Instead of drawing water and nutrients from soil, hydroponic produce is grown with the roots submerged in nutrient-fortified water. Aeroponics is a related method in which the roots hang in the air and are regularly misted with water and nutrients.

One benefit of hydroponic farming is that it allows large amounts of produce to be grown on a relatively small piece of land and in places where traditional farming would be untenable, such as urban centers, or limited by geography and weather, such as in Alaska.

Hydroponic growers help satisfy demand for local produce in areas that are not well-suited for traditional farming. But even in farm-friendly regions where rain and sun are plentiful, storms, heat waves and unexpected freezes can cause unpredictable and costly crop losses, to which indoor farmers are largely immune.

Hydroponic crops also are less susceptible to weeds, insects and other pests, which means the plants can be produced without herbicides and pesticides.

All this has made hydroponics one of the fastest growing sectors of the agriculture industry, with more traditional growers investing in hydroponics as a supplement to existing operations or switching over entirely.

Another potential advantage of hydroponic farming is the degree of control the grower has over the conditions to which plants are exposed and the ability to precisely replicate those which produce better results.

However, not every plant does equally well in hydroponic growing conditions, at least with current technology. Lettuce and other leafy greens, herbs, tomatoes, peppers, cucumbers and strawberries are the most commonly grown hydroponics.

Hydroponic operations, which often use sophisticated water recycling systems, may use up to 90 percent less water than traditional farming, depending on the location. While traditional farms in water-stressed areas rely heavily on irrigation and use far more water than hydroponics, other areas get most of their water from rain.

Some hydroponic growers also rely on electric grow-lights instead of the sun. This allows growers to artificially extend the length of the day and manipulate light wavelengths to increase yield and productivity year-round.

Not having to till and plow fields can reduce the amount of greenhouse gasses associated with crop production. However, the overall carbon footprint of a food depends on additional factors, such as the distance it is transported after harvest, which complicates comparisons of environmental impact between hydroponically and soil-grown crops.

How Do Hydroponics Compare Nutritionally?

Comparing the nutritional content of hydroponic and soil-grown produce is challenging, and research involving direct comparisons is limited. Both traditional and hydroponic farmers can influence the nutritional content of produce by adding nutrients to the soil or growing medium. But the nutritional composition of a fruit or vegetable also depends on the particular cultivar or variety, the degree of ripeness when harvested and the storage period after harvest.

With hydroponics, there is no danger of plants absorbing heavy metals that may be in the soil. On the other hand, growing vegetables in soil may yield benefits that we don’t yet fully understand. Raw produce can be a source of beneficial probiotic soil-based bacteria, for example. Although it’s not yet clear to what extent this can be replicated indoors, commercial hydroponic growers are experimenting with techniques that foster a healthy and diverse microbiome.

What about Flavor?

Although you may think sun and soil are essential for good flavor, the factors that influence flavor — including air temperature, humidity, the amount and color spectrum of light-nutrient availability and moisture — can be precisely controlled and more reliably replicated in a hydroponic environment.

As with nutrient content, the flavor of produce depends on the variety and freshness, as well as growing conditions. “We can breed for flavor, texture and nutrition instead of mold resistance, pest resistance or shelf life,” says Alina Zolotareva, RDN, marketing manager for AeroFarms, an aeroponic grower of salad greens in Newark, N.J. “And because hydroponics can move the farms to the people, it can give people access to fresher produce.”

But the hydroponic produce at a local grocer isn’t necessarily grown locally. Although hydroponics make it possible to grow fruits and vegetables anywhere, the largest hydroponic growers in the U.S., accounting for about half of hydroponic sales, are clustered in Pennsylvania, California, New York, Vermont and Wisconsin.

The Organic Debate

Because hydroponically grown fruits and vegetables can be produced without the use of pesticides or herbicides, many hydroponic growers are pursuing organic certification, which allows produce to be sold at a higher price point. But many traditional organic farmers are crying foul.

“[Hydroponics] is a really efficient model of production,” says Mark Kastel, co-founder of The Cornucopia Institute, a public interest group supporting sustainable and organic agriculture. “If unchecked, hydroponics could squeeze out traditional organic farmers to the extent that consumers wouldn’t really have the option to buy soil-grown organic produce.”

“Allowing hydroponic produce to be certified as organic is completely contrary to the values of the organic movement,” Kastel says. “Improving and maintaining the health and biodiversity of soil is one of the core principles of organic growing. How can you be stewarding the soil if there is no soil?”

Proponents of organic hydroponics argue that hydroponic systems are aligned with the principles of stewardship, conservation and environmental harmony outlined in the Organic Foods Production Act of 1990. They also view new technology, such as hydroponics, as essential to meeting the demand for organics.

In 2010, the National Organic Standards Board, or NOSB, a federal advisory board, petitioned the United States Department of Agriculture to make hydroponically grown vegetables ineligible for organic certification, a recommendation that the USDA has so far declined to adopt.

