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Updating the Medicated Diet

By Gordon Cohen, LAc

In order to achieve optimum effectiveness when using diet therapy, the first consideration is compliance. The main reason for the limited information available to the Western practitioner regarding food therapy is the obscure and often odd ingredients and flavors found in traditional recipes.
 
 
By identifying the therapeutic combinations of ingredients, we can locate similar combinations in other styles of cooking.

For the novice, the use of dietary drugs will suffice. Dietary drugs are classified for individual use and may be prepared in decoctions or porridges as single herbs. Ginseng for shock or hawthorn berry for coronary artery disease can be used with no additional support from other herbs. For kidney stones, two ears of corn, either in porridge or steamed on the cob, may be used.

In more complex use of food herbs, we use a dietary drug as a chief herb and combine it with an envoy with complementary nature and flavors. A traditional example would a decoction of 250 g oxtail and 30 g red dates to treat spinal pain. Cut dressed oxtail into 3/4-inch sections. Combine with red dates in a pot with 750 ml water. Bring to boil. Reduce heat and simmer over low heat until reduced to 250 ml. Take warm in two doses. Oxtail is the chief ingredient. It is sweet and neutral, and activates the spleen, stomach and governing vessel. Its function in this recipe is to tonify the governing vessel and treat spinal pain. The envoy ingredient is red date. It is sweet and neutral, and activates the spleen and stomach. Its function is to speed absorption of the ingredients. A Western approach to the ingredients would be:

Barbecued Oxtail

2 oxtails
2 cloves garlic
1 can tomato sauce
1 cup catsup
3/4 cup brown sugar
1/2 tsp thyme
1 small onion
1/2 cup cider vinegar
1 tbs mustard
2 tsp Worcestershire
Salt and pepper

Cut dressed oxtail into one-inch sections. Set aside. Finely chop garlic and onion. Add to saucepan containing tomato sauce, catsup, brown sugar, thyme, mustard, vinegar, Worcester, salt and pepper. Bring to simmer over low heat and stir occasionally for five minutes. Place oxtails in a covered baking dish and bake at 350 degrees F for 45 minutes or until tender. Garlic, onion, tomato sauce, tomato catsup, table salt, black pepper, Worcester, cider vinegar, thyme and brown sugar are all envoys. Their function is to harmonize the recipe and encourage absorption of the ingredients. Both these recipes use a chief herb which is supplemented by envoys. The envoys support the chief by harmonizing the formula and aiding in its absorption.

There are also recipes with identical chief and deputy ingredients. The envoys may vary greatly but do nothing to interfere with the action of the formula. For treatment of deficiency of kidney yang and qi :

Fried Duck with Walnut

200 g walnut
150 g water chestnut
1 old duck
100 g minced chicken
1 scallion
3 g fresh ginger
1 egg white
16 ml shaoxing wine
2 tbs peanut oil
2 tbs cornstarch and water

Parboil whole duck 5 minutes. Halve duck and remove bones. Steam in basin with scallion, ginger, salt and wine until soft. Make a paste with the remaining ingredients after finely chopping walnut and water chestnut. Spread paste on inside of duck halves and fry in peanut oil until crisp. The chief ingredient is duck. It is sweet, spicy and neutral, and activates the lung spleen and stomach. Its function is to tonify kidney qi. Walnut is the deputy. It is sweet and warm, and activates the kidney and lung. Its function is to support the chief. Water chestnut is an envoy. It is sweet, slippery and slightly cold. It activates the lung, large intestine and stomach, and activates the middle burner. Minced chicken is another envoy. It is sweet, sour and neutral and activates the five organs. It harmonizes the ingredients and facilitates absorption of the formula. Scallion, ginger, wine, cornstarch and peanut oil are all envoys. Their function is to adjust and harmonize the flavors of the dish. There is a similar Persian dish:

Fasenjian

1 duck quartered
2 onions sliced
300 g ground walnuts
2 ½ cups water
4 tbs pomegranate molasses
2 tsp granulated sugar
2 tsp lemon juice
Salt and pepper to taste

Stew all ingredients in a covered pot over low heat for 45 minutes or until the duck is tender. The chief ingredient is duck. It is sweet, spicy and neutral, and activates the spleen, stomach and lung. Its function is to tonify kidney qi. Walnut is the deputy ingredient. It is sweet and warm, and activates the kidney and lung. Its function is to support the chief. Onion is an envoy. It is spicy, sweet and warm, and activates the lung and spleen. Its function is to activate the middle burner. Pomegranate molasses, lemon juice, sugar, salt and pepper are all envoy ingredients. Their function is to harmonize the recipe.

