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 |
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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. |
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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. | |
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