The wisdom of the Donguibogam aligns closely with modern medical understanding. In Korean medicine, the spleen and stomach falling into distress corresponds directly to worsening insulin resistance or the exhaustion and dysfunction of pancreatic beta cells caused by chronic overload.
When a large amount of sugar from fruit is consumed at once, particularly fructose, the liver must metabolize it rapidly. When intake exceeds capacity, the liver cannot process the full load; excess fructose is converted into fat and stored in the liver, or shifted into glucose that rapidly raises blood glucose. A blood sugar spike, where blood glucose rises abruptly, damages the vascular endothelium, triggers inflammatory cascades, and creates a vicious cycle that diminishes the insulin secretion capacity of the pancreas over time. Just as the Donguibogam describes dampness-phlegm gathering internally, modern medicine recognizes that advanced glycation end products and cholesterol accumulate on the vascular endothelium, stiffening blood vessels and elevating the risk of diabetic complications.
This does not mean fruits must be avoided entirely. Fruits contain essential vitamins, minerals, and dietary fiber, which slows the rate of glucose absorption. However, fruits vary significantly. Some have a high glycemic index that quickly raises blood glucose, such as watermelon, ripe bananas, and mangoes, whereas others, like berries, grapefruit, and kiwi, have a low glycemic index. Just as the Donguibogam evaluated the nature and flavor of foods, modern medicine uses the glycemic index and glycemic load to guide which fruits to choose and in what quantities.
The critical factor is how fruits are consumed. Rather than eliminating them completely, it is better to consume appropriate amounts through practical methods. Eating mindfully ensures that the pancreas and liver do not become overwhelmed.
