(Not medical advice nor a substitute for medical diagnosis or treatment; educational resources only)
Proper digestion, absorption, and elimination is central to human health.
Even if you don’t deal with digestive issues like IBS, gas, bloating, constipation, diarrhea, gut dysbiosis and leaky gut can be important drivers for:
- Auto-immune disease
- Fatigue/ tiredness
- Anxiety and depression mental health (the gut-brain axis is real)
- Blood sugar issues
- Heart disease, high blood pressure, heart failure
- Kidney disease
- Estrogen dominance
- Fatty Liver
- Difficulty concentrating
- Osteoporosis (not absorbing your minerals has consequences for your bones)
We live in a society where the most abundant food available is highly processed, high in calories and things not found in nature but low on nutrient density. Most of us don’t eat the way our ancestors ate in terms of what, how, or when.
Chinese Medicine offers a time-tested model of how to care for our digestive systems. Dietary therapy is one of the branches of the medicine (in addition to acupuncture and herbology). Understanding a bit about the energetics of food can be game-changing for how well we digest, and how well we feel.
While there is no one right diet that’s right for everyone, there are certain principles of digestion that apply to human beings. We ignore these principles at our peril, as we are not what we eat: we’re what we digest.
Over the years I’ve created a bunch of resources on the subject. Here are a few I give out to patients every day:
Digestion and Dampness Tip Sheet a stream-lined guide on what to avoid vs. include to support your gut
Stoking Your Digestive Fire Check List download and post to your fridge
Abdominal massage video for better digestion
Kitchen Clean Out Cheat Sheet: a guide to eating more natural, whole foods
Kitchari Recipe a one-pot meal for when your digestion is off
Podcast episodes I’ve recorded on the topic include:
The links will allow you to listen wherever you get your podcasts. Cue them up on your phone and enjoy.
Dampness and Digestion Master Class solo episode
TCM Nutrition tips for a Healthy Digestive Microbiome with Dr. Darlene Easton, DACM
Care and Feeding of Your Microbiome with Dr. Chris Dammon
Chinese Herbal Medicine, Neurology, and the Gut-Brain Axis with Dr. Chloe Weber, DACM
Microbiome Biohacking with Dr. Andrew Miles, DOM
Poop: Why You Should Give A Crap with Dr. Marisol Tijero, MD
How We Eat is How We Live: Unapologetic Feminist Self-Care with Ali Shapiro
Timing Is Everything solo episode
Cooking for Hormone Balance with Magdalena Wszelakis
Nutritional Healing with Chinese Medicine with Ellen Goldsmith, L.Ac.
Excerpt from my Basics of Chinese Medicine: Your Inner Ecosystem class from 2016:
The Earth element is about nourishment. Just as the Earth nourishes all life, so too do the Spleen and Stomach, the organs we associate with the Earth element. The Spleen’s main job is to transform our food and our life experiences into something nutritious and to transport that nutrition to where it needs to go in the body. The Spleen plays a fundamental role in the production of qi and Blood to provide energy and nourishment to all the other organ systems. It follows that if we’re not digesting our food, we’re going to feel tired and weak, we’ll start dipping into our reserves pretty quickly, and our health will suffer. We need healthy Spleen qi in order to feel energized. Our Stomach and Spleen literally create the stuff of who we are out of stuff that we’re not: converting food and drink into usable energy but also turning it into our flesh, the physical stuff of who we are. Furthermore, it’s the Spleen’s job to distribute energy and nourishment to all of the muscles in the body. For this reason, the Spleen is said to govern the four limbs: it gives us our physical strength. And on a psychological level, remember that our sense of who we think we are lives in our Blood. We need strong qi and Blood in order to have a strong sense of self, and to feel capable and powerful.
