Spicy Food Intake Research Articles

Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!

A substantial proportion of patients with irritable bowel syndrome (IBS) associate their symptoms with the ingestion of specific foods. Therefore, in recent years, scientific research has increasingly focused on the role of diet in IBS and dietary management is now considered an important tool in IBS treatment. This article reviews the main dietary approaches in IBS emphasizing evidence from experimental and observational studies and summarizing the main diet and lifestyle recommendations provided by dietary guidelines and scientific literature. Despite the limited evidence for a beneficial role, general advice on healthy eating and lifestyle is recommended as the first-line approach in the dietary management of IBS. Standard recommendations include adhering to a regular meal pattern, reducing intake of insoluble fibers, alcohol, caffeine, spicy foods, and fat, as well as performing regular physical activity and ensuring a good hydration. Second-line dietary approach should be considered where IBS symptoms persist and recommendations include following a low FODMAP diet, to be delivered only by a healthcare professional with expertise in dietary management. The efficacy of this diet is supported by a growing body of evidence. In contrast, the role of lactose or gluten dietary restriction in the treatment of IBS remains subject to ongoing research with a lack of high-quality evidence. Likewise, further clinical trials are needed to conclude the efficacy of probiotics on IBS symptoms.

Ovarian Ablation in Breast Cancer Patients and the Possibility of Influencing Treatment Side Effects

Ovarian suppression or ovarian ablation used in treatment of breast carcinoma results in temporary or permanent menopause and associated menopausal symptoms - most frequently vasomotoric symptoms (hot flashes, sweats), vaginal atrophy, sleep disturbances. Patients can also experience frequent decrease in bone density (osteopenia, osteoporosis), mood swings or depression, less frequently cardiac toxicity. Managements of these symptoms is complex. As hormonal replacement therapy (estrogens or combined estrogen/gestagen therapy) is contraindicated in women with breast carcinoma, other available options include non-hormonal pharmacological or non-pharmacological methods or their combinations. Women should be advised about cooling techniques and how to avoid known triggers; these measures should be combined with other non-pharmacological and pharmacological intervention. Non-pharmacological methods include the use of acupuncture or cognitive behavioral therapy. Some tips to help stay cool and decrease hot flashes - avoid hot beverages, spicy food, limit coffee or alcohol intake, dress in layers of clothing that can be removed if necessary. Pharmacological options include most frequently antidepressants - SSRI (selective serotonin reuptake inhibitor), SNRI (serotonin norepinephrin reuptake inhibitor), or alternatively gabapentin or pregabali. A very promising drug is paroxetine with a lot of clinical trials. Only this drug has FDA approval for the indication of hot flashes. Paroxetine can lead to disproportional changes in plasma levels of drug in CYP2D6 metabolism and thus it is not suitable for combination of paroxetine with tamoxifen. Several studies demonstrated the effectiveness of the newer generation of SSRI - citalopram, escitalopram, sertralin and duloxetin in ameliorating hot flashes. Venlafaxine in dose 75 or 150 mg has been associated with a 61% reduction in hot flashes frequency if compared to 27% reduction with placebo. Medroxyprogesterone acetate and megestrol acetate were investigated especially in patients with breast cancer history and both drugs demonstrate an effect in hot flashes treatment. Management of vaginal atrophy is challenging. Vaginal dryness/atrophy can be relieved with use of topical lubricants/gels or possibly in highly symptomatic patients with short term use of topical estrogens. As these symptoms require highly complex management, multidisciplinary approach is recommended.Key words: breast cancer - postmenopause - ovarian suppression - postmenopausal osteoporosis - therapyThis work was supported by grant of the Czech Ministry of Health - RVO (MOÚ, 00209805).The author declares she has no potential conflicts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 20. 7. 2016Accepted: 10. 8. 2016.

