constitution.

Body weight normal to thin, dark complexion on face and body, may have red threads on cheeks, red spots on body, greenish purple spots in sclera of eyes.  Dry scaly skin, especially on elderly people’s legs. Pale, dark or purplish lips, dark tongue with purplish hue on the sides and sometimes blotchy areas. Pulse will be wiry or deep, or fine and choppy, sometimes intermittent (heart is affected). No signs in the stools, urine, or emotions, but will develop masses and lumps when sick.  Although constitutional, this condition can also develop from blood loss, injury, or long-term clinical depression.

Overall climate: Slightly Dry.

To avoid: No special contraindications.

To increase: Moistening and dispersing foods.  Peanuts, spinach, canola, chives, eggplant, hawthorn berries, peaches (kernels are used as medicine for severe blood stasis), brown sugar, alcohol, vinegar, rose petals, azuki beans and garlic.

**Stewing eggplant with garlic, ginger, scallions and soy sauce makes a dish that is both tasty and healthy for such conditions as intestinal lumps, blood in stools, itchy skin sores, and arteriosclerosis due to blood stasis. Use 100:5:2:1 eggplant:garlic:scallions:fresh ginger by weight, add soy sauce and sugar to taste.

VII. Phlegm-dampness Constitution.

Obese, puffiness around eyes. Always feels heavy, face is dark or pale yellow. Likes to drink tea.  Tongue has sticky coating and there is either a bland or sweet taste in the mouth. Pulse is soft and/or slippery, stools will be normal to soft and urine will be cloudy. Underlying this type is often yang or qi deficiency with weakness of the pancreas/stomach. When sick, yang is affected, and edema and/or cysts develop easily. (This constitution has yang-deficiency as a root, but manifests as an excess of yin.)

Overall climate: Damp, slightly Cool.

To avoid: Since Yang deficiency is often at the root of this constitution, avoid rich, oily or fried foods, bananas, milk, cold or uncooked foods.

To increase: In addition to warming foods for Qi and Yang deficiency, the following are also helpful in draining excess dampness: taro, broad beans, yellow onions, pomelo, seaweed, turnips.

VIII. Damp-heat Constitution.

No set weight, shiny-oily face prone to acne, yellow skin and eyes. Skin around nose may be greasy (damp) but mouth and sinuses are dry with a slight bitter taste present (heat).  Impatient and easily angered, may feel fatigued as well. Slippery fast pulse, red tongue with sticky coat. Likes oily, deep-fried and sweet foods. Stools are dry, but may contain sticky fluids. Urine is scanty and yellow.  Will get sick from emotions, or bad food. Easily develops heat or fire.

This constitution, alone or in conjunction with others is common in our culture because of our chronic over consumption of sweets and fats.
Overall climate: Damp and Hot

To avoid: Oily, deep-fried foods will trigger skin allergies, Also avoid acrid and warm foods, like lamb, shrimp, chives, alcohol. Acrid and warm spices should be reduced, like garlic and peppers. In general, richer foods will produce more internal heat and exacerbate any imbalances.

To increase: Cooling and drying foods. Corn, mung beans, aduki beans, peas, black beans, celery, amaranth, day lily, bamboo shoots, mushrooms, pears, watermelon, cucumber, tea, duck and quail.

In addition to the above, the following foods should be reduced or avoided by people with damp skin disorders (itching and oozing), as they tend to either supply toxins, rot easily and make toxins, or drive toxins out to the skin: lamb, fish, shrimp, ginger, scallions, chives, garlic, bamboo and mushrooms.  This same group of foods should be reduced in breast-feeding women, as they may cause excessive irritability in the child, especially when they are teething.

BEYOND CONSTITUTIONAL ADVICE

Constitutional recommendations are very useful for regular dietary advice, but there are circumstances in which additional knowledge may be helpful.  Food intake should be adjusted according to the climate, the season, the energy needs of each of us, if we are fighting a cold or flu, or if we are coping with an organic medical imbalance.  Oriental medicine provides some guidelines for all of these circumstances which can be very helpful if properly applied.

Here are some guidelines to think about adjusting your food intake according to climate and season:

Winter, and colder climates tend to bring out problems in Yang deficient, qi deficient, and phlegm-damp types.  Most of us can benefit from mildly slanting our diets in that direction in the winter.  However, any person experiencing heat-related problems would want to remain within the guidelines for Yin-deficiency, or dampheat.

Summer, and warmer climates to tend to injure the yin which we can preserve with guidelines for yin deficiency and damp-heat types.  If it is warm and dry, cool and moist like tropical fruits and watermelon are especially important. If it is warm and damp, we need drying foods as well, just as the damp-heat types.

Illnesses can accent a person’s constitution.  The same cold virus will evoke copious clear or white phlegm and muscle aches to a yang-deficient type, and thick yellow nasal discharge to a dampheat type.  In some cases, the pathogen is so strong that it evokes the same symptoms in everyone.  Foods and herbs can be selectively applied while you have symptoms to complement your constitution.

Recommended reading: Healing With Whole Foods: Oriental Traditions and Modern Nutrition    by Paul Pitchford

North Atlantic Books, Berkeley, CA 1993

1 Comment (+add yours?)

  1. Galen
    Oct 01, 2014 @ 09:59:27

    It’s nearpy impossible tto find experienced
    people for this topic, but you sound like you know what you’re talking about!
    Thanks

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