Live Well, Live Long: Traditional Chinese health preservation teachings and modern research

The human body and mind do not come with a maintenance manual. To achieve a long and healthy life, we require guidance on which behaviours will help or harm our chances. Fortunately, we can access two and a half thousand years of Chinese lifestyle wisdom known as yangsheng (nourishment of life). This article introduces the fundamental teachings of yangsheng and aligns them with the findings of modern lifestyle research.

Introduction

A Ming dynasty saying reminds us, “Heaven and earth exist for ten thousand ages, but this body you will not receive again” (Hong Yingming, Ming dynasty). Unlike many cultures that focus on an afterlife, Daoism, Buddhism, and Confucianism place a profound emphasis on making the most of the one life we are given. To this end, yangsheng integrates the self-cultivation teachings of these philosophies with an uninterrupted, 2500-year medical tradition. It is particularly indebted to Daoist principles like free flow and following nature, while also incorporating Confucian ethics, such as the idea that one must not harm the body received from one's parents.

The principles of yangsheng were clearly articulated in the Yellow Emperor’s Classic of Internal Medicine. The text observes that people no longer live as long as they once did because their eating, drinking, sleeping, and sexual lives have become chaotic. It famously argues that waiting to act until after a disease has already appeared is like forging weapons only when the battle has already begun. This philosophy places prevention at the highest level of medicine, offering health solutions for both individuals and entire populations—a message the modern world, with its growing epidemic of chronic disease, desperately needs to hear.

The Pillars of Health: Constitution, Luck, and Behaviour

Three primary factors determine our health and lifespan: our constitution, luck, and behaviour. Both traditional Chinese and modern medicine agree that our constitutional inheritance is the most significant factor. In the Chinese tradition, this is known as prenatal or pre-heaven jing (essence), inherited from our parents at conception. We can get a rough idea of our own prenatal jing by looking at the longevity of our parents and grandparents. This inherited essence cannot be supplemented, only consumed; it determines our innate robustness, the strength of our immune system, and our ability to recover from overwork.

While this genetic lottery may seem unfair, yangsheng provides two strategies to work with what we have been given: slowing the rate at which we consume our prenatal jing and supplementing it with postnatal jing. This is summarised as ‘minimising output and maximising input’. Minimising output starts with gaining control over chaotic emotions and avoiding exhaustion, overwork, poor diet, and substance abuse. We maximise input by building postnatal jing through self-cultivation. From our first breath, we absorb qi from air, food, drink, and our connection to the world. Through practices like emotional quietness, meditation, and deep sleep, we can transmute this daily qi into postnatal jing, allowing even those with a weaker constitution to achieve a long and healthy life.

Luck also plays its part. We do not choose our parents, the circumstances of our birth, or whether we are born into safety and plenty or a region afflicted by poverty, conflict, and hunger. Poverty, for instance, is a powerful negative influence on health and longevity.

Our behaviour, however, is the one area over which we have some control, and this is the focus of yangsheng. Four key behaviours form the legs of the "chair of health": managing our mind and emotions, diet, the balance of rest and movement, and sleep. If any of these legs are weak, the chair becomes unstable. As the 4th-century alchemist-doctor Ge Hong wisely wrote, "In all matters of nurturing life, one must widely hear and then embody the most essential things, broadly look and then choose well. The partial cultivation of one thing will not prove sufficient to rely on. Furthermore, one must be on guard against the tendency of specialists to only tout the one thing they are good at.” This article will focus on the first three legs of the chair.

First Leg: Cultivating the Mind and Emotions

Modern discourse on healthy living typically focuses on diet, exercise, and sleep, often overlooking the critical need to manage our mental and emotional health. Yet, there is extensive evidence that stilling the mind, avoiding intense negative emotions, fostering intimate relationships, laughing, and cultivating generosity and gratitude all contribute to health and longevity.

An ancient text warns, “Extremes of joy, anger, anxiety, fear, or grief – if these five become part of the spirit (jing shen), life is harmed" (Lushi Chunqiu, The Spring and Autumn Annals of Master Lü, 239 BCE). For at least two millennia, Chinese medicine has understood that disease has discernible, non-magical causes. By the 12th century, these causes were categorised as external (environmental factors), miscellaneous, and internal—diseases arising from disordered mental and emotional states. Emotions are a natural response to life, but when they become too extreme or prolonged, they cause harm. For example, studies have shown that an acute flare-up of anger significantly increases the risk of a heart attack or stroke. Harm also occurs when emotions become chronic, turning a feeling of anger into the state of being an angry person. To change these deep-seated tendencies, yangsheng offers tools like meditation and mindfulness to increase self-awareness and cultivate positive mental states.

