EDITOR’S SUMMARY: Alzheimer's, Parkinson's and ALS are widely assumed to be genetically driven—but genes account for only a minority of cases. Environmental and lifestyle factors play a primary role, operating through overlapping mechanisms: oxidative stress, chronic inflammation, mitochondrial dysfunction and misfolded protein accumulation. The gut microbiome is a surprisingly central player, with disturbances sometimes appearing years before neurological symptoms emerge. Toxic exposures including pesticides, heavy metals, aluminum and microplastics are increasingly implicated—and the dominant amyloid hypothesis in Alzheimer's research has itself come under scrutiny. Many of these risk factors are modifiable, and earlier intervention may matter more than previously understood.

“You have to die of something!” This off-the-cuff statement is often heard in response to concerns expressed about lifestyle choices. At first glance, it is hard to argue with. But while death is inevitable, not all ways of reaching it are equal. There are certain off-ramps to life’s freeway that most would avoid taking, if given the choice. Not least among those are disorders that affect mobility or the mind, like Alzheimer’s Disease, Parkinson’s Disease and Amyotrophic Lateral Sclerosis (ALS). All three of these conditions fall under the heading of neurodegenerative disease. Yet they each have a distinctive symptom profile.

The principal impact of Alzheimer’s is the erosion of memory and cognition. Parkinson’s can impair cognition, as well, although it primarily inhibits movement, and ALS (also known as Lou Gehrig’s Disease) progressively paralyzes the voluntary muscles. The experience of developing them has been powerfully portrayed on screen. Alzheimer’s was depicted both by Julianne Moore in Still Alice and Judi Dench in Iris, Parkinson’s by Michael J. Fox in STILL: A Michael J. Fox Movie, and ALS by Frances McDormand in North Country, to name a few.

Perhaps the most terrifying in terms of its rapid and relentless progression, ALS is also, mercifully, the rarest, with approximately 9.1 per 100,000 Americans currently affected. One high-profile example was physicist Stephen Hawking, who lived with the disease for more than 50 years. His case, however, is outstandingly atypical, as the average life expectancy after symptom onset is no more than two to five years. Alzheimer’s and Parkinson’s, on the other hand, though less immediately lethal, are far more prevalent. Alzheimer’s affects a staggering 1 in 9 Americans over 65, and around 1 in 300 is living with Parkinson’s. Moreover, even if the latter two may allow for longer life, the loss of memory, cognition, and physical independence raises difficult questions about the extent to which a prolonged decline is more desirable than a rapid one.

More importantly, all three conditions beg a bigger question: what is at their root, and can you reduce your risk of developing them? Much has been said about the role of genetics in their genesis, but genes account for only a minority of cases. And even where genetic factors are present, it would be more accurate to describe them as increasing your probability of receiving a diagnosis than as determining the matter with fatalistic certainty. Rare exceptions do exist. Certain inherited mutations associated with early-onset Alzheimer’s disease, for instance, as portrayed in the film Still Alice, can make the development of symptoms highly likely. In the overwhelming majority of cases, however, researchers increasingly attribute causation to an interplay between genetic susceptibility and the cumulative impact of biological and environmental stressors.

Establishing a definitive causal connection between environmental factors and the origin of disease is notoriously difficult. After all, it would be neither ethical nor feasible to expose humans to potentially harmful substances in order to observe the long-term outcomes. As a result, scientists must rely on indirect approaches: studying how toxins behave in laboratory models, tracing disease patterns across populations, and examining how specific exposures interact with known biological pathways. Even then, the sheer number of variables—genetics, age, timing of exposure, lifestyle, and chance—makes conclusive proof elusive. Nonetheless, a substantial body of epidemiological and experimental research is beginning to converge upon a striking pattern. Toxic environmental exposures such as pesticides, airborne particulate pollution, industrial solvents, and heavy metals have repeatedly been associated with processes involved in neurodegeneration.

Among the heavy metals of growing interest is aluminum. Researcher Chris Exley, who spent decades studying aluminum biochemistry at Keele University, has documented elevated aluminum concentrations in the brain tissue of Alzheimer’s patients—in some cases at levels he describes as unequivocally high. He and others have proposed that aluminum may promote oxidative stress and protein aggregation, two of the key processes implicated in neurodegeneration. While mainstream science has not reached consensus on aluminum as a causal factor, the accumulating evidence has prompted calls for further investigation. And despite their differing clinical presentations, these same processes have been observed in all three of the aforementioned diseases.

Underlying Mechanisms

One of the biological processes most consistently implicated across these diseases is oxidative stress, a state in which reactive molecules called free radicals accumulate faster than the body’s antioxidant systems can neutralize them. To understand where these molecules come from, it helps to look inside the mitochondria. Here, electrons are passed along a kind of assembly line known as the electron transport chain, in a carefully controlled sequence that enables the cell to produce energy. Factors that drive disruption include diets high in refined carbohydrates, low levels of physical activity, chronic stress, inflammation, and various toxic environmental exposures. Together, these influences interfere with how cells regulate fuel use and contribute to mitochondrial dysfunction.

One key contributor is insulin resistance. Under normal conditions, insulin signals cells to absorb glucose from the bloodstream and use it for energy. But when blood sugar levels remain consistently elevated, cells become less responsive to the cue. Glucose then builds up in the bloodstream as cells struggle to make efficient use of it. This puts a strain on cellular energy systems, compromises mitochondrial function, and increases the likelihood of oxidative stress.

Another major driver of cellular damage is chronic inflammation. Normally, it serves as a protective immune response to injury, toxins, or infection, helping coordinate the body’s defense and repair processes. However, when it becomes persistent—whether due to ongoing stress, environmental exposures, or metabolic imbalance—the signaling molecules that typically support repair start to interfere with cellular regulation. They can blunt the cells’ response to insulin, hinder mitochondrial function, and contribute to oxidative stress and cell damage.

As these changes persist, they begin to affect another critical aspect of cellular health: protein structure maintenance. Proteins must be precisely folded to function properly, and cells rely on quality-control systems to repair or remove misfolded ones. But when oxidative stress and chronic cellular strain overwhelm these systems, protein aggregates accumulate. Over time, their accumulation interferes with cellular activity, ultimately leading to neuron damage and loss.

Environmental toxins are believed to contribute to neurodegeneration precisely because they promote these overlapping processes: oxidative stress, inflammation, mitochondrial dysfunction, and impaired protein maintenance. Which disease develops in a given individual likely depends on which regions of the brain are most at risk. In ALS, genetic variants such as C9orf72 or SOD1 make motor neurons more susceptible to damage, so when stressors accumulate, these are the ones most prone to fail first.

In Alzheimer’s, variants like APOE ε4 can make hippocampal neurons more vulnerable, particularly to protein aggregation (amyloid, tau) and impaired energy metabolism—so when combined with chronic inflammation or metabolic stress, these are the ones most likely to degenerate. In Parkinson’s, the vulnerability resides in the dopaminergic neurons, due to variants like LRRK2 or SNCA. That said, with no known genetic risk, you can still develop one of the conditions if enough cumulative stressors affect vulnerable neurons in a particular area of your brain, while someone with a high-risk gene might never develop disease if biological and environmental stressors are kept to a minimum.

Emerging evidence suggests these stressors—metabolic strain, chronic inflammation, and environmental toxins—interact closely with the gut. The community of microbes that inhabits the digestive tract, known as the microbiome, plays a crucial role in regulating inflammation, supporting the immune system, and maintaining the integrity of the body’s protective barriers. The gut, in fact, functions as a central control hub, influencing the processes that set the stage for brain health or disease. Its lining is designed to allow nutrients to enter the bloodstream while keeping harmful substances out. The beneficial microbes that predominate in a diverse and healthy microbiome help maintain that lining in two important ways.

They support the production of protective mucus and ferment both dietary fiber and resistant starches to produce short-chain fatty acids like butyrate. These not only nourish the gut lining but also help support the brain’s protective barrier. When microbial diversity and beneficial bacteria are lost, the gut lining can weaken, allowing inflammatory molecules—including bacterial fragments called lipopolysaccharides—to enter the bloodstream. The systemic inflammation that follows then compromises the integrity of the blood-brain barrier, increasing oxidative stress in the brain.

Indeed, disturbances in gut function can be like the proverbial canary in the coalmine, appearing as a precursor to neurological symptoms long before their onset. They precede the motor symptoms of Parkinson’s, for example, by many years, and there is evidence to suggest they may be integral to the development of the disease itself. In animal studies, abnormal alpha-synuclein protein introduced into the gut was later detected in the brain, apparently having traveled there along the vagus nerve. In one such study, when the vagus nerve was severed, the spread did not occur.

These findings have contributed to a broader shift in how some researchers think about neurodegenerative disease. Rather than viewing protein deposits such as beta-amyloid, tau, or alpha-synuclein solely as toxic end products, some now suspect they may initially arise as protective responses to infection or as part of the body’s attempt to contain damage. To what degree these accumulations are more a symptom of pathology than a cause of it remains an active area of investigation.

The dominant theory underlying much of Alzheimer’s research—the amyloid hypothesis—has itself come under significant scrutiny. For decades, beta-amyloid plaques were viewed as the primary driver of the disease, directing the lion’s share of research funding and pharmaceutical development toward their removal. Yet drug after drug targeting amyloid has failed to meaningfully alter disease progression. In 2022, a Science investigation raised serious concerns about potential data manipulation in a landmark 2006 paper that had underpinned the hypothesis for nearly two decades. While amyloid almost certainly plays a role in the disease process, the field is now acknowledging that it may be one piece of a far more complex picture—and that researchers who emphasized metabolic dysfunction, neuroinflammation, and environmental factors were perhaps too quickly sidelined.

What You Can Do to Support Your Brain and Gut Health

So, what does all this mean for you? Your gut and your brain are in constant conversation, and you have meaningful influence over both. Start with what you put into your body: invest in a quality water filter and eat a rainbow of organic, fiber-rich foods—fruits, vegetables, nuts, and seeds. These feed the beneficial microbes in your gut and help them produce short-chain fatty acids like butyrate. Incorporate fermented products such as yogurt, kefir, sauerkraut, and kimchi—or raw milk dairy, if accessible and appropriate for you—to introduce additional helpful microbes. Foods rich in antioxidants and anti-inflammatory compounds can likewise protect neurons. For example, polyphenols in sources such as berries, raw honey, and extra-virgin olive oil help combat oxidative stress, while the curcumin in turmeric promotes the growth of new neurons by boosting Brain-Derived Neurotrophic Factor (BDNF).

Resistant starches in cooked and cooled potatoes, beans, and other legumes act as beneficial prebiotics, feeding your gut without spiking blood sugar. Build up fiber gradually, though, and pay attention to how your gut responds. If you’re dealing with conditions like small intestinal bacterial overgrowth (SIBO), certain high-fiber or fermented foods can initially worsen symptoms, and a more targeted approach may be required.

Other valuable additions to your dietary arsenal are sources of omega-3 fatty acids like flaxseed, chia, walnuts, and algae, all of which reduce inflammation and protect neurons from oxidative damage. Equally important for intestinal barrier and microbiome health are essential nutrients such as vitamin D (from sunlight, fatty fish, and eggs), zinc (found in shellfish, grass-fed and finished beef, nuts, and seeds), and vitamin A. Supplements like L-glutamine may also help maintain your gut lining, while recent research has explored the potential neuroprotective effects of the trace mineral lithium. Movement is another indispensable ally. Regular physical activity fuels your mitochondria and stimulates BDNF. Even a short 10-minute walk a few times a week can make an appreciable difference.

Sleep, too, is vital. During rest, your brain’s glymphatic system clears out the byproducts of daily activity, including damaged proteins. By protecting your sleep schedule and prioritizing restorative rest, you can strengthen both brain and gut health with minimal effort. Finally, pay attention to stress. Chronic stress directly affects blood sugar regulation, inflammation, and mitochondrial function. Approaches that help regulate the stress response—whether through lifestyle practices or, in some cases, targeted supplementation—can have far-reaching effects on brain health.

If you are experiencing health challenges despite implementing all of the above, it may be worth investigating less obvious sources of chronic biological stress. Not all harmful exposures are easy to identify. Hidden mold, lingering pathogens such as persistent viral or bacterial infections (potentially including dental sources), and electromagnetic fields can place constant strain on the systems that regulate inflammation, metabolism, and cellular repair. Microplastics are an emerging concern as well—when possible, store food and beverages in glass rather than plastic, and limit exposure to chemicals in household and personal care products, including artificial fragrances.

Aluminum exposure is also worth minimizing where practical. Common sources include aluminum cookware and foil used with acidic foods, many conventional antiperspirants, and certain antacids. Opting for stainless steel or cast iron cookware, choosing aluminum-free personal care products, and reading labels on over-the-counter medications are simple steps that may reduce cumulative contact over time. When these sources go unnoticed, they can persist for years, steadily contributing to biological changes that damage brain cells.

Grounds for Hope

On an encouraging note, your brain is shaped by how you use it and appears to be able to compensate to some extent for biological damage. A neuroimaging initiative revealed that about 30% of elderly adults had beta-amyloid plaques and tau tangles in their brains without showing any symptoms of dementia. This is explained by the concept of “cognitive reserve,” whereby the more you challenge your brain over a lifetime—through learning, problem-solving, social interaction, or acquiring new skills—the more resilient it becomes. In other words, two people with similar levels of physical brain pathology might experience very different levels of impairment. Keeping your brain active is not only enriching; it may help delay or reduce the impact of age-related cognitive decline.

Even a diagnosis does not have to mean that it’s game over. Mainstream medicine will certainly tell you that neurodegenerative disease is irreversible. But is this position justified in every case? Or could it owe something to the failure of conventional treatments to effectively target the multifactorial underlying causes? There is anecdotal evidence to suggest that, in some cases, symptoms may be amenable to reversal, particularly when addressed sufficiently early. A case in point is Dr. Judy Byrne Benjamin, founder of the Alzheimer’s Survivors Foundation, who walked coast to coast across the U.S. 14 years after being told by a doctor that there was nothing that could be done for her. Featured in an article by Apollo Health, Benjamin, who had lost a mother and four uncles to the disease, attributes her recovery to a protocol developed by neurologist Dr. Dale Bredesen and says she is one of a growing number.

The study, “Reversal of Cognitive Decline: 100 Patients,” gives credence to this idea, as a substantial portion of participants either significantly improved or stabilized in response to the same protocol. This method focuses on addressing multiple potential contributors to cognitive decline simultaneously, including metabolic dysfunction, inflammation, sleep quality, nutrition, stress, toxin exposure, and gut health. And Bredesen’s is not the only non-drug-based protocol of this kind to have produced results. In 2024, a documentary called “The Last Alzheimer’s Patient” profiled several people who experienced substantial gains by participating in a clinical trial exploring the impact of intensive lifestyle interventions on early dementia. Even in ALS, rare instances of symptom reversal have been documented. Dr. Richard Bedlack, a neurologist at Duke, has investigated 89 possible cases, of which he has confirmed 65, including that of Mike McDuff, who recovered his ability to speak and swallow within six months of taking a soy-derived peptide called lunasin.

Another natural intervention that has shown promise in all three diseases—at least in terms of slowing progression—is N-acetyl-cysteine (NAC). This compound is a precursor to glutathione, one of the body’s primary antioxidants, and an augmented form has recently been developed that is considerably more absorbable. Not all damage is reversible, of course, and since dopaminergic neurons have a much more limited capacity for regeneration, Parkinson’s symptom reversal stories tend to be less dramatic. Improvement is still possible, however, and collectively, these developments suggest that the trajectory of disease may be more modifiable than once believed. Realizing that potential, however, requires proactive engagement—and the earlier you address underlying imbalances, the greater your opportunity to influence long-term outcomes.

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EDITOR’S SUMMARY: For decades, eggs were blamed for rising cholesterol and heart disease, pushed aside in favor of processed substitutes and low-fat promises. But modern research tells a far more complicated story. Once feared as nutritional liabilities, eggs are being reexamined as one of nature’s most complete biological packages—rich in protein, choline, healthy fats, vitamins, minerals, and the nutrients needed to build, repair, and restore. From mitochondrial energy production to brain health and recovery, the egg has become a powerful example of how nutritional science, public perception, and the body’s own biological intelligence are not always in alignment.

Long before fields were furrowed, orchards planted, or livestock filled fenced pastures, you—or those whose blood and biology live on in you—searched the wild for sustenance, gathering berries, digging roots, cracking nuts, and hunting prey that demanded energy, skill, and risk. Among nature’s richest discoveries was something far easier to claim and even more complete: a hidden clutch of eggs—concentrated containers of nourishment filled with nearly every building block needed to sustain life.

When European settlers arrived in America, they carried more than tools, seed stock and a dream of freedom and prosperity—they brought with them familiar animals including the humble chicken. This was a practical and wise choice born from necessity. Cattle demanded pasture, feed, and years before reliably supporting a household. Pigs, goats, and sheep took months to mature enough to provide substantial meat. Larger livestock represented future security, but hunger lived in the present tense—and chickens were the answer.

In roughly 18 weeks hens could begin laying eggs—daily nourishment wrapped in a perfect package, asking little in return beyond scraps, forage, and shelter. Soon one hen would become many, and many would become a flock. Breakfast at sunrise prepared households for the day ahead, while protein at supper satisfied hungry bellies after long hours of work, with fresh baking helping fill the meals in between. For families settling into life in an unfamiliar land, the egg wasn’t taken for granted—it was survival—and perhaps one of the reasons America, not just early Americans, survived and thrived. From frontier cabins to farmhouse kitchens, eggs became woven into the American story. They represented abundance, resilience, health, and longevity. But nearly 200 years later, that trust began to fracture as the scientific community increasingly warned that eggs were dangerous to human health.

When the Egg Fell From Grace

The fracture began in 1968, when the American Heart Association warned that cholesterol was a major driver of heart disease and strongly advised limiting eggs to three per week. This message—and the fear behind it—began to spread: dietary cholesterol raises blood cholesterol, elevated blood cholesterol raises heart disease risk, and therefore eggs are dangerous. It was simple, easy-to-follow logic, yet it was incomplete and fundamentally misguided. Much of the evidence behind these claims came from flawed animal studies, broad correlations that failed to separate eggs from smoking, processed food, and sedentary living, or clinical trials using unrealistic intakes. Missing from the headlines—and from scientific consensus—was a critical truth: your body is capable of regulating cholesterol with remarkable precision. When intake falls, production can rise. Cholesterol is not an intruder to be kept at bay—it is something produced innately and essential for nearly every process in your body.

But fear travels faster than discernment, so egg whites were praised, yolks were discarded, and omelets turned pale. Grocery shelves became crowded with substitutes stripped of the very nutrients nature had designed into the yolk. That perfect yolk was replaced with low-quality, genetically engineered ingredients. Yet eggs were only one casualty in a much larger shift—real, whole foods across the American table were increasingly traded for manufactured imitations: eggs for Egg Beaters, butter for “I Can’t Believe It’s Not Butter,” and sugar for Sweet & Low. As nature’s nourishment was steadily exchanged by inferior imposters, Americans grew sicker, while scientists held their position.

It wasn’t until the 1990s that large studies—including major research from Harvard University—found no meaningful link between moderate egg intake and cardiovascular disease in healthy people. In 2015, the Dietary Guidelines Advisory Committee concluded that cholesterol was “not considered a nutrient of concern for overconsumption,” marking a major shift in decades of dietary guidance. Recent guidelines have taken a more cautious tone while continuing to move away from strict cholesterol limits. Still, old beliefs die hard. Even with decades of data tempering cholesterol fears, skepticism remains—which is why some researchers have taken matters into their own hands.

Recently, Nick Norwitz, a Harvard medical student with a Ph.D. in metabolic health, decided to conduct his own experiment: eat 720 eggs in one month and document what happens. The 133,200 mg of dietary cholesterol he consumed during that period did not raise his serum cholesterol or low-density lipoprotein (LDL) levels. LDL molecules help transport cholesterol through the body and have long been associated with poor health outcomes when chronically elevated. Norwitz later explained that when dietary cholesterol rises, the body can reduce its own cholesterol production through signaling between the gut and liver, helping maintain balance and internal stability.

While one experiment does not settle the question, it adds to a growing body of evidence suggesting that dietary cholesterol does not behave in the body the way it was once feared to. What is becoming clearer is that cholesterol metabolism is not a simple process of intake and accumulation—it is a dynamic, responsive system that senses what is consumed and adjusts internal production to maintain balance. This is thought to be accomplished through intricate feedback loops that science is still working to fully map. Rather than acting as a passive recipient, the body is a participant—regulating, adapting, and preserving internal stability.

Beyond the specifics, there is a more profound lesson here. The mechanisms may be newly described, but the intelligence behind them is not new at all. The body has always known how to maintain balance. Science is not discovering something entirely novel—it is catching up and putting words to a system that has been working with precision all along. To understand the parts, you must first trust the design of the whole.

A Complete Package by Design

Crack an egg and consider what rests in your hand. This is not merely food—it is potential. A concentrated source of sustenance with the raw materials needed to transform a single fertilized cell into a fully formed creature. Within that shell is the design for every bodily system and reserve of stored energy. Nothing extra. Nothing missing. Nature did not create the egg merely to be high in protein. It created it to build a body. Only when fertilized and incubated can that process unfold. Without those final two steps, the egg never becomes a living creature, though it still retains the potential to sustain you.

A single egg contains complete protein with all essential amino acids, nourishing fats, cholesterol, choline, vitamins A, D, E, B12, riboflavin, folate, selenium, iodine, phosphorus, iron, lutein, and zeaxanthin. Nearly every one of these compounds supports your tissues—from vision and immunity to hormones, metabolism, and cellular repair. Among them, choline stands out as one of the egg’s most important and abundant nutrients. Eggs are among the richest sources available, furnishing what is needed to make acetylcholine, a neurotransmitter central to memory, learning, focus, and muscular control. Choline also supports liver health, methylation, and the phospholipid membranes that form every cell in your body. For a developing baby, it helps shape the brain and spinal cord. For you, it sustains cognition and resilience. While chicken eggs get all the attention and shelf space at the store, they are only one example.

Quail eggs pack remarkable density, often offering more iron, B12, and phosphorus gram for gram. Duck eggs provide higher levels of omega-3s, more choline, and greater concentrations of fat-soluble vitamins. Ostrich eggs—equal to nearly two dozen chicken eggs—contain enough developmental fuel to launch one of the strongest hatchlings in the bird world. While they contain less vitamin E than a chicken egg, they contain more magnesium and iron. As you can see, not all eggs are created equal, but species is only part of the story.

The life of the bird shapes the content inside the shell. Store-bought and pasture-raised eggs may look identical before being cracked into a pan, yet the way hens are raised influences nearly everything found within them. The light yellow yolks of conventional eggs often come from caged hens kept indoors with limited movement, fed grain-based diets designed for efficiency rather than nutrition. These feeds may also contain pesticide-treated grains, synthetic additives, industrial byproducts, and other ingredients designed to maximize production rather than support long-term animal or human health. Cage-free hens are spared the cage, though many still live crowded indoors with little meaningful access to sunlight or open land. Free-range sounds ideal, but regulations only require some outdoor access—often a small door leading to a modest outdoor area that many birds rarely use.

Pasture-raised stands apart because hens are given abundant open space—typically more than 100 square feet per bird—to roam, scratch, peck, hunt insects, eat grasses, and live much closer to their natural design. That difference in movement, sunlight exposure, and a diverse omnivorous diet can produce eggs richer in nutrients like omega-3 fats, vitamin D, and carotenoids, often reflected in darker yolks and fuller flavor. This should not be confused with how some farmers artificially darken yolks with high-carotenoid feed like peppers or marigolds. Conversely, yolks may appear pale when hens consume diets lower in carotenoid-rich feed such as corn. In the case of yolks, appearances can be deceiving.

Fat quality is important to consider too. Conventional hens fed heavy diets of corn and soy tend to lay eggs with disproportionately high levels of omega-6 fats—particularly linoleic acid—creating inflammatory omega-6-to-omega-3 ratios that can approach 10:1 or higher. Removing soy from feed can significantly improve that balance, but labels like organic, pasture-raised, or soy-free do not automatically guarantee a healthy fat profile. Some farms replace soy with sunflower meal or oils, which remain high in omega-6, while others heavily fortify feed with flax to boost omega-3 numbers—improving ratios on paper, yet creating delicate fats that are prone to oxidation.

Labels like organic, non-GMO, soy-free, corn-free, vegetarian-fed, or omega-3-enriched each describe one piece of the picture—what the hens are fed, what they avoid, or nutrients added through feed—but none automatically speak to how the hens actually live. When both nutrition and animal welfare are addressed, pasture-raised—especially when paired with strong humane certification—represents the closest thing on the grocery shelf to the kind of egg nature intended. What these hens build in their bodies ultimately becomes fuel for yours—especially within the tiny energy systems that power every cell.

The Golden Engine

Inside every cell in your body are mitochondria—tiny structures that transform food into ATP, the currency that powers thought, movement, repair, detoxification, and endurance. When mitochondria function well, you feel alive. When they struggle, fatigue, inflammation, sluggish recovery, and mental fog often follow. This is where yolks shine. Rich in choline, B vitamins, and bioavailable cholesterol, they supply nutrients directly tied to mitochondrial membrane strength, cellular signaling, and efficient energy production. Together, these compounds help defend mitochondria from oxidative injury while supplying many of the cofactors needed for metabolism to run cleanly and consistently. What makes the yolk even more remarkable is that it arrives with its own built-in protective chemistry.

Egg yolks naturally contain antioxidants such as vitamin E, selenium, carotenoids, and phospholipids that help shield their delicate fats from oxidation. Research on omega-3-enriched eggs found that while cooking preserves total fat content, higher-heat methods—particularly frying—significantly increase lipid damage and cholesterol oxidation products, whereas boiling better preserves the egg’s fragile fats. When hens’ diets were fortified with antioxidants like vitamin E and organic selenium, oxidative stress during cooking was markedly reduced—cutting markers of fat damage by as much as 40 percent and cholesterol degradation by 12 percent. In other words, the egg is not merely rich in energy-supporting fats—it carries protective elements designed to defend those fats from breakdown. That same antioxidant profile may help protect the delicate lipid membranes that power your cells. This is why some ancestral and holistic circles call raw yolks “captured sunlight.”

The phrase, although poetic, is grounded in chemistry. Sunlight becomes plant life. Plants become seeds, greens, insects, and forage. Hens convert those sun-fed nutrients—carotenoids, tocopherols (vitamin E), selenium, healthy fats, and antioxidant pigments—into a golden reservoir of stored vitality. Within that yolk rests concentrated biological energy and a nutrient matrix built to nourish life at its most foundational level. In a sense, you are eating the sun’s energy.

Some choose raw yolks for this reason—to preserve nutrients that heat can diminish. These yolks can be blended with a quality oil, such as cold-pressed olive oil, or avocados, to make homemade mayonnaise or Caesar dressing. Others prefer gently cooked eggs, particularly soft-boiled, poached, or steamed, which strike a balance between safety, digestibility, and nutrient preservation. Either way, the lesson is the same: how you consume your eggs matters, especially if they are raw. Because raw eggs can carry Salmonella, a common food-borne bacterium that can cause gastrointestinal distress, they are best avoided by young children, older adults, pregnant women, and those with compromised health.

Raw egg whites contain avidin, which can interfere with biotin absorption. For those choosing to use raw eggs, pasteurized or carefully sourced pasture-raised eggs may offer peace of mind regarding bacterial contamination. While pasteurization is not known to significantly affect lipid quality or overall nutrition, some enzymes present in eggs may denature, which can affect the way the proteins behave during cooking.

The egg and your brain

Your brain is among the most energy-demanding structures in your body. It depends on protein, phospholipids, cholesterol, B vitamins, selenium, antioxidants, and fats to build neurons, maintain signaling, and power cognition.

Eggs, once again, supply nearly all of these nutrients. Sometimes dubbed “nature’s cognitive multivitamin,” a new study found that regular egg consumption was associated with a lower risk of Alzheimer’s disease, while postmortem examinations of individuals who frequently ate eggs revealed lower levels of toxic Alzheimer’s-related proteins in the brain. They provide complete protein for neurotransmitter creation, choline for acetylcholine and membrane health, mitochondrial cofactors for ATP production, healthy fats for neural structure, and tryptophan—a precursor that contributes to niacin (vitamin B3/nicotinamide), helping feed NAD+, one of the body’s most important molecules for energy and cellular repair. In simple terms, eggs deliver much of what your brain is built from—and much of what keeps it running. And it’s that same nutrient density that also becomes especially important when the body enters profound repair mode.

Because of their nutrient density, eggs are invaluable for physical recovery. Severe burn patients, for example, enter a hypermetabolic state in which the body urgently needs the raw materials required to rebuild skin, connective tissue, blood vessels, and damaged cells. In some recovery protocols, patients may receive up to 35 eggs daily to help support that intense repair process.

When Eggs Aren’t For Everyone

Of course, no food is universally tolerated. While eggs are among the most nutrient-dense foods available, they are also one of the more common food allergens, particularly in infants and young children. Many children outgrow an egg allergy, but some continue to react into adulthood, and others may develop sensitivities later in life. The proteins found in eggs—especially those concentrated in the whites—can trigger immune reactions ranging from mild digestive upset, skin rashes, or congestion to more serious symptoms such as difficulty breathing. You may experience a food sensitivity rather than a true allergy, with symptoms that are less immediate but still significant.

Interestingly, how an egg is prepared can make a difference. You may tolerate thoroughly cooked eggs in baked goods or other dishes more easily than raw or lightly cooked eggs because cooking alters the structure of egg proteins. This is not a golden rule, however, and if you have a known egg allergy, you should follow the guidance of your healthcare provider. If eggs seem to cause symptoms, an elimination diet followed by a careful reintroduction can sometimes help identify a problem. More formal evaluation may include skin-prick testing, blood tests that measure egg-specific antibodies, or supervised food challenges conducted by an allergist.

Another consideration is the hen’s diet. If you are allergic or highly sensitive to foods such as corn or soy, you may tolerate eggs poorly when hens are raised on feed containing these ingredients. While a true egg allergy involves the egg proteins themselves, some practitioners and consumers have observed that feed composition may influence how certain sensitive individuals respond. Research in this area remains limited, and the mechanism is not fully understood, but you may find that you tolerate eggs from hens fed soy-free and corn-free diets more comfortably.

If you absolutely cannot consume eggs, nutrient replacement becomes important. Pasture-raised poultry, wild seafood, 100% grass-fed meats, organic dairy products, and legumes can help supply protein and many of the vitamins and minerals eggs provide. Choline—one of eggs’ standout nutrients—can also be found in foods such as liver, beef, salmon, and cruciferous vegetables, though often in lower amounts. While few foods match the nutritional package of a whole egg, a thoughtfully varied diet can provide many of the same building blocks.

Bringing The Egg Home Again

In 1918, during World War I, the United States Department of Agriculture encouraged families to keep two hens per family member so they would always have fresh eggs. Their advertising slogan read: “In Time of Peace a Profitable Recreation. In Time of War a Patriotic Duty.” Today, that advice still rings true. Over the last decade, the cost of eggs has risen dramatically, with a dozen pasture-raised eggs costing anywhere from $9 to more than $15 depending on the region. While not everyone has the space, time, or ability to raise a small flock, for some people, producing their own eggs may eventually become both practical and economical.

It’s true that standard stationary coops require regular manure removal—which is excellent for the garden—to keep conditions sanitary. A small mobile coop and movable electric fencing, on the other hand, can minimize cleaning while bringing fertilization directly to the land. Chickens are also excellent recyclers and can be fed many healthy food scraps and vegetable trimmings to supplement their diet and help reduce feed costs. If you have limited space—or simply want a quieter, smaller bird—quail, a compact ground-dwelling bird that lays small nutrient-dense eggs, can also be a practical option requiring far less room than chickens.

Whatever option you choose, having access to healthy eggs can be a steady source of quality food for you and your family. But abundance naturally raises another question: how many eggs truly support optimal health? For many healthy people, one to three eggs daily fits beautifully into a nutrient-dense diet. Active individuals, growing children, older adults, and those recovering from illness may benefit from more. Your metabolic health, overall diet, and personal biology matter far more than rigid universal rules. If you have significant metabolic dysfunction, diabetes, or a rare cholesterol-processing disorder, your response to dietary cholesterol may be different and should be evaluated individually.

For millennia, eggs have nourished the hungry, strengthened the growing, sustained the weary, and supplied nearly everything needed to build, repair, and renew life itself. It should be no surprise that they may also help restore the human body. Small in size. Astonishing in potential. “The incredible, edible egg.”

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EDITOR’S SUMMARY: Emerging research suggests that early human access to nutrient-dense shellfish may have played a meaningful role in cognitive development—and oysters remain one of the most concentrated sources of brain-supporting nutrition available today. Packed with vitamin B12, zinc, copper, DHA and taurine, they deliver nutrients that support brain function, mood, immunity, hormonal health and gut integrity. Researchers continue to explore their potential role in supporting BDNF—a key factor in neuroplasticity and resilience—alongside applications in bone health, thyroid function and gut repair.

Excavations of a cave along the southern coast of Africa reveal something astonishing—early humans were eating shellfish as far back as 164,000 years ago. At the time, this kind of underwater foraging was less about culinary curiosity and more about survival. But what may have begun as necessity appears to have delivered an unexpected evolutionary advantage. Researchers now propose that access to nutrient-dense marine foods helped fuel the rapid expansion of the human brain. It’s not that oysters alone are responsible for the ingenuity that defines the species, but they may have provided key building blocks at a critical moment in its unfolding. And in that sense, these unassuming creatures—clustered on rocks, filtering seawater—may have played a far more significant role in history than they tend to receive credit for. And that’s just the beginning.

The Case for Nutrient Density

Oysters, along with other bivalve mollusks like clams and mussels, continue to stand out as some of the most wholesome foods available. What makes them particularly interesting is their concentration of nutrients that are otherwise difficult to obtain in consequential amounts—the very ones early humans may have struggled to source inland. Often referred to as “nature’s multivitamin,” they are packed with iron, zinc, copper, long-chain omega-3 fatty acids (like docosahexaenoic acid, or DHA), high-quality protein, and amino acids such as taurine and vitamin B12—nutrients that sustain everything from immune defense to energy production.

