There is a lot of conversation right now about alcohol. How much is safe? Is any amount safe? Should we drink less? Should we stop drinking altogether? Those are legitimate questions, and the evidence around alcohol itself deserves to be taken seriously. The CDC currently states that drinking alcohol increases the risk of several cancers and that, from a health-risk perspective, drinking less is better than drinking more. The U.S. Surgeon General has likewise highlighted the causal relationship between alcohol consumption and at least seven types of cancer.

But there is another conversation that I almost never hear.

What the hell is everything else in the glass?

When we talk about the health implications of drinking a Margarita, Piña Colada, Whiskey Sour, Bloody Mary, Tequila Sunrise, Gin & Tonic, or any of the hundreds of cocktails being served every night in America, we tend to reduce the entire conversation to one ingredient: alcohol. But alcohol often accounts for only a portion of what is actually in that glass. Depending on what you order, your cocktail may also contain high-fructose corn syrup, refined sugar, artificial colors, artificial flavors, preservatives, stabilizers, emulsifiers, gums, concentrated juices and a collection of ingredients most of us would never intentionally put into our bodies.

Once I started looking at cocktail mixers through the same lens we use to look at food at Modern Stone Age Kitchen, I couldn't stop looking.

*Our MSAK margarita with kombucha and maple syrup*

Take the Margarita. At its most fundamental, a Margarita is a remarkably simple drink: tequila, citrus and something to provide sweetness and orange character. But pick up a bottle of Jose Cuervo Classic Lime Margarita Mix and the ingredient list includes water, high-fructose corn syrup, citric acid, sodium citrate, natural flavors, sodium benzoate, potassium sorbate, gum acacia, CMC gum, SAIB, polysorbate 60 and Yellow 5. A four-ounce serving contains 26 grams of sugar.

Another popular commercial Margarita mixer, Master of Mixes, lists water, sugar, lime and lemon juices from concentrate, citric acid, agave syrup, natural flavor, sodium benzoate, sodium metabisulfite, polysorbate 60, Yellow 5 and Blue 1. Four ounces contains about 31 grams of sugar, including 30 grams of added sugar. And that's before the alcohol ever goes into the glass.

Think about that for a second. Someone trying to reduce carbohydrate or refined-sugar intake could order a Margarita and assume the tequila is the thing they need to worry about. Meanwhile, the mixer alone can deliver roughly seven teaspoons' worth of refined sugar before we've even considered anything else in the drink.

Or consider a Piña Colada. One commercially available Master of Mixes Piña Colada mixer lists sugar, coconut, pineapple juice concentrate, xanthan gum, citric acid, sodium bisulfate, natural flavor, sodium benzoate, sodium metabisulfite, polysorbate 60 and titanium dioxide among its ingredients. A four-ounce serving contains about 50 grams of sugar, 49 grams of it added refined sugar.

Fifty grams!! That's roughly twelve teaspoons of sugar in the mixer alone.

Then there is grenadine, something traditionally made from pomegranate juice and used in drinks ranging from a Tequila Sunrise to a Shirley Temple. Look at a bottle of Rose's Grenadine and you won't find pomegranate on the ingredient list. Instead you'll find high-fructose corn syrup, water, citric acid, sodium citrate, sodium benzoate, Red 40, natural and artificial flavors, and Blue 1. One ounce contains about 20 grams of added sugar.

Even tonic water, the seemingly innocuous partner in a Gin & Tonic, can essentially function as a sweetened soft drink. Canada Dry Tonic Water lists carbonated water followed by high-fructose corn syrup, along with citric acid, sodium benzoate, quinine and natural flavors. A 12-ounce serving contains 35 grams of added sugar.

And then there is the ubiquitous bar bottle labeled SWEET & SOUR. Finest Call describes its Sweet & Sour Mix as useful for Margaritas, Daiquiris and sour cocktails. One U.S. formulation lists water, high-fructose corn syrup, lemon juice from concentrate, citric acid, natural lemon and lime oil, sodium benzoate, quillaja extract, sodium metabisulfite, natural flavor and Yellow 5.

Suddenly a Whiskey Sour doesn't necessarily mean whiskey, lemon and something sweet. It can mean whiskey plus a premanufactured liquid engineered to be shelf-stable, consistently colored and identical every time somebody squeezes it out of a bottle.

