Food therapy needs to reclaim its central place in the practice of Chinese medicine and reconnect with the spirit of Hippocrates, the father of modern medicine, who echoed the Yellow Emperor with his motto: "Let food be thy medicine and medicine be thy food." Food therapy is given lip service in most Chinese medicine schools, not unlike PE in high schools.It is reduced most often to one or two lonely classes offered toward the end of the curriculum; a sad mirror image of the current Western medicine curriculum that surveys nutrition in a few cursory class hours.
On the other hand, there is no doubt that much of Chinese medicine food therapy needs to be revised and thoroughly updated since much of its content is too obsolete and cumbersome for our modern world. One can hardly expect people to memorize the materia medica of foods, and many ingredients such as quail eggs, turtle shells, birds' nests, animal testes, black chicken, duck feet or goat liver are simply too foreign to our culture, to say nothing of our palates.
We also need to compute the fact that the Chinese medicine food therapy we inherited originated against the background of a homogenous diet composed mostly of rice, vegetables and occasional meat. Until industrialization, availability and production of meat and dairy were necessarily limited, while others such as refined sugar, processed foods and drinks with long lists of chemicals, colorings and preservative agents simply did not exist. Neither did the worldwide epidemic proportions of modern degenerative diseases such as diabetes that directly stem from our modern lifestyle and diet.
Within such a context, a few therapeutic dishes added to the diet with a congee thrown in here and there, while they may represent a start in the right direction, cannot really address root problems. In order to be effective, food therapy must encompass coherent general dietary guidelines of a sound diet based on grain, beans and vegetables; a framework sorely missing in the modern curriculum. The present fragmented patchwork of various recipes and herbal dishes for various ailments lacks a consistent approach to the practice of health and preventive medicine.
Many practitioners, themselves lacking proper training in nutrition, are unable to guide their patients toward a comprehensive model of what would constitute a healthy diet. We must remember that many present-day AOM students, as well as our patients, are heirs to the quick junk-food revolution and have never, or hardly ever, cooked for themselves.
An important point that needs debating is the strong reluctance in the Chinese medicine community to adopt and recommend a plant-based diet in spite of all the studies, including the book China Study by Colin Campbell, that point to its benefits. One may attribute the reluctance of Chinese practitioners to advocate a vegetarian-based diet to cultural factors and the recent memory of famine in China. The same phenomenon was seen in Europe after World War II. When people are deprived of food in violent environments, meat, besides providing a much-needed source of protein (or maybe because of it), becomes a symbol of survival and strength. We must also remember that in modern Asia, the rice used for everyday consumption is almost exclusively white and polished, thus lacking the necessary nutrients and vitamins (B in particular) only found in the husk. White rice is a very low energy source and the attraction to meat as a source of protein makes sense in that context.
One very common misconception on the part of Chinese medicine practitioners is that a vegetarian diet leads to "blood deficiency" or anemia. Obviously, if meat was a guarantee against anemia, it should be non-existent in the West where meat consumption has reached all-level highs. In the China Study, Colin Campbell shows how even a small amount of animal protein in the form of casein or meat dramatically increases all epidemiological levels of diseases across the board. Our Western modern-world diseases are not the result of a lack of protein but the result of its excess and brilliantly marketed obsession with it.
It is true, however, that many vegetarians, due to poor training and education in nutrition, rely on dairy, nut butters, sugar and flour products for their sustenance. Vegetarianism is certainly not, of and by itself, a guarantee of health. The China Study results were based on the study of a population that, unlike today's society, was still linked to a long tradition of ethnic cooking and did not have access to the modern processed foods. To make things even more complex, today's industry has not missed a beat and has very successfully developed a market of vegetarian and vegan highly processed junk food, none of it any healthier that the more traditional market. That is why education in nutrition in Chinese medicine schools must go way beyond the one or two classes presently allowed in the curriculum.
Finally, many of us Western, modern practitioners of "alternative" medicine come to this field with the hope of contributing to a more holistic practice of medicine, an ideal to nurture and keep in focus. Many of us resonate with the Taoist philosophy that links human beings to their environment, as indicated by words such as heat, damp, cold, wood, water and metal, which we use in our diagnosis and treatment principles.
The concept of food therapy in Chinese medicine provides a tremendous template for health education. We need, however, to revise it and fully integrate it in our practice if we want to be at the forefront of a truly integrative medicine. As things stand today, the truth is that we are actually painfully lagging behind the times when it comes to nutrition.