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Tag: beverages

  • Mold Toxins in Cereals, Herbs, Spices, and Wine | NutritionFacts.org

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    Most crops are contaminated with fungal mycotoxins, but some foods are worse than others.

    Oats can be thought of as “uniquely nutritious.” One route by which they improve human health is by providing prebiotics that “increase the growth of beneficial gut microbiota.” There are all manner of oats, ranging from steel-cut oats to, even better, intact oat groats (their form before being cut), all the way down to highly processed cereals, like Honey Nut Cheerios.

    “Rolling crushes the grain, which may disrupt cell walls and damage starch granules, making them more available for digestion.” This is bad because we want the starch to make it all the way down to our colon to feed our good gut bacteria. Grinding oats into oat flour to make breakfast cereals is even worse. When you compare blood sugar and insulin responses, you can see significantly lower spikes with the more intact steel-cut oats, as shown below and at 0:54 in my video Ochratoxin in Certain Herbs, Spices, and Wine.

    What about ochratoxin? As seen here and at 1:01 in my video, oats are the leading source of dietary exposure to this mold contaminant, but they aren’t the only source.

    There is a global contamination of food crops with mycotoxins, with some experts estimating as much as 25% of the world’s crops being affected. That statistic is attributed to the Food and Agriculture Organization of the United Nations, but it turns out the stat is bogus. It isn’t 25%. Instead, it may be more like 60% to 80%. “The high occurrence is likely explained by a combination of the improved sensitivity of analytical [testing] methods and the impact of climate change.”

    Spices have been found to have some of the highest concentrations of mycotoxins, but because they are ingested in such small quantities, they aren’t considered to be a significant source. We can certainly do our part to minimize our risk, though. For instance, we should keep spices dry after opening sealed containers or packages.

    What about dried herbs? In “Mycotoxins in Plant-Based Dietary Supplements: Hidden Health Risk for Consumers,” researchers found that milk thistle–based supplements had the highest mycotoxin concentrations. It turns out that humid, wet weather is needed during milk thistle harvest, which is evidently why they get so moldy. “Considering the fact that milk thistle preparations are mainly used by people who suffer from liver disease,” such a high intake of compounds toxic to the liver may present some concern.

    Wine sourced from the United States also appears to have particularly high levels. In fact, the single highest level found to date around the world is in a U.S. wine, but there’s contamination in wine in general. In fact, some suggest that’s why we see such consistent levels in people’s blood—perhaps because a lot of people are regular wine drinkers.

    Ochratoxin is said to be a kidney toxin with immunosuppressive, birth defect–causing, and carcinogenic properties. So, what about ochratoxin decontamination in wine? That is, removing the toxin? Ideally, we’d try to prevent the contamination in the first place, but since this isn’t always practical, there is increased focus on finding effective methods of detoxification of mycotoxins already present in foods. This is where yeast enters as “a promising and friendly solution,” because the mycotoxins bind to the yeast cell wall. The thought is that we could strain out the yeast. Another approach is to eat something like nutritional yeast to prevent the absorption.

    It works in chickens. Give yeast along with aflatoxin (another mycotoxin), and the severity of the resulting disease is diminished. However, using something like nutritional yeast as a binder “depends on stability of the yeast-mycotoxin complex through the passage of the gastrointestinal tract.” We know yeasts can remove ochratoxin in foods, but we didn’t have a clue if it would work in the gut until 2016. Yeast was found to bind up to 44% of the ochratoxin, but, in actuality, it was probably closer to only about a third, since some of the bindings weren’t stable. So, if you’re trying to stay under the maximum daily intake and you drink a single glass of wine, even if your bar snack is popcorn seasoned with nutritional yeast, you’d still probably exceed the tolerable intake. But what does that mean? How bad is this ochratoxin? We’ll find out next.

    Doctor’s Note

    This is the second video in a four-part series on mold toxins. The first one was Ochratoxin in Breakfast Cereals.

    Stay tuned for Should We Be Concerned About the Effects of Ochratoxin? and Should We Be Concerned About Aflatoxin?. You can also check: Friday Favorites: Should We Be Concerned About Ochratoxin and Aflatoxin?.

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    Michael Greger M.D. FACLM

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  • Recess Just Raised $30 Million. Could It Be the Next Poppi?

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    Recess is making big moves in the beverage aisle. The New York-based packaged drink brand just announced a $30 million series B funding round led by Cavu Consumer Partners, a private equity firm with a track record of scaling brands like Once Upon a Farm, Beyond Meat, and Oatly 

    The deal could set the stage for a major expansion: The last beverage brand Cavu invested in and incubated was Poppi, the Austin-based soda startup that in May sold to Pepsi for $1.95 billion. 

    Recess also named Kyle Thomas as its new president and co-CEO. Thomas, who was previously the head of emerging brands at Coca-Cola, oversaw the acquisition of Topo Chico and its expansion into hard seltzer. After that, he moved to Nutrabolt, where he increased its sales from $10 million to a projected $1 billion this year, and helped it acquire a controlling stake in greens powder and beverage brand Bloom in September. 

    Taken together, the moves suggest Recess may be eyeing a Poppi-style blockbuster exit. “We definitely want to have that option,” Recess’s founder and co-CEO Ben Witte tells Inc. “But my view is I want to build a business plan that allows us to control our own destiny.”  

    To that end, the new round of funding will allow Recess to expand its marketing efforts and increase its retail presence. Cavu partners Brett Thomas and Jared Jacobs also joined Recess’s board.  

    If you’ve strolled down the beverage aisle at your local grocery or convenience store, you may have noticed that the offerings have become increasingly unhinged: drinks made from seaweed and obscure mushrooms next to cannabis drinks that sit in a legal gray area and an array of beverages loosely known as “functional beverages” that promise everything from better gut health to improved memory. There’s no set definition for the category or its market size, but energy drinks alone are an estimated $25 billion market in the U.S. 

    With the tagline “calm cool collected,” Recess focuses on the corner of the market Witte calls “relaxation beverages,” and many of its bestsellers include the trending drink additive magnesium and adaptogens the company says can help people unwind. 

    Witte conceived of Recess in 2016, during the chaotic presidential election between Hillary Clinton and Donald Trump. “The thesis was, we were entering this new period in history driven by technology, and it was going to leave everyone stressed out and anxious,” says Witte. “As a result, people would be looking for healthy ways to relax and reduce stress and chill in a crazy world.” 

    Recess launched its first products in 2018, canned beverages made with CBD, or cannabidiol, then a trendy ingredient being added to everything from ice cream to body lotion. Like THC, CBD is derived from cannabis plants, but while CBD does not have psychoactive components, it’s sometimes caught between conflicting state and national regulations, similar to other cannabis products.  

    “I saw the writing on the wall, which was that full regulatory clarity was going to take a lot longer than everyone thought,” says Witte. “We were in this position where we had a product that was clearly resonating with consumers, but we couldn’t scale into the national retailers because they wanted additional regulatory clarity for the ingredient of CBD.” 

    Realizing the challenging road ahead, he began developing drinks that did not include CBD—a move he insists was not a pivot, but a natural extension of his vision to create “the Red Bull for relaxation.” “I actually quibble with the term ‘pivot,’” says Witte. “To me it was actually an acceleration.” 

    He never intended for Recess to be tied to a single hero ingredient, he says. In fact, from the start, he saw the brand as carving out a “fundamentally new space of products that all have the overarching proposition of relaxation,” he says. “I took a pretty expansive view of the space that was going to emerge and architected the Recess brand to ultimately be a platform brand.” 

    In 2021, Recess launched canned drinks called Recess Mood, which are made with magnesium and adaptogens. “That became this incredible bet that not just saved the company, but it also set us on this path to becoming a platform brand,” he says. 

    Later that year, it introduced powdered electrolyte beverages, and in 2023, Recess rolled out canned mocktails, in what turned out to be another savvy bet on the future of the beverage industry. At the time, zero-proof beers were ascendant, and Witte thought there might be a market for a non-alcoholic counterpart to canned cocktails like High Noon and White Claw. 

    Today, Recess is available in 15,000 stores nationwide, including Target, Albertsons, and Safeway.  Its products also sell well on Amazon, which accounts for half of its sales. Meanwhile, the original CBD drinks that launched the brand now account for less than 5 percent of its sales. 

    The company declined to share revenue but said that it has doubled revenue every year for the past few years and expects to double its revenue again next year. Witte says its retail velocity—the rate at which products sell in stores—is comparable to that of Poppi. Witte won’t say where the company might venture next, but he has his eye on the supplement space: Think “chill gummies, chill powders.” 

    Today, Witte calls the early challenges of entering the CBD space “the best thing that ever happened to us” because it forced him to get creative about new product lines. “A lot of people wrote us off for a very long time,” says Witte. “They were like, they raised too much money and they can’t sell anywhere.” Critics suggested it was unrealistic to move into different product categories.  

    “I think we were able to navigate that situation extremely well in the way I’m very proud of,” he adds. “It was very challenging, but I believed that if I was able to kind of stay in the game and get these new ideas off the ground, that it would ultimately allow us to create something very big and valuable.” 

    The final deadline for the 2026 Inc. Regionals Awards is Friday, December 12, at 11:59 p.m. PT. Apply now.