The Spleen also gives us our ability to think clearly in that it houses the yi. The yi is often translated as intention, but it actually encompasses pretty much our entire mental capacity to analyze and assimilate new information, hone our focus, memorize, and organize our thoughts. On the mental-emotional level, the Spleen is associated with worry and obsessive thinking: chewing on the same things over and over again, not being able to let something go, like mental constipation.
The ability to digest our lives, to make sense of what has happened, and to integrate it into our world view are functions of the yi. How we interpret the events of our lives is in part determined by the people in the culture around us. The expectations of others influence how we react to the world: how we’re supposed to feel when someone dies, when we get a promotion, or when we turn 50. It can be difficult to separate our own actual, organic feelings from the culture dictates of what we should be feeling. If what we’re feeling doesn’t match what those around us expect, and we’re invested in what those around us think, we can get really mired in an emotional swamp in which we feel stuck. Being overly concerned with what other people think, or “shoulding” on ourselves, can be a Spleen issue.
In addition to housing the yi, the Spleen is also in charge of ascending the qi to the head so that we can perceive the world clearly. The Spleen also holds things in place, preventing our organs from prolapsing, and keeping the Blood inside the vessels where it belongs.
The Earth element relates to the season of Late Summer, a season that corresponds with harvest time, before the arrival of fall but after the peak heat of the summer. This is the phase of reaping what we’ve sown, when we integrating everything that has happened in the cycle of change thus far. The time of manifestation and maturity, the Earth phase is when we enjoy the fruits of our labor, or try and digest the difficult thing that just happened. (It may be interesting to note that prior to our modern conception of the 5 phases, Earth occupied the position between each of the four seasons — the weeks before and after the solstices and equinoxes. It was a time of transition, integrating what has come before.) So Spleen has to do with processing and integrating our life experiences.
All life on Earth is interdependent. The emotional state we associate with Earth is sympathy, where we connect to the pain of another. We need to care enough about other people in order to sympathize, or empathize; we also need to be able to stay grounded enough in ourselves to not get mired in other people’s problems.
The taste we associate with Earth is sweet, which is the taste of most of our food, and the sensory organ that corresponds with the Spleen is the mouth and lips, which mark the opening of the digestive tract.
The Spleen and Stomach are the main officials in charge of digestion and assimilation. In The Tao of Healthy Eating, Bob Flaws offers the following analogy as to how they relate: the Stomach is like a cook pot, the Spleen is the burner on your gas stove, and the Kidney yang is the pilot light. So the Stomach is essentially a chamber that receives food and drink (yin from the outside world), while the main thing powering our ability to digest is the Spleen. Spleen qi provides the transformative power to convert our food into ourselves, which is pretty miraculous. We can think of Spleen qi as the digestive fire that allows us to take input and make us of it, whether that’s in the form of food, information, or life experience.
If you’re familiar with Ayurvedic medicine, you can consider the notion of agni, or digestive fire, as being very similar to Spleen qi. After the Stomach receives the food and drink and begins the process of transformation, the Spleen begins to “separate the pure from the turbid,” to sort out what’s useful and what isn’t. It then passes the baton to Small Intestine for further clarification of the turbid stuff, and ascends the clear fluids up to the Lungs to be distributed to the body as moisture. The Spleen and Stomach comprise the Middle of the Three Burners, which is where most of the digestive action takes place. The functions of the pancreas are also subsumed under the heading of the Spleen; the two are described as a single organ in Chinese Medical Classics.
But the Kidney yang (in the Lower Burner) also has a role to play: it provides a little spark of yang to support the Spleen, like the pilot light of the stove.
The Spleen and Stomach work together to digest our food, but they appreciate different things. The Stomach, as a yang organ, doesn’t like to be too hot or too dry; it appreciates some moisture. To help the Stomach, we drink a bit of liquid with our meals, just as we typically add a bit of liquid to the cooking process – we don’t just put food directly into a pot. It’s also important not to scorch the pot by giving it too much heat in the form of super-spicy foods.
