Vietnamese Healing Cuisine: The Medicine Bowl

Overview

Vietnamese cuisine is one of the world’s great healing food traditions — a living pharmacopeia of fresh herbs, slow-simmered bone broths, fermented condiments, and carefully balanced flavors that collectively constitute a sophisticated food-medicine system. Unlike Western nutrition, which isolates individual nutrients, Vietnamese culinary wisdom integrates flavor, nutrition, and therapeutic intent into every dish, guided by principles of balance that parallel Traditional Chinese Medicine (TCM) while incorporating uniquely Southeast Asian botanical and cultural elements.

The Vietnamese concept of am/duong (yin/yang) and nong/lanh (hot/cold) food classification governs daily cooking decisions at every level — from what ingredients to combine, to how to cook them, to what season demands which dishes. A bowl of pho is not simply a satisfying meal; it is a calibrated delivery system for collagen, anti-inflammatory herbs, and warming spices that has served as Vietnam’s primary cold and flu remedy for generations. Chao (congee) for the sick, canh (clear soups) for daily nourishment, and the ubiquitous plate of fresh herbs that accompanies nearly every dish — these are not culinary accidents but the crystallized wisdom of centuries of empirical food-medicine practice.

This article examines the pharmacological basis of Vietnamese healing cuisine, translating traditional knowledge into modern scientific understanding while honoring the cultural context that gives these practices their depth and meaning. For the Vietnamese diaspora navigating Western healthcare systems, and for practitioners seeking to integrate food-medicine traditions into clinical practice, understanding the science behind Vietnamese healing cuisine bridges two worlds.

Pho as Medicine

The Broth Foundation

Pho — Vietnam’s iconic soup — begins with a broth that is itself a medical preparation. Traditional pho bo (beef pho) requires simmering beef bones (marrow bones, knuckle bones, oxtail) for 12-24 hours, often with charred onion and ginger. This prolonged extraction process yields:

Collagen and gelatin: Bones and connective tissue release collagen that hydrolyzes into gelatin — a complex of glycine, proline, and hydroxyproline that supports gut lining integrity, joint health, and skin elasticity. A properly made pho broth should gel when cooled, indicating sufficient gelatin extraction. Glycine (the most abundant amino acid in gelatin) is an inhibitory neurotransmitter, anti-inflammatory agent, and glutathione precursor.

Glycosaminoglycans (GAGs): Chondroitin sulfate, hyaluronic acid, and glucosamine from cartilage and connective tissue. These compounds support joint function and intestinal mucosa integrity. The traditional preference for knuckle bones and oxtail (cartilage-rich cuts) maximizes GAG extraction.

Minerals: Calcium, magnesium, phosphorus, silicon, and sulfur are extracted from bones into the broth in bioavailable forms, chelated with amino acids. The addition of a small amount of acid (traditionally from charring) enhances mineral extraction.

Marrow lipids: Bone marrow provides alkylglycerols (immune-modulating lipids), conjugated linoleic acid (CLA), and fat-soluble vitamins A, D, and K2. These lipids also enhance absorption of fat-soluble phytochemicals from the herbs and spices in the broth.

The Spice Packet (Goi Gia Vi)

Traditional pho spice packets contain star anise (Illicium verum), cinnamon (Cinnamomum cassia or C. louroi), clove (Syzygium aromaticum), cardamom (Amomum tsao-ko), coriander seed (Coriandrum sativum), and fennel seed (Foeniculum vulgare). Each contributes both flavor and pharmacology:

• Star anise: Contains anethole (anti-inflammatory, estrogenic), shikimic acid (the precursor for Tamiflu/oseltamivir synthesis — not coincidentally, pho is Vietnam’s flu remedy), and terpenoids with antimicrobial activity.
• Cinnamon (Vietnamese cassia): Cinnamaldehyde is anti-inflammatory (NF-kB inhibition), insulin-sensitizing, and antimicrobial. Vietnamese cinnamon (C. louroi) has among the highest cinnamaldehyde content of any cinnamon species.
• Clove: Eugenol is a potent COX-2 inhibitor, topical analgesic, and antioxidant — clove has the highest ORAC (Oxygen Radical Absorbance Capacity) value of any spice.
• Cardamom (thao qua): Volatile oils (cineole, limonene) are carminative (relieving gas and bloating) and anti-inflammatory. Traditional Vietnamese medicine uses cardamom for digestive complaints and as a warming agent.
• Coriander seed: Contains linalool (anxiolytic, antibacterial) and is traditionally used as a digestive aid and for reducing postprandial bloating.