DHA in particular is a structural component of the brain, especially within the cerebral cortex, the region responsible for memory, language and complex thought. Unlike many common foods, oysters deliver concentrated nutrition without empty calories or additives. The human brain is an incredibly energy-intensive organ. It requires a steady supply of very specific nutrients to grow and function properly. Consistent access to foods rich in these nutrients and bioavailable minerals may have supported early human cognitive advancements—tool use, communication and eventually the development of culture itself.

Animal foods tend to provide nutrients in forms the body can readily absorb and utilize, whereas many plant foods—such as spinach or raw nuts—contain compounds like oxalates and phytates that can bind to minerals and reduce their absorption, unless properly prepared through methods like soaking, sprouting or fermenting. Some scientists, such as Curtis Marean, who studied cave-dwelling societies in South Africa for over twenty years, hypothesize that oysters helped Homo sapiens dominate the planet over all other species of genus Homo—like Neanderthals and Erectus—by expediting their transition from early human to a modern one. Marean says:

“Shellfish may have been a critical food source for the survival of early human populations. For millions of years, humans survived on inland plants and animals. Shellfish was one of the last additions to the human diet before the introduction of domesticated plants and animals at the end of the ice age, also called the Pleistocene. It is possible that this population could be the progenitor population for all modern humans.”

While no single food can fully explain mankind’s transformation, oysters offer a provocative piece of the puzzle. What’s remarkable is how little you actually need: just two to four oysters can provide a full day’s worth of several essential nutrients. At present, most diets are built on abundance—people are overfed but undernourished. Despite consuming enough calories, many still fall short on key micronutrients. In this landscape of nutritional dilution, oysters are notable for their density. Thankfully, modern options like pure oyster powder and freeze-dried oyster extract preserve delicate amino acids and other bioactive components, so you can enjoy their benefits regularly without having to visit your local oyster bar or fish market.

The biological demands of human cognition have changed very little over time. The same vitamins and minerals that once propelled the growth of the human brain are still required to maintain its function. While some research suggests that IQ scores have flattened in recent years—as a result of shifts in environment, technology and culture—this raises broader questions: have humans fully tapped their cognitive potential? And could nutrient-dense foods like oysters play a meaningful role in supporting mental performance today?

What’s Inside the Shell

Much of oysters’ reputation comes down to vitamin B12. They are among the richest sources available, with a single serving of three to six medium oysters providing up to 1,000 percent of your daily requirement. B12 plays a central role in nerve health, red blood cell formation and overall brain function. If your levels drop, the effects are not subtle—fatigue sets in, memory falters and even basic mental tasks can feel overwhelming. Because B12 is involved in the production of red blood cells, it also influences how efficiently oxygen is delivered throughout your body. The brain, being highly metabolically active—it accounts for only two percent of overall body weight but consumes twenty percent of total resting oxygen—is particularly sensitive to even small disruptions in oxygen supply.

This is just one part of the equation. Oysters provide omega-3 fatty acids that help build flexible, resilient brain cell membranes while reducing inflammation. Zinc plays a role in neurotransmitter signaling and has been linked to memory and learning. Selenium acts as a protective agent against oxidative stress, while iron and copper support oxygen transport and energy production at the cellular level. When you take a step back, the picture that emerges is remarkable: this is a food designed, almost perfectly, to support the human brain.

Copper deserves attention, and oysters are among the richest dietary sources of this trace mineral. According to Morley Robbins, creator of “The Root Cause Protocol,” copper not only boosts antioxidant defense, but it also works alongside iron and magnesium to help regulate how oxygen is utilized within the mitochondria—the microscopic structures responsible for generating cellular energy. Robbins argues that it is copper, not iron, that is the body’s innate healer, and that what might look like an iron deficiency may actually reflect poor copper availability and impaired iron recycling. Current agricultural practices that deplete nutrients from the soil—such as the use of glyphosate, synthetic additives and highly processed foods—contribute to declining copper levels in the modern diet. In this context, oysters stand out: two cooked oysters provide up to 140 percent of the daily recommended intake.

Oysters’ nutritional benefits also extend to emotional well-being. Deficiencies in key nutrients such as B12, zinc and omega-3s have been associated with changes in disposition, energy and inner resilience. Once you begin to correct these shortages, you may notice your mood stabilizing, your body feeling more energized and your focus sharpening. This intersection between diet and mental health has gained increasing attention in the field of nutritional psychiatry.

Psychiatrist and founder of the Brain Food Clinic in New York, Dr. Drew Ramsey explores how dietary inputs influence brain function and mental health. He highlights nutrient-dense options—including oysters, which he refers to as “perfect brain food”—as powerful contributors to overall well-being. In an effort to better understand which nutrients matter most for fending off cognitive decline, Ramsey analyzes top scientific research and ranks foods based on the minerals and vitamins most strongly connected with preventing and treating depression. The result is his “antidepressant food scale,” on which oysters and mussels rise to the top among animal sources for their potential to support new cell growth in the hippocampus. —the region of the brain central to learning and memory.

“Nutritious diets actually keep brain-ageing at bay, meaning you live a more vibrant life,” Ramsey says. “This is crucial in midlife. If you look at the data, it’s not adolescents who have the worst mental health, it’s people in midlife, particularly white middle-aged men, in terms of depression and suicide.”

Dr. Ramsey emphasizes whole foods such as oysters over multivitamins, and believes that antidepressants fail to address the fundamental problem by focusing on serotonin rather than brain-derived neurotrophic factor (BDNF). “Numerous studies show that patients with major depression and anxiety disorder have lower BDNF levels than those without such diagnoses.” Oysters and their extracts may play a role in boosting BDNF and supporting the brain’s ability to strengthen or weaken connections over time.

From Fertility to Immunity

There’s a familiar, and slightly controversial, claim attached to oysters: their role as an aphrodisiac. For centuries, they have been associated with desire, and while the folklore runs deep, biology offers at least part of the explanation. Zinc plays a central role in regulating dopamine, a neurotransmitter tied to pleasure, motivation and libido. Oysters happen to be the richest dietary source of zinc, with even a small serving exceeding daily requirements several times over. In men, zinc is essential for testosterone production and sperm health, and inadequate amounts have been linked to reduced fertility. In women, it supports hormone balance and reproductive function. Just six oysters can deliver more than 180 percent of your daily zinc and over 400 percent of your B12 —nutrients that contribute to hormone regulation, ovulation and sperm production. When the body has what it needs, these systems can function more efficiently.

Zinc’s reach extends well beyond reproduction. It plays a critical role in over 300 enzymatic reactions in the human body, influencing immune function, DNA synthesis and wound healing, as well as the development and activation of T cells—essential for identifying and eliminating viral and bacterial pathogens as well as tumor cells. Because the body does not store zinc, consistent intake is necessary. Adding to this, compounds like phytic acid—found in grains and legumes—can reduce its absorption, making mild deficiency more common than expected.

Once considered rare, zinc deficiency is now surprisingly widespread in both developed and developing countries. It’s especially common among older adults—affecting up to 45 percent of those over 60—as well as women of reproductive age, due to menstruation and typically lower dietary intake. Signs of deficiency can be subtle at first: some hair loss, a diminished sense of taste, dry or irritated skin and getting sick more often than usual. The recommended daily allowance is 11 mg for men and 9 mg for women—an amount you can meet with just two oysters, which provide about 11 mg of zinc.

Zinc also helps maintain the integrity of the gut lining by supporting tight junction proteins, reducing intestinal permeability and inflammation, and preventing undigested food or harmful pathogens from entering the bloodstream. As a structural component, zinc reduces inflammation and oxidative stress while promoting beneficial bacterial diversity. In the event that your mucosal lining is damaged—whether by stress, illness or even a night of less-than-ideal food choices—zinc helps drive the repair process by promoting the regeneration of epithelial cells that form the protective barrier. Compounds naturally found in oysters, including omega-3s and bioactive polysaccharides—complex carbohydrates that regulate immune response and boost antioxidant activity—may further support gut health and microbial balance.

The thyroid offers yet another example of oysters’ reach. This butterfly-shaped endocrine gland depends on iodine and zinc for hormone production, while selenium helps convert thyroxine (T4)—the primary hormone produced and released by the thyroid gland, and a key regulator of metabolism, growth, temperature and energy expenditure—into its biologically active form, triiodothyronine (T3). When deficiencies in these nutrients occur, thyroid function can become impaired, leading to fatigue, weight changes and metabolic slowdown. Oysters address all three needs in one compact package.

Bone health may be the least expected entry on oysters’ nutritional résumé—yet the evidence is compelling. They provide a high concentration of calcium, phosphorus, vitamin D and protein—key building blocks of bone formation and maintenance. Working together, these components stimulate osteoblasts, the cells responsible for building new bone and strengthening existing tissue, while also contributing to collagen production, which gives bone and cartilage their resilience. Research published in Nutrients suggests that fermented oyster extract may help prevent bone loss following an ovariectomy—the surgical removal of the ovaries.

“Among marine organisms, oysters contain diverse bioactive compounds with antioxidant activity. A recent study on bone growth revealed that both oyster extract and taurine, a main component of oysters, can improve various bone parameters including bone volume/tissue volume, trabecular thickness, and trabecular number and can increase growth plate thickness in a mouse model.”

One compound of particular interest is taurine, an amino acid found in especially high concentrations in oysters—every 100 grams of raw oyster meat contains approximately 396 to 700 mg. Taurine acts as an antioxidant, supports cardiovascular function and aids digestion through bile salt formation. A study in Food Science & Nutrition, “Oyster broth concentrate and its major component taurine alleviate acute alcohol‐induced liver damage,” suggests it may also protect against liver injury, including fatty liver and fibrosis.

Of course, preparation matters. Consuming oysters raw ensures their full nutrient profile, but that benefit comes with a risk. The old rule of only eating oysters in months containing the letter “R”—which excluded the warmer summer months of May, June, July and August—no longer applies in the United States, thanks to aquaculture and strict safety monitoring. But oysters are natural filter feeders and can accumulate Vibrio vulnificus, a potentially harmful bacterium that thrives in warm coastal waters. Infection can cause serious and even fatal illness, with symptoms including vomiting, diarrhea and fever. For this reason, the Centers for Disease Control and Prevention recommends cooking shucked oysters using one of the following methods:

• Frying in oil at 375 degrees for at least three minutes

• Boiling for three minutes or longer

• Baking at 450 degrees for ten minutes

• Steaming—add to an already-steaming pot and cook for another four to nine minutes

• Broiling three inches from heat for three minutes

Some fragile nutrients—including certain B vitamins, omega-3 fatty acids and bioactive compounds—can be diminished by heat. Of the methods above, steaming tends to preserve more of these compounds since the oysters are not submerged directly in boiling water.

Oysters have always carried a certain mystique, bordering on dare and delicacy—and the question of how to prepare them is nearly as old as the practice itself. Jonathan Swift, who famously admired the “bold man” who first tried one, offered his own method in Gulliver’s Travels in 1726: “Take oysters, wash their shells clean, then put the oysters into an earthen pot, then put the pot into a kettle of water, and let them boil. Your oysters are boiled in their own liquor and not mixed with water.” For most purposes today, simple is still best. Consider a squeeze of fresh lemon or a dab of hot sauce rather than breading or deep-frying. When buying oysters, look for tightly closed shells and discard any that don’t open during cooking. Avoid overcrowding them in the pot, which can lead to uneven cooking. As with most seafood, freshness matters—the closer you can get to the source, the better.

Water quality matters not only for freshness and flavor but also for toxin exposure. Because oysters filter large volumes of seawater, they can accumulate environmental pollutants—including trace amounts of arsenic, mercury, lead and cadmium—when grown in contaminated waters. Concentrations vary depending on proximity to industrial runoff or shipping activity. Source oysters from well-monitored estuaries and coastal waters far from heavily industrialized or urbanized areas to minimize exposure. In the United States, both commercially farmed and commercially harvested wild oysters are routinely regulated and tested for water quality. The greater risk comes from recreationally harvested wild oysters, which are not subject to the same oversight and may come from waters that haven’t been tested for contaminants. Compared to large predatory fish such as tuna and swordfish, oysters contain substantially lower levels of mercury. They are also rich in selenium, which may help counter some of the oxidative stress associated with heavy metal exposure.

Better for You, Better for the Ocean

As it turns out, oysters are also one of the most environmentally regenerative foods on the planet. As natural sieves of the sea, they continuously cycle the water around them, removing excess organic matter such as algae and particulate matter, improving water quality and clarity in the process. A single oyster can filter up to 50 gallons of water per day.

Over time, their shells accumulate and form reefs that create habitats for a wide range of marine life, from tiny crustaceans to large fish species. These reefs support biodiversity and stabilize ecosystems. Remarkably, oysters require no freshwater, feed inputs or arable land to grow. There are very few protein sources that can claim to actively improve their environment simply by existing in it. And yet, despite their resilience, oyster populations have declined significantly due to pollution and overharvesting. Restoration efforts are underway—because as it turns out, oysters represent something much larger than was once recognized.

In a world rich in options, it’s easy to overlook these humble creatures. But as you move toward greater wellness—paying attention to how you feel, how you function and how your choices affect the systems around you—there’s something compelling about returning to the sources of nourishment that supported human evolution in the first place.

Your early ancestors stumbled upon something powerful without fully realizing it. There was no nutrition science to guide them, no language for vitamins or fatty acids—just the basic pull of survival. And once their bodies had a taste, they didn’t forget it. Only a fraction of the ocean has been explored, and yet these small shellfish continue to shape humankind in ways both visible and unseen.

Consider reaching for an oyster—not just as a meal, but as a small act of alignment with your biology and the planet. And if you can, take it one step further: return the shells to a local restoration program, where they can become the foundation for new reefs and continue the cycle they’ve sustained for centuries.

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EDITOR’S SUMMARY: Artificial intelligence is rapidly becoming part of daily life—including emotional support and mental health guidance. But as AI tools grow more human-like, concerns are mounting over emotional dependency, misinformation, privacy and the risks of treating machines like therapists. As organizations race to adopt the technology, questions remain about how to use it safely, responsibly and without replacing real human connection.

Artificial intelligence (AI) exploded onto the global stage in 2022 with the arrival of a chat app called ChatGPT. Since then, organizations and world leaders have touted AI as a technology poised to reshape daily life, business and communication. According to the U.S. government, it’s “ushering in a new Golden Age of innovation, human flourishing, and technological achievement for the American people.” The bold claims are understandable. AI offers clear practical advantages. It can create content—drafting an email, building a resume or producing a video. It boosts productivity by helping you complete tasks like financial budgeting, planning an event and researching information online. It can act as a personal assistant by suggesting a workout routine, planning travel itineraries and helping you stay on top of daily priorities. It can even assist in building a digital app or website of your own.

The technology is easy to use. Several companies offer an AI app to download, or you can access it on their website. From there, you type a question or request into a box—called a prompt. The software responds in seconds. It can mimic human speech, making the interaction feel surprisingly human. It replies in plain language rather than technical jargon, allowing for natural back-and-forth conversations.

Using AI can feel less like a traditional search engine and more like interacting with a collaborator. It can summarize complex information in seconds, help brainstorm ideas, explain difficult concepts in accessible terms and accelerate tasks that once required hours of research or technical expertise. For small businesses, students, creatives and people juggling demanding schedules, the shift can feel genuinely transformative—expanding what a single person is capable of accomplishing in a day.

To some, the technology represents more than the arrival of a powerful new app or software platform. It signals a fundamental shift in how humans access information, solve problems and approach creative work. Tasks that once required specialized expertise, extensive research or entire teams can now begin with a simple prompt. Writers use AI to brainstorm and edit. Programmers use it to troubleshoot code. Students use it to simplify difficult concepts. For many people, AI feels like a genuine expansion of their capabilities—one reason adoption has accelerated so rapidly across nearly every sector of society.

The technology is also evolving rapidly beyond simple chat interfaces. A new wave of AI “agents” is being designed to carry out tasks autonomously—managing schedules, conducting research, organizing workflows, making purchases and interacting with other software on a user’s behalf. As these systems become more personalized and integrated into daily life, the line between digital assistant, tool and companion may become even more blurred. AI’s growing utility has fueled enormous enthusiasm, but discussion of the downsides has lagged behind as governments and businesses race to adopt it. One problem is that AI can provide inaccurate information, requiring you to verify it against credible sources. Several law firms, for instance, got in hot water for using AI to create court briefs that cited legal cases that didn’t exist.

More concerning is that people are now turning to AI for medical and mental health advice—relying on it like a doctor, therapist or confidant. AI’s conversational nature makes it appear suited for this role. No major medical organization endorses AI as a replacement for professional care, yet many Americans are increasingly using it that way. According to a 2026 survey, “KFF Tracking Poll on Health Information and Trust: Use of AI For Health Information and Advice,” about a third of adults adopted the tech for health-related matters, with 16 percent seeking emotional support through AI tools. Some analysts now describe ChatGPT as functioning like one of the largest informal mental health support systems in the U.S. Before diving further into the pitfalls of using AI for mental health, it’s helpful to first understand some background about the technology.

What Exactly Is AI?

Artificial intelligence is a branch of computer science focused on creating systems that can perform tasks associated with human thinking. It uses clusters of interconnected computers housed in massive facilities—some requiring enormous amounts of land, energy and water—to perform tasks requiring learning, reasoning, problem-solving and decision-making. The companies building the technology start by gathering data from various sources: collecting publicly available information on the internet, buying it from organizations and harvesting it from the usage of their apps. This data trains algorithms to identify patterns, and the software then applies statistical models to choose the most relevant response to your request. For example, you might ask an AI app, “Summarize the causes of the American Revolution in three sentences.” Rather than retrieving a single source, the system generates a response by identifying patterns and relationships across enormous amounts of training data.

Some semblance of artificial intelligence has existed for decades. Tech giant IBM made headlines in 1997 when its Deep Blue AI beat the world’s reigning chess champion—the first time a computer demonstrated that machines could out-think humans in a complex strategic setting. ChatGPT’s arrival represented another milestone by bringing generative AI, or genAI, into the mainstream. This form of AI is distinguished by its ability to generate original responses or content, which allows it to “chat” with you. It’s how ChatGPT got its name: Chat Generative Pre-trained Transformer. A transformer is the software engine that analyzes the relationship between words in a sequence. Before genAI, most AI systems could analyze data and efficiently carry out predetermined tasks, but they were generally far more limited in generating open-ended responses or creating original content. GenAI can do this, and it’s also able to learn from existing data—enabling it to create new content based on your prompt, carry on a conversation, and construct original images, videos and music in seconds.

Using these apps is intuitive for both adults and children, since it requires no technical knowledge—only entering a text or voice prompt. GenAI’s sophisticated conversational ability can make interactions feel remarkably human. For instance, the prompt “I’m feeling overwhelmed with work; suggest ways to organize my tasks” can produce a response such as “I’m so sorry you’re feeling that way. It sounds incredibly stressful to have so much on your plate at once. We can break your to-do list down into smaller, more manageable steps together.” Its ease of use and human-like responses helped propel ChatGPT into one of the most visited websites in the world within two months of its rollout. GenAI’s accessible, powerful capabilities led to a slew of products such as Midjourney, Claude and Character.ai.

Why AI Can Be Dangerous

One reason AI can feel so compelling is how naturally it communicates. While those interactions can feel comforting, reflective or emotionally meaningful, problems can arise when the line between tool and trusted relationship begins to blur—especially when AI begins replacing real-world support, guidance or professional care. The widespread isolation, uncertainty and disruption that accompanied the COVID-19 response were associated with a 25% global spike in depression and anxiety disorders according to the World Health Organization. Demand for behavioral health services grew, but the U.S. faced a shortage of qualified mental health professionals—driven by burnout, retirements and insurance systems that often reimburse poorly or fail to cover treatment altogether. That scarcity, combined with ChatGPT’s timely arrival, drove people to turn to AI for help. Companies capitalized on this, releasing a flood of digital mental health apps such as Character.ai’s Therapist and Psychologist bots, Wysa, Woebot Health, Therabot, Earkick and Limbic Access.

There are clear reasons people are drawn to AI for therapy-like support. It’s always available, even in the middle of the night. No appointment is necessary. There’s no time pressure—you can talk as long as you want. Because it’s a machine, there’s no feeling of being judged, and the price tag is low or free depending on the service. Part of what can make AI interactions feel so personal is that the software adapts to your prompts, conversational style and recurring interests over time. As interactions accumulate, responses may begin to feel increasingly familiar, tailored and emotionally attuned. While this can create a sense of being understood, the system is still recognizing patterns in data—not forming human awareness, memory or emotional connection in the way people do.

At the same time, the system’s lack of human judgment, accountability and emotional understanding can create risks for people who are emotionally distressed, isolated or seeking reassurance during difficult periods in their lives. AI is programmed to prioritize helpfulness—to the point of being overly agreeable. This makes business sense: the more people enjoy using an app, the greater the opportunity to gain and retain customers. Computer scientists at Stanford University published a study in March 2026, “Sycophantic AI decreases prosocial intentions and promotes dependence,” confirming genAI’s bias toward pleasing its users, finding it agrees with users nearly 50 percent more often than humans do—even when users express self-destructive or ethically troubling ideas.

Dr. Jodi Halpern, a psychiatrist and bioethics scholar at UC Berkeley, described the false sense of intimacy the software can elicit: “You can develop powerful attachments—and the bots don’t have the ethical training or oversight to handle that. They’re products, not professionals.” Halpern noted genAI apps are designed to maximize engagement, not provide mental health support, yet they continue reaching vulnerable users with limited regulation or oversight. She stated:

“We’ve already seen tragic outcomes, including people expressing suicidal intent to bots who didn’t flag it — and children dying by suicide. These companies aren’t bound by HIPAA. There’s no therapist on the other end of the line.”

In a lawsuit against Character.ai, parents assert their teenage son attacked them after interacting with the app. In a separate lawsuit filed in 2025 against OpenAI—the creator of ChatGPT—parents allege that a teenager using the app for homework received guidance related to suicide before later taking their own life. OpenAI retired the software version involved in early 2026. That same year, the company released an age-prediction capability where ChatGPT estimates the age of its user and, if it determines the person is under 18, limits exposure to content involving self-harm, body shaming and unhealthy dieting. Even so, AI systems still cannot reliably recognize or appropriately respond to signs that a person may be at risk of harming themselves or others. The state of Florida is investigating whether OpenAI bears criminal responsibility for a 2025 school shooting after the gunman used ChatGPT to plan the attack.

Another inherent issue with AI is that it reflects the biases present in the data used to train it. A 2025 study from Stanford University’s Human-Centered Artificial Intelligence institute, “Exploring the Dangers of AI in Mental Health Care,” revealed AI displayed greater stigma toward individuals with alcohol dependence and schizophrenia compared to those with depression—labeling a person with schizophrenia as likely to be violent, and indicating unwillingness to work closely with someone diagnosed with alcohol dependence. AI can also fabricate responses that have no basis in fact—a phenomenon called “hallucination.” The software does this because it prioritizes predicting the best reply over verifying accuracy. If it lacks data on a topic you ask about, it will make up an answer rather than admit the gap. Companies also face pressure to keep interactions smooth and responsive, since users frustrated by too many dead ends may switch to competing platforms.

Artificial intelligence apps presented as substitutes for clinical guidance can pose significant risks, according to Stephen Schueller, a licensed psychologist and professor of clinical psychology at UC Irvine who specializes in digital mental health technologies. He noted that people in crisis may not seek needed medical attention—a particular concern for groups unable to accurately assess risk, such as children, teens and individuals struggling with serious mental health conditions. Schueller stated:

“If you’re in a dark place, hope is a very powerful tool. But some of these products can give vulnerable people false hope… Innovation in this space is sorely needed, but we have to do innovation responsibly by protecting people, especially those who are going through mental health challenges.”

Not all clinicians view AI as inherently harmful. Cedars-Sinai researchers created an app called the eXtended-Reality Artificially Intelligent Ally (XAIA), designed to treat patients with mild-to-moderate anxiety or depression. Clinical psychologist Robert Chernoff, who helped assess the program’s safety, stated: “(XAIA) handled a range of situations very well and did not show evidence of safety concerns during our testing.” Dr. Brennan Spiegel, Cedars-Sinai’s director of Health Services Research, added:

“By harnessing the potential of technology in an evidence-based and safe manner, we can build a more accessible mental healthcare system.”

Using AI Responsibly

The rapid adoption of artificial intelligence has outpaced the laws governing its use. Formal guardrails are largely left to the businesses making the apps. The U.S. government is taking a hands-off approach—in December 2025, President Trump signed an executive order penalizing states that attempt to rein in AI with new laws, threatening to withhold federal funding and block enforcement. This means the burden falls on you to use AI systems responsibly. The first step is to approach AI as a tool rather than a companion. Make sure you and your loved ones understand its risks: interactions are recorded and shared with the company behind the app, advice can be inaccurate, and emotional dependency can develop without you realizing it. Recognizing that AI isn’t a replacement for a human therapist is harder than it sounds—especially for children and teens, who may not always distinguish between artificial interaction and genuine emotional support. The American Psychological Association (APA) explains:

AI bots “can foster unhealthy dependencies by blurring the lines between a relationship with a digital tool and a human relationship. This phenomenon is in part driven by anthropomorphism—a natural human tendency to attribute human qualities like empathy, consciousness, and intent to nonhuman agents… This illusion of a human connection can make users more likely to disclose sensitive information. For example, despite a general preference for human connection, 33% of teens reported they would rather discuss something serious or important with an AI companion than a person.”

It’s also worth noticing when AI interactions begin crowding out real-world connections. Spending excessive time with these apps, preferring them over interactions with people, or hiding their use from others may indicate an unhealthy level of dependence. The APA recommends against using AI bots for psychological treatment, noting that “even regarding fit-for-purpose AI tools, there is a lack of high-quality, large-scale clinical trials to establish the effectiveness, safety, and appropriate use of these technologies in mental health care.”

When turning to AI for medical information, recognize that while it may offer useful insights or possible explanations, it is not a replacement for professional medical evaluation or care. Always cross-check its responses against credible sources—it can fabricate answers, so treat its output as a starting point rather than fact. Its responses can spark new ideas or point you toward reference material you might not have found on your own. The quality of what you get also depends on how you ask. The more specific your prompt, the more useful the response is likely to be. You may need to refine your wording several times to get accurate or relevant results. Strong prompts might look like: “I’m feeling stressed out. Give me three techniques I can use in the next 10 minutes to reset”; “Explain this medical study in simpler terms and summarize the key findings”; or “Help me organize a realistic weekly schedule that balances work, exercise and sleep.”

Keeping Perspective

While purpose-built AI therapy tools are still in development, progress is being made. Alongside XAIA, researchers from Dartmouth College constructed a therapeutic AI and ran the first randomized controlled trial demonstrating its effectiveness at treating patients diagnosed with major depressive disorder, generalized anxiety disorder or clinically high risk for eating disorders. The researchers cautioned they are still far from bringing this technology to market, citing the need for further studies.

For now, safely using AI comes down to understanding both its strengths and its limits. Its ability to communicate in emotionally resonant ways can make interactions feel deeply personal, but it remains a machine trained to generate responses—not a substitute for wisdom, accountability or professional care. As AI becomes more integrated into daily life, staying connected to your own judgment, lived experience and discernment may become more essential than ever. While AI can offer useful perspectives, ideas and information, not every question needs to be answered by a chatbot. In the age of AI, the ability to think critically rather than reflexively outsource decisions may become increasingly important. AI can be useful for organizing ideas, answering questions and supporting productivity, but real human connection still matters.

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EDITOR’S SUMMARY: Medical history is filled with ideas once dismissed as implausible, dangerous or unscientific—until science evolved enough to understand what was there all along. From handwashing and organ transplantation to the evolving story of DMSO, the history of medicine reveals how progress is often limited by what can be measured—and what happens when discovery outpaces explanation.

You step into a hospital in the mid-1800s, and what strikes you first is not the urgency—it’s the certainty. Physicians move with confidence, guided by training, tradition, and the authority of established knowledge. Their black coats—rarely washed and bearing the daily evidence of blood and other bodily fluids—serve as symbols of experience. They move from dissecting cadavers to delivering babies, from treating wounds to performing surgeries, without pause, without question, and without the slightest awareness that something unseen and dangerous may be traveling with them.

At the time, disease is explained through “miasma“ (”bad air”) or fate. The idea that something invisible could be responsible is more than unproven—it is inconceivable. And more importantly, it is unmeasurable. The striking reality is not what they missed, but how certain they were that nothing was missing. Medicine did not lack intelligence or intention; it lacked the ability to detect what had not yet been made visible. Ideas that could not be measured were often dismissed or ridiculed—not always because they failed, but because they could not yet be proven.

Before Science Could See

In medicine—largely before the 20th century—what cannot be quantified often struggles to be recognized at all. Into this world steps Ignaz Semmelweis, a Hungarian physician working at Vienna General Hospital in the mid-1800s, who begins to notice a pattern others overlook. In one maternity ward, women are dying at alarming rates after childbirth. In another, under nearly identical conditions, far fewer women die. The difference is not the patients. It is the practitioners. Semmelweis observes that doctors in the high-mortality ward often come directly from performing autopsies. Without realizing it, they are carrying something from the dead to the living. He cannot see it. He cannot isolate it. The technology does not yet exist to confirm what he suspects. But he identifies the pattern and can see the outcome.

In a stroke of clarity, he institutes a simple intervention: physicians must wash their hands with a chlorinated lime solution before examining patients. The results are immediate and undeniable. Mortality rates plummet—from 18.27 percent in April 1847 before handwashing to 0.19 percent by year’s end. Women who would have died begin to survive. And yet the intervention is rejected. To accept Semmelweis’s findings would require physicians to confront something far more uncomfortable than an undetected pathogen: that they themselves are contributing to the deaths of their patients. Without a mechanism to explain why it works, the evidence—lives saved—is not enough. His colleagues disregard his conclusions, his methods are criticized, and his reputation deteriorates. He dies before his discovery is recognized. Not because he was wrong—but because the tools to prove him right had not yet arrived.

Years later, the missing piece begins to take shape through the work of French chemist and microbiologist Louis Pasteur. Pasteur demonstrates that microorganisms exist, that they are present in the environment, and that they can cause disease. What had once been invisible becomes observable; what had been seen as illogical becomes explainable. With that shift, the same idea that cost Semmelweis everything becomes undeniable.

Building on these discoveries, Joseph Lister, an English surgeon and medical scientist, brings this new understanding into the surgical theater in the mid-1860s. At the time, surgery is not feared for the procedure itself, but for what follows. Infection is expected. Wounds become inflamed, fevers rise, and many patients do not survive. Lister recognizes that if unseen organisms are responsible, then reducing their presence could change outcomes. He starts sterilizing instruments, cleaning wounds, and using carbolic acid in operating environments. His methods are met with resistance—seen as excessive, unnecessary, even impractical. But the results speak for themselves.

Infection rates fall. Survival improves. What once seemed excessive becomes essential. Over time, antiseptic technique transforms from a controversial theory into a foundational standard of care. The shift extends far beyond surgical practice—it redefined the limits of what medicine can safely pursue. When infection is no longer an inevitability, the operating room transforms from a place of risk management into a space of possibility. Procedures that once guaranteed fatal outcomes could now be reconsidered, refined, and eventually reimagined. With infection brought under control, another frontier comes into focus—one that would challenge not only surgical skill, but the very definition of life and death itself: organ transplantation.

Rejected by the Body, Then by Medicine

Once considered implausible, organ transplants faced early failure not because the idea lacked merit, but because the immune system was not yet understood. The body rejects what it does not recognize, and without the ability to manage that response, success is out of reach. Only when advances in immunology and the development of immunosuppressive therapies arrived did transplantation become viable.

For much of human history, the idea of replacing parts of the body existed more in myth than medicine. Ancient Greek, Roman, and Chinese stories told of gods and healers performing miraculous transplants, hinting at a concept that science had yet to grasp. Yet by around 800 BC, Indian physicians were already practicing early forms of skin grafting—moving tissue from one part of the body to another to repair wounds and burns. Centuries later, Italian surgeon Gasparo Tagliacozzi advanced these techniques, reconstructing noses and ears using a patient’s own skin. He also detected a critical limitation: tissue from another person often failed—an early glimpse into the immune response that would later define transplant success or failure.

By the early 20th century, physicians pushed further, attempting organ transplants despite limited understanding. Early efforts—such as transplanting animal organs into humans, known as xenotransplantation—ended in rapid failure, reinforcing skepticism. As transplant pioneer Norman Shumway once remarked, “Xenotransplantation is the future—and always will be,” a statement often repeated in the field to reflect both its promise and its persistent challenges.

Breakthroughs came incrementally. In 1905, Eduard Zirm restored sight with the first successful corneal transplant, and in 1954, surgeons achieved the first successful kidney transplant between identical twins, bypassing immune rejection entirely. The work of pioneers like Alexis Carrel and Peter Medawar laid the scientific foundation for modern transplantation. These Nobel Prize-winning physicians developed techniques for connecting organs through vascular suturing and identified the immunological basis for organ rejection, respectively.

Medawar’s work led to the development of anti-rejection drugs that made organ replacement broadly viable. From the first heart transplant by Christiaan Barnard in 1967 to complex procedures like full face transplants in the 21st century, what once seemed impossible became routine—not through belief alone, but through a deeper understanding of how the human body operates. The path from Semmelweis to transplantation follows a relatively clean arc—rejected, then proven, then accepted. But not every story resolves that neatly. Some discoveries are validated in parts, limited in others, and remain contested to this day.

Regulated, Restricted, Reconsidered

Some discoveries arrive with promise, become entangled in uncertainty, and are set aside—not disproven, but left unresolved because they defied easy explanation. Dimethyl sulfoxide—DMSO—is one such example. First identified in the late 19th century as a byproduct of the process used to turn wood pulp into paper, DMSO would later be synthesized by Russian chemist Alexander Zaytsev—a method still used today. In laboratories and industry, it proved invaluable: a highly stable, relatively nontoxic solvent capable of dissolving a wide range of substances, from gases and salts to synthetic fibers and natural compounds. Its chemical properties make it indispensable for research, even serving as a preferred medium in techniques like nuclear magnetic resonance. But it was not until the 1960s that its most unusual characteristic drew serious attention—its ability to pass through human skin and enter the bloodstream with minimal immediate harm to tissues.