“The USDA has made it clear that hydroponics will be allowed to be certified organic,” says Nate Lewis, farm policy director for the Organic Trade Association. “At the very least, we’d like to see a rule that requires hydroponically grown vegetables to be labeled as such.”

In April 2017, the NOSB convened and discussed potential recommendations it would provide the USDA for organic certification of hydroponic systems. No decisions were made, and the Crops Subcommittee will be developing a proposal on this topic for a meeting in the fall.

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Ginger shots are usually made with one to two ounces of fresh ginger juice, and a pound of ginger will produce about 12 ounces of juice. Will a daily ginger shot detox your organs, kill cancer cells or melt away fat? Of course not. But ginger does have some legitimate health benefits. 

Ginger root contains small amounts of various vitamins and minerals but not enough to have a substantial impact on your overall nutrition. However, ginger also contains compounds called gingerols that translate to anti-inflammatory activity in the body. If your ginger shot also contains a substantial amount of sugar, which tends to be pro-inflammatory, it might end up being a wash.

Gingerol also has anticoagulant properties, reducing the tendency of the blood to form clots. Consuming natural foods with these properties can help reduce the risk of heart attack and stroke. However, they also could interact with prescription anticoagulants like Warfarin to cause excessive bleeding. Even if you’re not on any meds, too many ginger shots could potentially cause you to bruise more easily. Ginger shots probably are best avoided by those who take prescription blood thinners, those with any kind of bleeding disorder, and anyone planning surgery or dental procedures.

Ginger also is possibly effective in reducing and preventing nausea, so a ginger shot might settle a queasy stomach. On the other hand, some people report heartburn or mild stomach discomfort after consuming ginger.

Fresh ginger juice has a little too much kick for most people to enjoy straight up, so it’s usually blended with other ingredients such as lemon juice, honey, turmeric or, in Gomez’s case, yerba mate tea. Bottoms up!

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The impact of individual dietary factors, such as fat, fiber and meat, on recurrence of various types of cancer has been evaluated in studies with mixed or inconclusive results. Overall, diets rich in plant foods have a positive impact on health and quality of life after cancer treatment, due in part to their nutrient density and fiber, which also help promote a healthy weight. Research suggests a lower risk of cancer recurrence in people who eat a diet rich in fruits, vegetables and whole grains, with most dietary fat coming from nuts and olive oil, and low amounts of red and processed meats, refined grains and full-fat dairy.

Although many people with a history of breast cancer worry about the potential cancer-promoting effects of dairy or soy, evidence indicates that neither low-fat dairy nor soy is linked to increased risk of recurrence — and moderate consumption of minimally processed soy foods may even have a protective effect. Similar questions have been raised regarding the effect of phytoestrogens in soy or flax on prostate cancer recurrence. The best available evidence suggests consuming soy and flaxseed may have a protective benefit, but people with a history of prostate cancer should avoid consuming large amounts of flax oil.

Restrictive dietary regimens, such as The Gerson Therapy or macrobiotic diets, are often promoted to people with a history of cancer. However, there is no evidence that such approaches reduce the risk of recurrence any more than a prudent dietary pattern.

The American Cancer Society recommends working with a registered dietitian nutritionist during and after cancer treatment for individualized nutrition care. Research suggests working with an RDN is especially helpful for healthy weight management, particularly in individuals with past female reproductive cancers.

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Enter brewed cacao: a trendy new beverage that delivers all the benefits and decadent flavor of dark chocolate, without any of the sugar and fat, and virtually no calories.  It also is low in caffeine, so you can enjoy it any time of day. Brewed cacao is, however, rich in theobromine, another mild central nervous system stimulant. Some users believe that theobromine boosts their mental energy and focus but without the nerve-jangling effects of caffeine. Controlled trials have so far failed to support these impressions.

Cacao beans intended for brewing are processed a bit differently than those destined to become chocolate or cocoa powder. Instead of the slow “baking” required to bring out the optimal flavor for chocolate, the beans are handled more like coffee beans and roasted quickly at high temperatures. Less processing means more of the beneficial compounds are preserved. As a result, a cup of brewed cacao contains roughly twice the amount of the flavonoids catechin and epicatechin as a square of dark chocolate or cup of hot cocoa.

With its rich, chocolatey aroma and full-bodied mouthfeel, brewed cacao is somehow more than just a beverage. Although an afternoon cup of tea or coffee often feels incomplete without a little something to go with it, a cup of brewed cacao, with or without a splash of milk, feels completely satisfying. As an after-dinner offering, it easily replaces both coffee and dessert.

To brew the perfect cup, place 2 tablespoons of ground cacao beans in a French press, add 1 cup of boiling water, stir briefly, and steep for 5 to 7 minutes before pressing. Brewed cacao can be enjoyed black or with milk or nondairy creamer and a touch of sweetener, if desired.  The spent grounds make great compost, and your compost heap will smell wonderful.