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    Jennifer Conrad

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  • The Manhattan Cocktail Is a Magical 3-Ingredient Combination

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    The sharp, full-bodied combination of aged American whiskey, sweet vermouth, and bitters was likely first minted sometime in the latter half of the 1800s, most likely at the Manhattan Club in New York. Its exact origins are unknown, but clearly the bartender who created the Manhattan was on to something, because this drink has truly stood the test of time.

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    Roger Kamholz

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  • The “Showgirl” Cocktail Is the Only Drink I’m Sipping This Weekend (Taylor Swift Would Approve!)

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    In our Showgirl era.
    READ MORE…

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    Patty Catalano

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  • My “Autumn Spritz” Is the Hit of Every Fall Gathering (It’s a Cocktail Everyone Loves)

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    We independently select these products—if you buy from one of our links, we may earn a commission. All prices were accurate at the time of publishing.

    The beauty of delicious, refreshing, summery libations is that with a few ingredient swaps, you can bring them right with you into fall. While scrolling, I came across a mesmerizing video of an autumn Aperol spritz. I unabashedly replayed the video over a dozen times. The drink weaves together all of the components of the classic cocktail, but leans on cider, apples, and a few warm spices to make it appropriate for this season. I decided to try it to see if it’s worth the hype.  

    How to Make an Autumn Aperol Spritz

    First, make the ice cubes. Add diced apples, cinnamon sticks, and star anise to a large ice tray. Then pour water into them to cover, and put the tray in the freezer.

    Garnish the rim of a cocktail glass with simple syrup, sugar, cinnamon, and edible glitter. To assemble the drink, add the spiced ice cube, then pour in Aperol and apple cider, and top it with Prosecco. 

    My Honest Review of the Autumn Aperol Spritz

    If you love a delicious and refreshingly crisp Aperol spritz, you should definitely try this recipe this fall. Because it uses such big cubes of ice, you don’t have to worry about them melting super quickly and watering down this drink. Instead, they slowly thaw, releasing hints of the star anise and cinnamon sticks (and the flavors of those spices aren’t overwhelming, either).

    The most prep you have to do for this recipe is to make the spiced ice cubes, which took me less than five minutes. I can’t wait to host a fall-themed party this year and serve these drinks. They’re ideal because you can make it in advance and even keep a pitcher of the spritz for easy-to-access refills. If you’re searching for a new trendy drink, it’s definitely worth a try. 

    Tips for Making an Autumn Aperol Spritz

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    Ashia Aubourg

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  • Inside PepsiCo’s Project Helping Local Restaurants | Entrepreneur

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    Opinions expressed by Entrepreneur contributors are their own.

    Restaurants are racing to go digital, and PepsiCo wants to help them get there.

    To the world, PepsiCo is a global brand known for bold flavors, iconic ads and entertainment partnerships. To restaurant owners, it is also a growth partner offering tools to strengthen their businesses.

    André Moraes, who leads global digital marketing for PepsiCo, explains how the multinational food and beverage corporation has been building a digital powerhouse for restaurant partners. “Restaurants are at the center of our lives,” Moraes tells Shawn Walchef of Restaurant Influencers. “If they succeed, the whole community does.”

    The initiative includes the Digital Lab, Menu Pro, Local Eats and Media Pro, all designed to make restaurants stronger in the digital age. “Everything that we offer to our customer partners is completely free,” Moraes adds.

    That commitment has already scaled in a big way. Through its Menu Pro program, PepsiCo has worked with more than 200,000 restaurants and optimized over one million menus worldwide. It can share insights from one market to another, giving local operators access to the same expertise that benefits national chains. The data collected from this global reach has helped restaurants improve ordering experiences and grow sales.

    The results, Moraes noted, are measurable.

    “We continue to see double-digit growth in overall digital sales for our restaurant partners,” he says. “Through it, we see growth in beverage sales as well, but it’s profitable growth, which is what we’re really excited about.”

    PepsiCo also makes sure the support is hands-on. Digital leads across the country work directly with restaurant operators, helping them improve their menus, adopt new tools and stay on top of changes.

    For many operators, it is the kind of one-on-one guidance they would not be able to afford on their own. Proprietary AI systems monitor menus continuously, ensuring items, prices and photos stay accurate across platforms.

    For Moraes, the outcome matters most. “Guests are ordering and going to our restaurants, [and they’re] excelling through the tools and services and partnerships that we’re offering,” he says. “We are truly coming through as the growth partner for our restaurant partners.”

    Related: People Line Up Down the Block to Try This Iconic NYC Pizza. Now, It Could Be Coming to Your City.

    Why local matters

    PepsiCo’s impact goes further than digital tools. The company is investing directly in local restaurants and the communities they anchor.

    That is where PepsiCo’s Local Eats program comes in. “Local Eats is our program specifically focused on local restaurants,” Moraes says. “If you’ve got one location to even upwards of 100 locations — but focused on local markets — we’re here for you through the Local Eats program.”

    Local Eats drives awareness, traffic and loyalty for independent and regional restaurants. The program invests in digital ads, out-of-home campaigns and even connects restaurants to PepsiCo’s national marketing. When PepsiCo shows food in ads, it often highlights a partner restaurant’s story.

    Inside the restaurant, PepsiCo provides branded assets to enhance the guest experience. Online, the company buys search and maps ads that put local restaurants at the top of results when hungry customers are deciding where to eat.

    The impact was on display at the National Restaurant Show with Russell’s Barbecue, a partner PepsiCo guided through a Local Eats transformation. “What you see here is a bit of the before and after, and you’ll see what their business looks like today,” Moraes says. The results included sharper branding, stronger digital traffic and more in-person visits.

    Related: He Went from Tech CEO to Dishwasher. Now, He’s Behind 320 Restaurants and $750 Million in Assets.

    “Local Eats is about reaching, converting and retaining guests for our partners,” Moraes says. “We want to make sure we are not just driving traffic, but helping restaurants keep customers coming back.”

    There is also a community element. Local Eats includes a digital and delivery community program, where operators join live courses with PepsiCo experts and peers to learn best practices and build long-term strategies together.

    Diners still want to eat out, connect and be part of a local scene. And for PepsiCo, success means being part of that journey. By investing in digital tools, marketing support and hands-on partnerships, the company is showing that it is not only a beverage brand but also a growth partner committed to helping restaurants thrive in their communities.

    Related: His Sushi Burger Got 50 Million Views — and Launched an Entire Business

    About Restaurant Influencers

    Restaurant Influencers is brought to you by Toast, the powerful restaurant point-of-sale and management system that helps restaurants improve operations, increase sales and create a better guest experience.

    Toast — Powering Successful Restaurants. Learn more about Toast.

    Related: Von Miller Learned About Chicken Farming in a College Class – And It Became the Inspiration for a Business That Counts Patrick Mahomes as an Investor

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    Shawn P. Walchef

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  • Why I Don’t Recommend Moringa Leaf Powder  | NutritionFacts.org

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    “Clearly, in spite of the widely held ‘belief’ in the health benefits of M. oleifera [moringa], the interest of the international biomedical community in the medicinal potential of this plant has been rather tepid.” In fact, it has been “spectacularly hesitant in exploring its nutritional and medicinal potential. This lukewarm attitude is curious, as other ‘superfoods’ such as garlic and green tea have enjoyed better reception,” but those have more scientific support. There are thousands of human studies on garlic and more than ten thousand on green tea, but only a few hundred on moringa.

    The most promising appears to be moringa’s effects on blood sugar control. Below and at 0:55 in my video The Efficacy and Side Effects of Moringa Leaf Powder, you can see the blood sugar spikes after study participants ate about five control cookies each (top line labeled “a”), compared with cookies containing about two teaspoons of moringa leaf powder into the batter (bottom line labeled “b”). Even with the same amount of sugar and carbohydrates as the control cookies, the moringa-containing cookies resulted in a dampening of the surge in blood sugar.

    Researchers found that drinking just one or two cups of moringa leaf tea before a sugar challenge “suppressed the elevation in blood glucose [sugar] in all cases compared to controls that did not receive the tea initially” and instead drank plain water. As you can see here and at 1:16 in my video, drinking moringa tea with sugar dampened blood sugar spikes after 30 minutes of consumption of the same amount of sugar without moringa tea. It’s no wonder that moringa is used in traditional medicine practice for diabetes, but we don’t really know if it can help until we put it to the test. 
    People with diabetes were given about three-quarters of a teaspoon of moringa leaf powder every day for 12 weeks and had significant improvements in measures of inflammation and long-term blood sugar control. The researchers called it a “quasi-experimental study” because there was no control group. They just took measurements before and after the study participants took moringa powder, and we know that simply being in a dietary study can lead some to eat more healthfully, whether consciously or unconsciously, so we don’t know what effect the moringa itself had. However, even in a moringa study with a control group, it’s not clear if the participants were randomly allocated. The researchers didn’t even specify how much moringa people were given—just that they took “two tablets daily with one tablet each after breakfast and dinner,” but what does “one tablet” mean? There was no significant improvement in this study, but perhaps the participants weren’t given enough moringa. Another study used a tablespoon a day and not only saw a significant drop in fasting blood sugars, but a significant drop in LDL cholesterol as well, as seen below and at 2:27 in my video. 

