As the holiday season begins this week, many will make an important decision at dinner: red wine or white wine? And if your choice is red, will you risk a headache? The fact that red wine can cause headaches in certain individuals (especially those prone to migraines) is common knowledge—so that the phenomenon (“RWH”) also has its Your own Wikipedia page. The Roman encyclopedist Celsus wrote in his book Come to Medicine about the pain he felt after drinking alcohol, while six years later, Paul of Aegina mention that drinking alcohol can cause headaches.
But science to date is not very clear about which components of red wine are responsible, and the mechanisms behind the phenomenon. A group of California scientists have narrowed down the possible culprits to a so-called flavonol quercetinaccording to us new book published in the journal Scientific Reports, although they have yet to run experiments with participants susceptible to RWH to test their hypothesis.
It’s a knotty issue due to the complexities of alcoholism and human genetics/physiology. Wine is basically water and alcohol, along with acids, dissolved sugars, and other compounds that give it color and flavor. For example, the tannins in wine are polyphenolic compounds responsible for much of the bitterness and astringency in a given wine; they come from skins and grapes, or as a result of aging in oak barrels.
Red wines usually contain more amines, sulfites, flavonoids, and tannins, especially a phenolic compound with antioxidant properties called Resveratrol, also found in grape skins and leaves. That’s because red wines are usually made by soaking the grape skins in mash (maceration), while making white wines allows you to extract the water immediately from the grape skins. The grape skins also contain anthocyanins, which give wine its red color.
Drink alcohol of any kind and you will suffer from a headache and at least a little nausea. What is unusual about RWH is that even a small to moderate amount of red wine can cause a headache. It is common these days to blame those sulphites, a preservative that is a natural by-product of fermentation, but white wine and many other foods also contain sulfites. In fact, white wine often has more sulfites than red wine. There is a small percentage of the population that is allergic to sulfites, but they usually get hives and have trouble breathing rather than developing a headache.
Then there are biogenic amines, another fermentation product that contains substances like histamine and tyramine, both of which have been linked to headaches. Genetics is a factor here; some people just can’t produce histamine very effectively, for example, because they don’t produce enough of the enzyme responsible for breaking it down in the small intestine. And alcohol inhibits that enzyme to begin with, causing blood levels of histamine to rise. This can dilate the blood vessels, causing a headache. Those amines are also found in aged cheeses, smoked charcuterie, and dried fruits—all of which are often eaten with red wine, predicting even more effects. However, at least one study found no correlation between histamine and RWH, although the sample size was small.