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In Hawai‘i, Restoring Kava Helps Sustain Native Food Culture

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Monday, February 24, 2025

Last fall, Ava Taesali opened Kava Queen, O‘ahu’s only brick-and-mortar kava bar, after three years of building a loyal following for this traditional beverage at farmers’ markets in Honolulu. Located in the repurposed Waialua Sugar Mill, former home of a sugar industry giant, the establishment is surrounded by a mix of local businesses that includes a yoga studio, a surf shop, and a sewing collective. The eclectic space reflects the North Shore’s laid-back, community vibe—a perfect backdrop for sipping the Polynesian brew. “Kava is meant to bring people together,” said Taesali. Earthy, bitter, and tingly on the tongue, kava—‘awa in Hawaiian—calms the body without dulling the brain. “The only thing it numbs is your mouth,” said Taesali, a Samoan American whose first name, aptly, means kava in Samoan. Kava, also known as Piper methysticum, is a perennial shrub with large, heart-shaped leaves. Its fibrous root, when crushed and steeped in water and massaged to release its essence, produces a cloudy, cool infusion traditionally served in an apu, or coconut-shell cup. Consumed in the South Pacific for at least 2,000 years for pleasure, relaxation, and in cultural and spiritual ceremonies, the drink holds deep significance in both Hawaiian mythology and Polynesian identity. “This designation helps sustain Native culture, reassure public health, and encourage state food sovereignty.” Beyond its traditional ceremonial and social importance, kava’s calming effects have sparked new research into kavalactones, the plant’s active compounds known to reduce stress, as an anti-anxiety remedy. Studies have also found that the elixir may have broader medicinal potential, from anti-cancer benefits to treatment for post-traumatic stress disorder. Despite these findings, the U.S. Food and Drug Administration (FDA) has yet to embrace these benefits. A longstanding federal advisory memorandum labels kava as an “unsafe” ingredient and classifies it as “an unapproved food additive,” citing unresolved health concerns including potential liver damage and cancer. The FDA’s Generally Recognized as Safe (GRAS) designation deems substances safe to use in foods and beverages, covering everything from staples such as salt and vinegar to certain food dyes and other controversial additives. However, the FDA has withheld GRAS status from kava, classifying it instead as a dietary supplement alongside vitamins, herbs, and probiotics, subjecting it to stricter labeling requirements and health warnings—as well as lower consumer demand. Beyond limiting kava’s mainstream acceptance, the cautious stance has also cast a shadow over its reputation, overshadowing its deep-rooted significance in Polynesian culture. Last year, however, Hawai‘i took matters into its own hands by labeling the root as GRAS. While states can’t overturn federal standards, they can set their own restrictions—California, for example, bans potassium bromate, a baking additive—or, as is the case here, make exceptions for certain substances. Ava Taesali pours kava into an apu at Kava Queen in Waialua. (Photo credit: Naoki Nitta) By adopting the FDA term for safe-to-consume ingredients, the decision honors the plant’s cultural legacy. It also aligns with the international Codex Alimentarius, the food safety standard of the World Health Organization (WHO), which recognized the safety of traditional kava preparations in 2020, citing their cultural significance to Native Polynesians. “This designation helps sustain Native culture, reassure public health, and encourage state food sovereignty,” said Kristen Wong, an information specialist for the Hawai‘i Department of Health (DOH). The Stigma Surrounding Kava Advocates blame the kava controversy on widespread adulteration of the ingredient. In 2002, Germany banned the substance due to reports of liver toxicity, which were later traced to extracts mixed with kratom, a Southeast Asian herb linked to liver damage and addiction. Though the national ban was eventually lifted, the stigma lingers. “There are so many misconceptions about kava,” Taesali said, adding that official recognition is key to changing the narrative. Kava has endured a long history of adversity, said Lakea Trask, a Hawaiian farmer and local activist who cultivates kava and other Native crops for Kanaka Kava, his family’s farm-to-table restaurant in Kailua-Kona, on the Big Island. The plant has weathered centuries of hardship, he notes, from missionaries suppressing its use during colonization to the shift toward large-scale monocultures that crowded out Indigenous staples. The GRAS stamp is a long-overdue validation, he said, of kava’s importance to Hawaiian agriculture and identity. As recognition grows, so have opportunities for small-scale farming initiatives and environmental restoration. By reviving Hawaiian self-sufficiency and healing the scars left by plantations, Trask said, “‘awa [presents] an opportunity to restore our sovereignty and our ancestral connection to the land.” A History of Resilience Polynesian settlers brought kava to Hawai‘i roughly 1,600 years ago, selecting it as a canoe plant—essential crops carried across the Pacific by ancestral voyagers—alongside taro (kalo), breadfruit (‘ulu), and other staples that fed, healed, and built thriving communities across the archipelago. Along with its ceremonial and medicinal role, kava was also an important social drink. Yet by the 19th century, kava was headed toward obscurity. The rise of plantation agriculture uprooted Native communities, replacing local food systems with sprawling sugarcane and pineapple fields. “It’s the same story as all of our Indigenous crops,” said Noa Kekuewa Lincoln, a University of Hawai‘i (UH) associate professor at the College of Tropical Agriculture and Human Resources and head of the Indigenous Cropping Systems Laboratory. Despite these challenges, kava’s ability to thrive in sun, shade, and diverse soils enabled it to persist, mainly in the wild. Forty years ago, Edward Johnston, a leading kava expert and co-founder of the Association for Hawaiian ‘Awa (AHA), stumbled on a hidden patch of kava deep in the Big Island’s Waipi‘o Valley. Struck by its calming properties, he began collecting and propagating different varieties in his back yard, eventually offering them for sale at the newly established Hilo Farmers Market. Since kava reproduces only through cuttings, not seeds, Johnston’s work has been vital to preserving Hawai‘i’s 13 known cultivars. Known as noble varieties, all Hawaiian strains contain balanced levels of kavalactones, the compounds responsible for kava’s calming effects. Through AHA, a non-profit promoting the cultural, educational, and sustainable use of kava, Johnston has helped safeguard these native plants and elevated their cultural significance. Edward Johnston walks through a field of kava in 1999. (Photo credit: Edward Johnston) Johnston’s efforts helped spark a kava comeback, riding the wave of the Hawaiian Renaissance, a late-1960s cultural movement to reclaim Native traditions, language, and sovereignty. The resurgence gained further traction in the 1990s with support from the Department of Defense’s Rural Economic Transition Assistance-Hawai‘i grants, which helped farmers shift from sugarcane plantations to diversified agriculture. The late Senator Daniel Inouye (D-Hawai‘i) championed the program amid the decline of the sugarcane industry, spurring about 200 acres of kava cultivation by backyard growers and commercial farms, according to Johnston. Demand for kava soared during this time, especially in Germany, where Hawaiian strains fetched a premium. In a 1998 newsreel, AHA co-founder Jerry Konanui urged farmers to seize the moment, highlighting that the raw kava prices had doubled to $10 a pound, presenting a sustainable source of supplemental income. But when the liver toxicity reports surfaced in 2000, “everything went downhill,” Johnston said. Germany’s 2002 ban left a lasting impact: Despite inclusion in the Codex Alimentarius in 2020, kava is still illegal in Poland, the United Kingdom, and a host of other countries. And in the U.S., the FDA’s 2002 advisory, which labels kava as an unapproved food