The ground beans also are edible — and quite tasty! Try blending a spoonful into a smoothie, stirring into hot cereal or sprinkling over ice cream.  

Although newly trendy, brewed cacao actually is nothing new. It was enjoyed by native Central Americans as early as 1,500 BC. So, the next time you get a craving for chocolate, instead of heading for the candy counter, why not make like the ancient Mayans and brew up a cup of cacao?

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This decade-by-decade guide outlines the most effective ways to protect bones at every age.

Teens

Even as teens approach their mature height, bone density and thickness continue to increase. Maximizing bone mineral acquisition early in life increases lifetime peak bone mass and reduces the risk of osteoporosis in later years; calcium enhances the rate of bone mineral acquisition by providing more of the material of which bones are made.

Unfortunately, only 42 percent of teenage boys and 13 percent of teenage girls get the recommended daily intake of 1,300 milligrams per day of calcium.

In the past, studies reported an inverse correlation between soda consumption and bone mass, leading many to hypothesize that phosphoric acid or other components of soda (such as caffeine) may rob bones of calcium. Subsequent research suggests the negative effect on bone density is more likely due to the fact that teens who drink more soda also consume less calcium.

Recommendation: Make the most of the rapid-rate bone formation throughout teen years by prioritizing foods rich in calcium and vitamin D.

Twenties

Bone mass continues to increase but the rate of bone acquisition begins to slow. Research has found that white women may reach their peak lifetime bone mass up to five years sooner than non-white women and men.

Young adults are often living on their own for the first time and are more likely to engage in behaviors such as binge drinking and social smoking, both of which can have a lasting and detrimental impact on bone health.

Extreme dieting and other disordered eating patterns also are common at this age, especially in women. Weight loss leads to bone loss, and a history of repeated weight loss, such as yo-yo dieting, has been shown to have negative consequences on bone density later in life.

Recommendation: Continue to prioritize adequate calcium and vitamin D intake and avoid behaviors such as smoking, excessive drinking and yo-yo dieting, which rob the bones of minerals.

Thirties

By the early 30s, bone density has typically reached its maximum level. Osteoporosis prevention shifts from maximizing bone acquisition to maintaining strong bones.

Caffeine consumption typically increases throughout adulthood and is known to increase urinary calcium losses. The effect is relatively modest, however; a cup of coffee may result in the loss of 2 to 3 milligrams of calcium. As long as calcium intake is adequate, the effect on bone density appears to be minimal.

Epidemiological surveys also report a positive association between fruit and vegetable consumption and bone health later in life. Unfortunately, those in their 30s consume less produce than any other age group.

Recommendation: Focus on eating more fruits and vegetables as part of a balanced diet. Heavy caffeine consumers should take extra care to ensure adequate calcium consumption.

Forties

Total body bone density continues its gradual decline in both men and women throughout this decade. Weight-bearing exercise, which includes walking, jogging, tennis, hiking and strength training (but not swimming or biking), is one of the best ways to preserve bone mass.

Although the percentage of Americans who exercise regularly has increased over the last decade, only one in four men and one in five women in their 40s get the recommended amount of exercise.

Typical sodium consumption for Americans in their 40s is about 3,800 milligrams per day, which is 65 percent higher than the recommended daily consumption of 2,300 milligrams per day. In addition to increasing the risk of hypertension, high-sodium diets also increase urinary calcium excretion.

Recommendations: Develop or maintain a regular exercise habit, and be mindful of sodium consumption. Increase intake of fruits, vegetables and calcium-rich foods to mitigate the effects of sodium on blood pressure and bones.

Fifties

Although bone mass may decline gradually in both men and women after the early 30s, the rate of bone loss begins to accelerate dramatically when women reach menopause. The recommended daily intake of calcium for adults over 50 increases from 1,000 milligrams per day to 1,200 milligrams.

Not surprisingly, women older than 50 are more likely than men or younger women to take calcium supplements, but several recent studies have found supplementation is of questionable benefit.

Other researchers have noted an association between calcium supplementation and increased risk of cardiovascular events in men and women over the age of 50.

Recommendation: Get as much calcium as possible from foods rather than supplements. Leafy greens, such as kale and collards, are good sources of calcium and are rich in vitamin K, which helps move calcium out of the arteries and into the bones. However, some greens (particularly spinach and beet greens) also are high in oxalates, which can bind to calcium. Oxalates can be significantly reduced by cooking.

Sixties

Bone density continues to decline gradually in men and resumes a more gradual decline in postmenopausal women. As total bone density decreases, fracture rate increases, but fracture risk also increases with age, independent of bone density. A 65-year-old woman is at greater risk of fracture than a 45-year-old woman with the same bone density.