Behavioral measures of risk tasking, sensation seeking and sensitivity to reward may reflect different motivations for spicy food liking and consumption

Based on work a quarter century ago, it is widely accepted personality traits like sensation seeking are related to the enjoyment and intake of spicy foods; however, data supporting this belief is actually quite limited. Recently, we reported strong to moderate correlations between remembered spicy food liking and two personality traits measured with validated questionnaires. Here, participants consumed capsaicin-containing strawberry jelly to generate acute estimates of spicy food liking. Additionally, we used a laboratory-based behavioral measure of risk taking (the mobile Balloon Analogue Risk Task; mBART) to complement a range of validated self-report measures of risk-related personality traits. Present data confirm Sensation Seeking correlates with overall spicy meal liking and liking of the burn of a spicy meal, and extends prior findings by showing novel correlations with the liking of sampled stimuli. Other personality measures, including Sensitivity to Punishment (SP), Sensitivity to Reward (SR), and the Impulsivity and Risk Taking subscales of the DSM5 Personality Inventory (PID-5) did not show significant relationships with liking of spicy foods, either sampled or remembered. Our behavioral risk taking measure, the mBART, also failed to show a relationship with remembered or sampled liking. However, significant relationships were observed between reported intake of spicy foods and Sensitivity to Reward, and the Risk Taking subscale of the PID-5 (PID5-RT). Based on the observed patterns among various personality measures, and spicy food liking and intake, we propose that personality measures may exert their influence on intake of spicy food via different mechanisms. We also speculate that Sensation Seeking may reflect motivations for consuming spicy foods that are more intrinsic, while the motivations for eating spicy foods measured by SR and PID5-RT may be more extrinsic.

A prospective study on symptom generation according to spicy food intake and TRPV1 genotypes in functional dyspepsia patients.

Capsaicin is an ingredient of red peppers that binds to transient receptor potential vanilloid subtype 1 (TRPV1), and Koreans eat more capsaicin-rich food than do Japanese. This study aimed to compare symptom generation according to TRPV1 genotypes and the intake of spicy foods. Consecutive functional dyspepsia (FD) patients who were evaluated at Konkuk University Medical Centre (Korea) and Keio University Hospital (Japan) were included. Questionnaires on spicy food intake, patient assessment of gastrointestinal symptoms (PAGI-SYM), patient assessment of quality of life, and hospital anxiety and depression scale were provided. Blood was sampled for the detection of TRPV1 polymorphisms, and upper gastrointestinal endoscopy was performed with biopsies. Of 121 included subjects, 35 and 28 carried the TRPV1 CC and GG genotypes, respectively, with the prevalence rates not differing between Japan and Korea. The prevalence of FD subtypes did not differ with the spicy food intake, TRPV1 genotypes, or Helicobacter pylori infection. Neither TRPV1 polymorphisms nor H. pylori infections were related to scores on the PAGI-SYM questionnaires, but spicy food intake was positively correlated with the scores for stomach fullness (p = 0.001) and retching (p = 0.001). Using the linear regression analysis, stomach fullness was associated with spicy food intake (p = 0.007), whereas retching was related to younger age (p < 0.001) and female gender (p = 0.014). Upper gastrointestinal symptoms are more common in subjects with a higher consumption of spicy foods, younger age and female gender, regardless of TRPV1 genotypes and the H. pylori infection status. Capsaicin-rich foods may induce stomach fullness.

Relationship between spicy food intake and chronic uninvestigated dyspepsia in Iranian adults.