    Two teaspoons of moringa a day didn’t seem to help, but what about a third, making it a whole tablespoon? Apparently not, since, finally, a randomized, placebo-controlled study using one tablespoon of moringa a day failed to show any benefit on blood sugar control in people with type 2 diabetes.

    So, we’re left with a couple of studies showing potential, but most failing to show benefit. Why not just give moringa a try to see for yourself? That’s a legitimate course of action in the face of conflicting data when we’re talking about safe, simple, side–effect–free solutions, but is moringa safe? Probably not during pregnancy, as “about 80% of women folk” in some areas of the world use it to abort pregnancies, and its effectiveness for that purpose has been confirmed (at least in rats), though breastfeeding women may get a boost of about half a cup in milk production based on six randomized, blinded, placebo-controlled clinical trials.

    Just because moringa has “long been used in traditional medicine” does not in any way prove that the plant is safe to consume. A lot of horribly toxic substances, like mercury and lead, have been used in traditional medical systems the world over, but at least “no major harmful effects of M. oleifera [moringa]…have been reported by the scientific community.” More accurately, “no adverse effects were reported in any of the human studies that have been conducted to date.” In other words, no harmful effects had been reported until now. 

    Stevens-Johnson syndrome (SJS) is probably the most dreaded drug side effect, “a rare but potentially fatal condition characterized by…epidermal detachment and mucous membrane erosions.” In other words, your skin may fall off. Fourteen hours after consuming moringa, a man broke out in a rash. The same thing had happened three months earlier, the last time he had eaten moringa, causing him to suffer “extensive mucocutaneous lesions with blister formation over face, mouth, chest, abdomen, and genitalia.” “This case report suggests that consumption of Moringa leaf is better avoided by individuals who are at risk of developing SJS.” Although it can happen to anyone, HIV is a risk factor.

    My take on moringa is that the evidence of benefit isn’t compelling enough to justify shopping online for something special when you can get healthy vegetables in your local market, like broccoli, which has yet to be implicated in any genital blistering. 

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    Michael Greger M.D. FACLM

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  • Should We Drink Kombucha  | NutritionFacts.org

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    What are the risks versus benefits of drinking kombucha?

    Is Kombucha Tea Good for You? is one of my first videos. It was featured in a blog entry entitled “NutritionFacts.org: the first month,” where I marveled the video had reached nearly 100,000 people. You can see it below and at 0:20 in my video Kombucha’s Side Effects: Is It Bad for You?. I’m honored to say that we now reach more than 100,000 people a day.

    In that first kombucha video, I profiled a report published in the Journal of Intensive Care Medicine of “a case of kombucha tea toxicity” in which a young man ended up in an acidotic coma. The authors concluded, “While Kombucha tea is considered a healthy elixir, the limited evidence currently available raises considerable concern that it may pose serious health risks. Consumption of this tea should be discouraged, as it may be associated with life-threatening lactic acidosis.” And this was just one of several case reports of “serious, and sometimes fatal, hepatic [liver] dysfunction and lactic acidosis within close proximity of ingestion.”

    For example, there were two cases in Iowa of severe metabolic acidosis, including one death. There was also a triggering of a life-threatening autoimmune muscle disease that required emergency surgery and was “probably related to the consumption of a fermented Kombucha beverage.” Another patient presented with shortness of breath, shaking, and a movement disorder “after consumption of tea and no other medications,” and a middle-aged woman complained of xerostomia, dizziness, nausea, vomiting, headache, and neck pain,” and her symptoms recurred on reingestion of the tea. There was another case of severe metabolic lactic acidosis, as well as a case of hepatotoxicity (liver toxicity) that resolved after stopping kombucha.

    Why these sporadic cases? Maybe some unusual toxins developed in a particular batch. I mean, it is a fermented product, so it’s possible there was just some contamination by a bad bug, like the time people smeared kombucha on their skin because they were told it had “magical healing power.” What it had instead was anthrax. So, even though such reports were rare, I concluded ten years ago that we should probably stick to foods that haven’t put people in a coma. But what about its risks versus benefits? Maybe kombucha is worth it. After all, it’s “reputed to cure cancer,” “eliminate wrinkles,” “and even restore gray hair to its original color”—as “marketed by alternative and naturopathic healers throughout the United States.”

    “Currently, kombucha is alternately praised as ‘the ultimate health drink’ or damned as ‘unsafe medicinal tea.’” It’s been “claimed to be a universal wonderful drug…a potion which improves awareness and concentration, slimming, also purifying, regenerating and life extending.” Which is it? Is it “potion or poison?

    Back in the 1920s, 1930s, and 1940s, there were several medical studies conducted by recognized physicians confirming all sorts of beneficial effects, as you can see below and at 2:55 in my video. 

    I couldn’t wait to read them. Dufrense and Farnworth were cited, and when I went to that paper, I saw the same claim, citing Allen 1998. When I went to that source, I saw the citation is for a random kombucha website, as shown below, and at 3:10 in my video. And guess what? That website’s been defunct since 2001, and “much of the Kombucha information” posted came from comments on some mailing list.

    Finally, in 2003, a systematic review of the clinical evidence that had been published was conducted. “The main result of this systematic review, it seems, is the total lack of efficacy data…No clinical studies were found relating to the efficacy of this remedy.” We just have these cautionary tales, these case reports. So, based on these data, it was concluded that the largely undetermined benefits do not outweigh the documented risks of kombucha. It can therefore not be recommended for therapeutic use.” That was back in 2003, though. How about a 2019 systematic review of the empirical evidence of human health benefit?

    “The nonhuman subjects literature claims numerous health benefits of kombucha,” with “nonhuman” meaning mice and rats. We need human clinical trials, yet there is still not a single controlled human study. (I did find one uncontrolled study purporting to show a significant reduction in fasting and after-meal blood sugars among individuals with type 2 diabetes, though, as seen below and at 4:19 in my video.)

    “Nonetheless,” despite no controlled trials, “significant commercial shelf space is now dedicated to kombucha products, and there is widespread belief that the products promote health.” So, we are left with this extreme disparity between science and belief: “There is no convincingly positive clinical evidence at all; the [health] claims for it are as far-reaching as they are implausible; the potential for harm seems considerable. In such extreme cases, healthcare professionals should discourage consumers from using (and paying for) remedies that only seem to benefit those who sell them.”

    Doctor’s Note:

    Friday Favorites: What Are the Best Beverages? Watch the video to find out. 

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    Michael Greger M.D. FACLM

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  • Drinking Water, Losing Weight  | NutritionFacts.org

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    A few times a day, drink two cups of cold water on an empty stomach for weight loss.

    After drinking two cups (half a liter) of water, you can get a surge of the adrenal hormone noradrenaline in your bloodstream, as if you had just smoked a few cigarettes or had a few cups of coffee, boosting your metabolic rate up to 30 percent within an hour, as shown below and at 0:22 in my video Optimizing Water Intake to Lose Weight. When put to the test in randomized controlled trials, that appeared to accelerate weight loss by 44 percent, making drinking water the safest, simplest, and cheapest way to boost your metabolism. 

    Now, this entire strategy may fail if you’re on a beta-blocker drug. (Beta blockers are typically prescribed for heart conditions or high blood pressure and tend to end with the letters lol, such as atenolol, nadolol, or propranolol, sold as Tenormin, Corgard, or Inderal, respectively.) So, for example, as you can see below and at 0:59 in my video, if you give people the beta-blocker drug metoprolol (sold as Lopressor) before they drink their two cups (480 mL) of water, the metabolic boost is effectively prevented. This makes sense since the “beta” being blocked by beta blockers are the beta receptors triggered by noradrenaline. Otherwise, drinking water should work. But what’s the best dose, type, temperature, and timing?

    Just a single cup (240 mL) of water may be sufficient to rev up the noradrenaline nerves, but additional benefit is seen with drinking two or more cups (480 mL). A note of caution: One should never drink more than about three cups (710 mL) in an hour, since that starts to exceed the amount of fluid your kidneys can handle. If you have heart or kidney failure, your physician may not want you to drink extra water at all, but even with healthy kidneys, any more than three cups of water an hour can start to critically dilute the electrolytes in your brain with potentially critical consequences. (In How Not to Diet, I talk about a devastating, harrowing experience I had in the hospital as an intern. A patient drank himself to death—with water. He suffered from a neurological condition that causes pathological thirst. I knew enough to order his liquids to be restricted and have his sink shut off, but I didn’t think to turn off his toilet.)

    Getting back to it. What kind of water are we talking about? Does it have to be plain, regular water? It shouldn’t matter, right? Isn’t water just water whether it’s flavored or sweetened in a diet drink? Actually, it does matter. When trying to prevent fainting before blood donation, drinking something like juice doesn’t work as well as plain water. When trying to keep people from getting dizzy when they stand up, water works, but the same amount of water with salt added doesn’t, as seen below and at 2:40 in my video. What’s going on? 

