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CBD Beverages


It’s a growing category that has become the fascination of many consumers. But are companies moving too fast to make and sell these products without established FDA regulations?

Products containing cannabidiol (CBD) seem to be everywhere, from corner stores to mail-order giants. Consumers can pick from supplements and sprays to balms and brownies as they seek the serenity promised by this cannabis derivative. Cannabis beverages are particularly appealing to consumers. According to a survey by High Yield Insights, 17% of current CBD respondents, led by men aged 21–34, reported consuming CBD beverages, and 30% of nonusers reported interest.1 With a projected average annual growth in the United States of 75%, from 2018 to 2023, the emerging category of CBD beverages is hard to ignore.

Overview of CBD
Of the Cannabis sativa plant, marijuana and hemp are the best-known strains; CBD and tetrahydrocannabinol (THC) are the best-known bioactive compounds. More than 80 phytocannabinoid compounds have been identified in the Cannabis sativa plant alone.2 CBD is the nonintoxicating cannabinoid associated with health benefits, including analgesic properties. THC, the intoxicating compound, features prominently in marijuana but is present at less than 0.3% in hemp; therefore, hemp is the source of choice for CBD.

A quick scan of the available research demonstrates broad interest in the functions and health-supporting roles of the body’s endocannabinoid system, including mental and physical health, as well as disease treatment and prevention. Plant-derived cannabinoids (ie, phytocannabinoids) have been researched as potential therapeutic options because of their modulation of the endocannabinoid system.2

In her FNCE® 2019 presentation, “CBD is Everywhere! Navigating the MNT and Its Role in the Marketplace,” Laura Lagano, MS, RDN, CDN, highlighted more than two dozen conditions CBD usage can help alleviate. She noted that CBD acts by impacting serotonin, opioid, dopamine, and other receptors located throughout the body.

Studies suggest the effects of CBD on the activity of the endocannabinoid system have the potential to benefit treatment for a broad range of conditions, including neurodegenerative, cardiovascular, and inflammatory disorders; obesity and metabolic syndrome; cachexia; chemotherapy-induced nausea and vomiting; and tissue injury and pain.3 Clinical trials, however, have focused primarily on THC and its targets, CB1 receptors. To date, CBD studies are limited to preclinical and pilot studies that elucidate its anti-inflammatory, antioxidative, and neuroprotective effects.4

One preliminary study published in 2011 compared the effects of simulated public speaking on healthy control patients, patients with diagnosed but untreated social anxiety who received a single 600-mg dose of CBD, and patients with diagnosed speaker anxiety who received a placebo.5 Subjective mood and self-deprecation tests and physiological tests were measured several times during the public speaking exercise. Patients who were pretreated with CBD showed significantly less anxiety, cognitive impairment, and discomfort during the simulation.

Janice Newell Bissex, MS, RDN, FAND, a holistic cannabis practitioner, culinary nutritionist, and owner of Jannabis Wellness in Melrose, Massachusetts, says, “We are beginning to learn about the variety of health benefits of CBD to help alleviate pain, anxiety, insomnia, muscle spasms, inflammation, depression, and possibly autism. It isn’t a cure-all, but it can improve or relieve a lot of conditions in a more natural way. Some of my clients have been able to decrease their use of antianxiety and pain medications after adding cannabis to their regimen.”

Questions remain, however, regarding the safety of CBD, including the effects of long-term use and using multiple CBD-containing products simultaneously. CBD use has been associated with liver toxicity, extreme sleepiness, interaction with certain medications, and potential harm to a fetus or breast-fed baby. More research is needed to better understand the benefits and drawbacks of CBD and to increase knowledge about the endocannabinoid system, its potential modulators, and its impact on various conditions.