Even the Bloody Mary isn't immune. One currently listed formulation of Mr & Mrs T Original Bloody Mary Mix contains a long list that includes tomato concentrate and vinegar, but also high-fructose corn syrup, hydrolyzed corn protein, disodium inosinate, disodium guanylate, autolyzed yeast extract, caramel color, natural flavors, molasses, dextrose and xanthan gum.

None of this means that every one of these individual additives is uniquely dangerous in the amounts used, and I don't think we need to exaggerate the science to make the point. The point is that most people have absolutely no idea they're drinking them. A menu says “Margarita,” not “tequila with high-fructose corn syrup, preservatives, gums and artificial color.” A menu says “Piña Colada,” not “rum with a mixer containing 50 grams of refined sugar per four ounces.” And a beautiful red cocktail doesn't come with an explanation that some of that brilliant color may have come from Red 40 or Blue 1.

What is fascinating is that this is exactly what we did with our food. We outsourced the difficult parts. We wanted food faster, cheaper, easier and more consistent. So somewhere along the way, squeezing citrus became opening a bottle. Making syrup became ordering a jug. Extracting botanicals became buying bitters. Fermenting something became adding acid. Fresh color became artificial color. Real fruit became “natural flavor.” Shelf life became more important than seasonality.

Convenience quietly replaced craft - and cocktails followed exactly the same trajectory.

What about “cleaner” cocktails?

Even when you eliminate the artificial colors, preservatives and long ingredient lists, there is another issue hiding in plain sight: sugar.

Classic cocktail construction frequently depends upon a balance between alcohol, acidity, bitterness and sweetness. There is nothing inherently wrong with sweetness as a culinary tool. But when sweetened mixers, syrups, liqueurs, juices and garnishes begin stacking on top of one another, the carbohydrate load can climb extraordinarily quickly.

That matters especially for someone who has deliberately reduced sugar or carbohydrate intake in the rest of their diet. You can eat a carefully prepared dinner with protein, vegetables and fermented foods, then unknowingly consume tens of grams of sugar in one or two drinks.

So when we began developing a real cocktail program for Modern Stone Age Kitchen, we asked exactly the same question we ask about everything else we serve:

What happens if we make it ourselves?

And, as usual, that question opened a rabbit hole.

Peeling back the cocktail

*Dr. Bill making tinctures in the Food Lab*

If you want to eliminate the commercial mixers, artificial ingredients, refined sugars, preservatives and shortcuts, you can't simply remove them.

You have to replace their function.

Where does the bitterness come from? Where does the sweetness come from? What creates the orange character in a Margarita if we aren't using a commercial orange liqueur? What creates the ginger intensity and carbonation of a Moscow Mule if we aren't buying ginger beer? What gives a Negroni its bitterness, citrus, herbal complexity and color? What makes aromatic bitters taste like aromatic bitters? What gives vermouth its botanical character?

Those questions sent us straight back to plants.

Our bar now has more than 50 individual tinctures made from roots, barks, seeds, flowers, fruits, herbs and spices. Gentian. Cinchona. Quassia. Wormwood. Bitter orange. Coriander. Cardamom. Ginger. Cinnamon. Clove. Nutmeg. Chamomile. Angelica. Yarrow. Hyssop. Lemon balm. Juniper. Vanilla. Spicebush berries. And on and on.

And every one behaves differently.

Different alcohol concentrations. Different botanical-to-liquid ratios. Different extraction times. Some are ready in hours. Others take days. Some take considerably longer. Too little extraction and you leave flavor behind. Too much and a beautiful botanical can become harsh, medicinal or overwhelmingly bitter.

Then we blend those individual extractions together.

We are developing our own aromatic bitters, botanical bitters, orange bitters and red bitter aperitivo. We made our own vermouths. We're making ginger-honey syrup from actual ginger and local honey instead of pouring commercial ginger beer. We're squeezing actual lemons, limes and oranges. Our Old Fashioned is sweetened with muscovado syrup. Our sours use honey rather than refined white sugar. Our Bloody Mary starts with our own kimchi mix and fermented horseradish. Our garnishes include our own fermented carrots and jalapeños, lye-cured and fermented Sevillano olives, fermented and sous-vide cherries, and citrus we process ourselves.

It is absurdly more complicated than ordering a case of mixers.