Meanwhile, the Stomach’s yin partner, the Spleen, doesn’t like to be cold and wet: too much moisture will dampen the digestive fire. Just as we wouldn’t smother a struggling campfire with cold, wet leaves, we make life difficult for the Spleen when we overwhelm it with a lot of cold, raw food, like salad. We also wouldn’t expect our little campfire to be able to consume the trunk of a giant redwood tree. A giant slab of meat would be the dietary equivalent: a lot of nutrients there, but way too much to digest well. When we add something unnatural, like particle board, to the campfire, all kinds of noxious weirdness can result. This is the risk we run when we give our body highly processed things it doesn’t recognize, or things with a complicated list of ingredients: from soy protein isolate to MSG to vitamins with 300 ingredients in it. Foods that are warm, cooked, and simple tend to digest best.
Let’s talk about digestion for a moment. I learned early on that many people have no idea what it means to digest well. “How’s your digestion?” I would ask, and people would predictably respond “it’s fine.” As a culture, we’re weirdly squeamish about talking about our guts and our poop. Or maybe we’re not conditioned to be tuned into it. But when I would ask specific, less comfortable questions like “how many times a day do you poop?” I would commonly hear things like “oh, maybe two or three times a week. Like normal.” This is not fine! Or, after telling me that their digestion is “fine,” the person shares that she’s popping a couple of Tums every night because of stomach pain. Also not fine. Good digestion means you have an appetite, eat food, and feel just as good if not better afterwards. It means that the qi moves in the right direction: no reflux, nausea, heartburn, vomiting, unpleasant feelings in the stomach or abdomen, foul smelling gas, abdominal distention or fullness, urgency in elimination, diarrhea, or constipation. Stools are eliminated easily, without assistance from caffeine or laxatives, at least one a day if not more, and appear formed, banana-shaped, and without any mucus or undigested food. In addition to those signs and symptoms that are clearly related to digestion, chronic tiredness, nasal congestion, phlegm in your throat, cloudy thinking, acne, and frequent colds are other signs that something might not be going right with digestion.
So the maxim “you are what eat” is a bit misleading. A more accurate statement would be you are what you digest. When digestion is weak, we could be putting the most beautiful, vibrant organic wholesome wonderful stuff into our bodies but not having it do us any good. Likewise, we can be reading a ton of books but if we’re not present to retain what we’re taking in, the new information isn’t going to have much of an impact.
Digestion begins before we even take our first bite of food: just thinking about looking at food and smelling it triggers the release of digestive enzymes. We salivate, and the Stomach increases its digestive juices in preparation for a meal. A lot of people miss this step because we’re eating in our cars or eating while at our desks or reading something on our phones. Simply pausing to look at, smell, and appreciate our food benefits digestion.
Because the Spleen is responsible not only for the digestion of food, but of information, eating while studying can be especially problematic. And, of course, eating while you’re stressed can cause the Liver to overact on the Spleen, leading to all sorts of digestive issues. (Remember, the nervous system can either be in fight-flight-freeze mode or rest-and-digest mode – but not both at the same time.) When eating gets our full attention, we’re more likely to digest well. Consider the somewhat radical notion of eating at a table, away from distractions.
Another simple but often-overlooked step is chewing. Ideally, we chew until our food is mush, because the stomach doesn’t have teeth. And our saliva contains digestive enzymes. Chewing allows the digestive enzymes from our saliva to intermingle with the food, breaking it down before we even swallow. It also slows us down. It takes 20 minutes for the stomach to register that it’s full, so eating quickly easily results in over-eating – we simply haven’t gotten the feedback that we’ve had enough.
Breaking food down into smaller bits by pureeing something in your blender, grating up your carrots, or simmering a stew for hours leaves less work for the Stomach and Spleen, and will help our bodies extract more nutrition from our food.
Good digestion depends on when we eat, often even more so than what we’re eating.