    We used to think the trigger was stomach distention. When we eat, our body shifts blood flow to our digestive tract, in part by releasing noradrenaline to pull in blood from our limbs. This has been called the gastrovascular reflex. So, drinking water was thought to be a zero-calorie way of stretching our stomachs. But, instead, if we drink two cups (480 mL) of saline (basically salt water), the metabolic boost vanishes, so stomach expansion can’t explain the water effect.

    We now realize our body appears to detect osmolarity, the concentration of stuff within a liquid. When liquids of different concentrations were covertly slipped into people’s stomachs via feeding tubes, detection of plain water versus another liquid was demonstrated by monitoring sweat production, which is a proxy for noradrenaline release. It may be a spinal reflex, as it’s preserved in people who are quadriplegic, or picked up by the liver, as we see less noradrenaline release in liver transplant patients (who’ve had their liver nerves severed). Whichever the pathway, our body can tell. Thought we only had five senses? The current count is upwards of 33.

    In my Daily Dozen recommendation, I rank certain teas as among the healthiest beverages. After all, they have all the water of water with an antioxidant bonus. But, from a weight-loss perspective, plain water may have an edge. That may explain the studies that found that overweight and obese individuals randomized to replace diet beverages with water lost significantly more weight. This was chalked up to getting rid of all those artificial sweeteners, but, instead, it may be that the diet drinks were too concentrated to offer the same water-induced metabolic boost. As you can see below and at 4:29 in my video, diet soda, like tea, has about ten times the concentration of dissolved substances compared to tap water. So, plain water on an empty stomach may be the best. 

    Does the temperature of the water matter? In a journal published by the American Society of Mechanical Engineers, an engineering professor proposed that the “secret” of a raw food diet for weight loss was the temperature at which the food was served. “Raw food, by its very nature, is consumed at room temperature or lower.” To bring two cups (480 mL) of room-temperature water up to body temperature, he calculated the body would have to dip into its fat stores and use up 6,000 calories. Just do the math, he says: A calorie is defined as the amount of energy required to raise one gram of water one degree Celsius. So, since two cups of water are about 500 grams and the difference between room temp and body temp is about a dozen degrees Celsius, it’s about 500 x 12 = 6,000 calories needed. 

    Do you see the mistake? In nutrition, a “calorie” is actually a kilocalorie, a thousand times bigger than the same word used in the rest of the sciences. Confusing, right? Still, I’m shocked that the paper was even published.

    So, drinking two cups of room-temperature water actually takes only 6 calories to warm up, not 6,000. Now, if you were a hummingbird drinking four times your body weight in chilly nectar, you could burn up to 2 percent of your energy reserves warming it up, but it doesn’t make as much of a difference for us.

    What about really cold water, though? A letter called “The Ice Diet” published in the Annals of Internal Medicine estimated that eating about a quart (1 L) of ice—like a gigantic snow cone without any syrup—could rob our body of more than 150 calories, which is the “same amount of energy as the calorie expenditure in running 1 mile.” It’s not like you directly burn fat to warm up the water, though. Your body just corrals more of the waste heat you normally give off by constricting blood flow to your skin. How does it do that? Noradrenaline.

    If you compare drinking body-temperature water, room-temperature water, and cold water, there’s only a significant constriction in blood flow to the skin after the room-temperature water and the cold water, as seen below and at 6:39 in my video. 

    What’s more, as you can see here and at 6:45 in the video, neither the warm nor tepid water could boost metabolic rate as much as cold (fridge temperature) water. Our body does end up burning off more calories when we drink our water cold (at least indirectly). 

    So, two cups of cold water on an empty stomach a few times a day. Does it matter when? Yes, watch my Evidence-Based Weight Loss lecture to see how you can add the benefit of negative-calorie preloading by drinking that water right before your meals.

    Too good to be true? No. Check out my other three videos on water and weight loss in the related posts below.

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    Michael Greger M.D. FACLM

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  • Boosting Your Metabolism Safely  | NutritionFacts.org

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    If you drink two cups of water, the adrenal hormone noradrenaline can surge in your bloodstream, similar to the response of smoking a few cigarettes or having a few cups of coffee.

    Given the 60 percent surge in noradrenaline within minutes of drinking just two cups of water, as shown in the graph below and at 0:13 in my video What Is the Safest Metabolism Booster?, might one be able to get the weight-loss benefits of noradrenaline-releasing drugs like ephedra—without the risks? You don’t know until you put it to the test. Published in the Journal of the Endocrine Society, the results were described as “uniquely spectacular.” Researchers found that drinking two cups of water increased the metabolic rate of men and women by 30 percent. The increase started within ten minutes and reached a maximum within an hour. In the 90 minutes after drinking one tall glass of water, the study participants burned about an extra 25 calories (100 kJ). Do that four times throughout the day, and you could eliminate 100 additional calories (400 kJ). That’s more than if you had taken ephedra! You’d trim off more calories drinking water than taking weight-loss doses of the banned substance ephedrine (the active component of ephedra) three times a day. And we’re just talking about plain, cheap, safe, and legal tap water.

    Using the Ten-Calorie Rule I’ve explained previously, drinking that much water could make us lose ten pounds over time unless we somehow compensated by eating more or moving less. Concluded one research team, “In essence, water drinking provides negative calories.

    A similar effect was found in overweight and obese children. Drinking about two cups of water led to a 25 percent increase in metabolic rate within 24 minutes, and it lasted at least 66 minutes, until the experiment ended. So, just getting the recommended daily “adequate intake” of water—about 7 cups (1.7 L) a day for children aged 4 through 8, and for ages 9 through 13, 8 cups (2.1 L) for girls and 10 cups (2.4 L) for boys, as shown below and at 1:45 in my video—may offer more than just hydration benefits. 

    Not all research teams were able to replicate these findings, though. For example, one found an increase of only about 10 to 20 percent, while another found only a 5 percent increase, and yet another team found effectively none at all. What we care about, though, is weight loss. The proof is in the pudding. Let’s test the waters, shall we?

    Some researchers suggest that the “increase in metabolic rate with water drinking could be systematically applied in the prevention of weight gain….” Talk about a safe, simple, side-effect-free solution. It’s free in every sense. Drug companies may spend billions of dollars getting a new drug to market. Surely a little could be spared to test something that, at the very least, couldn’t hurt. That’s the problem, though. Drinking water is a “cost-free intervention.”

    There are observational studies suggesting that those who drink four or more cups (1 L) of water a day, for example, appear to lose more weight, independent of confounding factors, such as drinking less soda or exercising more. What happens when you put it to the test?

    In 2013, “Effect of ‘Water Induced Thermogenesis’ on Body Weight, Body Mass Index and Body Composition of Overweight Subjects” was published. Fifty “overweight girls”—who were actually women, aged 18 to 23—“were instructed to drink 500 ml [2 cups] of water, three times a day, half an hour before breakfast, lunch, and dinner, which was over and above their daily water intake” and without otherwise changing their diets or physical activity. The result? They lost an average of three pounds (1.4 kg) in eight weeks. What happened to those in the control group? There was no control group, a fatal flaw for any weight-loss study due to the “Hawthorne effect,” where just knowing you’re being watched and weighed may subtly affect your behavior. Of course, we’re just talking about drinking water. With no downsides, why not give it a try? I’d feel more confident if there were some randomized, controlled trials to really put it to the test. Thankfully, there are!

    I hate it when the title ruins the suspense. “Water Consumption Increases Weight Loss During a Hypocaloric Diet Intervention in Middle-Aged and Older Adults.” Overweight and obese men and women randomized to two cups of water before each meal lost nearly five pounds more body fat in 12 weeks than those in the control group, as shown below and at 4:08 in my video. Both groups were put on the same calorie-restricted diet, but the one with the added water lost weight 44 percent faster.

    A similar randomized controlled trial found that about 1 in 4 in the water group lost more than 5 percent of their body weight compared to only 1 in 20 in the control group. The average weight-loss difference was only about three pounds (1.3 kg), but those who claimed to have actually complied with the three-times-a-day instructions lost about eight more pounds (4.3 kg) compared to those who only drank the extra water once a day or less. This is comparable to commercial weight-loss programs, like Weight Watchers, and all the participants did was drink some extra water. 

    The video I mentioned is The New Calories per Pound of Weight Loss Rule.

    If you missed my previous video, see The Effect of Drinking Water on Adrenal Hormones.

    For all the specifics, check out Optimizing Water Intake to Lose Weight, coming up next. 

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    Michael Greger M.D. FACLM

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  • The burrito king in coffee land: Starbucks CEO Brian Niccol’s most important job is fixing the bad vibes

    The burrito king in coffee land: Starbucks CEO Brian Niccol’s most important job is fixing the bad vibes

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    Baristas are overworked as they try to churn out a constant stream of complicated customized drinks. Mobile orders and staffing problems have only made the problem worse, and added to longer wait times. There’s often nowhere to sit. In short, it’s the last place anyone would want to linger over a $3.45 cup of coffee, let alone a $6.65 pumpkin spice latte. 

    Customers have noticed. The company released a painful earnings report this week, revealing that fourth-quarter revenues tumbled 3% to $9.1 billion, and the magic retail metric—quarterly global comparable store sales—were down 7%. Ultimately, business challenges prompted the $110 billion coffee chain to suspend guidance last week for the full fiscal year of 2025 “to allow ample opportunity to complete an assessment of the business and solidify key strategies.” 

