Grandma’s chicken soup is one of many popular remedies for acute viral nasopharyngitis, better known as the common cold. Colds and other non-influenza-related viral respiratory tract infections account for nearly 500 million episodes annually in the United States (Fendrick et al., 2003).
Symptoms associated with this respiratory nuisance are caused primarily by an array of rhinoviruses and may be alleviated by numerous over-the-counter decongestants and pain relievers. Among the more trendy tonics are hot water and tea with lemon juice as well as a variety of spirited beverages.
Alcohol is contraindicated during periods of colds and flu since this substance promotes peripheral vasodilatation and diuresis, which can worsen one’s hydration status.
Several studies examined the clinical hypothesis that alcohol consumption may increase susceptibility to the common cold. In the early 1990s, Cohen et al. (1993) challenged 391 healthy adult subjects with low infectious doses of one of five respiratory viruses. This 30-day study suggested that alcohol consumption among non-smokers and the entire population of infected subjects was associated with decreased susceptibility to clinical colds in a dose-response manner up to approximately three to four drinks per day. These results counter animal studies that indicate alcohol is immunosuppressive through a cascade of events that lead to the loss of T helper CD4(+) lymphocytes and subsequent dysfunction of the immune system (Hote et al., 2007). Yet, early human lymphocyte models suggest that alcohol may limit viral replication and increase cAMP, which, in general terms, may present anti-inflammatory action and inhibit histamine release (Atkinson et al., 1977).
More recently, Takkouche et al. (2002) examined more than 1,300 cases of the common cold among nearly 4,300 faculty and students at five Spanish universities. Data from this cohort study suggested alcohol consumption from beer and spirits was not associated with the resistance or susceptibility to the common cold. However, consumption of more than 14 glasses of red wine/wk relative to non-drinkers was inversely associated with the risk of this respiratory nemesis. As a follow-up, Watzel et al. (2002), in a very small (n=6) clinical study, observed the effect when healthy males consumed a single 500 mL dose of red wine or other alcoholic or non-alcoholic product. This study indicated that an acute consumption of these products does affect many immune or inflammatory biomarkers. However, the entirety of medical literature indicates that the prolonged or abusive use of alcohol contributes to immunosuppression.
According to the 2005 Dietary Guidelines for Americans, moderate alcohol consumption (less than two drinks/day) may have health benefits, including reduced risk of mortality from coronary heart disease. These guidelines do not extend benefits to reduced risk of the common cold. In the face of a divided and relatively limited literature, it is tempting to speculate that while alcohol may confer some benefit in limiting vulnerability to—or duration and intensity of—cold virus syndromes, it may simultaneously present health risks or insults in other tissues. It is, therefore, difficult to endorse the use of alcohol as part of a broadly recommended approach to medical treatment of the common cold.
On the other hand, and in the context of moderation, alcohol may ultimately be demonstrated to be a beneficial constituent of a balanced diet that is supportive of good health. In 1819, the Irish physician Samuel Black coined the term “French Paradox” in observing that the French appeared to have low rates of cardiovascular disease, despite a diet rich in saturated fats. Over the years, the hypothesis has lived on that the comparatively high consumption of red wine in France is the principal explanation for the Paradox. At least a dozen international epidemiologic studies indicate that sensible drinking is associated with increased longevity. No specific mechanisms or causal links are identified or proposed.
One cannot help but wonder about the need to better illuminate the nutritional biochemistry and to suggest the possibility that particular dietary patterns are really a proxy for larger lifestyle variables that may be the more direct link between dietary factors and disease. Do those who drink moderately also profit from personality styles that mediate the sympatho-adrenal medullary “fight-and-flight” axis? Are sensible drinkers more likely to engage in outdoor exercise that significantly promotes health? Until we have the answers to these questions, we can only counsel moderation and balance.
References for the studies mentioned above are available from the authors.
by Roger Clemens, Dr.P.H.,
Special Projects Advisor,
ETHorn, La Mirada, Calif.
by Peter Pressman, M.D.,
Attending Staff, Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif.