Peppers: Benefits, side effects, research and dosage

Nutrition buffs around the world are deluged with an endless list of nutritional programs.

Low fat-diets have long been recognised as essential in promoting health and wellbeing., however, this list has grown to include the Keto diet, which is a fat-rich diet and low in carbohydrates. Included as well are the Paleo diet, the South beach diet and the list goes on and on. 

Recently, nutrients from a common spice have been identified to be important in maintaining optimal health. Pepper, a common spice used in our meals may yield health benefits you have never imagined before. 

Can pepper be beneficial for your health? 

Promote longevity, reduce risk of cardiovascular disease and cancer 

Reported benefits of pepper include increased life span and reduced risk of cancer and cardiovascular disease.

A report published by the American Heart Association [1] included data from multiple countries. It examined more than 500,000 patients and their health outcomes.

Findings of this report revealed that people who never ate or rarely ate chili pepper had an increased risk of death due to cardiovascular disease by 26%, death due to any cause by 25% and death due to cancer by 23%. This was compared with people regularly ate chili pepper. 

Findings of this report were built on several studies in different countries that examined the link or association between chili pepper consumption and health benefits.

Meanwhile, a supporting study [2] stated that chili pepper intake of at least four times a week or more resulted in reduced risk of mortality due to cardiovascular disease and all-cause mortality.

Further, regular intake of chili pepper was inversely linked with ischaemic heart disease and cerebrovascular death risks.

Interestingly, the study found out that in hypertension-free individuals or those without hypertension, the benefits of eating chili pepper were increased.

These individuals had reduced risk of cardiovascular death and reduced risk of all-cause mortality. 

The study [2], which was published in the Journal of the American College of Cardiology, followed a total of 22,811 men and women who were enrolled in a cohort study from 2005 to 2010. The median follow-up period was 8.2 years.

Notably, the population sample was recruited from the general population of Molise in Italy. Here, people were following the Mediterranean diet, which is known to include chili pepper. 

Peppers: Benefits, side effects, research and dosage
Photograph: ActiorJordan/Envato

It is unclear why chili pepper can yield health benefits such as reduction in risk of all-cause mortality and death due to cardiovascular diseases.

However, it is hypothesized that capsaicin, a component of chili pepper, might promote optimal health and reduce risk of mortality due to its anti-inflammatory properties.

Chronic low-grade inflammation can increase the risk of death due to cardiovascular diseases. Further, capsaicin has been shown to be a potent antioxidant.

In the body, antioxidants help scavenge for excess free radicals. These free radicals hasten the aging process and cause premature cellular death. 

Meanwhile, another study [3] published in the PLoS One journal examined the association of hot red chili pepper consumption and mortality. This study was a large, population-based cohort.

Although cohort studies rank lower in the hierarchy of evidence since it could not establish a cause and effect relationship. These studies are still crucial since they can establish associations between variables.

Further, the recruitment of a very large sample population in the study increased the strength and validity of the results of this study. 

A total of 16, 179 participants were followed from 1988 to 1994 to determine their hot chili pepper consumption and risk of death due to cardiovascular diseases. All participants were at least 18 years old while the follow-up period was 18.9 years on average.

During the follow-up period, a total of 4,946 deaths were recorded. Total mortality for those who did not or rarely consumed red hot chili pepper was 33.6%.

In contrast, 21.6% of those who ate chili pepper died during the follow-up period. In total, there was a 13% reduction in mortality or hazard of death in participants who ate red hot chili pepper.

This suggests that red hot chili consumption could reduce the risk of premature death and promote longevity.

Notably, those who ate red hot chili peppers also had significantly reduced levels of high-density lipoprotein cholesterol levels compared with those who did not or rarely ate red hot chili peppers.

However, it should be noted that all the studies that support the benefits of chili pepper were cohort studies. There is a need to verify the findings of these earlier studies in large clinical trials in the future.

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Weight management 

Investigators have pointed out that capsaicinoids present in red hot chili pepper may help reduce weight and may become an important component in the diets of those who want to lose weight. 

A study [4] that was published in the FASEB Journal examined if intake of capsaicinoids supplements reduced body circumferences and weight in healthy men and women.

