Can I have a side of Qi with that?  A Balanced Diet from a Traditional Chinese Medical Perspective 

Traditional Chinese Medicine, or TCM, should be viewed as a complete health care system.  This is because it consists of several distinct but integrated parts including acupuncture, Chinese herbal medicine, mediation and breathing exercises as well as dietary practice.  Chinese theory differs from western medicine in that it emphasizes the prevention of illness before it occurs as opposed to treating symptoms once an illness has already taken hold.  For this reason, diet is considered one of TCMâs most important elements.

From an Eastern perspective a balanced diet can be used both for the prevention and treatment of illness.  In addition, a balanced diet makes other forms of treatment such as acupuncture and Chinese herbs more effective. This is because, according to TCM, the body requires a healthy supply of Qi (pronounced chee) to stay healthy and perform physical and mental functions.  Qi, often interpreted as energy, is the vital life force within all living things.  Excess, deficient, or obstructed Qi can cause pain, dysfunction and disease.  Qi is derived directly from the food we eat and the air we breathe.  Therefore, the types and quality of the food we consume has a profound effect on oneâs Qi and ultimately on our ability to perform such functions as heal and grow as well as staying physically and emotionally balanced

The Chinese idea of a balanced diet is very different from that of in the West.  Food is categorized by its energetic properties in the Chinese system.  The most general ways in which it categorizes food is that of Yin and Yang.  The concept of Yin and Yang helps describe the relationships between different phenomena.  With regards to diet, Yang foods tends to be warming and will direct energy outward and higher in the body.  Chilly peppers are a very yang food.  When eaten they are very warming.  The heat often rises up making an individualâs face red.  In addition the heat is often forced outward causing and individual to sweat.  In contrast Yin foods tend to be cooling.  They tend to draw energy lower and inward.  Lemons are a yin food.  When an individual tastes a lemon their lips pucker inward.  Lemonade is a testament to the lemons cooling energetic properties.  Pain, dysfunction and disease can be described in terms of an imbalance between the yin and yang aspects of our bodies.  Selecting food for their individual yin or yang properties can help restore balance and harmony to our bodies. 

Yin and Yang can be further subdivided into the five flavors:  pungent, salty, sour, bitter and sweet.  In the Chinese system, a balanced diet is one in which all five flavors are balanced for an individualâs needs. Because flavors are designated to reflect energetic properties occasionally a food is assigned a flavor that does not correspond with its taste. However, a flavor will generally correspond with the particular taste it is named for.  Pungent and sweet foods tend to be Yang in nature while sour, bitter and salty foods tend to by Yin.

Spicy, hot, acrid, and aromatic foods are characterized as pungent. Yang in nature, they tend to be warming (though some are neutral or even cooling).  Pungent foods also stimulate the movement of energy and blood.  For these reasons they are effective for breaking up mucus and helping to protect against conditions like the common cold.  Some foods considered to be pungent are hot peppers, ginger, and cinnamon.

Yin in nature, salty foods such as seaweeds, soy sauce, miso and pickles, tend to cool and moisten the body as well as move energy downward.  Epson salt is a common remedy for constipation. From a Chinese perspective, it moistens as well as stimulates the downward energy of the bowels. Salty foods also have a detoxifying effect on the body.  Brushing teeth with fine salt is often used to treat inflammation of the gums while gargling with hot, salty water can treat a sore throat.  Salty foods can be helpful in increasing appetite. In general the American diet tends to include far too much salt. This excess ultimately negatively effects an individualâs health.

Sour foods such as lemons, sauerkraut, and crab apples are also yin in nature; therefore they tend to be cooling.  Unlike other yin foods, they also tend to have an astringent effect on the body.  In other words they contract and draw things inward, like a lemon making oneâs lips pucker.  Sour foods are often used in Chinese medicine to treat excessive sweating or dribbling urination. Some sour foods are even used topically to dry and firm up skin.
Also having a cooling effect on the body, bitter foods are considered Yin.  They are often used in the treatment of infection and inflammation.  In China, congee, a thin porridge traditionally made with rice, is often supplemented with foods that are bitter, like celery and water chestnuts, to help cool down inflammation in an easily digestible form.  Lettuce, asparagus, turnips and rye are all considered bitter foods.

Sweet foods are at the center of traditional Chinese diets. Yang in nature, they not only help energy expand upward and outward but they also have a profound harmonizing effect, strengthening and relaxing the body.  Therefore sweet foods are used in the diet to strengthen individuals who are weakened and depleted.  Sweet foods also help soothe many emotional imbalances.  All grains are sweet in nature. Legumes (beans, peas, lentils) and most meat, dairy, and many fruit and vegetables are considered sweet as well. Unlike the traditional Eastern diet which contains mostly complex carbohydrates, Americans tend to eat an over abundance of harmful simple sugars such as table sugar, foods containing corn syrup, soft drinks, cakes and candies which can lead to such health imbalances as diabetes.

