Wine World

My thoughts on the Green Flash are fairly simple. In 40 years of living in Naples, I have seen the sun set well over a hundred times. On each of those occasions, not only did the sky remain nongreen, I also observed dozens of tourists snapping away at the sunset with their cameras. In the event that a Green Flash were to occur on a day when I was not at the beach, chances are that an industrious visitor would have captured the photographic evidence, and it would appear the following morning on the front page of the Naples Daily News under a 96-point headline "Green Flash Observed!"

Granted, I have had friends—and even family members—swear to me that they have seen the Green Flash. Despite my fondness for them, I would not put any of them above pulling my leg. My long-time opinion on red wine headaches (or "RWH," as those in the headache profession apparently refer to them) suffers from a similar stigma—the fact that I can’t completely trust another’s version of the events. On most occasions when I hear a tale of a person with a red wine headache, the individual involved does not normally drink red wine, mixed several beverages that evening, and is not precisely certain how much red wine was consumed. I have always ascribed tales of RWHs to overindulgence and not as a bona fide phenomenon.

It appears my skepticism has been misplaced. In fact, the RWH phenomenon is apparently quite real. In 1988, research physicians in London tested 19 patients who believed that red wine, but not alcohol in general, caused headaches. The physicians diluted vodka to an alcohol content equivalent to red wine and served it and red wine to the patients who had complained of RWH. The findings, published in Lancet, showed that red wine provoked a typical migraine attack in nine of 11 patients in the red wine test group, while none in the vodka test group experienced a migraine. Over the last 18 years, several studies have replicated these results, some with mixtures as low as one part red wine to 49 parts water. Naples neurologist and wine aficionado Dr. Mark Rubino confirms that "red wine can often act as a trigger for individuals who are prone to migraines."

Common wisdom blames sulfites for this reaction. However, testing has shown that dry white wines contain higher levels of sulfites than red wines, and sweet white wines and roses contain the highest level of sulfites.

Three more likely culprits for RWH are histamines, tannins and prostaglandins. Histamine sensitivity appears to be the most likely cause of red wine headaches. Histamines, as well as tyramine, are among the most toxic members of a group called "biogenic amines" known to cause headaches. They are both byproducts of a secondary fermentation common to red wine, resulting in amine quantities up to 200 percent higher in red wine than in white.

Tannins are astringent particles in young red wines. Red wines contain higher levels of tannin than white wines, as they are traditionally fermented on their skins and seeds and that exposure during the fermentation process extracts tannin molecules. Most winemaking techniques find the presence of tannins, at least in moderate levels, to be desirable in a red wine as they can add to the wine’s structure and its ability to age. Tannins also cause the release of serotonin, a neuro-transmitter. As high levels of serotonin can cause headaches, it is also a possible culprit.

Prostaglandins are substances that contribute to pain and swelling and, therefore, headaches. In three studies, British physician Herbert Kaufman reported that the ingestion of aspirin prior to red wine consumption prevented the occurrence of RWH, but once the headache began, aspirin had little or no effect in altering it.

Unfortunately, much of the traditional research in this area has finished with the advice "avoid red wine." Given the joys and infinite variety in the world of red wine, a proscription hardly seems the best prescription. For individuals in the class identified by Kaufman, a daily regimen of aspirin achieved a remarkable success rate in his follow-up studies. A 1996 article in the International Archives of Allergy and Immunology found success with a treatment with an antihistamine for two weeks as well as avoidance of histamine-rich food, an approach targeted at those susceptible to histamine reactions.

A combination of these approaches worked for my wife, who no longer suffers from red wine headaches. At this point, I am beginning to believe her tales of sudden wine-related migraines. My faith in her, when backed by peer-reviewed articles from British physicians, has convinced me to take her at her word. Now if Lancet would only publish an article on the Green Flash, I could learn to believe my parents.