To assess the association between spicy food consumption and chronic uninvestigated dyspepsia (CUD) in a large sample of Iranian adults. In this cross-sectional study we assessed the consumption of spicy foods in 4763 Iranian adults living in Isfahan Province using a dietary habit questionnaire. A modified validated version of the Rome III questionnaire was used to assess CUD-related symptoms. CUD was defined as having one or more of the following characteristics: distressing postprandial fullness, early satiation and/or epigastric pain or epigastric burning at least often during the past three months. Information on meal regularity, meal frequency, intra-meal intake of fluid as well as other potential confounders was also collected. CUD was prevalent in 15% of the participants. The frequent consumption of spicy foods (≥ 10 times/week) was associated with greater odds of having CUD [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.09-2.49, P < 0.05). This relationship was significant even after adjusted for diet-related practices (OR 1.68, 95% CI 1.01-2.79, P < 0.05). There was a significantly positive association between spicy food consumption and postprandial fullness (OR 1.76, 95% CI 1.29-2.40, P < 0.05) and epigastric pain (OR 1.78, 95% CI 1.30-2.44, P < 0.05). However, no significant relationship was observed between the frequent consumption of spicy foods and early satiation. High consumption of spicy foods is associated with greater odds of CUD, frequent postprandial fullness and epigastric pain. Further studies, particularly of a prospective nature, are needed to confirm our findings.

Factors affecting occurrence of gastric varioliform lesions: A case-control study.

To investigate the factors influencing the occurrence of gastric varioliform lesions (GVLs) and their possible link with gastric cancer. A 1:1 matched case-control study was performed to retrospectively analyze data from 1638 chronic gastritis patients who had undergone gastroscopy at one of two Chinese hospitals between 2009 and 2014. Patients with GVLs (cases) were compared to those without such lesions (controls). Endoscopic and pathological findings were recorded, along with interview information on Helicobacter pylori (H. pylori) infection, medical, drug and family histories, lifestyle and eating habits. The association between each factor and the occurrence of GVLs was estimated, and then multivariate conditional logistic regression was used to evaluate the independent factors. The frequency and severity of glandular atrophy, intestinal metaplasia (IM) and low-grade intraepithelial neoplasia were significantly increased in the GVL group (P < 0.01). Overall analysis showed that H. pylori infection [3.051 (2.157, 4.317), P <0.001], allergic respiratory diseases [3.636 (2.183, 6.055), P < 0.001], work-related stress [2.019 (1.568, 2.600), P < 0.001], irregular meals [2.300 (1.462, 3.619), P < 0.001], high intake of spicy food [1.754 (1.227, 2.507), P = 0.002] and high intake of fresh fruit [0.231 (0.101, 0.529), P = 0.001] were significantly correlated with the occurrence of GVLs (positively, except for the latter). Stratified analyses indicated that pickled food consumption in patients over 50 years old [7.224 (2.360, 22.115), P = 0.001] and excessive smoking in men [2.013 (1.282, 3.163), P = 0.002] were also positively correlated, and that, for antral GVLs, vegetable consumption [0.491 (0.311, 0.776), P = 0.002] was negatively correlated. Seven risk factors and two protective factors are determined for GVLs, which were found to be associated with premalignant abnormalities.

Salty and spicy food; are they involved in the pathogenesis of acne vulgaris? A case controlled study

Many studies have suggested a strong relation between diet and acne. Many patients with acne believe that spicy and salty foods exacerbate acne. To assess the relationship between the dietary intake of salty and spicy food and the onset, severity, duration of acne. Two hundred patients with acne vulgaris and 200 age- and gender-matched controls were subjected to a detailed questionnaire taking, clinical examination and dietary assessment through using "24h recall" method. Sodium content of the 24-h food intake was computed by a computer program connecting participants' dietary information to the food composition table of National Nutrition Institute data base. Patients with acne consumed significantly higher daily amounts of sodium chloride (NaCl) (median 3367.54mg) compared to the controls (median 2271.8mg) (P<0.001). A negative correlation between the amount of NaCl in the diet of patients with acne and the age of onset of acne lesions was detected (r=-0.216, P=0.031). However, neither salty nor spicy food correlated with duration or severity of the disease. Consumption of salty foods was significantly higher among patients with acne compared to acne free subjects, making the consumption of salty food a possible participating factor in the development of acne.

Lifestyle and Sporadic Colorectal Cancer in India.