    Seattle-based Starbucks is betting new rockstar CEO Brian Niccol can turn things around with a strategic plan called “Back to Starbucks.” Niccol, who was offered a $113 million payday to take the barista-in-chief job, is an outsider to the company, which has had four different CEOs since 2022. Starbucks’ board members are banking on the former Chipotle wunderkind, who took over in September, to fix a slew of operational and labor issues. And analysts and experts say he has one overarching mandate: Make the in-store experience the kind of pleasant yet affordable luxury it once was. 

    “Starbucks used to have an energy around it,” Sharon Zackfia, an analyst at William Blair & Co., an investment bank and financial services company, tells Fortune. “Starbucks just needs to figure out how to kind of recapture that love and affinity.”

    Niccol addressed the issue head-on during the company’s earnings call this week, and discussed getting back to the brand’s “core identity.” 

    “We have to get back to what has always set Starbucks apart: a welcoming coffee house where people gather.” 

    The burrito king in coffee land

    When it comes to cultivating an ephemeral atmosphere of luxury, the devil’s in the details. Niccol must figure out a way to maintain the revenue of mobile and drive-thru orders while still making the in-store experience something to be desired. 

    It’s hard to imagine a CEO better suited for the moment, or with as much goodwill behind him. Niccol brings extensive experience in the food and beverage space, with stints at Chipotle and Taco Bell. Wall Street has high hopes for the 50-year-old executive: Starbucks stock popped 25% in September on the news that he would be taking over the company. But his operational chops, and how they could solve Starbucks’ atmosphere problems, will be tested. 

    Chipotle focuses “relentlessly on fitting cogs into their burrito machine,” Sean Dunlop, an analyst at Morningstar, a financial services company, tells Fortune. On average, the fast-casual Mexican chain can make around 25 entrees in 15 minutes, he says, and some locations can do much more than that. Dunlop also says people are looking at Chipotle’s assembly line and thinking that if Niccol could just do the same thing at Starbucks, “we can solve all the speed of service issues. We can solve the employee dissatisfaction issues.” 

    Niccol said this week that Starbucks will be slimming down its complex menu, and working on getting every order into the hands of a customer within four minutes. He also envisioned separating the in-store experience from the mobile order pickup experience, taming the mobile app with some “common-sense guardrails,” and reining in highly customized drink orders.

    “We kind of incentivize people to customize drinks that probably aren’t the best way to execute the drink,” said Niccol, adding that “we have some clean up to do.” 

    The love is gone

    Starbucks isn’t the same as it used to be, and neither are its customers.  

    “The Starbucks experience has fundamentally changed over the last five or 10 years,” notes Dunlop.

    Mobile purchases now make up more than 30% of all orders, according to the company. Combined with drive-thru orders, they reportedly make up around 70% of sales at American stores run by the company. Roughly 76% of beverages sold are now cold drinks, but the back-of-counter layout is not always equipped for that reality. And the drinks that customers order have also become much more complicated, and sometimes fueled by social-media hijinx. 

    All of those factors have combined to create longer wait times, and heavier workloads for baristas. Slammed with an incessant stream of drink requests, they don’t have as much bandwidth to spend much quality time or chat with walk-in customers. 

    A staffing-first approach

    Michelle Eisen, 41, has been working at Starbucks for 14 years, and currently works at a location in Buffalo, NY. She’s also a member of the Starbucks Workers United union, serves as a bargaining delegate, and is from the first store to win their union. She says the workload has shifted “monumentally” over the past five years in terms of the “pressure that’s put on the hourly workers, baristas and shift supervisors, who are on the floors of these stores every single day.”

    Investing in food quality, making sure there are seating options for walk-in customers, and choosing the right music for the right time of day all play a part in making the stores comfortable—somewhere you actually want to spend time. But those time-stretched baristas are a bigger hindrance to the kind of atmosphere that Starbucks is trying to create than tables and chairs ever could be, says Stephan Meier, an economist and professor at the Columbia Business School. It’s not the art or the furniture that creates a cozy “third space,” he adds—it’s the workers who make the customers feel special.

    “The experience of the customer, in my view, has to come through the experience of the employees,” says Meier. “I think they have to figure out how to operationally free up capacity for the baristas to really focus on the human aspect.” 

    For Starbucks to fix its atmosphere and operations problems, it may have to hire more workers. “I think you could argue that maybe labor productivity is too high and they need to add more labor in order to bring back some of the experiential differentiation that made Starbucks what it is today,” says Zackfia. 

    Eisen agrees that better scheduling and more workers is key, so that three baristas aren’t bearing the load more appropriate for six people. “It’s additional wages, it’s additional labor costs, but it pays out in the end,” she says. “It creates a positive experience for the barista, and hopefully helps with employee retention. And it creates a much more positive experience for the customer, because they can see that their orders are being taken seriously.”

    Over the past few years, 500 Starbucks stores have voted to unionize, representing more than 11,000 baristas. The response from previous CEO Howard Schultz was not always enthusiastic. Niccol has taken a more conciliatory tone with the union. In response to an open letter from the union, Niccol wrote in September that he was “committed to continue to bargain in good faith.” 

    Starbucks CFO Rachel Ruggeri said in the earnings call this week that the company had increased hours per partner, which was helping with turnover, but that it had more work to do to help with staffing issues. Niccol addressed also the barista experience, and mentioned staffing first in a list of changes the company is making. 

    “Our efforts to get partners the hours and schedules they want are working,” he said. “Now we need to make sure we have the right number of partners on the floor, particularly during our morning peak and shoulder hours.” He added the company was cultivating leaders from within its own ranks, and planning a conference for store managers in 2025. 

    Zarian Pouncy, 30, has been a Starbucks employee for 11 years. He is also a union member and a bargaining delegate for Starbucks Workers United. He’d like to see a level of comfort come back to the stores themselves. The location where he works in Las Vegas got rid of its chairs a few years ago, and now has wooden stools instead. It has also removed electrical outlets. But he’s optimistic about the future. 

    “I am hopeful,” he says. “Once we can kind of slow down, simplify things, go back to what coffee shop culture was, we can get back to a place that baristas might be happy.”

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    Azure Gilman

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  • Does Drinking Water Affect Our Adrenal Hormones?  | NutritionFacts.org

    Does Drinking Water Affect Our Adrenal Hormones?  | NutritionFacts.org

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    Drinking water can be a safe, simple, and effective way to prevent yourself from fainting.

    Within three minutes of drinking a few cups of water (12 mL/kg of body weight), the level of the adrenal gland hormone noradrenaline in our bloodstream can shoot up by 60 percent, as you can see in the graph below and at 0:19 in my video The Effect of Drinking Water on Adrenal Hormones. 

    When researchers had people drink two cups (500 mL) of water with electrodes on their legs, about a 40 percent increase in bursts of fight-or-flight nerve activity within 20 minutes was documented, as shown in the graph below and at 0:25 in my video. 

    If you drink two or three cups (11 mL/kg of body weight) of water, blood flow squeezes down in your arms and calves, clamping down nearly in half, as the arteries to your limbs and skin constrict to divert blood to your core, as you can see in the graph below and at 0:42 in my video. That’s why drinking water can be such a safe, simple, and effective way to prevent yourself from fainting, which is known medically as syncope. 

    Fainting is “the sudden brief loss of consciousness caused by diminished cerebral blood flow,” that is, to the brain. About one in five people experience this at least once, and about one in ten may have repeated episodes. It’s the cause of millions of emergency room visits and hospitalizations every year. Though fainting can be caused by heart problems, it is most often triggered by prolonged standing (because blood pools in our legs) or strong emotions, which can cause our blood pressure to bottom out. 

    About 1 in 25 people has what’s called blood-injury-injection phobia, where getting a needle stick, for example, can cause you to faint. More than 150,000 people experience fainting or near-fainting spells each year when they donate blood. To help prevent yourself from getting woozy, try drinking two cups of water (500 mL) five minutes before getting stuck with the needle. The secret isn’t in bolstering your overall blood volume. If you drink two cups of water or even a whole quart (500 to 1,000 mL), your blood volume doesn’t change by more than 1 or 2 percent. Rather, it’s due to the shift in the distribution of blood toward your center, caused by the noradrenaline-induced peripheral artery constriction, as you can see in the graph below and at 1:56 in my video. 

    Drinking water stimulates as much noradrenaline release as drinking a couple cups of coffee or smoking a couple unfiltered cigarettes. If the simple act of drinking water causes such a profound fight-or-flight reaction, why doesn’t it cause our heart to pound and shoot our blood pressure through the roof? It’s like the diving reflex I talked about in my previous video. When we drink water, our body simultaneously sends signals to our heart to slow it down, to “still your beating heart.” You can try it at home: Measure your heart rate before and after drinking two cups (500 mL) of water. Within ten minutes, your heart rate should slow by about four beats per minute. By 15 minutes, you should be down by six or seven beats, as you can see in the graph below and at 2:42 in my video. 

