Optimizing Our Diet in the Time of COVID – 19
“Those who take medicine and neglect their diet waste the skill of the physician.”
Optimizing our diet in the time of COVID-19 can rely upon the wisdom and guidance of Chinese nutritional healing and Chinese medicine. Chinese medicine and its 3,000-year-old tradition of embedding food as medicine in the culture can teach us a lot, no matter what culture we are from or live in now.
The basics of Chinese nutritional therapy are steeped in the foundations of Chinese medicine, on the observation of nature and our unique interaction with it. Each of us live in specific climates, we live through seasons and their changes and each of us has a unique physical constitution and condition. These considerations are important to consider when making food choices and recommendations.
In the time of COVID-19 food can be one of our first forms of medicine to enhance the immune system, prevent infection and in minimizing the effect of the virus in its initial stages. Chinese medicine’s unique approach to food as medicine provides a more specific and individualized approach to health.
The Seasonal Changes
The importance of cyclical and seasonal changes has an impact on our health. Each of us lives in a changing climate in which we are experiencing unprecedented changes in weather (warmer winters and hotter summers), extreme fluctuations in weather and disturbed growing seasons. At this time we are emerging from winter, which in its usual state appears barren upon the surface yet is one of the important times of the year for regeneration and growth.
This is a time when the yang qi of nature is unperturbed, when we also need to cultivate and nourish the innermost foundation of our bodies. According to the National Centers for Environmental Information, this past winter has been one of the warmest on record. The emergence and spread of COVID-19 during an unusually warmer winter leading to damper conditions is important to pay attention to as, from a Chinese medicine, perspective COVID- 19 is a warm disease with wind heat pathogens that transmit easily. Finally, we know that increased environmental instability contribute to increased stress, which is further exacerbated in people who have compromised health, high levels of stress and fatigue.
The elements of damp, heat and cold are important to consider when making unique and global food recommendations in the prevention of disease.
The food we eat, though no matter how “healthy,” is only as beneficial to us as our capacity to break down, digest, transform and assimilate it, which is attributed to Stomach and Spleen yang qi. The harmonious process of digestion is key to the quality of our vitality and qi, our physical treasure. And the state of our qi creates the physiological ground for a strong and clear spirit or shen, our most subtle treasure. Thus, we not only nourish our bodies to prevent disease but to nourish a stable and well balanced state of mind.
This article will outline food strategies to improve general health (supporting the digestive capacity and the Stomach/Spleen network), provide you with general and specific guidelines from a Chinese medicine perspective on foods, cooking methods and lifestyle recommendations to support your health during this time of the coronavirus.
The effect of stressors on your health
If our health is compromised due to poor underlying health conditions, stress, overwork or fatigue we become more susceptible to acute illness as our protective qi is diminished and our immune system is taxed. So what do we do? First things first, we need to remove those obstacles to cure which obstruct healing and are interwoven in our lifestyle and the foods we eat:
- Stress is inevitable during this time. However, we can learn to manage and lower our stress response with exercise (walking, biking, yoga, strength training, tai chi or qi gong, swimming), meditation practices, any artistic outlet, strong emotional bonds with friends and family, being out in nature. Stress can lead to anxiety, insomnia, physical tension, reactivity and mood swings.
- Improve sleep. Poor sleep is a tremendous burden on the immune system. If you are having trouble with sleep cut back on caffeine and stimulating and spicy foods, try a hot bath before bed. Add in calming herbal teas such as chamomile, chrysanthemum, skullcap, lavender, lemon balm or licorice.
- Move your body. Movement is crucial to moving the lymphatic system and moving fluids through the body. Gentle exercise is just fine. Do what makes you feel good; dance, walk, do yoga, tai chi or qi gong, bike or swim. But move at least 30-minutes a day.
Support a healthy and harmonized Stomach and Spleen:
- Eating regular meals. Even if your meals are small regular eating is important. Blood sugar regulation reduces stress on the endocrine system and digestive system.
- Avoid overeating. Overeating taxes our digestive system the center of good health in the body and adds to stagnation and dampness. Overeating happens for so many different reasons and it can be hard to change. Here are some ways to work with it:
- See if you can serve yourself from the stove. Make a plate and stop after eating that plate.
- Chew. Chew. Chewing well slows down everything, is calming to the nervous system and helps the digestion of food. Try chewing your food at least 30 times and you will start to note a big difference.
- Breathe in and breathe out, over and over again. This is enormously calming to the whole body.
- Avoid foods that contribute to a warm and damp condition in the body such as spicy, greasy, fatty or creamy foods (rich sauces, ice cream), heavy dairy usage, shrimp, sugar (including artificial sweeteners) and alcohol.
- Avoid foods that can be hard on digestion such as raw and cold foods ( especially foods eaten directly from the refrigerator) which weaken the stomach fire and digestive capacity as raw and cold food require enormous amount of stomach qi to break down.
- Cooking methods: Avoid fried foods, heavy grilling or the overuse of heavy animal fat in cooking.
- Eat foods that are easy to digest and are nourishing such as lightly cooked vegetable broths or soups or congee (a rice soup made with ratios of 1 cup rice to 12 cups of water cooked slowly for 2 hours).