additive with potential health risks, still rules, lumping traditional preparations together with processed products. A Growing Market Amid Regulatory Ambiguity With federal oversight of kava in a gray zone that allows its use as a supplement, kava bars have popped up across the country over the last decade. Currently, about 180 establishments cater to a growing thirst for the drink as a social tonic and alcohol alternative. As kava’s allure grows, so, too, have local restrictions. In Florida, the so-called “U.S. Kava Capital” and home to 75 kava venues and a small crop of farms, one county recently imposed limits on kava bars near schools (there are no state age regulations around kava consumption). And in New York City, officials shut down a cafe serving kava and kratom, calling the combination “dangerous.” Sampling Kava SafelyThe Hawai‘i Department of Health recommends these guidelines when trying kava: Choose Noble Strains: Always look for kava harvested from noble cultivars—Hawaiian kava is inherently noble—as these are the only strains designated as GRAS. While state production still remains in the hundreds of acres, according to Edward Johnston, several producers sell kava online. Stick to Traditional Preparations: Traditional aqueous extraction methods—using water or coconut water to prepare the beverage—are considered safe and follow long-established cultural practices. Avoid Chemical Extracts: Stay away from adulterated and concentrated kava products, including those made with ethanol and other organic solvents, which can lead to elevated kavalactone levels and increase health risks. Michigan, however, greenlit kava in 2023, becoming the first state to grant it GRAS status. “Michigan relies on the FDA to provide new information on GRAS products,” said a spokesperson for the state’s Department of Agriculture and Rural Development (MDARD), which issued the designation. But in this case, “MDARD believed the WHO document provided sufficient evidence” to confirm the safety of traditionally prepared kava. Soon after, Hawai‘i followed suit, citing the FDA’s “erroneous” classification of kava. The state’s health department invoked a federal exception that grants GRAS status to substances with a proven history of safe use before 1958—a milestone in food safety marked by the Food Additives Amendment. The state ruling recognizes noble kava cultivars brewed with water or coconut water as safe, while warning against alcohol-based extracts and processed products. Although studies have linked kava to elevated liver enzyme levels, research shows that most cases of liver damage involve concentrated extracts or products made with non-root parts, like leaves or stems, rather than traditional brews. Genetics also play a role: While nearly all Pacific Islanders have an enzyme that metabolizes kava safely, upwards of a fifth of Caucasians lack it, increasing their risk of liver toxicity when consuming adulterated kava. In an email to Civil Eats, an FDA spokesperson clarified that, absent GRAS status, kava can’t be used in foods and drinks and must be sold as a dietary supplement. Even though “this determination does not apply to kava steeped in water and consumed as food,” the agency’s warning still stands; “the cultural use of kava does not influence its safety assessment,” added the spokesperson, citing “data gaps” in the WHO evaluation. Yet, as U.H.’s Lincoln notes, by the FDA’s own definition, kava—safely consumed for millennia—should qualify as GRAS. Not recognizing the historical safety of traditional preparations amounts to “[an] erasure of indigenous Hawaiian identity,” he adds, and an act of “ongoing colonial repression.” Ultimately, the regulatory ambiguity creates inconsistent approaches for other agencies, including the Drug Enforcement Administration (DEA). While the DEA doesn’t classify kava as a controlled substance, it lists the root alongside LSD and fentanyl on its Drugs of Abuse list, further muddling its legal status. Adding to the uncertainty, California echoed the FDA’s position last May by issuing its own caution in a consumer fact sheet. Harvesting ‘awa requires leaving the corm and lateral roots intact. (Photo credit: Kanaka Kava) The ambiguity is causing significant challenges for Rami Kayali, who owns two kava bars in California with plans to open a third—‘Awa Hou—in Honolulu this month. After six years of insuring his two mainland establishments, Kayali’s provider abruptly canceled coverage, citing the DEA scrutiny. Kayali has had to scramble, turning to pricey cannabis-industry insurance at nearly triple the cost. “It’s been a nightmare,” he said. Amid these challenges, Hawai‘i’s formal stance provides vital legal footing for the industry, said Trask of Kanaka Kava, at least in the islands. “To have some of those protections put on paper is important.” Yet those protections are weakly enforced. “We conduct investigations when notified,” a DOH spokesperson said, conceding that while state statutes require labeling and compliance, enforcement is largely reactive. “Blasphemous” kava extracts and adulterations are widely available, both on-island and online, said Trask, perpetuating misconceptions about “‘awa done traditionally,” prepared with just water or coconut water. Supporting Local and Sustainable Kava Production Nevertheless, the GRAS designation is opening new doors for kava entrepreneurs and farmers alike. A recent $70,000 state grant aims to boost sustainable kava production and reduce Hawai‘i’s reliance on food imports, which currently hovers at around 85 percent of the state’s total food supply. And the economic potential is clear: In Vanuatu, kava makes up 75 percent of exports, generating nearly $50 million a year for the remote South Pacific island nation. Hawai‘i’s noble kava varieties fetch premium prices—fresh “wet” kava can retail for $64 a pound—though local production remains “microscopic,” said Taesali of Kava Queen in O‘ahu. Her bar, like many in the U.S., serves mainly Fijian and Vanuatuan kava. Scaling up won’t be easy, as kava plants take a few years to establish, and the slow returns can deter farmers. Growers like Trask of the farm-to-table Kanaka Kava, however, are tackling these hurdles by creating regional hubs and kava farm networks. “We’re building a place-based community model of production,” Trask said, helping farmers grow cultivars suited to local microclimates, offering harvest support, and buying back crops in three to five years. For Trask, kava is also central to healing Hawai‘i’s post-plantation scars. Fertile rainforests were razed for sugarcane fields, then abandoned after the industry’s collapse in the 1990s. Now overrun with “acres and acres of pasture and eucalyptus,” the land faces threats from pests and wildfires. By integrating native trees such as breadfruit and morinda (noni) with kava, taro, and other canoe plants, “we’re rebuilding our agroforestry system,” he said. Doing so “restores pono,” he adds, using a Hawaiian expression for the reestablishment of balance in the soil, in biodiversity, and in cultural practices. Still, U.H,’s Lincoln is wary of kava becoming another commodity crop, where profits flow up, not down. “Hawai‘i is a state of small farms,” he said, with more than 90 percent measuring less than 50 acres. Aggregators and marketers tend to dominate supply chains, however, siphoning revenue and squeezing out small-scale growers. Kona coffee beans are a prime example: While beans retail upwards of $80 a pound, farmers, on average, earn just $2.25 per pound of cherries. Lincoln sees co-ops as a promising model. His wife, Dana Shapiro, heads the Hawaiʻi ʻUlu Cooperative, which has helped revitalize breadfruit as an island staple. Co-ops allow farmers to “increase their equity and power,” he said, through collective control over aggregation, processing, and marketing. That results in fairer prices, higher profits, and greater “‘āina”—land stewardship practices like agroforestry and crop rotation that nurture both the land and local food system. Trask echoes the sentiment. As demand for kava grows, restoring pono means honoring kava from soil to cup. “It’s about cultivating more farmers—and more [informed] consumers,” he said, to ensure that this ancient crop once again thrives. The post In Hawai‘i, Restoring Kava Helps Sustain Native Food Culture appeared first on Civil Eats.