The Herb Plate (Dia Rau Song)

No bowl of pho is complete without the accompanying plate of fresh herbs — a practice that distinguishes Vietnamese cuisine and constitutes an entire pharmacopeia in miniature:

• Rau que (Thai basil/Ocimum basilicum var. thyrsiflora): Contains eugenol, linalool, and rosmarinic acid. Anti-inflammatory, antimicrobial, and adaptogenic. The volatile oils are partially preserved even in hot broth when added just before eating.
• Ngo gai (culantro/Eryngium foetidum): Contains eryngial and other aldehydes with antibacterial activity. Traditional use for digestive complaints and as an appetite stimulant.
• Gia (bean sprouts): Fresh mung bean sprouts provide vitamin C, folate, and enzymes. Their crisp freshness provides textural and thermal contrast (cool/raw vs. hot broth).
• Ot (chili): Capsaicin activates TRPV1 receptors, promoting endorphin release, vasodilation, and thermogenesis. Regular consumption is associated with reduced all-cause mortality in large epidemiological studies.
• Chanh (lime): Citric acid enhances mineral absorption from the broth, vitamin C supports immune function, and limonene in the zest has anti-inflammatory and anticancer properties.

The practice of adding raw herbs to hot broth just before eating is biochemically intelligent: it preserves heat-sensitive volatile oils and vitamin C while the broth temperature is sufficient to partially release bound phytochemicals.

Vietnamese Herbs in Cooking

Rau Ram (Vietnamese Coriander/Persicaria odorata)

This distinctive herb, with its spicy-citrusy flavor, is ubiquitous in Southern Vietnamese cuisine (accompanying banh xeo, goi cuon, and many salads). Phytochemical analysis reveals:

• Flavonoids (quercetin, rutin, catechin) with antioxidant and anti-inflammatory activity
• Essential oils (dodecanal, decanal) with antimicrobial properties
• Traditional use as a digestive aid, appetite suppressant, and treatment for flatulence
• In folk medicine, rau ram is considered “cooling” and is used to reduce heat-related conditions

Tia To (Perilla/Perilla frutescens)

Purple-leaved perilla is used in Vietnamese cooking with snails (bun oc), certain soups, and as a wrapping herb. Its pharmacological profile is remarkable:

• Rosmarinic acid (highest concentration among culinary herbs) — potent NF-kB inhibitor and anti-allergic compound
• Perillaldehyde — antimicrobial and anti-inflammatory
• Alpha-linolenic acid (ALA) — the highest omega-3 content of any leafy herb
• Luteolin — anti-allergic, anti-inflammatory, neuroprotective
• Traditional Vietnamese medicine uses tia to for respiratory conditions, allergic reactions, and as an anti-inflammatory

Kinh Gioi (Vietnamese Balm/Elsholtzia ciliata)

This aromatic herb, eaten fresh with pho, bun, and many other dishes, contains:

• Elsholtzia ketone and other volatile terpenoids with antimicrobial and anti-inflammatory activity
• Flavonoids with antioxidant properties
• Traditional use for colds, fever reduction, and digestive support
• Considered a “warming” herb in Vietnamese traditional medicine

Hung Que (Vietnamese Basil/Ocimum basilicum)

Vietnamese sweet basil varieties provide:

• Estragole and eugenol (anti-inflammatory, analgesic)
• Rosmarinic acid (anti-allergic, antioxidant)
• Linalool (anxiolytic, stress-reducing)
• Beta-caryophyllene (a dietary cannabinoid that activates CB2 receptors — anti-inflammatory without psychoactive effects)

La Lot (Wild Betel Leaf/Piper sarmentosum)

Used to wrap grilled beef (bo la lot) and in traditional medicine, la lot contains:

• Piperine analogs with anti-inflammatory activity
• Hydroxychavicol — antioxidant, antimicrobial, anti-tumor
• Naringenin — anti-inflammatory flavonoid
• Traditional use for joint pain, gout, and respiratory conditions

Chao (Congee) for Recovery

Chao — rice porridge simmered to a smooth, easily digestible consistency — is Vietnam’s quintessential recovery food, served to the sick, the elderly, the postpartum mother, and the weaning infant. The therapeutic rationale is both traditional and scientifically sound:

Ease of digestion: Prolonged cooking breaks down starch granules into a dextrinized, easily absorbable form that requires minimal digestive enzyme activity. This is ideal for recovering digestive systems — whether from illness, surgery, or inflammation.

Vehicle for healing additions: Plain chao is a blank canvas for therapeutic customization:

• Chao ga (chicken congee): Gentle protein from chicken, with ginger and scallion — the Vietnamese version of “chicken soup for the sick.” Ginger provides anti-nausea (5-HT3 receptor antagonism), anti-inflammatory, and prokinetic effects.
• Chao huyet (blood congee): Pig or duck blood cooked into congee, providing highly bioavailable heme iron — traditional treatment for anemia, particularly postpartum.
• Chao ca (fish congee): Light, easily digested protein with omega-3 fatty acids and dill (thi la) — traditional for convalescence.
• Chao thit bam (minced pork congee): With preserved egg and fried shallots, providing protein density for recovery.

