{"url":"https://whatshealthyandwhy.com/what-to-eat-when-sick/what-to-eat-and-drink-when-ill","path":"/what-to-eat-when-sick/what-to-eat-and-drink-when-ill","alternates":{"json":"https://whatshealthyandwhy.com/api/articles/what-to-eat-when-sick/what-to-eat-and-drink-when-ill.json","markdown":"https://whatshealthyandwhy.com/what-to-eat-when-sick/what-to-eat-and-drink-when-ill.md"},"topic":{"slug":"what-to-eat-when-sick","name":"What to Eat When Sick","url":"https://whatshealthyandwhy.com/what-to-eat-when-sick"},"slug":"what-to-eat-and-drink-when-ill","order":1,"title":"What to Eat and Drink When You Are Sick","question":"What should you eat and drink when you are sick?","answer":"Sip fluids and eat what appeals; warm drinks, soup and honey may ease cold symptoms, but no food has been shown to speed recovery.","description":"What research says about fluids, chicken soup, honey and appetite loss with a cold, flu or stomach bug, and whether to feed a cold and starve a fever.","confidence":2,"confidenceNote":"Warm drinks rest on one small trial, soup on lab work, and feed-or-fast on mouse studies and a short human immune-marker report; only rehydration for children's diarrhea is well supported.","evidenceSummary":{"rctCount":2,"observationalCount":2,"metaAnalysisCount":1,"totalParticipants":"1,600+","replicated":false,"newestStudyYear":2024},"category":{"categoryTitle":"Detox & Heal","categorySlug":"detox-and-heal","subcategoryName":"Home Remedies","subcategorySlug":"home-remedies","url":"https://whatshealthyandwhy.com/explore/detox-and-heal/home-remedies"},"actions":["With vomiting or diarrhea, sip an oral rehydration solution: it is the main treatment recommended for children, and normal feeding should carry on [10].","For a cold, a hot drink is a cheap comfort that eased symptoms in a small trial; for cough in children over 12 months, honey may help [2][8].","Eat small amounts of whatever appeals and do not force food: no diet has been proven to shorten a cold or flu [3][5][6]."],"cautions":["Babies, young children and anyone who cannot keep fluids down can dehydrate fast; call a doctor about a dry mouth, no tears, sunken eyes or very little urine [10][12].","Never give honey to a baby under 12 months; it can carry botulism spores [9].","If a doctor has limited your fluids, ask before drinking extra: trials of extra fluids in chest infections do not exist, and some observational reports hint at harm [1]."],"simpleText":"Drink enough, eat what appeals, and do not force food. A hot drink eased cold and flu symptoms in a small trial [2], and honey calms cough in children over one year old [8]. The rule \"feed a cold, starve a fever\" comes from mouse experiments and a short human immune-marker report, not illness trials [3][5][6]. With vomiting or diarrhea, an oral rehydration solution is the main treatment [10].","mediumText":"How it works\n\nFluids first\n\nFever, vomiting and diarrhea increase the water your body loses, so fluids come first [1][10]. Yet no randomized trial has tested whether extra fluids shorten a respiratory infection, and some observational reports suggest over-drinking may harm in chest infections. For a cold or flu, drink to thirst and keep sipping [1].\n\nStomach bugs are different. European pediatric guidelines name oral rehydration solution (a measured mix of water, salt and sugar) as the main treatment, to be started as soon as possible, with regular feeding, including milk and breastfeeding, continuing [10]. In 647 young children with mild gastroenteritis, half-strength apple juice followed by preferred drinks led to fewer treatment failures than a branded electrolyte drink [11]. That applies to mildly dehydrated children; guidelines still favor oral rehydration solution [10]. See diarrhea and stomach bugs.\n\nWarm drinks and soup\n\nIn 30 people with colds or flu, a hot fruit drink relieved runny nose, cough, sneezing, sore throat, chilliness and tiredness, while the same drink at room temperature helped only three of those symptoms [2]. In test-tube work, chicken soup and each of its ingredients slowed neutrophils, white blood cells that drive inflammation [4]. Nobody has shown that soup shortens a cold, so think of it as a hydrating comfort food.\n\nHoney\n\nFor children aged 12 months and over, honey probably eases cough more than no treatment or placebo, based on six trials, mostly after one night's use [8]. It must never be given to babies under 12 months, because it can carry the spores that cause infant botulism [9]. See what calms a cough.\n\nFeed a cold, starve a fever?\n\nIn mouse models of bacterial sepsis, not eating protected and feeding harmed; in influenza and viral sepsis, feeding protected [5]. In human volunteers, a short report found that eating raised interferon-gamma and fasting raised interleukin-4, immune markers rather than illness outcomes [3]. A 2024 review found too little human data to advise by type of infection [6]. Let your appetite lead: small amounts of what appeals, and skip what does not.