Earthy, bitter, and tingly on the tongue, kava—‘awa in Hawaiian—calms the body without dulling the brain. “The only thing it numbs is your mouth,” said Taesali, a Samoan American whose first name, aptly, means kava in Samoan. Kava, also known as Piper methysticum, is a perennial shrub with large, heart-shaped leaves. Its fibrous root, when […] The post In Hawai‘i, Restoring Kava Helps Sustain Native Food Culture appeared first on Civil Eats.

Last fall, Ava Taesali opened Kava Queen, O‘ahu’s only brick-and-mortar kava bar, after three years of building a loyal following for this traditional beverage at farmers’ markets in Honolulu. Located in the repurposed Waialua Sugar Mill, former home of a sugar industry giant, the establishment is surrounded by a mix of local businesses that includes a yoga studio, a surf shop, and a sewing collective. The eclectic space reflects the North Shore’s laid-back, community vibe—a perfect backdrop for sipping the Polynesian brew. “Kava is meant to bring people together,” said Taesali.

Earthy, bitter, and tingly on the tongue, kava—‘awa in Hawaiian—calms the body without dulling the brain. “The only thing it numbs is your mouth,” said Taesali, a Samoan American whose first name, aptly, means kava in Samoan.

Kava, also known as Piper methysticum, is a perennial shrub with large, heart-shaped leaves. Its fibrous root, when crushed and steeped in water and massaged to release its essence, produces a cloudy, cool infusion traditionally served in an apu, or coconut-shell cup. Consumed in the South Pacific for at least 2,000 years for pleasure, relaxation, and in cultural and spiritual ceremonies, the drink holds deep significance in both Hawaiian mythology and Polynesian identity.

“This designation helps sustain Native culture, reassure public health, and encourage state food sovereignty.”

Beyond its traditional ceremonial and social importance, kava’s calming effects have sparked new research into kavalactones, the plant’s active compounds known to reduce stress, as an anti-anxiety remedy. Studies have also found that the elixir may have broader medicinal potential, from anti-cancer benefits to treatment for post-traumatic stress disorder.

Despite these findings, the U.S. Food and Drug Administration (FDA) has yet to embrace these benefits. A longstanding federal advisory memorandum labels kava as an “unsafe” ingredient and classifies it as “an unapproved food additive,” citing unresolved health concerns including potential liver damage and cancer.

The FDA’s Generally Recognized as Safe (GRAS) designation deems substances safe to use in foods and beverages, covering everything from staples such as salt and vinegar to certain food dyes and other controversial additives. However, the FDA has withheld GRAS status from kava, classifying it instead as a dietary supplement alongside vitamins, herbs, and probiotics, subjecting it to stricter labeling requirements and health warnings—as well as lower consumer demand. Beyond limiting kava’s mainstream acceptance, the cautious stance has also cast a shadow over its reputation, overshadowing its deep-rooted significance in Polynesian culture.

Last year, however, Hawai‘i took matters into its own hands by labeling the root as GRAS. While states can’t overturn federal standards, they can set their own restrictions—California, for example, bans potassium bromate, a baking additive—or, as is the case here, make exceptions for certain substances.

Ava Taesali pours kava into an apu at Kava Queen in Waialua. (Photo credit: Naoki Nitta)

Ava Taesali pours kava into an apu at Kava Queen in Waialua. (Photo credit: Naoki Nitta)

By adopting the FDA term for safe-to-consume ingredients, the decision honors the plant’s cultural legacy. It also aligns with the international Codex Alimentarius, the food safety standard of the World Health Organization (WHO), which recognized the safety of traditional kava preparations in 2020, citing their cultural significance to Native Polynesians.

“This designation helps sustain Native culture, reassure public health, and encourage state food sovereignty,” said Kristen Wong, an information specialist for the Hawai‘i Department of Health (DOH).

The Stigma Surrounding Kava

Advocates blame the kava controversy on widespread adulteration of the ingredient. In 2002, Germany banned the substance due to reports of liver toxicity, which were later traced to extracts mixed with kratom, a Southeast Asian herb linked to liver damage and addiction. Though the national ban was eventually lifted, the stigma lingers. “There are so many misconceptions about kava,” Taesali said, adding that official recognition is key to changing the narrative.

Kava has endured a long history of adversity, said Lakea Trask, a Hawaiian farmer and local activist who cultivates kava and other Native crops for Kanaka Kava, his family’s farm-to-table restaurant in Kailua-Kona, on the Big Island. The plant has weathered centuries of hardship, he notes, from missionaries suppressing its use during colonization to the shift toward large-scale monocultures that crowded out Indigenous staples. The GRAS stamp is a long-overdue validation, he said, of kava’s importance to Hawaiian agriculture and identity.

As recognition grows, so have opportunities for small-scale farming initiatives and environmental restoration. By reviving Hawaiian self-sufficiency and healing the scars left by plantations, Trask said, “‘awa [presents] an opportunity to restore our sovereignty and our ancestral connection to the land.”

A History of Resilience

Polynesian settlers brought kava to Hawai‘i roughly 1,600 years ago, selecting it as a canoe plant—essential crops carried across the Pacific by ancestral voyagers—alongside taro (kalo), breadfruit (‘ulu), and other staples that fed, healed, and built thriving communities across the archipelago. Along with its ceremonial and medicinal role, kava was also an important social drink.

Yet by the 19th century, kava was headed toward obscurity. The rise of plantation agriculture uprooted Native communities, replacing local food systems with sprawling sugarcane and pineapple fields. “It’s the same story as all of our Indigenous crops,” said Noa Kekuewa Lincoln, a University of Hawai‘i (UH) associate professor at the College of Tropical Agriculture and Human Resources and head of the Indigenous Cropping Systems Laboratory.

Despite these challenges, kava’s ability to thrive in sun, shade, and diverse soils enabled it to persist, mainly in the wild. Forty years ago, Edward Johnston, a leading kava expert and co-founder of the Association for Hawaiian ‘Awa (AHA), stumbled on a hidden patch of kava deep in the Big Island’s Waipi‘o Valley. Struck by its calming properties, he began collecting and propagating different varieties in his back yard, eventually offering them for sale at the newly established Hilo Farmers Market.

Since kava reproduces only through cuttings, not seeds, Johnston’s work has been vital to preserving Hawai‘i’s 13 known cultivars. Known as noble varieties, all Hawaiian strains contain balanced levels of kavalactones, the compounds responsible for kava’s calming effects. Through AHA, a non-profit promoting the cultural, educational, and sustainable use of kava, Johnston has helped safeguard these native plants and elevated their cultural significance.

Edward Johnston walks through a field of kava in 1999. (Photo credit: Edward Johnston)

Edward Johnston walks through a field of kava in 1999. (Photo credit: Edward Johnston)

Johnston’s efforts helped spark a kava comeback, riding the wave of the Hawaiian Renaissance, a late-1960s cultural movement to reclaim Native traditions, language, and sovereignty. The resurgence gained further traction in the 1990s with support from the Department of Defense’s Rural Economic Transition Assistance-Hawai‘i grants, which helped farmers shift from sugarcane plantations to diversified agriculture. The late Senator Daniel Inouye (D-Hawai‘i) championed the program amid the decline of the sugarcane industry, spurring about 200 acres of kava cultivation by backyard growers and commercial farms, according to Johnston.

