Heat is not a flavor; it is pain. Capsaicin, the molecule in chili, opens a detector on pain nerves whose job is to report scalding (TRPV1), so your brain receives a report that says this spot is being burned. Your mouth is actually completely unharmed.
Taste buds recognize five things: sweet, salty, sour, bitter, and umami. Heat is not on the list, because it never travels the taste pathway at all. Chili makes you sweat, tear up, and flush because your body is running a cooling response to being scalded; you build tolerance because this alarm pathway gets duller after being set off again and again. Bell pepper and chili are the same species; breeding simply stripped out almost all the capsaicin, which is why bell pepper is not hot.
Chili itself does not burn your stomach. But vomiting blood, black stools, or difficulty swallowing are not something spicy food can explain — get medical care right away.
A CLOSER LOOK
Capsaicin opens a pain-alarm channel
Molecule and channel are functional symbols; the final node is a heat signal, not rising mouth temperature or an actual burn.
1TRPV1 opens
Capsaicin activates a channel that also senses heat and acid, allowing calcium and sodium into the nerve ending.
2It follows the pain pathway
Nerves send an alarm that feels hot, through a route different from the taste buds' five tastes.
Illustration for understanding; not to scale. Saved figures include explanations and sources.
Mechanism · How capsaicin fakes a burn
The molecule behind the rush is capsaicin. It is fat-loving, so it slips into the membrane of a pain-nerve ending and parks on a receptor there — a channel called TRPV1.
The crucial part is that TRPV1's day job has nothing to do with taste. It is a detector, normally reporting two things:
Heat: temperatures above roughly 43°CAcid: the protons released when tissue is injured or inflamed Capsaicin happens to be shaped to open that same lock (Caterina 1997). The channel opens, calcium and sodium pour into the nerve, and the nerve fires a burst of signals to the brain. The brain reads one message: this spot is being burned.
So spicy is your brain processing a burn alarm. That is also why chili makes you sweat, tear up, and flush — your body is running a full cooling response to being scalded. The response is entirely real; only the alarm is false. Your mouth is completely unharmed.
This mechanism matters. David Julius used capsaicin as the key to fish TRPV1 out — work that won the 2021 Nobel Prize in Physiology or Medicine.
One last boundary: bell pepper and chili are the same species (Capsicum annuum). Breeding simply took another road and stripped the capsaicin out. Bell pepper is not mild — it never carried the key at all. What else bell pepper offers: see Bell Pepper.
In practice · Where the heat hides; reading vitamin C
De-seeding doesn't help
People carefully scrape out the seeds, assuming that's where the heat lives. The seeds themselves produce no capsaicin. The real factory is the white pith the seeds attach to — the placenta. In a metabolomic analysis of Tabasco peppers, the placenta was the tissue richest in capsaicinoids; the trace found on seeds most likely rubbed off the placenta (Cervantes-Hernández 2019).
So to cut the heat, scrape the white pith, not the seeds.
How heat is measured
The Scoville scale (SHU) began as human tasting: dilute a pepper extract until nobody can detect heat, and the dilution factor is the score. Today high-performance liquid chromatography (HPLC) measures capsaicin content directly, so taster fatigue and tolerance can't skew the number.
A nutrition number that's easy to misread
Raw red chili holds about 144 mg of vitamin C per 100 g, around 40 kcal, and is nearly 90% water (USDA FoodData Central). That vitamin C figure beats red bell pepper (~128 mg/100 g), which is why chili sometimes gets called a vitamin C champion.
Here's the trap: you cannot eat 100 g of chili in a sitting. Eat that much and chili has stopped being a nutrition question. The few grams that go into a dish contribute a negligible amount of vitamin C.
This is the classic way 'per 100 g' figures mislead: high concentration is not high intake. To judge whether a food actually supplies a nutrient, ask how much of it you can realistically eat. For vitamin C, that means foods you can eat by the bowl — bell pepper, broccoli, citrus.
When your mouth is on fire, gulping water barely helps and milk does. Capsaicin is fat-loving and almost insoluble in water, so water cannot wash it off.
The popular explanation is that the fat in milk dissolves the capsaicin. But in an experiment that put skim milk and whole milk side by side, the two worked equally well — so the active part is more likely milk's protein (mainly casein), not its fat. Colder milk is better, because low temperature itself damps the burn.
Evidence · Skim and whole milk worked equally well
Why water fails
A big gulp does not carry capsaicin away — it just spreads it more evenly around your mouth. Ice water feels better, but that is cold itself damping the burn: painkilling, not removal. Once you swallow, capsaicin is still parked on the same receptor (TRPV1, the detector that reports heat as a scald), and the fire burns on.
