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A 2019 review, Antinutrients in Plant-Based Foods: A Review, discussed naturally occurring compounds such as phytates, tannins, lectins, and oxalates that are found in many plant-based foods, including grains, legumes, nuts, leafy vegetables, root vegetables, and fruits. The review also examined how food preparation can affect these compounds.

Modern nutrition often emphasizes eating more fruits and vegetables, and raw salads, fresh fruit, and vegetable juices have become increasingly popular. From a Traditional Chinese Medicine (TCM) perspective, however, the question is not simply whether a food contains nutrients. How the food affects the body as a whole also matters.

What Does “Cold” Mean in Chinese Medicine?

When TCM describes a food as cold or cooling, it does not necessarily mean that the food is physically cold.

There are two different concepts.

The first is physical temperature.

Eating or drinking something very cold can temporarily lower the temperature of the digestive tract. The body then has to restore its normal internal temperature. For a healthy person, this may not be particularly significant. But when digestion is already compromised or the body is under stress, TCM traditionally considers excessive exposure to cold foods and drinks potentially burdensome to the digestive system.

The second is the energetic or functional nature of a food.

In TCM, foods are traditionally classified according to their overall effects on the body — such as warming, cooling, drying, or moistening. These classifications were developed through generations of clinical observation rather than through modern chemical analysis.

This is one reason why the TCM concept of cold cannot be directly equated with a specific chemical component or nutrient.

Why Does TCM Often Recommend Cooked Foods?

TCM traditionally places significant importance on digestion. Cooking is thought to make many foods easier for the digestive system to process, particularly for people who already experience digestive weakness, bloating, loose stools, fatigue, or a tendency toward feeling cold.

This does not mean that raw vegetables or fresh fruit are inherently “bad.”

Rather, TCM considers the individual, the quantity, the frequency, the season, and the person's digestive capacity.

A food that feels refreshing and beneficial for one person may not have the same effect on another.

What About Raw Salads and Green Juices?

In clinical practice, some patients consume large amounts of raw salads, fresh fruit, or raw fruit-and-vegetable juices on a daily basis — sometimes replacing a cooked breakfast with a large cold smoothie or juice.

Some people feel lighter or more refreshed when they first make this dietary change. However, if a person already has digestive symptoms or a tendency toward what TCM describes as Cold and Dampness, a long-term diet heavily centered around raw and cooling foods may not be ideal from a TCM perspective.

Patients may experience symptoms such as bloating, loose stools, reduced appetite, fatigue, or a persistent feeling of coldness.

TCM would not necessarily attribute these symptoms to one particular food or compound. Instead, practitioners look at the overall pattern of symptoms, digestion, sleep, energy, tongue, pulse, and other individual findings.

What About Adding Ginger?

Some people add fresh ginger to smoothies or juices because ginger is traditionally considered warming.

Ginger can certainly be a useful food and herb, but from a TCM perspective, adding ginger does not simply “cancel out” the cooling nature of a large amount of raw food.

TCM does not generally view foods and herbs as mathematical opposites that cancel each other out.

For example, within a herbal formula, a warming herb and a cooling herb may each have a specific purpose. They work together according to the overall design of the formula rather than simply neutralizing one another.

The same principle can be applied to food.

Balance Matters

The message is not that everyone should completely avoid raw vegetables or fruit.

For a healthy person with strong digestion, enjoying a fresh salad or some fruit can be perfectly reasonable. Food is also part of enjoying life, and there is no need to turn every meal into a medical treatment.

The TCM perspective is simply to pay attention to how your body responds to what you eat.

If you frequently experience bloating, loose stools, fatigue, poor appetite, abdominal discomfort, or a tendency to feel cold, it may be worth considering whether a diet heavily focused on raw, cold, or cooling foods is working well for you.

Sometimes, simply changing the way food is prepared — such as lightly cooking vegetables, choosing warm meals, or reducing large quantities of cold drinks and raw foods — can make digestion feel easier.

At Shamrock Acupuncture, we look beyond individual symptoms and consider the overall pattern of the body. The goal is not to label a food as universally good or bad, but to understand what may be appropriate for your body at this particular stage of life.