A similar pair of recipes combine the chief ingredient quail with radish for the deputy. It is a cornerstone of a longevity diet and should be taken in the evening.

Stir-Fried Quail

10 quail cleaned and dressed
1,000 g daikon radish
3 g fresh ginger
200 g canola oil
3 tbs cooking wine
Salt to taste

Heat oil in a very hot pan. Add ginger, radish and scallions. Stir and add seasoned quail. Stir fry until all ingredients are tender. The chief ingredient is quail. It is sweet and neutral, and activates the five organs. It tonifies the viscera and clears damp heat, promoting longevity. Radish is the deputy. It is spicy, sweet and cool, and activates the lung and stomach. It clears damp heat and supports the chief. Fresh ginger is an envoy. It is spicy and slightly warm, and activates the lung and spleen. It circulates the qi of the middle burner. Wine, canola oil and salt are all envoys and harmonize the recipe.

Grilled Quail with Horseradish Glaze

8 de-boned quail
1/4 cup pomegranate molasses
2 tbs grated horseradish
1 tbs Dijon mustard
Salt and black pepper

Grill quail until tender. Combine remaining ingredients and glaze quail. Cook quail until glaze is set. Quail is the chief ingredient. Horseradish is the deputy ingredient. It is spicy and cool, and activates the lung and stomach. It clears damp heat and supports the function of the chief. Pomegranate molasses, Dijon mustard, salt and pepper are envoys. They harmonize the recipe.

There are also instances where a "foreign" recipe can be more effective than the traditional ones. This can be attributed to combinations of foods with similar medicinal properties that are not normally considered in traditional recipes. An example is goose. In traditional recipes, it is boiled, steamed, or in decoction for strengthening muscles and bones, and to treat migratory arthralgia. It is paired with pine nuts and celery to treat the latter and chestnuts for the former. A traditional American approach offers a combination of all three important deputy ingredients in one dish:

Roast Goose With Chestnut and Pine Nut Stuffing

14-lb. goose
1 cup water
1/2 cup wild rice
1 cup white rice
1/2 cup diced onion
1 can mandarin oranges
1 cup chestnuts
1/2 cup pine nuts
1/2 cup celery
1/2 cube butter

Cook rice. Saute onions in butter with celery. Shell pine and chestnuts. Salt and pepper goose and trim fat. Stuff with mixture of mandarins, rice, nuts, onions and celery. Cover with a foil tent to prevent burning and roast at 375 F for four hours. Remove tent and roast 30 minutes longer. Goose, the chief ingredient, is sweet and neutral, and activates the lung, liver and kidney. It strengthens muscles and bones, and relieves migratory arthralgia. Chestnut is the deputy. It is sweet and warm, and activates the spleen, stomach and kidney. Its function is to help the chief strengthen muscles and bones. Celery is an assistant ingredient. It is sweet, bitter and cool, and activates the liver and stomach. It helps subdue migratory arthralgia. Pine nut is sweet and warm, and activates the liver, lung and large intestine. It also helps subdue migratory arthralgia. Mandarin orange is an envoy. It is sweet and cool, and activates the lung and spleen. It regulates the flow of qi. Onion is spicy and warm and activates the lung and stomach. It is an envoy and regulates qi. The rice activates the spleen and stomach. Butter is sweet and neutral, and activates the heart, lung and stomach. It is an envoy and harmonizes the recipe. Employing deputies which emphasize the different traditional functions of the chief, this dish can strengthen muscles and bones, expel wind or both. It is an example of utilizing all of the potential of the chief ingredient.

Medicated diet can be available to all regions of the world using any style of cooking. Dietary drugs are present in most common recipes and simply require identification. By combining them in manners specified by basic principles of TCM, sophisticated dietary treatments can be constructed from among the foods available to the common kitchen.

Acupuncture Today
February, 2010, Vol. 11, Issue 02
Depressed Women Can Lose Weight as Successfully as Others Do
 
ScienceDaily (Jan. 5, 2010) — Women with major depression were no less likely than were women without it to have successful results with a weight loss program, according to an article in the Winter 2009 Behavioral Medicine. Group Health Research Institute Senior Research Associate Evette J. Ludman, PhD, the study leader, concluded that weight loss programs should not exclude depressed people.
 

Dr. Ludman's study included 190 female Group Health patients age 40 to 65 with a body mass index (BMI) of 30 or more: 65 with major depressive disorder and 125 without it. The women had not been seeking treatment, but they enrolled in a one-year behavioral weight loss intervention involving 26 group sessions. The intervention, developed at the University of Minnesota over the past 20 years, has proven at least as good as any other currently available non-medical treatment.