Sixty-eight percent of men and 61 percent of women in their 60s fail to get the recommended daily amounts of calcium. Declining protein consumption among older adults also may contribute to bone density loss.

Although protein consumption can increase urinary calcium excretion, it also increases absorption of calcium from the gut. A prospective study of healthy men and women in their 60s found that higher protein intake was associated with higher bone density and that supplementation with calcium provided no bone benefit in those with low protein consumption.

Recommendations: Increasing protein consumption can help preserve bone density and muscle mass. Develop an exercise routine that includes activities to improve balance and flexibility.

Seventies and Beyond

Age-related osteoporosis occurs at approximately 70 years old and beyond. One in five women have osteoporosis by age 70; by age 90, it’s one out of every three.

Although men never completely "catch up" with women in terms of osteoporosis risk, those living into their 80s and 90s are increasingly likely to be affected.

Elderly men and women who consume more protein have a reduced rate of bone loss. Vitamin D deficiency, which accelerates bone loss, affects 80 percent of those older than 70.

Recommendations: Although calorie needs decline with age, protein requirements do not. Be sure to keep protein intake up, even as total food consumption diminishes. A vitamin D supplement may be necessary to maintain adequate levels.

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Defined as a blood sodium level below 135 mmol/L, hyponatremia can occur when excessive amounts of sodium are lost through urination, perspiration, vomiting or diarrhea. Health conditions or medications that cause fluid retention can cause dilutional hyponatremia, as can overhydration. Medical conditions that may lead to hyponatremia include congestive heart failure, kidney disease and syndrome of inappropriate anti-diuretic hormone. Psychogenic polydipsia, which leads sufferers to drink excessive amounts of water, affects up to one-fifth of psychiatric patients and frequently leads to hyponatremia.

Overhydration leading to hyponatremia used to be more common among athletes, particularly women, who participated in long-duration sports, such as marathons. Nowadays, those who engage in endurance sports — as well as emergency personnel who treat athletes in distress — are far better equipped to prevent, recognize and manage hyponatremia, thanks to a concerted effort in the sports medicine community to raise awareness about risks and signs of overhydration.

But there are other at-risk populations who health professionals may encounter. Being alert to risk factors and early signs of hyponatremia enables nutrition professionals to work with the entire health-care team to avert acute problems. Diuretics may deplete the body of electrolytes, including sodium. SSRI antidepressants, such as paroxetine, which increase levels of antidiuretic hormone, have led to life-threatening cases of hyponatremia, especially in elderly patients.

Intravenous administration of hypotonic fluids, which contain a lower concentration of sodium than blood, in excessive quantities or speeds can cause dilutional hyponatremia. This occurs most commonly in children and the elderly. Patients receiving parental nutrition also need to be closely monitored, and their orders adjusted as needed, to maintain proper fluid and electrolyte balance.

Avoiding dietary sodium, on the other hand, is unlikely to cause hyponatremia. Even a very low-sodium diet (500 to 1,000 milligrams/day) should maintain adequate levels under normal circumstances.

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Although Alexander Fleming's discovery of antibiotics in 1928 was a game changer in the ability to treat routine bacterial infections, the development of antibiotic resistance is a natural and inevitable phenomenon. In his acceptance speech for a 1945 Nobel Prize, Fleming noted, "It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them."

It was only five years later in 1950 when researchers discovered putting low levels of antibiotics in the feed of healthy animals (specifically poultry) increased the speed at which they grew, resulting in higher production yields at lower costs. Under pressure to provide meat for an expanding urban population — and still feeling the stings of angry protests over high meat prices after World War I and farming struggles during World War II — meat and poultry producers quickly adopted the practice.

However, adding antibiotics to the feed of healthy animals also exposed disease-causing microbes present in these animals to non-lethal doses of antibiotics — precisely the scenario that accelerates the survival and growth of resistant bacteria. Illnesses due to resistant bacteria are more prevalent among those who work in concentrated animal feeding operations, but these "super-bugs" don't necessarily stay on the farm. Research shows they can end up in the soil, water and air surrounding meat-growing operations, where they may drift to adjacent farms, waterways or to a neighbor's backyard vegetable patch. Resistant bacteria (as well as antibiotic residue) also are present in the manure of antibiotic-fed animals, which often is used as fertilizer. And although all soil contains resistant bacteria, soil amended with manure from antibiotic-fed animals is more likely to contain bacteria resistant to multiple drugs and which require higher doses of antibiotics to kill.

In addition, resistant bacteria can be readily transported (by an infected person or simply on a farm worker's shoes or car tires) to other environments, including hospitals and clinics. Resistant strains of staphylococcus and E. coli have become medical menaces in hospitals and day care centers, putting at risk those whose natural defenses are low. Without effective treatments, health-care workers can do little but try to manage the symptoms of the sick and attempt to prevent transmission to new patients.

