{"id":804,"date":"2015-08-13T14:56:05","date_gmt":"2015-08-13T14:56:05","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=804"},"modified":"2017-08-21T11:41:48","modified_gmt":"2017-08-21T11:41:48","slug":"primary-care-corner-with-geoffrey-modest-md-spicy-foods-and-mortality","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2015\/08\/13\/primary-care-corner-with-geoffrey-modest-md-spicy-foods-and-mortality\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: Spicy Foods and Mortality"},"content":{"rendered":"<p><strong>By Dr. Geoffrey Modest<\/strong><\/p>\n<p>A large epidemiologic study from 10 diverse areas in China looked at total and cause specific mortality in those eating spicy foods (see\u00a0BMJ 2015;351:h3942).<\/p>\n<p>Background:<\/p>\n<ul>\n<li>Spices (esp capsaicin) have antibacterial activity and modify the intestinal microbiome (no clear data on exactly how the microbiome is altered, or to what effect)<\/li>\n<li>Capsaicin has been studied in small populations or experimental conditions, finding it has anti-obesity, antioxidant, anti-inflammatory, anti-cancer,\u00a0antihypertensive effects, and improves glucose homeostasis.\u200b<\/li>\n<li>Ingestion of hot\u00a0red pepper decreases the appetite of both Asian and white people (?decreasing obesity-related morbidity\/mortality<img loading=\"lazy\" decoding=\"async\" class=\"  wp-image-805 alignright\" src=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/files\/2015\/08\/chili-61898_640.jpg\" alt=\"chili-61898_640\" width=\"273\" height=\"182\" \/>)<\/li>\n<li>A large ecological study has found higher spice consumption is associated with lower cancer incidence (these are rough-and-dirty studies which just show that in areas of high spice consumption there is less cancer, without the specifics showing individuals who eat spice have less cancer)<\/li>\n<\/ul>\n<p>Details of this\u00a0study:<\/p>\n<ul>\n<li>199,293 men and 288,082 women aged 30-79, without known cancer, heart disease or stroke at baseline, had an initial food questionnaire including consumption frequency of spicy foods, then followed 7.2 years (3.5M person-years of followup) between 2004-2013.<\/li>\n<li>mean age 50, BMI 23, 5% diabetic, 35% hypertensive<\/li>\n<li>11,820 men and 8404 women died during this time period<\/li>\n<li>those who consumed more spicy foods were from more rural areas (48% of low consumers, 82% high),\u00a0more likely to smoke (57% vs 70% for men and 1.8 vs 3.0% for women)\u00a0and drink alcohol (27% vs 47%\u00a0men and 1.2 vs 3.8% women), and more frequently consumed red meat, vegetables and fruits (though not huge differences in these numbers). \u00a0Most common spice was fresh or dried chili peppers<\/li>\n<li>Absolute mortality rates (in deaths\/1000 person years):\n<ul>\n<li>\u200b6.1 for those eating spicy foods &lt;1x\/week<\/li>\n<li>4 for those eating spicy foods 1-2x\/week, adjusted hazard\u00a0ratio compared to those &lt;1x\/week=0.90 (0.84-.96)<\/li>\n<li>3\u00a0for those eating spicy foods 3-5x\/week,\u00a0adjusted hazard\u00a0ratio compared to those &lt;1x\/week=0.86 (0.80-.92)<\/li>\n<li>8\u00a0for those eating spicy foods 6-7x\/week,\u00a0adjusted hazard\u00a0ratio compared to those &lt;1x\/week=0.86 (0.82-.90) &#8212; ie, a 14% relative risk reduction<\/li>\n<li>The above numbers adjusted for underlying\u00a0hepatitis, smoking, prevalent diabetes or hypertension, red meat or vege consumption, alcohol, SES, BMI, physical activity, family history<\/li>\n<li>Overall, women did better than men, with a 20% risk reduction,\u00a0vs 10% for men<\/li>\n<\/ul>\n<\/li>\n<li>The relationship between eating spicy food was stronger in those not consuming alcohol (p=0.033 for interaction). somewhat stronger benefit if eating fresh vs dried chili peppers<\/li>\n<li>Inverse relations also noted for deaths due to cancer, ischemic heart disease, and respiratory diseases<\/li>\n<\/ul>\n<p>So, a couple of comments:<\/p>\n<ul>\n<li>This is a large epidemiologic study, subject to the usual caveats: concerns about\u00a0adequacy of consumption\u00a0data (only one initial dietary assessment, and self-reported;\u00a0also those with high chili consumption likely used other unmeasured spices and ingredients) and\u00a0adequacy of outcome data (quality of death reports). Also, hard to separate the non-measured differences between those living in more rural than more urban settings (and the difference in spicy food consumption was pretty striking in the different settings). Though it is notable that the high spicy food consumers did have some\u00a0not-so-great lifestyle parameters (smoking alcohol, red meat). And, perhaps most importantly,\u00a0epidemiologic studies preclude determining\u00a0that a\u00a0relationship is causal<\/li>\n<li>In this study, there was a threshold: when people consumed spicy foods 1-2x\/week, they achieved almost all of the benefit<\/li>\n<li>But my real bottom line\u00a0is that I should now add fresh chilies to my dark chocolate snacks.<\/li>\n<\/ul>\n<p>[Here are a couple of the blogs on chocolate:\u00a0<a href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2015\/01\/27\/primary-care-corner-with-geoffrey-modest-md-chocolate-and-memory-this-time-reviewing-the-reference\/\">https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2015\/01\/27\/primary-care-corner-with-geoffrey-modest-md-chocolate-and-memory-this-time-reviewing-the-reference\/<\/a> and\u00a0<a href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/09\/29\/primary-care-corner-with-geoffrey-modest-md-dark-chocolate-helps-with-peripheral-arterial-disease-pad\/\">https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2014\/09\/29\/primary-care-corner-with-geoffrey-modest-md-dark-chocolate-helps-with-peripheral-arterial-disease-pad\/<\/a>\u00a0]\u200b<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Primary Care Corner with Geoffrey Modest MD: Spicy Foods and Mortality  [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2015\/08\/13\/primary-care-corner-with-geoffrey-modest-md-spicy-foods-and-mortality\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":148,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[14283],"tags":[],"class_list":["post-804","post","type-post","status-publish","format-standard","hentry","category-archive"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/804","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/users\/148"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/comments?post=804"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/posts\/804\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/media?parent=804"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/categories?post=804"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/wp-json\/wp\/v2\/tags?post=804"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}