    One of the ways scientists figured this out was by studying heart transplant patients. When you move a heart from one person to another, you have to sever all the attached nerves. Amazingly, some of the nerves grow back. But still, if you give healed heart transplant patients two glasses of water, their blood pressure goes up as much as 29 points. The body is unable to sufficiently quell the effect of that burst of noradrenaline. Some people have a condition known as autonomic failure, in which blood pressure regulation nerves don’t work properly and their pressures can skyrocket dangerously by more than 100 points after drinking about two cups (480 mL) of water. That’s how powerful an effect the simple act of drinking water can be. The only reason that doesn’t happen to all of us is that we have an even more powerful counter-response to keep our hearts in check. (This reminds me of the woman who had a stroke after taking the ice bucket challenge due to an insufficient diving reflex to tamp down all that extra noradrenaline release.)

    This remarkable water effect can be useful for people suffering from milder forms of autonomic failure, such as orthostatic hypotension, which is when people get dizzy after standing up suddenly. Drinking some water before getting out of bed in the morning can be a big help. What about that metabolic boost, though? With so much noradrenaline being released and your adrenal gland hormones in overdrive, might drinking a few glasses of water cause you to burn more body fat? Could tap water be a safe form of ephedra, giving us all the weight loss but with a nice slowing of our heart rate instead? Researchers decided to put it to the test, which we’ll explore next.

    If you missed the previous video, check out How to Get the Weight Loss Benefits of Ephedra Without the Risks.

    Stay tuned for What Is the Safest Metabolism Booster? and Friday Favorites: Optimizing Water Intake to Lose Weight.

    What kind of water is better? Find out in Is it Best to Drink Tap, Filtered, or Bottled Water?.

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    Michael Greger M.D. FACLM

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  • Ephedra-Like Weight Loss Minus the Risks  | NutritionFacts.org

    Ephedra-Like Weight Loss Minus the Risks  | NutritionFacts.org

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    The diving reflex shows that it’s possible to have selective adrenal hormone effects.

    Thermogenic drugs like DNP can cause people to overheat to death; they can increase resting metabolic rates by 300 percent or more. A more physiological spread would range about ten times less, from a 30 percent slower metabolism in people with an underactive thyroid to a 30 percent higher metabolism when the part of our nervous system that controls our fight-or-flight response is activated. In response to a fright or acute stress, special nerves release a chemical called noradrenaline to ready us for confrontation. We experience this by our skin getting paler, cold, and clammy, as blood is diverted to our more vital organs. Our mouth can get dry as our digestive system is put on hold, and our heart starts to beat faster. What we don’t feel is the extra fat being burned to liberate energy for the fight.

    That’s why people started taking ephedra for weight loss—“to stimulate the release of noradrenaline from nerve endings.”

    Ephedra is an evergreen shrub. It’s been used in China for thousands of years to treat asthma because it causes that same release of noradrenaline that offers relief to people with asthma by dilating their airways. In the United States, it was appropriated for use as a metabolic stimulant, shown to result in about 2 pounds (0.9 kg) of weight loss a month in 19 placebo-controlled trials. By the late 1990s, millions of Americans were taking it. The problem is that it also had all the other noradrenaline effects, like increasing heart rate and blood pressure. So, chronic use resulted in “stroke, cardiac arrhythmia, and death.” The U.S. Food and Drug Administration warned of its risks in 1994, but ephedra wasn’t banned until a decade later after a 23-year-old Major League Baseball pitcher dropped dead. His “autopsy report revealed evidence of ephedra, which the medical examiner said contributed to his death.”

    In the current Wild West of dietary supplement regulation, not only can a supplement be “marketed without any safety data” at all, but the manufacturer is under no obligation to disclose adverse effects that may arise. No surprise, then, that online vendors assured absolute safety: “No negative side effects to date.” “No adverse side-effects, no nervous jitters or underlying anxiety, no moodiness…” “100% safe for long-term use.” “It will not interact with medications and has no harmful side effects.” The president of Metabolife International, a leading seller of ephedra, assured the FDA that the company had never received a single “notice from a consumer that any serious adverse health event has occurred…” In reality, it had received about 13,000 health complaints, including reports of serious injuries, hospitalizations, and even deaths. 

    If only there were a way to get the good without the bad. As I discuss in my video How to Get the Weight Loss Benefits of Ephedra Without the Risks, there is. But to understand it, you first have to grasp a remarkable biological phenomenon known as the diving reflex.

    Imagine walking across a frozen lake and suddenly falling through the ice, plunging into the freezing depths. It’s hard to think of a greater, instantaneous fight-or-flight shock than that. Indeed, noradrenaline would be released, causing the blood vessels in your arms and legs to constrict to bring blood back to your core. You can imagine how fast your heart might start racing, but that would be counterproductive because you’d use up your oxygen faster. Remarkably, what happens instead is your heart rate slows down. That’s the diving reflex, first described in the 1700s. Air-breathing animals are born with this automatic safety feature to help keep us from drowning.

    In medicine, we can exploit this physiological quirk with what’s called a “cold face test.” To determine if a comatose patient has intact neural pathways, you can apply cold compresses to their face to see if their heart immediately starts slowing down. Or, more dramatically, it can be used to treat people who flip into an abnormally rapid heartbeat. Remember that episode of ER where Carter dunked a patient’s face into a tray of ice water? (That show aired on TV when I was in medical school, and a group of us would gather around and count how many times they violated “universal precautions.”)

    What does this have to do with weight loss? The problem with noradrenaline-releasing drugs like ephedra is the accompanying rise in heart rate and blood pressure. What the diving reflex shows is that it’s possible to experience selective noradrenaline effects, raising the possibility that there may be a way to get the metabolic boost without the risk of stroking out. Unbelievably, this intricate physiological feat may be accomplished by the simplest of acts: Instead of drowning in water, simply drink it. Really? Yes, you can boost your metabolism by drinking water. Buckle your safety belts because you are in for a wild ride—one that continues next.

    This is the first in a four-part video series. Stay tuned for:

    You may also be interested in Friday Favorites: The Best Diet for Weight Loss and Disease Prevention.

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    Michael Greger M.D. FACLM

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  • The Stroke Risk of Vegetarians  | NutritionFacts.org

    The Stroke Risk of Vegetarians  | NutritionFacts.org

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    The first study in history on the incidence of stroke in vegetarians and vegans suggests they may be at higher risk.

    “When ranked in order of importance, among the interventions available to prevent stroke, the three most important are probably diet, smoking cessation, and blood pressure control.” Most of us these days are doing pretty good about not smoking, but less than half of us exercise enough. And, according to the American Heart Association, only 1 in 1,000 Americans is eating a healthy diet and less than 1 in 10 is even eating a moderately healthy diet, as you can see in the graph below and at 0:41 in my video Do Vegetarians Really Have Higher Stroke Risk?. Why does it matter? It matters because “diet is an important part of stroke prevention. Reducing sodium intake, avoiding egg yolks, limiting the intake of animal flesh (particularly red meat), and increasing the intake of whole grains, fruits, vegetables, and lentils….Like the sugar industry, the meat and egg industries spend hundreds of millions of dollars on propaganda, unfortunately with great success.” 

    The paper goes on to say, “Box 1 provides links to information about the issue.” I was excited to click on the hyperlink for “Box 1” and was so honored to see four links to my videos on egg industry propaganda, as you can see below and at 1:08 in my video. 

    The strongest evidence for stroke protection lies in increasing fruit and vegetable intake, with more uncertainty regarding “the role of whole grains, animal products, and dietary patterns,” such as vegetarian diets. One would expect meat-free diets would do great. Meta-analyses have found that vegetarian diets lower cholesterol and blood pressure, as well as enhance weight loss and blood sugar control, and vegan diets may work even better. All the key biomarkers are going in the right direction. Given this, you may be surprised to learn that there hadn’t been any studies on the incidence of stroke in vegetarians and vegans until now. And if you think that is surprising, wait until you hear the results. 

    “Risks of Ischaemic Heart Disease and Stroke in Meat Eaters, Fish Eaters, and Vegetarians Over 18 Years of Follow-Up: Results from the Prospective EPIC-Oxford Study”: There was less heart disease among vegetarians (by which the researchers meant vegetarians and vegans combined). No surprise. Been there, done that. But there was more stroke, as you can see below, and at 2:14 in my video. 

    An understandable knee-jerk reaction might be: Wait a second, who did this study? Was there a conflict of interest? This is EPIC-Oxford, world-class researchers whose conflicts of interest may be more likely to read: “I am a member of the Vegan Society.”

    What about overadjustment? When the numbers over ten years were crunched, the researchers found 15 strokes for every 1,000 meat eaters, compared to only 9 strokes for every 1,000 vegetarians and vegans, as you can see below and at 2:41 in my video. In that case, how can they say there were more strokes in the vegetarians? This was after adjusting for a variety of factors. The vegetarians were less likely to smoke, for example, so you’d want to cancel that out by adjusting for smoking to effectively compare the stroke risk of nonsmoking vegetarians to nonsmoking meat eaters. If you want to know how a vegetarian diet itself affects stroke rates, you want to cancel out these non-diet-related factors. Sometimes, though, you can overadjust. 

