A little girl takes a bite from a sandwich. Nutrition and food safety in China have become an international issue since it was discovered that melamine was added to Chinese milk and infant formula to artificially increase its protein levels. The chemical caused the poisoning of many Chinese children and contaminated many foods exported from China. PHOTO BY JOAN LEBOLD COHEN.

Traditionally, Chinese food was healthy, mainly because millennia of famine led people to learn by trial and error how to eat to survive. But the Chinese diet has changed with modernization, as more fats and sugars have become available. Traditional nutritional medicine worked well to remedy certain deficiencies, despite being based on concepts very different from those accepted today.

Food has always been integral not only to the health but also to the culture of the Chinese people. China’s traditional diet was adapted to scarcity. Before the mid-twentieth century, China suffered famine in some part of the country almost every year, and a major famine every two to four years. Malnutrition and starvation were the commonest causes of death. Enormous developments in food production took place but were counterbalanced by rising populations and by environmental decline from deforestation, cultivation of marginal lands, and similar processes that led to erosion and drought–flood cycles. The people adjusted by eating a diet that maximized the amount of nutrients produced per acre.

Most nutrients came from the humble, often despised everyday grains and greens. Grain staples provided the most calories and nutrients. Where possible wheat and millet, more nutritious grains, dominated. Rice is less nutritious but yields far more crop per acre, thus it became the choice in places where it could grow well. Soybeans, another prevalent crop, yield high amounts of protein. Common vegetables such as Chinese cabbages, beans, and spinach are particularly rich in vitamins and minerals. The few animal protein sources—usually pork, chicken, and fish—were particularly economical to raise or catch and a rich source of protein and vitamins. Chinese women traditionally breastfed for a long time, sometimes three years, though usually half of that. Virtually all people lose the ability to digest lactose (milk sugar) after early childhood. This, along with the lack of pastureland and ancient conflicts with herding peoples, explains the lack of dairy products in the Chinese diet. In the West fermented dairy products are common. The lactose turns to lactic acid and is thus safely consumed.

Medical works from the Han dynasty (206 BCE–220 CE) show that the Chinese learned how certain foods corrected problems we now recognize as vitamin and mineral deficiencies. Watercress cured scurvy. Fresh foods and whole grains and beans cured beriberi. Red meats, especially iron-rich wild meats and liver, cured anemia. Goji (Lycium chinense) leaves and berries produced strength, vigor, and general health. We now know they are extremely rich in key vitamins and minerals and are, in fact, a vitamin-mineral supplement. They were, and are, used especially for women recovering from childbirth. Many spices have both mineral value and antiseptic action and were used to preserve food and improve its nutritional value. Diarrhea was effectively treated with broth in which fresh foods were cooked, an early oral rehydration therapy.

In the low-meat diets of ordinary people, lack of vitamin B12 was a special problem. B12 occurs only in animal and fungal foods. The solution was soy sauce and other soy and grain products fermented by yeasts and fungi. Early Chinese, though ignorant of vitamin B12, found that such products complemented other foods and helped survival. Also important was bean curd (tofu). It provides not only protein but also vital calcium because it is usually coagulated with calcium salts.

Anyone with the means to survive could at least have a healthful diet. Studies by Cornell University in the 1980s and 1990s showed that Chinese living in traditional rural conditions had low levels of cholesterol (average of 127 vs. above 200 in the contemporary United States); were lean and in good shape; and had low rates of heart disease, certain cancers, and circulatory and degenerative ailments. Some areas, however, showed high rates of cancer, possibly because of extremely low cholesterol levels.

The situation has changed in recent years. Meat, fat, and sugar have become more available. People prefer them to bean curd, vegetables, and unprocessed grain. The result has been a rapid increase in obesity, heart disease, and diabetes. Problems for the future also include specific deficiencies. Folic acid deficiency is an emergent danger because of the decline in vegetable and whole grains consumption. Folic acid deficiency is a major cause of birth defects around the world and may be increasing in China.

Traditional beliefs about food and health centered on ideas of yin (cool, dark, soft) and yang (warm, bright, assertive). Foods were categorized in various ways within this system. Early on the ancient Greek system of humoral medicine reached China. It was known in the sixth and seventh centuries as still a rather exotic system. It fused with the yin–yang system and other Chinese nutritional knowledge. Foods were categorized as heating, cooling, wetting, or drying. Only heating and cooling remained important. In general, “heating foods” were high calorie and thus, literally, heating—calories are a measure of heat energy. “Heating foods” were generally prepared over high heat and frequently oily, spicy, or strong flavored. Examples are fatty meats, strong alcohol, fried and baked foods, and spicy foods. Some foods were regarded as “heating” only because they were of “hot” colors, red and orange. “Cooling foods “were low calorie, sour or astringent, cool colored, and bland: greens and other vegetable foods. Rice, noodles, and similar staples and moderate-calorie foods were balanced, at the midpoint between heating and cooling.

This system generally worked well because conditions such as scurvy and indigestion were considered hot and effectively treated with fresh vegetables. Anemia, tuberculosis, and general debility were cold and effectively treated with a diet of red meats, spices, and high-nutrient foods in general. Some “cooling foods” are also cleansing, helping the body to get rid of toxins or simply making one feel better by improving digestion and metabolism. The system did not always work, but it worked often enough to keep it valuable and functional up to the present.

Another system was the consumption of “strengthening (bu) foods,” considered to build body, blood, and vigor. These are easily digestible, mineral-rich protein foods, ranging from game meats and mushrooms to pine seeds and edible birds’ nests (from the swift, Collocalia esculenta). These do indeed have nutritional value. Unfortunately for biodiversity, a less valuable belief arose that any strong, sexually potent, or strange-looking animal had special magical powers and could transfer them to the eater. Dozens of species of wildlife are now disappearing because of this belief, which, unlike so much of Chinese traditional nutrition, has been disproved by modern biomedicine. A less formal but widespread concept that does not stand up well is the folk idea that red liquids build blood, brain-shaped foods (like walnuts) build brain cells, and similar associations.

To this may be added the thousands of medicinal herbs and products recognized in traditional Chinese medicine. Many of these fail modern tests, but others are useful and have become worldwide remedies. The boundary between food and medicine has never existed in China. Foods are eaten for health, and herbal medicines are incorporated into gourmet dishes.

Chinese medicinal food has spread to the Western world through books, Chinese clinics, and medicinal-food restaurants. In China itself restaurants serving yaoshan—“medical dining,” traditional medicinal dishes—have been growing in number and elaborateness since their beginning around 1980 in Sichuan. They serve updated recipes based on the medical-nutrition classics.

Further Reading

Anderson, E. N. (1988). The food of China. New Haven, CT: Yale University Press.

Anderson, E. N. (1990). Up against famine: Chinese diet in the early twentieth century. Crossroads, 1(1), 11–24.

Campbell, T. C., & Campbell II, T. M. (2005). The China study. Dallas, TX: Benbella Books.

Hu Shiu-ying. (2005). Food plants of China. Hong Kong: Chinese University of Hong Kong.

Mallory, W. (1926). China, land of famine. New York: American Geographic Society.

Source: Anderson, E. N. (2009). Health, Nutrition, and Food. In Linsun Cheng, et al. (Eds.), Berkshire Encyclopedia of China, pp. 1010–1012. Great Barrington, MA: Berkshire Publishing.

Various animals are considered healthy, but for different reasons. Here the head and legs of an alligator are for sale in a restaurant in Guangzhou.

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