"Starve a fever and feed a cold": Feeding and anorexia may be adaptive behavioral modulators of autonomic and T helper balance

Kimberly A. Bazar, A. Joon Yun, Patrick Y. Lee

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Anorexia is a common symptom accompanying infections, but the teleology of the phenomenon remains unexplained. We hypothesize that anorexia may represent a prehistoric behavioral adaptation to fight infection by maintaining T helper (Th)2 bias, which is particularly vital in fighting bacterial pathogens. Specifically, we propose that anorexia may avert the reduction of Th 2/Th1 ratio by preventing feeding-induced neurohormonal and vagal output from the gut. Emerging evidence suggests that the vagal and neurohormonal output of the gut during feeding promotes Th1 function, which is desirable in fighting viral infections. Since fever may be an adaptation to fight bacteria and "colds" are generally viral in origin, the adage "starve a fever and feed a cold" may reflect a sensible behavioral strategy to tilt autonomic and Th balance in directions that are optimal for fighting the particular type of infection. The ability to modulate T helper balance through the neurohormonal and autonomic axis by adjusting food intake may be the mechanism behind other unexplained clinical observations such as the improved outcomes of ICU patients after enteric versus parenteric feedings. Compared to the prehistoric period when bacterial infection was commonplace, the anorexic response may be less adaptive today when viruses and cancers have become common triggers of anorexia. By promoting host anorexia, cachexia, and insomnia, cancers and viruses can deter behaviors such as digestion and sleep that would raise vagal and Th1 activity against tumors and viruses. Hydration and sleep, unexplained but widely accepted recommendations for flu patients, may also work by promoting vagal and Th 1 functions. Modulating feeding, hydration, and sleep may prove beneficial in treating other conditions associated with abnormal autonomic and Th balance.

Original languageEnglish (US)
Pages (from-to)1080-1084
Number of pages5
JournalMedical Hypotheses
Issue number6
StatePublished - 2005
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine


Dive into the research topics of '"Starve a fever and feed a cold": Feeding and anorexia may be adaptive behavioral modulators of autonomic and T helper balance'. Together they form a unique fingerprint.

Cite this