    The sugar industry does this all the time. This is how it works: Imagine you just got a grant from the soda industry to study the effect of soda on the childhood obesity epidemic. What could you possibly do after putting all the studies together to conclude that there was a “near zero” effect of sugary beverage consumption on body weight? Well, since you know that drinking liquid candy can lead to excess calories that can lead to obesity, if you control for calories, if you control for a factor that’s in the causal chain, effectively only comparing soda drinkers who take in the same number of calories as non-soda-drinkers, then you could undermine the soda-to-obesity effect, and that’s exactly what they did. That introduces “over adjustment bias.” Instead of just controlling for some unrelated factor, you control for an intermediate variable on the cause-and-effect pathway between exposure and outcome.

    Overadjustment is how meat and dairy industry-funded researchers have been accused of “obscuring true associations” between saturated fat and cardiovascular disease. We know that saturated fat increases cholesterol, which increases heart disease risk. Therefore, if you control for cholesterol, effectively only comparing saturated fat eaters with the same cholesterol levels as non-saturated-fat eaters, that could undermine the saturated fat-to-heart disease effect.

    Let’s get back to the EPIC-Oxford study. Since vegetarian eating lowers blood pressure and a lowered blood pressure leads to less stroke, controlling for blood pressure would be an overadjustment, effectively only comparing vegetarians to meat eaters with the same low blood pressure. That’s not fair, since lower blood pressure is one of the benefits of vegetarian eating, not some unrelated factor like smoking. So, that would undermine the afforded protection. Did the researchers do that? No. They only adjusted for unrelated factors, like education, socioeconomic class, smoking, exercise, and alcohol. That’s what you want. You want to tease out the effects of a vegetarian diet on stroke risk. You want to try to equalize everything else to tease out the effects of just the dietary choice. And, since the meat eaters in the study were an average of ten years older than the vegetarians, you can see how vegetarians could come out worse after adjusting for that. Since stroke risk can increase exponentially with age, you can see how 9 strokes among 1,000 vegetarians in their 40s could be worse than 15 strokes among 1,000 meat-eaters in their 50s. 

    The fact that vegetarians had greater stroke risk despite their lower blood pressure suggests there’s something about meat-free diets that so increases stroke risk it’s enough to cancel out the blood pressure benefits. But, even if that’s true, you would still want to eat that way. As you can see in the graph below and at 6:16 in my video, stroke is our fifth leading cause of death, whereas heart disease is number one. 

    So, yes, in the study, there were more cases of stroke in vegetarians, but there were fewer cases of heart disease, as you can see below and at 6:29. If there is something increasing stroke risk in vegetarians, it would be nice to know what it is in hopes of figuring out how to get the best of both worlds. This is the question we will turn to next. 

    I called it 21 years ago. There’s an old video of me on YouTube where I air my concerns about stroke risk in vegetarians and vegans. (You can tell it’s from 2003 by my cutting-edge use of advanced whiteboard technology and the fact that I still had hair.) The good news is that I think there’s an easy fix.

    This is the third in a 12-video series on stroke risk. Links to the others are in the related posts below.

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    Michael Greger M.D. FACLM

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  • Are Food Ads Making Us Obese?  | NutritionFacts.org

    Are Food Ads Making Us Obese?  | NutritionFacts.org

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    We all like to think we make important life decisions, like what to eat, consciously and rationally, but if that were the case, we wouldn’t be in the midst of an obesity epidemic.

    The opening words of the Institute of Medicine’s report on the potential threat posed by food ads were: “Marketing works.” Certainly, there is a “large number of well-conducted randomized experiments” I could go through with you that “have shown that exposure to marketing—especially, but not only, advertising—changes people’s eating behavior. Marketing causes people to choose to eat more.” But, what do you need to know beyond the fact that the industry spends tens of billions of dollars a year on it? To get people to drink its brown sugar water, do you think Coca-Cola would spend a penny more than it thought it had to? It’s like when my medical colleagues accept “drug lunches” from pharmaceutical representatives and take offense that I would suggest it might affect their prescribing practices. Do they really think drug companies are in the business of giving away free money for nothing? They wouldn’t do it if it didn’t work. 

    To give you a sense of marketing’s insidious nature, let me share an interesting piece of research published in the world’s leading scientific journal: “In-Store Music Affects Product Choice” documented an experiment in which French accordion music or German Bierkeller music was played on alternate days in the wine section of a grocery store. As you can see below and at 1:27 in my video The Role of Food Advertisements in the Obesity Epidemic, on the days the French music played in the background, people were three times more likely to buy French wine, and on German music days, shoppers were about three times more likely to buy German wine. And it wasn’t a difference of just a few percent; it was a complete three-fold reversal. Despite the dramatic effect, when shoppers were approached afterward, the vast majority of them denied the music had influence on their choice. 

    Most of our day-to-day behavior does not appear to be dictated by careful, considered deliberations, even if we’d like to think that were the case. Rather, we tend to make more automatic, impulsive decisions triggered by unconscious cues or habitual patterns, especially when we are “under stress, tired, or preoccupied. This unconscious part of our brain is estimated to function and guide our behaviors at least 95% of the time.” This is the arena where marketing manipulations do most of their dirty work. 

    The part of our brain that governs conscious awareness may only be able to process about 50 bits of information per second, which is roughly equivalent to a short tweet. Our entire cognitive capacity, on the other hand, is estimated to process more than 10 million bits per second. Because we’re only able to purposefully process a limited amount of information at a time, if we’re distracted or otherwise unable to concentrate, our decisions can become even more impulsive. An elegant illustration of this “cognitive overload” effect was provided from an experiment involving fruit salad and chocolate cake.

    Before calls could be made at the touch of a button or the sound of our voice, the seven-digit span of phone numbers in the United States was based in part on the longest sequence most people can recall on the fly. We only seem to be able to hold about seven chunks of information (plus or minus two) in our immediate short-term memory. The study’s setup: Randomize people to memorize either a seven-digit number or a two-digit number to be recalled in another room down the hall. On the way, offer them the choice of a fruit salad or a piece of chocolate cake. Memorizing a two-digit number is easy and presumably takes few cognitive resources. As you can see in the graph below and at 3:52 in my video, under the two-digit condition, most study participants chose fruit salad. Faced with the same decision, most of those trying to keep seven digits in their heads just went for the cake. 

    This can play out in the real world by potentiating the effect of advertising. Have people watch a TV show with commercials for unhealthy snacks, and, no surprise, they eat more unhealthy snacks compared to those exposed to non-food ads. Or maybe that is a surprise. We all like to think we’re in control and not so easily manipulated. The kicker, though, is that we may be even more susceptible the less we pay attention. Randomize people to the same two-digit or seven-digit memorization task during the TV show, and the snack-attack effect was magnified among those who were more preoccupied. How many of us have the TV on in the background or multi-task during commercial breaks? Research suggests that may make us even more impressionable to the subversion of our better judgment. 

    There’s an irony in all of this. Calls for restrictions on marketing are often resisted by invoking the banner of freedom. What does that even mean in this context, when research shows how easily our free choices can be influenced without our conscious control? A senior policy researcher at the RAND Corporation even went as far as to suggest that, given the dire health consequences of our unhealthy eating habits, “the marketing techniques of which we are unaware should be considered in the same light as the invisible carcinogens and toxins in the air and water that can poison us without our awareness.”

    Given the role marketing can play even when we least suspect it, what is the role of personal responsibility in the obesity epidemic? That’s the subject of my next video.

    We are winding down this series on obesity, with three videos remaining: 

     If you missed any of the previous videos, see the related posts below. 

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    Michael Greger M.D. FACLM

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  • Marketing Takes Off and Obesity Soars  | NutritionFacts.org

    Marketing Takes Off and Obesity Soars  | NutritionFacts.org

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    The unprecedented rise in the power, scope, and sophistication of food marketing starting around 1980 aligns well with the blastoff slope of the obesity epidemic.

    In the 1970s, the U.S. government went from just subsidizing some of the worst foods to paying companies to make more of them: “Congress passed laws reversing long-standing farm policies aimed at protecting prices by limiting production” and started giving payouts in proportion to output. Extra calories started pouring into the food supply.

    Then Jack Welch gave a speech. In 1981, the CEO of General Electric effectively launched the “shareholder value movement,” reorienting the primary goal of corporations towards maximizing short-term returns for investors. This placed extraordinary pressure from Wall Street on food companies to post increasing profit growth every quarter to boost their share price. There was already a glut of calories on the market and now they had to sell even more.

    This placed food and beverage CEOs in an impossible bind. It’s not like they’re rubbing their sticky hands together at the thought of luring more Hansels and Gretels to their doom in their houses of candy. Food giants couldn’t do the right thing even if they wanted. They are beholden to investors. If they stopped marketing to kids or tried to sell healthier food or did anything else that could jeopardize their quarterly profit growth, Wall Street would demand a change in management. Healthy eating is bad for business. It’s not some grand conspiracy; it’s not even anyone’s fault. It’s just how the system works.

