Skip to main content

Moderate alcohol consumption and the immune system: A review

  • Javier Romeo (a1), Julia Wärnberg (a1), Esther Nova (a1), Ligia E. Díaz (a1), Sonia Gómez-Martinez (a1) and Ascensión Marcos (a1)...

Increasing evidence suggests that light to moderate amounts of polyphenol-rich alcoholic beverages like wine or beer could have health benefits. Scientists have long debated the effects of alcohol on immune function, showing on the one hand, that high doses of alcohol consumption can directly suppress a wide range of immune responses, and that alcohol abuse is associated with an increased incidence of a number of infectious diseases. On the other hand, moderate alcohol consumption seems to have a beneficial impact on the immune system compared to alcohol abuse or abstinence. Therefore, the link between alcohol consumption, immune response, as well as infectious and inflammatory processes remains not completely understood. With this in mind, it is important to realise that other factors, unrelated or indirectly related to immune function, like drinking patterns, beverage type, amount of alcohol, or gender differences, will affect the influence that alcohol consumption may have on the immune system. This review summarises published data describing the effects that light to moderate amounts of polyphenol-rich beverages like wine or beer seem to have on immunity in healthy adults.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Moderate alcohol consumption and the immune system: A review
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Moderate alcohol consumption and the immune system: A review
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Moderate alcohol consumption and the immune system: A review
      Available formats
Corresponding author
*Corresponding author: Dr. Javier Romeo Marín, fax +34 915493627, email
Hide All
1Keys A (1980) The Seven Countries. a multivariate analysis of death and coronary heart disease. London: Harvard University Press.
2Ahmed FE (1995) Toxicological effects of ethanol on human health. Crit Rev Tox 77, 347367.
3Szabo G (1998) Monocytes, alcohol use, and altered immunity. Alcohol Clin Exp Res 22, 216S219S.
4MacGregor RR (1986) Alcohol and immune defense. JAMA 256, 14741479.
5Straus B & Berenyi MR (1973) Infection and immunity in alcoholic cirrhosis. Mt Sinai J Med 40, 631640.
6Watzl B & Watson RR (1992) Role of alcohol abuse in nutritional immunosuppression. J Nutr 122, 733737.
7Engs RC & Aldo-Benson M (1995) The association of alcohol consumption with self-reported illness in university students. Psychol Rep 76, 727736.
8Cohen S, Tyrrell DA, Russell MA, Jarvis MJ & Smith AP (1993) Smoking, alcohol consumption, and susceptibility to the common cold. Am J Public Health 83, 12771283.
9Mendenhall CL, Theus SA, Roselle GA, Grossman CJ & Rouster SD (1997) Biphasic in vivo immune function after low- versus high-dose alcohol consumption. Alcohol 14, 255260.
10Diaz LE, Montero A, González-Gross M, Vallejo AI, Romeo J & Marcos A (2002) Influence of alcohol consumption on immunological status: a review. Eur J Clin Nutr 56, 5053.
11Romeo J, Warnberg J, Nova E, Díaz LE, González-Gross M & Marcos A (2007) Changes in the Immune System after Moderate Beer Consumption. Ann Nutr Metab 51, 359366.
12Romeo J, Warnberg J, Díaz LE, González-Gross M & Marcos A (2007) Effects of moderate beer consumption on first-line immunity of healthy adults. J Physiol Biochem 63, 153160.
13Jimenez V, Cardinali DP, Alvarez MP, Fernandez MP, Boggio V & Esquifino AI (2005) Effect of chronic ethanol feeding on 24-hour rhythms of mitogenic responses and lymphocyte subset populations in thymus and spleen of peripubertal male rats. Neuroimmunomodulation 12, 357365.
14Bautista AP (2001) Free radicals, chemokines, and cell injury in HIV-1 and SIV infections and alcoholic hepatitis. Free Radical Biology Medicine 31, 15271532.
15Deaciuc IV (1997) Alcohol and cytokine networks. Alcohol 14, 421430.
16Szabo G (1999) Consequences of alcohol consumption on host defence. Alcohol Alcohol 34, 830841.
17Budec M, Ciric O, Koko V & Asanin R (1992) The possible mechanism of action of ethanol on rat thymus. Drug Alcohol Depend 30, 181185.
18Cook RT (1998) Alcohol abuse, alcoholism, and damage to the immune system. A review. Alcohol Clin Exp Res 22, 19271942.
19Boyadjieva NI, Dokur M, Advis JP, Meadows GG & Sarkar DK (2002) Beta-endorphin modulation of lymphocyte proliferation: effects of ethanol. Alcohol Clin Exp 26, 17191727.
20Dominguez-Santalla MJ, Vidal C, Vinuela J, Perez LF & Gonzalez-Quintela A (2001) Increased serum IgE in alcoholics: relationship with Th1/Th2 cytokine production by stimulated blood mononuclear cells. Alcohol Clin Exp Res 25, 11981205.
21Crews FT, Bechara R, Brown LA, et al. (2006) Cytokines and Alcohol. Alcohol Clin Exp Res 30, 720730.
