US researchers say they may have discovered why some people get headaches after just a small glass of red wine, even though they don't get the same effect from other types of alcohol.
The University of California team says this is due to a compound in red grapes that can interfere with the way the body metabolizes alcohol.
The compound is an antioxidant or flavanol called quercetin.
Red grapes produce more quercetin when exposed to the sun, and this suggests that more expensive red wines are more prone to causing headaches, according to expert Andrew Waterhouse.
"The cheap grape varieties are grown on vines with very large canopies and lots of leaves, so they don't get as much sun," he said. "While high-quality grapes are from smaller crops with fewer leaves and receive more sun."
However, others are skeptical.
Professor Roger Corder, an expert in experimental therapy at Queen Mary University of London, says the evidence shows that cheaper wines are worse for headaches.
The likely culprit
Several theories have been put forward to explain red wine headaches, which can start within 30 minutes of drinking small amounts.
Some have suggested that sulfites, preservatives used to extend shelf life and keep wine fresh, may be the cause.
However, in general, sulfite content is higher in sweet white wines than in reds.
And while some people may be allergic to sulfites and should avoid them, there is little evidence that they are "to blame" for headaches.
Another possible culprit is histamine, a compound more common in red wine than white wine.
Histamine can dilate blood vessels in the body, which can cause headaches. But again, absolute proof is lacking.
Meanwhile, experts know that more than one in three people of East Asian origin are intolerant to all types of alcohol in beer, wine and spirits and experience flushing, headaches and nausea when drinking.
This is due to a gene that affects how an alcohol metabolizing enzyme called ALDH2 or aldehyde dehydrogenase works.
Alcohol is broken down in the body in two steps: it is converted into a toxic compound called acetaldehyde, which ALDH2 then converts into harmless acetate, mainly vinegar.
If this cannot happen, harmful acetaldehyde builds up, causing symptoms.
And researchers say a similar pathway is involved in red wine headaches.
They showed in the laboratory that quercetin can indirectly block the action of ALDH2, through one of its metabolites.
Quercetin only becomes problematic when mixed with alcohol, according to the researchers, who published their findings in the journal Scientific Reports.
Quercetin is also found in many other fruits and vegetables, is even given as a health supplement due to its beneficial anti-inflammatory properties, and does not appear to cause headaches on its own.
The researchers still need to test their theory in humans, and say a simple experiment could be to give volunteers prone to red wine headaches a quercetin supplement along with a standard drink like vodka.
Co-author Morris Levin, an expert in neurology, says that “we are finally on the right track to explaining this millennia-old mystery. The next step is to scientifically test it in people who develop these headaches."
But Corder, who has studied the potential health benefits of wine, suspects other ingredients worth exploring as headache triggers such as pectinases that accelerate the release of anthocyanins, which accelerate wine production by releasing color, or dimethyl bicarbonate, a food additive used to preserve cheap wines that are transported from one place to another.