Which, of course, is precisely why we're doing it.

Because this is the same philosophy that drives our kitchen. If there is an important transformation between the raw ingredient and the finished food or in this case, the finished drink, we want to understand that transformation and take responsibility for it.

WANT TO SEE HOW WE ACTUALLY DO THIS?

*Dr. Bill & Christina having fun during the weekly Q&A*

This is the kind of rabbit hole we explore at The Ancestral Table.

Go beyond the ingredient list and learn the traditional techniques that transform food and drink—from fermentation and sourdough to cheesemaking, preservation, extraction and more.

Bill takes you inside both the how and the why, so you can bring these techniques into your own kitchen.

PULL UP A CHAIR

A cocktail can have terroir, too

Something else happened once we stopped thinking about cocktails as combinations of branded bottles.

We realized the bar could become another way of connecting people to place.

Why should every cocktail in America taste exactly the same?

We live on the Eastern Shore of Maryland. We have access to local honey, herbs, fruit, berries, roots and an extraordinary agricultural landscape. We can ferment local produce. We can preserve seasonal ingredients when they are at their peak. We can work with native aromatics such as spicebush. We can capture summer fruit for a drink served months later. We can use fermentation, dehydration, freeze-drying, infusion and extraction to preserve not merely an ingredient, but a moment in the year.

A cocktail can tell you where you are.

That is far more interesting to me than opening another bottle of artificially colored mixer designed to taste identical whether you're drinking it in Maryland, Miami or Manhattan.

Tinctures and their organic, scratch-made craft cocktail counterparts — *Tinctures and their healthier, scratch-made craft cocktail counterparts*

And then there are mocktails

Perhaps the greatest irony in all of this is the explosive interest in alcohol-free cocktails.

There are very good reasons someone might choose not to drink alcohol. And the current movement toward drinking less has created enormous demand for sophisticated adult beverages that still provide the ritual and experience of having a cocktail.

I think that's fantastic.

But removing the alcohol does not automatically make the drink healthy.

A virgin Margarita made with the same commercial Margarita mixer still contains the mixer. A virgin Piña Colada made with four ounces of the commercial mixer described above can still contain around 50 grams of sugar. A Shirley Temple made with an ounce of the grenadine described above gets about 20 grams of added sugar from that ingredient alone. A virgin Bloody Mary made with a bottled mix still contains whatever sweeteners, flavor enhancers, colors and other additives are in that mix.

In other words, “non-alcoholic” and “healthy” are not synonyms.

I would actually go further: depending on the specific drinks being compared, it is entirely possible for removing alcohol while dramatically increasing sugar and highly processed mixer ingredients to produce a beverage that doesn't align with the health goals that motivated the switch in the first place. I would not claim that those ingredients are categorically more harmful than alcohol, the evidence does not support making that blanket statement, and alcohol itself has well-established health risks. But I absolutely think we should be scrutinizing the entire glass, not giving everything else in it a free pass simply because the ethanol is gone.

And that's why our work on cocktails and mocktails is really the same project.

We want the alcohol-free version to receive every bit as much attention as the alcoholic one. Real citrus. Real herbs. Real fruit. Fermentation. Botanicals. Bitterness. Acidity. Carbonation. Texture. Aroma. Seasonality. Local ingredients. Thoughtful amounts of sweetness rather than sugar being used as a blunt instrument.

The goal isn't to make a “healthy cocktail” and pretend alcohol has no consequences.

The goal is much simpler and much more consistent with everything we believe at Modern Stone Age Kitchen:

If you choose to have a cocktail, we want to make the best version of that cocktail we possibly can.

We want to know what every ingredient is, why it's there, where it came from and how it was transformed. No refined sugar. No artificial colors. No artificial flavors. No artificial preservatives. No mystery mixes. No neon liquid squeezed from a plastic bottle because that's the way bars have always done it. Just real ingredients, transformed with intention.

It has taken tinctures, fermentation projects, endless test batches, lots of tasting, more than a little chemistry, and an increasingly ridiculous collection of jars in the Food Lab.

And we're just getting started.

Keep your eye out… we're launching the new Modern Stone Age Kitchen bar program in just a few days. And, no matter what you order you'll be able to know exactly what's in your glass!!

*He’s getting fancy with his containers now ;-)*

What’s Really in Your Cocktail?