Because it is easy to integrate Chinese nutritional theory into any diet, you do not necessarily have to eat traditional Eastern foods. TCM practitioners develop specific diets for each individual in order to harmonize the flavors and avoid dysfunction or treat disease. 

Acupuncture as an Adjunct in the Treatment of Heart Failure Patients:

In the first controlled clinical trial of its kind, researchers have found that acupuncture has an effect in dramatically reducing sympathetic nerve activity in advanced heart failure patients.  This suggests that acupuncture can be a useful treatment in improving the survival rate for people with heart disease.  The sympathetic nervous system regulates involuntary activity such as blood pressure, heart rate as well as cardiac output.  Heart failure occurs when several neurohumoral systems, including the sympathetic nervous system are activated. Patients with the poorest survival rate have the greatest sympathetic activation.  This is because elevated sympathetic nerve activity creates additional stress on already weakened cardiac muscle.  This causes an already damaged heart have to work harder causing it to get even weaker.  

Medications that have targeted sympathetic activation have greatly improved survival of patients with heart failure. Evidence that acupuncture reduces sympathetic nerve activity suggests that it too could potentially improve survival rate.  One such investigation was undertaken by Holly Middlekauff, M.D. of the University of California Los Angeles School of Medicine in her article, âAcupuncture Inhibits Sympathetic Activation During Mental Stress in Advance Heart Failure Patientsâ from the Journal of Cardiac Failure.

All participants in Middlekauffâs acupuncture study had chronic heart failure for greater than three months and had been recommended for heart transplantation.   The average age of the subjectâs were 43 years old.  All subjects presented with slight to severe limitation of ordinary daily activities due to symptoms. The subjects were randomly divided into three groups.  The first group, the âreal acu-pointâ group received an actual acupuncture treatment.   Acupuncture points were selected for their historically associated functions of reducing stress or treating cardiac conditions.  Many of these points have a relaxing effect.  The volunteers rested with the needles in place for fifteen minutes.  Group two, the ânon-acu-pointâ group followed the same protocol however needles were inserted in non-acupuncture points.  Though needles were inserted, the locations in which the needles were placed are not thought of as functional points from a traditional acupuncture perspective.  The third group, or âNo-needleâ group, were shown acupuncture needles, however only a small plastic tube was tapped against the skin, out the patientâs field of vision in order to simulate that an acupuncture treatment was being performed. Subjects were then allowed to rest for fifteen minutes.  Therefore no needles were inserted at all.  At no time did any of the subjects raise suspicions about the authenticity of their treatments.

Prior to their respective treatments all participants were subjected to a four-minute mental stress test where they had to complete complicated math problems in their heads and speak them out loud as quickly and accurately as possible.  Blood pressure, heart rate and sympathetic nerve activity were all measured at this time. Following their respective treatments all groups were subjected to a second mental stress test.  During the first stress test all three groups exhibited a 25% increase in sympathetic nerve activity.  This suggests that there is an increase of stress on the heart as a result of the elevated activity.

The sympathetic activation during the second mental stress test was virtually eliminated in the âreal acupunctureâ group while in both groups two and three, the ânon-acu-pointâ group and âno needleâ group, there was no decrease in sympathetic nerve activity. The lack of decrease in the two control groups eliminates any question of a placebo effect occurring.  These findings also demonstrate that acupuncture successfully reduces sympathetic nerve activity.

Further studies utilizing larger study groups receiving multiple treatments are required to fully assess the role acupuncture may play in contemporary cardiac care. These findings potentially open up additional research questions with regards to acupuncture beyond cardiac care.  Currently there are several studies examining the role of the sympathetic nervous system on such disorders as hypertension, obesity, stress and mood disorders, sleep apnea and insomnia as well as digestive disorders like irritable bowel syndrome to name only a few.   Historically the ancient practice of acupuncture has been used in the treatment of these disorders as well as several others.  Further research may lead to a better understanding of what the underlying bio-mechanism of acupuncture is as well as what role acupuncture may play in a modern Western medical system in the treatment of these disorders.

Though this research demonstrates the positive effects acupuncture has on the sympathetic nervous system, sympathetic nerve activity is not the only precipitating factor in heart failure.  Acupuncture is not a substitute for conventional cardiac care. If you are considering using acupuncture as an adjunct treatment, it is important to inform your health care providers.  

Your safety is assured in the hands of a comprehensively trained, licensed and board certified acupuncturist.   You can find a licensed and board certified acupuncturist at the National Certification Commission for Acupuncture and Oriental Medicine at or at the Maryland State Board of Acupuncture at (800) 530-2481.

Eastern Shore Acupuncture
             and Healing Arts
Katherine Binder CP, MS, LAc
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