Hydration and electrolyte delivery: The high water content of chao provides fluid replacement during illness, while the starchy base delivers glucose for energy and the salty condiments (fish sauce, soy sauce) replace electrolytes.

Gut rest: By providing pre-digested carbohydrate and gentle protein, chao allows the digestive system to rest while maintaining caloric intake — the culinary equivalent of the medical “bowel rest” concept.

Balancing Nong/Lanh (Hot/Cold) Foods

The Classification System

Vietnamese food-medicine theory classifies all foods along a thermal spectrum from nong (hot/warming) to lanh (cold/cooling), with mat (cool) as an intermediate category. This classification is not about physical temperature but about the food’s perceived effect on the body’s internal balance:

Nong (hot/warming) foods: Ginger, cinnamon, pepper, chili, garlic, beef, lamb, durian, longan, lychee, alcohol, fried foods. These increase metabolic heat, stimulate circulation, and are prescribed for cold conditions, fatigue, and poor digestion.

Lanh/mat (cold/cooling) foods: Watermelon, cucumber, bitter melon (kho qua), mung bean, tofu, duck, crab, coconut water, chrysanthemum tea, lotus seed. These reduce internal heat, clear inflammation, and are prescribed for hot conditions, fever, acne, constipation, and irritability.

Clinical Parallels

While the nong/lanh system is not directly equivalent to Western biochemical categories, meaningful parallels exist:

• Many “warming” foods are thermogenic (capsaicin, gingerols, cinnamaldehyde) — they literally increase metabolic rate and core body temperature through TRPV1 receptor activation and sympathetic nervous system stimulation.
• Many “cooling” foods are anti-inflammatory — bitter melon contains charantin and momordicin with documented anti-inflammatory and hypoglycemic activity; mung bean contains vitexin and isovitexin with anti-inflammatory effects.
• The principle of matching food thermal nature to the individual’s current condition parallels functional medicine’s constitutional approach and Ayurveda’s dosha-based dietary recommendations.

Seasonal Eating (An Theo Mua)

Vietnamese traditional eating follows seasonal patterns that optimize the nong/lanh balance:

• Summer/hot season: Emphasis on cooling foods — bitter melon soup (canh kho qua), mung bean dessert (che dau xanh), water spinach (rau muong), chrysanthemum tea, coconut water. These foods counteract environmental heat and prevent “noi nhiet” (internal heat/inflammation).
• Winter/cool season: Emphasis on warming foods — ginger-based soups, bo kho (beef stew with lemongrass and star anise), hot pot (lau), warming herbs and spices. These foods build internal warmth and support immunity during cold months.
• Transitional seasons: Balanced eating with attention to immune support — congee, clear soups, moderate herbs.

This seasonal approach mirrors emerging research on circadian and seasonal metabolic rhythms — the body’s metabolic needs genuinely shift with seasons, light exposure, and temperature.

Clinical and Practical Applications

Vietnamese healing cuisine offers several clinically applicable protocols:

• Cold and flu protocol: Hot pho with extra ginger, garlic, chili, and lime. The combination of collagen-rich broth, antimicrobial spices (star anise, cinnamon, clove), anti-inflammatory herbs, and hydration makes pho a remarkably complete flu intervention — providing what Western medicine delivers through separate prescriptions for fluids, anti-inflammatories, decongestants, and rest.
• Postpartum recovery: Traditional Vietnamese postpartum care (o cu or kieng cu) prescribes warming foods for 30-100 days — ginger-based soups, pork leg and papaya soup (for lactation), chicken congee, and avoidance of cold/raw foods. This protocol supports uterine involution, lactation establishment, and immune recovery through warming, nutrient-dense, easily digestible foods.
• Digestive recovery: Plain chao (congee) with ginger and scallion, progressing to more complex additions as digestion strengthens — a graduated refeeding protocol that functional medicine practitioners are rediscovering.
• Inflammatory conditions: Emphasis on cooling foods — bitter melon, mung bean, water spinach, tofu — combined with anti-inflammatory herbs (tia to, rau ram) and avoidance of fried and spicy foods.

Four Directions Integration

• Serpent (Physical/Body): Vietnamese healing cuisine operates directly at the physical level — bone broth rebuilding connective tissue, herbs delivering specific phytochemicals, fermented condiments supporting the microbiome, and thermal food classification maintaining metabolic balance. The Vietnamese kitchen is a pharmacy, and every cook is an empirical pharmacologist.