Why milk works — and an honest surprise
Nolden 2019 lined up seven beverages: skim milk, whole milk, seltzer, cola, non-alcoholic beer, a fruit drink, and room-temperature water. Two results:
Milk clearly beat water — as expected.Skim and whole milk worked equally well — not as expected. If fat were dissolving the capsaicin, whole milk should have crushed skim. It did not. So the authors infer the active agent is more likely milk protein, especially casein, which can wrap capsaicin molecules and lift them off the receptor. Fat is not the lead.
Carbonated drinks came last
Seltzer and cola barely beat plain water. One possible reason: carbonation itself irritates another channel (TRPA1), creating its own tingle that works against putting the fire out.
What to actually do
Drink milk, or eat yogurt — protein is the keyColder is better: low temperature damps the alarm on its ownIce water alone is temporary numbing; do not count on it What is worth keeping is not just the action (drink milk) but the surprise: a perfect-sounding explanation (fat dissolves it) was overturned by one simple comparison (skim vs whole). A mechanism making sense does not make it true.
Chapter 3
Tolerance is real — and it's how a painkiller works
Building tolerance is real. And it is not that you got braver — your nerves genuinely got duller.
The alarm pathway behind the detector that reports heat as a scald (TRPV1) desensitizes after being set off again and again: the same amount of capsaicin produces a weaker signal. In one human trial, volunteers rinsed with low-concentration capsaicin every day; after two weeks the burn had clearly dropped, and other mouth-burning substances felt duller too. Exactly how the dulling happens, researchers have not yet found out.
Turn the same road around and you get the capsaicin patch: high-concentration capsaicin makes pain-nerve endings in the skin fire hard and then go temporarily silent, so pain signaling weakens. It is used for some kinds of nerve pain.
Evidence · Desensitization is real; the cause is unknown
Human evidence
Nolden 2024 had volunteers rinse with low-concentration capsaicin twice daily for 14 days (~28 exposures). Results:
Burn dropped clearly (about 24% in the second study)And it transferred across substances: the burn from cinnamaldehyde (the source of cinnamon's bite) and from ethanol fell too That second point is interesting — desensitization did not stop at one molecule, suggesting what got turned down is the alarm pathway itself, not just one lock.
An honest gap
In the same work, the researchers expected desensitization to come from TRPV1 gene expression dropping. They biopsied fungiform papillae on the tongue to check — and found no decrease in mRNA.
So: desensitization definitely happens, but how it happens is still unknown. This is a common state in science: the phenomenon is solid, the explanation is still owed.
Clinical · How much a capsaicin patch helps
If repeated activation dulls pain nerves, you can build a painkiller out of it. That is exactly how capsaicin patches and creams work: sustained high-concentration capsaicin makes pain-nerve endings in the skin fire hard, then go functionally silent — the endings even reversibly retract, so pain signaling weakens (Anand and Bley 2011).
A Cochrane review (Derry 2017) pooled 8 randomized trials and 2,488 people. The high-concentration (8%) capsaicin patch showed some benefit for post-herpetic neuralgia (nerve pain after shingles) and HIV-related nerve pain, but the authors judged the results susceptible to publication bias (studies with good results are more likely to get published) and gave only a weak, second-line recommendation. Brief pain where the patch is applied is common.
It is a real thing, not a miracle. The topical capsaicin mentioned for knee pain and low back pain runs down this same road — see Knee Pain and Low Back Pain.
Chapter 4
Chili for weight loss? Say the honest number
Chili really does make you burn a bit more energy, but that bit is far too small to matter for weight loss.
After capsaicin opens TRPV1 on pain nerves, it also nudges up the sympathetic nervous system (the part of the autonomic nervous system that speeds the body up and makes heat), and the extra heat production is real. A review that pooled human studies did the arithmetic: at a heat level people will actually eat, it comes to about 10 kcal a day — spread over body weight, it may not show up on the scale even after several years. Taking capsaicinoids before a meal leads people to eat a little less at that meal, but results vary a lot between studies.
If you love chili, eat it; it makes food taste good, and that reason is good enough. Just do not treat it as a weight-loss tool.