Regulatory Status in Flux
The 2018 Farm Bill removed hemp from the list of Schedule 1 narcotics (where it previously was categorized with marijuana) and legalized its cultivation, opening the door for production of topical and other products containing CBD. The Farm Bill retains FDA’s authority to regulate the sale and marketing of CBD-containing foods. However, under the federal Food, Drug, and Cosmetic (FD&C) Act, because CBD is an active pharmaceutical ingredient in an approved drug, Epidiolex, food (or beverage) products containing CBD can’t be introduced into interstate commerce, that is, manufactured in one state and sold in another, according to the FDA.6

The FDA issued warning letters in late November 2019 to companies regarding CBD in their food and beverage products and for higher amounts of THC than are stated on labels or legally permitted. In a November 26, 2019, consumer notice, the FDA stated that “under the FD&C Act, it’s illegal to introduce into interstate commerce any human or animal food to which certain drug ingredients, such as CBD, have been added. In addition, the FDA isn’t aware of any basis to conclude that CBD is GRAS [generally recognized as safe] among qualified experts for its use in human or animal food. There also is no food additive regulation which authorizes the use of CBD as an ingredient in human food or animal food, and the agency is not aware of any other exemption from the food additive definition that would apply to CBD. CBD is therefore an unapproved food additive and its use in human or animal food violates the FD&C Act for reasons that are independent of its status as a drug ingredient.”7 Individual states have passed legislation allowing the sale of CBD products.

Many companies, particularly larger manufacturers, have avoided entering the market until FDA regulations are established. Moving forward, FDA regulation of CBD in beverages would provide rules and guidelines for manufacturers and could protect consumers from substandard or inaccurately labeled products.

Regulatory inconsistencies also confuse consumers. In October 2019, the Grocery Manufacturers Association reported on research regarding consumers’ assumptions about CBD, stating that “a whopping 92% of American consumers incorrectly assume or have no idea if CBD is federally regulated. Upon learning that CBD products are not regulated federally, 82% of respondents were concerned.”8

CBD Beverage Marketplace
Despite the fact CBD isn’t federally regulated, beverages are a hot bed of innovation regarding CBD. According to Innova Market Insights, beverages hold seven of the top 10 positions for new product launches containing CBD—flavored bottled water, tea, carbonates, noncarbonated soft drinks, iced tea, ready-to-drink sports drinks, and unflavored bottled water. CBD-infused beverages are more popular than beverages containing THC or CBD plus alcohol. Despite the lack of clarity in regulations, CBD is widely available, easy to add to beverages, and less strictly regulated than THC.9 CBD beverages appeal to general consumers for their therapeutic benefits and calming properties and to those who use it medicinally to treat a variety of conditions. Because CBD doesn’t have the intoxicating properties that THC does, it’s less likely to have negative effects if overconsumed.1

“Incorporating CBD into beverages is relatively easy using a CBD powder or CBD dissolved in a water-soluble liquid,” Bissex says. “Most research studies use a CBD isolate product so the dose can be precisely controlled, and many manufacturers add this inexpensive CBD isolate to their products. The downside is that because the isolate doesn’t have the synergistic benefit of the other cannabinoids—the flavonoids and terpenes found in broad or full spectrum CBD products—you need a much higher dose for efficacy.”

Bissex notes that hemp was a legal pharmacological ingredient until less than 100 years ago. “Then it became vilified because of its association with THC and the overconsumption of THC. Although the hemp plant is extremely low in THC, consumption could trigger a positive drug test. That is why it’s important to buy CBD products that have zero THC. The hemp plant has hundreds of beneficial phytocompounds, so look for CBD sources with just the THC removed rather than CBD isolates that have only CBD.”

Broad spectrum CBD includes all of the cannabinoids and terpenes from the cannabis plant except THC, while full spectrum also includes THC. The term “entourage effect” describes a theory that a product with a broad or full spectrum of terpenes, flavonoids, cannabinoids, and other botanicals delivers synergistic ingredients that can enhance one another’s efficacy. Beverages also may incorporate other functional compounds such as L-theanine, an amino acid analogue said to promote relaxation.

One factor to note is that CBD doesn’t mix well with water and can separate out or adhere to the inside of the beverage bottle over time, so it’s hard to know exactly how much gets consumed. Separation also decreases bioavailability. In addition, one manufacturer states that 90% or more of the CBD particles in a typical CBD beverage product are too large to be incorporated into cells in the body.10 Some manufacturers try to overcome this by using nano-emulsion technology to improve bioavailability. In nano-enhanced CBD, also called nano-CBD, clustered CBD isolate molecules are broken down into extremely small, water-soluble particles that are said to be absorbed rapidly and able to cross the blood-brain barrier.