The rainbow of colors on your plate. Include foods that have all the colors: orange/yellow, red, green, green and more green, beige, blue or black. This will ensure a balance of the five flavors (sweet, sour, salty, pungent and bitter).
- Foods of a neutral thermal or slightly warming thermal nature such as whole grains, beans and legumes, carrots, winter squashes, nuts and seeds, mushrooms of all varieties.
- Vegetables: radishes, daikon, scallions which all have a pungent and dispersing nature. Include dark leafy greens.
- Fruits eaten whole are hydrating and cleansing. Gently cooking fruits make them easier to digest. Pears have an affinity for the lungs are sweet, slightly sour and cooling. Apples are sweet and sour, hydrating and support the stomach and spleen. Bananas and other tropical fruits have higher sugar content and a colder nature and thus are best to avoid. Oranges are high in sugar but can be eaten (not drunk) in small quantities to alleviate thirst. On another note the zest of tangerine, lemon or orange peel can be added to hot tea or foods to activate digestion and help to clear phlegm.
- Herbs and spices found in your kitchen cabinet are a treasure trove of medicine. Cook with herbs and spices to add flavor, increase palatability and medicinal effect of your cooking. The following aromatic herbs and spices have a gentle warming and moving effect on one’s digestion: Basil, thyme, rosemary, sage, oregano, parsley, cardamom, cinnamon, nutmeg, cloves, turmeric, cumin, coriander, ginger (fresh or dried), black pepper (in small amounts), anise seeds, or dill. These herbs and spices while stimulating digestion counter the accumulation of dampness in the body.
- Fermented Foods are eaten throughout the world and are among the oldest and easiest methods of food preparation. Some fermented foods include sauerkraut, pickles, miso, tempeh, tamari, kimchi, kombucha, natto, kefir, and yoghurt. These foods are filled with pro-biotics and support the promotion of beneficial bacteria to the gut a key component of the immune system.
- As a general guideline during this time the minimization of all dairy is recommended as it contributes to dampness. If you do eat any yogurt or kefir try goat or sheep products, which have a smaller fat molecule and are easier to digest. Add warming aromatic spices (cinnamon, ginger, nutmeg) to the food to counter the cold and damp quality of those foods.
ADDITIONAL FOODS TO SUPPORT IMMUNE SYSTEM and GENERAL HEALTH:
- Vinegar – Vinegar adds dimension to cooked greens and bean soups. Added to meat stews it helps in the digestion of the fat. Vinegar is sour and sweet and is not a beneficial food if you are getting sick.
- Nutrient dense foods such as animal food in small quantities, trout, salmon or catfish, eggs (nourishes Stomach/Spleen, blood, qi and yin), avocado, good quality fats, nuts and seeds, non-gmo tofu and tempeh, beans and legumes.
- Honey is nourishing and fortifying.
- Sea Vegetables add minerals and trace minerals to our body that are important and help to moisten dryness and soften hardenings (phlegm accumulation) in the body.
- Try the spectrum of sea vegetables such as nori (the highest in protein), dulse (can eat uncooked), kombu (used in cooking of beans and soups to add umami and minerals), wakame (rich in calcium and magnesium), hijiiki and arame (can help to soften phlegm accumulations). All coastal cultures have included sea vegetables into their diet.
- Include Bitter Greens and Vegetables– the bitter flavor is cooling and cold in thermal nature and supports the clearing of heat and fire, dries dampness and phlegm. The bitter flavor is important to include on your plate. Choose from the wide variety of foods such as: dandelion greens, escarole and other chicories, lettuce stems, artichokes and asparagus, all types of rapini or rabe, milder notes of bitter can be found in celery leaves and cardoons, as well as mature turnips and rutabagas. For a strong medicinal dose of bitter, try cooked bitter melon.
- A note of caution: If you or your patient is yin deficient and dry be careful with bitter greens, as they dry dampness and are cold. However, with a constitutionally hot natured person bitter greens ought to become a staple.
The following herbs and medicinal foods have tonic effects supporting the immune system when you are feeling well (not when you are sick):
- Astragalus is best when you are healthy and can be added to soups and stews or teas. It is very woody so cannot be eaten.
- Mushrooms including button and cremini, shitake, maiitake, oyster, cordyceps and other varieties are well known for their immune boosting properties. Add them into soups, stews, stir-fries or roasted they are delicious and add umami deep flavor into your cooking.
- Red dates and goji berries nourish qi and blood. These can be added to teas, soups and stews.
What to eat when you start to feel sick (always consult your physician if you believe you may be sick with COVID):
If your symptoms start with a sore throat, aches and pains, fever or chills:
- Follow the general guidelines above in foods and cooking styles to avoid.
- It is crucial to not overeat to take the stress off of your digestive system
- Cooling and pungent foods such as radish, daikon, broccoli, lightly steamed pungent greens including: arugula and mustard greens.
- Pungent and cooling herbs can be added to cooked foods or utilized in teas. Include peppermint, spearmint, lonicera buds (lian qiao) and honeysuckle buds (jin yin hua) in equal amounts.