Numbers · A real mechanism, a negligible amount
Ludy 2012 (*Chemical Senses*) ran a systematic review plus of human studies, and the conclusion is sober:
Capsaicin had no overall significant effect on energy expenditure (SMD 0.11, 95% -0.06 to 0.29)A rise showed up only at high doses (≥135 mg capsaicin) — a heat level far past what people will actually eat The authors also did the arithmetic: at a hedonically acceptable dose — a heat level people actually enjoy — you might create a 10 kcal/day deficit, which may not show up on the scale even after several years.
One other line looks slightly better. Whiting 2014 (*Appetite*) pooled energy-intake data and found capsaicinoids before a meal cut intake at that meal by about 74 kcal (309.9 kJ). The authors likewise stress high variability between studies and urge caution.
'Chili burns fat' is not fabricated — the mechanism exists. Its problem is inflating a real mechanism many times over. This is the most common and hardest-to-catch marketing move: the first half of the sentence is true, so your guard drops, and what goes missing is the second half — how big is it.
One line from Ludy is worth copying down: capsaicin is a food ingredient, and cannot be expected to exert pharmacologic effects.
One layer deeper: even if you did burn a few dozen extra kcal daily, the body will not obediently convert them into lost fat — push the expenditure side up and it compensates elsewhere. For that counter-mechanism, see Adaptive Thermogenesis.
If you love chili, eat chili. It makes food taste good, and that reason is already good enough. Just do not treat it as a weight-loss tool.
Chapter 5
Does spicy food harm the stomach
Chili does not burn ulcers into your stomach. On endoscopy, what actually damaged the stomach lining was aspirin-type painkillers, and the main causes of stomach ulcers are H. pylori infection and long-term use of those drugs — not chili. But does not cause disease is not the same as does not make you feel bad, and the two have to be kept apart.
In people with gastroesophageal reflux (stomach acid flowing back up into the esophagus), chili makes heartburn arrive sooner: it does not make the stomach produce more acid; it makes the alarm nerves more sensitive. Hemorrhoids and anal fissures split the same way: in trials, chili did not worsen hemorrhoid symptoms, but it did worsen the pain of acute anal fissures.
If you have vomiting blood, black stools, unexplained weight loss, difficulty swallowing, or persistent severe abdominal pain, see a doctor immediately. None of these can be explained by chili.
Evidence · No ulcers from chili, but earlier heartburn
The real culprits behind gastric and duodenal ulcers were identified long ago, and there are two:
Helicobacter pylori (H. pylori): a bacterium that settles in the stomach lining and strips away the protective mucus layerLong-term painkillers: ibuprofen, aspirin, and that family The most direct evidence comes from Graham 1988 (JAMA). Twelve volunteers ate several different meals, then went straight to endoscopy to view the mucosa:
Spicy meal containing 30 g of jalapeño peppers: virtually no mucosal damageBland meal plus 1,950 mg of aspirin: multiple erosions On camera, the thing damaging the stomach was the drug, not the chili.
But reflux is another matter
People with gastro-esophageal reflux () genuinely get symptoms provoked by chili. Rodriguez-Stanley 2000 ran pH monitoring and gastric-emptying tests on 11 heartburn sufferers, once with capsaicin and once without:
Esophageal acid exposure: unchangedGastric emptying: unchangedBut peak heartburn arrived far sooner: 120 minutes vs 247 minutes Chili did not make more acid. It made the alarm nerves more sensitive. Same acid — felt earlier and harder.
So the lesson is: chili does not cause disease and chili makes you uncomfortable can both be true at once. Your discomfort is real, not fussiness — and it also does not mean your stomach is being corroded. For the mechanism and treatment of reflux itself, see the GERD story.
Red flag · seek care now: vomiting blood, black stools, unexplained weight loss, difficulty swallowing, or persistent severe abdominal pain — see a doctor immediately. These are outside the range of adjusting your diet, and chili is not the explanation for them.
This page is general education and does not replace a doctor's judgment of your individual situation.
Evidence · Hemorrhoids unaffected; fissures hurt more
The same line, replayed at the other end — and this time the answer splits in two.
Hemorrhoids: chili is innocent
Altomare 2006 ran a randomized, double-blind, placebo-controlled crossover trial: 50 patients with second- and third-degree symptomatic hemorrhoids swallowed a capsule of red hot chili powder or placebo at lunch, and then the groups swapped.
Result: bleeding, swelling, pain, itching, and burning — all five symptom scores showed no significant difference between chili and placebo. The authors' title is charmingly blunt: the explosion of a myth. Their conclusion: there is no scientific evidence that a spicy meal worsens hemorrhoidal symptoms, and therefore no reason to stop these patients from occasionally enjoying a spicy dish.
