Do 'Garam' and 'Thandi' Foods Cause Disease?

What does it mean?

"Anda garam hai, bukhar me nahin dena" — eggs are "hot," don't give them in fever. "Thandi cheez se zukam ho jayega" — cold things will give you a cold. "Dahi thandi hai, khansi me nahin deni." Almost every Pakistani grew up hearing these rules: chicken, meat, eggs, mangoes and masoor daal are "garam"; rice, yogurt, bananas and oranges are "thandi." The system feels like ancestral wisdom — and we describe it respectfully, because it was held sincerely for generations. But sincerity isn't evidence. In a 1999 Aga Khan University survey (small — just 60 physicians), even 10% of the physicians surveyed believed in hot-cold food concepts, and 70–80% of mothers classified everyday foods as hot or cold — most without being sure what "hot" or "cold" even meant. Nizami & Bhutta, JPMA 1999

Common causes

• 1Your body temperature doesn't come from your food's "temperature."
  Your body temperature doesn't come from your food's "temperature." A Pakistani physician writing in *The News* put it plainly: "eating too many eggs will not produce a fever… And eating cucumbers will not bring the body temperature down during a fever." Fever comes from infections and inflammation — the body's thermostat is reset by the immune system, not by lunch. The News
• 2Colds come from viruses — over 200 of them.
  Colds come from viruses — over 200 of them. The CDC states that more than 200 respiratory viruses can cause colds, with rhinoviruses the most frequent cause — spread through droplets and touch, not through cold drinks, ice cream, or "thandi" foods. Cold air itself doesn't give you a cold — viruses do; winter crowding spreads them. (Some lab research suggests cold air in the nose may slightly weaken local defences — reviewed by Eccles in *Rhinology* — but the infection still comes from a virus, not from the weather.) CDC · Rhinology review
• 3Eggs don't cause fever or "heat."
  Eggs don't cause fever or "heat." Pakistani press reviews of the evidence conclude there is "no scientific evidence suggesting that eating eggs in hot weather negatively affects health," and no link between egg consumption and heat-related illness. The "heaty" label comes from Unani/Ayurvedic tradition — centuries-old observation, not testing. ThePenPK · Minute Mirror
• 4A true food allergy is different from "garam."
  A true food allergy is different from "garam." Allergy causes rash, swelling, or breathing trouble soon after eating, and needs a doctor's diagnosis. That is not the same as the folk "heat" label — don't confuse the two.
• 5The real harm: protein is withheld from sick children.
  The real harm: protein is withheld from sick children. A systematic review of South Asian feeding practices (published in a peer-reviewed journal) found caregivers routinely avoid "hot" or "cold" foods for sick children: eggs and meat avoided during diarrhea in 25% to over 95% of cases across studies; curd/buttermilk avoided during pneumonia in 76–93%; rice and curd avoided during fever. An Aga Khan University survey of 400 women at AKU Hospital (published in the *Journal of Ayub Medical College*, 2003) found the same pattern in beliefs: 65% said "heavy food" should be restricted during diarrhea and 66% said "cold food" during cold/cough — mostly on relatives' advice. Systematic review, PMC · AKU women's-beliefs survey, JAMC 2003
• 6WHO says the opposite: feed through illness.
  WHO says the opposite: feed through illness. WHO's child-illness guidance instructs caregivers to continue feeding during illness — breastfeed more often, offer soft favorite foods frequently in small amounts — and to increase food intake during convalescence (about one extra meal a day for two weeks after illness) to make up for weight loss. Withholding food fights the body's recovery. WHO IMCI chart booklet (2014) · WHO Global Strategy, via PMC review

When to worry

Prevention & practical tips

• ✓Feed sick children normally — including protein. During fever, cold, or diarrhea: continue breastfeeding, and offer the child's usual foods — eggs, meat, daal, yogurt, rice — in small, frequent, appetizing servings. Appetite dips during illness; patience and small portions work better than food bans.
• ✓Push fluids, not restrictions. More water, soups, ORS during diarrhea — give ORS after every loose stool. For diarrhea, also ask your doctor or Lady Health Worker about zinc supplements for 10–14 days: WHO and UNICEF recommend zinc alongside ORS — it shortens the illness and reduces recurrence. Restricting food never treats the infection; treating the cause does. WHO/UNICEF zinc guidance · WHO EMRO
• ✓Keep the harmless traditions, drop the harmful ones. Enjoying yogurt in summer because it's refreshing is fine. Withholding eggs from a feverish child because they're "garam" is not — that's where tradition costs nutrition.
• ✓Treat the disease, not the food. Fever needs its cause found (infection, and appropriate care) — not a diet of only "thandi" foods. A child with pneumonia needs antibiotics and care, not curd avoidance.
• ✓Ask your doctor or Lady Health Worker what to feed during your child's specific illness — you'll get an answer based on the illness, not the food's "temperature."

FAQs

References

• thenews.com.pk: https://www.thenews.com.pk/tns/amp/564552
• cdc.gov: https://www.cdc.gov/common-cold/about/
• rhinologyjournal.com: https://www.rhinologyjournal.com/Rhinology_issues/109_Eccles.pdf
• thepenpk.com: https://thepenpk.com/hot-weather-cold-facts-can-you-eat-eggs-in-summer/
• minutemirror.com.pk: https://minutemirror.com.pk/eggs-in-hot-weather-harmful-or-healthy-410646/
• pmc.ncbi.nlm.nih.gov: https://pmc.ncbi.nlm.nih.gov/articles/PMC5067777/
• jamc.ayubmed.edu.pk: https://www.jamc.ayubmed.edu.pk/index.php/jamc/article/download/3930/2153
• scribd.com: https://www.scribd.com/document/512373991/2014-IMCI