This patient presented with complex arthritis affecting multiple joints — from the neck, shoulders, and elbows to the knees and ankles. The pain seemed to move from one area to another, while joint mobility was significantly restricted. Because of the pain, she was also unable to sleep normally, making daily life extremely difficult.

For several years, she had sought treatment from many practitioners of both Western and Chinese medicine. There is little need to discuss the limited results she experienced with Western medical treatment. She had also consulted numerous TCM practitioners, both in China and in the United States, including several practitioners known for their use of classical formulas. Yet the results remained disappointing. Every winter, her pain became significantly worse.

During the consultation, I first wanted to understand what treatments she had previously received and how she had responded to them. She went through the different TCM practitioners she had seen and the formulas they had prescribed.

I was familiar with some of these practitioners. Some had primarily used modifications of Guizhi Shaoyao Zhimutang (Cinnamon Twig, Peony, and Anemarrhena Decoction), while others had focused on modified Wutou Tang (Aconite Decoction). Some had even used relatively large doses of aconite-based herbs.

The patient was puzzled. She had also studied TCM through the textbooks and lectures of Dr. Ni Haixia, and many of these formulas were taught as treatments for arthritis. She asked, “If these are the formulas traditionally used for arthritis, why didn't they work for me?”

Rather than immediately trying to answer that question, let's first look at what happened after her initial remote consultation and at her response by the time of her second visit a few days ago.

At the initial consultation, I did not use strongly warming or aggressive herbs. Instead, I used a relatively gentle combination of modified Ganmai Dazao Tang (Licorice, Wheat, and Jujube Decoction), Suanzaoren Tang (Sour Jujube Seed Decoction), and related formulas.

She took the formula for more than a month. She had expected her pain to become severe again, as it usually did every winter. To her surprise, however, her joint pain decreased significantly, and her sleep improved considerably as well.

Why did this happen?

Among her many symptoms, if we rank them according to severity and apparent importance, the symptoms directly associated with her arthritis would occupy much of the top of the list.

So why did formulas specifically designed to treat arthritis fail to produce meaningful results, while relatively simple formulas such as Ganmai Dazao Tang and Suanzaoren Tang produced a noticeable improvement?

Because treatment is not simply a matter of matching symptoms to formulas.

Symptoms are clues that we collect. A clue is still only a clue.

Large and obvious clues can certainly provide us with a great deal of information, but that does not necessarily mean they are the most important clues. Nor does it mean they tell us where to begin treatment.

We need to use all of the clues to work backward toward the underlying physiological and pathological patterns described by Chinese medicine. Only then can we truly understand the patient's condition and determine an appropriate treatment strategy.

It is much like the work of a detective. If a detective finds someone's fingerprint — or even their DNA — and immediately concludes that the person committed the crime, a great many wrongful convictions could result.

The Key: Blood Deficiency

In this patient's case, a key underlying factor was Blood deficiency.

Years of chronic joint pain had prevented her from sleeping well, which in turn had further aggravated the Blood deficiency.

This does not mean that formulas such as Guizhi Shaoyao Zhimutang or Wutou Tang are without rationale. They can have a sound place within the appropriate clinical pattern.

But consider an analogy:

Imagine a car whose engine is struggling to produce power. If we respond by simply pressing harder and harder on the accelerator while overlooking the fact that there is not enough fuel — or that the fuel itself is inadequate — adding a turbocharger is not going to solve the fundamental problem.

Pressing the accelerator harder will only consume what little fuel remains.

First, restore the fuel supply. Then address the engine.

When the foundation is corrected, the rest of the treatment can become much more effective.

I explained to the patient that if she returned to some of the formulas previously prescribed by her TCM practitioners — such as modified Guizhi Shaoyao Zhimutang or Wutou Tang — she might now experience a different response.

However, I was still not in a hurry to introduce those stronger herbs or formulas.

At her second visit, I simply added a few herbs to the original prescription.

If her condition could already improve during the harshest part of winter, then as spring arrived, the treatment could progress naturally.

The goal is not to chase the most obvious symptom. It is to understand what is driving the entire pattern.