Acute anal fissure: chili is guilty
Different patients, opposite conclusion. Gupta 2008 ran an equally rigorous randomized, double-blind, placebo-controlled crossover trial with 43 completers:
Pain score: chili 2.05, placebo 0.97Burning was worse too81.3% of patients preferred the placebo; only a minority chose chili The authors are direct: chili consumption does increase acute anal fissure symptoms and reduces patient compliance.
What this pair teaches
Same food, same grade of trial design — one condition worsens, the other doesn't. Which is exactly why 'is chili bad for you' is the wrong question. The question is bad for whom, in what state.
Put these two beside the ulcer and reflux trials and the pattern emerges: chili barely creates damage, but wherever there is already a break or already sensitization, it amplifies sensation. Your body's state decides the answer, not the food.
And 'chili causes acne'
In current dermatology evidence, the dietary factors most linked to acne are a high-glycemic-load diet (a few small trials) and dairy, especially skim milk and whey protein powder (mainly observational studies). Chili is not on the list (Zaenglein 2016; details in the acne story). The folk idea of 'aggravating foods' that supposedly trigger flare-ups has no support in modern medical evidence.
Of course, if chili reliably breaks you out, avoid it — that's your personal response and it deserves respect. But it isn't a general rule, and it shouldn't be preached to others.
The world's largest population dataset on eating chili comes from China: a study that followed nearly half a million people found that the frequent chili eaters died somewhat less. But this is an observational study. It can only show that chili eating and lower death rates appear together; it cannot show that chili makes people live longer.
There are at least three more reasons not to jump to a conclusion: frequent chili eaters already lived differently — more of them lived in the countryside, and they smoked and drank more; the questionnaire asked how often people ate spicy food, not how much chili went in; and the frequent chili eaters died less does not lead to start eating chili tonight and you will die less. The taking-apart half matters more than the data.
Evidence · Taking apart a half-million-person cohort
The China Kadoorie Biobank (CKB) enrolled 487,375 people across 10 regions (199,293 men + 288,082 women), followed them for a median of 7.2 years, during which 20,224 died (Lv 2015, BMJ).
Compared with people who ate spicy food less than once a week, the (HR; below 1 means that group had a lower risk of dying during follow-up) for total mortality were:
1-2 days/week: 0.90 (95% 0.84-0.96)3-5 days/week: 0.86 (95% CI 0.80-0.92)6-7 days/week: 0.86 (95% CI 0.82-0.90) Later pooling points the same way: Ofori-Asenso 2021 combined 4 cohorts (US, China, Italy, Iran; 564,748 adults) and found regular chili eaters had about 12% lower all-cause mortality (HR 0.88, 95% CI 0.86-0.90).
Now take it apart
1. This is observational; it cannot yield causation. The paper says so plainly: given the observational nature of this study, it is not possible to make a causal inference.
2. Chili eaters and non-eaters differ in their whole lives. Open CKB's baseline table: among men eating spicy food 6-7 days/week, 82.1% lived rurally, versus only 47.8% among rare eaters. The chili eaters also had clearly higher rates of smoking and drinking and ate a little more red meat, while vegetable intake barely differed.
In other words, spicy in this dataset is not an isolated variable at all — it behaves like a label for where and how you live. China's chili-eating regions (Hunan, Sichuan, Guizhou) are also its inland, more rural provinces. Models can adjust for known factors; they cannot adjust for what was never measured.
Fairness to the authors, too: they note that if residual from smoking and drinking is not fully removed, its direction would pull the association toward the null — meaning a true benefit might be underestimated. Both possibilities sit on the table; neither wins. That is the honest state.
3. Eating spicy is not eating chili. The questionnaire asked how often you ate spicy food, not how much chili you consumed. Chili oil, chili sauce, and spicy snacks are nothing like a handful of fresh peppers — the former carry a great deal of oil and salt along with them. The paper does note that inverse associations for some causes of death looked stronger in people eating fresh chili. An interesting lead — still observational.
4. Do not read it as a prescription. HR 0.86 does not mean start eating chili tonight and cut your death risk 14%. It means among that group of Chinese adults from 2004 to 2013, the frequent chili eaters died somewhat less. Between those two sentences lies an entire causal inference.
Evidence · Chili and cancer: the studies disagree
'Chili prevents cancer' is the most instructive claim of all, because here the evidence fights itself.
