“The epidemiological evidence on chillies’ benefit on health is scarce, mainly based on popular folklore; only two prospective studies were available so far,” Marialaura Bonaccio, Ph.D., from the Istituto Neurologico Mediterraneo Neuromed, Pozzilli, who adds that this study represents “the first time that consumption of chilli pepper has been extensively analyzed within a Mediterranean population. We found chilli pepper to be beneficial independently from Mediterranean diet.“
This study involved a longitudinal analysis of 22,811 participants enrolled in the Moli-sani Study from 2005-2010; and using the European Prospective Investigation into Cancer Food Frequency Questionnaire the participant chilli pepper consumption was categorized as being either none/rare, up to 2 times/week, 2-4 times/week, and over 4 times/week.
1236 people died during a mean follow-up of 8.2 years, which included 444 from cardiovascular disease, 258 from ischemic heart disease/cerebrovascular disease, 482 from cancer, and 310 from other causes.
Compared to those who rarely or never ate chilli peppers those who ate them more than 4 times per week had a 23% lower risk of all-cause mortality and a 34% lower risk of CVD mortality, and no reduction of risk of death was found, in the fully adjusted model. The regular consumption of chilli peppers was also inversely associated with death from ischemic heart disease and cerebrovascular disease compared with no/low consumption of chilli peppers.
The observed protection from mortality risk was found to be independent of the type of diet that the participants followed, and the apparent protective effect seemed stronger in those without hypertension. Bonaccio explained that “In other words, someone can follow the healthy Mediterranean diet, someone else can eat less healthily, but for all of them chili pepper has a protective effect.”
“We tested several mechanisms possibly accounting for the associations between chilies and health outcomes; however, established biomarkers (such as inflammation, blood pressure, etc) did not turn out to be on the pathway. More studies are needed to understand the mechanisms through which chili pepper (and its major constituent, capsaicin) are likely to provide health advantages,” concluded Bonaccio.
The information in the study was noted not to distinguish between the type of heat of the consumed chilli peppers and risk reduction, and due to the nature of observational studies causality can only be suggested and residual confounding or confounding by unmeasured factors are not able to be fully ruled out. But despite the limitations, the researchers suggest that their findings support those of two earlier studies from non-Mediterranean cohorts.
Previously a large study found that the regular consumption of spicy foods lowered the risk of mortality by 14% and ischemic heart disease death by 22%. Additionally, recent data from the US National Health and Nutrition Examination Survey found that the regular consumption of hot red chilli pepper was associated with a 13% reduction in total mortality risk.
“Should we all begin taking tablets of capsaicin and dousing our food with hot sauce? The history of food supplements suggests that we should wait for randomized trials,” writes J. David Spence, MD, professor of neurology and clinical pharmacology and director of the Stroke Prevention and Atherosclerosis Research Centre in a linked editorial.
“What appears to be most beneficial is the eating pattern, rather than any one food,” says Spence. “The Mediterranean diet, which is high in whole grains, fruits, vegetables, and legumes, is high in beneficial phytochemicals. Because it is a ‘mainly vegetarian diet,’ the Mediterranean diet is also low in cholesterol and saturated fat. . . . Thus, adopting the Cretan Mediterranean diet would be much more likely to reduce cardiovascular risk than adding Tabasco sauce (McIlhenny Co., Avery Island, Louisiana) to the unhealthy American diet.”
