As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Food Therapy Case Study
In my last column, I discussed the importance of understanding the contributing role diet and lifestyle play in the disease process. In this article, I would like to continue this discussion by examining a case study in which food therapy played a crucial role in the healing process. The interesting point to consider with this particular case study is that the patient's herbal and acupuncture protocols were not changed or modified in order to achieve improved therapeutic results. The only factor that was modified was the patient's dietary habits.
Case Study
This patient was a 57-year-old white male suffering from primary hypertension. Blood pressure readings were consistently above 149 in the systolic, with the diastolic reading typically averaging 90-99 mmHG. The patient was not overweight and had a daily exercise regime. This patient was a referral because the previous acupuncturist was not happy with the lack of significant clinical results. The pattern differentiation relayed from the referring clinician was kidney yin vacuity, with liver yang rising and vacuity heat. This is a typical and often-expected presentation in primary hypertension cases.
The herbal protocol was a combination of patent medicines: zhi bai di huang wan and tian ma gou teng wan. The dose was a standard dose of 12 pills each, TID. Weekly acupuncture sessions were also being administered, along with relaxation exercises. Despite three weeks of these combined therapies, the systolic reading would not drop below 149 mmHg. After evaluating the patient's tongue and pulse, I agreed with the referring clinician's pattern differentiation. However, upon inquiring about the patient's dietary habits, some obvious issues were revealed.
The patient typically ate less than one serving of fruit and vegetables daily and suffered from chronic constipation. With this fact in mind, I suggested that instead of increasing the frequency of acupuncture or dosage of herbal medicine, a better approach might be to utilize dietary therapies. The patient was open to such an approach but expressed concern over the extent of dietary restrictions or modifications. I explained that we would introduce very simple changes initially and monitor the progress. The following are the foods that were utilized, along with a TCM description:
Pomegranate Juice: one glass daily; pomegranate juice is sweet, sour and astringent. Its actions are to clear heat and moisten dryness. It is also a rich source of potassium, which is known to lower the blood pressure via clearing heat.
Kiwi fruits: one serving daily; kiwi is sweet, sour and cool. Its actions are to clear heat and engender fluids. It is also a rich source of potassium.
Bananas: one serving daily; bananas are sweet and cool. Its actions are to clear heat and moisten the intestines. It is also a rich source of potassium.
Apples: one serving daily; apples are sweet and cool. Its actions are to clear heat and engender fluids. Apples are also an excellent source of dietary fiber.
Celery: two to four pieces daily; celery is sweet, bitter and cool. Its actions are to level the liver, anchor the yang and clear heat.
Beets: two to four servings per week; beets are sweet and cool. Its actions are to clear liver heat, nourish and quicken the blood, and moisten the intestines.
As you can see from this simple list, the dietary recommendations were far from unrealistic or restrictive. The patient was excited over the simplicity of the suggestions and consequently, the compliance was high. After one month of the above protocol, combined with the previously prescribed herbal medicines and weekly acupuncture sessions, the systolic readings consistently dropped to 135 or below, with the diastolic consistently reading 79-85 mmHg. The patient was experiencing improvements in energy, with less constipation, and asked if he could eat more bananas and apples than "prescribed!"
We increased the apples and bananas to two or more servings daily over the next month and decreased the acupuncture sessions to every other week, while the herbal medicines continued as initially administered. At the end of the second month, the systolic readings were constantly measuring at 130 or below, with the diastolic reading at 85 or below. Also, the previously chronic constipation was now not an issue. At this point, the patient was extremely interested in other dietary suggestions and was open to more options for increasing consumption of fruits and vegetables.
As you can see from this simple case study, dietary therapies do not always have to be overwhelming or extreme. When patients see how simple and consistent changes can produce significant clinical improvements, compliance with other suggestions will improve as well. And when these simple dietary therapies are combined with intelligently prescribed Chinese medicines or acupuncture, results are achieved with often surprising quickness. I hope you enjoyed these short articles on food therapy and were inspired to encourage patients to improve their dietary habits.