Since the study was double-blind, which means that both investigators and patients were blinded to the study, and used the randomized controlled study design, this increased the generalizability of the findings of the study. 

The study was authored by lead investigator Stacie L Urbina and colleagues from the University of Mary Hardin-Baylor’s Department of Exercise and Sports Science.

These investigators recruited healthy participants to participate in a 12-weeks study where they received 2 mg of capsaicinoids supplements daily.

Results indicated that daily intake of 2 mg of the supplement could suppress appetite and reduce key body composition metrics.

For example, the authors observed a 2.4% reduction in hip and waist circumferences at the end of six weeks.

At the end of 12 weeks, there was a significant reduction in appetite. The supplements used in the study did not have side effects common in raw hot red chili peppers such as gastric burning or oral burning. 

Therapeutic properties 

Chili peppers have been shown to have therapeutic effects against specific health conditions. A review [5] reiterated that chili peppers are used for centuries to treat specific ailments.

Examining several studies, the review stated that ingestion of chili peppers can relieve health conditions such as stiff joints, rheumatism, arthritis, certain types of cancer, chest colds and bronchitis, headache, cough and heart arrhythmias. Chili preparations to treat these ailments are favored over the raw red hot chili peppers.

These preparations include creams, gels, plasters, powder, essential oils distilled from pods, and extracts made through soaking pods in ethanol or water [6].

It is hypothesized that capsaicin, the active ingredient of chili, is responsible for the therapeutic effects of chili on these diseases. 

A report [6] published by the Arthritis Research UK identified capsaicin as the effective ingredient of chili that is responsible in addressing the signs and symptoms of different diseases.

The report also states that capsaicin is effective in treating fibromyalgia and osteoarthritis compared with placebo.

Furthermore, capsaicin is safe to use. It is believed that capsaicin can relieve pain from fibromyalgia or osteoarthritis through depleting the supply of subsistence P, which is a neuropeptide that helps in sending signals of pain to the individual’s brain.

Inhibiting the release of subsistence P from the nerves prevents the transmission of pain signals to the brain.

Hence, individuals with osteoarthritis and fibromyalgia who take capsaicin supplements would be relieved of their pain as pain signals to the brain are reduced or blocked.

Apart from treating different diseases, capsaicin in pepper has also been shown to have antimicrobial properties. 

The positive effects of pepper against many diseases may be due to the antioxidant property of capsaicin and other nutrients found in this plant.

Some of these nutrients and vitamins in chili that have antioxidant properties include carotenoids, xanthophylls and vitamins C and E.

However, not all peppers are equal in terms of their antioxidant properties. It is shown that red hot chili peppers have higher antioxidant properties and phenolic compounds compared with green peppers.

Hence, when deciding to use pepper to spice up your food, it is best to choose red, hot chili peppers to optimize health outcomes. The antioxidant levels of peppers vary according to where they are planted, soil type and temperature.  

Health risks and side effects 

Most of the studies that examined the effects of pepper and its compounds found these as safe. However, there are some reports indicating that some of the compounds may be linked to development of some cancers.

A study [7] conducted by Hwang and his colleagues from the Department of Bioscience and Biotechnology of the Konkuk University in South Korea reported that capsaicin is associated with skin cancer.

In South American countries such as Chile, Peru and Bolivia, where consumption of red hot chili peppers is high, incidences of gallbladder cancer is likewise high [8].

These incidence rates were found to be linked to high consumption of red chili pepper. Since these studies did not use the clinical trial study design, the findings could only point out an association between red hot chili consumption and the risk of gallbladder cancer and skin cancer.

A cause-and-effect relationship could not be established. Despite this lack of causal relationship, the association of very high consumption of these chili peppers with certain forms of cancer should warn people not to consume too much of these peppers. 

health risks and side effects

The concern that capsaicin might have mutagenic effects on mammals and bacteria was raised by a few studies.

To determine if this compound has mutagenic or cancer-causing effects, Szallasi and Blumberg [9] carried out a review of studies in this area.

These authors concluded that there were conflicting results on whether capsaicin has mutagenic effects. However, these authors explained that capsaicin is a weak mutagenic or not a mutagenic at all.

