Dietary therapy

What it is

Dietary Therapy in our practice is not general nutritional counseling. At the center of this work is a structured anti-inflammatory elimination and reintroduction program developed over many years of clinical practice.

The initial phase provides a common starting point: a simple, whole-food diet designed to reduce dietary irritants and give the digestive and immune systems an opportunity to settle. From there, foods are systematically reintroduced to determine what actually matters for the individual.

The result is not a permanent elimination diet. It is a personalized anti-inflammatory diet — one that takes into account which foods you tolerate, in what quantities, how often, and in what combinations.

Who is Dietary Therapy for?

We most often recommend this approach when chronic inflammation, digestive dysfunction, allergy, or immune reactivity appears to be part of the clinical picture.

It may be worth considering for allergic and respiratory conditions such as seasonal allergies, chronic sinusitis and asthma; skin conditions including eczema, hives, rosacea and acne; digestive problems including IBS, chronic bloating and reflux; endometriosis or adenomyosis; autoimmune conditions; persistent symptoms following infection, including long COVID and post-viral fatigue; and some recurrent conditions such as recurrent yeast infections and urinary tract infections.

These conditions have very different causes and require different kinds of medical care. What they can share is an inflammatory, digestive, or immune component that may be influenced by diet. Dietary Therapy gives us a way to investigate that relationship in the individual patient.

The goal is not to keep eliminating foods. It is to find the least restrictive diet that allows you to feel well.

How it fits into your care

For patients already receiving acupuncture or herbal medicine at the practice, dietary recommendations are generally incorporated into treatment rather than booked as a separate service.

Sometimes these recommendations are quite simple. A patient with chronic diarrhea or intestinal cramping, for example, might be advised to reduce raw and cold foods and favor warm, cooked meals. This kind of Chinese dietary therapy is simply part of how we practice Chinese medicine.

The structured elimination and reintroduction program is a more involved intervention. We recommend it selectively, when we think it is particularly appropriate for the patient's condition and clinical picture. We explain how to begin, help you navigate elimination and reintroduction, and adjust the program as we learn how your body responds.

How the approach developed

This approach began with a clinical observation. Early in Adele's practice, a patient with severe eczema, asthma, and significant digestive symptoms experienced a dramatic improvement after following a strict yeast-free diet recommended by a naturopath. The improvement was striking, but the diet itself was extraordinarily restrictive.

Adele's own experience subsequently suggested a different model. During periods of postgraduate clinical training in Beijing, chronic sinus problems that had troubled her since childhood disappeared while she was eating a relatively simple diet built largely around rice, vegetables, modest amounts of meat, fruit, nuts and seeds, with very little wheat, dairy, sugar, processed food or alcohol. The symptoms returned after she came home and resumed her previous diet, and the same pattern occurred during a later extended period of study in Beijing.

After returning to New York, she began experimenting more systematically, drawing on both experiences. By early 2004, these observations had become the foundation of a less restrictive and more sustainable approach that continued to evolve over the following two decades of clinical practice.

Today, the approach is not based on the assumption that yeast is the underlying problem. It provides a framework for simplifying the diet, exploring the relationship between food and symptoms, and gradually developing a diet that works for the individual.

What we take out — and what we leave in

The initial phase eliminates gluten, added sugars and sweeteners, most dairy, alcohol, highly processed foods, and other foods that may be relevant to the individual patient's symptoms. Deep-fried and very greasy foods are also avoided.

But this is not a carbohydrate-free diet. Vegetables, fruits, whole grains, legumes, nuts, seeds and starchy vegetables remain important parts of the program, along with appropriate sources of protein. We do not routinely remove gluten-free whole grains and legumes simply because they contain carbohydrates.

Depending on the condition, the basic diet may be modified. For significant irritable bowel symptoms, for example, we may incorporate elements of a low-FODMAP approach. With reflux or certain skin conditions, additional foods may be temporarily limited according to the person's symptoms and presentation.

Elimination and reintroduction

Most patients begin with a structured 28-day elimination period. For more entrenched or severe conditions, this initial phase may continue longer. The purpose is not to cure a chronic illness in four weeks. It is to establish a clearer baseline from which we can begin to understand how individual foods affect you.

Once symptoms have settled sufficiently, reintroduction begins. This is one of the most important parts of the program. Foods are brought back deliberately, and we pay attention to quality, quantity, frequency and combination.

A food you tolerate occasionally may cause symptoms when eaten every day. Two foods that are fine separately may exceed your threshold when combined. If a food clearly provokes symptoms, we generally remove it again and return to it later rather than assuming it must be avoided forever.

The goal is more freedom, not more restriction.

A flexible, individual approach

Chinese dietary principles also help us think about constitution, food preparation and season. We encourage variety and flexibility rather than dietary purity. As health improves, there should be room for pleasure as well as nourishment.

Over time, the aim is to learn where your individual thresholds lie and to develop a way of eating that is broad, sustainable and increasingly your own.

Probiotics, herbs, and other support

Diet is the foundation of the program, but it is not necessarily the only intervention. When appropriate, we may recommend a probiotic or use Chinese herbal medicine alongside dietary therapy, selected according to the patient's individual presentation.

These interventions support the dietary work; they do not replace it.

When this approach is not appropriate

Structured elimination diets are not appropriate for everyone. For someone with a history of disordered eating or significant anxiety surrounding food, restriction can do more harm than good. In those circumstances, we generally do not use an elimination protocol and instead focus on regular nourishment and less restrictive dietary recommendations.

Dietary therapy is also not a replacement for appropriate medical care. Established medical conditions require appropriate diagnosis and management. Diet may become one part of helping a person reduce symptoms, understand individual triggers, and support overall health while living with a chronic condition.

Remote Dietary Therapy Consultations

The program can be undertaken independently of acupuncture or herbal treatment. Remote Dietary Therapy consultations are available for people who would like to work with Adele specifically on the diet, including those who do not live in New York.

Consultations provide guidance through the initial elimination period, help adapt the diet to your symptoms and circumstances, and support the reintroduction process as you begin to identify your individual tolerances.

The goal is not ongoing dependence on dietary counseling. It is to give you a framework, help you interpret your body's responses, and ultimately give you the tools to manage your diet yourself.

A personal diet

There is no final version of the diet that every patient is expected to follow forever. The initial diet gives us a starting place. Reintroduction teaches us what is individual. Time allows us to revisit assumptions, and Chinese dietary principles help us adjust for constitution, symptoms, preparation and season.

The aim is not to spend your life worrying about food. It is to understand your body well enough that, eventually, you don't have to.