Eat breakfast. According to the Chinese Body clock, the time when the Spleen and Stomach receive the qi is from 7:00 AM to 11:00 AM. Since the Spleen rules the 4 limbs, as well as our capacity for mental focus, it’s a really good idea to give the Spleen something to work with. In the ecosystem that is our bodies, the digestive system is intimately related to all other systems. From a Western perspective, the adrenal hormone cortisol rises in the morning to help wake us up and make us on the alert to go find some food. When we eat breakfast, we signal to the body that we’re not going to starve today, and it can save the cortisol for emergencies. When we don’t eat breakfast, cortisol levels stay high, and chronically high cortisol can throw off all sorts of other hormones, like thyroid, insulin, estrogen and progesterone, as well as deplete our immunity and cause weight gain.
It also helps the Spleen to consume most of our food at lunch. This is when digestive fire is strongest, and therefore the best time to eat the largest, most complicated meal of the day. Giving ourselves an ample, satisfying meal at lunch provides us with calories to burn all afternoon, supplying our brains with much-needed fuel.
It then follows that we’d eat a light dinner, before 7 PM. The rhythms of nature dictate that night time is yin time – we don’t need a lot of food as we prepare for sleeping. The evening meal used to be called “supper,” meaning a supplement to the main meal of the day, which was eaten much earlier. According to the Chinese body clock, we have the least amount of qi in the digestive system (Spleen and Stomach), between 7pm and 11pm. So they’re not going to do their jobs as well. It’s also not a great idea to go to sleep when we’re still digesting, as that can create stagnation, dampness, and heat. Ideally, we allow at least three hours between the evening meal and bedtime. You may remember that Gall Bladder and Liver kick into gear to clean the Blood and detoxify our bodies between 11pm and 3am. They can’t do their job very well if they’re still busy digesting dinner.
When we eat three meals a day, we give our Spleens a chance to rest. If we’re eating every few hours, the digestive system is always on, and Spleen and Stomach never get a chance to rest. Meanwhile, the body will burn the meal or snack we just ate for fuel, and with a steady supply of calories always available, it has no reason at all to burn its fat. Regular fat-burning is important not only so we don’t gain too much weight, but so we can rid ourselves of fat-soluble toxins.
Only eat when you’re hungry.
So those are your guidelines for how and when to eat. Now we can start to focus on the question of what to eat:
Before we start micromanaging which grains are medicine for which organ systems, or whether it would better to have celery or cucumbers in your salad (or whether or not to turn on the news!), we need to consider the most important question, which is “Can I digest this?”
Warm, cooked, simple foods tend to digest most easily. Here, the word warm refers both to temperature and the nature of the food. Think soups, stews, and porridges that are served warm, and made from food that’s neutral to warm in temperature, or cooked with warming spices. When we cook our food, we help to break it down into usable nutrients, essentially beginning the process of digestion before the food enters our bodies. Warming spices also kindle our digestive fire. When our digestion is weak, go back to these basics.
Here’s another important basic: eat “food.” Avoid non-food, which would be, as Michael Pollen puts it, “anything your great-grandmother wouldn’t recognize as food,” things engineered in a laboratory, or overly messed-with. The Spleen may get very confused as to what to do with chemicals not found in nature.
I’d also consider refined sugar to be a non-food, in that it has undergone so much processing that it’s pretty hard to say it’s natural. It’s also easy to pick on sugar because it depletes the body of nutrients, stimulates the growth of the wrong kind of gut flora, while offering truly nothing in return except for calories. Artificial sugar substitutes are just as bad, tricking the body into thinking it’s getting something nourishing with the taste of sweet, when it isn’t. It’s not nice to trick the Spleen.
We tend to deliver the most qi to the body when we consume food that has qi in it. We can tell by its smell, color, and, of course, taste. Think of the smell and taste of a tomato just off the vine versus one that was picked weeks ago halfway across the world. Or a hunk of aged parmesan cheese versus the “parmesan cheese” from the green can. Or a packaged, frozen, microwaved meal versus one you’re cooking on your stove from fresh ingredients. Freshly prepared food will likely have more much qi in it than 4-day old leftovers. There is more to food than its ingredients.
