Category: Wires

Most of us have heard the adage “Feed a cold, starve a fever.”

It comes from an outdated theory that a cold makes your body cooler and eating can help warm it up, and that a fever makes your body warmer and fasting can help cool it down. The premise itself is flawed: While fevers do raise your body temperature, colds don’t make your body cold. You might even get a fever when you have a cold.

As for whether you should eat more or less, in most cases, there’s no convincing evidence that limiting food intake when you’re sick plays a meaningful role in recovery, experts said.

There may be a more accurate approach. “Feed a cold. Feed a fever, too,” said Roy Gulick, the chief of the infectious-disease division at Weill Cornell Medicine and an attending physician at New York-Presbyterian Hospital.

Experts recommend staying hydrated and eating healthy foods — at least when your stomach will allow it — to support your body when you’re sick. The advice holds true whether you’re dealing with a cold, which is an upper-respiratory infection that can be caused by more than 200 viruses, or a fever, which can be caused by viral and bacterial infections, autoimmune issues, and reactions to medications, among other things.

“If you are truly not feeling hungry, you don’t necessarily have to eat more than you feel like eating,” said Geeta Sood, an assistant professor in the infectious-disease division at Johns Hopkins University. However, you do want to make sure you’re getting enough calories, protein, and nutrients — and hydration — to help support your body as it heals, she said.

What does the research show?

Research in this area is limited — and mostly in animals. For example, in a 2016 study, mice were infected with either a bacterium that causes gastrointestinal illness or a virus that causes influenza. In mice with the bacterial infection, fasting was protective while nutritional supplementation was detrimental, the authors found. The pattern was reversed in mice with the flu and viral sepsis. While interesting fodder for further research, these results can’t be applied directly to humans, experts said.

In humans, researchers who conducted a 2021 review concluded that there is some evidence that nutrients such as vitamins and minerals can help support the body’s immune response and help fight infections in general. And a 2024 review that included newer studies that were conducted during the pandemic suggested that nutritional needs may depend on the specific pathogen you’re fighting and other variables, such as the duration and severity of your illness — not simply on whether it’s a bacterium or virus.

The reality is that most studies on how nutrition affects infections have looked at only a handful of pathogens, said David Schneider, a professor of microbiology and immunology at Stanford University. To further complicate matters, when you’re experiencing symptoms such as a runny nose or fever, you may not know whether you’re sick with a bacterium or virus, he said. Both of these things make it difficult to give generalized recommendations about what might be best for every cold or every fever, he said.

Why do I lose my appetite when I’m sick?

There is some rationale to the adage, because it’s common to lose your appetite when your body is fighting off an infection. As your immune system ramps up, it releases chemical messengers, known as cytokines, to rally immune cells to fight infection, and those same signals also tell the brain that eating isn’t a priority, said Sharon Bergquist, an internal medicine physician and associate professor at the Emory University School of Medicine.

While not well understood, one theory states that a drop in calorie and protein intake triggers a process called autophagy, which helps recycle damaged cell parts and may play a role in immune defense, she said.

That said, the process of fighting an infection is “metabolically really costly,” Bergquist said, explaining that although you can skip food for a day if you aren’t hungry, going longer than that may leave you without adequate nutrition. “It takes so much energy and calories that there’s a rationale for us needing to increase our food and our hydration during times of illness so that we can support our immune system,” she said.

What can I do if I have an infection?

Vaccines are the first-line defense to help prevent and lessen the severity of some viral infections, including COVID and the flu. If you get sick, however, you can try some medications that may help you recover faster.

• Antibiotics target specific kinds of bacteria such as those that cause strep throat, pneumonia, or urinary tract infections.
• Antiviral medications can help treat certain viral infections, including the coronavirus and influenza. Three antivirals — Paxlovid, remdesivir, and molnupiravir — are available by prescription to treat COVID in people who are at high risk of serious complications, and four antivirals are approved to treat the flu.

There are also a few other things you can do to help support your body.

