Insights & Discussion
Epidemiological studies suggest that the consumption of spicy chilli food is associated with reduced risk of all-cause as well as heart disease–related mortality.
This systematic review and meta-analysis examined the association between spicy food (chilli pepper, chilli sauce, or chilli oil) consumption with cardiovascular and all-cause mortality. Medline and EMBASE were searched from their inception until February 2020 to identify relevant prospective cohort studies. Hazard ratios (HRs)/relative risk (RRs) were pooled via random-effect meta-analysis. Of the 4387 citations identified, 4 studies (from the United States, China, Italy, and Iran) were included in the meta-analysis. The included studies involved a total of 564 748 adults (aged ≥18 years; 51.2% female) followed over a median duration of 9.7 years. The pooled data suggested that compared with people who did not regularly consume spicy food (none/<1 d/wk), regular consumers of spicy food experienced a 12% (HR/RRpooled 0.88, 95% CI, 0.86-0.90; I 2 = 0%) lower risk of all-cause mortality. Moreover, spicy food consumption was associated with significant reduction in the risk of death from cardiac diseases (HR/RRpooled 0.82, 0.73-0.91; I 2 = 0%), but not from cerebrovascular disorders (HR/RRpooled 0.79, 0.53-1.17; I 2 = 72.2%). In conclusion, available epidemiological studies suggest that the consumption of spicy chilli food is associated with reduced risk of all-cause as well as heart disease–related mortality. Further studies in different populations are needed to confirm this association.
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Consumption of tea and coffee may possibly provide anti-inflammatory effects, contributing to reduced cardiovascular risk and mortality.
2023 Pharmacological Research Coffee or tea: Anti-inflammatory properties in the context of atherosclerotic cardiovascular disease prevention Surma S, Sahebkar A, Banach M
Review Article Anti-Inflammatory Cardiovascular Disease Tea
The methodology of this narrative review examined the potential anti-inflammatory properties of consuming tea and coffee as a factor in reducing the risk of cardiovascular disease. This was done by analyzing a plethora of studies and meta-analyses that explored the impact of diet on inflammation, with a keen focus on the consumption of these beverages. The studies looked at a variety of risk factors for atherosclerotic cardiovascular disease, including inflammation biomarkers such as C-reactive protein, along with the impact of modern lipid-lowering treatments.
In discussing the results, it was noticed that inconsistent findings were produced from the analysed studies which made a conclusive determination challenging. However, a trend was observed where drinking tea and coffee seemed to raise adiponectin levels, reduce reactive oxygen species and lower low-density lipoprotein cholesterol levels. Despite these potential anti-inflammatory properties of tea and coffee being somewhat uncertain due to various confounding factors, their consumption is still recommended as part of a healthy diet.
Extra virgin olive oil (EVOO) has beneficial health properties and can promote cardiovascular health, lipoprotein metabolism, and diabetes management in clinical nutrition.
2022 Nutrients Therapeutic Properties and Use of Extra Virgin Olive Oil in Clinical Nutrition: A Narrative Review and Literature Update Jiménez-Sánchez A, Martínez-Ortega AJ, Remón-Ruiz PJ, Piñar-Gutiérrez A, Pereira-Cunill JL, García-Luna PP
Review Article Cardiovascular Disease Type 2 Diabetes
The methodology of this narrative review involved an extensive synthesis and illustration of the various characteristics and clinical applications of EVOO and its components such as oleic acid, hydroxytyrosol, and oleuropein. It looked at their significance in diet therapy, use in oleic acid-based enteral and parenteral nutrition formulations, and oral supplementation formulations.
In their discussion of the results, the researchers found diverse health benefits associated with EVOO. Particularly, they highlighted the potential of whole EVOO in diet therapy and its minor components in supplementation to enhance cardiovascular health, control lipoprotein metabolism, and manage diabetes mellitus within a clinical nutrition framework. It was seen as a significant addition to nutritional and dietary strategies, with a potential for therapeutic application in several diseases and clinical demographics.