That discovery shifted its trajectory. Researchers began exploring DMSO as a vehicle for delivering medications directly into tissue, bypassing traditional oral or injectable routes. Early findings suggested anti-inflammatory and analgesic potential, and it was tested for conditions ranging from tissue injury to chronic pain. Yet the same permeability that makes it promising also made it unpredictable. If it could carry therapeutic compounds, it could just as easily transport toxins or contaminants. Concerns deepened when animal studies revealed changes in the refractive index of eye lenses, prompting the U.S. Food and Drug Administration (FDA) to halt clinical trials in 1965. By 1966, the New York Times was reporting:

“Although it was only authorized for external use, some doctors appeared to be trying to administer it by mouth and even by injection. Furthermore, many persons were using it without adequate medical supervision. Experiments showed that some animals given heavy doses of the chemical developed abnormal changes in the refrac- tive index of their eyes. It was following these reports of adverse eye changes that the Food and Drug Administration halted its use. The action was protested by a substantial number of scientists who considered DMSO potentially valuable and worthy of further research. The new guidelines for its use in clinical studies will provide the maximum protection possible for the patients who will receive it, the drug agency announced today.”

Guidelines introduced in 1966 limited DMSO’s use to topical applications and only for conditions that had no other available treatments. By the time restrictions were lifted in 1980, enthusiasm had cooled, and the substance had been pushed to the margins—further complicated by unsubstantiated claims that it could cure diseases like cancer. And yet research continued in more limited and specialized applications. In 1978, the FDA approved DMSO for a narrow but specific use: the treatment of interstitial cystitis, a chronic bladder pain condition. Beyond that, it became essential in another domain entirely—cryopreservation. In this role, DMSO protects cells during freezing and thawing, preventing damage that would otherwise destroy them. Stem cells, reproductive cells, and biological samples rely on it as a preservative rather than a treatment—a safeguard for tissue intended for future use.

Research has continued to explore its effects in other areas. Studies have explored its potential role in scleroderma—a rare condition in which the body produces excess collagen, leading to pain, disability and breathing difficulties. Its collagen-softening, analgesic and free-radical scavenging properties have kept it a subject of ongoing investigation for inflammatory conditions, including arthritis, despite the skepticism that has followed it. Beyond these uses, smaller studies have also explored potential roles in central nervous system injury and stroke recovery—areas where findings remain preliminary and far from settled.

The Edge of Understanding

These are not simply stories of being right or wrong. They are accounts of evidence arriving late—of reality existing before the tools to assess it. Again and again, what delays acceptance is not the absence of effect, but the absence of a way to quantify it. Medicine, for all its precision, has always been limited by what it can detect. Until something can be situated within established frameworks, it exists in a kind of scientific limbo—seen, sometimes effective, yet not fully accepted. In that space, even groundbreaking ideas can be abandoned.

Researchers like Royal Raymond Rife (1888–1971) explored whether biological systems might respond to frequency and vibration. A scientist and inventor, Rife developed specialized microscopes and became convinced that microorganisms, like all matter, possessed specific resonant frequencies. He theorized that targeted electromagnetic frequencies could disrupt harmful organisms without damaging surrounding tissue. His work drew both interest and skepticism, but his question was not isolated—it reflected a broader effort to understand whether life could be influenced through energy as well as chemistry. Rife’s specific claims were never independently validated, and his later years were marked by professional collapse and legal trouble. But the question he was asking—whether biological systems respond to frequency—did not disappear with him. It migrated into other hands and other disciplines, where it continues to be explored.

Others approached this idea from different angles. Nikola Tesla explored resonance and energy transmission through fields, while Georges Lakhovsky suggested cells function like tiny circuits responding to external signals. Even within conventional science, researchers in the mid-20th century uncovered the body’s electrical nature—its signals, rhythms, and communication systems. Together, these ideas pointed to a shared insight: biology is not only chemical, but also electrical, and potentially responsive to frequency.

Modern quantum physics has prompted broader conversations about how matter, energy and observation interact. What appears solid is not fixed—at the smallest level, matter behaves differently depending on how it is observed, energy organizes into patterns, and interactions don’t follow straight, predictable paths. Reality is more dynamic and deeply connected than it appears. Your body is not a static object—it is a network of ongoing processes. Every cell is active. Every signal is being transmitted. Electrical impulses travel through nerves, chemical signals pass between cells, and rhythms coordinate everything from heartbeat to breath. Early thinkers raised the question of whether this communication also included frequency—whether the body responds not only to substances, but to signals.

This is not purely philosophical territory. Research in psychoneuroimmunology—the study of how the mind, nervous system and immune function interact—has documented measurable biological changes linked to stress, belief and perception. Placebo responses, once dismissed as noise in clinical trials, are now understood to involve real physiological mechanisms. This does not suggest that thought alone controls biology, but it clarifies something essential: your body is continuously responding to input—not just nutrients or medication, but environment, stress, perception and lived experience.

This is why outcomes vary. Two people can receive the same treatment, the same dose, the same protocol, and experience entirely different results, because the body receiving it is not neutral. It is shaped by history, current state, and individual physiology. What enters the system matters, but so does the system it enters. This is where mindset becomes relevant—not as wishful thinking, but as biological posture.

History offers repeated reminders that prevailing medical knowledge is not fixed. What seems impossible or implausible in one era may become widely accepted in another, just as those before you could not have imagined microbes, electricity, mitochondria—the structures inside your cells now understood as central drivers of cellular energy and health—or genetics. That uncertainty calls for something rare and powerful: an open mind—not empty enough to believe everything, but spacious enough to examine anything worth considering.

To hold such a mind requires humility—the willingness to say, there may be more here than I currently understand. It requires discernment. It asks you to remain teachable, to question your assumptions, to notice when certainty hardens into dogma. In contemplative traditions, this is called Beginner’s Mind—meeting the world without the burden of knowing, approaching each idea, sensation, or discovery with fresh attention rather than inherited conclusion. It can be cultivated through stillness, reflection, deep listening, meaningful dialogue, meditation, time in nature, and the deliberate practice of curiosity.

And because discovery so often begins with observation long before understanding, openness becomes the bridge that allows possibility to remain in view while explanation catches up. Signals emerge that suggest something real is occurring—yet without a clear mechanism, those observations remain vulnerable to rejection. It is not always the absence of effect that creates doubt, but the absence of a way to explain it.

Germs existed before microscopes revealed them. Electrical activity moved through the body before it was mapped. When a patient heals, something real has occurred, whether or not the mechanism is fully understood. Symptoms resolve. Function returns. This does not replace the need for rigorous science—it demands it. But it also reveals a truth: Understanding does not always lead to discovery. Sometimes, discovery—initially dismissed or ridiculed—forces understanding to catch up.

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EDITOR’S SUMMARY: Circumcision remains a routine part of newborn care in many U.S. hospitals, despite declining rates and ongoing debate over its medical necessity. Its rise as a standard practice was shaped by history, cultural norms and evolving medical claims about prevention. Current research points to potential benefits in certain contexts while also raising questions about complications, bodily autonomy and informed consent. As more parents revisit long-standing assumptions, the issue increasingly reflects a broader tension between tradition, prevention and personal choice.

Circumcision is one of the most commonly performed surgeries in the United States, yet it remains one of the least discussed. For generations, American parents have been convinced it’s a standard part of newborn care, sometimes nothing more than another checkmark on a hospital form. But beneath that decision is a long and complicated history shaped by religion, morality, early fears about disease, changing medical research, financial incentives and powerful cultural habits. Circumcision in the United States carries historical, sociological, economic and ethical implications that extend far beyond the procedure itself. To understand where things stand today, it helps to trace how it became embedded in modern healthcare.

From Sacred Ritual to Institutional Norm

Circumcision dates back to early civilizations. Archaeological evidence from Egypt, including tomb carvings and mummified remains, suggests it was practiced as early as 2300 BC, most likely as a transition into adulthood. In Judaism, circumcision is explicitly established in the Torah, in the book of Genesis, as a covenant between God and Abraham, formalized through the brit milah performed on the eighth day of life. In Islam, circumcision became widely adopted as a religious and cultural practice—not explicitly mandated in the Qur’an, but drawn from the Hadith, which records the sayings and teachings of the Prophet Muhammad. In these contexts, circumcision carried religious, cultural and communal significance. Outside those communities, it remained relatively uncommon until it was later medicalized in the West.

Its shift from religious tradition to medical intervention did not begin with infectious disease research. It began in the Victorian era, when medicine was often used to enforce moral and social norms. In the late nineteenth century, physicians promoted circumcision as a deterrent to masturbation, based on the belief that removing the foreskin would reduce sensitivity and make self-stimulation less appealing. At the time, they believed masturbation caused insanity, epilepsy, and moral decay. Among them was Dr. John Harvey Kellogg, who advocated circumcision without anesthesia, arguing that the pain itself would discourage sexual self-stimulation in boys. Today, those views are widely recognized as unscientific, yet they helped legitimize the procedure within mainstream medicine.

As hospital births became more common in the early twentieth century, circumcision migrated from religious ritual to a common, institutional practice. Historian David L. Gollaher, in his book, “Circumcision: A History of the World’s Most Controversial Surgery,” documents how physicians began framing circumcision as hygienic and preventative. At the time, the foreskin was increasingly viewed as a site where bacteria and secretions could accumulate, reinforcing concerns about infection and cleanliness during the rise of germ theory in the late nineteenth and early twentieth centuries.

During this period, ideas about cleanliness became closely tied to morality, discipline and social standing. Personal hygiene was seen as a reflection of character, and these beliefs coincided with broader public health efforts to prevent infectious diseases such as tuberculosis, cholera and sexually transmitted infections at a time when antibiotics did not yet exist. In that environment, surgical removal of the foreskin was framed as a prophylactic measure—a way to eliminate a perceived source of infection before problems emerged.

By the mid-twentieth century, circumcision had become normalized in the United States. Although it was never mandated, entering a hospital to give birth often came with the expectation that circumcision was part of newborn care. Rates climbed dramatically after World War II and by the 1960s and ‘70s, estimates suggest that between 80 and 90 percent of American newborn boys were circumcised. Yet this increase was not driven by randomized controlled trials demonstrating overwhelming medical necessity. It was reinforced by professional consensus among doctors, hospitals and insurers that framed the procedure as preventative medicine. As childbirth and postpartum services shifted from the home to hospitals, circumcision became easier to institutionalize. What had once been far less common outside religious communities increasingly became part of hospital protocols, often presented to parents as a standard option.

Today, the United States remains an outlier among developed nations, where routine newborn circumcision is far less common outside of religious communities. According to data from the Centers for Disease Control and Prevention (CDC), newborn circumcision rates in the U.S. currently range between 55 and 65 percent, marking a decline from the mid-twentieth century, when estimates were as high as 80 to 90 percent. This is partly due to medical organizations like the American Academy of Pediatrics (AAP) emphasizing the importance of parental decision-making in the process.

Though patterns vary significantly by region, parts of the Midwest and South have historically exceeded 70 percent, while rates in the West and Northeast have declined to below 40 percent in some areas. These differences are shaped by a combination of policy, culture, and demographics. Circumcision rates also tend to be lower in many Hispanic and immigrant communities than among non-Hispanic white populations. A recent Johns Hopkins study analyzing national hospital data from 2012 to 2022 found that neonatal circumcision rates fell most among families in the highest-income ZIP codes and among those with private insurance. In these groups, rates dropped from 59.4 percent to 51.1 percent and from 64.2 percent to 56.3 percent over the decade.

In the United States, newborn circumcision typically costs between $300 and $500 for privately insured patients. While the amount per case is modest, the volume isn’t, resulting in a procedure that has become a common, reimbursable component of newborn care in hospitals. In many other developed countries, by contrast, medical organizations have not adopted widespread newborn circumcision as a standard public health measure.

What the Procedure Involves—and What the Evidence Says

Circumcision is presented as a quick surgery, typically performed within the first week of life. In a hospital or medical setting (or sometimes at home), the baby is secured in a device that limits movement of the arms and legs. A local anesthetic is administered—the AAP recommends its use specifically because the procedure is painful. While pain management is now considered standard practice, research shows that anesthesia reduces pain rather than eliminating it entirely, and infants may still exhibit measurable stress responses during the procedure depending on the method used.

The foreskin, also called the prepuce, is then separated from the glans and removed using a clamp device. It is not excess skin. This specialized tissue protects the glans and contains nerve endings. Once removed, it cannot be restored.

Techniques may differ in religious or cultural settings. In the Jewish tradition, the procedure is performed by a trained practitioner called a mohel. In Muslim communities, practice varies by country and family resources—it may be performed in a clinic or through community-based practitioners, depending on local customs. The surgery itself typically lasts less than ten minutes, and complete healing usually takes several weeks.

Even though the surgery is brief, research shows that babies respond to it. Studies published in journals such as Pediatrics and JAMA have documented measurable physiological stress responses during circumcision, including increased heart rate, elevated stress hormones and, in some cases, fluctuations in oxygen levels, vomiting and skin color changes. Organizations such as the AAP have weighed these short-term stress responses against potential long-term health benefits. The AAP convened a Task Force on Circumcision in 2007 and again in 2012. In its 2012 policy statement, they concluded:

“...evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks, and the benefits of newborn male circumcision justify access to this procedure for those families who choose it.”

At the same time, the organization stopped short of recommending routine circumcision for all newborns, emphasizing that “Parents should determine what is in the best interest of their child.” The CDC has similarly emphasized potential health benefits while stopping short of recommending universal newborn circumcision. However, both organizations acknowledge that their conclusions depend on how risks and benefits are defined, framed and interpreted.

One frequently cited benefit of circumcision is a reduced risk of urinary tract infections (UTIs) during infancy. Some studies show lower UTI rates among circumcised boys, but the absolute risk remains low in both groups. Critics note that infant UTIs are relatively uncommon, typically treatable with antibiotics and may not justify routine surgery on healthy newborns. Researchers have also pointed out that a large number of circumcisions may be needed to prevent a single UTI hospitalization, adding important context that is often missing from broader prevention claims.

Large randomized controlled trials conducted in sub-Saharan Africa demonstrated that adult male circumcision reduces male-to-female HIV transmission by approximately 50 to 60 percent in high-prevalence settings. As a result, the World Health Organization (WHO) and UNAIDS endorse voluntary adult circumcision as part of comprehensive HIV prevention strategies in certain African countries. However, these findings have important limitations in the U.S. context. HIV prevalence is lower in the United States than in many of the African regions studied, condom use and safe sexual practices remain primary tools for prevention, and the trials were conducted in consenting adult men—not newborns.

Some studies have also explored whether circumcision may modestly reduce the risk of certain sexually transmitted infections, including HPV and herpes, though findings vary and these potential benefits are typically discussed in the context of sexually active adults—not babies. Penile cancer is also cited as a reason to circumcise newborns. Yet penile cancer is extremely rare in developed countries, with an incidence of roughly 1 case per 100,000 men annually in the United States.

Risks and Medical Considerations

Complications from circumcision are often described as unusual, and severe long-term issues as rare, but it is still surgery on a healthy baby, and problems do happen. Large U.S. studies suggest that about 0.5 percent of newborns experience some kind of complication, with estimates ranging from roughly 0.01 percent to 2 percent, depending on how researchers define “complication.” One analysis found early problems in about 1.5 percent of newborns and closer to 3 percent in boys circumcised after infancy, indicating that risk increases when the procedure is performed later in life. While most circumcisions are performed at birth, the procedure is also done later due to cultural or religious reasons, parental decisions as a child ages, adult choice, or medical conditions such as phimosis.

A systematic review of over six thousand articles on circumcision in 2021 resulted in the researchers’ conclusion:

“Complications from neonatal male circumcisions are common and healthcare providers need to be better informed of the potential complications of the surgery so that they can more effectively counsel their patients about potential risks, likelihood of complications and what can be done to prevent them.”

Another U.S. study found that approximately 0.3 percent of children who had elective circumcision were readmitted to the hospital within a week, and about 0.1 percent needed a second operation. Follow-up surgeries are typically performed to address complications from the initial procedure. While these percentages are small, they represent outcomes directly resulting from an intervention on otherwise healthy tissue:

Physical injury: The most immediate complications include bleeding, infection, improper healing, and in rare cases, death. While often described as minor, bleeding can require intervention, and infections in newborns can escalate quickly. Even when early recovery appears smooth, some issues do not become visible until later in childhood or even puberty. Although rare, catastrophic outcomes are documented in medical literature. Excessive tissue removal, accidental injury to the glans, necrosis from compromised blood supply, and even partial or total amputation have been reported.

Short- and long-term impacts: Follow-up problems can include adhesions, where remaining skin sticks to the glans, skin bridges that require surgical separation and meatal stenosis, a narrowing of the opening at the tip of the penis that can make urination painful and may require corrective surgery. Some studies show that 7 to 20 percent of circumcised males develop some degree of this narrowing. In severe cases, it can cause an upward urine stream, difficulty directing urine and prolonged time needed to empty the bladder.

Phimosis: One of the most commonly cited medical justifications for circumcision is phimosis, and it is frequently misunderstood. Phimosis simply means that the foreskin cannot be retracted over the glans. In infancy and early childhood, this is not a disease. Nearly all male infants are born with a foreskin that is naturally attached to the glans and is nonretractable. This is called physiologic phimosis, and is a normal stage of development. Studies show that only about half of boys can fully retract the foreskin by age 10, and full retractability may not occur until adolescence. Nonretractability in childhood is expected and is not a medical problem. Proper hygiene for uncircumcised boys is generally straightforward. Pediatric guidance advises against forcibly retracting the foreskin in infancy, as it naturally separates over time. Once retractable, routine washing with water is typically sufficient.

True pathologic phimosis is uncommon and typically results from scarring, forced retraction, infection or chronic inflammation. In these cases, pediatric research supports non-surgical treatment. Topical steroid cream, which is widely used, has been shown in clinical studies to be successful in a large majority of cases. Circumcision may be considered only if conservative treatments fail, and even then it is rarely medically urgent.

One aspect that is rarely discussed is how circumcision may affect sensation and sexual experience later in life. The foreskin contains nerve endings and serves a functional role in protection and natural lubrication. Its removal means eliminating tissue that plays a role in sexual response and function. Certain studies show that uncircumcised men describe a heightened level of sensitivity, while some circumcised men report feeling satisfied but still question what was lost.

Culture and Incentives

If circumcision were widely viewed as medically necessary in developed countries, rates would likely be more consistent across comparable healthcare systems. But outside of religious communities, routine newborn circumcision remains far less common across much of Europe and in countries such as Canada, Australia and New Zealand. Culture plays a powerful role in sustaining the practice. Parents may be influenced by what feels familiar within their family or community, including whether a father was circumcised or whether their child is expected to resemble other boys around them.

Some research suggests that concerns about being perceived as different from peers may influence caregivers’ choices. Parents may worry that their child will feel different in settings like locker rooms, camps or other peer environments. A Reuters report noted that among boys who experienced teasing about their bodies, many of the comments centered on genital appearance, including whether or not they were circumcised. In communities where circumcision rates remain high, uncircumcised boys may feel self-conscious about standing out, while some circumcised men later report feelings of loss, decreased sensitivity or frustration that the decision was made for them. Social pressure can cut in multiple directions.

According to a study published through DePaul University’s School of Nursing, “The desire for a child’s penis to aesthetically resemble his father’s was the primary motivating factor in parental decision-making.” The fact that the procedure is typically offered while the mother is still in the hospital is another factor. Research on parental decision-making suggests the choice is often shaped by social expectations, cultural norms, geography and the circumstances of birth itself.

Economics is also part of the story. In the U.S., circumcision is reimbursable, with hospitals and physicians receiving payments for performing it. In countries where national health systems do not routinely reimburse non-therapeutic circumcision, rates are significantly lower. Ethically, circumcision raises questions that extend beyond epidemiology. Most pediatric medical interventions are justified by urgent medical need or clear evidence of preventing significant harm. Routine circumcision presents a gray area. The possible benefits are statistical likelihoods that relate mostly to conditions that might arise later in life, not immediate medical needs in infancy.

The ethical conversation becomes more complex when placed alongside global condemnation of female genital cutting. Female genital mutilation (FGM) is widely prohibited and recognized internationally as a human rights violation—condemned because it removes healthy tissue from minors who cannot consent, regardless of cultural justification. Legal bans, global campaigns, and strong language from medical and human rights organizations have framed it as a matter of bodily integrity. According to the WHO, “FGM has no health benefits, and it harms girls and women in many ways.” While these procedures differ significantly in severity, cultural context and long-term health consequences, both raise broader questions about bodily autonomy when irreversible decisions are made for minors who cannot consent. As historian David L. Gollaher observed:

“Indeed, as the history of female circumcision suggests, if male circumcision were confined to developing nations, it would by now have emerged as an international cause célèbre, stirring passionate opposition from feminists, physicians, politicians and the global human rights community.”

Gollaher’s point is jarring. In one context, ritual genital cutting is seen as a grave human rights violation. In another, it is considered routine medical care. That disparity raises a deeper question: how much of your comfort with a practice depends on where it occurs and who performs it? That conflict between a parent’s right to make decisions for their child and a child’s right to bodily integrity is at the heart of this debate.

Rebuilding the Framework Around Choice

Advocacy, at its core, begins with a simple conversation of facts and numbers. Acknowledging that in much of the developed world, public health systems function without routine infant circumcision is a meaningful starting point. But in practice, the conversation is rarely that easy. Consent should be fully informed and unhurried. Parents need clear, evidence-based information presented in language that is easy to read and understand. Decisions should never feel rushed, especially during the vulnerable postpartum window. Instead, educational materials should be introduced during prenatal care, when families have time to consider their options thoughtfully.

Public health messaging can remain accurate without being distorted. Circumcision has been shown to lower the risk of HIV transmission through sex in regions where HIV prevalence is high. Urinary tract infections are slightly less common in circumcised infants, though they are uncommon in either group. Penile cancer is rare in both circumcised and uncircumcised men. All of these facts can be true simultaneously without any of them being overstated. Long-term research on sexual function, pain response and emotional outcomes remains limited and warrants further study. How other countries approach this issue also offers an important comparative perspective that the U.S. medical community would benefit from examining more closely.

Dr. Aaron Tobian, professor of pathology at the Johns Hopkins University School of Medicine, has noted that “multiple factors may contribute to the decline in the number of neonates circumcised.” Among them, he pointed to growing skepticism toward medical recommendations, as well as cultural and policy shifts. Hispanic families, who historically report lower circumcision rates, represent one of the fastest-growing populations in the United States. And by 2011, seventeen states had ended Medicaid coverage for routine newborn circumcision, creating financial barriers that likely contributed to the downward trend.

Research from the Pew Research Center shows that a growing number of Americans turn to the internet for health information before making medical decisions. For new parents, this can mean encountering a wider range of perspectives—including differing medical opinions, personal experiences and viewpoints that challenge long-standing practices. Social media has also helped parents ask deeper questions before consenting to surgery on their newborn. As a result, decisions that may once have been made quickly under hospital pressure are now being considered earlier and with greater scrutiny.

Asking pediatricians direct questions about both benefits and risks, reading relevant research and understanding how this procedure is viewed in other countries can provide valuable perspective. Most importantly, circumcision deserves more than a quick signature on a hospital form or a hurried glance at a pamphlet. It deserves time, careful thought and honest information, so that whatever choice is made, it is a considered one.

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EDITOR’S SUMMARY: Matcha differs from other teas in both how it is prepared and how it functions in the body. Rooted in Zen practice and shaped through specific cultivation and processing methods, it concentrates compounds such as L-theanine and catechins that contribute to sustained energy and focused attention. From ritual to physiology, it reveals how a centuries-old tradition translates into measurable effects.

In the familiarity of ritual, the mind is no longer tasked with deciding—only with being. With each step known, there is space to be fully present. Most tea asks very little of you: a bag lowered into hot water, left to steep. Matcha takes a different approach. Its preparation requires attention, and in that process, it invites a kind of balance that is reflected in the effects of the tea itself.

In a formal Japanese ceremony, the experience begins even before the tea room is entered—on the garden path. At a stone basin, you pause to wash your hands and rinse your mouth, acts of purification in both action and speech. Once inside, shoes are removed and you lower your head through a small doorway, leaving behind status, identity and the noise of the outside world. Woven mats meet your feet. The decor is intentionally spare: shoji screens of wood lattice and paper filter the light into a gentle glow. In a single alcove (tokonoma), a scroll hangs—bearing the characters for harmony (wa), respect (kei), or at times a poem honoring the season. Beneath it rests a simple floral arrangement.

Here, there is no rush. The air is warm with the gentle breath of steam rising from an iron kettle. You take your place, seated on a floor cushion (tatami), opposite the hearth. The host enters and kneels. From your seated position, you bow in greeting. One by one, utensils are wiped with a folded silk cloth—an act of care and respect. Hot water is first ladled into the bare tea bowl (chawan). It is warmed, readied, then emptied and gently dried—in preparation for what comes next. Before you, a small mound of vibrant green powder is placed into the earthen bowl. Its surface is uneven and its glaze imperfect. Using the bamboo scoop (chashaku), the host measures each serving carefully. Fresh hot water is added. The bamboo whisk (chasen) begins its work. The agitation is gentle but steady—bristles against ceramic, water and leaf settling into suspension.

Within moments, a froth appears, almost like the sea’s foam. Before that first sip, you are offered a seasonal sweet (wagashi): a delicate bean paste, a molded rice flour confection, or perhaps, a translucent jelly shaped to echo the time of year—cherry blossom in spring or maple leaf in autumn. Its subtle sweetness primes your palate for what’s to follow. The bowl is turned so that its most beautiful side faces you. You are about to partake in a Japanese matcha tea ritual—known as chanoyu, the art of preparing tea that would later give rise to sadō, or “The Way of Tea”—a philosophy lived daily beyond the walls that hold the ceremony.

You bow in greeting. You lift the bowl with both hands. You turn it slightly—so as not to sip from the front. The bowl touches your lips and you drink. Your palate awakens to notes that are bitter, sweet, complex and alive. Wiping the rim, you turn it back and return it with gratitude. This intimate exchange—host to guest, guest to host—is a gesture of humility, respect and shared presence.

This is matcha, prepared today much the same way it was hundreds of years ago in Japan and first experienced nearly a millennium ago by Buddhist monks. You won’t find it prepared this way at a chain coffee/tea shop, and it’s not typically served sweetened or as a latte with dairy foam. What you have just experienced is not merely tea, but the culmination of centuries of preservation, cultivation, refinement and tradition.

The Long Journey of a Leaf

Matcha’s story curiously begins not in Japan—but in China during the Tang Dynasty (618–907 AD), when tea leaves were once steamed and compressed into cakes for transport and trade along what is now called the Ancient Tea Horse Road. By the Song Dynasty (960–1279 AD), the use of the whole tea leaf was already established, and the practice of grinding it into a fine powder to be whisked with hot water became widespread.

This powdered tea would eventually be brought to Japan in 1191 by the Zen monk Eisai, who returned from study in Chinese monasteries carrying both tea seeds and a philosophy: that tea was not merely a drink—but a tonic for health, longevity and spiritual presence. Eisai wrote in Kissa Yōjōki (“Drinking Tea for Health”): “Tea is the ultimate mental and medical remedy and has the ability to make one’s life more full and complete.”

Matcha soon became embedded in Zen practice—not for enjoyment, but for purpose. Drinking a cup before meditation allowed monks to remain awake and alert, yet inwardly centered for extended periods. By the 16th century, tea master Sen no Rikyū would refine this method into the ritualized practice of chanoyu with a focus on the imperfect, impermanent and incomplete, known as wabi-sabi. In time, this tradition would give rise not just to a beverage, but to a life philosophy rooted in the principles practiced through the ceremony. This evolved into the “Way of Tea” that is known today.

From ceremony to cultivation

Beyond the tranquility of the tea room, the future of this ancient practice is patiently unfolding in the Japanese countryside. Uji, a town in Kyoto—widely regarded as the birthplace of matcha—is considered to produce some of the nation’s finest tea. However, other areas, including Shizuoka (the largest tea-producing region in Japan), Kagoshima, Fukuoka and Aichi, are also known for their high-quality production. In Wazuka, another town in the prefecture of Kyoto—one of Japan’s most renowned matcha-producing regions—multigenerational tea farmers continue to cultivate Camellia sinensis, the plant used to produce green tea (including matcha), as well as black, white and oolong varieties, much as their predecessors have for centuries—though not without growing concern.

The average age of Japan’s tea farmers is now near seventy. With fewer young people entering the profession, tea farming—once a pillar of rural sustainability—faces an uncertain future as many farms have been abandoned. In response, some small farms, instead of relying on their traditional local economy of tea schools, temples and merchants, have begun connecting directly with customers through the internet and social media.

What Matcha Is (and Why It’s Different)

As mentioned before, matcha comes from the same plant—Camellia sinensis—as all true teas. Some teas differ because they are grown in different regions or have added flavors, such as Darjeeling and Earl Grey (which are black teas). However, several critical cultivation and processing steps make matcha unique when compared to standard green tea grown in the sun, called sencha. True matcha is derived from shade-grown leaves called tencha. Unlike other teas, these leaves are then stone-ground into a powder. What sets matcha apart is its three distinct production steps:

1. Shading

For approximately 20–30 days before harvest, matcha plants are covered with cloth or reed screens—shielded from direct sunlight in a process that slows photosynthesis and shifts the plant into a stress-adaptation state.

During this time:

• Chlorophyll production increases

• Amino acids—especially L-theanine—accumulate

• Bitter catechins are balanced by the umami of compounds like L-theanine and glutamic acid

As a result, the leaves become a deeper, more vibrant green and undergo biochemical changes that influence both flavor and physiological effects. These changes deepen the leaf’s color, soften its bitterness and contribute to its distinctive balance of flavor and physiological effect.

2. Processing: Steaming and Stone Grinding

Immediately after harvest, the tencha leaves are:

• Steamed to halt oxidation

• Dried

• Stripped of stems and veins

They are then slowly ground into an ultrafine powder using traditional granite stone mills. This process is intentionally slow to prevent heat buildup that could degrade delicate phytonutrients, amino acids, and volatile compounds. The breakdown of carotenoids, for example, can lead to the development of a stale flavor.

3. Consuming the Whole Leaf

Traditional tea is steeped—meaning water extracts some constituents from the leaf, which is then discarded. Matcha is ingested whole. You are not drinking an infusion; you are consuming the leaf itself. This significantly increases the density of biologically active components delivered in a single serving.

Within the leaf you will find:

• Polyphenols, mostly epigallocatechin gallate (EGCG)

• Chlorophyll

• Amino acids like L-theanine

• Vitamins A, C, E, K and B1, B2, B3 and B6

• Trace minerals

• Fat-soluble phytonutrients such as carotenoids that would otherwise remain trapped in steeped leaves

Matcha’s Secret: Energy Without the Edge

All teas contain caffeine, usually 25–47 milligrams per cup. Matcha’s levels, however, typically range from 35 to 70 milligrams, higher than any other tea. Like all sources of caffeine, the energy you feel comes from the stimulant’s ability to block adenosine receptors in the brain, reducing the sensation of fatigue while increasing the activity of neurotransmitters such as dopamine and norepinephrine. This is why it is known to enhance alertness, improve reaction time and support sustained concentration. It’s also why it feels different.

However, caffeine in isolation, without the supportive compounds mentioned above, may also elevate cortisol levels, increase heart rate and trigger feelings of anxiety in more sensitive individuals. These compounds appear to temper caffeine’s effects by influencing neurotransmitter signaling and slowing absorption—resulting in a more gradual and balanced response.

What makes matcha physiologically distinct from other caffeinated beverages is its naturally high concentration of L-theanine—found almost exclusively in tea and especially abundant in shade-grown varieties like matcha. It can cross the blood-brain barrier and has been shown to increase alpha brain wave activity, which is associated with a state of still, focused awareness. It may also support the production of GABA, a calming neurotransmitter, and help modulate dopamine and serotonin levels within the central nervous system.

In combination, caffeine and L-theanine appear to produce what researchers describe as “calm alertness”—enhancing attention and working memory without overstimulation or jitteriness. With nearly identical levels of caffeine per cup as brewed coffee, matcha offers a different experience—one that favors focus over stimulation. It is this unique neurochemical synergy that allows a relatively high-caffeine beverage to promote a state of focused calm—an effect that historically made matcha well-suited for Zen monks seeking sustained, attentive presence during meditation.

A typical serving of matcha (about 1–2 grams) provides modest amounts of key constituents such as EGCG and L-theanine. While a single cup may offer subtle effects, regular intake—often two to three servings per day—more closely aligns with levels used in research. Unlike isolated supplements, these bioactive elements are delivered together in a naturally balanced form, which may influence how they are absorbed and perceived. This differs from isolated forms, which often deliver higher doses without the same buffering context.

Antioxidant, cellular and metabolic protection

Matcha is especially rich in catechins—plant-derived polyphenols known for their antioxidant activity. Among these, the most extensively studied is EGCG, which has been explored for its potential role in neutralizing reactive oxygen species—unstable molecules that can damage cells, often called free radicals—and enhancing the body’s endogenous defenses, including glutathione.

Oxidative stress—an imbalance between free radicals and the body’s ability to counteract their damaging effects—has been associated with a range of chronic health conditions, including insulin resistance, neurodegenerative disorders, cardiovascular dysfunction and accelerated cellular aging. In addition to directly scavenging free radicals, EGCG has been studied for its ability to influence inflammatory signaling pathways, stabilize cellular membranes and modulate gene expression related to immune and inflammatory responses. It can also inhibit histamine release. Emerging research has also explored EGCG’s role in cancer biology, with studies suggesting it may influence how certain cancer cells grow, survive, and respond to stress—adding another layer to its already complex interaction with cellular processes.

