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Dongfang You, Dianjianyi Sun, Ziyu Zhao | Chinese Medical Journal | (2024)
Primary Link Pubmed DOI Openalex Full text (OA)

Abstract

BACKGROUND: Spicy food consumption has been reported to be inversely associated with mortality from multiple diseases. However, the effect of spicy food intake on the incidence of vascular diseases in the Chinese population remains unclear. This study was conducted to explore this association. METHODS: This study was performed using the large-scale China Kadoorie Biobank (CKB) prospective cohort of 486,335 participants. The primary outcomes were vascular disease, ischemic heart disease (IHD), major coronary events (MCEs), cerebrovascular disease, stroke, and non-stroke cerebrovascular disease. A Cox proportional hazards regression model was used to assess the association between spicy food consumption and incident vascular diseases. Subgroup analysis was also performed to evaluate the heterogeneity of the association between spicy food consumption and the risk of vascular disease stratified by several basic characteristics. In addition, the joint effects of spicy food consumption and the healthy lifestyle score on the risk of vascular disease were also evaluated, and sensitivity analyses were performed to assess the reliability of the association results. RESULTS: During a median follow-up time of 12.1 years, a total of 136,125 patients with vascular disease, 46,689 patients with IHD, 10,097 patients with MCEs, 80,114 patients with cerebrovascular disease, 56,726 patients with stroke, and 40,098 patients with non-stroke cerebrovascular disease were identified. Participants who consumed spicy food 1-2 days/week (hazard ratio [HR] = 0.95, 95% confidence interval [95% CI] = [0.93, 0.97], P <0.001), 3-5 days/week (HR = 0.96, 95% CI = [0.94, 0.99], P = 0.003), and 6-7 days/week (HR = 0.97, 95% CI = [0.95, 0.99], P = 0.002) had a significantly lower risk of vascular disease than those who consumed spicy food less than once a week ( Ptrend <0.001), especially in those who were younger and living in rural areas. Notably, the disease-based subgroup analysis indicated that the inverse associations remained in IHD ( Ptrend = 0.011) and MCEs ( Ptrend = 0.002) risk. Intriguingly, there was an interaction effect between spicy food consumption and the healthy lifestyle score on the risk of IHD ( Pinteraction = 0.037). CONCLUSIONS: Our findings support an inverse association between spicy food consumption and vascular disease in the Chinese population, which may provide additional dietary guidance for the prevention of vascular diseases.

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Plain English Takeaway

People in China who eat spicy food regularly are less likely to develop heart and blood vessel diseases, especially if they are younger or live in rural areas.

Study Aim

The main goal of this study was to find out if eating spicy food is linked to a lower risk of developing vascular diseases (problems with blood vessels) in the Chinese population. The researchers wanted to see if this connection held true for specific conditions like ischemic heart disease (when the heart gets less blood), major coronary events (serious heart problems), and different types of stroke. They also aimed to check if a healthy lifestyle changes this relationship. Simply put: The study wanted to see if eating spicy food helps prevent heart and blood vessel diseases in China.

Study Design

This research used data from the China Kadoorie Biobank, a large ongoing study that follows over 486,000 adults from 10 regions in China. Participants were aged 30–79 years and had no history of cancer or vascular disease at the start. The study tracked how often people ate spicy food, along with their health and lifestyle habits, for a median of 12.1 years. Researchers used a statistical method called Cox proportional hazards regression to compare the risk of vascular diseases among people with different spicy food eating habits, while adjusting for factors like age, sex, income, and diet. They also looked at how a healthy lifestyle score (based on smoking, drinking, exercise, weight, and diet) affected the results. Simply put: The study followed hundreds of thousands of Chinese adults for over a decade to see if those who ate spicy food got fewer heart and blood vessel diseases.

Findings

The study reveals that people who ate spicy food at least once a week had a lower risk of developing vascular diseases compared to those who rarely ate spicy food. This protective effect was especially strong for ischemic heart disease and major coronary events, but not for all types of stroke. The benefit was more noticeable in younger people and those living in rural areas. The research also demonstrates that having a healthy lifestyle, along with eating spicy food, further reduced the risk of some vascular diseases. The results remained consistent even after adjusting for other health factors. The authors suggest that these findings could help guide dietary advice for preventing vascular diseases in China, but they recommend more research to understand exactly how spicy food might protect the heart and blood vessels. Simply put: People who eat spicy food regularly are less likely to get heart and blood vessel diseases, especially if they also have healthy habits.

Referenced In

Lee Johnson
14 days ago
Health, Fitness, and Nutrition

The Surprising Benefits of Eating Spicy Food

Capsaicin is the molecule that gives chilli peppers their distinctive, spicy kick; a potent irritant found in the fleshy, seed-holding parts of peppers and any dish that has you reaching for the milk after a few bites. But growing evidence links it to reduced all-cause mortality and protection from many specific vascular conditions.

The 2025 Chinese Cohort Study

One study in particular is making the rounds on Reddit and some news outlets: a huge cohort study following 500k adults living in China.

The researchers compared people who eat spicy food less than once a week with people who eat it more often, following up with them for an average of 12 years. They looked for differences in rates of vascular disease, major coronary events, ischemic heart disease, cerebrovascular disease, stroke, and non-stroke cerebrovascular disease.

They rated them on how healthy their lifestyles are, and adjusted some models for relevant factors like BMI, drinking and smoking status.

They found some statistically significant benefits to eating more spicy foods:

  • Reduced rates of vascular disease (3 to 5% risk reduction)

  • Lower risk of ischemic heart disease (2 to 5% risk reduction)

  • Lower risk of major coronary events (4 to 13% risk reduction)

  • No significant differences for other conditions

Benefits were more pronounced in people with better lifestyle scores (from better diets, less smoking, less drinking and more exercise), and were confined to people who ate mildly spicy or moderately spicy food (rather than very spicy).

Other Studies with Similar Results

This wasn’t the first study on the topic, either. Other research on 16k American adults found a 13% reduction in all-cause mortality, and a meta-analysis covering studies from four different countries broadly agreed, finding a 12% risk reduction.

Why Capsaicin Might Be Helpful

The research from the Chinese study proposed three possible mechanisms for this benefit:

  1. Capsaicin’s effect on messenger RNA and some specific cytochrome P450 enzymes (CYP7A1) results in lower cholesterol.

  2. Its effect on TRPV1 receptors (known as vanniloid or capsaicin receptors) helps regulate vascular tone.

  3. It reduces the level of an oxidative stress marker (MDA) and boosts superoxide dismutase, increasing the antioxidant capacity of blood vessels.

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