The study evaluated the patient, lifestyle and tumor profile in patients undergoing upfront surgery for sporadic colorectal cancer (CRC) in Indian population. One hundred consecutive patients were included. Details related to their demographic profile, habits, signs and symptoms, tumor profile, further treatment and follow up were recorded. The majority of the patients had colonic cancer (68%), advanced tumor stage 3 and 4 (46%), moderately differentiated tumors (70%) with absence of lymphatic invasion (60%) and metastasis (90%). Correlations between tumor location and abdominal pain (p-value 0.002), bleeding per rectum (p-value <0.001), difficulty in micturition (p-value 0.012) and constipation (p-value 0.007) were found to be statistically significant. Abdominal pain was more frequently reported in patients with metastasis (p-value 0.031). Loss of weight statistically correlated with absence of lymphatic invasion (p-value 0.047). Associations between tumor stage and alcohol intake (p-value 0.050) and non vegetarian diet (p-value 0.006); lymphatic invasion and intake of spicy food (p-value 0.040) and non vegetarian diet (p-value 0.001) and metastasis and alcohol intake (p-value 0.041) were also observed. Age and tumor grade were also correlated (p-value 0.020). Minimizing the adverse lifestyle factors can help in reducing the overall incidence of CRC in the Indian population.

Food intolerance prevalence in active ulcerative colitis in southwest China.

Food intolerance is believed to be a source of frequent medical problems in ulcerative colitis (UC), which closely correlate with patients' dietary pattern. Living in an underdeveloped area of China, residents in southwestern region have diverse dietary habits. The objective of this study is to determine the prevalence of food intolerance in the UC patients in this area and to discuss some of the possible risk factors leading to the condition. Food antibodies in serum of 80 patients with active UC were determined by standard enzyme-linked immuno sorbent assay (ELISA). This study examined the risk factors contributing to high titers of food antibodies and the dietary patterns correlating with food intolerance in these demographics. 83.8% of patients (67/80) were found to be seropositive for food intolerance. Patients of female, aged between 20 to 40 and the one who tended to have a high fat diet were tested to be highly seropositive (p<0.05). Neither spicy food intake nor the course the disease manifested any relationship with the presence of food intolerance (p>0.05). Active UC patients in southwestern region of China have showed to be high seropositive in food intolerance, particularly in female and young patients. Dietary patterns with high in fat intake seem to have caused high prevalence of seropositivity in food intolerance. Although rice has been taken as staple food and the spicy food has been popular among citizen in this region, these foods have indicated to no effect on food intolerance in this study.

Comparison of Capsaicin and Capsiate’s Effects at a Meal

Capsaicin, the major pungent component of hot peppers, promotes negative energy balance; however, many individuals avoid capsaicin-containing foods due to pungency. Capsiate, a capsaicin analog found in CH-19 sweet peppers, is a non-pungent alternative that promotes negative energy balance when consumed as an encapsulated supplement. No studies have investigated capsiate’s effects on energy balance when consumed orally with a meal. This randomized cross-over trial’s purpose was to compare effects of capsaicin and capsiate consumed orally at a meal. Participants were 24 healthy, lean individuals. Following capsaicin (2 mg), capsiate (2 mg), or control (no pepper) meals, appetitive sensations were recorded at 30-min intervals for 4.5 h, and blood pressure was taken every 15 min for 1 h. Energy intake was recorded at an ad libitum challenge meal (4.5 h after test meals) and self-reported for the remainder of the day. All meals were neutral to liked (≥3.2 on a 5-point category scale). The flavor of the control was better liked than the capsaicin-containing meal (p = 0.022). Purchase intent for similarly flavored restaurant meals was neutral to likely (≥2.9 on a 5-point category scale), with participants tending to prefer the capsiate or control meals (p = 0.066). Appetite, blood pressure, and energy intake did not vary between meals. This suggests that meals with low capsaicin and capsiate doses are acceptable and unlikely to cause unfavorable effects. Lack of metabolic changes could be related to dose, insufficient power to stratify by habitual spicy food intake, or that capsaicin and capsiate are not effective stimuli.