We’re more likely to digest well when we give the Stomach a little space, and a little liquid. Like an artist, the Stomach needs room to work, which means we best not crowd it through overeating. The Stomach has to turn everything we eat into soup, which it has a tough time doing in the absence of liquid. Offering the Stomach a bit of room- temperature water or tea helps it do its job. Flooding the stomach with liquid, however, will dilute the gastric juices, and be counterproductive.
It’s really important that liquids served with meals not be cold. Iced liquids easily damage the digestive fire of the Spleen, and the Spleen deserves our deepest respect.
Like a kitten, the Spleen hates being cold and wet. Food that is energetically cold (like most vegetables), served cold and raw (like salad) in a cold season of the year is not balancing for the body, and can weaken the spleen. So the simplest thing is to just cook our food in the winter, and eat it warm. In the summer, it becomes more appropriate to eat things like salad (cold food served cold), provided we can digest it, because it helps to balance out the heat of the season.
Actually, when we eat what’s in season in the place where we live, we’ll likely be giving our bodies what they need. And when possible, eat organic. Biocides, pesticides, and herbicides all have the potential to screw up our gut flora, even if they’re fed to the animals we’re eating.
A balanced meal in Chinese Medicine would be one that has not only a balance of the macronutrients: fat, protein, and carbohydrates, but a balance of all five tastes: sweet, sour, salty, bitter, and pungent. Bonus points for eating a variety of colors, since they all do something different, and support a different system in the body.
Beyond that, it’s just about listening to our bodies. They will tell us what they want and need.
So those are the general principles of Chinese dietetics. When we eat in accordance with these principles, we increase the likelihood of digesting well, thus producing high- quality qi and Blood. (Remember, it’s the creation of this surplus of qi and Blood that allows us to preserve our Jing, living off the interest in our bank accounts instead of dipping into our reserves.)
When we commit dietary indiscretions, we impede the Spleen’s ability to transform our food into usable nutrition, which can result in a kind of residue known as “dampness.”
Dampness is excess turbid moisture that the body doesn’t need. Like a fog inside our bodies, dampness can make us feel boggy, heavy, and cloudy both mentally and physically. We carry dampness around as extra weight. Or it may seep out as nasal discharge, vaginal discharge, or lodge in the lower burner as ovarian cysts, turbidity in the Bladder. Dampness can combine with heat to produce things like acne, yeast infections, and gallstones; it can also combine with cold and lead to fungal infections or ovarian cysts. All of these involve an element of excess yuckiness that the body doesn’t totally know what to do with.
When dampness combines with heat, it transforms into Phlegm, which is a form of congealed dampness, gunking up the works. Phlegm can “mist the mind,” distorting our perceptions of the world. Phlegm can combine with wind, leading to things like epilepsy or stroke. As it says in the Classics, “strange diseases are caused by phlegm.”
Dampness most commonly arises after eating too much sugar, too much greasy fried stuff, drinking too much alcohol, giving the Spleen stuff it doesn’t know how to break down (like anything artificial), or just plain overeating. Or it could be from drinking iced water, eating while stressed, or eating too late.
Apart from dietary causes, dampness can also enter the body directly from the external environment, through sleeping on damp ground, wearing a damp bathing suit for hours, or living in the Pacific Northwest in the winter. It can also arise from undigested, heavy emotions, like guilt and shame.
To keep our Spleens happy and nourished, it’s best to eat warm, cooked, foods with qi in them.
We can also pick foods for the Earth element based on the sweet taste. This doesn’t mean the empty sweet of refined sugar, but rather the full sweet taste that signifies that something is, in fact, edible. Most food involves a bit of sweetness, because that’s how we recognize it as food. The taste of sweet is nourishing and comforting and somewhat moistening (but in excess, bogs us down with dampness.) Bland, like the taste of most grain, is considered a subset of sweet. It’s a mild, neutral taste, useful for keeping us alive. Oats, corn, rice, barley, buckwheat, wheat, and spelt are good examples of bland.