Demand for kava soared during this time, especially in Germany, where Hawaiian strains fetched a premium. In a 1998 newsreel, AHA co-founder Jerry Konanui urged farmers to seize the moment, highlighting that the raw kava prices had doubled to $10 a pound, presenting a sustainable source of supplemental income.

But when the liver toxicity reports surfaced in 2000, “everything went downhill,” Johnston said. Germany’s 2002 ban left a lasting impact: Despite inclusion in the Codex Alimentarius in 2020, kava is still illegal in Poland, the United Kingdom, and a host of other countries. And in the U.S., the FDA’s 2002 advisory, which labels kava as an unapproved food additive with potential health risks, still rules, lumping traditional preparations together with processed products.

A Growing Market Amid Regulatory Ambiguity

With federal oversight of kava in a gray zone that allows its use as a supplement, kava bars have popped up across the country over the last decade. Currently, about 180 establishments cater to a growing thirst for the drink as a social tonic and alcohol alternative.

As kava’s allure grows, so, too, have local restrictions. In Florida, the so-called “U.S. Kava Capital” and home to 75 kava venues and a small crop of farms, one county recently imposed limits on kava bars near schools (there are no state age regulations around kava consumption). And in New York City, officials shut down a cafe serving kava and kratom, calling the combination “dangerous.”

Sampling Kava Safely

The Hawai‘i Department of Health recommends these guidelines when trying kava:

Choose Noble Strains: Always look for kava harvested from noble cultivars—Hawaiian kava is inherently noble—as these are the only strains designated as GRAS. While state production still remains in the hundreds of acres, according to Edward Johnston, several producers sell kava online.

Stick to Traditional Preparations: Traditional aqueous extraction methods—using water or coconut water to prepare the beverage—are considered safe and follow long-established cultural practices.

Avoid Chemical Extracts: Stay away from adulterated and concentrated kava products, including those made with ethanol and other organic solvents, which can lead to elevated kavalactone levels and increase health risks.

Michigan, however, greenlit kava in 2023, becoming the first state to grant it GRAS status. “Michigan relies on the FDA to provide new information on GRAS products,” said a spokesperson for the state’s Department of Agriculture and Rural Development (MDARD), which issued the designation. But in this case, “MDARD believed the WHO document provided sufficient evidence” to confirm the safety of traditionally prepared kava.

Soon after, Hawai‘i followed suit, citing the FDA’s “erroneous” classification of kava. The state’s health department invoked a federal exception that grants GRAS status to substances with a proven history of safe use before 1958—a milestone in food safety marked by the Food Additives Amendment. The state ruling recognizes noble kava cultivars brewed with water or coconut water as safe, while warning against alcohol-based extracts and processed products.

Although studies have linked kava to elevated liver enzyme levels, research shows that most cases of liver damage involve concentrated extracts or products made with non-root parts, like leaves or stems, rather than traditional brews. Genetics also play a role: While nearly all Pacific Islanders have an enzyme that metabolizes kava safely, upwards of a fifth of Caucasians lack it, increasing their risk of liver toxicity when consuming adulterated kava.

In an email to Civil Eats, an FDA spokesperson clarified that, absent GRAS status, kava can’t be used in foods and drinks and must be sold as a dietary supplement. Even though “this determination does not apply to kava steeped in water and consumed as food,” the agency’s warning still stands; “the cultural use of kava does not influence its safety assessment,” added the spokesperson, citing “data gaps” in the WHO evaluation.

Yet, as U.H.’s Lincoln notes, by the FDA’s own definition, kava—safely consumed for millennia—should qualify as GRAS. Not recognizing the historical safety of traditional preparations amounts to “[an] erasure of indigenous Hawaiian identity,” he adds, and an act of “ongoing colonial repression.”

Ultimately, the regulatory ambiguity creates inconsistent approaches for other agencies, including the Drug Enforcement Administration (DEA). While the DEA doesn’t classify kava as a controlled substance, it lists the root alongside LSD and fentanyl on its Drugs of Abuse list, further muddling its legal status. Adding to the uncertainty, California echoed the FDA’s position last May by issuing its own caution in a consumer fact sheet.

Harvesting ‘awa requires leaving the corm and lateral roots intact. (Photo credit: Kanaka Kava)

Harvesting ‘awa requires leaving the corm and lateral roots intact. (Photo credit: Kanaka Kava)

The ambiguity is causing significant challenges for Rami Kayali, who owns two kava bars in California with plans to open a third—‘Awa Hou—in Honolulu this month. After six years of insuring his two mainland establishments, Kayali’s provider abruptly canceled coverage, citing the DEA scrutiny. Kayali has had to scramble, turning to pricey cannabis-industry insurance at nearly triple the cost. “It’s been a nightmare,” he said.

Amid these challenges, Hawai‘i’s formal stance provides vital legal footing for the industry, said Trask of Kanaka Kava, at least in the islands. “To have some of those protections put on paper is important.”

Yet those protections are weakly enforced. “We conduct investigations when notified,” a DOH spokesperson said, conceding that while state statutes require labeling and compliance, enforcement is largely reactive. “Blasphemous” kava extracts and adulterations are widely available, both on-island and online, said Trask, perpetuating misconceptions about “‘awa done traditionally,” prepared with just water or coconut water.

Supporting Local and Sustainable Kava Production

Nevertheless, the GRAS designation is opening new doors for kava entrepreneurs and farmers alike. A recent $70,000 state grant aims to boost sustainable kava production and reduce Hawai‘i’s reliance on food imports, which currently hovers at around 85 percent of the state’s total food supply. And the economic potential is clear: In Vanuatu, kava makes up 75 percent of exports, generating nearly $50 million a year for the remote South Pacific island nation.

Hawai‘i’s noble kava varieties fetch premium prices—fresh “wet” kava can retail for $64 a pound—though local production remains “microscopic,” said Taesali of Kava Queen in O‘ahu. Her bar, like many in the U.S., serves mainly Fijian and Vanuatuan kava.

Scaling up won’t be easy, as kava plants take a few years to establish, and the slow returns can deter farmers. Growers like Trask of the farm-to-table Kanaka Kava, however, are tackling these hurdles by creating regional hubs and kava farm networks.

“We’re building a place-based community model of production,” Trask said, helping farmers grow cultivars suited to local microclimates, offering harvest support, and buying back crops in three to five years.

For Trask, kava is also central to healing Hawai‘i’s post-plantation scars. Fertile rainforests were razed for sugarcane fields, then abandoned after the industry’s collapse in the 1990s. Now overrun with “acres and acres of pasture and eucalyptus,” the land faces threats from pests and wildfires. By integrating native trees such as breadfruit and morinda (noni) with kava, taro, and other canoe plants, “we’re rebuilding our agroforestry system,” he said. Doing so “restores pono,” he adds, using a Hawaiian expression for the reestablishment of balance in the soil, in biodiversity, and in cultural practices.

Still, U.H,’s Lincoln is wary of kava becoming another commodity crop, where profits flow up, not down. “Hawai‘i is a state of small farms,” he said, with more than 90 percent measuring less than 50 acres. Aggregators and marketers tend to dominate supply chains, however, siphoning revenue and squeezing out small-scale growers. Kona coffee beans are a prime example: While beans retail upwards of $80 a pound, farmers, on average, earn just $2.25 per pound of cherries.