Part of what makes the antibiotics issue unique is that the risk of resistant bacteria affects everyone, regardless of personal dietary choices — making it not as much a food safety issue, but an environmental and public health issue. Avoiding meat from animals that were treated with antibiotics won't protect individuals from antibiotic-resistant bacteria, but that doesn't mean consumers aren't trying. In a 2012 Consumer Reports poll of American consumers, 86 percent said they agreed that local supermarkets should carry meat and poultry raised without antibiotics and more than 60 percent said they'd be willing to pay more for it.

Today, a vast majority of grocery stores now carry meat raised without antibiotics. Niman Ranch, the producer that supplies pork to the national Chipotle restaurant chain, raises its pigs without antibiotics except as needed to treat disease in individual animals. McDonald's Corporation announced its commitment to eliminate use of antibiotics important to human medicine by 2017, while the two largest chicken producers in the country, Tyson and Purdue, now offer chicken raised without antibiotics — accounting for about 9 percent of total sales.

But turning the tide, or even just holding the line, on antibiotic resistance may require more than a few boutique brands of chicken and bacon. In fact, despite an increased demand for "antibiotic-free" meat, the most recent available figures indicate sales of antibiotics to American livestock producers increased 16 percent from 2009 to 2013, including those antibiotics considered most critical to human medicine.

Raising more animals without antibiotics is a good thing, according to Patrick Baron, a fellow at the Johns Hopkins Center for a Livable Future who specializes in the epidemiology of antibiotic resistance. "But we've gone so far down this road that turning the ship around will take a much broader and more sustained effort," he says. "Subtracting a million pounds a year from a 30-million pound a year system can only do so much."

Antibiotics Reduction Legislation: Yeas and Nays

In 2007, U.S. Rep. Louise Slaughter (N.Y.) made antibiotic resistance her signature legislative issue with the Preservation of Antibiotics for Medical Treatment Act (H.R. 1150), or PAMTA. [Its respective bill in the Senate was the Preventing Antibiotic Resistance Act (S. 1256).] First introduced in 1999, the bill amended the Federal Food, Drug and Cosmetic Act to require comprehensive risk assessments and for drug manufacturers to demonstrate that there would be no harm to human health through certain uses of antimicrobials. The bill eventually garnered support from 450 medical, consumer advocacy and public health groups including the American Medical Association and the World Health Organization — as well as intense oppositional lobbying.

Anti-legislation arguments included concerns for animal health and welfare expressed by the American Veterinary Medical Association, which said PAMTA eliminated "the ability for veterinarians to prevent disease through the judicious use of antimicrobials" and pointed out that there were regulations and requirements already in place that oversee the use of antibiotics in agriculture.

Mike Apley, DVM, PhD, professor in clinical sciences at Kansas State University in Manhattan and beef production consultant, agrees. "We want drugs that are effective for humans and animals and harm neither, which is what the regulatory processes do," Apley says. "We don't want legislation that would ultimately result in circumventing regulation altogether. For example, completing qualitative risk assessments for every single drug would be physically impossible within the [PAMTA] bill's two-year timeline."

Some opponents warned that an accelerated reduction or elimination of prophylactic antibiotic use could destroy the livelihoods of meat and poultry farmers by driving down efficiency and driving up production costs — and by extension, meat and poultry prices. "Further limiting or eliminating animal antibiotic use for livestock will have negative economic and animal health consequences," according to an American Farm Bureau Federation issue brief.

Another argument is that scaling back antibiotic use in livestock is not the only means to decelerate the natural development of resistance. Up to 80 percent of the antibiotics sold today are for agricultural use; however, direct administration of antibiotics to humans also plays a role in the development of resistance. Patients demand (and physicians prescribe) antibiotics for conditions that are not caused by bacteria, such as colds, flus and unconfirmed ear or sinus infections. People may stop taking antibiotics when they begin to feel better rather than finishing the prescribed course as directed, thus eliminating the weaker bacteria but potentially allowing the stronger to survive and mutate. And pharmaceutical residues in wastewater are not always adequately removed by water treatment programs — another factor contributing to conditions that favor the emergence of drug-resistant bacteria.

About the only thing everyone does agree on that there is a significant need for committed resources to research the systemic complexities of antibiotic-resistant bacteria and the practices that create the greatest human health risk. The PAMTA bill died in committee in 2013. That year, the U.S. Food and Drug Administration issued guidelines encouraging meat producers to voluntarily phase out routine use of those antibiotics most important in human medicine.

Characterizing the FDA's guidelines as "woefully inadequate," Rep. Slaughter announced the re-introduction of PAMTA (H.R. 1552) in March 2015 [the Preventing Antibiotic Resistance Act (S. 621) was re-introduced in the Senate as a separate bill], in addition to plans to reintroduce the Delivering Antimicrobial Transparency Act, or DATA Act, which requires drug manufacturers to disclose how antimicrobials are used in food-producing animals, and large-scale poultry and livestock producers to detail the type and amount of antibiotics in their feed.