When eating grains, it’s generally best for our bodies to eat them in their whole-grain form, which includes the nutrient-rich outer germ layer. But when our digestion is really weak, it’s likely not strong enough to hack into that germ layer to unlock the nutrients. Someone who can’t digest or absorb simply needs a neutral, simple source of calories, and white rice may be the perfect medicine. In China, rice porridge cooked overnight as congee would be prescribed for weak digestion. In the Ayurvedic tradition, the equivalent medicine is kitchari, a traditional one-pot meal involving white basmati rice, split mung dal, and spices to kindle digestion. Kitchari is wonderful when your digestion is weak or needs a reset, but it’s also excellent to have at the change of the seasons, when we haven’t totally figured out how to eat for the new environmental influence.
Meat is a powerful qi and blood tonic, but its heavy proteins can pose a challenge to Spleen. It’s best absorbed when cooked into soups and stews, along with pungent, warming spices that kindle digestion, like fresh ginger, black pepper nutmeg, cardamom, fennel, cinnamon, basil, rosemary, onions, leeks, scallions, and chives. Most legumes are also sweet, but the smaller ones (like lentils and mung beans) tend to be less gas-producing and thus easier to digest. Legumes can be made more digestible by soaking, and cooking with seaweeds, cumin, epazote, and bay leaves.
If we think about our Food Spectrum, the Earth is relatively yin, so food grown on land but close to the ground corresponds to Earth. And the color that corresponds to the Earth Element is yellow. So rooty vegetables and tubers that grow close to the Earth and have a yellow or yellow-orange hue are exceptionally good for the Earth element. Think sweet potatoes, carrots, butternut squash, summer squash. But they don’t have to be yellow: beets and mushrooms are also Earthy, and can help us feel grounded.
Naturally fermented probiotic foods are wonderfully supportive for the Spleen. A few forkfuls of fermented vegetables each day helps keep our gut flora and digestive fire healthy.
Raw food and anything served cold will likely overwhelm a weak Spleen and lead to the production of dampness.
When dealing with dampness, the most important thing is going to be to avoid refined sugar and refined flour. (Remember that signs of dampness include feelings of heaviness, extra weight, cloudy thinking, sticky stool, nasal congestion, exc0essive nasal or vaginal discharges, fungal infections, etc.) Even natural sweeteners can make a damp situation worse. We’ll also want to limit dairy, especially cow dairy, which is mucogenic. Sheep and goat dairy tend to be less dampening, as their diets are more diverse than those of cows. And within the realm of dairy, yogurt and kefir which have been fermented tend to be less damp than something like milk. (Butter and ghee don’t typically contribute to dampness in the same way that cheese does, because they are primarily fat, without the sugar and protein that tends to lead to dampness.)
Because fruit is naturally so sweet, it’s to be eaten in moderation when combating a damp condition. Berries, apples, and pears are usually OK. But tropical fruits like mangos, bananas, and papaya, which tend to be the sweetest as well as the most watery, are best avoided in cases of damp. Nuts and seeds should also be consumed in small quantities because they’re so dense and oily. As far as the grains go, glutinous grains are sticky, and since like increases like, they’ll be more likely to contribute to dampness. The outer hull of pseudograins like wild rice and amaranth can actually help transform dampness because of their bitter taste. As you already learned in the last module, anything bitter will likely help transform dampness. Small legumes like lentils and aduki beans are excellent drainers of damp.
As I mentioned earlier in the course, Chinese diet theory can be super complex, but it can also be really simple. The simple version boils down to this: respect the Spleen: eat mostly warm, cooked, freshly prepared, natural food that’s in season. We can then get more specific based on our individual health goals.