22Gonzalez-Quintela A, Dominguez-Santalla MJ, Perez LF, Vidal C, Lojo S & Barrio E (2000) Influence of acute alcohol intake and alcohol withdrawal on circulating levels of IL-6, IL-8, IL-10 and IL-12. Cytokine 12, 14371440.
23Daniluk J, Szuster-Ciesielska A, Drabko J & Kandefer-Szerszen M (2001) Serum cytokine levels in alcohol-related liver cirrhosis. Alcohol 23, 2934.
24Winkler C, Wirleitner B, Schroecksnadel K, Schennach H & Fuchs D (2006) Beer down-regulates activated peripheral blood mononuclear cells in vitro. Int Immunopharmacol 6, 390395.
25Mandrekar P, Catalano D, White B & Szabo G (2006) Moderate alcohol intake in humans attenuates monocyte inflammatory responses: inhibition of nuclear regulatory factor kappa B and induction of interleukin 10. Alcohol Clin Exp Res 30, 135139.
26González-Gross M, Lebrón M & Marcos A (2000) Literature review about the effects of moderate beer consumption on health. Centro de Información Cerveza y Salud eds. Madrid.
27Percival SS & Sims CA (2000) Wine modifies the effects of alcohol on immune cells of mice. J Nutr 130, 10911094.
28Fenech M, Stockley C & Aitken C (1997) Moderate wine consumption protects against hydrogen peroxide-induced DNA damage. Mutagenesis 12, 289296.
29Takkouche B, Regueira-Mendez C, Garcia-Closas R, Figueiras A, Gestal-Otero JJ & Hernan MA (2002) Intake of wine, beer, and spirits and the risk of clinical common cold. Am J Epidemiol 155, 853858.
30Watzl B, Bub A, Pretzer G, Roser S, Barth SW & Rechkemmer G (2004) Daily moderate amounts of red wine or alcohol have no effect on the immune system of healthy men. Eur J Clin Nutr 58, 4045.
31Imhof A, Woodward M, Doering A, Helbecque N, Loewel H, Amouyel P, Lowe GD & Koenig W (2004) Overall alcohol intake, beer, wine, and systemic markers of inflammation in western Europe: results from three MONICA samples. Eur Heart J 25, 20922100.
32Badía E, Sacanella E, Fernández-Solá J, Nicolás JM, Antúnez E, Rotilio D, de Gaetano G, Urbano-Márquez A & Estruch R (2004) Decreased tumor necrosis factor-induced adhesion of human monocytes to endothelial cells after moderate alcohol consumption. Am J Clin Nutr 80, 225230.
33Estruch R, Sacanella E, Badia E, Antúnez E, Nicolás JM, Fernández-Solá J, Rotilio D, de Gaetano G, Rubin E & Urbano-Márquez A (2004) Different effects of red wine and gin consumption on inflammatory biomarkers of atherosclerosis: a prospective randomized crossover trial: effects of wine on inflammatory markers. Atherosclerosis 175, 1171123.
34Vinson JA, Mandarano M, Hirst M, Trevithick JR & Bose P (2003) Phenol antioxidant quantity and quality in foods: beers and the effect of two types of beer on an animal model of atherosclerosis. J Agric Food Chem 51, 55285533.
35Boscolo P, del Signore A, Sabbioni E, Di Gioacchino M, Di Giampaolo L, Reale M, Conti P, Paganelli R & Giaccio M (2003) Effects of resveratrol on lymphocyte proliferation and cytokine release. Ann Clin Lab Sci 33, 226231.
36Nardini M, Natella F, Scaccini C & Ghiselli A (2006) Phenolic acids from beer are absorbed and extensively metabolized in humans. J Nutr Biochem 17, 1422.
37Wilder RL (1998) Hormones, pregnancy and autoimmune diseases. Ann N Y Acad Sci 840, 4550.
38Da Silva JAP (1999) Sex hormones and glucocorticoids: interactions with the immune system. Ann N Y Acad Sci 876, 102117.
39Ciesielska A (2003) Immunosuppressive aspects of estrogen. Neuro Neurochi Pol 37, 7992.
40Liu HB, Loo KK, Palaszynski K, Ashouri J, Lubahn DB & Voskuhl RR (2003) Estrogen receptor alpha mediates estrogen's immune protection in autoimmune disease. J Immunol 171, 69366940.
41Grossman CJ, Nienaber M, Mendenhall CL, Hurtubise P, Roselle GA, Rouster S, Weber N, Schmitt G & Gartside PS (1993) Sex differences and the effects of alcohol on immune response in male and female rats. Alcohol Clin Exp Res 17, 832840.
42Spitzer JA & Zhang P (1996) Gender differences in phagocytic responses in the blood and liver, and the generation of cytokine-induced neutrophil chemoattractant in the liver of cutely ethanol-intoxicated rats. Alcohol Clin Exp Res 20, 914920.
43Colantoni A, Idilman R, De Maria N, La Paglia N, Belmonte J, Wezeman F, Emanuele N, Van Thiel DH, Kovacs EJ & Emanuele MA (2003) Hepatic apoptosis and proliferation in male and female rats fed alcohol: role of cytokines. Alcohol Clin Exp Res 27, 11841189.
44Baraona E, Abittan CS, Dohmen K, Moretti M, Pozzato G, Chayes ZW, Schaefer C & Lieber CS (2001) Gender Differences in Pharmacokinetics of Alcohol. Alcohol Clin Exp Res 25, 40S45S.
45Kovacs EJ & Messingham KA (2002) Influence of alcohol and gender on immune response. Alcohol Res Health 26, 257263.
46LaPorte RE, Cresanta JL & Kuller LH (1980) The relationship of alcohol consumption to atherosclerotic heart disease. Prev Med 9, 2240.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 400
Total number of PDF views: 1305 *
Loading metrics...

Abstract views

Total abstract views: 1660 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 25th November 2017. This data will be updated every 24 hours.