When did sodas, teas, and tonics become medicine?

 Consumer demand for drinks that offer added health benefits — known as functional beverages — is booming, and manufacturers are giving us what we demand. Olipop is just one of a growing group of “prebiotic” sodas, which claim to give a boost to the good bacteria in your gut microbiome. And prebiotic sodas are themselves just one of a cascade of these so-called functional beverages that are taking up increasing space in the global drink aisle.

Worldwide, the market for these products exceeds $150 billion, and it’s expected to top $200 billion in the next 4 years, with millennials twice as likely to consume them as any other age group in 2023. The proliferation of drinks in this category peaked just before the pandemic, but consumer demand for them has been on the rise ever since, jumping more than 50 percent in the US since 2020.

Wanting our beverages to do more than just quench our thirst isn’t a new phenomenon (see also: coffee; booze; whatever people sipped from the Holy Grail). But the list of wishes we’re asking our elixirs to grant is longer and includes more fantasy than ever before (except for maybe the Holy Grail). We’re not just hoping to be woken up or mellowed out — we’re asking to have glowier skin (SkinTē, Tru, Aura); stronger immunity (Kin Euphorics, Health-Ade, Bolthouse Farms); dreamier sleep (Som, Neuro, Elements of Balance); smoother digestion (Olipop, Poppi, Sunwink); keener focus (MUD\WTR, Odyssey, Focus); calmer dispositions (Recess, Moment, Tranquini); brighter moods (Juni, Kowa, Aplos); and lots more energy (Celsius, Red Bull, Gorgie.).

Increasingly, when brands tell us they can sell us these things, we’re ready to open up our wallets.

What is a functional beverage?

A dizzying variety of products fall into the category now known as functional beverages, which scholars define as non-alcoholic drinks that provide health benefits by including biologically active components from natural sources. A recent scientific review divided the crowded market into eight categories, including drinks to increase energy, enhance performance or appearance, manage weight, boost immunity, and improve digestive, cardiovascular, or cognitive health.

The active ingredients in these beverages comprise an alphabet soup of molecules and compounds. Some have been around for decades and may be familiar, in part because doctors have long been recommending them as part of a balanced diet. To be sure, lots of beverages do contain nutrients that are proven to play a role in improving health: The calcium and vitamin D in fortified milk are key for developing and strengthening bones in people of all ages; the yeast and bacteria in kombucha can have positive effects on digestion; the vitamin C in citrus juices is important for bone health and fuels countless other bodily processes.

However, the evidence for many of the ingredients in the buzziest new drinks is a lot more speculative. Do these substances actually get to the body parts you’re hoping they’ll tighten, strengthen, shrink, enlarge, purge, focus, or bulk?

Rows of grey and yellow bottles of energy drinks on a shelf.

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Indeed, the science on these beverages is very mixed. Some of the active ingredients have shown promising effects when studied on their own in clinical trials, but that doesn’t mean drinking them in a bottled beverage can reproduce those effects. Variables like the hardness of the water, the chemistry of other components, and the heat, light, and oxygen they’re exposed to during production and bottling can all affect how well any of these ingredients actually do what their consumers hope they’ll do. Many of these beverages haven’t been rigorously tested to determine if their claims are true, because that testing is expensive and in many markets, it’s not required. Additionally, product labeling often inadequately informs consumers about the ill effects of some of these drinks (e.g., energy drink overdoses, my Olipop situation).

Do these substances actually get to the body parts you’re hoping they’ll tighten, strengthen, shrink, enlarge, purge, focus, or bulk?

These products are nevertheless extraordinarily easy to sell. Unlike many other beverages — including orange juice (for breakfast), coffee (for work), gin and tonics (for happy hour), and their other creaky ancestors — functional beverages aren’t linked with any one particular time or place. “People might think, ‘I can drink this as much as I want, and I can do it at any frequency, at any time of the day, and there will be no effect,’ right? Especially if there’s this notion that this drink is healthy,” says Christina Collins, an Indiana University Bloomington anthropologist who studies beer.

Maintaining a certain vagueness around when and where these drinks should be consumed makes them a “marketing goldmine,” says Emily Contois, a food media scholar at the University of Tulsa. “There’s no limit to how much you could sell.”

How we started seeing our food and drink as medicine

In some ways, looking to beverages for added benefits is nothing new. Humans have been demanding medicinal effects from liquids for a long, long time. Ancient Chinese medicine and the Galenic and Hippocratic methods practiced in ancient Greece embraced tea and wine as therapeutic agents, and we’ve relied on coffee’s stimulating effects for more than a millennium.

But it’s only relatively recently that we’ve started to think of things we consume as “healthy” specifically because they contain certain nutrients. Scientists and food producers first began identifying, isolating, and adding make-or-break nutrients to grocery items at the beginning of the 20th century; iodine was among the first to be broadly added, as an ingredient of table salt, to the US food supply as a remedy for population-wide deficiencies and the high rates of thyroid goiter they caused. As the practice became more common, the general public began to connect the dots between particular nutrients and the health of the people consuming them.

As the tools and techniques of medicine became increasingly complex throughout the 20th century, conditions previously not thought of as pathologic began to be seen as needing treatment, such as anxiety, depression, erectile dysfunction, obesity, and infertility. Conveniently, pharmaceuticals — many of them derived from the natural world — were also exploding in availability. Contois calls the resulting shift the “medicalization of everyday life.” It contributed to the public’s growing sense that the human body was broken at its baseline, Contois says, and people increasingly demanded solutions to fix (or at least slow) that brokenness.

The borders between food and medicine became increasingly blurry, and food producers took notice. In the 1980’s, President Ronald Reagan’s Food and Drug Administration deregulated the industry, allowing food and beverage manufacturers to slap health claims on their products without any proof of their truth. Grocery store shelves were soon flooded with packaging promising all kinds of health benefits.

Asian woman leaning over to examine bottles of drinks on a grocery store shelf.

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Although subsequent legislation made it harder for manufacturers to lie outright, a loophole opened when the Dietary Supplement Health and Education Act passed in 1994: If a product was categorized as a dietary supplement when it was submitted for FDA approval, manufacturer claims about its structure and function didn’t need to be backed up with evidence.

These days, consumers can assuage their increasing anxiety about their bodies’ brokenness, and maybe even stave off decay, by buying and eating not just the right foods, but the best, most high-functioning versions of those foods — or at least, the ones with the most convincing hype. “It’s this expectation that what we’re going to eat and drink should do more than just achieve our dietary needs,” says Contois. “It should have additional benefits — it should make us better than good.”

The nutrition-curious consumer that’s evolved in the years since today throws around terms that didn’t even exist 15 years ago. “There’s an assumed amount of knowledge present in the current functional beverages landscape that wasn’t assumed in 2008,” says Christy Spackman, a food studies scholar at Arizona State University. Many people know — or at least have heard about — antioxidants, adaptogens, and nootropics; they know they should be eating the rainbow. The concept of food as medicine has fully entered our consciousness.

From Olipop to Health-Ade, what’s a functional beverage and what’s behind their popularity? | Vox