Gender differences in the influence of personality traits on spicy food liking and intake

It has been proposed, and only minimally explored, that personality factors may play a role in determining an individual’s sensitivity to and preference for capsaicin containing foods. We explored these relationships further here. Participants rated a number of foods and sensations on a generalized liking scale in a laboratory setting; after leaving the laboratory, they filled out an online personality survey, which included Arnett’s Inventory of Sensation Seeking (AISS) and the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ). Recently, we reported strong and moderate correlations between the liking of a spicy meal and the personality constructs of Sensation Seeking (AISS) and Sensitivity to Reward (SPSRQ), respectively. Here, we use moderation models to explore the relationships between personality traits, perceived intensity of the burn of capsaicin, and the liking and consumption of spicy foods. Limited evidence of moderation was observed; however differential effects of the personality traits were seen in men versus women. In men, Sensitivity to Reward associated more strongly with liking and consumption of spicy foods, while in women, Sensation Seeking associated more strongly with liking and intake of spicy foods. These differences suggest that in men and women, there may be divergent mechanisms leading to the intake of spicy foods; specifically, men may respond more to extrinsic factors, while women may respond more to intrinsic factors.

Spicy food consumption is associated with adiposity measures among half a million Chinese people: the China Kadoorie Biobank study.

BackgroundFew animal experiments and volunteer-based intervention studies have showed a controversial effect of spicy foods on weight management; however, information is scant on the association between spicy food intake and obesity. This study aims to examine the impact of spicy food on quantitative adiposity measures in the Chinese population; a population with a low prevalence of general obesity, but a high prevalence of central obesity.MethodsA total of 434,556 adults (255,094 females), aged 30–79 years, were included from the China Kadoorie Biobank (CKB) study. Information on spicy food intake was obtained using a questionnaire survey. Body mass index (BMI), percentage body fat (BF%), waist circumference (WC), and WC/height ratio (WHtR) were analyzed as continuous variables.ResultsThe prevalence of daily spicy food eating was 30.4% in males and 30.0% in females, with dramatically geographic diversity (ranging from 99.4% in Hunan to 2.7% in Zhejiang). The covariates-adjusted BMI, BF%, WC, and WHtR significantly increased with increasing frequency, strength, and duration of spicy food eating regardless of gender (p < 0.001). Among regular spicy food consumers, strength of spicy food eating showed significant and positive association with all adiposity measures in both genders (except for BF% in males). Compared with non-consumers, daily spicy food eating was significantly associated with an increase of 0.44 and 0.51 of BMI (kg/m2), 0.79 and 1.01 of BF%, 1.4 and 1.0 of WC (cm), and 0.008 and 0.006 of WHtR in males and females, respectively. In stratified analyses of 18 consecutive BMI subgroups, a significantly increasing trend in the effect of daily spicy food eating on WC and WHtR with increasing BMI was noted in males; whereas a decreasing trend was seen in females.ConclusionsThe data indicate that spicy food intake is a risk factor for obesity in Chinese adult population, especially for central obesity in males. Further studies are needed to elucidate the mechanisms underlying this association.

Triggers of spontaneous preterm delivery--why today?

Our goal is to study the triggers of spontaneous preterm delivery using a case-crossover design. In a pilot study, we enrolled 50 women with spontaneous preterm labour (PTL) and 50 with preterm premature rupture of membranes (PPROM) between 2011 and 2012. To assess non-transient risk factors, we also enrolled a control group of 158 pregnant women at their regular prenatal care visits matched to cases by gestational age and calendar time. The index time was defined as the onset of PTL/PPROM (for cases) or interview (for controls). Detailed data were collected through structured interviews regarding factors of interest during the 72 h that preceded the index time. Within case subjects, we compared the frequency of transient factors from 0 to 24 h before index time with that from 48 to 72 h before index time, and estimated matched odds ratios (OR) and 95% confidence intervals (CI). Previously hypothesised chronic risk factors for spontaneous preterm delivery, including mood disorders and stressful events, were more common among cases than among controls. Within cases, skipped meals [OR 4.3, 95% CI 1.2, 15.2], disturbed sleep [OR 4.5, 95% CI 1.5, 13.3], sexual activity [OR 6.0, 95% CI 0.7, 69.8], and intake of spicy foods [OR 7.0, 95% CI 1.6, 30.8] were associated with an increased risk for PTL/PPROM within the subsequent 24 h. For physical exertion and other potential risk factors evaluated, the OR was close to the null. Skipping meals and disturbed sleep may be associated with imminent PTL/PPROM; sexual activity and spicy food may trigger PTL/PPROM in susceptible women. Larger case-crossover studies will be able to evaluate the impact of modifiable risk factors and acute predictors of PTL/PPROM, and might help guide obstetrical management.