Beyond these antioxidant and anti-inflammatory actions, research on green tea catechins suggests they can influence metabolic function. EGCG has been associated with modest increases in fat oxidation (the use of fat as fuel) and improved post-meal glucose response. Its ability to influence enzymes involved in lipid metabolism and increase norepinephrine availability may enhance energy expenditure. Polyphenols in matcha have been shown to help slow carbohydrate digestion, support insulin receptor sensitivity and reduce glycemic variability.

Detoxification and chlorophyll

Because matcha leaves are shaded prior to harvest, they produce unusually high levels of chlorophyll—the green pigment that plays a central role in photosynthesis in plants and has been studied for its potential biological activity in humans. In response to the reduced light, the tea leaves compensate by producing more chlorophyll per leaf cell in an effort to capture as much light as possible.

Chlorophyll, while made in and for plants, has been investigated for its ability to interact with certain compounds in the body. It has been shown to bind cancer-causing by-products of high-heat cooking as well as aflatoxins produced by mold, support phase II liver detoxification and reduce oxidative burden. Chlorella, spirulina, wheatgrass, alfalfa and dark leafy greens also contain high levels of chlorophyll and are known to exert similar effects.

In the modern environment—characterized by increasing exposure to pollutants, industrial chemicals and microplastics—nutrients that support detoxification and oxidative balance are of growing interest. While matcha is not a detoxifying agent in its own right, its polyphenolic compounds can support the body’s natural detoxification processes. The naturally high chlorophyll content may offer subtle support for the body’s existing detoxification systems when included as part of a nutrient-dense diet.

Considerations

As with any biologically active substance, context matters. Despite its extraordinary benefits, matcha is not appropriate for everyone. Caffeine sensitivity may be an issue for you if you metabolize caffeine more slowly, which can prolong its effects and increase the likelihood of jitteriness, anxiety or sleep disruption. Matcha naturally contains vitamin K, which may interact with anticoagulant medications. Polyphenols may also inhibit iron absorption when consumed with meals, so timing intake away from iron-rich foods may be beneficial.

Studies suggest that compounds in tea, including EGCG, may reduce the absorption of folic acid when consumed at the same time. This effect appears to be more pronounced with synthetic folic acid than with naturally occurring folate. While this is not considered a concern for most people, it may be worth noting during pregnancy or if you have certain genetic variations, including MTHFR, COMT, or folate transporter variants. If you take a folate supplement, consider separating it from tea by a few hours. If tea is part of your daily routine and these genetic factors are present, periodic folate level testing may be helpful. Tea plants may accumulate lead or other contaminants from soil or environmental exposure, so choosing organic and third-party tested sources is recommended.

The final sip

Matcha’s truest potency lies not in measurable outcomes, but in the intentional act of its preparation. In the wisdom of Zen Buddhism, “The taste of Zen and the taste of tea are one.” Centuries ago, monks began drinking matcha to steady the mind and meet the infinite through meditation. In a busy world, an inwardly still mind paired with sustained, balanced energy may provide exactly the tools needed to meet the day ahead with a little more clarity. Instead of the wired rush of coffee, perhaps try something a little more contemplative. It is the same restraint—the subtle, shaded discipline needed to produce matcha that shapes the leaf into something extraordinary—that carries through in the experience.

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EDITOR’S SUMMARY: Fascia is a continuous, dynamic network that supports your body’s structure, movement, and internal communication—yet its role has long been overlooked. From elasticity and fluid balance to sensory signaling and adaptation, this tissue responds directly to how you move, rest, and nourish yourself. While research continues to uncover its full significance, caring for it through varied movement, adequate hydration, and regular bodywork such as stretching or massage may help preserve mobility, resilience, and function over time.

From your first morning stretch to curling up at night, you can thank the unsung hero of your body: fascia. This intricate, web-like network of fibers runs throughout your body from head to toe. One continuous piece, it works with (and within) bones and muscles, tendons, ligaments, and organs to quite literally hold you together. You might’ve seen this material in the kitchen—it’s the thin, whitish layer you can peel away from a chicken breast, the marbling in a cut of beef, or, for the vegetarian crowd, something akin to the pith of an orange that holds everything in place. Its importance is only now being recognized, as it turns out that the health of your fascia is crucial to staying mobile, functional, and comfortable throughout your life.

Regardless of candles on a cake, one factor that can make you feel old is a shift in flexibility: waking up feeling “stiff,” discomfort when bending over to pick up the phone you dropped, or tweaking a muscle when reaching up high for something. Your mobility depends on healthy fascia—this is the material that must stretch, recoil, and glide for you to move with ease. The earlier you begin to care for your fascia, the longer you’ll be able to maintain a wide range of motion and function in everyday life.

Strength, Signal, and Structure

Just as a spiderweb appears fragile, its strength rivals that of steel. Your web of fascia is equally remarkable, with a tensile strength of up to 2,000 pounds per square inch—able to withstand that amount of force before breaking. Despite its vital role, for decades, fascia was regularly cut away and tossed out of cadavers in medical school, with scientists treating it more as filler than a structure worthy of study. It wasn’t until 2013 that the first textbook specifically about fascia appeared.^,

Still, this level of appreciation is long overdue, especially for a substance that holds your whole body together and accounts for roughly 40–50 pounds of your total weight. Its structural function is the reason you can be 60% water and not exist as a puddle on the ground. It’s made up of collagen—thick, strong fibers that give your body its shape; elastin—thin, flexible fibers that can stretch up to 150 percent of their length; and “ground substance,” or hyaluronan, which acts as a lubricant between fascial layers, allowing them to glide smoothly.

Fascia runs throughout your body, including beneath and attached to the skin, similar to a wetsuit. Structurally, it functions via the principle of tensegrity—a system in which rigid elements and continuous tension balance each other. In his book “Anatomy Trains,” manual therapist Tom Myers mapped out 12 fascial routes, or “lines”—8 through the lower body and trunk, plus 4 arm lines running from the spine to the fingertips. For example, the spiral line connects the two sides of your body, running from your feet to your skull and crisscrossing near your belly button, providing balance and stability for walking, twisting, and rotational movements. These interconnected pathways help explain why tension in one area can show up as pain in another.

Among fascia’s many important functions is its ability to sense and adapt to what you need, meaning your repetitive positions and movements shape your connective tissue over time. Cells known as fibroblasts help produce tissue in response to these demands. This is why, for example, champion javelin thrower Thomas Röhler was found to have fascia measuring 3 mm deep in his right pectoral muscle—three times thicker than in his left. As fascia expert Dr. Robert Schleip, who conducted the measurements, noted in a research forum, it’s not surprising for a frequently used muscle to grow larger, but such a pronounced difference in the surrounding fascia was unexpected. This suggests that as muscle develops, the surrounding supportive fascia adapts alongside it.

Even the understanding of how fascia grows has changed in recent years. In a 2018 study led by Italian Professor Carla Stecco, her team discovered an entirely new type of cell they dubbed “fasciacytes.” It was previously thought that fibroblasts generated new connective tissue, but Stecco’s research found that fibroblasts are responsible for producing collagen and elastic fibers, while fasciacytes produce hyaluronan. If this component is not functioning properly, it can cause pain and restricted movement. Fasciacytes appear to line the boundaries of different fascial layers—positioning them to detect when more hyaluronan is needed and produce it accordingly. Your fascia is also piezoelectric, meaning the tissue can generate small electrical charges. Collagen—your body’s most abundant protein—plays a central role in this property and is involved in virtually every movement you make.

“Every time we move, stretch, or even shift in our seats, we create mechanical stress that deforms the collagen fibers in our fascia. This deformation generates tiny electrical currents . . . These currents help guide biological processes, especially in bones. For example, when you land from a jump, your bones bend ever so slightly, generating piezoelectric charges in the collagen. These charges signal bone cells to strengthen and grow, reinforcing the areas under stress. This is why weight-bearing exercise is so important for bone health–it literally electrifies your bones!”

Where the Body Feels and Responds

This piezoelectric quality may be part of the mechanism by which acupuncture works. In her team’s research, neuroscientist Dr. Helene Langevin, former director of the National Center for Complementary and Integrative Health, discovered that about 80 percent of acupuncture points correspond to areas where connective tissue planes converge—often compared to intersecting roads. This could be the physiological “Western” explanation aligning with the Eastern focus on energy and meridians. While the exact mechanism of signaling that occurs via an acupuncture needle is still not fully understood, whatever communication it initiates may have an effect both spatially “(connecting different parts of the body) as well as across physiological systems (connective tissue permeates all organs and surrounds all nerves, blood vessels, and lymphatics).”

When acupuncture needles are removed, your body’s resistance is known as “needle grasp.” While it was long thought that this resistance was due to muscles contracting, Langevin’s research suggests it is more likely caused by fascia wrapping around the needle. Her team found that once inserted, needles that were rotated produced greater resistance upon removal than those left still. Ultrasound imaging shows fine connective tissue fibers wrapped around the needle during rotation. Those same areas also reveal measurable changes in connective tissue architecture—indicating that an acupuncture session can physically alter fascial structure.

As if electrical signaling wasn’t enough, your fascia is also viscoelastic. This means it both springs back like a solid (the “elastic”) and slowly adapts like a fluid when gentle forces are held over time (the “viscous”). The elastic aspect allows you to jump and land, with tissue stretching quickly and returning to its original shape. The viscous aspect comes into play with sustained pressure—such as during a massage or longer stretches like yoga poses. You might notice that a quick stretch feels different from a long one because your connective tissue relies on different properties for each.

Fascia has since surpassed skin as your body’s largest sensory organ, with approximately 250 million nerve endings compared to skin’s 200 million. The release and relief felt after a yoga session or a massage are not always purely physiological. Because fascia is both your largest sensory organ and one continuous network—extending from your toes to your brain and gut (often referred to as your “second brain”) and facilitating communication—some experts believe emotions may be stored within this versatile tissue.

Whatever causes stress—a piece of bad news, a deadline you just remembered—you’ve probably felt it somewhere in your body. It could be a “pit” in your stomach, a knot in your throat, or tension in your shoulders. Of course, this happens with good news, too—like “butterflies” in your stomach when you’re excited or tearing up when moved. Feeling the internal state of your body is known as interoception—a sense that covers everything from thirst and hunger to nerves before a presentation or test. While interoception is an “accepted” sense, there is still disagreement on whether parts of your body are so connected to emotions that those sensations can be alleviated through treatments like myofascial release (MFR).

Similar to massage, MFR focuses on specific areas of restriction within the body. Where a Swedish massage typically uses consistent pressure and flowing movements for relaxation, an MFR therapist concentrates on areas where the fascia shows restriction. The pressure on each point can be deeper and is sustained longer than in a traditional full-body massage, held until the restriction begins to release. The therapist then follows the fascia’s loosening to the next restriction, and so on, as your body “communicates” its needs.

There are anecdotal reports of people experiencing emotional relief during fascial release, but studies have yet to support the idea that these are directly causal. Because of the complexity of emotions and the makeup and pervasiveness of fascia, it can be difficult to pinpoint how they directly influence one another. It’s possible that emotions or traumas can get “stuck” in your bodily tissues, especially since trauma or long-term stress can result in chronic muscular tension as the body attempts to protect itself, known as “armoring.” But it’s also possible that myofascial release feels emotionally meaningful because slow touch strongly affects the body’s interoceptive and nervous system pathways.

Most of the nerve receptors in your fascia are sympathetic nervous system receptors, and many of these nerve endings are vasoconstrictive, controlling blood flow, so it makes sense that “subtle changes in skin temperature often reflect acute and chronic changes in emotions.” While randomized controlled trials haven’t shown that emotions “live” inside your fascia, these tissues are so closely linked to the brain that, as Andrew Taylor Still, the founder of osteopathy, believed, “All fascial tissues should be treated with the same respect as if dealing with ‘the branch offices of the brain.’”

If connective tissue is so important, is more always better? Not necessarily. Tissue that develops in an organized manner in response to exercise reflects a healthy adaptation. When it forms excessively and in a disorganized way—due to scarring or chronic inflammation—it’s known as fibrosis. If this condition progresses, it can lead to organ failure and even death. When it comes to your fascia, it’s not quantity, but quality—making how you care for it essential.

Movement as Maintenance

Keeping your fascia loose and lubricated is important, and that can be achieved in several ways. Getting adequate sleep and hydration is always important, but especially so for connective tissue, which (when young and healthy) is composed of approximately 70% water. The regeneration it undergoes, including the secretion of human growth hormone, only occurs during deep sleep. General hydration guidelines, such as drinking roughly half your body weight in ounces, can be a helpful starting point, but don’t forget your electrolytes, as they help your cells more effectively hold moisture. This is where some water-rich foods can be helpful: watermelon, celery, and cucumber—each contributing hydration along with supportive compounds like natural electrolytes and silica, which support elasticity and structural integrity.

Protein is the most important building block in your connective tissue, and the amino acids it requires cannot be made by the body, so dietary intake is essential. Animal protein provides a complete source, while vegetarians can obtain adequate amounts from legumes and lentils with careful planning. Vitamin C is vital for collagen synthesis and is often more readily obtained from vegetables like spinach, parsley, and peppers, which can contain higher levels than many fruits. Zinc, found in foods like nuts and legumes, is a key mineral for synthesizing collagen and protein. Copper (via fish, cocoa, liver, nuts, and seeds—ideally not all in the same bite) and sulfur (found in cruciferous vegetables, onions, and garlic) are necessary to create the “crosslinks” (fibers) that connect new collagen and elastin fibers to each other when fascia is stimulated.

Nutrition and rest matter, but the way fascia primarily hydrates is through movement. Think of a sponge and how dribbling water on it won’t reach every part, whereas squeezing it allows moisture to spread throughout the material. To this end, Schleip penned a book titled “Fascial Fitness: How to Be Vital, Elastic and Dynamic in Everyday Life and Sport,” in which he lays out a plan that requires only 20 minutes of your week in the form of two 10-minute sessions. He recommends six exercises in a specific sequence, beginning with foot rolling and working your way through your legs, your front and back fascial lines, your waist and sides, followed by the shoulders, and a neck-back combo. The only “equipment” necessary is a tennis ball and a chair.

The exercises are designed to strengthen and nurture what Schleip calls the four functions of fascia: movement, communication, supply, and shape. The function of shape is as it sounds—giving structure to what would otherwise be an unorganized mass of organs, muscles, and bones. Fascia’s relationship to movement is that it maintains tension and elasticity, as well as supporting energy storage and transfer. The function of “supply” is about moving fluid and nutrients throughout your body, and communication refers to the transmission of stimuli and information. The corresponding exercises involve what he refers to as spring, revive, feel, and stretch.

“Spring” encompasses motions like hopping or swinging the upper body, promoting elasticity. Think of childhood activities like skipping and playing hopscotch—these increase elastic recoil capacity, or your tissues’ ability to return to their original shape after being stretched. This is one reason children tend to have much more malleable fascia than adults. Rebounders (small trampolines) have become increasingly popular and can also support cardiovascular exercise, but you don’t need equipment. Schleip’s jumping protocol involves gentle hops with a goal of landing as quietly as possible, only using (walking) poles if necessary for support.

“Revive” is designed to rejuvenate fascia via squeezing, as this is how your body dynamically hydrates—essentially wringing out old fluid and metabolic waste, allowing fresh fluid to fill the space. Dynamic hydration becomes especially important as you age, since studies have shown that by age 60, the water content of your fascia may drop from 70–80 percent to 50 percent. Professional massage can help in this endeavor and offers benefits beyond fascia, but a daily massage would be quite the financial investment. Instead, Schleip’s program begins with self-massage, often using a rubber ball, tennis ball, or foam roller under your feet. You may meet resistance and discomfort with this type of work, at least initially. In this situation, one tip physical therapist Dr. Kelley Starrett offers is to take a slow inhale (around four seconds), allowing the muscle to gently contract, holding for four seconds while applying pressure with the roller or ball, then exhaling (longer than your inhale) and allowing the muscle to relax. This sequence helps signal safety to your nervous system and can reduce resistance after a few repetitions.

“Feel,” in the quartet of workout principles, is characterized by awareness of your movement and coordination. This means being present with your body, staying connected rather than distracted during exercise. “Stretch” is fairly self-explanatory, except that when it comes to fascia, longer stretches are thought to be more beneficial, as it takes time to release and refresh tissue—something for which there is no shortcut. Stretch not only helps invigorate and hydrate your fascia—emerging research suggests it may also influence broader physiological processes, including those related to cancer.

In her lab, Langevin has worked with rodents in a practice she dubs “rat yoga.” In her 2018 study, mice were injected with breast cancer cells and divided into two groups: one non-stretch and one where the mice were put into a yoga-like gentle stretch for about ten minutes a day. After four weeks, the tumors of the mice who stretched were 52 percent smaller than those in the non-stretch group, without drugs or other treatment. Regarding Langevin’s results, it has been suggested that many people develop cancer but don’t die from it: “Whether we die from it depends mostly on how fibrotic is the connective tissue around it.”

In the case of cancer, if connective tissue surrounding the tumor builds up excessively, it can act “almost like scaffolding that helps a tumor take root, connect to blood vessels, and grow.” What many of the biomarkers in the study showed was that “stretching appeared to do something extraordinary: it helped the body ‘turn up’ its cancer-fighting immune response while simultaneously ‘turning down’ the chronic inflammation that helps cancer thrive.” Considering that approximately 45 percent of worldwide deaths in developed countries are attributed to fibrotic diseases, this finding has potential beyond cancer.

Fortunately, rejuvenating your fascia is very doable, with no fancy equipment or gym membership required. Schleip even proposes the idea of adults using playground equipment to awaken movement patterns you may have left behind in childhood but that still play a role in restoring fascia. His book includes a playful photo of Schleip, now in his 70s, on a playground rope climbing structure, hanging by his arms and legs. This, of course, should be approached with caution and common sense—no dangling upside down from a jungle gym on day one.

In some parts of the world, like the “Blue Zones”—areas where people regularly live past 100—physical activity such as lifting loads, bending, squatting, and walking steep slopes is woven into daily life. For example, in Ikaria, Greece, nonagenarians (those over age 90) reported spending less than three hours per day sitting—far less than the roughly 9.5 hours per day reported among older adults in the United States. These environments demand a lifestyle that includes activities like “walking to commute, working labor-intensive occupations, participating in outdoor hobbies, and navigating complex terrain with constant exposure to uneven surfaces.”

It’s not just the movement but how they move—reaching, bending, adjusting to slopes and rocky paths, and engaging leg and foot muscles in varied ways to maintain balance. These demanding motions help maintain fascial hydration and elasticity—a stark contrast to the American perception of aging as inherently fragile. These same types of movements—walking and running, climbing and swinging, throwing, squatting, carrying, digging, and playing—form the foundation of a healthy, resilient musculoskeletal system, no matter where you live.

If you’re looking for more real-time guidance, there are many fascia-focused exercises available online. Some involve dance-type movements, others focus on more standard workouts with minimal equipment, and some are even specific to facial fascia (say that three times fast), where the movements and self-massage are geared toward the muscles in your face and neck.

Since your fascia can both generate and conduct electrical signals, is one continuous piece, and runs throughout every part of your body, it’s worth devoting time to caring for this remarkable system. Attention to it can help ensure your mobility and flexibility—key components of freedom and independence as you age. The research is still catching up—but your body doesn’t need to wait for it.

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EDITOR’S SUMMARY: The GRAS (“Generally Recognized as Safe”) designation was designed to streamline food safety, but over time it has evolved into a complex and often opaque process through which many ingredients enter the food supply without formal FDA review. While some substances are later restricted or removed as new evidence emerges, others are reviewed, withdrawn, or reconsidered outside public view. As the system continues to shift under increasing scrutiny, understanding how these determinations are made offers a clearer lens into what safety in modern food truly means—and where its limits lie.

For most of human history, food was not a question of chemistry—it was a matter of survival. Where would the next meal come from? Would the harvest hold? Would the hunt succeed? What was meant to be eaten was recognizable—perishable and imperfect. It came from the soil, from animals, and with the rhythms of seasons that could not be controlled. The risks were immediate and visible—scarcity, spoilage, famine. But rarely was it considered whether the food itself, once obtained, was inherently unsafe to eat. Today, that question of survival has changed dramatically.

The modern consumer no longer asks just where their food comes from—but whether what is being presented is, in fact, safe. Not spoiled. Not contaminated in the traditional sense. But something more abstract: chemically altered, industrially processed, and engineered in ways that are no longer visible to the naked eye. This becomes clear the moment you visit a grocery store, where nearly 70% of food on store shelves is considered ultra-processed.

These products are made with ingredients that are difficult to recognize and far removed from anything found in a kitchen or growing naturally. Food is no longer just food—it’s a formulation. It’s a chemistry experiment designed to manipulate your taste buds and encourage overconsumption. In a profit-driven food system, your health is not the first priority—the bottom line is.

Yet, most people move through the grocery store with their list in hand and an unspoken agreement in place. There is an assumption that someone, somewhere—a chemist in a lab coat, a panel of toxicologists, a federal oversight committee—has already asked the hard questions on your behalf. That the emulsifier keeping the almond milk smooth, the preservative extending the shelf life of the gluten-free crackers, or the flavor enhancer rounding out the plant-based protein bar has been reviewed for safety long before you ever take a bite.

This assumption becomes the scaffolding of modern life. After all, in a world where a parent is juggling work, school drop-offs, personal commitments, and weeknight dinners—or a caregiver is preparing meals for a dependent family member—few people have the time (or training) to individually evaluate the toxicological profile of every additive in every jar, bag, carton, or box. You rely on a system that is designed (at least in theory) to keep you safe. A regulatory framework intended to ensure that what enters the food supply has been reviewed, assessed, and deemed safe for consumption under its intended conditions of use. But that determination is not a guarantee—it is an assertion.

Enter GRAS: Generally Recognized as Safe

In 1958, the GRAS designation was established under the Food Additives Amendment to the Federal Food, Drug, and Cosmetic Act. The intention was practical: to exempt substances with a long history of common use in food—like salt, vinegar, or baking soda—from the lengthy (often 2–5 year) pre-market approval process required for new chemical additives. In other words, if something had already been widely consumed and understood to be safe, it did not need to be re-proven.

A substance could be classified as GRAS (pronounced grass), as the U.S. Food and Drug Administration (FDA) puts it, “...either through scientific procedures or, for a substance used in food before 1958, through experience based on common use in food…” George P. Larrick, then FDA Commissioner, explained:

“We believe only those chemicals should be automatically exempted from the new law which are recognized among competent experts as safe for their intended use. This would make it unnecessary, for example, to do studies on table salt, but would not approve the continued use, without proof of safety, of the synthetic emulsifiers now widely used in some fabricated foods.”

Substances that were already long consumed and familiar before 1958 were “grandfathered in” and automatically qualified as GRAS. No new testing or formal FDA review was required. For all other substances—new, engineered, or not yet well understood—a different set of regulatory processes applied. Companies must establish that these ingredients can be used safely, and the system allows several distinct approaches:

1. Self-affirmed GRAS (with FDA notification): A company assembles a body of evidence (published studies, toxicology data, and sometimes research on structurally or functionally similar compounds) and concludes that the substance is safe. The company may then voluntarily notify the FDA. In response, the agency typically issues a “no questions” letter, indicating it does not object to the conclusion and the product can be brought to market without formal approval.

2. Self-affirmed GRAS (without FDA notification): A company can also bring a substance to market based solely on expert consensus, without ever informing the FDA.

3. Formal food additive approval: Ingredients without historical use or clear expert consensus must undergo a full Food Additive Petition process. This requires extensive safety data, toxicology studies, metabolic analyses, intended use levels, and projected dietary exposure. The FDA conducts a mandatory, exhaustive review and only grants legal authorization once it concludes there is reasonable certainty the product causes no harm. This process is government-driven, legally binding, and far more rigorous than any GRAS pathway.

In reality, many substances enter the food supply not through mandatory government review, but via a system in which safety is largely determined outside the agency—by qualified experts, often hired and compensated by the company, provided their conclusions are supported by publicly available scientific evidence. Over time, the GRAS framework has evolved. What began as a narrow exemption for familiar, time-tested ingredients gradually expanded, and the line between historically recognized substances and newly engineered compounds grew increasingly difficult to distinguish. In a world built on trust in unseen systems, GRAS is one that operates in the shadows—shaping what ends up on your shelves, in your kitchen, and ultimately, in your body.

The Ingredients That Were “Safe”…Until They Weren’t

For decades, partially hydrogenated oils (PHOs)—the primary dietary source of artificial trans fats—were considered GRAS. They appeared in everything from margarine to peanut butter to bread products, in part because early GRAS lists created in 1958 relied on the scientific knowledge available at the time. It wasn’t until years later—after mounting research linked trans fats to artery-clogging plaque (atherosclerosis) and increased risk of cardiovascular disease—that the FDA made a pivotal decision in 2015: PHOs were no longer GRAS. In their final determination notice, the agency summarized their findings:

“...the Food and Drug Administration (FDA or we) has made a final determination that there is no longer a consensus among qualified experts that partially hydrogenated oils (PHOs), which are the primary dietary source of industrially-produced trans fatty acids (IP-TFA) are generally recognized as safe (GRAS) for any use in human food. This action responds, in part, to citizen petitions we received, and we base our determination on available scientific evidence and the findings of expert scientific panels establishing the health risks associated with the consumption of trans fat.”

By 2018, manufacturers were prohibited from adding them to foods, with final compliance deadlines extending through 2021 to allow products already in distribution to clear the market. A substance that once moved through the food supply without notice under a safety designation had now been formally removed from it—with the FDA estimating that its elimination could prevent thousands of heart attacks and deaths each year.

Then there’s the story of brominated vegetable oil (BVO). Used since the 1930s to stabilize citrus-flavored soft drinks and prevent separation, BVO was initially designated as GRAS in 1958—only to have that status withdrawn in 1970 after safety concerns began to surface. Even so, it remained permitted at limited concentrations in beverages for decades under an “interim” regulatory status. In 2012, 15-year-old Sarah Kavanagh turned to the internet after noticing BVO on the label of a Gatorade. What she found was startling: it was patented for use as a flame retardant. She then launched a petition asking Gatorade’s parent company, PepsiCo, to remove the ingredient. After more than 200,000 signatures, they agreed.

It wasn’t until July 2024—following collaborative studies with the National Institutes of Health suggesting potential adverse effects, including neurological symptoms—that the FDA formally revoked authorization for its use in food. Manufacturers had until August 2025 to reformulate affected products. These two examples share a common thread: meaningful change came from outside the system, not from within it. While the removal of PHOs and BVO eventually made headlines, not every ingredient follows the same visible path. Some are gradually reformulated, withdrawn, or reconsidered behind the scenes—within the GRAS process itself—long before they ever attract public attention.

The Ones You Never See

What reaches the shelf is only part of the story. Beyond the ingredients that are approved, there is another category that rarely enters the conversation—those that come close but never reach the market. In recent years:

• DHA-rich algal oil (GRN 1128) was withdrawn due to concerns over chemical impurities linked to manufacturing processes.

• A rice bran wax ingredient (GRN 962) was pulled after estimated dietary exposure in children exceeded safety thresholds.

• The synthetic folate compound, Monosodium L-5-methyltetrahydrofolate (GRN 1023), was abandoned when safety data for infants proved insufficient.

In these cases, the issue wasn’t necessarily that harm had already occurred—but that the evidence needed to confidently assert safety simply wasn’t there. While these ingredients never reached the market, their withdrawal is revealing. Before an ingredient enters the food supply, companies compile detailed safety dossiers—bringing together toxicology data, projected intake levels, metabolic studies, and manufacturing details, including potential impurities or byproducts. These materials are reviewed by qualified experts to determine whether there is a reasonable certainty of no harm under the intended conditions of use. It is at this stage that problems often emerge.

Sometimes the concern lies in the manufacturing process itself—where trace impurities, solvent residues, or unintended chemical byproducts alter the safety profile of the final ingredient. In other cases, projected exposure levels—particularly in vulnerable populations like children—exceed established safety thresholds. And at times, the limitation is more fundamental: the available data is incomplete, leaving too much uncertainty to support a conclusion of safety.

When these issues arise, a submission may be revised or halted entirely, sometimes before formal FDA review is completed. The result is a category of substances that were developed, evaluated, and nearly introduced—but ultimately halted before reaching consumers. From one perspective, this reflects a system functioning as intended—identifying potential risks before exposure occurs. From another, it reveals something less visible: that safety determinations are contingent on available data, expert interpretation, and voluntary disclosure. Importantly, a withdrawal is not always an endpoint. In many cases, it marks a pause.

Manufacturers can return with additional studies, refined data, or new expert analysis to address the gaps that prevented a GRAS conclusion the first time. The same ingredient—reformulated, recharacterized, or supported by new evidence—can re-enter the process and be reconsidered. The GRAS system, in other words, relies on judgment as much as interpretation. The absence of exposure is not always evidence that a risk never existed. Sometimes, it is a sign that the question of safety is still being answered—out of view and over time.

The System Is Still Changing

The scale of this landscape is difficult to fully grasp. It is estimated that more than 10,000 chemicals and additives are permitted in the U.S. food supply, often used in small amounts, yet many have not been re-evaluated by the FDA in decades. The actual number is unknown. While the majority are considered safe, some substances still allowed in the United States have been restricted or banned in other countries—such as the UK and Canada—after research linked them to cancer, developmental concerns, or behavioral effects.

Another concern is that the system treats each ingredient as a separate entity, ignoring the reality that the Standard American Diet exposes you to a constant overlap of multiple additives at once. When ingredients are researched and approved in a vacuum, there is no clear understanding of how they interact with other substances, and new additives continue to be introduced.

At the same time, GRAS is not a fixed list but an evolving pipeline. Since 1998, more than 1,200 substances have been submitted through GRAS notices, resulting in “no questions” responses, ongoing reviews, or voluntary withdrawals. Even though the total number of ingredients in the food supply remains uncertain, recent leadership changes and increased public scrutiny have contributed to growing regulatory momentum.

In April 2025, the U.S. Department of Health and Human Services (HHS) and the FDA announced plans to phase out petroleum-based synthetic dyes from the national food supply—revoking authorization for Citrus Red No. 2 and Orange B. The agencies are also working with industry to eliminate several remaining FD&C dyes by the following year. Under HHS Secretary Robert F. Kennedy Jr., the FDA is exploring the elimination of the self-affirmed GRAS avenue as part of a broader push for “radical transparency” so Americans know exactly what is in their food. In a statement, Kennedy said:

“Eliminating this loophole will provide transparency to consumers, help get our nation’s food supply back on track by ensuring that ingredients being introduced into foods are safe, and ultimately Make America Healthy Again.”

This is the same “loophole” that has allowed companies to self-affirm the safety of new ingredients—without FDA review, public disclosure, or independent verification—before introducing them into the food supply, often with unknown safety implications. Closing this provision would require companies to publicly notify the FDA and submit supporting safety data before ingredients enter the market. HHS has already submitted plans to tighten oversight of the GRAS program to the White House, where they are now pending review.

In July 2025, Senator Edward J. Markey and Senator Cory Booker proposed the “Ensuring Safe and Toxic-Free Foods Act,” which would require manufacturers to submit safety data to HHS, make that data publicly available for a 90-day FDA review, bar carcinogenic or reproductively toxic substances, exclude experts with conflicts of interest from the GRAS process, and establish a system to reassess previously approved GRAS substances.

Real Food, Real Safety

Rather than getting lost in the complexity of GRAS notifications, self-affirmed determinations, and ingredient withdrawals, there is a simpler way to navigate the modern food environment. Instead of scrutinizing labels on the 70% of ultra-processed foods in the grocery store, turn your attention to the 30% that likely doesn’t need an ingredient list at all—whole, minimally processed foods like meat, dairy, fruits, and vegetables. These foods come with a history and a track record of safety that do not rely on GRAS designation for validation. As functional medicine doctor Robert Reier says:

“What’s the answer to achieve health, wellness and vibrancy? Well, drum roll please. Eat real one ingredient foods. That’s it end of story, and you’ll be well on your way to a healthier existence. Eat foods that come in nature’s wrapping without any ingredients.”

Prioritizing whole foods means bypassing much of the regulatory uncertainty, chemical additives, and marketing spin—returning to the kind of food your ancestors recognized and trusted. And the evidence supports it: dietary patterns lower in ultra-processed foods and higher in whole, minimally processed foods are associated with lower rates of chronic disease, improved metabolic health, and reduced risk of premature death.

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EDITOR’S SUMMARY: Plastic packaging is everywhere—and increasingly, so are questions about what it’s doing to your health and the planet. Follow the story of how synthetic materials came to dominate the global food system, what scientists are finding inside your body, and how governments, innovators and consumers are pushing back. The alternatives are real—but none are without compromise. The future of food packaging is being written right now, in policy chambers, research labs and the grocery store aisles you walk every week.

Walk through any modern grocery store and one detail is hard to overlook. Nearly every item is wrapped, sealed, lined, or laminated in plastic. Fresh meat sits on foam trays sealed in stretch film. Berries are packed into rigid clamshell containers. Salad greens are triple-washed and sealed inside plastic bags or boxes that promise freshness for days. Crackers, granola bars and tortilla chips live inside packaging designed to block oxygen and moisture, keeping contents shelf-stable for months. Even non-GMO, organic, ethically sourced foods arrive in the same plastic containers as everything else. You have learned to scrutinize ingredient labels—sugars, oils, additives—yet you are rarely taught to question the container itself. Plastic has become so embedded in the modern food system that it often fades into the background of everyday shopping decisions. It no longer simply surrounds what you eat. In many cases, it has become inseparable from the product itself—think Lunchables, Pringles or Cup Noodles. This wasn’t always the case.

Earlier generations purchased food wrapped in paper, stored in glass jars, or sold loose from markets and butcher counters—carried home in bags or wooden crates. But as food production expanded during the twentieth century, supply chains grew longer and more complex. By the 1940s, manufacturers needed packaging that could protect food during transport, extend shelf life, and withstand long periods in storage. Synthetic polymers—what we now call plastic—provided a solution. Polyethylene, first synthesized in 1933, began appearing in food packaging by the late 1940s. By 1960, plastic wrap was a household staple, and by the 1970s and 1980s, plastic had largely displaced glass, paper, and tin across the grocery industry.

