As China continues to prosper from its economic expansion and transform from a developing country to a global leader, many of the country’s cultural heritages have been adapted to suit the changing times. One such tradition is that of Traditional Chinese Medicine (TCM). TCM dates back thousands of years and is made up of a variety of disciplines such as herbology, acupuncture and massage, as well as other lesser-known modalities.
TCM like all other existing medical disciplines was founded on the principals of ancient philosophies, which attempted to explain the intricate relationships between the heavens, nature and our ancestors. Just like us, our distant cousins were concerned with the human condition, health and longevity. Over centuries of recorded observations, philosophers throughout the ancient world devised their own unique systems to explain, diagnose and treat a range of diseases.
The Greeks had the “Humors” that made up the four main bodily substances and the Chinese had the “Five Element” and “Yin Yang” theories, which came out of the Taoist school of thought. Greek and Chinese philosophers-turned-physicians were concerned with balancing the body’s substances or energies, which were constantly influenced by nature, diet, age and personal habits. Where these two systems differ is in how they were passed on and adapted over the centuries.
Modern “Western Medicine” as we know it today can trace its lineage back to Greek philosophy and medical theory—the most famous remnant of this ancient system is the “Hippocratic Oath.” Western medicine tends to replace medical modalities or drugs as newer systems and medicines are discovered. Conversely, the Chinese passed the complete system along and adapted or added to the existing knowledge base.
Unlike western medicine, TCM builds and adds to its theoretical foundations instead of replacing them. In fact, most of the herbal formulas prescribed today are variations of the same formulas that were used in ancient China. Moreover, techniques such as tongue and pulse diagnosis are still used by TCM practitioners. Because the system was passed along with its philosophies intact, the theory of “Five Element” and “Yin Yang” are deeply embedded in the consciousness of the Chinese as well as many other Asian cultures. For example, it is not uncommon to hear people talk about having aliments resulting from wind entering the body or too much fire in the body.
This ancient knowledge continues to influence how people choose their food and what herbs are prescribed to a patient based on the temperature and taste associated with it—such as cold, cool, warm, hot, pungent, sweet, sour, bitter and salty. For example, a well known TCM herb made famous in China as well as the U.S. is ginseng. While there are many varieties of ginseng, most are associated with having a warm or hot nature, so ginseng wouldn’t be prescribed to someone with heat symptoms. Instead, they would be prescribed herbs that have a more cooling nature, which would counteract the heat and bring the body back into balance. Another example of TCM theory relates to the avoidance of cold foods or beverages. While both cold food and drinks are available, the Chinese will typically choose to consume things that are hot with their meals, such as water, tea, soy or almond milk, as well as soup. The reason for this is directly related to the TCM theory of digestion. The stomach is seen as being a place that requires adequate amounts of fire or heat to boil the food, turning it into nutritive energy or “Qi,” which is used to nourish organs and animate the body. Cold drinks and food would of course hinder this boiling process and therefore cause problems, which could lead to other more serious conditions, especially for people who already have a weak or challenged digestive system.
TCM Ingredients Today
TCM herbal ingredients have spread across the globe and have crossed over into many markets, such as food, dietary supplements and cosmetics. With more than 1400 individual companies in China focusing on the production of TCM ingredients and an agricultural growing base in excessive of 2.7 million hectares, it is easy to see how this industry has grown to its current state. According to China’s Ministry of Commerce (Chamber for Drug and Natural Products), TCM ingredient production increased 28% in 2009 totaling more than $7 billion.
The dietary supplement industry is rich with TCM ingredients, such as ginseng and goji berry, among others. In 2009, ginseng exports from China totaled 298 tons worth $40 million, while goji berry exports totaled 5831 tons worth $29 million. But even with large amounts of these TCM ingredients being exported globally, the theories and concepts of TCM in regard to them have been lost in translation for most westerners. TCM prescriptions to treat specific ailments are formulated by keeping in mind the interaction of the various herbs in the formula. For example, just taking ginseng to try and treat a lack of “Qi,” or a cold condition, isn’t enough. Other herbs must be added to enhance, complement, activate, negate toxins or soften harsh effects of some of the key ingredients. This basic concept of ingredient interaction is one of the main reasons dietary supplement companies in China encounter such strict standards when trying to register their products.
China’s regulations for dietary supplements are some of strictest in the world, as well as time and capital intensive. China’s State Food and Drug Administration (SFDA) is in charge of approving dietary supplements to enter and be sold in the market. Most formulas that we in the U.S. have full access to are either not available in China or the formula and ingredients are not yet approved for human consumption by SFDA. Even though there are literally hundreds of studies available on these ingredients to prove their individual effectiveness and safety, Chinese regulators at this time will only approve formulas, not the ingredients that make up the formulas. This makes it very difficult for foreign and domestic companies to register their products in China. Industry groups are working with Chinese authorities to try and reform this system, and some progress has been made over the last couple of years. This summer SFDA is scheduled to release new dietary supplement regulations, which are rumored to be a step in the right direction. We’ll have to wait and see if they go far enough or fall short of the type of regulatory change that would allow the dietary supplement industry in China to live up to its expected potential.
A Global Leader in Exports
Although China is strict with dietary supplement finished good registrations and products entering its domestic market, it excels at exporting ingredients and raw materials all over the world. Actually, China is the leader in supplying raw materials to the global drug, food, cosmetic and dietary supplement industries. It is estimated that China supplies upward of 70% of the ingredients to the global dietary supplement industry. With this in mind, the U.S. government and those with a vested interest in China must continue to press for regulatory change, if for no other reason than to create a fair and balanced system of trade.
Industry reform would allow the further development of China’s dietary supplement industry, which would not only benefit manufacturers and suppliers, but also consumers. Transparency and openness of China’s dietary supplement industry will also entice more foreign and domestic investment, leading to an expanded range of products and a higher degree of awareness among consumers.
For the Future
China’s dietary supplement industry has tremendous potential and will one day rival that of the U.S. However, regulatory reform must take place in order for China to challenge the U.S. for the title of the largest market for dietary supplements.
There is a lot of overlap between the TCM and dietary supplement industries when it comes to government and consumer perception. For the dietary supplement industry to continue to develop in China, it must stand on its own and be viewed by both the government and consumers as separate from that of the drug and TCM industries.
The dietary supplement industry markets an array of products that are ideally consumed on a daily basis to support overall health and wellness. Dietary supplements do not claim to cure or treat disease, but drugs and TCM formulas do. This is the regulatory line that separates the dietary supplement industry from that of the drug or TCM industries. Until Chinese regulators acknowledge this and pass legislation to reflect that fact, China’s dietary supplement industry will continue to have difficulties reaching its full potential.