An International Menopause Society study of Climate, Altitude, Temperature (IMS-CAT) and vasomotor symptoms in urban Indian regions

Objective To examine the relationships between climate (season, temperature, humidity), lifestyle, health, mood and beliefs and experience of hot flushes and night sweats amongst mid-aged women living in eight urban Indian centers.Methods A total of 717 peri- and postmenopausal women, aged 45–55 years, from urban centers in different regions of India were included. Data were collected during both summer and winter months. Participants completed questionnaires eliciting information about sociodemographics, hot flushes (prevalence, frequency and problem-rating), health and lifestyle (body mass index, diet, exercise, alcohol use), mood (Women's Health Questionnaire) and attributions and beliefs (Menopause Representations Questionnaire).Results The prevalence of vasomotor symptoms was low, with 34% of the sample reporting hot flushes and/or night sweats. Seasonal variation in temperature was not associated with hot flush prevalence, frequency or problem rating. Hot flush prevalence was mainly associated with higher anxiety and intake of spicy foods, frequency with (older) age and (more) frequent exercise, while hot flushes were more problematic for women who reported poorer general health and more negative beliefs about menopause.Conclusions In this study of Indian women, seasonal temperature variation did not appear to influence hot flush reporting. Health, mood, beliefs and lifestyle factors appear to explain some, but not all, of the variance in experience of menopausal symptoms.

Personality factors predict spicy food liking and intake

A number of factors likely affect the liking of capsaicin-containing foods such as social influences, repeated exposure to capsaicin, physiological differences in chemosensation, and personality. For example, it is well known that repeated exposure to capsaicin and chilies can result in chronic desensitization. Here, we explore the relationship between multiple personality variables – body awareness/consciousness, sensation seeking, and sensitivity to punishment, and sensitivity to reward – and the liking and consumption of capsaicin-containing foods. As expected, a strong relationship was found between liking of spicy foods and frequency of chili consumption. However, no association was observed between frequency of chili consumption and the perceived burn/sting of sampled capsaicin. Nor was there any association between perceived burn/sting of capsaicin and any of the personality measures. Private Body Consciousness did not relate to any of the measures used in the current study. Sensation Seeking showed positive correlations with the liking of spicy foods, but not non-spicy control foods. Sensitivity to Punishment showed no relation with frequency of chili consumption, and nonsignificant negative trends with liking of spicy foods. Conversely, Sensitivity to Reward was weakly though significantly correlated with the liking of a spicy meal, and similar nonsignificant trends were seen for other spicy foods. Frequency of chili consumption was positively associated with Sensation Seeking and Sensitivity to Reward. Present data indicate individuals who enjoy spicy foods exhibit higher Sensation Seeking and Sensitivity to Reward traits. Rather than merely showing reduced response to the irritating qualities of capsaicin as might be expected under the chronic desensitization hypothesis, these findings support the hypothesis that personality differences may drive differences in spicy food liking and intake.