The same cohort says: maybe a little protective
Chan 2021 used the same CKB data to look at GI-tract cancers:
Esophageal cancer: people who ate spicy food daily had a lower risk than those who never did, and this inverse association was stronger among people who neither smoked nor drankStomach cancer: only a weak inverse association, which vanished after excluding the first 3 years of follow-up — usually a hint of reverse causation: people already unwell cut back on chili themselvesColorectal cancer: a weak inverse association, found for rectal cancer but not colon cancer A different body of studies says: harmful
Two built on case-control studies flip the conclusion ( is the odds ratio, the number case-control studies use to estimate risk; above 1 means higher risk):
Du 2021 (*Nutrition and Cancer*, 13 studies, 3,095 cases): high chili intake, gastric cancer OR 2.28 (95% 1.76-2.96)Pabalan 2014 (10 studies): an explicit U-shape — low intake OR 0.55 (lower risk), medium-high intake OR 1.94 (elevated); in Korean populations, high intake carried an even higher risk Why they fight
Three reasons worth memorizing — they are general-purpose tools for reading any nutrition research:
1. Different designs: prospective cohort (ask about diet first, wait for outcomes) vs case-control (find patients first, then ask them to recall diet). The latter carries built-in recall bias — someone with gastric cancer asked 'did I eat too much chili?' answers under the influence of the diagnosis itself. 2. Different doses: chili intake in some Korean and Mexican populations far exceeds the Chinese cohort's 'how many days a week' measure. A U-shape where low protects and high harms means how much matters more than whether. 3. Different populations: genetics, pickled foods, H. pylori prevalence, salt intake — these vary enormously between populations and all get swept in alongside 'spicy.'
The honest conclusion
'Chili prevents cancer' is unsupported. 'Chili causes cancer' is also unsettled. Same exposure — change the design, the population, or the dose, and the conclusion flips.
That is itself the most useful information: it tells you this question currently has no answer, rather than that the answer is 'beneficial.' Being able to stop here, without rushing to pick a side, is judgment.
In practice · Four questions for any chili headline
This story isn't here to hand you a verdict on whether to eat chili. It's here to give you a feel for how to read this kind of news.
Next time you see a headline like 'study proves chili makes you live longer,' you already know the four questions to ask:
1. Is it observational? If so, it can only tell you who appears alongside whom, not who caused whom. 2. What else is different about chili eaters? In CKB, the answer: more likely rural, more smoking, more drinking. 'Spicy' here is a lifestyle label. 3. What does 'spicy' actually mean? Fresh peppers? Chili oil? Chili sauce? What the questionnaire measured is often not what's in your head. 4. How big is the effect? Thermogenesis is real — and worth 10 kcal a day. Inflating a real mechanism many times over is marketing's favorite move.
These four questions aren't only for chili. They work on 'red wine protects the heart,' 'coffee prevents cancer,' and every 'superfood' there is. Learning them is worth more than memorizing any single .
As for whether to eat it
If you love it, eat it. It makes food taste good, and that reason is sufficient on its own — it doesn't need a health benefit bolted on to earn its place at the table.
Don't treat it as medicine: it won't slim you down or prevent cancer. And don't fear it: it doesn't cause ulcers, there is no evidence it causes acne, and in a trial it did not worsen hemorrhoids.
But if you have reflux, a fissure, or simply feel bad after eating it — that's your body handing you its own data. That dataset has a sample size of one, and it fits you better than any half-million-person cohort ever will. Trust it.
This story is general education and does not replace a doctor's judgment of your situation. Persistent or worsening digestive symptoms warrant medical care.