• Jaguar (Emotional/Heart): Vietnamese food culture is inseparable from family and emotional nourishment. The act of a mother preparing chao for a sick child, a grandmother simmering pho for the family, or a community sharing a hot pot carries emotional healing that transcends biochemistry. The love encoded in Vietnamese healing cuisine is its most potent ingredient — and the parasympathetic activation of eating in communal safety genuinely enhances digestion and nutrient absorption.

• Hummingbird (Soul/Mind): Vietnamese healing cuisine embodies the soul principle of harmony — the constant, dynamic balancing of nong/lanh, am/duong, the five flavors, and seasonal rhythms. This is not rigid rule-following but intuitive attunement to the body’s changing needs, cultivating the kind of embodied wisdom that no nutrition textbook can provide. Learning to eat this way is learning to listen to the body at the soul level.

• Eagle (Spirit): From the eagle’s perspective, Vietnamese healing cuisine expresses a worldview in which humans are embedded in nature, not separate from it — eating with the seasons, using what grows nearby, transforming ingredients through fermentation and fire with reverence for the living systems that provide them. The Vietnamese table, with its balance of raw and cooked, hot and cool, animal and plant, is a microcosm of the balanced universe.

Cross-Disciplinary Connections

• Traditional Chinese Medicine: Vietnamese food-medicine shares TCM’s foundational concepts (am/duong, ngu hanh/five elements, nong/lanh classification) but adds uniquely Southeast Asian botanical elements and culinary techniques. Vietnamese cuisine’s emphasis on fresh raw herbs alongside cooked dishes is a distinctive adaptation to tropical conditions.
• Functional medicine: Bone broth-based soups (pho, bun bo Hue, hu tieu) align with functional medicine’s gut healing protocols. The Vietnamese practice of including fermented condiments (nuoc mam, dua cai) with every meal supports microbiome diversity.
• Ayurveda: The nong/lanh system parallels Ayurveda’s heating/cooling food classification and the principle of matching food thermal nature to constitutional type and current condition.
• Herbal medicine: Vietnamese culinary herbs (rau ram, tia to, kinh gioi, la lot) are simultaneously culinary and medicinal, blurring the boundary between food and herbal medicine in ways that Western nutrition has only recently begun to appreciate.
• Psychoneuroimmunology: The communal, emotionally rich context of Vietnamese eating — always shared, always accompanied by conversation and connection — activates parasympathetic pathways that optimize digestion and immune function.

Key Takeaways

• Vietnamese cuisine is a sophisticated food-medicine system guided by principles of thermal balance (nong/lanh), seasonal eating, and the integration of medicinal herbs into daily cooking.
• Pho is a calibrated therapeutic preparation: collagen-rich bone broth, anti-inflammatory spice packet (star anise, cinnamon, clove, cardamom), and a pharmacopeia of fresh herbs added at the table.
• Vietnamese culinary herbs — rau ram, tia to, kinh gioi, hung que, la lot — have documented anti-inflammatory, antimicrobial, and antioxidant activities that validate their traditional uses.
• Chao (congee) represents a sophisticated recovery food protocol: easily digestible, customizable with therapeutic additions, hydrating, and gut-resting.
• The nong/lanh (hot/cold) food classification system, while not directly equivalent to Western biochemical categories, shows meaningful parallels with modern understanding of thermogenic and anti-inflammatory food properties.
• Vietnamese fermented condiments (nuoc mam, dua cai, tuong) provide daily probiotic and postbiotic support that the Western diet typically lacks.
• The emotional and communal context of Vietnamese eating is itself therapeutic, activating parasympathetic pathways that enhance digestion and healing.

References and Further Reading

• Nguyen, A.Q. (2006). Into the Vietnamese Kitchen: Treasured Foodways, Modern Flavors. Ten Speed Press.
• Pham, C. (2017). Vietnamese Food Any Day. Ten Speed Press.
• Bui, M.L. et al. (2019). “Phytochemical and pharmacological review of Perilla frutescens.” Phytochemistry Reviews, 18, 1183-1216.
• Vo, V.C. (2012). Dictionary of Vietnamese Medicinal Plants (Tu Dien Cay Thuoc Viet Nam). Medical Publishing House, Hanoi.
• Brand, S. et al. (2018). “Star anise as a medicinal plant.” Journal of the Saudi Society of Agricultural Sciences, 17(4), 405-410.
• Simopoulos, A.P. & Bhat, R.V. (2000). Street Foods (World Review of Nutrition and Dietetics, Vol. 86). Karger.
• Vu, H.T. et al. (2016). “Phenolic compounds within banana peel and their potential uses: A review.” Journal of Functional Foods, 21, 10-24.
• Katz, S.E. (2012). The Art of Fermentation. Chelsea Green Publishing.