Predictive Factors for Improvement of Atrophic Gastritis and Intestinal Metaplasia After Helicobacter Pylori Eradication: A Three‐Year Follow‐Up Study in Korea

To date, data on the effects of anti-Helicobacter therapy on the improvement of atrophic gastritis (AG) and intestinal metaplasia (IM) have been conflicting. This study was performed to investigate whether eradication of H. pylori could lead to the improvement of AG and IM, and the prognostic factors associated with the improvement of AG and IM. Four hundred patients consisting of H. pylori-negative (n = 116) and H. pylori-positive (n = 284) groups were followed up 1 and 3 years after initial H. pylori tests. Serum levels of pepsinogen (PG), bacteria, environmental factors, and genetic polymorphisms were determined. The grade of corpus atrophy decreased at 1 and 3 years after successful eradication (p < .001 and p = .033, respectively). However, there was no significant change in the IM in the antrum and in the corpus. Prediction factors for the improvement of corpus AG by H. pylori eradication were baseline low PG I/II ratio (≤3), high salt intake, and corpus-predominant gastritis. IM improvement was also associated with spicy food intake and high baseline grade of IM, in addition to these factors. In addition, IL-1B-511 C/T and IL-6-572 C/G alleles were found to inhibit IM improvement. However, H. pylori-negative and noneradicated group did not show any significant change in AG or IM. Corpus AG was reversed by H. pylori eradication, and improvement of IM by H. pylori eradiation was more definite in patients with severe IM, low PG I/II ratio, and corpus-predominant gastritis, suggesting that H. pylori eradication is valuable even in severe cases.

The International Menopause Study of Climate, Altitude, Temperature (IMS-CAT) and vasomotor symptoms

ABSTRACTObjective To examine the relationship between climate (including altitude, temperature, humidity and annual range of temperature) and experience of hot flushes and night sweats amongst Spanish-speaking mid-aged women living in five urban centers.Methods A total of 896 peri- and postmenopausal women from centers in Chile (Santiago de Chile), Ecuador (Guayaquil and Quito), Panama (Panama City) and Spain (Madrid) completed questionnaires eliciting information about sociodemographics, hot flushes (prevalence, frequency and problem-rating), health and lifestyle (body mass index, diet, exercise, alcohol use) and mood (Women's Health Questionnaire).Results There was a wide range of altitude and temperature in the participating centers. Of the sample, 58.5% (524/896) were currently experiencing vasomotor symptoms. Prevalence was associated with higher temperatures, while hot flushes were more frequent and problematic for women living in higher temperature and lower altitudes. Hot flush variables were not associated with seasonal variation in temperature. When health and lifestyle variables were included as covariates in regression analyses, prevalence was best predicted by age (younger), poor general health, more depressed mood and anxiety; hot flush frequency by anxiety, temperature, life satisfaction (lower), age (higher), regular strenuous exercise (more strenuous exercise more frequent), and a diet including regular hot spicy food intake. Hot flush problem-rating was best predicted by anxiety, life satisfaction, altitude (lower more problematic), any regular exercise (more exercise less problematic), and depressed mood.Conclusions In this study of Spanish-speaking women, those living in countries with higher temperatures and lower altitudes reported more frequent and problematic hot flushes.

Evaluation of Helicobacter pylori infection and other risk factors in patients with benign peptic ulcer disease

Objective To assess and compare the risk factors in patients with benign gastric and duodenal ulcers and to correlate the prevalence of Helicobacter pylori ( H. pylori) infection in benign peptic ulcer disease. Methods A total of 30 consecutive patients with peptic ulcer disease were included in this study after upper gastrointestinal endoscopy. Their clinical profile and endoscopic findings were noted. Antral biopsies were subjected to histopathological examination and urease test for detection of H. pylori. Results were correlated. The study was cleared by the Institute Research Council and the Ethics committee. Results The male: female ratio was 11:4. Overall, H. pylori infection was prevalent in 93.3% of the patients. Patients who took spicy food had a significantly higher rate of H. pylori positivity ( P=0.04). Smoking, alcohol intake and NSAIDs did not affect H. pylori status in patients. There was no significant association between the site of the ulcer and H. pylori infection. Conclusions Based on our observations we conclude that prevalence of H. pylori infection is similar in duodenal and gastric ulcers and intake of spicy food is a significant risk factor.