It should be noted that in animal model studies, there are experiments suggesting that pepper consumption has carcinogenic effects. However, these animal model studies used very high concentrations of capsaicin or high volume of red hot chili peppers. 

It would be difficult to translate the findings of these animal model studies to humans since people do not eat high volumes of pepper everyday.

Since the concentrations used in the animal model studies were too high or way above the normal consumption of pepper in humans, it would be difficult to determine if pepper ingestion results in increased risk of cancer in people.

In addition, there are no animal model studies that confirmed that capsaicin or other compounds found in pepper have carcinogenic effects. 

Meanwhile, the Scientific Committee on Food from the European Union indicated that very high consumption of red hot chili might explain the increased incidence of cancer in India and Mexico.

This committee found out that ingestion of 25-200 mg of powdered pepper daily was associated with increased risk of upper gastrointestinal tract cancer.

A tablespoon contains 15 mg of powdered chili pepper. Ingesting 1 ½ tbsp to about 10 tbsp of chili powder could increase your risk of gastric cancer.

In contrast, in Europe, the average maximum intake of chili pepper was only 1.5 mg/day. There was no association between low levels of chili pepper ingestion and gastric cancer in Europe. 

It is hypothesized that presence of aflatoxin in the skin of the chili peppers might help explain the increased risk of cancer when eating these peppers. Aflatoxin is described as a naturally occurring compound that is highly carcinogenic and toxic.

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However, only minute amounts of this substance are produced. Chronic exposure to this carcinogenic toxin affects livestock and humans in several ways.

Some of the effects include immunosuppression, immunodeficiency, kwashiorkor and stunting. Dried peppers were reported to be at increased risk of contamination with aflatoxin. 

Factors that can increase the risk of contamination in peppers include poor farming practices from harvesting to post-harvest. Packaging, temperature and moisture can contribute to aflatoxin contamination of pepper.

For instance, drying pepper under the sun, having high temperature and humidity, and selling in the open are all favorable circumstances for the growth of aflatoxins.

Hence, packaging and the environment in which chili peppers are stored and sold should be safe and should meet standards to prevent the growth of aflatoxins. 

Other potential side effects of chili pepper include burning sensation in your stomach and esophagus.

For individuals suffering from acid reflux or heartburn, ingestion of capsaicin might exacerbate symptoms of heartburn. Hence, it is necessary to contact your doctor when planning to take capsaicin supplements to ensure your safety. 

Another potential side effect of chili pepper consumption includes elevation of body temperature. Ingesting too much capsaicin may lead to an uncomfortable feeling of being too warm. 

What is the appropriate dosage for chili pepper? 

Ingestion of 1.5 mg of powdered chili pepper daily would lead to beneficial results. However, when taking supplements of capsaicin, it is recommended to take 2-6 mg of this compound daily. 

Current research on chili peppers

Studies on chili peppers focus on the antioxidant properties of the compounds found in this spice. Chili peppers are reported to contain flavonoids and neutral phenolics that are essential when eating a plant-based diet.

Flavonoids are described as natural products that have a polyphenolic structure and found widely in vegetables, fruits and certain beverages.

They have antioxidant and biochemical effects and are associated with improvements in health outcomes of patients with Alzheimer’s disease, cancer and atherosclerosis or thickening of the blood vessels due to fatty deposits. 

Flavonoids present in chili peppers also have anti-mutagenic, anti-inflammatory and anti-carcinogenic properties. In nature, these compounds are produced by plants to protect themselves from plaques.

These are also found in tea, vegetables, wine, cocoa, fruits and vegetables. Due to their abundance in nature and in plants and vegetables, they are called dietary flavonoids. 

Apart from flavonoids, chili peppers also contain neutral phenolics or naturally occurring phenols. These compounds act as antioxidants and can inhibit, delay, or prevent the oxidation of compounds that can be oxidized.

Antioxidants scavenge excess free radicals produced during cellular metabolism. Excess free radicals can cause premature aging. 

Meanwhile, the potential anti-obesity effects of chilis are due to the ability of capsaicin to suppress appetite. Many scientists are now exploring the use of natural products in combating obesity.

Obesity remains to be an important health problem across the world. Obesity is a single risk factor for type 2 diabetes and cardiovascular diseases.

