To Americans, the leaf is a symbol of unhealthy habits, but in the Peruvian Andes, it’s a source of nutrients, energy, and flavor in food and drinks.

At 11,000 feet above sea level, the Cusco airport offers arriving passengers dry coca leaves for chewing—a millennia-old practice locals keep alive today. Coca leaves are ubiquitous in the historical capital of the Inca Empire in the Peruvian Andes. Throughout the surrounding Sacred Valley, hotels welcome tourists with bitter, earthy, and herbaceous coca tea to combat soroche (altitude sickness), bars serve coca-infused pisco cocktails, and bakers grind the leaves to make bread. The leaves are part of the cultural, culinary, and ecological fabric of the region.

Meanwhile, in the United States, coca leaves have two primary associations, neither of which is quite so wholesome: cocaine and Coca-Cola. In 1961, the United Nations declared coca leaves an illegal narcotic, and, outside of countries like Peru and Bolivia, it’s illegal to use the plant. But one US company was given a pass.

Coca leaves and kola nuts gave Coca-Cola its name and its distinct flavor, and cocaine—an isolated alkaloid from coca leaves that, in ultra-concentrated form, becomes the addictive narcotic—was once an ingredient in the drink. An advertisement from the late 19th century, when cocaine was legal in the United States, promoted Coca-Cola as a promising brain tonic that relieved headaches and mental or physical exhaustion. Another swore that Coca-Cola syrup cured nervous afflictions, with drugstore soda fountains soon becoming a vehicle to dispense over-the-counter doses to customers.

However, at the start of the 20th century, the US Food and Drug Administration began restricting the use of cocaine in the United States, and Coca-Cola removed cocaine from its recipe, although coca leaves are still an ingredient in the drink. According to a 1988 report in the New York Times, the Drug Enforcement Administration (then and today) allows only one US company, the Stepan Company, to legally import coca leaves, mostly from Peru. The company’s Maywood, New Jersey, laboratory processes coca leaves to yield two ingredients: cocaine for approved medicinal use, and a cocaine-free extract that Coca-Cola uses for flavoring.

Though the presence of cocaine in soda fountains was short-lived, and the use of coca leaves in the United States today is highly regulated, archeological research shows that Indigenous foragers in the lower Andes of northern Peru chewed coca leaves 8,000 years ago. And during the Spanish conquest, Felipe Guaman Poma de Ayala documented the role of coca leaves in Andean society. Peru’s Indigenous chronicler wrote about and illustrated Andean culture in Nueva Crónica y Buen Gobierno. The 1615 manuscript described how the Inca cultivated and harvested coca, chewed and sucked the juices from the leaves, and integrated coca into virtually every aspect of their lives.

Archeological research shows that Indigenous foragers in the lower Andes of northern Peru chewed coca leaves 8,000 years ago.

Centuries later, ethnobotanist Timothy Plowman dove into the study of coca leaves in Peru. In his 1984 paper “The Ethnobotany of Coca,” Plowman states that cocaine is an organic compound in coca leaves, but they also contain “a complex mixture of chemicals, including alkaloids, essential oils, flavonoids, vitamins, and minerals,” a combination with different effects than isolated cocaine. Unfortunately, many people, along with organizations like the UN, conflate coca leaves with cocaine, which are related but very different culturally and pharmacologically. Plowman also notes that coca leaves are high in protein and carbohydrates, and that 100 grams of coca leaves provide more than the recommended dietary allowance for calcium, iron, phosphorus, vitamin A, and riboflavin.

The sacred practice of chewing coca leaves—called “chacchar” in Quechua—is often done all day long throughout the Andes. Plowman describes how Quechua people roll the dry leaves into a ball in their mouths, sometimes adding ashes from burnt quinoa stems or other plants for a stronger effect; moisten the coca leaves with saliva; and ingest the grassy, green, stimulating juice—comparable to a strong coffee—to suppress ailments like stomach pain and to ward off hunger during hard labor.

In Cusco and the surrounding Sacred Valley, coca leaves are still part of the contemporary food and drink scene today. A few blocks from Cusco’s Plaza de Armas, the city’s main square, Daniel Choque is head of bar at Museo del Pisco. There, he makes a macerado de hoja de coca—pisco infused with coca leaves—for their signature cocktails. Museo del Pisco sources dry coca leaves from a small artisanal producer in Lares, which Choque adds to a large bottle with pisco.

“It takes seven days to infuse pisco with coca leaves. In that time, the Quebranta grape pisco acquires the aromas and flavors from the coca leaves,” says Choque about the process that adds an herbal bitterness to the roasted almond, lime, and peach notes in the high-proof grape distillate. “Afterward, we pass the pisco through a coffee filter to remove sediments or small pieces of coca leaves,” he adds. Choque shakes a sour with the coca-infused pisco and Andean aguaymanto (golden berry) juice. Behind him, large bottles labeled with handwritten tape hold pisco infused with various dry herbs—the light green pisco is the macerado de hoja de coca.

But Choque explains that alcohol and coca leaves also come together for medicinal use, “Some producers make macerados with methanol, coca leaves, and other herbs.” These macerados are household analgesic remedies that families apply to gauze-dressed bruises, for example.

Choque is proud to share the culture of coca leaves with tourists. “They have a preconceived notion that coca leaves are a bad product, but when they stay in Cusco, they learn the truth,” he says.

A 30-mile taxi drive from Cusco sits Mil, where Luis Valderrama is chef de cuisine. Adjacent to Moray, an ancient Inca agricultural laboratory with concentric terraces at various elevations, the restaurant features locally foraged and cultivated ingredients like potatoes, quinoa, corn, wild herbs, and coca leaves for tea and for baking pan de hoja de coca—coca leaf bread.

I’ve enjoyed coca leaves in tea, cocktails, and bread, as well as a coca candy that helped me run, in one day, the Inca Trail Marathon—a route that takes hikers four days to cover on foot across four high-elevation mountain passes.

To make these small, round, rustic, dark green, savory, soft loaves, Mil acquires coca leaves from Quillabamba, near the jungle’s edge in the Cusco region. Valderrama describes how they replace traditional wheat flour. “In a processor, we add dehydrated coca leaves until they are in powder form. Then, in a bowl, we mix the coca leaf powder with water, agave syrup, and salt.” To finish, they fill circles of dough with cooked tubers like mashua, oca, or potato and bake them until they rise slightly, their edges brown, and the flat-domed tops begin to crack.

“[The Inca] worked with quinoa or kiwicha doughs; however, it’s not bread making in the European tradition,” says Valderrama, whose first exposure to coca leaves was alongside farmers who chewed them as an energizer and as an aid in withstanding the Andean mountain cold. Baking bread is a result of colonization, but using coca leaves instead of flour combines European and Indigenous cultures

In Andean communities, the cultural significance of coca leaves goes beyond food, drink, and medicine. Coca leaves are also present at engagements, weddings, religious festivals, funerals, and shamanic rituals. Held as a trio, the fanned-out coca leaves represent the Inca realms of the world above, the surface world, and the world below. And, as a sacred offering to Pachamama (Mother Earth) or Apu mountain gods, they ensure a good harvest and provide protection.

During my travels to Cusco, I’ve enjoyed coca leaves in tea, cocktails, and bread, as well as a coca candy that helped me run, in one day, the Inca Trail Marathon—a route that takes hikers four days to cover on foot across four high-elevation mountain passes. That day, I felt close to my ancestors. Today, from my Portland, Oregon, home, I can’t enjoy coca leaves except in Coca-Cola, but next time I visit Cusco, as soon as the airplane lands, I will happily accept the offer to chew coca leaves.