- Hydrate, hydrate, and hydrate by eating steamed foods, soups, soupy dishes and warm teas. Green tea is more cooling than black teas.
- Gargle with warm salt water 3-4 times per day
If you are feeling sick with mild sore throat and chills:
- Follow the general guidelines above in foods and cooking styles to avoid.
- Do not overeat.
- A combination of warming and cooling pungent foods: as above and also include: scallions, chives, spring onions, shallots, small amounts of garlic (garlic is very warming and easily aggravate a wind condition), ginger fresh or dried.
- A combination of pungent/aromatic spices and herbs, which warm with added small amounts to cool. Include: nettles (fresh or dried as in a tea), shiso leaf (zi su ye or otherwise known as Japanese basil), basil, cardamom, cinnamon, nutmeg, caraway seeds (disperse cold), sage and thyme.
- Hydrate. Hydrate. Hydrate.
- Take hot Epsom salt baths until sweating and then go directly to bed.
If you have a mild dry cough:
- Continue to follow general guidelines.
- Avoid all hot, warming and drying foods including spicy and heating foods, beans and legumes (are drying), baked goods, crackers, chips and popcorn.
- Hydrate! Water is the best mucolytic agent there is. Make it warm or hot. Drink often.
- Cooking methods such as steaming, boiling or lightly braising. Eat easy to digest foods.
- Include foods, which support the lung and lubricate: slippery greens such as spinach or chard. Tofu, sea vegetables, almonds, sesame seeds both black and white, almonds, pine nuts and walnuts. Include pears, watercress, figs, honey (aids in lubrication) and lotus root.
- Teas, which include lily bulbs, mulberry leaf, chrysanthemum.
Mild cough with phlegm:
- Follow general guidelines.
- Include foods that are neutral in thermal nature and clear phlegm: mustard greens, mushrooms, radishes and daikon, carrots, rice, oats, pine nuts, almonds and small amounts of onion (cooked), sea vegetables, cooked napa cabbage. Utilize fresh ginger root grated into hot water, use zest of citrus.
- Kumquats can be cooked down with honey to make syrup that can be mixed in hot water to help clear phlegm.
Feeling overwhelmed already and not sure where to start? Take it slow. It is important to pace ourselves for the long haul. Our mental and emotional health is crucial in maintaining our physical health. We are in this together, throughout the world. By sharing our strengths and asking for help when we feel at sea we can help ourselves and each other maintain our health, vitality and well being
The list is long and you might be asking how you can implement all of this at once. First, don’t worry. If you can start by eliminating those foods (or just a couple of them) which obstruct healing and diminish the strength of your immune system you are making enormous changes.
Here are some supportive ideas to help:
- Ask a friend to join you in making some of these changes. Support during these times is crucial.
- If you need more specific health and guidance feel free to reach out to your health care provider or me. Each of us is unique and an individualized approach can be most helpful
- Don’t know how to cook? Go online where resources abound.
- Check out Catherine Deumling’s wonderful site Cook With What You Have for many recipes and online cooking demonstrations.
- Lauren Chandler of Lauren Chandler cooks is offering free virtual mini- cooking lessons
- Check out my book Nutritional Healing with Chinese Medicine: + 175 Seasonal Recipes for Optimal Health for more in depth learning on Chinese medicine and food, over 175 seasonal recipes and resources for food.
This article is meant to provide you with another perspective on how we can nourish and protect our health with food. The Chinese have a saying, “food heals and medicine is food.” There are many traditions that honor nurturing life and the food we eat and how we eat is one of the most powerful. Let’s do what we can to nurture and nourish ourselves in this time.
A note: The information here is not meant to provide medical advice. For a more individualized plan consult your medical provider or acupuncturist.
Ellen Goldsmith, M.S.O.M., L.Ac., Dip. C.H.
Ellen Goldsmith, MSOM, L.Ac., Dip. Chinese Herbalist is author of the book, Nutritional Healing with Chinese Medicine: + 175 Recipes for Optimal Health, a book to help people understand and put the nourishing wisdom of Chinese medicine into everyday lives, where it matters most; the kitchen. Ellen was co-founder of Pearl Natural Health, a naturopathic, acupuncture and Chinese medicine clinic in Portland. She is on the faculty of the National University of Natural Medicine’s College of Classical Chinese Medicine and the Nutrition Program and the faculty of the Academy of Integrative Health and Medicine teaching Chinese dietetics. She maintains a private practice in Chinese medicine, lectures widely and lives in Portland, Oregon. She can be reached at: email@example.com
 Xue Yan, Zhang Wei, Xu Guihua, Chen Xiaorong, Lu Yunfei, Wang Zhenwei, Shi Kehua, Wu Huan, Yu Jian Shanghai Journal of Traditional Chinese Medicine and Pharmacology, (Shanghai Zhongyiyao Zazhi). Fruehauf, Heiner, redaction and translation, The Dampness Epidemic: Exploring the Clinical Characteristics of COVID-19 in Shanghai
 McMahon, Bryan. Underneath the Epidemic: An Examination of the Seasonal Energetics of Wuyun Liuqi, Chinese Medical Treatment and Preventative Strategies for Covid-19