By the mid-twentieth century, convenience foods began reshaping how households approached cooking. Frozen dinners and boxed meals were marketed as symbols of modern efficiency, freeing families from hours in the kitchen. When microwave ovens became commonplace in the 1980s, plastic trays and films allowed meals to move directly from freezer to microwave in minutes. Packaging was no longer just protective—it had become part of the cooking process itself.

As convenience foods spread through the supermarket, everyday cooking habits changed. Bulk purchasing, home preserving and storing ingredients in reusable containers gave way to food that was pre-assembled and ready to heat and eat. Plastic became the foundation of this transformation at every stage of the supply chain—from processing equipment and shipping materials to retail packaging and takeout containers. It was lightweight, durable, inexpensive and could be molded into nearly any shape. Over time, glass, paper and tin—materials of earlier generations—could no longer compete on cost or convenience.

Today, plastic appears in nearly every phase of food distribution. In many cases, food interacts with multiple layers of packaging long before it reaches your kitchen—making plastic contact hard to escape even for the most diligent shopper. For most people, avoiding plastic entirely is unrealistic. Grocery stores rarely offer meat that hasn’t been wrapped, even if you never see it. Snack foods seldom appear in glass jars, and even produce can travel through plastic crates, liners or shrink wrap before reaching store shelves. Yet as plastic production has grown, so too has the realization that this expansion comes with a cost.

When the Container Becomes the Contaminant

As the world rushed forward with plastic as a durable and economical packaging solution, it simultaneously created one of the greatest environmental challenges of the modern era. Global plastic production has increased dramatically over the past several decades, with single-use packaging accounting for a significant portion of that growth. Items designed to be used briefly—bags, wrappers, containers and packaging materials—can persist in the environment for decades or even centuries. To put that in perspective, the plastic yogurt cup you throw away today may linger in a landfill for roughly as long as the time that has passed since Columbus reached the Americas.

Unlike organic materials that decompose naturally within weeks or months, plastics degrade slowly into smaller fragments, dispersing through soil, water and air. These particles accumulate in landfills, waterways and coastal ecosystems, affecting wildlife and natural habitats. As concerning as that is, the environment is only part of the story. As plastic breaks down, it forms microscopic particles known as microplastics that never fully disappear. These particles are now being detected not only in nature but inside the human body. Once you understand what they contain, the concern becomes much clearer.

Plastic packaging can contain additives such as phthalates and bisphenols—substances used to improve flexibility, durability and heat resistance. These belong to a broader category known as endocrine-disrupting chemicals (EDCs)—compounds that interfere with the body’s hormonal signaling. Hormones regulate essential biological processes including growth, metabolism, reproduction and development. Even small disturbances to these pathways can alter how cells and organs function over time. While bisphenol A (BPA) has largely been removed from many food containers, manufacturers often substitute chemically similar alternatives that perform the same functions but come with their own health concerns.

Researchers have linked exposure to these chemicals with a range of health outcomes, including immune disruption, developmental effects and increased cancer risk. Under conditions such as heat, acidity, fat content or prolonged storage, small amounts of these substances can migrate from packaging into food. Toxic-Free Future, a grassroots environmental health and advocacy group, weighs in:

“Food packaging made from certain plastics and other synthetic materials is contaminating what we eat. Harmful chemicals like PFAS, phthalates, and bisphenols can leach from packaging into our food—polluting our bodies with hormone disruptors and other toxic substances linked to serious health problems, from cancer and infertility to obesity and developmental delays.”

Author Matt Simon, in his book “A Poison Like No Other: How Microplastics Corrupted Our Planet and Our Bodies,” not only agrees but goes a step further:

“Mothers not only pass the harms of endocrine-disrupting chemicals on to their fetuses but on to even more distant generations. When a mother is exposed to EDCs, so too are her fetus’s germ cells, which develop into eggs or sperm.”

Because hormones operate at extremely small concentrations, even low-level exposures to chemicals that mimic or block these signals can alter biological processes. Researchers continue studying the extent and implications of these exposures, but the growing body of evidence has prompted governments and environmental organizations to reconsider how disposable plastics are used throughout the global food system.

The World Pushes Back On Plastic

In developed nations, food packaging alone accounts for more than two-thirds of all packaging circulating through the economy. Plastic has become the most dominant—and problematic—material within that system. Across the United States, approximately 42 million metric tons of plastic are produced annually, yet less than 10% is recycled, according to the Environmental Protection Agency. Slightly more than 15% is incinerated through energy recovery—a process that burns non-recyclable plastic to generate heat, steam or electricity—while the rest ends up in landfills or the natural environment.

As scientists publish more research on the chemicals used in plastics, the potential risks to environmental and human health have become increasingly difficult to ignore. The visible accumulation of plastic waste in landfills, waterways and oceans only compounds the pressure. Many nations have begun introducing legislation and public initiatives aimed at reducing plastic waste and encouraging safer, more sustainable packaging systems.

Rwanda became the first country to enact a nationwide ban on plastic bags in 2008, prohibiting their production, importation and use. The policy is strictly enforced, with plastic bags routinely confiscated at airports and border crossings. Kenya followed with one of the strictest plastic bag bans in the world, imposing substantial fines and potential prison sentences for manufacturing or distributing them.

Other countries have targeted broader categories of single-use plastics. China has prohibited plastic straws nationwide and restricted disposable plastic utensils and bags in major cities. The Pacific island nation of Palau has banned plastic bags and polystyrene food containers while limiting disposable plastics within government facilities.

Northern Europe has taken a different approach, focusing on infrastructure and cultural attitudes toward consumption. Sweden, often cited as a global leader in sustainability, has developed advanced recycling systems that recover or reuse nearly all household waste. Combined with deposit-refund programs for beverage containers and strong environmental education initiatives, the country has dramatically reduced plastic waste entering landfills, rivers and oceans.

At the core of many of these initiatives is a push to reuse, repair and recycle materials rather than continuously producing and discarding new ones—an approach that places less strain on ecosystems. These efforts reflect a growing understanding that reducing dependence on plastic requires systemic changes to how packaging is produced and distributed, not just shifts in individual consumer behavior.

How California Is Shaping Packaging Policy

In the United States, some of the most ambitious efforts to address plastic packaging are emerging at the state level. California has passed several laws targeting both the chemicals used in packaging and the waste it creates. One early measure, AB 1319, adopted in 2011, banned BPA in baby bottles and sippy cups and required manufacturers to replace it with the least toxic alternative available. This approach was later strengthened by SB 1266, enacted in 2024 with sponsorship from A Voice for Choice Advocacy, which expanded the restriction to ban all bisphenols in these products. While the law focused on products intended for infants and young children, it highlighted growing concern over endocrine-disrupting chemicals in plastics. However, food packaging outside that category may still contain BPA or other bisphenols.

California has also pursued broader reforms aimed at reducing plastic waste. The Plastic Pollution Prevention and Packaging Producer Responsibility Act (SB 54), spearheaded by the California Public Interest Research Group, is one of the most comprehensive plastic reduction laws in the country. The legislation shifts responsibility for plastic waste from consumers and municipalities to the companies that produce packaging. According to CalRecycle, producers must contribute:

“...$5 billion over 10 years — $500 million per year beginning in 2027 — to: Address the environmental impacts of plastic pollution and Aid affected environmental justice communities most impacted by the damaging effects of single-use plastic waste.”

The law also establishes major targets for packaging reduction. By 2032, 100 percent of single-use packaging and foodware sold in California must be recyclable or compostable, 65 percent must be recycled, and plastic packaging must be reduced by 25 percent. SB 54 aims to reduce plastic pollution by targeting packaging production rather than relying solely on recycling after disposal.

Additional legislation has also focused on the chemicals used in packaging. The California Safer Food Packaging Act of 2025 (AB 1148) sought to ban intentionally added bisphenols and phthalates in food and beverage packaging, including cans, liners, wrappers, pouches and takeout containers, but did not advance out of committee. Separate legislation has addressed materials used throughout the food system, including a requirement under SB 1046 (2022) that pre-checkout produce bags be reusable, recyclable or compostable. California has taken steps to restrict per- and polyfluoroalkyl substances (PFAS)—chemicals used in grease-resistant coatings for takeout containers, microwave packaging and fast-food wrappers. PFAS are often referred to as “forever chemicals” because of their remarkable persistence in both the environment and the human body.

Beyond California, more than half of U.S. states have adopted laws resembling its BPA restrictions, though many states still lack similar protections. As awareness grows around the potential health effects of bisphenols, phthalates and PFAS, additional states are considering measures aimed at reducing chemical exposure from food packaging.

A New Generation of Packaging Materials

Alongside these policy efforts, innovative companies are experimenting with alternatives that move beyond conventional plastic packaging. Some are turning to agricultural and marine materials that require little processing and avoid synthetic polymers altogether. Berlin-based startup Arekapak produces packaging from sun-dried areca palm leaves—sturdy containers that require minimal energy or water to manufacture and naturally biodegrade after use.

Paper and wood-fiber materials are also being reimagined. Italian manufacturer Ecopack, which has specialized in paper packaging for decades, continues to expand recyclable paper solutions for the food industry. Finnish company Paptic has developed a durable wood-fiber material that behaves like a flexible film but can be recycled like paper, offering an alternative to plastic films. Scandinavian materials producer Stora Enso is similarly investing in renewable packaging derived from forest resources, exploring fiber-based materials that can replace certain plastic applications.

Some of the most unusual innovations are emerging from the ocean. London-based startup NotPla—short for “not plastic”—developed a biodegradable membrane made from seaweed capable of encapsulating liquids. The material dissolves naturally within weeks and can even be eaten. Scottish company Oceanium is also exploring seaweed-based biomaterials that may serve as compostable packaging alternatives for food and consumer products. These materials represent some of the closest modern parallels to natural packaging—substances derived directly from plants or marine resources that can return to the environment without leaving persistent synthetic residues.

Other developers are pursuing compostable packaging designed to behave more like plastic while still breaking down under controlled conditions. German company Repaq produces flexible films composed largely of cellulose and natural binders, while Finnish startup Sulapac has developed biodegradable materials made from wood and plant fibers intended to leave no synthetic microplastic residue. Companies such as Bio Futura and BioPak also produce food containers and takeaway packaging from materials like sugarcane pulp and rapidly renewable plant fibers designed to replace petroleum-based plastics.

However, some of these products achieve their performance—grease resistance, moisture barriers, shelf stability—by incorporating bioplastics, most commonly polylactic acid (PLA). Others, like Israeli company TIPA, are marketed as “sustainable” and “compostable,” which they may be, but still rely on some engineered polymers that are fossil-based. Their compostable films claim to mimic the strength and shelf life of conventional plastic packaging.

Compostable polymers such as PLA—while arguably a better choice than plastic—still come with their own environmental challenges. PLA typically requires the high heat and microbial activity found only in industrial composting facilities to break down effectively, and often fails to degrade in landfills or home compost piles. Because PLA closely resembles conventional plastics like PET (polyethylene terephthalate, the hard, clear plastic commonly used in water bottles and food containers), it can also contaminate recycling streams, potentially ruining entire batches of recyclable material. If discarded improperly, PLA can persist in the environment much like traditional plastic, contributing to pollution in marine and terrestrial ecosystems.

There is also growing concern that even biodegradable polymers can fragment into microplastics during degradation, posing ingestion risks to wildlife and adding to the broader microplastic burden already in the environment. Large-scale production of PLA often relies on agricultural feedstocks such as corn, raising questions about land use, water consumption and pesticide inputs associated with producing packaging from food crops. These realities complicate the widespread perception that all “biodegradable” or “compostable” plastics are inherently benign.

The Path Forward

Change is beginning to emerge from several directions. Governments are introducing new policies to reduce disposable plastics while researchers and manufacturers experiment with materials that work more harmoniously with natural cycles. Yet policy and innovation alone cannot shift an industry of this scale.

You also shape what the market produces. Each time businesses see demand for packaging made from renewable fibers, reusable systems or safer materials, those alternatives move from niche experiments into mainstream practice. When you choose reusable canvas bags, shop at farmers markets and buy items in nontoxic, reusable containers such as glass, you are investing in change. Buying in bulk and freezing for later is another way to reduce the plastic moving through your household and into the environment.

The future of food packaging will not be determined only in laboratories or legislative chambers—it is being driven, day by day, by everyday decisions like yours. And in a system where the container has become inseparable from the food itself, those choices reach further than they appear—touching not only the environment, but the body as well.

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EDITOR’S SUMMARY: The muscles of the mouth do more than support eating and speech—they help shape sleep, facial development and airway function over time. When these functions are disrupted, the effects can show up as jaw tension, poor sleep, mouth breathing and other seemingly unrelated symptoms. Myofunctional therapy focuses on retraining these muscles through targeted exercises, addressing underlying dysfunction rather than isolated complaints. By improving how the tongue, lips and jaw work together, this approach may help stabilize the airway, reduce strain and restore more efficient function across the body.

Eating, drinking and talking are just a few of the movements the muscles of the mouth accomplish each day. They also guide airflow, manage tension and coordinate movement between the jaw, neck and face. When those structures aren’t working efficiently, your body can overcompensate, which can result in a range of symptoms. Clinicians frequently see the same issues appear together: jaw clenching, facial tension, headaches, neck pain, along with breathing and sleeping difficulties. You might not think to connect these to your mouth. But if you or your child wake up tired despite a full night’s sleep, breathe through the mouth during the day, snore lightly, clench the jaw, or carry tension in the face and neck, these may share a common root.

This cluster of symptoms is often addressed one at a time, without examining the underlying muscle dysfunction they share. You may see a dentist for grinding, a chiropractor for neck pain, or a sleep specialist for breathing concerns, moving through providers while the nagging issues remain unaddressed. Over time, this can lead to discomfort in the jaw and surrounding muscles and little clarity about why your symptoms continue—or even worsen—despite ongoing treatment.

Myofunctional therapy takes a unique approach by examining how oral muscles function as an integrated system, rather than focusing on individual symptoms. At its core is the concept of neuroplasticity—the brain’s ability to adapt through repetition—which is used to retrain the muscles of the lower face, tongue and jaw. By addressing these issues at their source, it aims to offer insight and correct the behaviors that may be driving concerns not just in the mouth, but throughout the body.

What Myofunctional Therapy Commonly Addresses

Breathing, airway and sleep-related concerns

Myofunctional therapy is often recommended for chronic mouth breathers. While mouth breathing is sometimes dismissed as just a bad habit, it’s actually a survival response that changes how the tongue, jaw and airway are used. The issue is that once this adaptation becomes your default, it can shape muscle function and influence how your face develops over time—affecting everything from sleep quality to jaw alignment. When the nose is bypassed and breathing shifts to the mouth, the tongue tends to rest lower, and the muscles that support the airway may become less stable. In an interview with A Voice for Choice Advocacy, certified myofunctional therapist Brigiett Ritchie explains:

“The body will always find a way to breathe, even if it has to compensate. One common compensation is mouth breathing, which can lead to upper airway obstruction and issues with the adenoids and tonsils.”

In children, tonsils are already relatively large, and chronic mouth breathing can cause them to swell even more, increasing the risk of obstruction during sleep. Even when tonsils are removed, they can regrow if the underlying airway habit remains unchanged, a phenomenon known as tonsillar regrowth, as documented in pediatric ear, nose and throat (ENT) literature.

Myofunctional therapy is used to support snoring and sleep-disordered breathing, including sleep apnea. Research suggests that how well the oral muscles work together can affect how easily the airway stays open, especially during sleep. When these muscles function more efficiently, airflow at night can become more stable.

Jaw, facial and muscle-related concerns

Myofunctional therapy can be a helpful part of treating temporomandibular joint (TMJ) disorders, which involve the joint that connects your jawbone to your skull. It may help relieve symptoms such as jaw pain, clenching, neck tension, earaches, toothaches and clicking or locking when chewing. TMJ disorders often develop from strain on the joint and adjoining muscles, such as chronic grinding, arthritis or a past injury. The most commonly affected group is women between 20 and 40 years old, who make up more than 90 percent of those seeking treatment. Researchers suggest this may be influenced by a combination of hormonal factors, joint structure and differences in pain sensitivity.

When your mouth and airway are not working properly, other muscles step in to compensate. As a result, the jaw and face may be carrying more tension than they were designed to handle. Appliances like mouthguards or retainers are commonly used to protect teeth from damage caused by clenching or grinding. While these devices can be helpful, they don’t address the root cause. Without retraining the underlying muscle function, jaw or facial tension may continue even while wearing them. In children, these tendencies can show up in subtle ways. You might notice your little one sleeps with their mouth open, snores or breathes noisily at night, struggles with certain speech sounds, prefers softer foods, or seems restless during sleep. These signs are easy to overlook but can reflect how the mouth and airway are functioning.

Oral habits, speech and feeding

Issues with the tongue’s ability to move freely and fully—including tongue tie, a congenital condition in which the tip of the tongue is tethered to the floor of the mouth by a short or tight band of tissue—can affect both swallowing and speech. Myofunctional therapy may be used to address persistent tendencies such as thumb sucking or prolonged pacifier use, difficulty chewing textured foods, as well as speech sound errors related to tongue placement.

Over time, these habits can influence muscle coordination and facial development. Because of this, concerns such as inefficient chewing, swallowing difficulties and certain speech issues are addressed through myofunctional therapy in collaboration with speech-language pathologists. A broader range of signs may indicate the need for evaluation. These include frequent mouth breathing, jaw clenching or grinding during sleep, difficulty keeping your lips gently closed, a tongue that rests low in the mouth, snoring or noisy nighttime respiration, waking feeling groggy, ongoing facial or jaw tension, or speech sounds that are unclear.

The way jaw and facial muscles develop affects more than just comfort and airway function. It also shapes the form of the face. This happens gradually, starting in infancy, as bones respond to how muscles are used day after day. The jaw grows in response to movement and pressure. Chewing, swallowing and tongue motion all stimulate the bones of the face, guiding how wide, forward and strong it becomes. When these muscles are used regularly and with effort, they help support a wider, more stable facial structure.

Breastfeeding plays a unique role in this process. Nursing requires coordinated use of the tongue, lips and jaw, with the tongue pressing upward against the palate, supporting these structures to work together. This repeated motion helps strengthen oral muscles and encourages forward and outward jaw growth. Bottle feeding, by contrast, relies on a different sucking mechanism that places less demand on these muscles and does not engage the jaw and tongue in the same way. According to a review in Springer Nature, “Influence of the duration of breastfeeding on quality of muscle function during mastication in preschoolers: a cohort study”:

“The jaw movements involved in extraction of milk from the breast provide major stimuli for growth of the temporomandibular joint and, consequently, encourage harmonious growth and development of the facial region.”

Importance of early intervention

Starting early can make a big difference. As children grow, chewing becomes an important driver of facial development. Diets that rely heavily on soft or processed foods require far less effort than those that involve tearing and grinding, such as fibrous vegetables, tougher cuts of meat or whole grains. When kids are chewing less because they are eating foods like soft white bread, yogurts and packets of mashed fruits and vegetables, the jaw receives less stimulation, which influences how it develops. Over time, reduced oral muscle use has been linked to narrower dental arches, crowded teeth and a jaw that sits farther back rather than developing forward. These structural changes do not just affect appearance; they can also influence how easily the airway stays open and how much effort the jaw and neck muscles must use during air exchange.

Even after bone structure is mostly set, muscle tone and posture continue to play a big role in teens, young adults and adults. Chronic clenching, a low resting tongue position, or ongoing mouth breathing can contribute to facial tension and muscle strain. While these factors may not significantly alter bone shape, they can influence how the face holds tension and how comfortably the jaw functions. Understanding how these habits develop helps explain how treatment works in practice. If these patterns sound familiar, it may not be a matter of isolated symptoms, but rather how the muscles of the mouth have adapted over time.

How Myofunctional Therapy Works

A central focus of myofunctional therapy is how the tongue, lips and jaw are positioned when not actively moving. Encouraging the tongue to rest gently against the palate and maintaining relaxed lip posture may reduce the need for surrounding muscles to compensate, resulting in less tension in the face, neck and jaw. Therapy also supports nasal breathing when possible, allowing air to be filtered, humidified and slowed before it reaches the lungs, which can promote steadier respiration. Because swallowing and chewing involve complex, coordinated muscle work, this method works to improve the timing and function of these movements, which may help reduce strain on the jaw and surrounding muscles.

“Therapy focuses on restoring muscle harmony so patterns align with proper oral posture. When muscle patterns are not aligned, issues develop later in life,” Ritchie said.

Ongoing research suggests that strengthening and synchronizing the muscles of the mouth and throat may help support airway stability, especially when sleeping. A study published in Sleep Medicine Reviews found that individuals who practiced myofunctional therapy experienced less snoring, improved oxygen levels, and reduced daytime sleepiness. A 2024 study in Scientific Reports similarly found fewer breathing interruptions during sleep among participants practicing daily oral and facial exercises, which researchers linked to improved muscle control in the upper airway. A 2025 review of multiple clinical trials, “Efficacy of myofunctional therapy for obstructive sleep apnea: A systematic review and network meta-analysis,” reported that participants often felt more rested and alert during the day.

Myofunctional therapy can be part of a team-based approach, with providers coming from a range of professional backgrounds depending on individual needs. This can include certified myofunctional therapists, certified orofacial myologists, speech-language pathologists, dentists and orthodontists involved in airway-focused care, as well as physical and occupational therapists who address posture and jaw function. Sleep specialists may also be involved when airway obstruction or sleep-related concerns are suspected.

A myofunctional therapy program typically begins with a comprehensive assessment. The therapist evaluates how the muscles of your mouth and face function during rest and movement, considering factors such as tongue posture, lip seal, respiratory habits, swallowing mechanics and jaw motion. In some cases, head and neck posture is also considered, as this can influence how easily air moves and the amount of effort required for breathing.

The process may include simple tasks, such as noting where the tongue rests when your mouth is closed, how air moves during quiet breathing, or how swallowing is initiated. The goal is not to diagnose a condition, but to identify how muscles are being used in ways that may contribute to ongoing symptoms. Based on this analysis, the therapist designs an individualized treatment plan. Exercises are selected to support improved muscle coordination, tone and endurance. These practices are typically brief and targeted, focusing on specific movements or positions. For example, therapy may involve activities that encourage the tongue to rest against the palate, promote efficient swallowing techniques, or support nasal breathing when possible.

Sessions often combine education with exercises. Therapists explain how oral muscles affect breathing, jaw tension or sleep quality, helping you better understand why certain techniques are used. Progress is monitored over time, with adjustments made based on how muscles respond and whether patterns begin to shift. Therapy is usually structured over weeks or months rather than days, so that muscles have time to adapt. Therapists may communicate with dentists, orthodontists, speech-language pathologists or sleep specialists to coordinate care and make sure that therapy aligns with other treatments. Programs typically last 6 to 12 months, though many patients see improvements within 4 to 8 weeks.

If you’re noticing any of the symptoms mentioned in yourself or your child, the first step is an evaluation. Ask your dentist or medical provider if they screen for oral muscle function or airway issues. If you have sleep or breathing concerns, collaboration with sleep medicine specialists or ENTs may be appropriate. Alongside professional care, exploring simple, low-intensity practices that support awareness of breathing and oral posture can help. One example is mouth taping during sleep, which involves placing a small piece of breathable tape over your lips to encourage nasal breathing. This method is not appropriate for everyone and should be avoided if you experience anxiety around breathing or untreated sleep apnea.

Other supportive practices include paying attention to how you breathe during the day, gently encouraging nasal breathing when it feels comfortable, and becoming aware of where the tongue rests when the mouth is closed. Addressing nasal congestion with humidifiers or saline rinses may also support easier breathing. These approaches do not replace professional care or medical evaluation, but they can help build awareness and support healthier day-to-day function while decisions about next steps are made.

Sometimes the most overlooked driver of symptoms sits right under your nose. The mouth isn’t just a passive part of the body—it’s an active driver of how you breathe, move and regulate tension. When these muscles have been trained to function inefficiently over years of unconscious behaviors, the effects don’t stay local; they ripple through the entire body.

Myofunctional therapy works by reconnecting these functional relationships, linking symptoms to meaningful improvements in how you feel. When the mouth, jaw, neck and tongue are in sync, they support the body as a whole—making breathing more efficient, reducing strain and restoring balance. It’s not a quick fix, but it offers a path forward for issues that may have been overlooked for years.

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EDITOR’S SUMMARY: Bayer’s removal of glyphosate from consumer Roundup products was widely viewed as a safety win. But emerging evidence suggests many replacement chemicals may pose equal or greater risks to human health and the environment. This investigation examines how reformulation, driven in part by litigation pressure, has reshaped the product’s composition—and why “glyphosate-free” does not necessarily mean safer.

For decades, Roundup was marketed as a household solution—an easy, effective way for people to keep weeds at bay. Its active ingredient, glyphosate, was widely promoted as safer than competing herbicides, with regulatory agencies repeatedly asserting it posed minimal risk when used as directed. That narrative began to unravel in 2015, when the International Agency for Research on Cancer (IARC), a division of the World Health Organization, classified glyphosate as “probably carcinogenic to humans.” What followed was not a simple scientific debate. It became a cascade of litigation, regulatory pressure and public reckoning—one that ultimately forced Bayer, which acquired Monsanto, the original manufacturer of Roundup, in 2018, to make a consequential shift. Beginning in 2023, Bayer pledged to remove glyphosate from U.S. consumer Roundup products, while continuing to sell glyphosate-based formulations for agricultural and professional use.

At first glance, this appeared to be a victory for public health. But a deeper examination reveals a far more troubling story: glyphosate has not been replaced with safer alternatives. Instead, it has largely been swapped for other herbicides that have been shown in some analyses to be more toxic, on average, to both human health and the environment, including chemicals banned in the European Union.

This phenomenon—known in environmental health as regrettable substitution—raises a critical question: If glyphosate was removed only to be replaced with herbicides that are often more harmful, was the product truly made safer—or was the problem simply repackaged?

The Legal Reckoning That Forced Change

Shortly after the IARC’s reclassification, thousands of lawsuits were filed across the United States alleging that long-term exposure to glyphosate-based herbicides caused non-Hodgkin’s lymphoma (NHL), a cancer of the lymphatic system. Many of these cases centered on failure-to-warn claims, arguing that Monsanto failed to disclose cancer risks on Roundup labels despite growing concern.

The first major verdict arrived in August 2018, when a California jury awarded groundskeeper Dewayne Johnson $39 million in compensatory damages and $250 million in punitive damages, finding Monsanto liable. The A Voice for Choice Advocacy article, “Hidden Glyphosate in Your Food: Part Two—Impact on Human Health,” goes on to explain:

“Dewayne took Monsanto, (who developed the product and introduced it to consumers in 1974) to court and the jury concluded, “Roundup® weedkiller caused his cancer,” and that the corporation failed to warn him of the health hazards from exposure. The jury further found that Monsanto “acted with malice or oppression.”

Although the award was later reduced on appeal, the verdict sent shockwaves through the agrochemical industry and shook home gardeners who had used the product for decades. Some of these consumers also developed NHL, and additional verdicts worth billions soon followed:

• Edwin Hardeman (2019): $80.3 million (later reduced) after decades of residential Roundup use.

• Alva and Alberta Pilliod (2019): An initial verdict exceeding $2 billion, later reduced to $86.7 million, tied to nearly 30 years of residential landscaping use.

• John McKivison (2024): A Pennsylvania jury issued a $2.25 billion verdict, the largest Roundup-related award so far, after he alleged the weedkiller caused his non-Hodgkin lymphoma following 20 years of use.

• John Barnes (2025): A Georgia court ruled that his NHL was caused by long-term use of Roundup.

In response to a surge of lawsuits, Bayer announced in June 2020 a sweeping settlement of up to $10.9 billion to resolve approximately 95,000–125,000 current claims (and set aside $1.25 billion for future claims). At the same time, the company has maintained that glyphosate products are safe when used as directed. Yet Bayer did not agree to place cancer warnings on glyphosate labels, nor did it remove glyphosate from agricultural Roundup.

Despite efforts to stem mounting legal losses, lawsuits continue to accumulate. As of May 2025, the company is reportedly weighing additional payouts beyond the $10.9 billion agreement reached in 2020. If those measures fail to ease public pressure, Bayer has even floated the possibility of placing its agricultural business into bankruptcy. In the meantime, the company has pursued a parallel strategy to regain public trust while also reformulating its products.

The New Roundup: What Replaced Glyphosate—and Why It Should Be a Concern

According to a detailed analysis by Friends of the Earth, Bayer replaced glyphosate in at least eight residential Roundup products with combinations of four alternative active ingredients:

• Diquat dibromide

• Fluazifop-P-butyl

• Triclopyr

• Imazapic

All four chemicals present greater long-term and/or reproductive health risks for humans than glyphosate, based on U.S. Environmental Protection Agency (EPA) toxicity evaluations. Two—diquat dibromide and imazapic—are so toxic they are among those banned in the European Union. Diquat dibromide alone is 200 times more toxic than glyphosate with chronic exposure and appears in all of the new formulations examined. This finding raises immediate concern. Friends of the Earth found that the addition of this chemical significantly increases the overall hazard in the reformulated products, stating:

“...on average, the new formulations are 3.9-fold more acutely toxic and 45.6-fold more chronically toxic than the glyphosate-based Roundup formulations.”

This finding upends the assumption that removing glyphosate automatically reduces risk. In reality, the hazard profile of residential Roundup has worsened, not improved, and most consumers have no idea.

Environmental Persistence and Ecological Harm

Beyond human toxicity, the replacement chemicals raise substantial environmental risks. Compared with glyphosate, the new active ingredients are significantly more likely to:

• Harm bees, birds, fish, earthworms and aquatic organisms

• Persist longer in soil and sediment

• Leach into groundwater, increasing the risk of drinking water contamination

These characteristics directly contradict the long-standing marketing of Roundup as an environmentally responsible product for home use. According to ENSR International Corp., an environmental consulting and remediation group, diquat dibromide poses a significant ecological threat. The company reports:

“Risks were predicted for pollinating insects due to direct spray and indirect contact with contaminated foliage. Acute risks were predicted for 7 of 10 wildlife scenarios, and chronic risks were predicted for 6 of 10 wildlife scenarios.”

Yet direct contact with sprayed plants isn’t the only way wildlife can encounter these chemicals. In a 2020 report titled “Environmental and Social Risk Assessment for Imazapic,” by the Pennsylvania Department of Conservation and Natural Resources Bureau of Forestry, the agency states:

“This product may contaminate water through drift of spray in wind. This product has a high potential for runoff for several months or more after application. Poorly draining soils and soils with shallow water tables are more prone to produce runoff that contains this product.”

More concerning, the report also notes:

“A study reported by the US Forest Service indicated that at the highest dose (100 µg/L) mortality was found in 25% of honeybees… long-term exposures (22 weeks or more) have resulted in reduced growth in birds of all sizes…[and]... Imazapic can be toxic to fish.”

Friends of the Earth has outlined these risks based on existing studies and reports, and issues a direct warning:

“Bayer’s reformulation of residential Roundup made it more toxic, and Bayer continues to mislead the public about Roundup’s potential to harm people and the planet.”

A Patchwork Exit Leaves Glyphosate Still on Shelves

Compounding the issue, glyphosate has not been fully removed from U.S. consumer markets. Older glyphosate-containing products remain legally sellable, meaning you may unknowingly purchase either version, depending on retail stock and labeling nuances. At the same time, glyphosate-based Roundup continues to be sold for agricultural and professional use, without cancer warnings, despite ongoing litigation and divergent court rulings.

Between 2021 and 2024, Bayer won several trials, as juries accepted arguments that federal pesticide labeling law—the Federal Insecticide, Fungicide, and Rodenticide Act—preempts state-level failure-to-warn claims. However, appellate courts remain split on this issue. In 2024, the Third Circuit ruled in Schaffner v. Monsanto that Bayer could not be sued under state law for failing to warn consumers because federal pesticide law already governs product labeling. Other federal courts—the Ninth and Eleventh Circuits—had reached the opposite conclusion, allowing those lawsuits to move forward. Acknowledging this disagreement, the Third Circuit explicitly invited the Supreme Court to step in, stating:

“The issue presented by this case, which is clearly of general interest, has yet to be decided by the highest court capable of resolving it — the United States Supreme Court.”

In early 2026, the Supreme Court agreed to take up the Durnell v. Monsanto case and issue a ruling by June, a decision that could reshape glyphosate litigation nationwide. The case is expected to clarify whether federal pesticide labeling laws preempt state failure-to-warn claims, potentially determining the viability of thousands of pending and future lawsuits. After seeking the Solicitor General’s view, the Justice Department sided with Bayer, arguing that federal law should limit claims despite EPA approval—a position supporters say ensures consistent national standards and protects businesses from massive, unpredictable liabilities. Critics, however, warn this approach could deny justice to tens of thousands of plaintiffs facing severe or terminal conditions.

Safer Paths Forward: What You Can Do

For those managing outdoor spaces, true safety may come not from replacing one herbicide with another, but from abandoning the substitution cycle altogether. Many common weeds can be managed with simple, low-toxicity approaches that have been used for generations. Household solutions such as boiling water, vinegar-based sprays, salt solutions or soap and water mixtures can kill weeds on sidewalks, driveways and gravel areas without introducing persistent herbicides into soil or waterways. Physical approaches—including hand-pulling, mulching, flame weeding (burning) or covering soil with cardboard or landscape fabric—can also suppress growth while improving soil health.

If you prefer store-bought formulas, several over-the-counter weed controls rely on acetic acid (horticultural vinegar), citric acid, clove oil or fatty acids derived from plants. While no herbicide is entirely without impact, as these substances can still affect biodiversity in soil and surrounding ecosystems, these options are generally less harmful. They tend to break down more rapidly and are less likely to pose long-term toxicity concerns than conventional synthetic herbicides.

As a consumer, you can also influence broader change through purchasing decisions and civic engagement. Choosing non-toxic products, supporting retailers that prioritize safer ingredients, and advocating for stronger chemical safety standards can shift market demand and public policy, whether you live in the United States or abroad.