Lincoln sees co-ops as a promising model. His wife, Dana Shapiro, heads the Hawaiʻi ʻUlu Cooperative, which has helped revitalize breadfruit as an island staple. Co-ops allow farmers to “increase their equity and power,” he said, through collective control over aggregation, processing, and marketing. That results in fairer prices, higher profits, and greater “‘āina”—land stewardship practices like agroforestry and crop rotation that nurture both the land and local food system.

Trask echoes the sentiment. As demand for kava grows, restoring pono means honoring kava from soil to cup. “It’s about cultivating more farmers—and more [informed] consumers,” he said, to ensure that this ancient crop once again thrives.

The post In Hawai‘i, Restoring Kava Helps Sustain Native Food Culture appeared first on Civil Eats.

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How to make sustainable seafood choices this Christmas to ease the pressure on Australia’s oceans

Australian Marine Conservation Society’s GoodFish guide aims to showcase the most environmentally friendly seafood sources Get our breaking news email, free app or daily news podcastAs a challenging year for marine life heads into its final weeks, GoodFish has shared its list of sustainable choices for the festive season to help take the pressure off Australia’s oceans.“It’s a time to be more careful than ever,” said Adrian Meder, sustainable seafood program manager at the Australian Marine Conservation Society, which produces the GoodFish guide. Continue reading...

As a challenging year for marine life heads into its final weeks, GoodFish has shared its list of sustainable choices for the festive season to help take the pressure off Australia’s oceans.“It’s a time to be more careful than ever,” said Adrian Meder, sustainable seafood program manager at the Australian Marine Conservation Society, which produces the GoodFish guide.The year has been marked by unprecedented high sea surface temperatures, mass fish kills and the persistent effects of South Australia’s toxic algal bloom, along with pollution from Tasmanian salmon farms and a renewed rise in overfishing, he said.Sign up: AU Breaking News email“The good news is, a whole lot of seafood producers are putting their best foot forward and showing the exact kind of leadership we need to address these challenges,” he said. “That’s who we’re showcasing this Christmas time.”Prawns are a summer staple for many families, commonly served chilled or thrown on the barbie.“Right now there’s a flood of imported prawns farmed with very questionable environmental practices pouring into Australia,” Meder said.Instead of imported vannamei prawns, GoodFish recommended locally caught king prawns from SA’s Spencer Gulf or Australian-farmed tiger or banana prawns as better options.The green-listed Spencer Gulf fishery was set for a bumper Christmas season, he said, while prawn farms along the Great Barrier Reef were required to meet stringent environmental requirements.The environmental practices of Tasmanian-farmed Atlantic salmon continue to be unacceptable, Meder said, with pollution, heavy antibiotic use and unacceptable treatment of wildlife such as seals.“We’re looking to steer people towards sustainably farmed fish, like barramundi and Murray cod,” he said. They are just as versatile in the kitchen, and uniquely Australian.Australian or New Zealand-farmed king salmon were also good alternatives to Atlantic salmon, according to the guide. For those wanting to try something different, New South Wales caught dusky flathead was a new addition to the guide’s green list.Farmed Australian oysters and mussels remained a good choice, Meder said.“They’re absolutely delicious and they’re farmed with remarkably low impact on the natural environment – an absolute Christmas classic from both a culinary and an environmental perspective.”Christmas was a good opportunity to support seafood producers in South Australia, an industry that had suffered due to the algal bloom. Meder said the state had a strong track record of monitoring the health of its seafood and the conditions of its marine environment, with a number of SA fisheries green-listed in the guide.“If you can find South Australian seafood on your shelves, you can have a really high confidence that it’s safe to eat,” he said.Sydney Fish Market’s existing Pyrmont site will remain open for a final Christmas seafood marathon, before moving to a brand new building in January. Shoppers were expected to turn out in record numbers for one “last hurrah” as retailers opened their doors for 36-hours straight, chief executive, Daniel Jarosch, said.“We will celebrate one final Christmas in our current home, before we open the doors to Sydney’s newest waterfront icon,” he said.Last year the market traded about 350 tonnes of seafood over the Christmas period, with 120t of prawns and 70,000 dozen oysters among the top sellers.Meder’s advice for anyone planning their festive feast was to “go straight to our GoodFish guide”. The guide rated the sustainability of 90% of seafood available in Australia, and suggested better alternatives when something came up as unsustainable.“Better yet, we’ll give you some advice on how to prepare it for friends and family as well to make sure Christmas is a special time and a sustainable time.”

Açaí is everywhere - but the next 'superfood' could be emerging from the Amazon

Move over açaí berries - a new superfood could be emerging from the Amazon rainforest.

