What Should I Eat for This?

It is a question I hear often in the clinic. People who came in for some discomfort ask it at the end of the conversation: "So what should I eat for this?"

When something in the body is off, the urge is to put one more good thing in. That is natural.

I usually turn the direction around, though. I look first at what is already coming in.

Whatever is added, the body still has to handle it

Whatever comes in, the same thing happens in the body. It is absorbed, worked over in the liver, and sent out through the kidneys.

That road is not unlimited. The enzymes that work substances over in the liver are set by type — the family carrying much of that load is called cytochrome P450 — and several substances share the same enzyme. So when one side gets crowded, another side waits. That is what happens between one medication and another, and on this point something taken because it is good for you is no different. (Can herbal medicine be taken alongside prescription drugs)

Adding something good does not mean the body handles that one thing separately. If there is already a queue of work, the good thing that just arrived joins the queue.

Take something away and the place restores itself

What I find interesting is that tissue comes back from subtraction alone.

Fatty liver is a good example. Hospital sources note that for fatty liver, losing weight through diet and exercise works better than medication. And studies that actually took tissue samples show how much improves at what point. Losing about 5% of body weight reduces the fat in the liver; going to 7–10% improves the inflammation and the ballooned cells as well.

That is not a result obtained by putting something in. Less came in, and the liver went back on its own.

I think this part matters for understanding the body. The body is less a machine waiting to be repaired than something that mends itself once the conditions are returned. Treatment is the work of returning those conditions.

That said, this is not "remove everything"

Tilting all the way to one side causes its own trouble.

If a test shows something genuinely lacking, it has to be filled. Anemia from a shortage of iron does not improve by being frugal. Subtraction is not always right — what comes first is telling apart where this person has too much and where too little.

And one thing has to be said plainly. Stopping medication on your own is not the subtraction I mean here. Medication was started for a reason, and the decision to stop belongs with whoever prescribed it.

The fatty liver material has a similar line: reduce weight slowly over 3–6 months, because losing it abruptly can make things worse. Subtraction has a speed to it too.

Isn't herbal medicine on the adding side?

A fair question.

Herbal medicine is not used as a way of filling in nutrition. It is used to return conditions that have tilted — reaching places circulation had stopped reaching, easing long-standing inflammation, letting absorption and excretion find their rhythm. After that the body goes back to doing what it was doing.

So when I settle on a prescription, I also settle on what to reduce. If what comes in stays the same and the medicine is simply laid on top, that medicine is one more item in the queue.

I start by asking what you are already taking

At a first visit I ask what you are taking. Medications, and also whatever is kept up because it is said to be good. The list is longer than one might expect, often enough.

Then I look at the day. Late meals, alcohol, the hour sleep begins. Something in those three turns up frequently.

I do not change everything at once. We pick one or two and change only those. Changed all together, they rarely last. (Why daily management is half the treatment)

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Adding something can come later. But in order of operations, subtraction comes first more often than not.

So to "what should I eat for this?" I often answer this way: rather than settling that first, try taking away one of the things already coming in.

Sources

• For fatty liver, weight loss through diet and exercise works better than medication, and weight should be reduced by about 10% slowly over 3–6 months — abrupt loss makes it worse — Asan Medical Center, Disease Encyclopedia
• With lifestyle change, a 5% weight reduction improved liver fat, and 7–10% improved inflammation and ballooning as well — Therapeutic Advances in Gastroenterology, 2016

Written by Dr. Heo Ji-young (Ph.D. in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)