• Stay hydrated. Losing water and electrolytes through sweat when you have a fever, as well as through diarrhea and vomiting, can put you at risk for dehydration, so it’s important to drink plenty of water and make sure you’re getting enough electrolytes, Gulick said. Pediatric beverages and sports drinks with added sodium and potassium can help you stay hydrated, and warm liquids such as soups, broths, and caffeine-free herbal teas can help ease symptoms such as congestion, body aches, and chills, Sood said. Avoid alcohol and caffeinated drinks because they are diuretics and can make dehydration worse.
• Eat, when possible. Listen to your body, but when you have an appetite, eat healthy, whole foods rich in vitamins, minerals, and antioxidants such as fresh fruits and vegetables. One strategy is to make smoothies or soups, Bergquist said. Avoid foods high in saturated fats and processed carbohydrates.
• Get rest. Take time to rest as your body does much of its repair work while you sleep, Bergquist said. “Don’t push your body because you want to dedicate that energy to your immune system,” she said.
• Take hot showers or baths. The steam can help break up congestion and clear airways.
• Try zinc. Zinc may help shorten a cold by a day or two. In a 2024 review, researchers found some evidence that zinc might reduce the duration of symptoms by about two days compared with a placebo, though the mineral was associated with mild side effects such as nasal and oral irritation, problems with taste, stomach pain, constipation, diarrhea, and vomiting. Most other supplements have no real advantage for colds, including vitamin C, which, when started at the onset of symptoms, doesn’t help lessen the duration or severity, research shows.
• Use honey for a cough or sore throat. Adults and children older than 1 year can add honey to warm tea or water to help soothe sore throats and calm coughs.

When Kelly McBride read Elizabeth Bruenig’s essay in the Atlantic about a child’s death from measles complications, she was moved and quickly shared the story on her Facebook account. She hadn’t realized that Bruenig’s family had been ravaged by virus and the well-known journalist had lost a child.

McBride, a media ethicist and senior vice president at the Poynter Institute, also didn’t realize the story was a hypothetical scenario — and the child a composite character based on the author’s research — until a friend alerted her to an editor’s note at the bottom of the story. Then, McBride felt duped.

“I feel deceived,” McBride said. “I spent all weekend talking about this story to my friends as if the reporter had experienced it.”

Bruenig’s stirring account of a mother’s experience learning her child will die of the long-term effects of measles has remained one of the Atlantic’s most read stories since it was published Thursday, receiving more than 700 comments. Written in the second person, some readers have called the essay a visceral and gut-wrenching exposé of the human impacts of the measles epidemic.

It has also generated controversy. Readers and media experts have condemned the story as breeching journalistic ethics by informing the reader that the story is fictionalized through a short editor’s note at the end of the 3,000-word essay. Some public health experts argued the story was a dangerous writing exercise that could evoke backlash and confusion as vaccine skepticism hits an all-time high across the country.

“Grateful to @ebruenig for sharing her and her family’s ordeal,” Gabby Stern, a former World Health Organization communications director, wrote on X shortly after the story published. “Friends, please ensure that your children receive vaccinations against preventable diseases like measles.”

She followed up soon after: “I missed the disclaimer at the bottom. Others did, too. You get to the end and you’re shattered, not looking for caveats and fine print. Disappointed in the magazine. The topic is too high-stakes for such shenanigans.”

Adrienne LaFrance, executive editor at the Atlantic, told The Washington Post in a statement that the magazine was “pleased that so many people are reading and praising Liz’s remarkable essay.”

“We trust our readers to understand all different kinds of writing and writerly devices,” she said. “And while we included a note about Liz’s methods for transparency’s sake, we’re finding that most readers already understand the second-person well enough to know that the ‘you’ referenced throughout the piece is not literally ‘you,’ the reader.”

The Atlantic, one of the most popular American magazines with 1.4 million subscribers, has become a destination for health reporting in recent years. The Atlantic is among a cohort of outlets that have reported on rising measles cases across the United States, as well as the role that misinformation and shifting government guidelines have on childhood vaccinations. Once eliminated in the country, outbreaks have led to the highest count of measles cases in more than three decades. Atlantic staff writer Tom Bartlett was first to find and interview the parents of a child who died of measles in Texas, the first such death in a decade.