Açai is everywhere - but the next "superfood" could be emerging from the AmazonGeorgina RannardClimate and science reporter, Belém, BrazilGetty ImagesAçaí is a popular health food sold around the worldIn a lab in a renovated warehouse on the banks of a churning, brown river in Belém, Brazil, machines are pulping candidates for the next global "superfood".Cupuaçu... Taperebá... Bacaba... Like açai berries - these strange fruits are rich in antioxidants, fibre or fatty acids.If Brazil has its way, they could soon be popping up on your social media feeds and being sold in fashionable cafes in the UK, Europe and the US.It's part of a bold plan by the country, which is hosting the COP30 UN climate talks, to tackle climate change, protect nature and create wealth in the face of considerable regional poverty."There's a lot of superfoods in the forest that people don't know," says Max Petrucci, founder of a local company Mahta that sells powdered cacao and brazil nuts for shakes.The drink he gives me to try is gritty and tastes like chocolate without sugar.Getty ImagesCupuaçu fruit is little known outside of the Amazon"We're focussed first on nutrition and the health benefits that these Amazonian ingredients provide," he explains.But the second benefit, he explains, is "social and environmental". He says they pay fair prices and only buy from farmers who practice sustainable farming.It sounds like a marketing pitch and the company's slick packaging promises "ancestral ingredients" and the "power of purple fruits from the forest". Getty ImagesTaperebá is another Amazonian fruit used for juices in some parts of northern BrazilScientific research into the benefits of "superfoods" is limited, but eating Amazonian fruits is generally recognised to be good for you.Larissa Bueno, also at Mahta, explains that they only sell powdered foods - "similar to Huel in the UK," she says.Transporting raw fruits that degrade within days of picking is expensive. But if companies freeze dry ingredients into powders to sell to supermarkets or ship abroad, "it keeps more of the nutritional value and it's a smart way to keep more economic value in Brazil", she explains. Getty ImagesAçaí fruit is harvested from palm trees - many in Pará state in BrazilThe lab in Belém's Bioeconomy Park is helping small companies test new ways of preserving fruits."People have been eating from these forests for more than 10,000 years. There are many, many, many undiscovered superfoods, " Max says.The Amazon rainforest, which covers 6m sq km, has always been full of natural wealth. But for decades its vast ecosystem has been decaying, with areas chopped down to sell timber or clear space for crops like soy or for cattle.This damaged one of the earth's great protections against climate change - trees that soak up planet-warming carbon dioxide.Unusually, more than two-thirds of Brazil's greenhouse gas emissions come from land use and agriculture, rather than energy like most countries. Those emissions mainly stem from cutting down forest or growing vast amounts of food.Getty ImagesSome farmers work on small parcels of land in the rainforest to sell products like coffee or fruitPresident Luiz Inácio Lula da Silva has promised to halve deforestation by 2030. In the 12 months to July 2025, rates reached an 11-year low.But the forest is a resource. The nearly 30 million people living in the Amazon region, and across Brazil, need and want to make a living.Brazil is pushing the idea of building a prospering economy by sustainably using natural resources, preserving nature to protect the vitality of the land, and developing valuable products including fuels, pharmaceuticals, and foods.Building this "bio-economy" features strongly in its national climate action plan.Sarah Sampaio runs a small coffee company that grows coffee beans in the shadow of trees, using a method called agroforesty - or agriculture that helps cultivate forests. She works with around 200 families of farmers in the Apui region, which has one of the highest rates of deforestation.CapozoliSarah Sampaio's company grows coffee in the shade in the Amazon"We plant native Amazonian trees and the coffee together. The trees shade the coffee plants and farmers can also grow their own food around those plants," she says."When the coffee plant dies, the trees remain as the forest, so it's helping to restore the Amazon," she says.The coffee she brews for me has a light, fruity taste. She's proud that the three of her coffees were selected among the 30 best in Brazil in a national competition called Coffee of the Year. "If we want to stop more trees from being chopped down, we have to provide people with an alternative income, a sustainable way of living," she says.Whatever the next Amazonian superfood is, it will need to challenge açaí. The purple berry is grown and eaten in huge quantities in northern Brazil and sold for nearly £10 per smoothie bowl in parts of London.Getty ImagesBrazil produces around a third of the world's coffeeDamien Benoit sells açaí ice cream in Europe. "It's very high in antioxidants, in fibres and unsaturated fatty acids, and in different minerals that make it very popular among people who do sports," he says.He works with families who keeps four hectares of açai plants in the forest "with a minimum number of species per hectare that must be monitored," he says."We make sure children go to school, and gender equality is a huge topic for us," he claims.On their own, these small companies cannot feed millions of people and, so far, they've prospered due to grants or capital from charities and funds that invest in companies aimed at protecting nature.CapozoliThe Laboratório-Fábrica in Belém's new Bioeconomy parkAnd there are questions around how much they can be scaled up. If açaí production was expanded into many industrial-size plantations, it could start to cause exactly the same problems that people like Damien are trying to solve.But there's a reason the word "bioeconomy" is plastered all over the UN climate talks."We need to move from a world dependent on fossil fuels - that is clear," says Ana Yang, Director of the Environment and Society Centre at Chatham House."And if we don't have solutions that are bio-based, we will not be able to do that," she says.This is by no means a magic bullet solution to the problem of how to replace fossil fuels with clean energy and use the land in a way that protects nature.Brazil has also promised a four-fold increase in the use of biofuels, which can be controversial, by 2035. Biofuels such as ethanol are often touted as a replacement for fossil fuels, but they can lead to deforestation as demand increases for the crop to burn to make the fuel.Some are concerned this will lead to the unsustainable extraction of timber or sugarcane to export abroad and burn, and the theft of indigenous peoples' land.Ms Yang says it's essential to put safeguards like strong regulation in place."Not all bio-based transitions are good," she says."If they lead to destruction of natural habitat or they don't have good social practices, then it isn't solving the original problem," she explains.

What are bio-beads used for and how did they get spilled on to Camber Sands beach?

Plastic pellets attract algae and smell like food so can be eaten by birds, fish and dolphins and can cause the animals’ deathsBeads spreading on Sussex coast after ‘catastrophic’ spill, meeting toldMillions of toxic plastic beads were spilled on to Camber Sands beach, in East Sussex, a few days ago, putting wildlife at risk in what the local MP called an “environmental catastrophe”.Southern Water, the local water company, has taken responsibility for the spill after a mechanical failure at one of its treatment plants, which caused the beads to be released. Continue reading...

Millions of toxic plastic beads were spilled on to Camber Sands beach, in East Sussex, a few days ago, putting wildlife at risk in what the local MP called an “environmental catastrophe”.Southern Water, the local water company, has taken responsibility for the spill after a mechanical failure at one of its treatment plants, which caused the beads to be released.What are “bio-beads”?These beads are referred to by water companies as “bio-beads”, though they are made of artificial materials.They are tiny plastic pellets used as filters in wastewater treatment. They are used to catch bacteria and other contaminants, and are about 5mm in length and have a dimpled surface to get bacteria to stick to them. They create a film of microorganisms which break down contaminants in water, known as a biofilm.Water treatment centres use billions of these tiny beads in their tanks.Why are they so bad for the natural environment?Firstly, they are plastic, and can be ingested by marine life. They attract algae and smell like food, so are eaten by birds, fish and dolphins, which can be fatal.They will break down into microplastics, which stay in the environment and are almost impossible to remove.The beads on Camber Sands. Photograph: Anna McGrath/The GuardianThey are also sometimes made of waste materials from electronic equipment such as televisions which means that they are contaminated with heavy metals. Studies have found that they contain a high number of polycyclic aromatic hydrocarbons, which are carcinogenic.Additionally, they are used to soak up bacteria, so they can also spread harmful pathogens into the environment.How do they get spilled?They escape from water treatment centres en masse if the filters break or are not working properly. Also, if untreated sewage is spilled into the environment from these centres at the point at which it is being filtered by plastic beads, the beads will also escape.They can also escape from recycling centres and if the container they were delivered in was damaged.Are they often spilled?Yes, fairly often. A report by the Cornish Plastic Pollution Coalition suggested that Cornwall and the Channel coast are major hotspots for bio-bead pollution within the UK.The Channel is a hotspot for bio-bead spillages. Photograph: Anna McGrath/The GuardianThey stay in the environment as they are so hard to remove. After the recent spill, volunteersspent days on their hands and knees trying to get rid of as many as possible from the beach by hand. However, beads spilled on Camber Sands in two major incidents in 2010 and 2017 are still being found. This most recent spill will therefore probably have a negative impact on the environment for many years.Are there any alternatives for their use?Yes. There are similar products made of glass, which is less harmful to the environment, but these are more costly.Other sustainable options are being developed, including filters made of coconut shells, which biodegrade harmlessly into the environment.Many water companies use fixed filters rather than buoyant, moving beads, which reduces the risk of plastic pollution being spilled into the environment. This includes “bio-blocks” which are solid, porous blocks made from materials such as ceramics, concrete, or polymers, designed to support the growth of biofilm.Water companies can also use electrocoagulation, which involves using electric currents to remove contaminants.

How urban farms can make cities more livable and help feed America

Metropolitan gardens and farms are extraordinarily powerful tools that can improve food security, lower temperatures, and create invaluable gathering spaces.