Meditation and mindfulness are practices that calm the mind and build psychological resilience. As one 16th-century text explains, "The sage regards his or her body like a country: the heart is the ruler, and the jing and the qi are the citizens. If the heart does not abuse its superior position, if it remains centred and focused, the jing will flourish and the qi will be steady...and every part of the body landscape will be light and at peace" (Li Yuheng, 1570). Research has shown that regular meditators have larger brain regions associated with emotional regulation and that meditation can alleviate anxiety, reduce the risk of heart disease, and strengthen the immune system.

Human connection is another cornerstone of wellbeing. While yangsheng texts rarely mention it, likely because social isolation was rare in a culture rooted in the extended family, modern life presents a different challenge. Research confirms that intimacy and close relationships are strongly linked to health. One study found that lacking a close relationship significantly increased the risk of a repeat heart attack. According to Dr. Dean Ornish, a medical pioneer in the field of heart disease, “Those who feel lonely, depressed or isolated are three to five times more likely to suffer premature death or disease.”

Positive emotions like laughter are also vital. A Chinese saying suggests, “A person should laugh three times a day, then he’ll live longer.” Chinese medicine defines health partly by the "free flow" of qi and blood. Laughter, happiness, and love are all understood to promote this free flow. In modern terms, they promote vasodilation, the relaxation and widening of blood vessels, which is crucial for circulatory health.

Cultivating gratitude and generosity also has profound effects. A study of older couples showed that individuals who regularly helped others were significantly less likely to die over a five-year period. This aligns with the wisdom from an 8th-century text: ”In general, those who are generous and laid-back live long; those who are stingy and uptight die young” (Nourishing Inner Nature and Extending Life).

Second Leg: The Regulation of Diet

While most dietary discussions focus on what to eat, yangsheng traditions suggest that how we eat may be even more important. This is captured in an 11th-century saying: "Experts at curing diseases are inferior to specialists who warn against diseases. Experts in the use of medicines are inferior to those who recommend proper diet" (Zhi Chen).

A central finding in modern longevity research is that caloric restriction extends lifespan. The simplest way to practice this is to eat a bit less at each meal, rising from the table still feeling slightly hungry, a practice echoed by the Jin dynasty scholar Zhang Hua: “The less one eats, the broader his mind and the longer his life span; the more one eats the narrower his mind and the shorter his life span”.

Timing is also crucial. Traditional cultures often advise making breakfast the main meal and supper the smallest. As Cao Tingdong advised in the 17th century, “Yang qi is swelling at noon and deficient at sunset; therefore more food should be taken for breakfast and less food for supper, and at night it is necessary to keep the stomach empty.” We should also only eat when calm and relaxed, as the digestive system is vulnerable to emotions like anger and frustration.

Yangsheng offers a simple perspective on what to eat, dividing foods into qing dan (clear and bland) and wei (rich and flavourful). The foundation of the diet should be mild-flavoured qing dan foods like grains, pulses, and vegetables, supplemented with smaller amounts of wei foods like meat, fish, and oils. This contrasts with modern Western diets where rich foods often form the centrepiece of a meal. Lastly, tea is considered a "miraculous medicine for the maintenance of health" (Zen monk Eisai, 1211) and is perhaps the world's single healthiest beverage, summed up by a Chinese Proverb: 'Drinking a daily cup of tea will surely starve the apothecary.'

Third Leg: The Balance of Work, Rest, and Exercise

The idea that movement benefits health is ancient. As one 3rd-century BCE text states, “The reason flowing water does not become putrid...is because they move. The physical body and its qi are like this too” (The Annals of Lu Buwei). The Chinese internal arts, such as qigong and tai chi, offer a particularly sophisticated approach. They prioritize softness, because muscular tension restricts the free flow of qi, and they teach exercising without reaching the point of exhaustion. Sun Simiao advised in the 7th century, "The way of nurturing life is to constantly strive for minor exertion but never become greatly fatigued and force what you cannot endure." While dedicated exercise is valuable, there is growing evidence that integrating natural movement—walking, carrying, climbing—into the course of the day yields even greater health benefits.

Conclusion

The ancient wisdom of yangsheng provides a timeless and increasingly relevant manual for living a long, healthy, and meaningful life. It teaches that while we cannot change our genetic inheritance or the hand that luck has dealt us, we hold significant power through our behaviour. By cultivating our minds and emotions, regulating our diet, and balancing our bodies with gentle, consistent movement, we can preserve our vital essence and make the most of the one precious life we have.