Days later, the White House released the National Action Plan for Combating Antibiotic-Resistant Bacteria, a five-year roadmap requiring "sustained, coordinated and complementary efforts of individuals and groups around the world, including public and private sector partners, health-care providers, health-care leaders, veterinarians, agriculture industry leaders, manufacturers, policymakers and patients." In addition, the U.S. Department of Agriculture's National Institute of Food and Agriculture announced more than $6.7 million in funding for research programs across the country to develop mitigation strategies for antimicrobial resistance.

"Antibiotic resistance is the most pressing public health crisis of our time," wrote Rep. Slaughter in a statement. "Both the American people and the U.S. government need to give this issue the attention it demands."

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Despite an image associating co-ops with back-to-nature, collectivist sensibilities of the 1970s, American food cooperatives actually were born of the Great Depression. Consumers had little cash and many local groceries were shuttered, leaving communities with limited access to fresh food. Families pooled resources in order to buy in volume, direct from wholesalers. By the end of the 1930s, there were approximately 600 well-organized food cooperatives across the country.

In the 1940s and 1950s, as a rebounding economy coincided with a seismic shift in the retail food industry, the first self-service grocery stores (antecedents of today’s supermarkets) brought lower prices and a bigger selection. Nearly all of the original Depression-era co-ops went the way of the Model T and disappeared.

In the 1970s, a new co-op movement took shape — this one fueled more by idealism than necessity. Organic farming, vegetarian diets and communal living were hip, and conventional grocery stores were suddenly out of sync. For a generation looking to buck the establishment, food cooperatives offered a way to practice communitarian ideals and fuel alternative lifestyles, and the number of food co-ops swelled again to about 500 nationwide.

Throughout the 1980s, well-capitalized grocery chains specializing in local and organic foods sprouted like mushrooms. And as vegetarian and organic options became increasingly available, cheaper and more slickly merchandized, the need for food co-ops once again seemed less relevant. By the end of the millennium, half of the second-wave co-ops had closed their doors.

Today, food co-ops once again are on the rise in numbers and revenues. This latest growth spurt appears to be fed by a number of cultural forces. “The notion that diet is a primary driver of health and wellness has become truly mainstream,” says C.E. Pugh, chief operating officer of the National Cooperative Grocers Association. More shoppers are shunning highly processed, industrial foods in favor of products that are (or at least seem) more wholesome, while today’s “conscious consumer” wants to know where and how their food is produced. Many even are willing to spend a bit more in order to support the environment, animal welfare and small local farmers while keeping dollars within the community.

“There is a growing thirst among consumers to vote with their dollar and to buy from places where business is being done fairly,” says Dan Nordley, executive director of the Cooperative Grocers Network.

Operating at the intersection of such interests are co-ops. However, these are not your grandmother’s (or her grandmother’s) food cooperatives. The worker/member model, in which every member spent a few hours a month bagging bulk raisins or operating the cash register to contribute to the cause, has all but disappeared — along with bi-level pricing for members and nonmembers and unwieldy efforts to manage by committee.

Although members still may vote on organizational policies, day-to-day operations are overseen by professional managers (often, veterans of the for-profit grocery industry) who supervise paid employees. Stores are well-lit and feature eye-catching displays, modern technology and expanded inventories. And in addition to organic produce, soy burgers, bulk grains and natural cleaning solutions, you’re likely to find a robust selection of meats, conventional produce, convenience foods and packaged goods. Don’t be surprised to see circulars and coupons, either.

But while co-ops have come to look much more like the conventional grocery stores, their tenets remain constant. All cooperatives operate under seven core principles, which state that members will decide how the co-op will operate and that any operating surplus will be shared by members. A commitment to sustainable community development is another core principle, as is a commitment to education of members and the public.

Some of these principles are costly. Compared to commercial grocers, co-ops have a higher percentage of full-time employees, a higher average hourly wage for part-time staff and more generous benefits packages. Money that could be spent on advertising and marketing may instead be spent on educational programming and outreach. And buying from small farmers and local vendors may support the community, but it often costs more than buying from mainline wholesalers.

Although they work hard to keep prices competitive, co-ops likely never will be the cheapest place to buy food. At their heart, co-ops are value-driven, not profit-driven — and success is not calculated solely in dollars and cents. “We measure many bottom lines,” says Mary Saucier Choate, MS, RDN, food and nutrition educator for the Co-Op Food Stores of New Hampshire and Vermont. “Not just the financial one, but also things like quality of life for our workers, education of our members and sustainability of our buying practices.”