If you’ve spent any time on a roof, you know that it’s not especially pleasant up there — blazing in the summer, frigid and windy in the winter. Slap some solar panels up there, though, and the calculus changes: Shaded from gusts and excessive sunlight, crops can proliferate, a technique known as rooftop agrivoltaics. And because that hardware provides shade, evaporation is reduced, resulting in big water savings. Plus, all that greenery insulates the top floor, reducing energy costs. Long held in opposition to one another, urban areas are embracing elements of the rural world as they try to produce more of their own food, in community gardens on the ground and agrivoltaics up above. In an increasingly chaotic climate, urban agriculture could improve food security, generate clean electricity, reduce local temperatures, provide refuges for pollinators, and improve mental and physical health for urbanites, among other benefits.  With relatively cheap investments in food production — especially if they’ve got empty lots sitting around — cities can solve a bunch of problems at once. Quezon City in the Philippines, for instance, has transformed unused land into more than 300 gardens and 10 farms, in the process training more than 4,000 urban farmers. Detroit is speckled with thousands of gardens and farms. In the Big Apple, the nonprofit Project Petals is turning vacant lots in under-resourced neighborhoods into oases. “You have some places in New York City where there’s not a green space for 5 miles,” said Alicia White, executive director and founder of the group. “And we know that green spaces help to reduce stress. We know they help to combat loneliness, and we know at this point that they help to improve our respiratory and heart health.” A Project Petals project in Queens, NY. Project Petals That makes these community spaces an especially potent climate solution, because it’s getting ever harder for people to stay healthy in cities due to the urban heat island effect, in which the built environment absorbs the sun’s energy and releases it throughout the night. Baking day after day during prolonged heat waves, the human body can’t get relief, an especially dangerous scenario for the elderly. But verdant patches reduce temperatures by releasing water vapor — essentially sweating into the neighborhood — and provide shade. At the same time, as climate change makes rainfall more extreme, urban gardens help soak up deluges, reducing the risk of flooding.  Oddly enough, while the oven-like effect is perilous for people, it can benefit city farms. On rooftops, scientists are finding that some crops, like leafy greens, thrive under the shade of solar panels, but others — especially warm-season crops like zucchini and watermelon — grow beautifully in harsh full-sun conditions. “Most of our high-value crops benefit from the urban heat island effect, because it extends their growing season. So growing food in the city is actually quite logical,” said horticulturist Jennifer Bousselot, who studies rooftop agrivoltaics at Colorado State University. “This summer we had cucumbers that were the size of baseball bats, that were perfectly suited to the green roof.” Plants grow on a roof at Colorado State University. Kevin Samuelson, CSU Spur That’s not all that’s thriving up there. Bousselot and her team are also growing a trio of Indigenous crops: corn, beans, and squash. The beans climb the corn stalks — and microbes in their roots fix nitrogen, enriching the soil — while the squash leaves shade the soil and reduce evaporation, saving water. In addition, they’ve found that saffron — an extremely expensive and difficult-to-harvest spice — tolerates the shade of rooftop solar panels. Water leaving the soil also cools the panels, increasing their efficiency. “We’re essentially creating a micro-climate, very much like a greenhouse, which is one of the most optimal conditions for most of our food crops to grow in,” Bousselot said. “But it’s not a system that needs heating or cooling or ventilation, like a greenhouse does.”  Growers might even use the extreme conditions of a rooftop for another advantage. Plants that aren’t shaded by solar panels produce “secondary metabolites” in response to the heat, wind, and constant sunlight that can stress them. These are often antioxidants, which a grower might be able to tease out of a medicinal plant like chamomile — at least in theory. “We are sort of exploring the breadth of what’s possible up there,” Bousselot said, “and using those unique environments to come up with crops that are hopefully even more valuable to the producer.” Kevin Samuelson, CSU Spur Down on the ground in New York City, Project Petals has seen a similar bonanza. Whereas agricultural regions cultivate vast fields and orchards of monocrops, like grains or fruit trees, an urban farm can pack a bunch of different foods into a tight space. “If you could grow it in rural areas, you could grow it in the city as well,” White said. “We’ve grown squash, snap peas, lemongrass. In our gardens, I’ve seen just about everything.” That sort of diversification means a cornucopia of nutritious foods flows into the community. (Lots of different species also provide different kinds of flowers for pollinators — and the more pollinators, the better the crops and native plants in the area can reproduce, creating a virtuous cycle.) That’s invaluable because in the United States, access to proper nutrition is extremely unequal: In Mississippi, for example, 30 percent of people live in low-income areas with low access to good food, compared to 4 percent in New York. This leads to “silent hunger,” in which people have access to enough calories — often from ultraprocessed foods purchased at corner stores — but not enough nutrients. Underserved neighborhoods need better access to supermarkets, of course, but rooftop and community gardens can provide fresh food and help educate people about improving their diets. ”It’s not only about growing our own veggies in the city, but actually too it’s a hook to change habits,” said Nikolas Galli, a postdoctoral researcher who studies urban agriculture at the Polytechnic University of Milan. Workers tend to crops in Queens, NY. Project Petals In a study published last month in the journal Earth’s Future, Galli modeled what this change could look like on a wide scale in São Paulo, Brazil. In a theoretical scenario in which the city turned its feasible free space — around 14 square miles — into gardens and farms, every couple of acres of food production could provide healthy sustenance to more than 600 people. Though the scenario isn’t particularly realistic, given the scale of change required, “it’s interesting to think about that, if we use more or less all the areas that we have, we could provide the missing fruits and vegetables for 13 to 21 percent of the population of the city,” Galli said. “Every square meter that you do can have a function, can be useful to increase the access to healthy food for someone.” Without urgent action here, silent hunger will only grow worse as urban populations explode around the world: By 2050, 70 percent of humans will live in cities. Urban farms could go a long way toward helping feed all those people, and could indeed benefit from rural farmers making the move to metropolises. “They’re able to pass it on to the community members like me from New York City, who maybe didn’t have the expertise,” White said, “and helping them to find their way in learning how to garden and learning how to grow their own food.” Whether it’s on top of a roof or tucked between apartment buildings, the urban garden is a simple yet uniquely powerful tool for solving a slew of environmental and human health problems. “They’re serving as spaces where people can grow, where they can learn, and they can help to fight climate change,” White said. “It’s so good to see that people are starting to come around to the fact that a garden space, and a green space, can actually make a bigger impact than just on that community overall.”  This story was originally published by Grist with the headline How urban farms can make cities more livable and help feed America on Nov 14, 2025.

What Is ARFID? Doctors Explain Why the Eating Disorder’s Rates Are Rising

Avoidant/restrictive food intake disorder, or ARFID, can cause malnutrition and weight loss in children and adults even when body image is not a factor

