Wine wars: Why we get headaches from drinking wine in U.S. but rarely in Italy — Chapter 2

The Metropole Hotel sits just two blocks from Rome’s Termini train station. The four-star palace is an inconspicuous jewel in a neighborhood of grime and chaos. On a recent cool spring night, it became my den of class and joy.

In the basement, underneath a lobby of modern art and an elegant piano bar was a gathering of my favorite wines in the world. Wineries representing Barolo and Barbaresco, as well as Roero, came down from Italy’s Piedmont region for a Go Wine-sponsored degustazione, Italian for wine tasting.

As I meandered down the line sampling luscious wines from nearly two dozen wineries, I took heart knowing one thing: The next day, I would not have a headache.

Why?

It’s a question I’ve heard a lot since retiring to Rome 11 years ago. American readers who drank their way across Italy and always woke with a clear head asked me why they would return to the United States and get a  headache after one glass. It’s the wine wars. U.S. vs. Italy.

I wrote about this topic after I’d lived here about a year and following a decade of continuous questions and barely a dent in my bottle of Excedrin, it was time to update the debate. I interviewed Italian winemakers and sommeliers. I called Italy’s leading wine expert. I had a long interview with a professor at the top wine science university in the world in California. I studied tables from food analysis websites. I came away with one conclusion.

Who knows?

Wine wars winner

It isn’t clear. Wine affects different people in different ways. Anything that is as complex as wine has too many factors to narrow it to one cause. 

For years I felt the main culprit was sulfites. They are the chemical compounds that prevent oxidation and preserve the freshness and consistency of wine. They add to a wine’s shelf life. However, in excess they can cause headaches and dizziness, according to the National Library of Medicine among other sources.

Here’s where I based my theory: The U.S. allows a maximum of 350 milligrams of sulfites per liter while the European Union allows only 150. Thus, sulfites look guilty. It’s not that simple but it’s what I asked the Italian wine reps at the Metropole.

Are fewer sulfites the reason people rarely get headaches in Italy but they do in the U.S?

“It’s true,” said Lorenza Camerlengo, a sommelier with Le Coste di Monforte winery. “In Italy there are many places where they use natural agriculture, like Abruzzo and Friuli, especially Abruzzo, the region in the center of Italy.”

Le Coste di Monforte is one of the few Italian wineries that adds sulfites to the wine it exports to the U.S.

“Sulfites maintain the freshness, the flavor,” she said.

Added Alessandra Aldieri of Villadoria winery: “American wines use a lot of sulfites. In Italy we have a really right way to produce wine. In Piedmont, we have only real DOCG appellation. That means we are at the top. We can not add anything. Sulfites are a natural element in the wine. But we try to get the best from the grape without any additions because in Italy we have limits.”

In Piedmont, the Consorzio is the agency that enforces the DOCG regulations. Before any wine is bottled, the Consorzio samples it and wineries must wait three weeks to a month for approval.

Sulfite levels are crucial.

“All wines have sulfites,” sommelier Guido Pace said, “but here there are less than American wines.”

Dr. Wine doesn’t agree

I’m no longer sure.

While American wines have a higher sulfite ceiling, no winery would dare reach it. According to the wine blog Wine Folly, a good U.S. red wine has about 50 milligrams of sulfites per liter. A good white has about 100.

While no comparative study has been done on the two countries, Italian wines generally contain between 50-75 milligrams in red and 100 in white. Some red wines have as few as 25.

See a difference? I don’t. Neither does Daniele Cernilli. He’s known in Italy as Dr. Wine and is arguably the utmost Italian wine authority. He just published his most recent Italian wine bible, Essential Guide to Italian Wines 2025.

“I don’t believe that there is such a phenomenon that there are more headaches in America than in Italy,” Cernilli told me. “The sulfites are not related to the headaches.”

Our bodies also produce about 700 milligrams of sulfites a day to metabolize the protein in our food. Cernilli said other factors are involved such as acidity, crucial in a wine’s flavor; biogenic amines, naturally occurring nitrogenous compounds found in the fermentation process; and histamines, a naturally occurring compound. 

“This crusade against sulfites that are probably more in America is a joke,” he said.

A top academic weighs in

Viticulture and enology is the study of wine production, and the University of California at Davis has the top department in the world. Students from around the world – even Italy – come to UCD to become experts in the scientific aspects of wine.

Professor emeritus Andrew Waterhouse has been at UCD for 34 years. Like Cernilli across the pond, Waterhouse scoffs at the sulfite theory but he’s well aware of the debate.

“I’ve heard this as well over the years from different people.” he told me. “But I have to say, after a while, it’s not sulfites. The practice of sulfites is universal. For many people on vacation, that’s an issue. But it’s not sulfites.”

True, sulfites are in a lot of other foods. Ever eaten dried fruit? Did you get a headache? Dried fruit is packed with sulfites. That’s one reason dried fruit has the shelf life of Ivory soap.

Italian winemakers also say the Italian peninsula is lined with volcanoes. Fortunately, most are dormant. But they say the volcanic soil provides a more natural growing process for the grapes.

“I’ve never heard that,” Waterhouse said. “They’re marketing their wine.The idea that volcanic soil is more natural … I don’t know how they define natural. That’s crazy. What makes soil natural? Come on. Give me a definition.”

He did offer one advantage Italian wine has over American wine in the headache department. California boasts arguably the best weather in the world. It is sunny nearly every day. Italy does have winters, particularly in the northern region of Piedmont which regularly gets snow.

He said sunshine induces the formation of the chemical compound Quercetin in the grape. When the Quercetin is extracted in the wine, it converts into Quercetin Glucuronide in the liver. That inhibits the breakdown of alcohol and causes headaches.

“In California, with better wine at least, we are very careful to get enough sun exposure on the grapes,” he said. “That increases the level of this compound. Possibly in Europe they don’t let as much sun on the grapes.”

My thoughts

I have had headaches in Italy but they’re rare. I sometimes get them if I mix with white and red. I sometimes get them if I start with a Prosecco or finish with a Grappa. One restaurant had a horrific table wine that left me with a screaming migraine three hours later. But if I stick to one type of wine I usually survive.

I have two theories that involve as much scientific evidence as 11 years of drinking in Italy can provide:

One, people get more headaches drinking wine in the U.S. because American table wine is ghastly. It’s often Merlot, which many American wineries turn into a vile swill sold off from the worst grapes in the harvest. The table wine I’m given in Rome is usually Montepulciano d’Abruzzo for red and Malvasia for white.

Both are produced near Rome. Both are solid wines that wineries take great care in producing.

Two, Americans in the U.S. often drink wine without food. Or, if they do eat, it’s food with more preservatives than in Italy. Unless I’m visiting an enoteca with friends, I rarely drink wine without food. I always have it paired with a proper dish which studies show is usually much healthier than what Americans eat.

Food helps soak up the alcohol. Water helps dilute it. At any restaurant I always order a bottle of natural water to drink between sips of wine.

I couldn’t at the degustazione. I came straight home and went to bed. I slept well, and I woke up better.

No headache. That’s all I need to know.