The effects of hedonically acceptable red pepper doses on thermogenesis and appetite

Previous studies suggest consumption of red pepper (RP) promotes negative energy balance. However, the RP dose provided in these studies (up to 10 g/meal) usually exceeded the amount preferred by the general population in the United States (mean=~1 g/meal). The objective of this study was to evaluate the effects of hedonically acceptable RP doses served at a single meal in healthy, lean individuals on thermogenesis and appetite. Twenty-five men and women (aged 23.0 ± 0.5 years, BMI 22.6 ± 0.3 kg/m(2), 13 spicy food users and 12 non-users) participated in a randomized crossover trial during which they consumed a standardized quantity (1 g); their preferred quantity (regular spicy food users 1.8 ± 0.3 g/meal, non-users 0.3 ± 0.1 g/meal); or no RP. Energy expenditure, core body and skin temperature, and appetite were measured. Postprandial energy expenditure and core body temperature were greater, and skin temperature was lower, after test loads with 1 g RP than no RP. Respiratory quotient was lower after the preferred RP dose was ingested orally, compared to in capsule form. These findings suggest that RP's effects on energy balance stem from a combination of metabolic and sensory inputs, and that oral exposure is necessary to achieve RP's maximum benefits. Energy intake was lower after test loads with 1 g RP than no RP in non-users, but not in users. Preoccupation with food, and the desire to consume fatty, salty, and sweet foods were decreased more (or tended to be decreased more) in non-users than users after a 1 g RP test load, but did not vary after a test load with no RP. This suggests that individuals may become desensitized to the effects of RP with long-term spicy food intake.

Prospective Evaluation of Risk Factors for Hemorrhoids

Purpose: While hemorrhoids are common in the general population, risk factors have not been well defined in the literature. Previous studies have been plagued by their retrospective design and lack of objective assessment of hemorrhoidal disease by experienced colorectal surgeons. In this study, we prospectively assessed which risk factors predispose to hemorrhoids in a cohort of patients evaluated by colorectal surgeons. Methods: Based on a comprehensive review of prior reports, we compiled a questionnaire encompassing over 80 factors possibly related to the development of hemorrhoids. This questionnaire was completed by patients presenting with anal symptoms to the offices of five board-certified colorectal surgeons in an urban setting. The incidence of these risk factors in patients with hemorrhoids (hemorrhoid group) was compared to patients who did not have hemorrhoids (control group). Univariate analysis using chi square and Student's t-test was performed. Variables with a p value <0.15 were then tested by multiple stepwise logistic regression. Results: Of the 551 patients studied, 324 (59%) were male, and 471 (85%) were white. Median body mass index was 24. There were 388 (70%) patients with hemorrhoids. The diagnosis in the remaining 163 (30%) patients included fissure (n=56), pruritus ani (n=17), anal abscess (n=15), normal (n=12), anal tag or wart (n=12), fistula-in-ano (n=9), and others (n=42). Univariate analysis revealed a statistically significant difference between the hemorrhoid and control group in percentage of individuals over 40 years of age (66% vs. 54%, p=0.01), income greater than $100,000 per year (54% vs. 36%, p=0.01), report of moderate or high intake of spicy food (43% vs. 31%, p=0.02), report of rushing to toilet when sensing urge to defecate (24% vs. 36%, p=0.01), and report of pain upon defecation (13% vs. 21%, p=0.03). On multivariate analysis, the only statistically significant differences between the hemorrhoid and control group were in the percentage of individuals over age 40 (p=0.04; OR=1.7, CI=1.0-2.8), and income over $100,000 per year (p=0.01; OR=1.9; CI=1.17-3.0). Conclusion: This first reported prospective study of patients examined by a group of experienced colorectal surgeons revealed that age over 40 and income greater than $100,000 per year are independently associated with hemorrhoids. Commonly held perceptions regarding hemorrhoidal risk factors should be strongly questioned.