\n\nMilk and mucus\n\nIn 60 volunteers given a cold virus, milk and dairy intake was not linked to more nasal secretions or congestion [7]. If milk feels unpleasant while you are ill, skip it, but there is no evidence you need to.\n\nWatch for dehydration\n\nFor feverish children under five, NICE advises parents to look for a sunken soft spot, dry mouth, sunken eyes and no tears, and to seek advice if they appear [12]. See Fever: Friend or Foe?. For gentle meal ideas, the recipe library has a \"When You're Sick\" collection.","deepText":"The evidence in detail\n\nFluids\n\nThe Cochrane review by Guppy and colleagues searched five databases up to late 2010 for randomized trials of advising people with acute respiratory infections to drink more. It found none, so there is no trial evidence either way. The authors noted that some observational studies of lower respiratory tract infections linked higher fluid intake to harm, and that antidiuretic hormone, which makes the body hold on to water, is raised in some chest infections [1]. For gastroenteritis in children, the 2014 European guideline puts early oral rehydration with a hypoosmolar solution first and says feeding should continue [10]. The Toronto trial randomized 647 children aged 6 to 60 months with mild gastroenteritis and minimal dehydration (68% had no sign of dehydration). Children given half-strength apple juice and then their preferred fluids (n=323) had treatment failure within seven days less often than those given apple-flavored electrolyte solution (n=324): 16.7% versus 25.0%. Intravenous rehydration was needed in 2.5% versus 9.0%; hospitalization and the frequency of diarrhea and vomiting did not differ [11]. It was single-blind, at one emergency department in a high-income country, so it does not overturn standard advice for moderate or severe dehydration.\n\nHot drinks and soup\n\nSanu and Eccles compared a hot fruit drink with the same drink at room temperature in 30 people with colds or flu. The hot drink did not change objectively measured nasal airflow, but it improved the sense of airflow and gave immediate, sustained relief from six symptoms; the cooler drink helped three. The authors discuss the effects in terms of placebo and of changes in salivation and airway secretions [2]. Rennard and colleagues found that a traditional chicken soup inhibited neutrophil migration in a chemotaxis chamber in a concentration-dependent manner; the chicken and every vegetable did so on their own, and commercial soups differed greatly [4]. The drink trial measured symptoms in a single session and the soup work was a laboratory assay: neither measured how long a cold lasts.\n\nFeeding and fasting\n\nWang and colleagues showed in mice that the effect of eating depends on the infection. In bacterial sepsis models, anorexia protected and nutritional supplementation was harmful, with glucose necessary and sufficient for those effects. In influenza and viral sepsis models the opposite held: supplementation protected, and blocking glucose use was lethal [5]. In a two-page report, van den Brink and colleagues found that activated T cells from human volunteers made more interferon-gamma after food intake and more interleukin-4 after food deprivation, shifting the balance between T-helper 1 and 2 responses; these were immune markers, not illness outcomes [3]. A 2024 review concluded that clinically applicable human data are limited, that needs appear to depend on the specific organism rather than a simple bacteria-versus-virus split, and that age, baseline nutrition, illness phase and other conditions all matter [6]. Nothing here tells a person with a cold what to put on a plate.\n\nMilk and honey\n\nPinnock and colleagues followed 51 of 60 volunteers infected with rhinovirus-2 for 10 days (510 person-days), recording milk intake (0 to 11 glasses a day, mean 2.7) and weighing used tissues. Milk and dairy intake was not associated with nasal secretion weight or congestion symptoms. People who believed that milk makes mucus reported more cough and congestion but did not produce more secretions [7]. This was a study in healthy adults with one virus, and intake was observed, not assigned. The honey Cochrane review pooled six trials with 899 children aged 12 months to 18 years. Against no treatment, honey lowered cough-frequency scores by a mean difference of -1.05 points on a 7-point scale (95% CI -1.48 to -0.62; 154 children; moderate certainty); against placebo the difference was -1.62 (95% CI -3.02 to -0.22; 402 children). Honey and dextromethorphan did not differ clearly (low certainty), and beyond three days honey had no advantage over placebo or salbutamol. Most children were treated for one night, and the authors saw no strong evidence for or against honey [8]. The infant botulism warning rests on repeated epidemiologic findings and positive honey samples, and the CDC advises against honey for babies under 12 months [9].