When not addressed, obesity can drain resources of the family and the healthcare system. Currently, billions of dollars are spent in managing obesity and its negative health effects in the population. 

Due to the properties of capsaicin, investigators have explored whether capsaicin supplements could help prevent obesity or manage this condition in the long-term. It is recognised that both diet and physical activities are required to address obesity.

However, supporting these activities with natural products or supplements that can effectively manage obesity would help reduce this health epidemic.

To date, there are still few studies that investigated the long-term effects of capsaicin supplementation with reducing obesity.

Most studies are short-term and only investigated if capsaicin can suppress appetite, which in turn might help reduce caloric intake in those who are obese or overweight.

Despite the lack of results from clinical trials, capsaicin is a promising supplement in addressing obesity in the near future. 

Meanwhile, capsaicin is currently being examined if its ability to reduce pain in patients with osteoarthritis and diabetic neuropathy can be sustained over time.

Current studies suggest that capsaicin can help block the signaling of pain to the brain in those with osteoarthritis and diabetic neuropathy.

However, there are also no clinical trials suggesting that capsaicin can treat pain in those with arthritis.

Although all studies supporting the observation that capsaicin may reduce pain are cohort studies and could not establish a cause-and-effect relationship, these studies continuously show the trend that capsaicin may relieve pain. 

Osteoarthritis is a debilitating condition characterized by pain for those who are diagnosed with this condition.

Most do not want to take drugs or medications due to the potential adverse and side effects of these medications.

Since chili pepper or capsaicin are naturally-occurring products, supplementation with capsaicin might be acceptable to those who do not want to take pain medications. 

Peppers: Benefits, side effects, research and dosage
Photograph: Ladanifer/Envato

Meanwhile, regular eating of red hot chili peppers could potentially benefit your health and lead to longer life, reduced risk of all-cause mortality or death from all causes. It may also suppress appetite, which in turn can help control your weight.

There are also studies suggesting that it can prevent certain forms of cancer and studies that link over-consumption with development of gastric cancer.

While this might be conflicting, it is only the intake of very high amounts of chili pepper for long periods is associated with gastric cancer risk.

Hence, consuming only the recommended amounts of chili and capsaicin would help you reap the benefits of chili peppers. 

Findings of current research on capsaicin and chili peppers prove to be encouraging. However, this does not mean that when you eat chili peppers or take capsaicin supplements daily that you will be protected from developing chronic diseases.

Instead, the studies only indicate that there is a link between consumption of chili peppers or intake of capsaicin supplements with health benefits that include improved cardiovascular health. 

If you want to improve your health, you can take capsaicin supplements under the direction of your doctor, and support this with a healthy diet. Examine your diet if this is consistent with achieving optimal health.

This means eating the right kinds of food in the right portion or amount. It also means engaging in daily physical exercise to protect you from stress, anxiety, depression and other mental and physical health conditions. 

Increasing the variety and amount of vegetables you have in your diet is another way of improving your health. You should also get enough sleep at night to keep you well rested and to prevent obesity.

It has been shown that chronic undersleeping increases the risk of obesity. In addition, reducing stress could also help you live a healthier life. 

Finally, chili pepper is a common spice used in food to increase flavor and aroma. However, the use of pepper is not only limited to making dishes more flavorful.

Recent studies have suggested that it might benefit human health through reducing the risk of certain forms of cancer, cardiovascular diseases and osteoarthritis. Further, chili has the potential to protect people from chronic diseases. 

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[1] https://www.sciencedaily.com/releases/2020/11/201109074114.htm 
[2] https://www.jacc.org/doi/full/10.1016/j.jacc.2019.09.068 
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5222470/ 
[4] https://onlinelibrary.wiley.com/doi/abs/ 
[5] https://www.ijpbs.com/ijpbsadmin/upload/ijpbs_50c8439388e3e.pdf 
[6] https://www.arthritisresearchuk.org/arthritis-information/complementary-and-alternative-medicines/cam-report.aspx
[7] https://pubmed.ncbi.nlm.nih.gov/20660715/ 
[8] https://pubmed.ncbi.nlm.nih.gov/23244129/ 
[9] https://pharmrev.aspetjournals.org/content/51/2/159 

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