    As I discuss in my video The Role of Marketing in the Obesity Epidemic, given the constant demands for corporate growth and rapid returns in an already oversaturated marketplace, the food industry needed to get people to eat more. Like the tobacco industry before them, it turned to the ad makers. The food industry spends about $10 billion a year on advertising and around another $20 billion on other forms of marketing, such as trade shows, consumer promotions, incentives, and supermarket “slotting fees.” Food and beverage companies purchase shelf space from supermarkets to prominently display their most profitable products. They pay supermarkets. The practice is also known as “cliffing,” because companies “force suppliers to bid against each other for shelf space with the loser pushed ‘over the cliff.’” With slotting fees costing up to $20,000 per item, per retailer, and per city, you can imagine what types of foods get the special treatment. Hint: It ain’t broccoli.

    To get a sense of what kind of products merit prime shelf real estate, look no further than the checkout aisle. “Merchandising the power categories on every lane is critical,” reads a trade publication on the “best practices for superior checkout merchandising.” It was referring to candy bars and beverages. Just a 1 percent power category boost in sales could earn a store an extra $15,000 a year. It’s not that publicly traded companies don’t care about their customers’ health. They might, but like most of the leading grocery store chains, their “primary fiduciary responsibility is to increase profits” above other considerations.

    For instance, tens of millions of dollars are spent annually advertising a single brand of candy bar. McDonald’s alone may spend billions a year. Now, “the food industry is the biggest spender on advertising of any major sector of the economy.”

    “Reagan-era deregulatory policies removed limits on television marketing of food products to children.” Now, the average child may see more than 10,000 TV food ads a year, and that’s on top of “the marketing content online, in print, at school, at the movies, in video games, or at school,” or even on their phones. “Nearly all food marketing to children worldwide promotes products that can adversely affect their health.”

    Besides the massive early exposure and ubiquity, food marketing has become “highly sophisticated. With the help of child psychologists, companies began to understand the factors that unconsciously influenced sales. They found out, for example, how to influence children and get them to manipulate their parents.” Packaging was designed to best attract a child’s attention, and then those products are placed at their eye level in the store. You know those mirrored bubbles in the ceilings of supermarkets? They aren’t just for shoplifters. Closed-circuit cameras and GPS-like devices on shopping carts are used to strategize how best to guide shoppers toward the market’s most profitable products. Behavioral psychology is widely applied to increase impulse buying, and eye movement tracking technologies are utilized.

    The “unprecedented expansion in the scope, power, and ubiquity of food marketing…coincided with an unprecedented expansion in food consumption in predictable ways.” Some techniques have “skyrocket[ed] from essentially zero to multi-billion-dollar industries” since the 1980s, including “product placement, in-school advertising, event sponsorships.” This led one noted economist to conclude that “the most compelling single interpretation of the admittedly incomplete data we have is that the large increase in obesity is due to marketing.” Yes, innovations in manufacturing and political maneuvering led to a food supply bursting at the seams with close to 4,000 calories a day for us all, but it’s the advances in marketing manipulations that try to peddle that surplus into our mouths. 

    I think the natural reaction to the suggestion of the power of marketing is: I’m too smart to fall for that. Marketing works on other people, but I can see through it. But that’s what everyone thinks! For a splash of cold water to shake us all out of this delusion, I next bring you some data: The Role of Food Advertisements in the Obesity Epidemic. 

    Also, for both the role of marketing and food advertisements, check out Friday Favorites: The Role of Marketing and Food Advertisements in the Obesity Epidemic.

    This is the seventh in an 11-video series. If you missed any of the first six, check out the related posts below. 

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    Michael Greger M.D. FACLM

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  • Here are 3 major reports that could drive the stock market in the week ahead

    Here are 3 major reports that could drive the stock market in the week ahead

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    U.S. flag is seen hanging on New York Stock Exchange building on Independence Day In New York, United States on America on July 4th, 2024. 

    Beata Zawrzel | Nurphoto | Getty Images

    Wall Street finished higher for the holiday-shortened trading week, with tech stocks leading the way.

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  • My Secret for Making THE Perfect Aperol Spritz in Seconds (Everyone Loves Them!)

    My Secret for Making THE Perfect Aperol Spritz in Seconds (Everyone Loves Them!)

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    We independently select these products—if you buy from one of our links, we may earn a commission. All prices were accurate at the time of publishing.

    If there’s one drink that’s my go-to for summer, it’s an Aperol spritz. I usually order one whenever I dine at an outdoor cafe or restaurant because it immediately transports me back to the piazzas of my favorite vacation destination, Italy, and I can almost ignore the fact that there’s an NYC garbage truck crushing awful-smelling waste just 10 feet away from my table. What I can’t ignore, however, is the fact that I’m paying double what I’d be charged in Italy — and I’m not even getting a free side of olives and potato chips. 

    This brings me to my next point: I could buy all the fixings to make spritzes at home — Aperol, Prosecco, club soda, and an orange for garnish — but that can get costly and even wasteful. I live alone, and unless I’m having friends over and fixing drinks for them, chances are good that the unused portions of Prosecco and club soda will sit in my fridge for days and lose their fizz. Thankfully, I found the ultimate solution when I was offered the chance to try the Aperol Spritz Ready to Serve.

    What Is Aperol Spritz Ready to Serve?

    Aperol Spritz Ready to Serve is a pre-made Aperol spritz that comes in single-serve glass bottles that are sold in packs of four for $20. Basically, the only work you have to do is pop open the top, pour the cocktail into a glass of ice, and add an optional orange slice. You’ve created a foolproof spritz in seconds, and you don’t have to worry about getting the measurements right or having large bottles cluttering up your countertop and your fridge. 

    Why I Love Aperol Spritz Ready to Serve

    Opening a bottle of Aperol Spritz Ready to Serve makes me feel like a master mixologist. Each glass I pour is absolutely perfect, every single time: Crisp, refreshing, infused with orange, and slightly bitter (aren’t we all?). But what I really love is that Aperol Spritz Ready to Serve is ideal for those who live solo and in small spaces. Rather than having to find a spot for full-sized bottles of Prosecco, Aperol, and club soda, I can keep a stash of four mini cocktails chilling in my fridge, with plenty of room to spare. I also appreciate that I can enjoy a single glass and not have to deal with leftover opened bottles of sparkling ingredients going flat. 

    While Aperol Spritz Ready to Serve may seem best suited to summer, I’m keeping it stocked in my apartment all year round. It saves me both time and money, and the cocktails make any occasion feel more special, whether I’m having a holiday get-together with friends or relaxing on my rooftop, dreaming of a holiday in Italy. 

    Buy: Aperol Spritz Ready to Serve, $19.99

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    Mark Marino

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  • Why This “So Refreshing” Cocktail Has Been So Beloved for Almost a Century

    Why This “So Refreshing” Cocktail Has Been So Beloved for Almost a Century

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    Rachel PerlmutterCulinary Producer

    Rachel Perlmutter is a recipe developer, food stylist, and culinary producer at The Kitchn. Originally from Houston, Texas, she spends her free time trying to perfect kolaches and breakfast tacos that taste like home. Rachel currently lives in Brooklyn with her partner, dog, cat and rabbit, where they all share a love of seasonal local produce.

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    Rachel Perlmutter

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  • Reese Witherspoon’s Watermelon Margarita Is So Delicious, I’m Definitely Making It for the Fourth of July

    Reese Witherspoon’s Watermelon Margarita Is So Delicious, I’m Definitely Making It for the Fourth of July

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    We independently select these products—if you buy from one of our links, we may earn a commission. All prices were accurate at the time of publishing.

    Reese Witherspoon is known for her acting chops, thriving online book club, and successful media company, but apparently the woman also knows her stuff when it comes to making a cocktail. Witherspoon shared on her Instagram a recipe for her favorite watermelon mint margarita, and it looks like the perfect refreshing cocktail we need this summer. So does it live up to the hype that this actress is giving this drink? We decided to give it a try and see if it’s worth pulling out the recipe for our summer barbecues this year.

    How to Make Reese Witherspoon’s Watermelon Mint Margarita

    Add cubed watermelon to a blender and blend until the fruit has been pureed.

    In a cocktail shaker, add the pureed watermelon with tequila, lime juice, agave nectar, and mint. Toss in ice cubes, then seal and shake the drink for at least 15 or 20 seconds, or until the cocktail shaker is very cold to touch on the outside.

    Fill a short drinking tumbler with ice. Strain the margarita into the glass, then garnish with a slice of watermelon and lime.

    This drink was exactly what I hoped for from a watermelon margarita recipe. It was refreshing, tasty, light, and the kind of thing I would want to sip on when it’s the summertime. The taste of this margarita is exactly what I would envision a bright summer day to taste like: fresh watermelon and mint with freshly squeezed lime juice. The tequila is not too overpowering, making this drink very drinkable. Perfect for summer happy hours or barbecues.

    However, while I did enjoy this margarita, I do have two small edits to the recipe that I think would very much enhance this dish. Because this is a margarita, I think adding in at least 1/2 ounce or 3/4 ounce of orange liqueur, like Triple Sec or Cointreau, would elevate this drink significantly. This would also mean decreasing the amount of agave nectar in each cocktail, given that the orange liqueur and the fresh fruit will help sweeten it enough already.

    Otherwise, I would highly recommend shaking up this drink this summer, and can whole-heartedly agree that Witherspoon knew what she was doing when dreaming up this one.

    Tips for Making Reese Witherspoon’s Watermelon Margarita

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    Kiersten Hickman

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