In 2023, the European Union renewed glyphosate’s approval through 2033, with restrictions. In part, this decision reflects a difficult reality faced by regulators on both sides of the Atlantic: many of the available chemical alternatives appear to be even more toxic. This has led some to conclude that while manual and non-toxic weed control methods are not perfect, they remain viable. Employing time-tested strategies like planting cover crops and tilling is a practical starting point. According to the Danish Centre for Food and Agriculture, the organization states:

“...to explore and implement alternative methods that can maintain productivity while minimizing the negative environmental and health impacts of pesticide use.”

What the Roundup saga ultimately reveals is not merely a dispute over glyphosate, but a systemic failure in how risk is managed and communicated to consumers. Removing a single controversial ingredient—without meaningfully reducing overall toxicity—creates the appearance of safety while preserving legal and commercial viability. This strategy may reduce litigation exposure, but it does little to protect public health or ecosystems.

As regulators, courts and the public focus narrowly on glyphosate, the replacement chemicals remain largely unknown, unchallenged and under-scrutinized, despite clear evidence of increased hazard. The implication is stark: “glyphosate-free” does not mean safer—it simply signals a shift in formulation. Until regulation prioritizes cumulative toxicity, long-term exposure and environmental persistence, the Roundup story will continue to repeat itself, under different names and compositions, with the same consequences unfolding beneath your feet. In this sense, the evolution of Roundup is not a story of reform—it is a case study in substitution without accountability.

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EDITOR’S SUMMARY: Wearable technology offers a powerful idea: that your body can be measured, optimized and improved through constant feedback. But more information doesn’t always translate into better health. As self-tracking becomes more precise, it can also become more consuming—shifting attention away from how you feel and toward what your devices report. This tension raises an important question: does the pursuit of perfect data come at the cost of something harder to quantify?

A home filtration system is connected to an app on your phone, alerting you the minute it needs a new filter. Your smart thermostat adjusts automatically, maintaining the perfect temperature without you ever touching a dial. With a few voice commands, Alexa updates your grocery list and a shipment of toilet paper appears on your doorstep the next day. Google Maps recalculates your route in real time, constantly processing new traffic data to deliver you to your destination as efficiently as possible.

Modern life runs on continuous monitoring, instant feedback and automated correction. Whether you’re aware of it, you interact with a dozen systems a day that track performance in real time, detect small changes before they become problems, and optimize outcomes with minimal effort on your part. Information is expected to be immediate, precise and actionable. Convenience is no longer a luxury, it has become the baseline for everyday living.

It makes sense, then, that you would begin to expect the same from your body. What if your health could be monitored like your home’s air quality? What if subtle changes in your physiology could be detected the moment they begin—before symptoms appear, disease develops or anything feels wrong? What if your body could generate a steady stream of data that helps you make small adjustments each day to improve performance, extend lifespan and prevent illness altogether? This is the potential of wearable health technology—but does it live up to it??

Devices that track physical activity, heart rate and sleep began gaining acceptance in the early 2000s with the introduction of Fitbit and smartphone-based sleep trackers such as Sleep Cycle. Around the same time, the term “biohacking” entered mainstream culture—referring to the practice of using data-driven experimentation to optimize your body, brain health and lifespan—and was popularized by longevity expert Dave Asprey. By systematically tracking his own health metrics and applying insights from long-lived populations, Asprey reports that he lost 100 pounds and reversed conditions including arthritis, prediabetes and chronic fatigue syndrome.

A Silicon Valley transplant, Asprey reflects the core demographic of wearable health technology: affluent, analytically minded, tech-savvy and comfortable using data to guide decision-making. For biohackers, wearable devices are foundational tools used to transform health into something measurable, trackable and improvable. In this framework, health becomes less about reacting to illness and more about making ongoing adjustments in pursuit of optimal function. Dr. Sara Gottfried, a board-certified OB-GYN and integrative medicine physician, is another advocate of using technology and self-experimentation to create highly individualized health strategies:

“The point is to leverage every means possible—genetic, biochemical, psychological, emotional, spiritual—toward a specific goal, usually to feel your best and most productive. What differentiates biohacking from other health strategies is that it involves rigorous self-testing… and self-monitoring technology, such as with wearables and trackers.”

According to Dr. Gottfried, wearable technology allows you to move beyond generalized health advice and toward precision care, achieved through continuous measurement. By tracking biological signals over time and around the clock—using fitness wearables, metabolic monitors and periodic lab testing—subtle patterns begin to emerge. Those insights can then guide targeted adjustments to diet, sleep, stress management and daily routines.

Some of the tools she recommends include continuous glucose monitors (CGMs), which measure how blood sugar responds to food, exercise and stress; sleep trackers such as Oura and Fitbit that monitor duration and sleep stages; metabolic devices like Lumen, which estimate metabolic fuel use by analyzing breath; and recovery trackers such as Whoop, which measure strain and heart rate variability—a marker of autonomic nervous system activity that reflects stress and recovery. These devices come in many forms, including watches and wristbands, adhesive sensors (flexible patches worn on the skin), sensor-embedded clothing, ear-worn headsets, smart jewelry like rings, clip-on devices and even glasses or contact lenses.

For Dr. Gottfried, this level of feedback has produced tangible changes. By tracking her own sleep cycles, she was able to identify environmental and behavioral factors that improved rest and doubled her sleep—for example, lowering room temperature at night and discovering that ashwagandha (Indian ginseng) worked more effectively for her than melatonin. Glucose tracking revealed that while certain foods such as bananas produced stable responses, others such as oatmeal caused unexpected spikes.

“Blood sugar monitoring is really important if you want to lose weight and live a long, healthy life. I check my blood sugar at home once per week, and occasionally do a “carb” test where I’ll eat 25-50 grams of a type of carb and then measure my blood sugar 2 hours later.”

Stress is measurable too—by tracking heart rate variability, it’s possible to intervene in real time by employing meditation or visualization techniques until levels stabilize. The stress hormone cortisol has been shown to contribute to neuronal damage and accelerated aging, particularly in women—so managing this metric alone can make a noticeable difference in quality of life.

The capacity to observe cause and effect so precisely is what makes wearable technology appealing to many people. Blood glucose patterns, for example, can signal early metabolic dysfunction long before symptoms appear. Since elevated glucose contributes to conditions such as cardiovascular disease, type 2 diabetes, neuropathy and kidney disease, early detection may allow for timely intervention before irreversible damage occurs.

Persistently high glucose levels trigger immune cells to release inflammatory cytokines—proteins that regulate inflammation, immunity and blood cell production. Over time, this process can contribute to physiological strain associated with chronic illness. If you’re dealing with ongoing inflammation, continuous blood sugar monitoring may offer valuable immediate insight—potentially helping identify harmful trends early enough to make meaningful adjustments.

Many experts are now advocating for broader use of continuous glucose monitors, even among people without diabetes. One reason is that insulin resistance can begin as early as 20 years before diabetes is formally diagnosed. Real-time feedback from a CGM can reveal how specific foods, activity levels and even stress influence your metabolic health—allowing you to tailor your diet to your physiology rather than rely on generalized nutritional advice. Nutrient metabolism is highly individualized and can shift depending on where you are in your health journey. By helping to keep glucose levels stable, wearable use may support more consistent energy, improved mental clarity and better long-term health outcomes.

When Data Starts to Distort

The ability to check blood sugar continuously can feel reassuring—until awareness tips into hypervigilance. In this state, constant monitoring can start to feel necessary rather than useful. The same ongoing feedback that enables precision can lead to unintended psychological effects. Tracking may become less informative and more compulsive, and normal physiological fluctuations may begin to feel like warning signs. For example, a wearable might alert you to a subtle rise in heart rate—panic follows, increasing bodily stress—when the underlying cause is something simple, like dehydration. Systems that are designed to notify can instead alarm you, creating urgency around changes that are clinically insignificant.

Repeated checking may provide momentary relief, but it can also reinforce anxiety and lead to increased vigilance. Over time, your body may begin to feel less like something experienced internally and more like something evaluated externally. Emotional and physical cues may start to be missed or ignored, replaced by numbers and graphs that demand constant attention. Sleep tracking provides a clear example: research published in Sleep Medicine has shown that individuals who rely heavily on sleep trackers sometimes develop increased concern about sleep quality—even when they are objectively sleeping longer. This phenomenon, known as orthosomnia, reflects a paradox in which striving for “perfect” sleep can actually make sleep worse. In these cases, taking a break from trackers and shifting focus back to how you feel may be the best course of action.

Studies have found that wearable users with health anxiety seek more medical testing and clinical visits despite having no underlying disease or medical condition. Similar findings were reported in a study published in the Journal of the American Heart Association: among patients with atrial fibrillation (AFib), those who monitor heart rhythms continuously report greater symptom preoccupation and emotional distress compared to those who do not. This anxiety can also worsen AFib symptoms.

In these cases, wearable devices are not simply measuring health—they are shaping perception, behavior and physiology in real time. If your smartwatch says that you didn’t get good sleep, it may plant a subtle expectation that leads to reduced work performance the next day. Seeing an elevated heart rate can trigger fear and drive it even higher. Conversely, positive metrics can boost confidence and motivation, with stress levels shifting accordingly.

Aside from psychological effects, wearables have limits when it comes to measurement, and data is not always conclusive. Consumer wearable devices are not held to the same standards as clinical-grade equipment used in healthcare settings. As a result, measurement accuracy can vary by device, context and even individual physiology. While some studies show many wearables perform strongly when it comes to heart rate measurement, energy expenditure—a commonly tracked metric that estimates how many calories your body burns—remains difficult to evaluate reliably.

Perhaps more concerning is the potential for wearables to provide false reassurance. Cardiologist Dr. James Stein has described cases in which patients experiencing serious cardiac events delayed seeking care because their smartwatch readings appeared normal. Physiological data that appears reassuring does not always reflect what is happening internally. This serves as a reminder that while numbers can inform, they cannot fully replace professional judgment or subjective experience.

Another concern is chronic exposure to radiofrequency electromagnetic fields (RF-EMFs) emitted by wearable devices. Smartwatches and similar technologies transmit signals through Bluetooth, Wi-Fi, embedded sensors and sometimes cellular connections. These emissions are classified as non-ionizing radiation, meaning they do not directly damage DNA in the way ionizing radiation can (such as X-rays or gamma rays). However, some researchers have explored whether long-term, low-level exposure may influence biological processes such as melatonin production, mitochondrial function, oxidative stress, inflammation or nervous system regulation. The specific absorption rate measures the amount of RF-EMF energy absorbed by body tissue. Most wearable devices operate well below established safety limits. Still, continuous skin contact—often 24 hours a day—raises questions about cumulative exposure.

If you are sensitive to RF-EMFs, contact with these signals may be associated with symptoms such as fatigue, skin burning or tingling, tinnitus (ringing in the ears), headaches or migraines, brain fog, anxiety, heart palpitations or dizziness. Symptoms may intensify near active devices or in environments with higher electromagnetic exposure. In some cases, RF-EMFs may also interfere with heart rhythms, which can be especially concerning for those with cardiovascular conditions. If you’re worried, simple precautions—such as using airplane mode, removing devices while sleeping or limiting cellular-enabled features—may help reduce overall exposure.

In addition to physiological concerns, wearables present another growing issue: data ownership, privacy and surveillance. Highly personal information is continuously collected—activity levels, sleep patterns, heart rhythms, location, behavioral habits—and stored in digital systems that may be shared with third parties, sometimes without clear user awareness. Data breaches have already demonstrated how vulnerable large health data sets can be. In 2025, a breach of UnitedHealth records led to 100 million individuals’ information being compromised.

You can take practical steps to better safeguard your information. Start by disabling location tracking in your device’s privacy settings and reviewing the company’s privacy policy—many consumer health products are not protected under the Health Insurance Portability and Accountability Act (HIPAA). It’s also wise to decline unnecessary permissions, switch your profile to “private” or “friends only” (as many platforms default to public) and use strong, unique passwords. When transferring data or syncing devices, connect only to secure, private Wi-Fi networks rather than public hotspots.

Potential downstream uses of this information extend beyond the goal of personal wellness. Insurers could incorporate these metrics into risk calculations, leading to higher premiums. Employers may gain access to health data through workplace wellness programs and use it to discriminate, influence or penalize you—or even to guide targeted layoffs. Incentive-based monitoring systems are already emerging, and what begins as voluntary participation could, in some settings, evolve into an expectation or requirement—whether stated or implied. For example, a system that rewards adherence to a medication regimen could gradually shift from offering incentives for success to imposing penalties for noncompliance, infringing on personal autonomy and creating pressure to follow recommendations that you may not fully agree with.

Promise, Potential and Practical Limits

Despite these concerns, wearable technology holds considerable potential, particularly for people with chronic illness. Continuous data collection may help detect early signs of Parkinson’s disease, identify sleep apnea, track mood-related behavioral changes and alert patients or clinicians to dangerous physiological shifts. Some researchers, such as Dr. Sandeep Kishore of UC San Francisco, envision systems in which abnormal readings automatically trigger outreach from healthcare providers—or even emergency response when necessary.

At the forefront of ongoing advances in artificial intelligence, he and others suggest that long-term physiological data streams may eventually allow algorithms to detect meaningful patterns earlier than traditional clinical observation. The current medical model—seeing patients once every six months for a check-up—can miss critical information that could help prevent future health issues. Instead of periodic appointments, preventive medicine could move toward continuous background insight. Dr. Kishore says:

“I think about a patient I had on the wards recently. She was in her 30s and had type 1 diabetes, meaning that she requires frequent insulin to manage her blood sugar. Unfortunately, she ran out of insulin and presented to the hospital nearly comatose. In many ways, she was hidden. Her roommate was the one who found her slouched in her room. If my patient had some sort of passive blood sugar monitoring, we could envision a day when that data could be part of a feedback loop between her and her health care team. Imagine if it sent an alert to a physician or a pharmacist monitoring a dashboard? Or maybe initiated a call or text to her phone that — if she didn’t respond — would trigger an emergency response? Maybe, we could have prevented this from happening.”

Future wearable health devices may be embedded in everyday objects, worn invisibly or even powered indefinitely. Imagine your steering wheel keeping track of your heart rate, contact lenses that act as a biochemical laboratory, or a patch that looks like a Band-Aid and can be worn for weeks at a time—all sending wellness metrics to a centralized system where they are sorted and analyzed for actionable signals. In the next decade, tech experts expect to have smartwatches that last for the life of the product, with no charging required. Aside from diagnosing cancer, heart disease and diabetes, these devices may detect colds 72 hours in advance or “talk” to your doctor, alerting them to time-sensitive health emergencies.

Yet translating this vision into practice raises several practical challenges. Healthcare systems are already strained—persistent streams of patient data would require time, infrastructure and personnel to interpret effectively. If abnormal data is transmitted but not reviewed, who is responsible? The promise of round-the-clock observation may exceed the current capacity of medicine to respond when needed.

It’s human to want to understand your body and reduce uncertainty—and wearable health technology offers a way to help you stay one step ahead of illness. This can be appealing, especially if you are frustrated with the current healthcare model, which is highly reactive and lacking in preventive measures. Being able to convey a year’s worth of information about your health to your doctor, rather than attempt to sum it up in your own words within a 15-minute office visit, seems efficient and reasonable.

But does more data translate into more health? While these tools offer clarity, they have also been shown to contribute to dependency, anxiety and false reassurance, and to shift natural awareness of your body toward a state in which it is constantly managed. This constant self-checking may be why the majority of those who try wearable health devices abandon them within a few months.

Wearables should not be viewed as a threat, but they are not a cure-all either—they are tools that, at best, may be used to highlight recurring signals you might miss and support lasting behavior change. At their worst, they may distract you from simple things that are critical to health: nourishment, connection, rest and attention to how you actually feel. As these devices become more integrated into daily life—collecting personal data, transmitting signals through wireless networks and sometimes staying in near-constant contact with the body—it becomes increasingly important to use them thoughtfully.

If wearable health technology is here to stay—and it certainly seems like it is—then the call is simple: use the data, but don’t lose your own wisdom. Innovation can offer valuable support for a healthy lifestyle, but don’t let it overshadow your intuition. Stay curious, stay present and remember—you have the ability to know your body better than any device ever will.

~

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EDITOR’S SUMMARY: Cancer is often framed as a genetic accident, but a growing body of research suggests a deeper story—one rooted in metabolism, environment and the body’s internal terrain. The role of toxic exposure, mitochondrial dysfunction, nutrition and emotional health may shape cancer’s development and progression. Drawing on the work of researchers and survivor experiences, integrative strategies aim to restore metabolic balance, reduce toxic burden and strengthen the body’s natural defenses.

Cancer is one of the greatest paradoxes of modern medicine: a disease studied for more than a century, treated with billions of dollars in therapies and mapped down to the molecular level, yet one that continues to elude complete understanding—and consistently safe, effective treatment—within conventional medicine. For decades, the dominant narrative has held that cancer is primarily a disease of genetics: mutations, random errors and rogue DNA gone wild. The truth is that this story is incomplete.

What if cancer, rather than being a purely genetic malfunction, is instead a survival strategy in a body under strain—a cell adapting to a harsh environment, toxic load, nutrient deficiency and mitochondrial breakdown? It is here that cancer transforms from a mysterious foe into a condition that can be questioned, decoded and ultimately addressed.

This perspective, while lofty, did not emerge in ignorance. It traces back to the work of Dr. Otto Warburg, the Nobel Prize–winning biochemist who observed that cancer cells behave fundamentally differently from healthy cells in how they generate energy. Warburg noted that even in the presence of oxygen, cancer cells rely heavily on inefficient fermentation—now known as the Warburg Effect—rather than mitochondrial respiration. He viewed this shift as a sign of underlying metabolic injury. His work has gained renewed relevance through researchers such as Dr. Thomas Seyfried, who has expanded this framework by linking cancer progression to disrupted energy production and altered fuel use. Together, their findings suggest that cancer may be less a random genetic rebellion and more a biological adaptation to internal stress.

Building on this metabolic view, the idea that cancer flourishes in a toxic terrain was not the revelation of any single scientist, but rather the gradual convergence of insights across generations. As early as the 1880s, English surgeon Stephen Paget proposed his now-famous “seed and soil” hypothesis, observing that cancer cells (the seeds) only take root where the biological environment (the soil) permits their survival. More than a century later, researchers have begun to define that soil with unsettling clarity, revealing just how pervasive environmental exposure has become.

Following the work of Theo Colborn, who first highlighted how everyday chemicals can disrupt hormones and developmental processes, researchers have shown that many environmental toxins do not need to damage DNA to contribute to disease. Instead, they interfere with hormonal signaling, immune regulation and cellular energy pathways, gradually reshaping the body’s internal landscape. Dr. Bruce Blumberg demonstrated how certain chemicals can reprogram metabolism, promote fat storage, impair mitochondrial function and trigger chronic inflammation. These significant changes weaken healthy tissue, creating conditions in which cancer and other chronic illnesses are more likely to take hold.

Ruthann Rudel and colleagues at the Silent Spring Institute have identified environmental carcinogens—chemicals that not only damage DNA but promote chronic inflammation, hormonal disruption and stress on cellular energy systems. In such environments, cancer cells sometimes use compounds like ammonia, a byproduct of cellular metabolism, as fuel to survive and proliferate.

While many who face a cancer diagnosis seek radiation, chemotherapy and/or surgery, the experiences of cancer survivors like Chris Wark (Chris Beat Cancer) and chiropractor Dr. Pete Sulack bring these concepts out of theory and into lived experience. Their journeys suggest that cancer’s strength is also its weakness: it can only survive under very specific conditions, and both men used that knowledge to change the terrain in their favor. Chris Wark, while discussing his journey with cancer, said:

“The world needs to know that chronic diseases like cancer, heart disease, diabetes, auto immune diseases, many of these chronic diseases are not accidental… they’re not… people don’t get them because they are unlucky or because they have bad genes. They are caused by our diet and our lifestyle choices and our environment. In fact, up to 90% of cancers are considered to be caused by diet, lifestyle and environmental factors.”

Yet leaning into this philosophy often raises tension within modern oncology. Conventional chemotherapy and radiation, while verifiably capable of shrinking tumors, often do so by introducing a toxic burden—generating oxidative stress, mitochondrial injury, inflammation and collateral damage to healthy tissue. This approach may further disrupt the body’s internal balance that a functional or restorative perspective seeks to support. Cancer is not invincible, but when treatments add to the body’s overall strain instead of restoring balance, they can unintentionally strengthen the very conditions on which cancer depends to survive.

The bright side of this perspective is profound, though: if cancer relies on specific internal environmental conditions, then altering them can starve it of opportunity. Through nutrition, detoxification, targeted lifestyle interventions, faith and a positive attitude, it becomes possible to create an internal environment that favors health over disease processes. This is the mind-body connection. The lived experiences of many survivors who chose a holistic approach over conventional treatment offer real-world examples suggesting the body can be supported in returning toward balance and strength. Together, these stories reveal something powerful: cancer is not invincible. It is vulnerable. And one of its greatest vulnerabilities is its hunger.

The Metabolic Roots of Cancer: A Disease of Energy and Environment

What Dr. Warburg revealed was not merely a curiosity of cancer metabolism, but a fundamental survival tradeoff. Fermentation allows cancer cells to persist under hostile conditions—low oxygen, high toxicity, damaged mitochondria—but it comes at a cost: inefficiency. In this context, fermentation does not mean the beneficial process used to make foods like yogurt or sauerkraut. It refers to a primitive, oxygen-independent way of producing energy that relies heavily on sugar and generates acidic waste. Cancer cells fall back on this inefficient process when their normal energy systems are impaired or when oxygen is scarce. While fermentation allows short-term survival, it forces cancer to consume far more fuel than healthy tissue, creating a metabolic weakness that can be targeted.

To compensate, cancer cells must dramatically increase their intake of glucose and glutamine, hijacking the body’s fuel supply to sustain rapid growth. This relentless demand reshapes the body’s metabolism, driving insulin spikes, chronic inflammation, muscle wasting and immune suppression—all conditions that perpetuate tumor survival. This dependency also happens to be cancer’s Achilles’ heel.

Unlike healthy cells, which can flexibly shift between glucose, fats and ketones—molecules produced when the body burns fat for fuel—most cancer cells lose this adaptability and remain locked into sugar-driven growth. Modern dietary therapies, such as nutritional ketosis, fasting and glucose restriction, target this weakness by lowering growth signals like insulin that drive cancer.

Ketosis is a natural physiological state in which the body relies more heavily on fat for fuel, producing ketones. This shift can support mitochondrial function while limiting the fuel many cancer cells depend on. While every body is different, entering ketosis typically involves reducing carbohydrate intake, and this state can be monitored through simple at-home testing methods. Supplying the body with clean-burning ketones—which produce fewer damaging byproducts—may further support cellular function while placing metabolic pressure on malignant cells. Ketosis also promotes autophagy, the body’s natural cleanup system, which helps remove damaged or precancerous cells.

Gerson Therapy: Detox, Flood, Repair

Dr. Max Gerson, a German physician in the early 20th century, observed that cancer and other chronic illnesses often arise from a toxic internal environment—one clobbered by poor nutrition, liver stress, mineral imbalances, weakened immunity and systemic deficiencies. To address this, he developed a comprehensive approach used with patients that emphasized internal cleansing, nutrition and immune support. The “Gerson Therapy” was standardized when his daughter Charlotte opened a clinic in San Diego in 1978. That clinic has since moved south to Tijuana, Mexico and overseas to Budapest, Hungary, because California law (Health and Safety Code – HSC § 109290) only allows individuals licensed by the state to diagnose, treat or attempt to relieve cancer using drugs, surgery or radiation. The protocol emphasizes frequent consumption of freshly prepared organic juices, a raw plant-based diet rich in phytonutrients, strict sodium restriction to support fluid balance, targeted supplementation and the use of coffee enemas to assist liver function.

Central to Gerson’s approach—and shared by modern protocols—is the principle that the body’s internal physiological state determines whether cancer grows or withers. Detoxification, particularly through coffee enemas, natural heavy-metal chelators like modified citrus pectin and lymphatic stimulation or massage, can help to:

• Lower toxic load

• Enhance glutathione, the body’s master antioxidant

• Unburden the liver

• Strengthen immunity

• Reduce inflammation

While Gerson Therapy does not align with nutritional ketosis—since it relies heavily on carbohydrates from fruits and vegetables—it has still been shown to be effective against cancer for several reasons. First, it restores the body, improving function and reducing the toxic dietary burden on the liver, boosting mineral balance and modulating the immune system. Second, it floods cells with antioxidants and phytonutrients, supporting mitochondrial repair and reducing oxidative stress. Third, by emphasizing whole, organic plant foods, it reduces exposure to environmental toxins that can promote cancer growth.

At first glance, this appears contradictory. If cancer thrives on sugar, how can a carbohydrate-rich approach offer benefits? The answer lies in context. Cancer does not simply respond to glucose—it responds to the metabolic environment. In a system marked by toxicity, inflammation and nutrient depletion, sugar can act as a growth signal. When detoxification pathways are supported, minerals rebalanced and immune function strengthened, those same carbohydrates may instead nourish healthy cells. In this way, Gerson Therapy does not feed cancer; it removes the conditions that allow cancer to use available fuel in the first place. Ultimately, Gerson Therapy tackles cancer by focusing on clearing, nourishing and supporting a body where healthy cells can flourish and cancer cells lose their advantage.

Rebuilding Health: Diet, Therapeutic Interventions and Mind-Body Medicine

So what was it that both Chris Wark and Dr. Pete Sulack embraced that led to their success in battling cancer? Despite differences in their cancers and protocols, their strategies converge around three principles: restoring metabolic balance, reducing toxicity and harnessing the mind-body connection to strengthen resilience. Chris focused on a high intake of raw fruits and vegetables, particularly cruciferous varieties that support apoptosis (the body’s natural process of programmed cell death that removes damaged or abnormal cells), along with targeted herbs, coffee enemas and a low-toxicity lifestyle. Dr. Sulack, by contrast, integrated therapeutic ketosis to starve cancer cells of glucose, high-dose intravenous vitamin C, therapeutic fasting and Budwig protocol-inspired flax-quark therapy (a diet that mixes flaxseed oil with cottage cheese, believed to help cells use oxygen more efficiently and support the body in fighting cancer).

All of these interventions support energy production, stabilize mitochondria, modulate inflammation, enhance immune surveillance and reduce oxidative stress. However, there are a couple of areas in Dr. Pete Sulack’s method that take it a step further. First, he employed oxygenation therapies—including hyperbaric oxygen, red light therapy, breathwork, grounding and exercise—to further create an inhospitable environment for malignancies. Tumors thrive in low-oxygen (hypoxic) environments, which allow them to evade normal cellular control and resist therapy.

Second, he employed the antiparasitic drugs ivermectin and fenbendazole to exploit cancer’s biological weaknesses. Studies have shown that ivermectin reduces energy production in tumor cells, increases oxidative stress and inhibits blood vessel formation, while fenbendazole blocks glucose uptake, destabilizes microtubules and triggers cancer cell self-destruction through apoptosis and pyroptosis. Compared to chemotherapy, these alternative pharmaceutical approaches, combined with a systemic reset and emotional-biological strengthening, exemplify how multiple complementary strategies can converge to shift the body against cancer.

Natural compounds can mimic many of these effects. Herbs, spices and botanicals—such as frankincense, turmeric, thyme, oregano, cinnamon, cloves, ginger and milk thistle—may influence apoptosis, cellular structure and mitochondrial function. Medicinal mushrooms like lion’s mane, chaga, reishi, turkey tail, maitake and cordyceps can enhance immune function, modulate oxidative stress and improve cellular energy. These natural agents act as gentle, complementary tools that act on the same dependencies cancer cells rely on. While they each walked their own path toward healing their bodies, Chris and Dr. Pete both agree on one thing: unresolved trauma in the body or mind can manifest as disease.

Mind-body medicine: the power of attitude, laughter, and emotional healing

The mental and emotional dimensions of healing are not mere feel-good concepts—they have measurable physiological effects on the body. Norman Cousins, the journalist and author, famously used humor and laughter as a therapeutic tool during his battle with a serious autoimmune condition. He documented in his best-selling book “Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration,” that frequent, hearty laughter reduced pain, improved sleep and seemed to accelerate recovery. Modern science supports this: laughter lowers stress hormones like cortisol and adrenaline, boosts endorphins, enhances immune function and even improves circulation. In essence, laughter creates a physiological environment that promotes healing and reduces the inflammatory stressors that cancer relies on. According to an article in the Journal of Oncology Navigation & Survivorship, “The Benefits of Humor When Confronted with Cancer”:

“Several studies have shown that watching as little as 30 to 60 minutes of a comedy video is enough to increase saliva and blood levels of immunoglobulin A, the body’s first line of defense against upper respiratory infections. Watching 1 hour of a humorous video also increases the number of T cells in the body—the natural killer cells that play a significant role in destroying cancer cells.”

Louise L. Hay, author of “You Can Heal Your Life,” emphasized the profound connection between unresolved emotions and physical disease. Hay proposed that suppressed anger, resentment and chronic fear can manifest in the body over time, creating conditions conducive to illness—including cancer. Her solution? Positive affirmations that bathe the body in love and self-acceptance. For cancer she suggests reciting the following: “I lovingly forgive and release all of the past. I choose to fill my world with joy. I love and approve of myself.”

American surgeon and author Bernie Siegel, M.D., wrote in his best-selling book “Love, Medicine and Miracles,” that when he performed surgery on cancer patients, he hoped he could “buy people time,” trusting they would do the mental and emotional work needed to “heal themselves.” He wrote:

“[The] inability to love themselves, having been unloved by others during some crucial part of their lives. This period is almost always childhood, when our relations with our parents establish our characteristic ways of reacting to stress. As adults we repeat these reactions and make ourselves vulnerable to illness, and our personalities often determine the specific nature of the illnesses. The ability to love oneself, combined with the ability to love life, fully accepting that it won’t last forever, enables one to improve the quality of life.”

Contemporary research aligns with this concept: chronic psychological stress has been linked to increased inflammation, impaired immune surveillance and disrupted hormonal balance, all of which can create a “fertile soil” for tumor growth. Practices such as forgiveness, emotional release and cultivating positive self-perception may help shift that internal environment toward conditions that support cellular health and healing.

Addressing emotional stress can influence the body’s internal biochemical landscape. Reducing anxiety may lower cortisol and other stress hormones, regulate inflammatory mediators and support optimal immune function, creating conditions that favor healthy cells and make it harder for cancer cells to gain a foothold. In essence, shifting your mental and emotional state can translate into measurable changes in cellular resilience and overall metabolic balance.

Together, the approaches of Cousins, Hay and Siegel illustrate a fundamental principle: the mind is not separate from the body. Attitudes, emotions and beliefs have tangible biological effects, influencing immunity, inflammation and homeostasis. When integrated with nutritional therapies, the intelligence linking mind and body forms a powerful foundation for healing—showing that nurturing emotional and spiritual health is as crucial as restoring cellular and metabolic health in the fight against cancer.

Though Chris’s plan leans more toward high-phytonutrient, detox-focused nutrition, while Pete’s emphasizes ketosis and advanced whole-body systems support, both approaches share a unifying principle: cancer tends to take hold in conditions shaped by systemic stress, immune imbalance, disrupted energy production and unresolved emotional strain.

The Cancer Hydra: Five Strategic Strikes

Cancer is not simple, and no single approach serves as a “holy grail” cure. It is a hydra with many heads—cellular dysfunction, immune dysregulation, disrupted energy production, hormonal imbalance, accumulated environmental burden, poor oxygenation, nutrient deficiency and genetic susceptibility. Targeting just one head rarely works. Cancer gains an advantage when multiple systems fall out of alignment—and addressing it requires a strategy just as multifaceted. The most effective approaches reflect this complexity. Regardless of the exact protocol, five key strategies consistently emerge:

• Metabolic starvation: Cut off the cancer’s fuel. Nutritional ketosis, fasting and low-glucose approaches limit the primary fuels cancer cells depend on, placing pressure on their already inefficient energy systems.

• Detoxification and terrain restoration: Reduce accumulated chemical burden and restore physiological balance within the body. Coffee enemas, modified citrus pectin, liver support and phytonutrient-dense diets support cellular repair, calm inflammatory signaling and reinforce immune resilience.

• Oxygenation and mitochondrial support: By increasing oxygen availability through hyperbaric therapy, red light, breathwork, grounding and exercise, these approaches shift cellular conditions in ways that challenge tumor survival, helping restore normal regulatory control and improve responsiveness to treatment.

• Targeted natural and pharmaceutical agents: Use molecules that disrupt cancer signaling and structure. Pharmaceuticals like fenbendazole and ivermectin slow and destabilize malignant cells. Potent herbs and medicinal mushrooms can produce similar effects.

• Mind-body medicine and emotional state: Faith, prayer, meditation, forgiveness, gratitude and a positive mindset shape the entire human system. No thought, emotion or belief exists in isolation from the body that holds it—each one influences the other.

Cancer is not the end of the story—it can become a turning point, revealing where the body is under strain and where support is needed most. As daunting as it may seem, it can illuminate which systems are undernourished or overwhelmed—and where meaningful intervention can begin. An African proverb captures the idea well: “A smooth sea never made a skilled sailor.”

Challenges, adversity and difficult experiences are essential for developing true skill, strength and adaptability. Facing cancer can catalyze this growth. It may challenge your body, it may test your mind, but it also illuminates the path to a restored life. It is not a sentence; it is a teacher. With knowledge, determination, the right strategies and a humble, gracious and optimistic attitude, your body can be guided back toward strength, vitality and renewed resilience.

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EDITOR’S SUMMARY: Thermal paper receipts contain bisphenol compounds used in heat-activated coatings that allow receipts to print without ink. These chemicals, including BPA and BPS, can transfer to skin during routine handling, raising concerns about repeated exposure—particularly for retail workers who handle receipts throughout the day. Industry shifts from BPA to closely related substitutes have complicated regulatory efforts, as many replacement chemicals remain less studied. Emerging policies and practical steps to reduce contact with receipt paper are also examined.