Cocoa extract supplementation in older adults reduced cardiovascular disease related death rates, but did not significantly lessen total cardiovascular events.
2022 The American Journal of Clinical Nutrition Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial Sesso HD, Manson JAE, Aragaki AK, Rist PM, Johnson LG, Friedenberg G, et al.
Randomised Controlled Trial Cardiovascular Disease Cocoa
A randomized, double-blind, placebo-controlled trial was conducted on 21,442 US adults aged 60 or over, all of who were free of major cardiovascular disease and recently diagnosed cancer. The participants were assigned to either a cocoa extract supplement, which included 500 mg flavanols per day, or a placebo. The intervention phase ran from June 2015 to December 2020. The primary outcome was focused on the number of total cardiovascular events, including myocardial infarction, stroke, and cardiovascular death among others.
The results showed that during a median follow-up of 3.6 years, there were 410 participants taking cocoa extract and 456 under placebo who had confirmed total cardiovascular events. Secondary endpoints showed reduced death due to cardiovascular disease for the cocoa extract supplement users. However, there was no significant impact on the incidence of total cardiovascular events. Conversely, a lower risk of total cardiovascular events was supported when analyses were censored at nonadherence. Overall, no safety concerns were raised during the trial.
Pomegranate extract consumption improves antioxidant levels, reduces oxidative stress and cardiovascular risk factors including blood pressure and body fat, and increases lean body mass.
2022 Antioxidants Antioxidant Properties and Beneficial Cardiovascular Effects of a Natural Extract of Pomegranate in Healthy Volunteers: A Randomized Preliminary Single-Blind Controlled Study Al-Dujaili EAS, Casey C, Stockton A
Randomised Controlled Trial Cardiovascular Disease High Blood Pressure
In the study, 24 healthy participants were divided into two groups: one consumed a natural standardized pomegranate extract, while the other, a placebo, in a randomized, single-blind placebo-controlled trial. Evaluations were conducted at baseline and post 14 and 28 days of the experiment, with variables including anthropometric measurements, blood pressure, pulse wave speed, body composition, as well as the levels of salivary and urinary cortisol, cortisone, total phenolics, antioxidant capacity, and lipid peroxidation.
The results indicated significant increases in urinary total phenolics excretion and antioxidant capacity after 14 and 28 days of pomegranate extract intake. By day 28, notable decreases were noted in systolic and diastolic blood pressure, pulse wave velocity, body fat and fat mass, and an increase in lean body mass. In terms of glucocorticoid levels, there was a marked decrease in saliva cortisol at day 28 in the morning for the pomegranate extract group, along with a decrease in the cortisol/cortisone ratio following 28 days of pomegranate extract intake at morning, noon, and evening. Reductions were also seen in urine free cortisol levels by day 14. These observations were unique to the pomegranate extract group, with no significant changes noted in the placebo group.
Our findings showing that chocolate and flavonoid intake significantly improves the flow-mediated dilatation, provide mechanistic evidence to support a causal link between chocolate and flavonoid intake and lowered CVD risk.
2020 Clinical Nutrition ESPEN Effect of dark chocolate on flow-mediated dilatation: Systematic review, meta-analysis, and dose–response analysis of randomized controlled trials Ebaditabar M, Djafarian K, Saeidifard N, Shab-Bidar S
Systematic Review Cardiovascular Disease Dark Chocolate Flow-Mediated Dilatation
This meta-analysis identified 23 studies that randomly assigned participants to dark chocolate, cocoa, or flavonoid in comparison with control groups in acute or short-term chronic interventions. At the end of our meta-analysis, we found a protective effect of acute and chronic consumption of dark chocolate and flavonoids on FMD. Greater improvement was seen in higher doses (>20 day) of chronic consumption of dark chocolate with more than about one month. A non-linear effect of acute consumption of dark chocolate and flavonoids on FMD was also found.
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