The CBD dosage in beverages currently on the market generally ranges from 10 mg to about 25 mg per serving. “It’s important to ask clients how much they’re drinking,” Bissex says. “Someone who is having several drinks a day may be getting much more than the minimally effective dose of CBD.” The form of CBD, namely, conventional vs nano-enhanced, impacts the speed of absorption and action.

Cautionary Notes
Due to questions surrounding federal regulation, the complexities of manufacturing, and the sourcing of CBD, “the CBD beverage landscape is confusing and inconsistent,” Lagano says. “CBD and cannabis use in beverages is not standardized, and the sources of CBD vary. Some companies try to circumvent FDA guidelines by claiming their products contain hemp oil. But if that oil is from hemp seeds, it will contain little CBD. The source needs to be hemp/CBD oil. Bioavailability is variable, and extraction methods vary. Effects will differ based on the form and format of the CBD, along with a person’s biochemical individuality, microbiome, and endocannabinoid system. The good news is that the industry is trying to mimic the supplement industry with detailed labels.”

In September 2019, the Academy of Nutrition and Dietetics (the Academy) issued a public policy statement that recommends caution around consuming food items with CBD because of the “lack of rigorous scientific trials and data regarding dosing, effectiveness, and safety.”11 The Academy also noted its intention to support advocacy efforts to secure funding to close the research gap regarding CBD and THC as food additives, including research on differential effects across the lifecycle; monitoring legislative and regulatory initiatives related to CBD and marijuana as the evidence base is further established, and reviewing and updating policy stances and recommendations accordingly; and communicating the potential for misuse, consumer confusion, and a lack of sufficient scientific substantiation in the marketing of CBD in food products and the use of associated health claims.

In the absence of regulations, product quality and CBD-related claims are inconsistent. Bissex highlights an FDA finding that a majority of CBD products on the market are mislabeled, including that 1 in 10 contain zero CBD. Lagano’s presentation at FNCE® emphasized the importance of third-party laboratory testing, labeling, quality seals, and Certified Good Manufacturing Practices (CGMP) to identify quality products with a reliable CBD content.

In the article “Clinicians’ Guide to Cannabidiol and Hemp Oils,” published in Mayo Clinic Proceedings, VanDolah and colleagues present the following questions pertaining to product quality that consumers should consider or discuss with a health professional before consuming any CBD product2:

• Does it meet the FDA’s CGMP standards, or European Union, Australian, or Canadian organic certification, and National Science Foundation international certification?
• Does the company have an independent adverse event reporting program?
• Is the product certified organic or eco-farmed?
• Have the company’s products been laboratory tested by batch to confirm THC levels <0.3% and no pesticides or heavy metals?

“I recommend only choosing products made from organically grown ingredients,” Bissex says. “Hemp and cannabis are bioaccumulators that gather chemicals, including toxins and pollutants, from the soil through their extensive root network.” Of interest, Bissex shares that hemp was planted after the Chernobyl nuclear disaster to decontaminate radioactive soil.

The CBD beverage industry is likely to grow and expand into more subcategories, including sports and recovery beverages and alcohol-CBD combinations. Dietitians who counsel clients on the use of CBD beverages can expect more transparency from companies regarding CBD source and content, guidance on dosing, information on bioavailability, and an expanded marketplace once the FDA establishes regulations.12 For now, inconsistencies in product quality, including declarations of CBD content, add to the challenge of guiding consumers toward responsible choices.

— Mindy Hermann, MBA, RDN, is a food and nutrition communicator based in metropolitan New York.


1. Giandelone E. Cheers to growth: the CBD beverage opportunity. High Yield Insights website. Published August 6, 2019.

2. VanDolah HJ, Bauer BA, Mauck KF. Clinicians’ guide to cannabidiol and hemp oils. Mayo Clin Proc. 2019;94(9):1840-1851.

3. Pacher P, Kunos G. Modulating the endocannabinoid system in human health and disease—successes and failures. FEBS J. 2013;280(9):1918-1943.

4. Zuardi AW. Cannabidiol: from an inactive cannabinoid to a drug with wide spectrum of action. Braz J Psychiatry. 2008;30(3):271-280.

5. Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.

6. FDA regulation of cannabis and cannabis-derived products, including cannabidiol (CBD). US Food and Drug Administration website. Updated December 31, 2019.