As food co-ops ride this third wave of growth, those within the movement (many of whom are veterans of the second wave’s boom and bust) are thinking hard about how to avoid a third colony collapse. “In the last couple of years, the competitive landscape has changed dramatically, in a way that’s putting pressure on food co-ops,” says Pugh. “Investors are buying up and consolidating the remaining independent natural grocers. And although their early efforts to enter the natural and organic market were haphazard and ineffective, the big industry players have now gotten serious about it, expanding their offerings and launching generic organic labels. We’ll have to become more efficient and productive in order to compete.”

However, co-ops are also becoming more organized, forming coalitions such as the Cooperative Grocers Network and the National Cooperative Grocers’ Association. These meta-cooperatives allow individual co-ops to support and learn from each other, share resources and best practices and negotiate better prices from vendors while preserving their autonomy. Teaming up to get better prices from suppliers is part of that, as is sharing educational materials and operational procedures. “But the primary thing co-ops offer is local ownership and cooperative structure,” Pugh points out. “Our success doesn’t benefit investors; it goes back to the members and the community. That’s always had value and resonance — and that won’t change.”

Monica Reinagel, MS, LD/N, CNS, is the author of Nutrition Diva's Secrets for a Healthy Diet: What to Eat, What to Avoid, and What to Stop Worrying About (St. Martin's Griffin 2011).

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The very first kefir grains — a semi-solid complex of microorganisms, proteins and liposaccharides — probably arose spontaneously. The exact details of kefir's advent remain shrouded in history but it seems likely that kefir was originally discovered by nomads, who used animal skins to carry milk from their sheep or camels. The fresh milk served as a food source for microorganisms present in the animal skins, and a symbiotic colony of bacteria and yeasts (or SCOBY) eventually formed, turning the containers into natural fermentation tanks.

Although it dramatically altered the flavor and texture of fresh milk, fermentation also greatly extended its shelf life without refrigeration. Early kefir consumers learned to strain the grains out of the soured milk and use them to ferment the next batch. These living colonies — gelatinous, walnut-sized blobs resembling cauliflower florets — were carefully nurtured, often passed down through generations.

Kefir is similar to yogurt, but the two differ in several important ways. In both, lactobacillus bacteria digest lactose in milk, producing lactic acid. But kefir also involves yeasts that produce carbon dioxide and ethanol as they multiply, which means that in addition to having the tartness or sourness we associate with yogurt, kefir is also slightly carbonated and contains small amounts of alcohol. Commercially produced kefir is usually processed to remove the alcohol. Home-brewed kefir, however, can range from 0.5-percent to 2-percent alcohol, depending on how long it is allowed to ferment. As a rule of thumb, the fizzier it is, the more alcohol it contains.

Kefir may also be lower in residual lactose than yogurt. In both cases, longer fermentation allows bacteria to digest more lactose. In yogurt, however, increasing lactic acid levels lower the pH, which eventually inhibits the bacteria's activity and slows fermentation. In kefir, yeasts and their by-products buffer some of the lactic acid's acidity, allowing bacteria to continue to work on the lactose. (The bacteria return the favor by creating conditions that are favorable to yeast growth).

Kefir's reputation as a functional food extends back hundreds of years. It was traditionally believed to improve digestion, boost well-being and enhance longevity. More recently, it's been put forth as a treatment for everything from allergies to tuberculosis to heart disease, although evidence for these uses is largely anecdotal.

Modern research confirms kefir's role as a probiotic food. The beneficial microorganisms it contains inhibit the growth of pathological microorganisms (both in foods and in the digestive tract), enhance digestion of other foods, and synthetize valuable nutrients such as B12 and vitamin K. Preliminary research in vitro and in animal models also suggests possible anticarcinogenic, immune-stimulating and cholesterol-lowering effects. But with kefir, researchers face some unique challenges.

The specific health benefits of any probiotic food depends on the particular strains of bacteria or yeasts, and kefir grains host an extremely diverse population. Using electronic microscopy and genome sequencing, researchers have cataloged hundreds of different bacteria and yeasts in traditional kefir products, including numerous strains and subspecies of lactobacilli, streptoccoi, acetobacter and saccharomyces. Many are thought to be unique to kefir; several are even named after it.

Adding to the complexity is the enormous variation in kefirs from different sources. Each colony of kefir grains develops a unique microbial profile, depending on the milk in which it is grown and the ambient microbial environment where fermentation occurs. This, in turn, makes every batch of kefir unique. (Even if I share my colony of grains with you, the kefir I ferment on my counter will not be exactly the same as the kefir you brew in your kitchen.)

Traditionally produced kefir typically contains dozens of different bacteria and yeasts. Commercial producers, on the other hand, use a limited number of carefully selected species to create a more consistent product. But some health benefits ascribed to kefir may depend on the more varied cultures found in traditionally fermented kefir. Fortunately, kefir is exceedingly easy to make at home. Unlike yogurt, which must be incubated between 100 degrees Fahrenheit and 110 degrees Fahrenheit, kefir ferments best at room temperature. Simply pour any type of milk (cow, goat or sheep; non-fat, reduced-fat or whole) over the grains and leave the container on the counter for one to two days.