That retail store receipt you just tucked into your purse carries more than a record of your purchase. Printed on thermal paper—a heat-activated material—it contains chemicals you cannot see, smell or feel. The coating transfers easily, and studies suggest it can pass through your skin. Unlike plastics that must be heated or worn down, receipts can shed chemicals the moment they touch your fingers, making even brief contact a potential source of absorption. Researchers have spent decades studying what these coatings contain and why they matter for human health.

Bisphenols

One of the most common chemicals used in receipt coatings today is Bisphenol S (BPS), which is closely related to Bisphenol A (BPA). The name may sound familiar because “BPA-free” has become a common marketing term across many industries. When you purchase a product labeled “BPA-free,” it often suggests the item is nontoxic and safe. In reality, removing BPA does not eliminate chemical exposure. Companies often substitute other compounds—such as BPS—that can raise similar health concerns.

Bisphenols are widely used industrial chemicals that help strengthen plastics. They are found in canned food linings, plastic food containers, baby bottles (before regulations reduced their use), thermal receipt paper and many other products. For decades, BPA was the dominant compound until evidence of endocrine disruption—linked to a range of biological effects—forced a public rethink. Manufacturers shifted toward closely related alternatives, including Bisphenol S. Understanding the thermal printing process used to produce receipts is the first step in minimizing chemical contact.

Plastic water bottles are often cited as a major source of bisphenol exposure. Chemicals embedded in the plastic can leach into water over time, especially when bottles are reused or exposed to heat. However, you could avoid them entirely and still absorb meaningful amounts of bisphenols from just a few minutes spent at the checkout counter each week. Bisphenols are a common ingredient in thermal receipt coatings because they react to heat and make the print appear instantaneously. The same property that makes them effective in printing also makes them easy to transfer to skin.

In thermal receipts, bisphenols exist in a free or unbound form, meaning they are not chemically attached to the paper fibers. They sit on the surface as loose molecules, almost like powder resting on the coating rather than embedded within the material. Unlike bisphenols inside plastic, which remain locked into a polymer chain until heat, abrasion or time breaks them down, the bisphenol layer on receipts can transfer immediately when the paper is touched. Skin warmth, friction or moisture can activate the coating, allowing the chemicals to move onto the next surface—your fingers. You will not feel the transfer, but absorption still occurs.

Thermal printing is used for receipts because it is inexpensive. Instead of ink or toner, the paper itself is chemically treated to react to heat during printing. Although ordinary paper pulp is used, the chemical coating is where the concern lies. Multiple layers, including leuco dyes, developers (BPA and BPS), sensitizers and stabilizers are applied to the surface. As the paper passes under the printer head, heat triggers reactions within these layers, producing the darker, readable images on the paper.

Policy and regulation

When BPA faced global scrutiny over the past decade, many manufacturers pivoted to BPS. They needed an immediate replacement so they could market products as “BPA-free.” Europe was among the first regions to recognize the risks tied to thermal receipt paper. Regulators did not eliminate bisphenols entirely, but acknowledged that printed receipts required oversight. France and Belgium moved toward digital default systems for many retail transactions. Japan shifted to non-phenol alternatives—developers that do not rely on phenol-based chemicals such as BPA or BPS—for several major retail chains.

In the United States, regulation of bisphenols in thermal paper varies by state rather than at the federal level. There is no nationwide rule requiring retailers to disclose which chemical developer their receipt paper contains, and labeling practices remain inconsistent. Some stores have switched voluntarily to phenol-free paper because consumer demand has pushed for safer alternatives.

A handful of states have taken more direct action. California’s Proposition 65 requires warning labels for thermal paper containing BPA or BPS. Suffolk County in New York enacted similar rules, and Washington state banned bisphenol-based thermal paper starting January 1, 2026. Several other states have introduced legislation over the years. While many states have restrictions on BPA for certain products, very few have addressed bisphenols in receipt paper specifically.

Other developers, including Bisphenol F (BPF) and related phenol compounds, have also entered the market, though far less toxicity research exists on these alternatives. In California, the rules have tightened and thermal receipt paper is now specifically regulated. The passage of AB 2244, sponsored by A Voice for Choice Advocacy, prohibits BPA in thermal paper as of January 1, 2025, and bans all intentionally added bisphenols as of January 1, 2026, making it one of the strongest state-level protections against everyday bisphenol exposure in the country.

Importantly, scientists do not need to guess whether bisphenols leave receipt paper. They can measure them directly on the skin. In 2014, researchers at the Swiss Federal Institute of Technology tracked BPA transfer after brief handling of receipts. The results showed that bisphenols readily transferred to the skin of those handling them. Additionally, participants who first used hand cream or other moist substances on their hands absorbed even higher amounts of the chemicals into their skin. Switzerland eventually aligned with broader European restrictions, limiting BPA and many other forms of bisphenols in paper receipts as well as in certain food-contact materials.

Studies have detected BPS in the majority of receipts collected from major retail chains. This suggests thermal paper can be a significant non-dietary source of bisphenol exposure, particularly for workers who handle receipts repeatedly throughout the day. While no one study claims receipts alone drive negative health effects, they remain one of the most direct and controllable sources of chemical contact in daily life.

Health Impacts You Can’t Ignore

You don’t see hormones at work, but their effects unfold over time. They affect sleep, metabolism, fertility, temperature regulation, mood, immune response, memory, bone density and more. Bisphenols interfere with hormones in a variety of ways, many of which do not produce an immediate reaction like a rash or a cough. More specifically, they disrupt hormone signaling, which means their impact often emerges gradually across multiple systems in the body. Researchers have linked bisphenol exposure to a range of biological effects, including:

• Reproductive changes, including altered estrogen and testosterone activity, reduced sperm quality and changes in ovarian function

• Metabolic disruption, with associations to obesity and increased diabetes risk

• Thyroid interference, which can influence energy balance and temperature regulation

• Immune and cardiovascular impacts, including shifts in cholesterol and heart health

The Endocrine Society has consistently emphasized the importance of the endocrine system and the risks that arise when it is disrupted. The organization notes:

“Because of the endocrine system’s critical role in so many important biological and physiological functions, impairments in any part of the endocrine system can lead to disease or even death.”

Endocrine-disrupting chemicals mimic or block natural hormones, and the body misreads the signal. Hormones work through ongoing messages over time, so when contact occurs repeatedly, even at low levels, the body continues responding as if the signal were real. This is why chronic contact—such as regularly handling thermal receipts—matters more than occasional encounters.

Animal studies do not map perfectly onto humans, yet they can provide early evidence that potential harms may exist. In a recent study, “Hazard characterization of bisphenol A (BPA) based on rodent models – Multilevel meta-analysis and dose-response analysis for reproductive toxicity,” it is stated:

“Adverse effects of BPA exposure have been reported in both animal and epidemiological studies, including reproductive disruption, neurotoxicity, immunotoxicity and metabolic diseases.”

From the journal Molecular and Cellular Endocrinology, an analysis titled “Bisphenol S chronic exposure impairs pancreatic function and induces obesity in male mice independently of high-fat diet intake,” offers one of the clearest examples of how BPS may influence metabolism. Researchers exposed mice to chronic, low-level BPS and found that their pancreatic function shifted in ways that resemble early insulin resistance. When this exposure was paired with a high-fat diet, those metabolic disruptions intensified. The explanation was straightforward: even small, repeated contact with BPS altered glucose markers over time, and diet appeared to magnify the effect.

Who carries the greatest burden?

For most shoppers, contact with receipt paper is brief. For retail workers, it is routine. Grocery clerks, ticket takers, pharmacy techs and small business owners who manually tally sales may handle several hundred slips in one shift, creating repeated dermal contact throughout the day. In the study, “Higher dermal exposure of cashiers to BPA and its association with DNA oxidative damage,” it was concluded that “Urinary BPA levels increased significantly due to the dermal contact of receipts made with high BPA concentrations.” The chemical clears from the body over time, but repeated contact creates a cycle in which levels may not fully return to baseline. This makes receipt paper an occupational concern rather than solely a matter of individual choice. Few retail environments offer gloves, and even fewer provide alternatives or education about the receipt coating. For many workers, exposure is simply part of the job. This is ultimately a labor issue, not simply a lifestyle concern. Without protective options, responsibility for the risk falls on workers who may not have the ability to reduce it on their own.

Reducing contact should not fall solely on workers, many of whom are never informed about the materials they handle. Retailers and suppliers can choose phenol-free receipt paper and adjust their systems so receipts print only on request. For both workers and customers, identifying these safer alternatives is not always straightforward. While some receipts made without phenol developers may appear lighter or less glossy, there is no consistent color or texture that reliably indicates which developer is used. Without clear labeling or documentation, greater transparency is essential.

Beyond BPS

Even if BPS vanished tomorrow, the problem would not end. Producers have already begun using other bisphenol chemicals in receipt paper. Researchers have detected BPF and bisphenol-related polymers—including Bisphenol S–induced polymer—in receipts, and some samples contain more than one bisphenol at a time. If the chemistry changes again, the labels may shift, but the underlying issue remains. The coating still sits on the surface, and skin contact allows chemicals to transfer.

Replacing one bisphenol does not solve what receipts fundamentally are. They are single-use coated paper designed to deliver information you are unlikely to keep. After a brief moment of use, these slips move quickly into the waste stream. As treated paper breaks down, chemical developers can enter landfills, recycling streams and wastewater systems. Fortunately, reducing contact does not require complicated steps. Simple habits can limit exposure. Here are a few tips to minimize contact:

• Ask for digital receipts when available. If a store prints automatically, you can simply decline.

• Keep necessary receipts in one envelope rather than loose in pockets or in your purse or backpack. Handle them only when needed for returns, tax documentation or reimbursements.

• Wash hands before eating, and after unpacking groceries if you grabbed receipts along the way.

Something meant for your convenience has become another health concern. If you choose to skip the slip, you eliminate one avoidable point of contact that never needed to exist. Change begins with awareness and choice. By opting for digital receipts, supporting retailers that use safer alternatives, and advocating for clear labeling, you become part of that shift. You have the right to know what you touch and what your body absorbs. Don’t let this tiny piece of paper remain an invisible source of chemical exposure at the checkout counter.

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At A Voice for Choice Advocacy, we’ve also examined how industry practices and formulation strategies shape what ends up on grocery store shelves. Our article “The Sweetness of Foods: Manufacturers Make It Their Business To Keep You Addicted” looks at how food companies design products to maximize appeal while responding to consumer demand and regulatory scrutiny.

Originally published by STAT on February 6, 2026
By Sarah Todd

So you’re a bear in the forest, and you’re hungry. When you trundle toward a raspberry bush and get your first taste of ripe, sweet fruit, dopamine floods your brain, pleasure as a form of instruction: More of this. Faithful to your body’s signals, you’ll be back to these same bushes throughout the summer, and every summer after that.

The dopamine hits that a tasty meal provides help animals — people included — survive. But ultra-processed food manufacturers have perverted the brain’s built-in reward system, according to researchers, nutrition advocates, and leaders across the political spectrum, keeping people coming back for the Cheetos and Chips Ahoy! that wreak havoc on their health.

Now the question is whether the food industry will change. Critics are intensifying a public relations war against ultra-processed food by highlighting its history with the widely distrusted tobacco industry — and exploring how strategies against Big Tobacco might be applied to food. Meanwhile, the food industry is fighting for its reputation with a new seven-figure ad campaign from the trade group Consumer Brands Association that emphasizes the manufacturing jobs it creates and the benefits of “everyday essentials that are convenient, affordable, and above all, safe.”

One of the biggest recent developments was the city of San Francisco’s groundbreaking lawsuit against 10 ultra-processed food manufacturers, filed late last year. “Big Food was, and still is, using the deceitful tactics it inherited from the Big Tobacco industry to flood the market with harmful UPF products and to aggressively sell those products to children,” the lawsuit says. The case is the first time the U.S. government has taken on the industry and may pave the way for future complaints, much in the way tobacco litigation had state attorneys general teaming up to land major settlements, according to Harvard Law School professor Emily Broad Leib.

Health secretary Robert F. Kennedy Jr. struck a similar note in a radio interview in late January, explaining how R.J. Reynolds and Altria Group (then known as Philip Morris) steered food giants like Nabisco and Kraft through the 1980s and 1990s. “They moved all of these thousands of scientists who were for years making tobacco more addictive, and they moved them to figure out ways to make food addictive,” said Kennedy, whose recently released U.S. dietary guidelines urge Americans to stay away from ultra-processed foods.

“We’ve forgotten what real nourishment and satisfaction feels like,” said Ashley Gearhardt, a psychology professor at the University of Michigan who’s part of the push to treat Big Food through the lens of tobacco. Her most recent paper, published this week in The Milbank Quarterly journal with co-authors from Harvard and Duke universities, argues that because cigarettes and ultra-processed foods are both industrially engineered to be addictive, anti-tobacco strategies offer a roadmap for future public health efforts. Just as cigarette companies titrated the precise amount of nicotine and additives in their products to deliver the quick rush that smokers craved, she said, food companies calculated combinations of salt, sugar, fat, and flavor in “just the right dose, so people are stimulated but not satisfied.”

The food industry rejects the association with tobacco. “Comparisons between food and tobacco are inaccurate and risk oversimplifying complex nutrition challenges,” Rocco Renaldi, secretary-general of the International Food and Beverage Alliance, said in a statement. “Tobacco is inherently harmful and unsafe at any level of use. Food, by contrast, is essential to life, and many foods that are labeled ‘ultra-processed’ — including whole grain breads, fortified cereals, and shelf-stable staples — contribute important nutrients.”

Gearhardt sees her work as part of a broader movement to highlight all the ways innate human drives for pleasure and connection have been “hijacked and wired toward corporate profits.”

“We’re caught in the cycle, whether it’s cigarettes or ultra-processed foods and beverages or social media or sports betting — all of these things are like the junk-food equivalents of trying to feel rewarded,” Gearhardt said. “And I think, in our bones, we know that this isn’t what life is supposed to feel like. I’m not supposed to feel this frantic and constantly unsettled, and like my mind’s always looking for the next fix.”

The grocery aisles that tobacco built

Gearhardt grew up on a 100-acre farm in rural Ohio. Her family grew corn for ethanol, soy for soybean oil, and hay for cattle, encouraged by agricultural policies that favored those crops. “There honestly wasn’t a single thing on our farm that we could eat directly,” she said.

In addition to working the farm, Gearhardt’s parents were attorneys, which meant they had enough money for nutritious food. But they didn’t have a lot of time to cook, so her family relied heavily on frozen meals and ultra-processed foods that they all perceived as healthy. Because fat was the big dietary villain at the time, Gearhardt said, her pantry was stocked with foods like caramel-flavored rice cakes, low-fat bagels with I Can’t Believe It’s Not Butter spray, and Special K strawberry cereal. “We had very few fruits and vegetables in the house,” she said.

Many Americans still live much the same way. Certain elements come in and out of vogue — these days fat’s back in, while seed oils and artificial ingredients are out. But overall, more than half the calories American adults consume in a day come from ultra-processed foods. For kids, it’s 62%.

These foods became omnipresent in our diets not by accident, but by design.

R.J. Reynolds got an early start in the ultra-processed food and beverage business, purchasing Hawaiian Punch and Penick & Ford, which made starches and gums used in processed food, in the 1960s. Under Reynolds, Hawaiian Punch went from a cocktail mixer to a brightly colored children’s drink in innovative packaging now known as the juice box. It was not merely a tobacco company, its manager of biochemical research declared back in 1962, but “in the flavour business.”

By the end of the 1980s, Reynolds had snapped up Nabisco, maker of Oreo cookies and Ritz crackers; Del Monte; Planters Lifesavers; and Kentucky Fried Chicken.

Not to be outdone, Philip Morris controlled General Foods, maker of Kool-Aid and Jell-O, as well as Kraft, purveyor of Oscar Mayer wieners and Velveeta cheese, and 7Up. Later, it would acquire Nabisco.

Both tobacco titans also owned alcohol companies. One Philip Morris executive said the goal was to control “all the pleasure drugs that are not regulated.”

Tobacco scientists took what they’d learned about how to make their products irresistible and passed those lessons onto food companies, internal documents show. (The benefits flowed both ways — Philip Morris developed a low-nicotine cigarette with extraction technology that General Foods used for coffee beans.) A Chicago Tribune investigation, for example, found that a leading Philip Morris nicotine researcher shared his work on how the brain processes smell and taste with Kraft food scientists.

Tobacco companies also applied marketing strategies that had worked with cigarettes to foods explicitly marketed to children and low-income demographics. When Philip Morris introduced Kool-Aid points redeemable for swag, one executive wrote that it was “our version of the Marlboro Country Store,” a cigarette loyalty program. Kraft used Philip Morris’s tobacco database to persuade corner stores in low-income neighborhoods to carry their sugary drinks, journalist Michael Moss reports in his 2013 book “Salt Sugar Fat: How the Food Giants Hooked Us.”

Though tobacco companies divested from the food industry in the 2000s, the aisles of American grocery stores are still stocked with the products they helped create.

Understanding ultra-processed food addiction

Given the tobacco industry’s influence, it’s fitting that a growing body of research supports the idea that, like nicotine, ultra-processed foods are addictive.

A 2022 paper, co-authored by Gearhardt, argues that addiction to ultra-processed foods meet the scientific criteria used to classify tobacco products as addictive in the 1988 Surgeon General’s report. People keep eating ultra-processed foods even when they want to stop. They have a mood-altering effect on the brain, increasing “dopamine in the striatum at a similar magnitude as nicotine,” by 150% to 200%. They’re so appealing that people keep eating them, and craving them, even when they’re full.

Gearhardt also sees similarities in how the food and tobacco industries use flavor to mask what she calls “low-quality products.” Cigarettes add sweeteners and flavors like synthetic chocolate to what she says are essentially gelatinized tobacco strips that also contain additives like ammonia. Food companies, meanwhile, put additives in the base of blitzed starches like corn and potato that make up so many savory snacks and breakfast cereals.

Because blitzing of the “starch slurry” makes molecules in the starches smaller and more porous, they break down more rapidly, producing that melt-in-your-mouth quality that makes it so easy to plow through an entire bag of cheese puffs without even noticing. “That’s so similar to the core mechanism of how you create cigarettes, where you’re trying to increase the speed of absorption in the body,” Gearhardt said. And in both cigarettes and ultra-processed food, she said, flavoring agents and additives provide bursts of flavor not found in nature.

Research shows the companies’ shift toward hyper-palatability. Comparing foods on the shelves in 1988 and 2001, a recent paper found that products that had been owned by tobacco companies were 29% more likely to combine higher levels of fat and sodium, and 80% more likely to combine carbohydrates and sodium.

I think that what we’re learning about the cigarette addiction model and how it got applied to food is going to revolutionize how we think about addiction,” said Laura Schmidt, a professor at the University of California San Francisco who studies how companies shape our health.

Getting ultra-processed food addiction formally recognized as a medical diagnosis, supporters say, would promote research on potential treatments and encourage policies and regulation that focus on the food industry’s culpability. But Schmidt says the groups responsible for creating official diagnoses — expert committees at the World Health Organization and the American Psychiatric Association — are “excruciatingly conservative.”

It’s possible that GLP-1 drugs will speed that process along. The weight loss drugs seem to muffle cravings for substances like tobacco and alcohol as well as food. “The idea that they are working on that mechanism in the brain highlights the addictive nature of ultra-processed foods,” said Diana Winters, who researches food and health law at the University of California Los Angeles.

Lessons from the tobacco playbook

There are, of course, ways that the comparisons between cigarettes and ultra-processed foods fall short. Writing in The Atlantic, Nick Florko noted that food is a more complicated issue for public health campaigns than tobacco: “To push Americans away from cigarettes, public-health advocates had a simple message: Don’t smoke. There is no equivalent slogan for food.” (Perhaps the dietary guidelines’ newly launched mandate to “eat real food” will catch on.)

Some other strategies from the anti-tobacco playbook may not translate so well to ultra-processed foods. Higher taxes on cigarettes were another important factor in helping the U.S. adult smoking rate fall dramatically over the past few decades, said Winters. She’s not sure if taxing ultra-processed foods the same way would be viable: “They make up such a large part of the American diet.”

A more selective approach could work. After five U.S. cities introduced higher taxes on soda and other sugar-sweetened beverages, one study found that consumption fell. Eight cities now have such taxes. (Some were passed with help from donations by Bloomberg Philanthropies, which also supports STAT’s chronic disease coverage as well as many anti-smoking efforts. Bloomberg Philanthropies does not have any editorial input on STAT’s articles.)

Litigation may also prove more complicated than it was with tobacco. While diet is a major factor in chronic illnesses like cardiovascular disease and type 2 diabetes, there’s not yet consensus on what ultra-processed foods are, and research is still evolving on whether, and how, their health effects may be distinct from foods that are generally higher in fat, sugar, and sodium.

There is, however, evidence that food industry leaders have long been aware of the health concerns. Geoffrey Bible, who led Philip Morris from 1994 to 2002, told Moss that the company knew during his tenure that people were criticizing their foods for being too high in salt, fat, and sugar. “Well, that’s what the consumer wants, and we’re not putting a gun to their head to eat it,” he said of the logic at the time. “If we give them less, they’ll buy less, and the competitor will get our market.”

From a messaging perspective, researchers say that anti-tobacco efforts helped the public health community learn that focusing on individual choices is not a winning strategy. “We made this big mistake in tobacco, we made it with food — you just blame the individual and you shake your finger at them and say, ‘Oh you’re bad, stop doing this,’” said Gearhardt. That doesn’t motivate people to change their behaviors. Better, she said, to focus on “the corporate engineering of these products and ways that they are designed to hook [you] in and deceive.”

Breaking out of the doom loop

Besides advertising campaigns, there are a lot of ways that the food industry may push back against comparisons to tobacco as well as efforts to control its offerings. “I think the biggest threat is reformulation,” said Gearhardt, as with when tobacco companies rolled out “better for you” features like filters. Evidence suggests the filters were no safer than the alternatives, and possibly more harmful. Altria Group and Reynolds American did not respond to requests for comment.

But Gearhardt also sees promise in the fact that healthier alternatives to ultra-processed foods are already abundant. “We just have to reacclimate our tastes and our brain to that, and demand that our government officials start funneling money toward making real food affordable and convenient and accessible,” she said.

When people quit smoking, they don’t just lower their risks of illnesses like lung cancer and heart disease. Studies show people who quit have lower rates of anxiety and depression and more positive outlooks on life overall. Gearhardt sees the potential knock-on effects of giving up ultra-processed foods as perhaps even more vast — perhaps opening up a way to escape the contemporary doom loop of tech-enabled anxiety and isolation.

On an average day, you might eat a bag of chips, “which makes you feel low-energy and sluggish,” Gearhardt said. “Then you don’t have the energy to go see your friends, so you cancel, and then you’re binge-watching Netflix while scrolling social media on your phone, which makes you not sleep well,” she said. “It’s this nasty cycle.” Breaking free of the ultra-processed foods designed to keep us chasing pleasure, she thinks, could help us all do more of what actually feels good.

STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.

EDITOR’S SUMMARY: Esterified Propoxylated Glycerol (EPG) is an engineered fat substitute designed to lower calories while preserving the taste and texture of traditional fats. Its growing use reflects a trend toward reformulating processed foods to meet high-protein, low-calorie demands. Although current data have not identified major safety concerns, questions remain about labeling practices and how such ingredients are represented on nutrition panels. EPG illustrates the tension between technological innovation and transparency in today’s food supply.

Your favorite protein bar or indulgent snack from the health food store might contain a new ingredient reflecting the latest phase of food innovation. The taste and texture will feel familiar, but a closer look at the nutrition label reveals a dramatic drop in calories and fat content, made possible by advances in food science. One example is Esterified Propoxylated Glycerol (EPG), a fat substitute that signals how technology is reshaping the modern food supply. For manufacturers and some consumers, it represents a solution for lowering overall energy content. For others concerned with transparency and regulation, it highlights ongoing debate about the long-term role of engineered ingredients.

What Is EPG and How Does It Work?

EPG is designed to mimic the creaminess and structure of traditional dietary fat, while differing in its molecular design. It is a patented additive derived from plant oils such as canola (rapeseed) oil that has been chemically modified to resist digestion. In simplified terms, the oil is separated into its basic components, altered using food-grade compounds, and then reassembled into a structure that digestive enzymes cannot easily break down. As a result, most of it passes through the body unabsorbed, contributing fewer calories while maintaining texture and mouthfeel. This engineered resistance to digestion is central to EPG’s appeal—and to the questions surrounding it.

Unlike traditional fats, which are broken down into fatty acids and absorbed into the bloodstream for energy or storage, EPG largely moves through your digestive tract intact. Its high melting point allows it to remain stable at body temperature, preventing enzymes from accessing and dismantling its structure. This physical resistance to digestion is not accidental but foundational to its design. In essence, EPG delivers the sensory experience of fat without fully participating in the metabolic pathways that define it.

From a physiological standpoint, this distinction is significant. Conventional fats serve biological roles beyond energy, contributing to hormone production, cell membrane structure, and the absorption of nutrients. EPG, by contrast, is engineered primarily for texture and caloric reduction rather than physiology. It behaves like fat in a recipe but not in your body. That separation between culinary performance and biological response is part of what makes it technologically innovative—and conceptually complex.

For some people, particularly at higher intake levels, this physical presence in the gut may be associated with reports of gastrointestinal discomfort. While manufacturers provide serving guidance, questions remain about how such ingredients behave when consumed across multiple products within the food supply.

Why food companies are turning to EPG

EPG offers a solution to a familiar industry challenge: how to reduce calories and saturated fat without sacrificing taste. Rather than removing fat entirely, food makers use EPG to replace a portion of it, preserving flavor and structure while reducing overall caloric load. On ingredient labels, EPG may appear as “modified plant-based oil” or “modified vegetable oil (EPG).” It is often marketed as GMO-free, allergen-free, trans-fat-free, gluten-free, vegan, kosher, and halal-certified. These claims make it easier for brands to market products to health-conscious shoppers.

EPG’s chemical structure makes it stable across a range of temperatures, allowing products to maintain consistency in both shelf and freezer environments. This stability extends product life, reduces waste, and strengthens commercial viability. For food companies navigating intense competition in the high-protein snack category, such advantages are not trivial. Texture, appearance, and shelf life can determine whether a product succeeds or simply disappears.

EPG’s market evolution

EPG was first developed in 2015 by Epogee, an Indianapolis-based company. For several years, its use remained relatively limited. The ingredient gained greater visibility when David Protein, a fast-growing high-protein snack company, adopted it in its protein bars. In 2025, the company acquired Epogee, consolidating control over production and distribution. The acquisition prompted legal challenges from smaller companies that had previously used the ingredient. A court ultimately ruled that after the acquisition, David Protein was not legally required to continue selling the patented ingredient to competitors.

The consolidation marked a turning point in EPG’s trajectory, shifting it from a niche ingredient into a more vertically integrated business model. At the same time, David’s own website notes that consuming more than two EPG-containing bars per day may cause gastrointestinal discomfort. Such disclosures, combined with limited long-term human dietary data, may help explain why larger corporations have remained cautious about widespread adoption.

Transparency and Regulatory Questions

EPG has received “Generally Recognized As Safe” (GRAS) status from the U.S. Food and Drug Administration, based in part on submitted safety data that included trials in animals and human volunteers. In those studies, no major adverse effects were reported. Unlike earlier fat substitutes such as Olestra—a non-caloric fat replacer introduced in the 1990s that was later associated with gastrointestinal side effects—EPG does not appear to significantly interfere with the absorption of fat-soluble vitamins, though slight impacts on certain nutrients have been noted.

While these findings provide a degree of reassurance, questions about transparency and labeling remain. Additional scrutiny has focused on how EPG is represented on nutrition panels. Because EPG is not fully absorbed, some manufacturers do not include it in the “total fat” calculation. In 2025, independent testing suggested that when EPG is accounted for structurally, total fat content may be higher than originally listed. This has intensified debate about how such ingredients should be presented to the public.

At the heart of this debate is a technical but meaningful distinction: should nutrition labels reflect the physical presence of a fat-like substance, or only the portion that is metabolically absorbed? U.S. nutrition labeling is based on metabolizable energy—the portion of calories your body can digest and use. Under this framework, substances that pass through largely undigested may be counted differently from conventional fats. While this approach aligns with regulatory definitions, it can create a gap between chemical composition and consumer perception.

A product may contain a substantial amount of a fat-like ingredient while still displaying a significantly reduced “total fat” number. For those scanning labels for quick comparisons, the nuance between structural fat and absorbed fat is rarely visible. The label reflects regulatory logic; most people interpret it through everyday expectations about the physical amount of fat in a product. Questions about classification extend beyond the Nutrition Facts panel. EPG cannot be included in USDA Certified Organic products because its multi-step synthetic processing falls outside organic standards. If you rely on organic certification as a safeguard against highly engineered additives, this distinction is relevant.

Federal labeling regulations also require foods that substitute for and resemble another food but are nutritionally inferior to be labeled as “imitation.” Although EPG does not currently carry this designation, some advocates argue that clearer labeling may be warranted for substances designed to function like fat without providing comparable nutritional characteristics.

These issues highlight an underlying tension within modern food systems, particularly within the GRAS framework that allows companies to submit safety determinations for certain ingredients. Regulatory compliance does not always translate into intuitive clarity. As food technology grows more sophisticated, the burden of interpretation increasingly shifts to consumers navigating terminology that may be technically accurate yet difficult to decode.

Broader context: protein trends and consumer demand

While protein needs vary, the Recommended Dietary Allowance is approximately 0.36 grams per pound (0.8 grams per kilogram) of body weight per day, though higher intakes—often in the range of 0.5 to 1 gram per pound—are commonly considered for physically active individuals or those seeking to preserve or build lean muscle mass. Whole food sources such as eggs, beans, seafood, and meat provide protein along with vitamins, minerals, and other essential nutrients.

In recent years, however, protein has taken on a distinct cultural status. Social media trends, fitness communities, and weight-management conversations have amplified interest in high-protein snacks, often positioning protein as a shortcut to satiety, muscle preservation, or metabolic advantage. In that environment, products that can deliver high protein with minimal calories or fat content gain a competitive edge. EPG fits neatly into this landscape. By reducing fat-derived calories without altering taste or overall sensory experience, it enables manufacturers to engineer products that meet specific macronutrient targets. A protein bar can display 25 or 28 grams of protein with strikingly low fat and calorie numbers, reinforcing a perception of nutritional efficiency. The numerical profile becomes part of the marketing appeal.

At the same time, reformulating processed foods to optimize macronutrient ratios does not necessarily make them more nutrient-dense. A snack may become lower in fat while remaining industrially produced. This reflects a larger trend within the food industry: adjusting isolated nutrient metrics rather than fundamentally rethinking formulations or overall dietary quality.

For consumers, the question may not be whether protein is important—it clearly is—but how protein is being delivered. Whole-food sources provide additional nutrients, fiber, and culinary familiarity. Formulated snacks offer convenience and precision. EPG enables processed products to preserve fat-like qualities while meeting protein-driven macronutrient goals, positioning it between whole-food appeal and engineered efficiency.

What this means for you

EPG reflects an ongoing balancing act within modern food systems: weighing technological innovation against transparency and trust. History suggests that enthusiasm for novel fat substitutes can shift quickly if unintended consequences emerge. Although EPG differs in composition and regulatory review, the Olestra experience remains a reminder that early safety data do not always capture long-term population effects. Food systems operate at scale, and even modest physiological impacts can accumulate when exposure becomes widespread.

Your decision to embrace or avoid ingredients like EPG depends on your priorities, dietary goals, and comfort with engineered food technologies. As innovation continues, informed choices may rely less on front-of-package claims and more on understanding how such ingredients are created and regulated. Whether you choose products containing EPG occasionally or prefer whole-food fats with established nutritional profiles, the enduring question is not simply whether EPG is safe or unsafe, but how you assess new ingredients as advances in food science continue to redefine the marketplace.

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At A Voice for Choice Advocacy (AVFCA), our work begins with education. When large policies reshape food systems, chemical regulation, and health protections, people deserve clear, balanced information before being asked to take action. A series of recent federal developments, including the 2026 Farm Bill, a presidential Executive Order on glyphosate, and pending court cases on pesticide liability, are actively reshaping those systems.

Together, these policies raise fundamental questions about who sets safety standards, how chemical risks are evaluated, whether states can act when federal protections lag, and the extent to which individuals harmed by toxic exposure retain meaningful access to the courts.

The 2026 Federal Farm Bill

Farm Bills are large, multi-year legislative packages that shape how food is grown, how agricultural chemicals are regulated, the authority of states and communities to protect residents, and whether individuals harmed by products can seek accountability. Although updated on a regular legislative cycle, their impacts last for years.

The current House version is H.R. 7567, the Farm, Food, and National Security Act of 2026. Committee markup was originally scheduled for February and has been postponed to March 3, 2026. It remains in process and subject to revision. The bill does not name glyphosate or any specific pesticide. Instead, it proposes structural changes to pesticide regulation nationwide. Key provisions affect pesticide registration and review timelines, expand the role of economic considerations in safety decisions, limit state and local authority beyond federal standards, and restrict legal claims tied to federally approved labels. These changes would apply across all federally registered pesticides.

Historically, when federal protections lagged behind emerging science, states and local governments were able to act to protect residents. Courts also served as a backstop when warnings were inadequate or risks were not fully disclosed. This framework allowed public health protections to evolve rather than remain fixed at a single federal standard.

From AVFCA’s perspective, the concern is structural. Narrowing state authority and limiting accountability pathways affects safeguards related to all chemicals, not just one. This is particularly relevant in California, where health and consumer protections have long exceeded federal minimums. Expanded federal preemption could constrain California’s ability, and that of other states, to respond to new science, local conditions, or emerging harms even when stronger standards are warranted.

The Glyphosate Executive Order

In February 2026, President Donald Trump signed an Executive Order titled “Promoting the National Defense by Ensuring an Adequate Supply of Elemental Phosphorus and Glyphosate-Based Herbicides.” The order directs the federal government to prioritize domestic production of glyphosate and elemental phosphorus under national defense and supply chain authorities. The stated rationale is food security and national resilience. Much of the glyphosate used in U.S. agriculture is currently imported, including from China. The order seeks to reduce reliance on foreign supply chains for a chemical deeply embedded in current agricultural systems.