7. What you need to know (and what we’re working to find out) about products containing cannabis or cannabis-derived compounds, including CBD. US Food and Drug Administration website. Updated November 25, 2019.

8. Federal regulation must catch up with unprecedented CBD boom. Grocery Manufacturers Association website. Published October 28, 2019.

9. CBD-infused drinks tries to offer a more health conscious way to consume cannabis. Cision PR Newswire website. Published August 20, 2019.

10. What is nano-amplified CBD? Isodiol website.

11. Academy announces stance on CBD in food and beverage products. Academy of Nutrition and Dietetics website. Published September 24, 2019.

12. Jones K. Visualizing the boom in the CBD beverage market. Visual Capitalist website. Published August 1, 2019.

The Connection Between Intermittent Fasting And Your Endocannabinoid System

This article originally appeared in The Fresh Toast.


Balancing your endocannabinoid tone by implementing intermittent fasting may help you achieve an optimal weight, improve longevity, and provide additional health benefits. 

Keto, Paleo, and Whole-30 are a few of the most popular diets based on guidelines about what foods you can and cannot eat. Valter Longo, a cell biologist, has a different approach. As a pioneer of intermittent fasting, which focuses on when you eat, rather than what you eat, his research shows that shortening the “eating window” can have a profound impact on weight, longevity, immunity, and overall health.   

Humans evolved to live for extended periods of time without food. Our physiological systems boast adaptations to both survive and thrive during periods of starvation. In our modern food system, we have plentiful access to processed, high-sugar foods. We are no longer hunting and foraging for our food and going long stretches of time with absolutely nothing. If we want the benefits of unintentional fasting that our primal ancestors reaped, induced intermittent fasting may be the answer. 

The endocannabinoid system (ECS) is intimately involved in hormone regulation and metabolism. It plays a crucial role in food intake and weight management. Endocannabinoids, which our bodies naturally produce, are altered during fasting and feeding.

According to neurologist Ethan Russo, we all have a clinical endocannabinoid tone, which is basically the overall state of your ECS. Individuals who are obese may have an elevated (or imbalanced) endocannabinoid tone, which impacts overeating. Intermittent fasting can break the cycle by theoretically reducing the expression of CB1 receptors along with endocannabinoid levels. 


Intermittent fasting works to calibrate your body’s sensitivity to hormones such as insulin. During fasting, your body is burning through glucose stored in the liver for 10-12 hours. After that, a process called metabolic switching happens, where fat is used for energy .

Though the term “fasting” may conjure up negative thoughts and emotions for many, this type of intermittent fasting can be manageable. Thinking about “dieting” is generally more stressful than the doing. Like everything wellness-related, it requires planning. That means that you need to schedule your mealtimes. Here are few choices for intermittent fasting:  

  • 16/8: eat all your food within an 8-hour daily window and fast the remaining 16 hours. 
  • 5/2:  consume your typical calories for 5 days and 600 calories or fewer for 2 days. 
  • Eat Stop Eat: fast for a full 24-hours 1-2 times weekly.

Balancing your endocannabinoid tone by implementing intermittent fasting may help you achieve an optimal weight, improve longevity, and provide additional health benefits. 

You can catch Laura speaking about the interaction among the endocannabinoid system, eating behavior, and cannabis at Villanova University on March 6.

How CBD Can Potentially Combat Obesity

This article originally appeared in The Fresh Toast.


If recent studies on mice are any indication, CBD will someday be in the toolbox of every healthcare practitioner and in the homes of every health and weight-conscious consumer.  

One way to categorize the fat in our bodies is by its color: white or brown. The vast majority of our body fat is white fat, also called white adipose tissue (WAT), which is the stored fat. Categorizing this fat a step further is visceral fat versus subcutaneous (under the skin) fat. Visceral fat is stored in the abdomen and around organs, such as the stomach, intestines, and liver.

Referred to as “active fat,” visceral fat is associated with chronic diseases such as diabetes, heart disease, and metabolic disorder. White, visceral fat is the unhealthy fat that accumulates in obesity and the fat that you want to reduce in weight loss to improve health.  