Stella was eight years old when she stopped eating solid foods. She went from being a “foodie” to strictly consuming liquids, says Briana, Stella’s mother. That diet soon became problematic for Stella, too: later, she removed chunks from her soup and struggled to drink smoothies that contained small seeds. She grew so afraid of swallowing that she’d spit out her saliva. “She said she had a fear of choking,” Briana says. (The last names of Stella and Briana have been withheld for privacy.)In less than a month, Stella became so tired and malnourished that her parents took her to the hospital. Doctors put her on a feeding tube, and they were concerned that the rapid weight loss for her age might cause heart issues. Within 24 hours of being hospitalized, a psychologist diagnosed Stella with avoidant/restrictive food intake disorder, or ARFID, a serious eating disorder that’s become steadily more prevalent globally in recent years. Health care providers and psychologists are now trying to untangle ARFID’s causes, signs and disconcerting rise.Clinicians emphasize that ARFID is much more than a dislike of certain foods. It’s developmentally normal for many kids to go through a picky eating phase between ages two and six. But ARFID presents as a food avoidance so persistent and pervasive that it can cause adults to drop below the minimum health body mass index, or BMI (a hotly debated measurement that links a person’s weight to their height), or to lose so much weight that they experience symptoms of malnutrition, such as vitamin deficiencies, irregular menstrual cycles, low testosterone, hair loss, muscle loss and a constant feeling of being cold. In kids, drastic weight loss from ARFID can cause children to fall off standard U.S. growth charts for healthy development. Developmental issues linked to the loss in weight and calories often spur doctors to recommend supplemental nutritional intake.On supporting science journalismIf you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.“We’re not just trying to treat kids who don’t like broccoli. It’s the kid who is malnourished as a result of their food choices,” says James Lock, a psychiatry professor and director of the Child and Adolescent Eating Disorder Program at the Stanford University School of Medicine.An Increasingly Recognized DisorderARFID was formally recognized as a feeding and eating disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013. That enabled clinicians to put a name to a condition that had been around but had gone undetected for some time.“Probably there were people who had this syndrome, but they didn’t really talk about it because there’s a stigma around it,” says Jennifer Thomas, co-director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital, who has treated people with ARFID.Wider recognition of the condition is partly driving the recent increase in cases. Real-world data on ARFID cases are lacking, but some studies have reported a global prevalence ranging from 0.35 to 3 percent across all age groups. Certain countries and regions report much higher numbers: a recent study in the Netherlands, for example, found that among 2,862 children aged 10, 6.4 percent had ARFID. The eating disorder clinic that provided specialized care to Stella after she was hospitalized says it treated more than 1,000 people in the U.S. with ARFID in 2024—a 144 percent jump from 2023.“I think that’s one of the things that has made ARFID a challenging eating disorder [to diagnose]—because it is a lot of different things.” —Jessie Menzel, clinical psychologistAnd the National Alliance for Eating Disorders has found that ARFID now accounts for up to 15 percent of all new eating disorder cases. People can experience ARFID at any age, although recently diagnosed cases have mostly been in children and teens. The average age of diagnosis is 11 years old, and 20 to 30 percent of cases are in boys—a higher percentage than other eating disorders, according to the alliance.Signs and SymptomsUnlike other eating disorders such as anorexia nervosa and bulimia, ARFID doesn’t appear to be associated with body image. The problem—and seeming cause—is the food itself and the emotional and physiological response toward it.People with ARFID generally fall into one or several of three categories. According to one study of adults with ARFID, 80 percent of respondents said they were uninterested in eating, 55 percent said they stay away from many foods because of sensory issues, and 31 percent said they avoid food because they are afraid of adverse consequences such as choking or vomiting. About two thirds of the participants were in more than one of these categories.“I think that’s one of the things that has made ARFID a challenging eating disorder [to diagnose]—because it is a lot of different things,” says Jessie Menzel, a clinical psychologist who treats the condition and other eating disorders.There are some common signs that signal ARFID, however. In addition to significant weight loss and signs of malnutrition, ARFID’s physical symptoms include gastrointestinal issues, low body temperature and the growth of a type of soft, fine body hair called lanugo that is typically not present after infancy. Behavioral changes include a lack of appetite, difficulty paying attention, food texture avoidance, extreme selective eating and a fear of vomiting or choking.Although ARFID is classified as an eating disorder, it has a lot of overlap with mental health conditions. A 2022 metastudy found that among people diagnosed with ARFID, up to 72 percent had an anxiety disorder. Studies also suggest the uptick in ARFID cases may be tied to the overall increase in mental health conditions diagnosed in kids. ARFID is particularly pronounced in those who have an anxiety disorder, Thomas says. Her team’s studies have found that about 30 to 40 percent of individuals with ARFID have a co-occurring anxiety disorder in their lifetime. “There are key similarities between ARFID and anxiety disorders,” although they are clinically distinct conditions, Thomas says. “Patients [with ARFID] themselves often describe feeling intense anxiety around food.”Because ARFID and anxiety can be so closely intertwined, it can be difficult to identify one from the other. “Often families will tell us it’s hard to get an [ARFID] diagnosis,” says Doreen Marshall, chief executive officer of the National Eating Disorders Association.ARFID is typically flagged when a child veers from growth curves—charts recommended by the American Academy of Pediatrics to assess a child’s weight and height for their age. “If your lack of interest [in food] has led to your being a couple of standard deviations off your growth curve and you’re not going to hit puberty or grow, that’s a problem,” Lock says.Pinpointing signs of ARFID is trickier when a child has nutritional deficits but is of average or higher body weight. Such discrepancies make it “important that pediatricians listen to parents,” Marshall says. Health care providers should ask parents to describe what they see their child eating or avoiding, she says.ARFID in the BrainScientists don’t fully understand what causes ARFID, although they believe that it’s driven by a combination of genetic, environmental and neurobiological factors. Thomas is currently investigating the latter.In a study published in JAMA Network Open in February, Thomas and her team presented 110 participants with photographs of food, household objects and blurred images and observed their brain activity using functional magnetic resonance imaging (fMRI). The results revealed that the three different ARFID categories correspond to activation of different brain regions. When shown food images, those who fell into the fear-related ARFID category (participants who had a fear of choking, for example) showed hyperactivation of the amygdala, the brain’s fear center. Participants with ARFID who were uninterested in food had lower activation of the hypothalamus, the brain’s appetite-regulation region. People diagnosed with the sensory form of ARFID showed hyperactivation of the brain’s sensory areas, such as the somatosensory cortex or the supplementary motor cortex.“What we found is that there might be different neural circuitry associated with each of the three ARFID presentations,” Thomas says. Results from fMRI have known limitations involving reliability and reproducibility, however. Thomas says that these initial findings need to be replicated to understand if the differences in brain activity are a cause or link to ARFID types; her team is currently collecting data from adults with ARFID for a second study. In a separate 2023 study, her team found that people who lack interest in food experienced a loss of pleasure in a lot of things—a condition known as anhedonia—and that depression partly contributed. “Folks who have that lack-of-interest [version of] ARFID don’t look forward to things in general, not just food,” she says.Understanding the neurological activity involved in ARFID may help clinicians develop more targeted treatments. For now, practitioners rely largely on a treatment known as cognitive-behavioral therapy (CBT), which has shown some success. A 2020 study co-authored by Thomas found that, post-CBT, 70 percent of those treated no longer met the criteria for ARFID. Another study published by Thomas and her colleagues in 2021 in the Journal of Behavioral and Cognitive Therapy found similar results.“With true ARFID, we don’t see a lot of spontaneous remission,” Thomas says. “Recovering from ARFID takes hard work, either at home, making a concerted effort to try new foods, or with a supportive treatment provider.”Most treatments for younger kids rely on parents to manage their child’s eating habits. After a month at the hospital, doctors sent Stella home, and her parents were advised not to cater to Stella’s limited palate. At home, the whole family, including Stella, ate the same meals. When they ate at restaurants, Stella didn’t have to eat a big meal, but she did have to take a few bites of something solid. Within a few months, Stella’s regular eating habits returned, and her ARFID disappeared.Treatments based on controlling eating habits can only go so far, however. They are less effective for people with the types of ARFID that are associated with higher sensitivity to or a lack of interest in food. “I think that’s where it’s so important to understand what’s happening physiologically or neurobiologically,” Menzel says. “That’s going to guide us toward more effective treatments.”If you or someone you know is struggling with an eating disorder, you can contact the National Association of Anorexia Nervosa and Associated Disorders helpline by calling (888) 375-7767. For crisis situations, you can text “NEDA” to 741741 to connect to a trained volunteer at Crisis Text Line.

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