References · 13
Caterina, M. J., Schumacher, M. A., Tominaga, M., Rosen, T. A., Levine, J. D., & Julius, D. (1997). The capsaicin receptor: a heat-activated ion channel in the pain pathway. Nature, 389(6653), 816-824. Expression cloning of TRPV1: a non-selective cation channel on nociceptive sensory neurons, activated by capsaicin and by noxious heat above ~43 C. 10.1038/39807
The Nobel Assembly at Karolinska Institutet. (2021). The Nobel Prize in Physiology or Medicine 2021: Discoveries of receptors for temperature and touch. Awarded to David Julius and Ardem Patapoutian; Julius used capsaicin to identify TRPV1 as the heat-sensing ion channel. www.nobelprize.org/prizes/medicine/2021/press-release
U.S. Department of Agriculture, Agricultural Research Service. (2019). FoodData Central: Peppers, hot chili, red and green, raw. Raw red chili ~40 kcal/100 g and ~144 mg vitamin C/100 g; realistic culinary portions are only a few grams, so per-100 g nutrient density greatly overstates actual intake. fdc.nal.usda.gov
Nolden, A. A., Lenart, G., & Hayes, J. E. (2019). Putting out the fire - efficacy of common beverages in reducing oral burn from capsaicin. Physiology & Behavior, 208, 112557. Seven beverages compared; milk beat water, but skim and whole milk never differed, challenging the lipophilic-partitioning hypothesis and implicating casein over fat. 10.1016/j.physbeh.2019.05.018
Nolden, A. A., Lenart, G., Spielman, A. I., & Hayes, J. E. (2024). Inducible desensitization to capsaicin with repeated low-dose exposure in human volunteers. Physiology & Behavior, 275, 114447. Capsaicin rinse twice daily for 14 days cut burn ~24% with cross-desensitization; TRPV1 mRNA did not decrease, so the mechanism remains unresolved. 10.1016/j.physbeh.2023.114447
Anand, P., & Bley, K. (2011). Topical capsaicin for pain management: therapeutic potential and mechanisms of action of the new high-concentration capsaicin 8% patch. British Journal of Anaesthesia, 107(4), 490-502. Sustained high-concentration capsaicin defunctionalizes nociceptors via TRPV1 overactivation, with reversible retraction of epidermal nerve fibers. 10.1093/bja/aer260
Derry, S., Rice, A. S. C., Cole, P., Tan, T., & Moore, R. A. (2017). Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews, 1, CD007393. Eight RCTs, 2488 participants; results were judged susceptible to publication bias and only a weak second-line recommendation was given. 10.1002/14651858.CD007393.pub4
Ludy, M. J., Moore, G. E., & Mattes, R. D. (2012). The effects of capsaicin and capsiate on energy balance: critical review and meta-analyses of studies in humans. Chemical Senses, 37(2), 103-121. No overall significant effect on energy expenditure (SMD 0.11, 95% CI -0.06 to 0.29); a rise appeared only at doses at or above 135 mg. Authors estimate a hedonically acceptable dose yields ~10 kcal/day. 10.1093/chemse/bjr100
Whiting, S., Derbyshire, E. J., & Tiwari, B. (2014). Could capsaicinoids help to support weight management? A systematic review and meta-analysis of energy intake data. Appetite, 73, 183-188. Capsaicinoids before a meal reduced ad libitum intake at that meal by 309.9 kJ (74.0 kcal); authors urge caution given high between-study variability. 10.1016/j.appet.2013.11.005
Graham, D. Y., Smith, J. L., & Opekun, A. R. (1988). Spicy food and the stomach: evaluation by videoendoscopy. JAMA, 260(23), 3473-3475. Twelve volunteers; a spicy Mexican meal with 30 g jalapeno caused virtually no gastric mucosal damage, whereas a bland meal plus 1950 mg aspirin produced multiple erosions. jamanetwork.com/journals/jama/fullarticle/375639
Rodriguez-Stanley, S., Collings, K. L., Robinson, M., Owen, W., & Miner, P. B. (2000). The effects of capsaicin on reflux, gastric emptying and dyspepsia. Alimentary Pharmacology & Therapeutics, 14(1), 129-134. In 11 heartburn sufferers, capsaicin left esophageal/gastric pH profiles unchanged but significantly shortened time to peak heartburn (120 vs 247 min), indicating sensitization of sensory neurons rather than increased acid. 10.1046/j.1365-2036.2000.00682.x
Lv, J., Qi, L., Yu, C., Yang, L., Guo, Y., Chen, Y., et al. (2015). Consumption of spicy foods and total and cause specific mortality: population based cohort study. BMJ, 351, h3942. China Kadoorie Biobank; 487,375 adults, median 7.2 years follow-up, 20,224 deaths. Versus under 1 day/week, adjusted HR for total mortality was 0.86 (95% CI 0.82-0.90) at 6-7 days/week. Baseline table shows frequent eaters were 82.1% vs 47.8% rural and smoked and drank more. Authors state causal inference is not possible. 10.1136/bmj.h3942
Ofori-Asenso, R., Mohsenpour, M. A., Nouri, M., Faghih, S., Liew, D., & Mazidi, M. (2021). Association of spicy chilli food consumption with cardiovascular and all-cause mortality: a meta-analysis of prospective cohort studies. Angiology, 72(7), 625-632. Four cohorts, 564,748 adults; regular chilli consumers had ~12% lower all-cause mortality (pooled 0.88, 95% CI 0.86-0.90). Observational - not causal. 10.1177/0003319721995666