On the other hand, brown fat, also referred to as brown adipose tissue (BAT), gets its color from iron-rich mitochondria, the powerhouse of the cell. When brown fat burns, a process called thermogenesis happens, which creates heat without shivering. Guess what else happens? Calories in the form of white fat are burned for energy. Not surprisingly, individuals at optimal weights have more brown fat than those who are overweight.   

The next question: Is there a way to turn white fat into brown fat? Because brown fat gets activated when your body is cold, keeping the heat down in winter, getting outside during the cold weather, and taking ice baths may be helpful. In the field of obesity, exercise is recommended to maintain weight loss, while changing food intake is recommended for weight loss. It appears that exercise can incite brown fat production and adequate sleep can theoretically promoting weight loss.   

cbd oil

There may be one more lifestyle factor that can potentially create brown fat. You guessed it, CBD. In one mouse study, CBD was found to increase the expression of multiple genes that are involved in the browning of fat. Gene expression is the process where DNA in our genes is translated into instructions for making functional gene products, such as proteins or other molecules.

Multiple factors can impact gene expression, including diet, nutritional status, stress, physical activity, and much more. If these animal studies can be replicated in humans, CBD will be in the toolbox of every healthcare practitioner and in the homes of every health and weight-conscious consumer. 

Laura will be speaking about the importance of the endocrine system in eating behavior and weight at Villanova on March 6. Be sure to say hello if you attend.

Inflammation & Obesity: Can Cannabis Help Break The Cycle?

This article originally appeared in The Fresh Toast.

weight loss

To kick-start quelling inflammation, adding cannabis cultivars (strains) that are high in CBD may be just what the dietitian ordered.

Like most chronic lifestyle-related diseases, inflammation is at the core. Obesity is no different. When it comes to obesity, many doctors often prescribe a slew of medications to treat the accompanying co-morbidities of obesity, such as high blood pressure, elevated cholesterol, and dysregulated blood glucose. Inflammation, of course, is at the root of high blood pressure, high cholesterol, and high blood sugar.  

Substances, called cytokines, which are secreted by immune system cells, can create other health issues, including insulin resistance. Insulin resistance, a precursor of type 2 diabetes, which is frequently (but not always) related to obesity. Chronic diseases, such as diabetes, do not happen overnight. They happen over a lifetime of less–than–optimal lifestyle habits. A habitual diet high in sugar and processed food raises blood sugar, which tells the body to make insulin to clear glucose from the bloodstream.

Chronic consumption of these foods forces the body to produce increasing amounts of insulin in order to keep up with the increasing influx of sugar. Eventually, the body becomes desensitized and insulin stops responding. The result is high blood sugar, which causes more inflammation, further exacerbating insulin resistance. And, so the vicious, unhealthy cycle continues.   

Reaching for sugary, processed foods becomes the routine way of eating, which may be related to endocannabinoid (ECS) signaling. All roads lead to the endocannabinoid system.  ECS signaling involves the activation of receptors by endocannabinoids, triggering specific actions in the body.


Signaling in the gut may drive overeating of the Standard American Diet (SAD) of processed, low-nutrient foods, which leads to elevated levels of endocannabinoids and potentially more overeating. What eventually happens when consumption of processed, sugary foods increases? Insulin resistance. Now, we are back at the beginning of the cycle again.

The question is: how to reduce the inflammation? Changing eating habits to follow an anti-inflammatory food plan is vital. For those with endocannabinoid system dysfunction and resultant food addiction, changing lifestyle routines can be challenging. Consulting with a nutritionist who is well-versed in the endocannabinoid system is helpful.

To kick-start quelling inflammation, adding cannabis cultivars (strains) that are high in CBD may be just what the dietitian ordered. CBD (cannabidiol) is one of the most potent anti-inflammatory compounds in the plant world. In fact, the US government has a patent on this cannabinoid as an anti-inflammatory. Because the ECS is involved in the modulation of many physiological systems, CBD can work to combat inflammation throughout the entire body. Ultimately, CBD may help reduce disordered food consumption, lower inflammation, and help manage obesity.   

Laura will be speaking about the importance of the endocrine system in eating behavior and weight at Villanova on March 6. Be sure to say hello if you attend.

Cannabis & Coffee: From Taboo To Trendy

This article originally appeared in The Fresh Toast.

Cannabis & Coffee

Is coffee just a familiar vehicle for cannabis consumption or is there something more to it? 