When the milk has thickened, pass it through a mesh strainer to remove the grains. As long as they have regular access to a fresh food supply (milk), the grains remain viable indefinitely. In fact, you could end up making the kefir faster than you can consume it. Refrigeration slows their activity, and although the grains will survive on their own for a few days between use, they will eventually starve.

Alternatively, you can store the strained grains in a small amount of milk (just enough to cover them) in the refrigerator for up to ten days. When you're ready to use them again, discard the milk they've been stored in and start over with fresh milk.

Kefir can be an acquired taste. If you enjoy drinking buttermilk, you'll probably enjoy unsweetened kefir. For those who find it too sour, it can be flavored with pureed fruit or vanilla extract, or used in smoothies. It can also be used in place of milk or buttermilk in things like muffins and pancakes and to add a sourdough-like tang to breads or pizza crust. Like any probiotic food, however, heating kefir above 110 degrees Fahrenheit or so will kill the beneficial bacteria and yeasts and nullify its probiotic benefits.

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Yet even those on the front lines of addiction research can’t quite agree on what qualifies as addiction. Witness the debate in scientific journals over whether sugar can be classified as an addictive substance or whether obesity should be added to the Diagnostic and Statistical Manual of Mental Disorders as a form of substance (food) abuse or addiction.

Advocates of treating food as a potentially addictive substance point out that palatable food and drugs like cocaine stimulate some of the same regions of the brain, and both trigger a flood of dopamine and feelings of well-being. In both cases, the euphoria is short-lived and the brain craves more. When these pleasure pathways are powerfully and repeatedly stimulated, the brain adapts and it takes more of the substance to achieve the same high. Abusers will continue to pursue that pleasure despite painful consequences.

Research done by Bart Hoebel, Ph.D., and Nicole Avena, Ph.D., at Princeton University lends support to the concept of food addiction. Like humans, rats prefer sweetened water to plain water. Once rats have habituated themselves to drinking sugar water, they exhibit symptoms of withdrawal once it’s taken away — nearly identical to those observed with other chemical dependencies — and they will binge when sugar water access is restored.

Experiments designed by neuropharmacologist Paul J. Kenny, Ph.D., at the Scripps Research Institute demonstrate that rats will continue to pursue palatable foods despite painful consequences — another hallmark of addiction. Rats will scamper away from regular rat chow when they hear a sound signaling an impending electrical shock, but rats with access to chocolate, cheesecake and sausage will keep eating those foods, even when they know a painful shock is coming.

Opponents argue that there are important differences between humans and rats, and between the world we live (and eat) in and the conditions required to induce sugar addiction in lab animals. Even those who argue for the food addiction model acknowledge that — for humans at least — it’s not sugar that pushes our buttons; it’s the combination of sugar, fat and salt. But as unpleasant as it may be to give up favorite foods, nothing like true drug withdrawal symptoms have ever been observed in dieting humans.

Treating Obesity through the Lens of Addiction
For nutrition professionals, the salient question is whether the concept of food addiction suggests more effective treatments for obesity. If food addiction is a real illness, then drugs developed to combat other addictions might offer some hope.

Drugs that block endorphin activity in the brain have been shown to reduce use of heroin, cocaine and alcohol in addicted humans. They also inhibit the consumption of appetizing food in both humans and rats. Similarly, some appetite-suppressing drugs have the bonus effect of reducing the desire to smoke.

One problem is that response to dopamine-blocking drugs depends a lot on a person’s individual baseline. In someone with elevated production of (or sensitivity to) dopamine, a drug that suppresses dopamine makes the reward less rewarding, making compelling foods a bit easier to resist. But in someone with low production of (or sensitivity to) dopamine, such a drug can suppress feelings of well-being so much that depression or even suicidal thoughts may ensue.

Further complicating matters is that obesity is sometimes characterized both by hyper- and hypo-responsiveness to dopamine. Either state, an exaggerated pleasure response to foods or a reduced ability to derive pleasure from foods, could plausibly lead to overeating. Kenny believes that the production of and responsivity to dopamine and other endorphins may change over the course of the disease, similar to the way in which the body’s production of and responsiveness to insulin changes as metabolic syndrome progresses — first surging and ultimately declining.

Although Kenny is hopeful that pharmaceutical interventions may one day be a potent weapon in the fight against obesity, he’s also quick to point out that — as with any addiction — behavioral modification is a crucial element of successful treatment.

Just as those struggling to maintain sobriety are advised to avoid bars and ex-smokers need an activity to replace the after-dinner cigarette, dieters still will need to modify behaviors and habits. But if an anti-addiction drug could safely improve the dismal success rate for dieters, it would be a welcome addition to the arsenal.

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