\n\nWhere the evidence is thin or conflicting\n\nAdvice to drink more has never been tested in a trial for colds or flu, and observational signals for chest infections point the other way [1]. The hot-drink benefit may largely reflect expectation [2], and the soup effect is shown only in a test tube [4]. Mouse studies show feeding helps in one kind of infection and hurts in another, and the human report measured only immune markers, so the old saying may be half right for the wrong reasons [3][5][6]. The milk study cannot rule out effects at higher intakes or in people with a milk allergy [7].\n\nBottom line\n\nConfidence is low (2 of 5). Fluids and oral rehydration are well supported for children's diarrhea and vomiting [10][11], and honey has moderate-certainty support for night cough in children over one year [8]. Hot drinks, soup and the feed-or-fast rule are comfort-level advice built on a small trial, lab work, animals or immune markers [2][3][4][5][6]. No food or diet has been shown to shorten a cold or flu.","deepTruncated":false,"references":[{"id":"1","title":"Advising patients to increase fluid intake for treating acute respiratory infections","authors":"Guppy MP, Mickan SM, Del Mar CB, et al.","year":2011,"journal":"Cochrane Database Syst Rev","pmid":"21328268","url":"https://pubmed.ncbi.nlm.nih.gov/21328268/"},{"id":"2","title":"The effects of a hot drink on nasal airflow and symptoms of common cold and flu","authors":"Sanu A, Eccles R","year":2008,"journal":"Rhinology","pmid":"19145994","url":"https://pubmed.ncbi.nlm.nih.gov/19145994/"},{"id":"3","title":"Feed a cold, starve a fever?","authors":"van den Brink GR, van den Boogaardt DE, van Deventer SJ, et al.","year":2002,"journal":"Clin Diagn Lab Immunol","pmid":"11777851","url":"https://pubmed.ncbi.nlm.nih.gov/11777851/"},{"id":"4","title":"Chicken soup inhibits neutrophil chemotaxis in vitro","authors":"Rennard BO, Ertl RF, Gossman GL, et al.","year":2000,"journal":"Chest","pmid":"11035691","url":"https://pubmed.ncbi.nlm.nih.gov/11035691/"},{"id":"5","title":"Opposing Effects of Fasting Metabolism on Tissue Tolerance in Bacterial and Viral Inflammation","authors":"Wang A, Huen SC, Luan HH, et al.","year":2016,"journal":"Cell","pmid":"27610573","url":"https://pubmed.ncbi.nlm.nih.gov/27610573/"},{"id":"6","title":"\"Feed a Cold, Starve a Fever?\" A Review of Nutritional Strategies in the Setting of Bacterial Versus Viral Infections","authors":"Sankararaman S, Venegas C, Seth S, et al.","year":2024,"journal":"Curr Nutr Rep","pmid":"38587572","url":"https://pubmed.ncbi.nlm.nih.gov/38587572/"},{"id":"7","title":"Relationship between milk intake and mucus production in adult volunteers challenged with rhinovirus-2","authors":"Pinnock CB, Graham NM, Mylvaganam A, et al.","year":1990,"journal":"Am Rev Respir Dis","pmid":"2154152","url":"https://pubmed.ncbi.nlm.nih.gov/2154152/"},{"id":"8","title":"Honey for acute cough in children","authors":"Oduwole O, Udoh EE, Oyo-Ita A, et al.","year":2018,"journal":"Cochrane Database Syst Rev","pmid":"29633783","url":"https://pubmed.ncbi.nlm.nih.gov/29633783/"},{"id":"9","title":"Association between honey consumption and infant botulism","authors":"Tanzi MG, Gabay MP","year":2002,"journal":"Pharmacotherapy","pmid":"12432974","url":"https://pubmed.ncbi.nlm.nih.gov/12432974/"},{"id":"10","title":"European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014","authors":"Guarino A, Ashkenazi S, Gendrel D, et al.","year":2014,"journal":"J Pediatr Gastroenterol Nutr","pmid":"24739189","url":"https://pubmed.ncbi.nlm.nih.gov/24739189/"},{"id":"11","title":"Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis: A Randomized Clinical Trial","authors":"Freedman SB, Willan AR, Boutis K, et al.","year":2016,"journal":"JAMA","pmid":"27131100","url":"https://pubmed.ncbi.nlm.nih.gov/27131100/"},{"id":"12","title":"Fever in under 5s: assessment and initial management","authors":"National Institute for Health and Care Excellence","year":2021,"journal":"NICE guideline NG143","url":"https://www.nice.org.uk/guidance/ng143"}],"wordCount":1372,"source":{"path":"src/content/topics/what-to-eat-when-sick/what-to-eat-and-drink-when-ill.md"},"citeAs":"“What should you eat and drink when you are sick?.” What's Healthy and Why. https://whatshealthyandwhy.com/what-to-eat-when-sick/what-to-eat-and-drink-when-ill","notice":"General information backed by peer-reviewed research, not medical advice."}