Bruenig, a former Post opinion writer, has twice been a finalist for the Pulitzer Prize for feature writing, one of the industry’s top honors for narrative journalism. (This reporter worked for the Atlantic from 2017 to 2019.)

Bruenig wrote the essay in the second person, detailing a scenario where two unvaccinated children attend a birthday party and catch measles from an infected-but-asymptomatic child. “Your daughter behaves normally over the next week while the virus slowly spreads inside her, infecting immune cells that carry it to the lymph nodes, where it replicates and spreads at a rapid pace.”

It includes a short disclaimer at the bottom of the 3,000-word piece: “This story is based on extensive reporting and interviews with physicians, including those who have cared directly for patients with measles.”

Reported hypotheticals have been used in other grim chronicles such as Outside Magazine’s 1997 story “Frozen Alive,” about freezing to death; a passage of Kathryn Schulz’s 2015 New Yorker essay “The Really Big One” about the risks of a large earthquake; and the 2024 Annie Jacobsen book “Nuclear War: A Scenario,” about how nuclear warfare could transpire. The first two stories also are written in second person.

Many readers, including physicians, praised the Atlantic essay, writing that its evocative writing and storytelling forced readers to grapple with the impact of vaccine hesitancy. “Read this while holding my almost-one-month-old, and it absolutely wrecked me. What a powerful and important piece,” one commenter wrote. “Tragically realistic story exquisitely described by Ms. Breunig,” wrote another. “I’m a pediatrician who has never seen a case of measles but am awaiting my first one.”

Others, however, expressed their confusion in the essay’s comments. “The fact that readers in the discussion are unsure of whether this is a true story or fiction highlights a fundamental failure on the part of the author, and the editor,” one reader wrote.

“I know the internet is full of made up stuff, but I trusted the Atlantic,” another reader wrote. “I feel foolish that I told my husband about this as if it were the truth. Glad I didn’t share it with my sisters. We are all pro vaccines, and I’m concerned this story masquerading as a first person memoir will encourage people on the edge to blow off vaccines.”

Tom Rosenstiel, a professor at University of Maryland’s Philip Merrill College of Journalism and former executive director of the American Press Institute, felt the piece did the reader a disservice by not being fully transparent about they were about to read. He said the Atlantic needed to clearly explain the unusual choices in the story upfront, avoiding deception.

“Any time you’re answering questions about why you did something in the story after you’ve published it, you’re in a bad place,” he said.

Some physicians argued the uncertainty around the essay could fan distrust of vaccines. Angela Rasmussen, a virologist at the University of Saskatchewan who edits the journal “Vaccine,” said she found the essay scientifically sound but extremely confusing. She initially believed the essay was about Bruenig’s real child and felt the essay could backfire. “We need effective communicators like this,” she said. “But if that effective communication is being presented in such a way that it actually diminishes trust further, then we’re in real trouble.”

Rachael Bedard, a physician and writer, called herself an admirer of Bruenig, but expressed similar concerns in a series of posts on X.

“One of the things that people who have actually interacted [with] anti-vaxxers know is that they often think the liberal media is lying to them about how bad measles is,” she wrote, writing that the Atlantic’s presentation of this essay as anything other than fiction “affirms all of those concerns.”

Bruenig, in an interview with the website Nieman Lab, defended the structure of her essay. “It is a hypothetical account of a very real phenomenon based on careful reporting,” she said. “I would place it somewhere on the creative nonfiction spectrum.” She said that she interviewed doctors for her piece, and based the character of the mother on herself.

“I have no doubt that there are a lot of people out there who are unhappy with the story or reject its premises, and they are entitled to their interpretations. I get it,” she said. “But my job is to report the truth about the world — and I use all kinds of literary, and narrative devices to do that. I do it because telling the truth is important in its own right, whether or not anyone finds it persuasive.”