From a supply chain perspective, reducing dependence on a foreign adversary for a widely used and potentially hazardous input raises legitimate concerns. Domestic production may allow for clearer oversight, greater accountability, and more direct regulatory control than reliance on imports. At the same time, the Executive Order does not mandate glyphosate use, prohibit alternatives, change existing pesticide law, eliminate ongoing litigation, or resolve health concerns associated with glyphosate exposure. It does not establish a plan or timeline for transitioning away from glyphosate. The order addresses near-term supply stability, not long-term agricultural reform.

Glyphosate cannot simply be eliminated overnight. Crops, equipment, and farming practices have been structured around its use for decades. An abrupt ban without a transition plan would disrupt food production, increase costs, and place strain on farmers already operating on narrow margins. Acknowledging this reality is not an endorsement of glyphosate. It reflects how the current system was built through long-standing federal policy and regulatory decisions.

AVFCA has previously outlined both the scope of glyphosate exposure and practical steps you can take to reduce risk in its articles, Hidden Glyphosate in Your Food, Part One and Part Two. These include purchasing organic food, supporting farmers who reduce chemical inputs, minimizing cumulative toxic exposure, and supporting the body’s natural detoxification processes while broader reforms evolve.

Courts, Liability, and Accountability

Beyond regulation, courts have historically played a critical role in public health protection. When new evidence emerged, when warnings were inadequate, or when risks were concealed, injured individuals could present evidence and seek accountability.

The U.S. Supreme Court previously affirmed this balance in cases such as Bates v. Dow Agrosciences, recognizing that federal pesticide registration does not automatically eliminate state law claims. This approach allowed regulatory standards and scientific understanding to evolve together. That balance is now under pressure. The Supreme Court is currently considering Monsanto Co. v. Durnell, a case that may determine whether state failure-to-warn claims related to glyphosate are preempted by federal law. A broad ruling in favor of preemption could significantly narrow access to the courts even when new science or previously undisclosed risks emerge. If combined with Farm Bill provisions that further restrict liability, this would represent a fundamental shift toward exclusive federal control with fewer avenues for accountability when harm occurs.

The Executive Order also raises liability concerns. While it does not eliminate existing lawsuits, it confers statutory protections for actions taken in compliance with directives issued under the Defense Production Act. This creates the possibility that routine production could be shielded from liability if framed as government-directed activity, even without Congress explicitly granting immunity.

In response, Representative Thomas Massie introduced the No Immunity for Glyphosate Act, H.R. 7601, which seeks to clarify that national defense authorities cannot be used to shield glyphosate manufacturers from liability for harm caused by their products. The bill reflects concern not just about glyphosate, but about the broader precedent of insulating corporations from accountability through emergency powers.

Why This Moment Matters

Taken together, the Farm Bill, the Executive Order, pending Supreme Court cases, and proposed legislation such as the Massie bill represent a pivotal moment. Decisions made now will determine whether health protections remain adaptive and responsive, or whether they become fixed at a single federal standard with limited oversight.

AVFCA’s role is to ensure the public understands how these pieces fit together, what is being proposed, and what the long-term implications may be. We will continue to provide clear, fact-based information and will clearly indicate when meaningful public action is appropriate.

A Voice for Choice Advocacy educates, advocates, and empowers people to be fully informed about their health rights, including informed choice, transparency, and the short- and long-term health effects of what goes into our bodies, from food and water to air and consumer products.

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EDITOR’S SUMMARY: Recent changes to childhood vaccination guidance have reopened questions about how public health decisions are made and what factors shape health outcomes over time. This examination places vaccine policy alongside nutrition, baseline health, and immune resilience, distinguishing acute protection from the broader conditions that influence disease severity and recovery. It considers how dietary quality, metabolic health, and access to care intersect with medical decision-making across the lifespan, with particular attention to pediatric care where policy changes are most visible.

In January 2026, federal health officials announced revisions to the Centers for Disease Control and Prevention childhood vaccination recommendations, reducing the number of vaccines advised for routine use. The change marked a notable shift in federal public health guidance and reignited debates about vaccine risk, benefit, and medical decision-making. Supporters framed the decision as an affirmation of personal medical choice and parental authority, while critics warned it could increase risk from vaccine-preventable diseases and complicate protection of vulnerable populations. Mandates can also limit flexibility in clinical decision-making, particularly for families managing complex medical histories or unique health considerations.

A central consideration in this discussion is the relationship between underlying health status and infectious disease outcomes. During the COVID-19 pandemic, U.S. data showed that severe illness and death were significantly more common in individuals with pre-existing conditions such as obesity, type 2 diabetes, and cardiovascular disease. These patterns drew attention to the role of baseline health in shaping disease severity, recovery, and clinical outcomes across populations. From a preventive health perspective, reducing or removing vaccine mandates may be seen as an opportunity to emphasize healthcare decisions tailored to individual circumstances. However, reducing reliance on vaccines without strengthening public health measures that support baseline health could increase vulnerability to illness.

One proposed strategy involves increased emphasis on what some practitioners refer to as nutritional immunity. In the scientific literature, this concept is described in the study “Nutritional Immunity: Starving Pathogens of Trace Minerals,” which defines nutritional immunity as “a process by which a host organism sequesters trace minerals in an effort to limit pathogenicity during infection.” In this view, nutrition is not positioned as a replacement for medical care, but as one component of a comprehensive approach to health that may influence how individuals respond to infectious challenges over time and across contexts.

Shared decision-making and pediatric care

While baseline health influences outcomes at every age, these considerations take on distinct nuances in pediatric care. In U.S. healthcare, this collaborative approach is recognized as a framework in which clinicians and families work together to evaluate benefits, risks, and options of a particular medical treatment in a way that aligns with family values and medical evidence. Rather than prescribing a single course of action, this model emphasizes dialogue, transparency, and mutual understanding, particularly in areas where benefits and risks may vary by individual circumstance. When vaccine mandates for school attendance are in place, families often make vaccination decisions within the context of school entry requirements. In these cases, the timing and circumstances of the decision may be shaped more by administrative necessity than by clinical nuance. When mandates are reduced or removed, vaccination decisions return more fully to the pediatric healthcare setting.

This shifts the discussion to direct conversations between parents and pediatricians, allowing decisions to reflect the child’s medical history, needs, and family priorities. These exchanges often consider a range of factors, including prior health conditions, developmental stage, previous vaccine responses in the child and family members, and the family’s capacity for follow-up and monitoring. They also allow space for guidance, questions, and ongoing reassessment over time, without the additional influence of school enrollment requirements.

Within this care framework, nutritional status becomes one modifiable factor clinicians and families can assess and support. Because nutrition intersects with immune function, metabolic health, and overall development, it can be discussed alongside other aspects of pediatric care without displacing medical oversight.

Foundational health vs. acute protection

Public health strategies operate on different time scales. Acute protections, such as vaccines and antiviral treatments, are designed to reduce the risk or severity of infection at the moment exposure occurs. They function as targeted interventions, intended to interrupt disease transmission or blunt illness once a pathogen is encountered. Because protection from some vaccines can decrease over time—as observed with COVID-19 and pertussis—baseline health remains relevant even among vaccinated individuals.

In contrast, baseline health operates differently. Factors such as metabolic status, nutrient sufficiency, sleep quality, and overall resilience shape how the body responds when illness arises. These conditions influence inflammatory signaling, immune activity, and recovery capacity over time. While foundational health factors do not prevent exposure to infectious agents, they may affect the likelihood of severe outcomes once infection occurs. Understanding this distinction clarifies why dietary and lifestyle factors function as complementary supports alongside acute medical tools rather than substitutes.

Within this broader perspective on acute and foundational influences, questions may arise about how repeated immune stimulation may affect immune function. Critics of vaccination policies raise concerns about whether repeated or poorly timed immune stimulation could alter immune responsiveness over time. In scientific terms, this discussion reflects questions about physiologic tradeoffs rather than immune suppression. Vaccines are designed to train specific immune responses, not weaken the immune system overall.

Current evidence does not support the claim that vaccination broadly lowers immune function, but it does highlight the importance of context. Immune responses are shaped by multiple influences, including metabolic health, stress, sleep, and nutrient sufficiency. Understanding vaccination as one influence within a broader immune landscape helps move the conversation away from absolutes and toward a more comprehensive view of biological response. If baseline health influences how the body responds to infection, nutrition becomes one of the most discussed foundational elements.

Nutritional Considerations and Immune Function

Many of these mechanisms apply broadly, though their implications vary by age and developmental stage. Overall dietary patterns—particularly diets that are nutrient-dense, meaning rich in vitamins, minerals, and other essential compounds relative to their calorie content, and lower in refined carbohydrates and ultra-processed foods—may influence metabolic and immune resilience. Rather than acting through a single pathway, nutrition influences immune function through interconnected systems that regulate inflammation, cellular communication, and energy availability. Several key nutrients play established roles in supporting normal host defense. The examples below highlight several well-studied nutrients involved in immune regulation:

• Vitamin D supports immune signaling and plays a role in regulating both innate and adaptive immune responses. Insufficiency is common in many populations, particularly among individuals with limited sun exposure, darker skin pigmentation, or certain metabolic conditions. Low vitamin D status has been associated with altered immune responses, prompting ongoing research into its role in infection outcomes, including respiratory illnesses such as COVID-19. Adequate vitamin K2 is also important for directing calcium metabolism alongside vitamin D, highlighting the complexity of nutrient interactions within immune and metabolic systems. Dietary sources include fatty fish such as salmon and sardines, egg yolks, and fermented foods like natto and certain cheeses, alongside sunlight exposure.

• Vitamin C functions as an antioxidant and contributes to immune defense by supporting epithelial barriers, leukocyte function, and oxidative stress regulation. During periods of illness or physiological stress, vitamin C demands may increase, reflecting its role in maintaining healthy immune responses rather than acting as a direct antimicrobial agent. Research has explored its supportive role during respiratory infections, including pertussis, though it is not a substitute for medical care. Whole food sources include citrus fruits, berries, kiwi, bell peppers, and leafy greens.

• Vitamin A plays a critical role in maintaining epithelial integrity and supporting mucosal immune defenses. Deficiency has historically been associated with increased severity of infections, particularly measles, and supplementation has been used in certain clinical settings to reduce complications. Its role reinforces the importance of baseline nutrient sufficiency in shaping immune responses. Sources include liver, eggs, dairy products, and provitamin A carotenoid–rich foods such as carrots, sweet potatoes, and dark leafy greens.

• Zinc and selenium are trace minerals involved in antiviral defense and immune regulation. Zinc plays a role in maintaining the integrity of immune cells and intracellular pathways, while selenium contributes to antioxidant systems that help regulate inflammation and cellular damage. Deficiencies in either mineral can impair immune responsiveness, highlighting the importance of adequate intake through diet or, when appropriate, supplementation. Food sources include zinc-rich options such as shellfish, red meat, poultry, pumpkin seeds, and nuts, along with selenium-rich foods including Brazil nuts and seafood such as tuna, salmon, sardines, and shrimp.

• Magnesium supports immune function indirectly through its role in energy metabolism, stress regulation, and inflammatory control. It participates in hundreds of enzymatic reactions, including those involved in cellular energy production and nervous system activity. Suboptimal magnesium status has been associated with increased inflammatory markers and altered stress responses, which may influence immune resilience over time. Dietary sources include leafy greens, legumes, nuts, seeds, and whole grains.

• Omega-3 fatty acids, particularly EPA and DHA, contribute to immune balance by modulating inflammatory pathways rather than suppressing immune activity. These fatty acids are involved in the production of regulatory molecules that help resolve inflammation, a process essential for appropriate immune responses and recovery following infection. Dietary intake of omega-3s varies widely, often depending on access to fatty fish or fortified foods. Primary sources include wild salmon, mackerel, and sardines, as well as walnuts, flaxseeds, and chia seeds.

Nutrition is closely linked with other lifestyle factors. Sleep quality, physical activity, and chronic stress levels are interconnected with nutrient metabolism, inflammatory processes, and physiological regulation. Inadequate sleep can alter host defenses and impair glucose regulation, while regular movement supports metabolic flexibility and circulation of immune cells. Grounding techniques that reduce physiological stress may also influence biological pathways indirectly through nervous system function.

Chronic psychological stress, particularly when unaddressed, can disrupt hormonal balance and increase inflammatory activity, potentially diminishing the benefits of otherwise adequate nutrition. These interrelated behaviors are also associated with lower rates of obesity, insulin resistance, and other chronic conditions linked to worse infectious disease outcomes.

Pediatric immune development in context

These determinants are especially important during childhood, when immune systems are still developing. Immune function evolves dynamically throughout childhood, shaped by a combination of genetics, early-life exposures, nutrition, sleep, and overall health status. During infancy, the immune system is still maturing, relying heavily on innate defenses while gradually building adaptive responses. This early period represents a particularly sensitive window, as immune regulation and tolerance are still being established.

Nutrition plays a distinct role during this phase of development. In the first year of life, when the majority of routine childhood vaccinations are administered, immune support is influenced not only by an infant’s direct intake but also by maternal health and nutrition. Breastfeeding, when present, provides immune-active components such as antibodies, fatty acids, and bioactive compounds that help shape early immune responses. Maternal nutrient status during pregnancy and lactation may also influence immune development during this foundational period.

As children grow, immune development continues to be shaped by diet alongside other factors, including physical activity, stress, and environmental exposures. Encountering common pathogens is also a natural part of immune maturation. For most children, experiencing and recovering from routine infections contributes to immune memory and functional calibration over time. While severe illness warrants appropriate medical care, not every exposure represents failure; in many cases, recovery reflects an immune system performing as designed.

Within this context, nutrition becomes one meaningful element of pediatric health, integrated alongside medical guidance and age-appropriate preventive care. These developmental considerations also highlight how broader food environments shape nutritional exposures across populations.

Dietary guidance and unresolved gaps

Although nutrition influences immune and metabolic health biologically, that impact is not always reflected in how dietary guidance is written or implemented at the population level. Recent updates to the Dietary Guidelines for Americans, 2025–2030, the federal nutrition recommendations issued every five years, have effectively introduced a new food pyramid, with a renewed emphasis on whole foods. The revised framework highlights adequate protein across meals, the inclusion of full-fat or minimally processed dairy, and the role of dietary fats in supporting metabolic and immune health. It also prioritizes vegetables, fruits, whole grains, legumes, nuts, and other real foods, while encouraging reduced intake on ultra-processed products high in added sugars and refined starches. This shift aligns federal nutrition guidance more closely with evidence linking dietary quality to long-term health outcomes.

Because federal nutrition standards shape institutional meals—particularly school breakfast and lunch programs—these recommendations also carry implications for immune resilience across communities. For many children, especially those in food-insecure households, school meals represent a primary source of daily nutrition. Aligning these programs with whole-food patterns—including regular access to vegetables and fruits, adequate protein, and nutrient-dense options—may support immune function during critical periods of growth while also helping address issues of access and affordability. These changes may have ripple effects across other institutional settings shaped by federal nutrition guidance.

While the updated Dietary Guidelines for Americans reflect meaningful shifts toward whole foods and dietary quality, some long-standing fat recommendations continue unchanged. Limiting saturated fat to no more than 10 percent of daily calories remains the subject of ongoing scientific debate. In recent years, several large reviews and meta-analyses have questioned the strength of evidence linking saturated fat in isolation to increased cardiovascular disease risk, suggesting that overall dietary composition, food sources, and metabolic context may be more important than any single macronutrient threshold.

At the same time, the guidelines offer little direction on limiting industrial seed oils, commonly derived from corn, soybean, canola, sunflower, and safflower. These oils now account for a significant share of modern fat intake, largely through ultra-processed foods. Because they are high in omega-6 polyunsaturated fatty acids and prone to oxidation during processing, storage, and high-heat cooking, their quality and stability have become an increasing focus of metabolic research. Emerging evidence has explored associations between excessive omega-6 intake, oxidized fats, chronic inflammation, and disruptions in metabolic and immune signaling. In this context, fat quality may be as important as total fat quantity. The absence of specific guidance on industrial seed oils highlights the difference between emphasizing dietary quality in principle and addressing the fat sources that shape metabolic and immune resilience in practice.

Equity and access considerations

However, guidance alone does not ensure implementation. Recommendations built around fresh, nutrient-dense foods often presume consistent access to affordable groceries, adequate food storage and preparation resources, and the time required to plan and prepare meals—conditions that vary widely across communities.

If vaccine mandates are reduced or removed without parallel investments in nutritional education and food access, existing disparities in health outcomes may widen. Populations already facing higher rates of chronic disease, food insecurity, or limited healthcare access may be more vulnerable to infectious illness, regardless of individual intent or awareness. In this context, personal choice does not always translate to equal opportunity.

Addressing equity does not require uniform solutions, but it does depend on acknowledging that health status is shaped by structural conditions as well as individual behavior. Public health strategies that emphasize nutrition are most effective when paired with efforts to improve access to real food, preventive care, and credible health information across diverse settings. Without attention to access, even well-intentioned health guidance may fall short of its intended effect.

Public Health Approaches Going Forward

Given these intersecting considerations, public health strategies may benefit from a broader focus on strengthening overall health foundations while preserving access to medical interventions. A balanced approach recognizes that population resilience is shaped by multiple inputs operating together over time. A forward-looking strategy may involve:

• Maintaining voluntary access to vaccines while allowing greater autonomy in decision-making, ensuring that individuals and families can engage with vaccination through informed discussions with healthcare providers rather than administrative mandates alone.

• Implementing public programs to improve nutritional literacy and nutrient intake, particularly in settings such as schools, assisted living facilities, and underserved communities, where access to nutrient-dense foods and health education may be limited.

• Monitoring indicators such as vitamin D status and general nutrient sufficiency alongside traditional health measures, allowing clinicians and public health systems to identify modifiable risk factors that may influence immune function and disease outcomes.

• Addressing broader lifestyle factors, including diet quality, metabolic health, sleep, movement, and stress, as part of disease prevention efforts that extend beyond acute care and toward long-term resilience.

• Supporting public education on early recognition and treatment options for infectious illnesses, including vaccine-preventable diseases, so individuals and families understand when to seek care and what evidence-based therapies may be available.

Practical guardrails

As you think about how nutrition, lifestyle, and medical care fit together, a few practical guardrails can help keep expectations realistic and decisions well-informed for both children and adults. Nutrition can support baseline wellness when integrated with appropriate medical guidance, especially for children with underlying conditions or complex health needs. Decisions are best made with an understanding of medical history, developmental stage, and environment.

Supplement use also deserves care. More isn’t always better, and excessive intake of certain nutrients can carry risks. Focusing first on overall dietary quality and daily health habits often provides a stronger foundation than adding supplements early, especially without direction from a qualified healthcare provider familiar with pediatric needs.

Sustainability matters as well. Health practices that are overly restrictive, expensive, or difficult to maintain can create stress without delivering meaningful benefit. Approaches that fit your resources, culture, and day-to-day realities are more likely to support long-term health than rigid or idealized plans. Finally, it helps to view health decisions as something you revisit over time rather than a fixed choice. Children’s needs change as they grow, and what works at one stage may need adjustment later. Staying open to reassessment and maintaining dialogue with healthcare providers allows you to respond thoughtfully as circumstances evolve.

A broader view of prevention

As policies shift, the conditions shaping baseline health become increasingly important. Strengthening nutritional support, improving access to preventive care, and addressing underlying metabolic and lifestyle risk factors may help sustain community resilience, regardless of how vaccination decisions are structured. These measures function upstream, influencing how individuals and populations respond when illness occurs.

Approaching public health through this broader lens supports a more balanced conversation—one that respects individual decision-making while acknowledging the shared environments in which health outcomes unfold. In this context, informed choices are supported not only by access to medical tools, but by the systems and conditions that help people remain resilient over time.

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EDITOR’S SUMMARY: From ancient ritual to modern research, frankincense has long been valued for its medicinal and spiritual significance. An exploration of the resin’s complex chemistry, its effects on inflammation and tissue repair, and growing scientific interest in its therapeutic potential offers insight while acknowledging what remains unknown.

Among the treasures of ancient times, frankincense may be the most mysterious. Best known as a gift brought to the baby Jesus by the Magi—mystical starwatchers from the East—this prized resin was once worth its weight in gold. Long before that night in Bethlehem, frankincense had been used in coronations, rituals, and funerals meant to guide the soul into the afterlife. Its very name, “frankincense,” literally means “pure incense,” reflecting its revered role in sacred offerings and rites.

One fall evening in 1922, the modern world bore witness to this reverence: Howard Carter, the famed Egyptologist, together with his patron Lord Carnarvon, pried open the entrance to King Tutankhamun’s tomb in the Valley of the Kings. Inside they found a pristine chamber glittering with gold and treasures beyond imagination. Yet, it was the alabaster vessels that once contained frankincense—emptied long ago by thieves who recognized its value—that hinted at what was considered the most precious.

The story of this medicinal sap begins long before sovereigns and sages, in a sun-blasted corner of the world where the desert meets the sea. Here, in the rugged mountains of Oman on the southeastern edge of the Arabian Peninsula—where jagged cliffs hold secrets older than civilization—grows the Boswellia sacra tree, prized for producing some of the finest frankincense resin. To the untrained eye, it looks twisted, scraggly…almost forgettable. But to the wise elders of old, it was a living portal—a bridge between the physical and the divine. The sap that bled from its wounded bark was frankincense and legend held that it did more than scent the air; it healed.

The Trail Of Smoke

For thousands of years, explorers, mystics, and empire-builders followed the same trail through blistering deserts—the fabled Incense Route. A 1,500-mile artery of trade stretching from Arabia to the Mediterranean, pumping wealth into kingdoms and building cities from dust. As caravans crossed the dunes, shimmering heat rising around them like a mirage, their cargo was guarded with the kind of intensity usually reserved for royal jewels because they knew frankincense wasn’t just perfume…

It was currency.

It was medicine.

It was a potent spiritual remedy; a healing force concentrated into an essence so rich and balsamic it seemed to alter the very air around it.

While it may have been burnt on altars for millennia, what people long ago knew through intuition, ritual and long observation, modern science is only now beginning to decipher—it had the power to restore. In Egypt, priests crushed the sap into salves for wounds and burns, a practice recorded in the Ebers Papyrus. They even used it for mummification to seal the flesh and stall decay. Generation after generation noticed the same thing: when frankincense touched damaged tissue, the skin seemed calmer, cleaner, protected, and eager to knit itself whole again.

Frankincense may appear to be a single substance, yet it is remarkably diverse from region to region. Different species of Boswellia trees grow in distinct corners of the world, each carrying its own character and potency. Boswellia serrata, commonly known as “Indian frankincense,” thrives in the forests of India, while Boswellia sacra, the storied resin of Oman, Yemen and Somalia, was historically prominent in trade and ritual. Further north in Somalia grows Boswellia frereana, prized for its exceptional quality and high value. Even within Somalia, Boswellia occulta produces a chemically distinct resin, once confused with its relatives but now recognized for its unique composition. And in Ethiopia and Eritrea, Boswellia papyrifera—known since antiquity and now studied for its unusually high levels of distinctive compounds—continues to thrive in harsh terrain. Each species differs not only in geography but in chemical profile, subtly shaping aroma, therapeutic properties and trade value. Frankincense refers to the aromatic resin itself, while “Boswellia” is the botanical genus from which it originates.

Skin Deep: Frankincense’s Molecular and Visible Benefits

What the ancients sensed instinctively is now confirmed at the molecular level. The sticky gum produced by Boswellia trees carries a pharmacologic architecture of boswellic acids, monoterpenes, diterpenes, triterpenes and other resinous compounds. Boswellic acids, in particular, are potent and specific inhibitors of 5-lipoxygenase—one of the master enzymes that drives inflammation and leukotriene formation. When this pathway is calmed, tissues can repair with less swelling, reduced oxidative damage, and moderated immune activation.

Cell and animal studies extend this story: frankincense preparations speed wound contraction and improve re-epithelialization, effectively encouraging injured skin to rebuild itself more efficiently, even in conditions like frostbite. Human skin cells—specifically the fibroblasts that build your skin’s structure—respond to frankincense by shifting toward repair-oriented gene expression. When exposed to the resin, they shift their gene activity toward healthier repair, increasing collagen production and ultimately improving the texture and firmness of aging skin.

These biochemical actions translate into visible effects. Topical or resin-based preparations can ease angry dermatitis, reduce microbial burden in wounds or acne, buffer oxidative stress, promote microcirculation and support the architectural renewal that gives skin its resilience. An article entitled “Frankincense: The Ancient Remedy,” notes:

“Its astringent and toning qualities minimize the appearance of wrinkles and fine lines giving it a rejuvenating effect on aging skin, and incredibly beneficial when treating scars and blemishes. Antimicrobial, aromatherapeutic, antioxidant, anti-inflammatory…the list of health benefits frankincense essential oil has to offer is seemingly endless.“

Yet it is here that distinction matters: the boswellic acids responsible for many of these benefits reside in standardized Boswellia extracts (botanical preparations with exact amounts of active ingredients) rather than the volatile perfume-grade oil you may have at home. A drop of frankincense essential oil used in aromatherapy carries scent and some bioactivity, but the concentrated medical effects described in studies typically come from properly dosed formulations, carefully prepared ointments, or Boswellia-derived compounds. Fortunately, high-grade frankincense tears—the hardened resin droplets that form when the tree releases sap in response to tapping—can be sourced and infused into oils or ground and blended into a salve or balm, much as they were thousands of years ago. These dermatologic effects are only the beginning. The deeper you look, the more its biological reach seems to widen. The same anti-inflammatory, antioxidant, and immune-modulating actions that support wound repair also appear in studies on arthritis, colitis, asthma, pain, and oral health.

For arthritis, compounds derived from Boswellia resin help reduce inflammatory signals that make joints swollen and stiff, which may explain why some studies have found improvements in pain and mobility. Inflammation reduction also appears in the gut: in colitis, frankincense has been shown to soothe irritated intestinal tissue and support repair of the gut lining. In the lungs, it helps relax inflamed airways, which is why small studies in people with asthma have reported easier breathing and fewer symptoms.

Oral health is an overlooked area of personal care where frankincense shows measurable activity. It can control harmful bacteria in the mouth, calm inflamed gums, and support recovery after irritation or dental procedures. Rather than relying on conventional rinses and pastes that may introduce unnecessary additives, you can opt for botanical formulations that support the body more broadly. Frankincense acts less like a quick fix and more like a gentle, whole-body ally, supporting your body’s ability to settle inflammation whether it shows up in the joints, gut, lungs, mouth, or as persistent low-grade discomfort.

Protection and Defense: Frankincense in Cancer Research

After exploring how frankincense has supported recovery in skin conditions for millennia and hinting at its other therapeutic potential, it is appropriate to examine its relevance in oncology. In case studies and laboratory models of melanoma and non-melanoma forms, boswellic acids show a remarkable ability to slow proliferation, trigger apoptosis (a regulated process that allows damaged or abnormal cells to safely self-destruct, helping protect surrounding tissue) and disrupt tumor-supporting inflammatory pathways.

​​What makes these findings especially compelling is how consistent they are with frankincense’s broader biochemical behavior. Boswellic acids do not act like blunt instruments; they modulate signaling cascades with notable regulatory precision—dialing down excessive inflammation, stabilizing oxidative environments and helping tissues return to physiological balance. When these same mechanisms are examined in the context of cancer biology, they appear to redirect distorted cellular pathways rather than simply suppress them.

Basal-cell carcinoma (BCC) is the most common skin cancer, and its rates are rising globally, creating a growing burden on healthcare systems. Although many treatments exist, including surgery, radiation, and topical therapies, researchers have also begun exploring complementary approaches. Frankincense has been studied for its ability to influence tumor-related mechanisms, suggesting a potential supportive role for certain superficial or early-stage BCCs. In a published case report titled “Management of basal cell carcinoma of the skin using frankincense (Boswellia sacra) essential oil,” topical frankincense oil was used on two lesions in a single patient, prompting interest in its possible role alongside conventional care and highlighting the need for further research.

Aside from boswellic acids found in Boswellia resin, frankincense oil contains natural compounds like terpenes, specifically alpha-pinene, that have shown anti-cancer effects when applied to the skin. However, cancer scientists have not identified a single compound responsible for these effects. Veterinary oncologist John Robertson, VMD, MS, Ph.D., has conducted exploratory testing of frankincense oil in real-world oncology settings, including experimental treatment of equine melanoma, an infiltrative, pigment-rich cancer that closely mirrors human malignant melanoma. His early-phase observations suggest selective anti-tumor activity: some injected or topically treated lesions shrank or showed cellular destruction, while untreated tumors continued their course. While these findings remain preliminary and far from clinical recommendation, they point toward a botanical therapy whose complex chemistry may hold modern oncologic relevance and highlight the need for careful, controlled study.

Though these findings rest mostly on preclinical work, they sketch an intriguing continuity: this molecular precision that eases inflammation in a simple wound can, under controlled conditions, interfere with the aberrant growth programming of malignant cells. Emerging research suggests this precision may extend into the brain itself. As stated in the study, “Genus Boswellia as a New Candidate for Neurodegenerative Disorders”:

“Boswellia exhibited therapeutic potential for brain ischemia and injuries, which is most likely related at least in part to its anti-inflammatory, anti-apoptotic, as well as anti-oxidative and free radical scavenging activities.”

Some of the most compelling findings now emerge in neurological research. In small human studies on patients with brain tumors or radiation-induced cerebral edema, standardized Boswellia extracts have reduced swelling visible on MRI and, in some cases, allowed physicians to taper steroids. These findings point to measurable anti-inflammatory effects within the central nervous system, supporting ongoing investigation into Boswellia’s role in neuroinflammation, neuro-oncology, and recovery after neural injury.

Boswellic acids have also demonstrated antiproliferative effects in colorectal, pancreatic, breast, prostate, and leukemia models—always with a consistent signature pattern: reduced inflammatory signaling, increased programmed cell death, and interference with tumor-invading behavior. Clinical evidence remains early and cautious, yet even these tentative signals echo an age-old respect for the power of this medicine. Frankincense was never a folk remedy for just one complaint; it was understood as a substance that altered the body’s internal conditions in profound ways. In the study “Anti-cancer Effects of Frankincense Methanolic Extract on Brain Metastatic Breast Cancer Cells,” the authors report:

“Our findings indicated that frankincense extract has a potent cytotoxic effect on brain metastatic tumor cells and induces apoptosis in these cells. Unlike many anti-cancer drugs which have very little ability to combat and kill brain metastatic cancer cells, frankincense extract can be considered a suitable candidate to fight these cells.”

These discoveries, still early yet undeniably compelling, mark the furthest reach of frankincense’s therapeutic spectrum—from guarding vulnerable neurons to challenging some of the most treatment-resistant cancer cells known to medicine.

What Is Known—And What Remains Shrouded In Mystery

After tracing frankincense through molecular pathways, clinical trials, and imaging studies, a timeless question resurfaces: why did so many civilizations regard this resin as sacred? Long before MRIs or laboratory tests that analyze molecules existed, healers applied this aromatic resin for restorative purposes. Yet the lore behind this compound reaches beyond the physical into the divine. Why did every distant culture think this resin held supernatural power? Modern research offers possible explanations.

For thousands of years, people understood that frankincense didn’t merely heal the skin or ease the breath—it altered experience. The Egyptians burned it at dawn to summon gods and purify the air around their temples. The Greeks cast it into ritual fires, practicing libanomancy, a form of divination that reads the rising smoke for omens. The Hebrews blended it into a consecrated incense so holy that only the high priest could handle it. Exodus preserves the instructions:

“Take for yourself aromatics, [namely] balsam sap, onycha and galbanum, aromatics and pure frankincense; they shall be of equal weight. And you shall make it into incense, a compound according to the art of the perfumer, well blended, pure, holy.”

Its allure went beyond sight and scent, stirring awe, focus and a sense of something greater at work. Those who carried, burned or touched it sensed a subtle shift in the world around them, a quiet potency that lingered long after the smoke had faded. Across cultures and empires, frankincense was treated as a mediator between realms—an idea that modern research is now beginning to interpret through the lens of neurochemistry.

When frankincense burns, it releases psychoactive molecules—including incensole acetate and related derivatives—that interact with ion channels and multiple neural pathways. These compounds affect key regions, including the amygdala, hippocampus, prefrontal cortex, and insula, which govern emotion, memory, attention, introspection and interoception. Remarkably, these are the very networks engaged and altered during prayer, meditation, trance and ritual, linking neurochemistry to contemplative and spiritual experience. Gerald Weissmann, M.D., Editor-in-Chief of The Federation of American Societies for Experimental Biology Journal adds:

“The discovery of how incensole acetate, purified from frankincense, works on specific targets in the brain should also help us understand diseases of the nervous system. This study also provides a biological explanation for millennia-old spiritual practices that have persisted across time, distance, culture, language, and religion--burning incense really does make you feel warm and tingly all over!”

For all the reverence surrounding it, frankincense has also earned a notable distinction in modern toxicology: its potent biological effects are paired with a consistently favorable safety profile when used in pure, properly sourced forms. Products acquired from reputable suppliers that provide species identification, transparent sourcing, and third-party testing for purity and contaminants—non-synthetic and never adulterated—are consistently well tolerated. Across thousands of years of use—applied to the skin, taken orally in resin or extract, or inhaled as smoke—there is no historical or modern toxicology evidence suggesting harm. Contemporary safety reviews echo this as well. And yet, for all that is known, substantial questions remain. The vast gum fraction (the substantial portion of frankincense composed of water-soluble polysaccharides)—rich in arabinogalactans and other complex glycans—remains understudied on its own. Even the most famous constituents, such as the boswellic acids, still do not have complete pharmacological profiles. Their full set of metabolites in human tissues, and which ones carry the primary physiological activity, remains unclear.

So here you stand with a substance both ancient and scientifically provocative—one that early civilizations burned, prepared and revered, and one that modern science is still working to fully decipher. After millennia of uninterrupted use, frankincense remains what it has always been: a resin whose full nature is still unfolding. As research accelerates, one truth becomes impossible to ignore—the story of frankincense isn’t ending; it is entering its most revealing chapter.

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