From its reputation as a taboo herb that the hippie crowd smoked in college to a socially–acceptable add-on to your favorite barista drink, cannabis has completely rebranded itself. As cannaphobia is diminishing, people are becoming more comfortable with the idea of using cannabis products in everyday life.

What better place to start than coffee, the sacred bean juice that America runs on!  After all, caffeine is the most widely consumed psychotropic compound around the globe. And, cannabis — though not available in cafes worldwide, yet — ranks fourth.

Why not combine two plant products, coffee and cannabis, that boast mind-altering substances, caffeine and cannabinoids, respectively? Is coffee just a familiar vehicle for cannabis consumption or is there something more to it? Do the seemingly opposite effects of each cancel one another out? Well, not exactly. Science is always a bit more complicated.  

Difference between Cannabis & Coffee

Let’s examine how caffeine works its magic to rev us up. Essentially, it’s all about adenosine, a neuromodulator, whose primary purpose is to promote sleep. Caffeine functions as an antagonist to the adenosine receptors. That means that it gets in the way by blocking adenosine receptors. The end result is a delay of drowsiness signals to the brain. On the other hand, cannabidiol (CBD), a cannabinoid in cannabis, interferes with the reuptake of adenosine, increasing adenosine levels.  

Should You Mix CBD With Your Morning Coffee?
Photo by Nathan Dumlao via Unsplash

For some people, caffeine can trigger anxiety and an over-alertness and jittery sensation. CBD is a well-known anxiolytic, or anti-anxiety compound. Perhaps, this is the reason why coffee and CBD have been together, effectively working to take the smooth the edges, so to speak. 

While coffee is consumed to rev up the body and help individuals focus, cannabis is typically used to chill and relax. THC, the most potent psychotropic in cannabis, can impair short-term memory. As one of its fundamental properties, forgetting is why cannabis can be useful for individuals with PTSD. Memory loss is not always a bad thing. Interestingly, caffeine can ramp up the memory impairment brought on by THC. 

At the end of the day, it’s all about biochemistry and biochemical individuality. What about the differences that can be attributed to genetics in caffeine clearance from the body? Are you a fast or slow caffeine metabolizer? Though a genetic test can reveal this difference, most of us already know. Can you fall asleep before your head hits the pillow immediately after a cup of joe late at night? Or, do you need to stop your caffeine consumption in the morning to avoid insomnia? Maybe a study comparing the impact of cannabinoids on fast and slow caffeine metabolizers is in the works. 

Where to Get Your Cannabis Education

Cannabis Education Center

Choosing the right training program to launch your cannabis career is a super important decision. And it’s based on various different factors, just like any other educational investment you make. Luckily, a recent Forbes article has cut through some of the clutter and did the legwork for you. But still, everyone has to answer a few important questions for themselves.

First and foremost, does the curriculum fit your career goals?  Some programs are perfect for those interested in the cultivation end of the business, but that same program probably isn’t the right fit if you’re thinking about a niche in regulatory and compliance issues. Similarly, if you’re a health professional with a bent toward holistic healing, then the online Holistic Cannabis Academy (included in the Forbes round-up) may be right up your alley compared to another more traditional clinical curriculum. This doesn’t make any of them better or worse; they’re just different so decide what will work best for you.

For most people, another important consideration is flexibility. Sandwiching in a new training program between an existing job and family obligations means you probably want a program that works within your schedule. Some have set starting dates (a few times per year) while others let you join at any time. And are you a learner that does well with online curriculums or do you need a brick-and-mortar location for attending classes? All of this goes into the flexibility factor.

Last but not least: what does it cost? We all love a bargain and discounts, but this can truly be a matter of “you get what you pay for.” Does the program have qualified instructors? Are there collateral materials you can download and keep? Do you have access to students and the program planners for Q&A? Are there quizzes or exams to measure your learning? Do you get a meaningful certificate of training or other designation that will be recognized by the industry?

There’s plenty of considerations when deciding what’s the best place for getting a cannabis education, but it all starts with you. Are you looking to be a cannabis coach, cultivator, budtender, regulatory or legal expert, a human resources staffer or to fill any one of the many ancillary services needed by this exploding industry?  Be clear about your career goals then get started.

Photo by NeONBRAND on Unsplash