Some previous research had hinted that depression might worsen outcomes in behavioral weight loss programs. That's why trials of weight loss interventions typically exclude people with major depression.

"We expected women with major depression to lose less weight, attend fewer sessions, eat more calories, and get less exercise than those without depression," Dr. Ludman said. "We were surprised to find no significant differences between the women who had depression and those who did not have it." Women had lost around the same amount of weight at 6 months (8 or 9 pounds) and 12 months (7 or 8 pounds), with no significant differences between the groups with and without depression.

"Instead, what made a difference was just showing up," she said. Women who attended at least 12 sessions lost more weight (14 pounds at 6 months, and 11 pounds at 12 months) than did those who attended fewer sessions (4 pounds at both 6 and 12 months), regardless of whether they had depression. Being depressed didn't lead them to attend fewer sessions or lose less weight.

"Because of our findings and the well-documented health risks of obesity, we think rigorous efforts should be taken to engage and retain all women in need of such services in intensive weight loss programs," Dr. Ludman said.

For years, Dr. Ludman and her colleagues have been researching the link between depression and obesity. She is also the coauthor of a self-help workbook called Overcoming Bipolar Disorder: A Comprehensive Workbook for Managing Your Symptoms and Achieving Your Life Goals. Her Harvard coauthors include Mark Bauer, MD. Published in 2008, the book outlines the research-based Life Goals Program to help people live with bipolar disorder.

Dr. Ludman's co-authors on this study are Group Health psychiatrist Gregory E. Simon, MD, MPH, who is also a senior investigator at Group Health Research Institute; Biostatistician Laura Ichikawa, MS, Project Manager Belinda H. Operskalski, MPH, and Assistant Investigator David Arterburn, MD, MPH of Group Health Research Institute; Jennifer A. Linde, PhD, and Robert W. Jeffery, PhD, of the University of Minnesota School of Public Health in Minneapolis; Paul Rohde, PhD, of the Oregon Research Institute in Eugene; and Emily A. Finch, MA, of Indiana University School of Medicine in Indianapolis.

The National Institute of Mental Health and the Office of Behavioral Social Sciences Research funded this study.

 
 
 

 

Obesity, Depression Often Coexist In Middle-Aged Women

 
ScienceDaily (Jan. 12, 2008) — Middle-aged women are much more likely to be depressed if they are obese, and vice versa, a new study finds. Rising excess weight goes along with less physical activity, higher calorie intake — and depression — according to the research.
 

What is the reason? Depression and obesity likely fuel one another, said lead author Gregory Simon, M.D. “When people gain weight, they’re more likely to become depressed, and when they get depressed, they have more trouble losing weight,” said Simon, a psychiatrist and researcher at Group Health Cooperative in Seattle.

In the study, published in the January/February issue of General Hospital Psychiatry, researchers interviewed 4,641 female health-plan enrollees, ages 40 to 65, by phone. The women responded to items on height, weight, exercise levels, dietary habits and body image. They also completed the Patient Health Questionnaire, a measure of depression symptoms.

Women with clinical depression were more than twice as likely to be obese, defined as having a body-mass index (BMI) of 30 or more; likewise, obese women were more than twice as likely to be depressed.

Moreover, women with BMIs at or above 30 exercised the least, had the poorest body image and ingested 20 percent more calories than those with lower BMIs. The depression-obesity association held even when the researchers controlled for marital status, education, tobacco use and antidepressant use.

The association was stronger in this study than in previous, comparable ones — possibly because the sample was predominantly white and middle-class, Simon said: “There is some evidence that being overweight is less stigmatized for men, for lower-income people and for women in nonwhite ethnic groups.”

The stigma of being overweight could hurt self-esteem, and thus, efforts to lose weight, Simon said. “It’s not that these women are clueless,” he said. “It’s that they’re hopeless.”

The takeaway for obese women is to focus on rebuilding their spirit, which can help with losing pounds, he said.

Health care providers should glean a similar message from the study results, said Richard Rubin, Ph.D., a Johns Hopkins University psychologist. “Providers need to monitor for depression and treat it in overweight individuals, especially given the dramatically increased risk of diabetes among those who are overweight,” said Rubin, former president for health care and education of the American Diabetes Association.

General Hospital Psychiatry is a peer-reviewed research journal published bimonthly by Elsevier Science. For information about the journal, contact Wayne Katon, M.D., at (206) 543-7177.

Simon GE, et al. Association between obesity and depression in middle-aged women. Gen Hosp Psychiatry 30(1), 2008.