# What's the worst that can happen from eating too many spicy peppers? Can you die?

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Some peppers, such as the habanero or Carolina reaper are extremely spicy, and when eaten in larger amounts than one is accustomed to, can cause some discomfort.

I've also heard anecdotes claiming that pepper spray, if applied with sufficient intensity, can cause death.

What if you were to eat as many spicy peppers as possible, despite the noxious taste? Is it possible to commit suicide in this way (and what would the cause of death)? Would you faint from excessive mouth pain? Would uncontrollable vomiting prevent you from consuming further peppers?

The more "dangerous" properties of spicy peppers are chiefly due to capsaicin.

Sigma-Aldrich sells purified capsaicin, for which they provide safety information, including an MSDS. Most of it is the usual, unsurprising set of warnings about irritation to eyes and the respiratory system. However, there are LD50 numbers:

LD50 Oral - rat - male - 161.2 mg/kg

LD50 Oral - rat - female - 148.1 mg/kg

LD50 Dermal - mouse - >512 mg/kg

From this, we can conclude that one would have to eat quite a bit of capsaicin to die. If lethality in humans is exactly the same as rat (which it probably isn't), a 70 kg human would need to consume about 11 g of capsaicin to reach similar levels of lethality.

The Carolina Reaper, one of the hottest known peppers, averages about 1.6 million on the Scoville scale. Capsaicin amount is related to Scoville heat units, so we can make an imprecise conversion from one to the other.

Using values given in 2 publications (Nwokem 2010 and Al Othman 2011) we can observe the following trend:

So on average, about $$6.25 cdot 10^{-5}$$ mg/g capsaicin per SHU. With this, we get $$(1.6 cdot 10^5) cdot (6.25 cdot 10^{-5}) = 10$$ mg/g, or 1% capsaicin for dry Carolina Reapers. To eat the equivalent of 11 g of capsaicin in peppers, you would have to eat 1.1 kg of dry peppers - which should be a couple of dozen.

So, I think we can conclude that it is relatively "feasible" to consume a dangerously large amount of capsaicin by eating very spicy peppers. However, there are numerous caveats with my reasoning:

• Human LD50 and rat LD50 are not necessarily the same.
• Toxicity is not necessarily linearly related to body weight.
• Peppers have compounds besides capsaicin that contribute to hotness.
• It would be very difficult to eat such a large amount of spicy peppers, and various involuntary reflexes would interfere. Even if one were force fed the peppers, I imagine the body would attempt to vomit it up - which brings up the question of how the toxicologists even managed to feed several milligrams of capsaicin to rats to measure the LD50.

If you have cardiovascular problems, then it should be quite possible for the pain cause by spicy peppers to trigger a heart attack via a spike in blood pressure. A similar scenario might occur with respiratory diseases. And of course an anaphylactic shock, if you are allergic.

Apart from such special circumstances, I imagine that it would be nearly impossible to overcome the debilitating effects of capsaicin long enough to consume a lethal dose.

## What's the worst that can happen from eating too many spicy peppers? Can you die? - Biology

Posted by Jonathan Soma on feb 5, 2012 under Blog Post

I've been doing a lot of "candy science" research in preparation for next month's Masters of Social Gastronomy, and being in love with spicy flavors, Atomic Fireballs were on the top of my list.

Atomic Fireballs were brought to us by the Ferrara Pan Candy Company, which is the best candy company because they also invented Lemonheads. If you make a super spicy candy and a super sour candy you're aces in my book.

Fireballs were released in the Cold War era of 1954, a perfect time for nuclear-themed candy, as America was certain of warhead-borne destruction coming our way [SIDENOTE: Looks like the similarly-named Warheads candy has a rather different provenance, as it came out of Taiwan in 1975]. I guess going in a blaze of cinnamon isn't the worst way to die.

The thing that interests me about Atomic Fireballs, though, is how damn spicy they are. But cinnamon isn't that spicy, is it? Bear with me science-wise for a second, then we'll get to the secret answer.

Cinnamaldehyde, the oil that makes cinnamon taste cinnamony, affects a receptor in your mouth called TRPA1. TRPA1 is part of the TRPA family of ion channels that detect when crazy chemical things go on they're responsible for your reaction to raw garlic, horseradish, mustard oil, stuff like that. Kind of like irritant detectors.

While being an irritant is pretty bad, you probably swear that it's more than that. It's spicy, you promise! It's more than raw garlic! It's like, you don't know, hot peppers or something!

And you'd be right. Turns out Ferrara adds capsaicin to Atomic Fireballs to give them that little extra zing (or that lotta extra zing). Capsaicin is the compound that makes hot peppers spicy, and is found in everything from jalepeños to . other hot candies. It reacts with a channel called TRPV1 (a.k.a. the capsaicin channel, which is what you should name your spicy-foods television network) which is good pals with the TRPA set.

The fun thing about TRPV1 (the spiciness receptor) is that instead of detecting chemicals, its primary purpose is to check the temperature. It's kind of like an alarm, in that when the receptor gets too hot it starts firing like crazy. How hot? About 43°C, or 110°F. So turns out that by eating something with capsaicin in it you're tricking your brain into thinking it's 110° in your mouth.

Also, look at this fun chart from Nature about what activates what receptors!

Go here if you want the science details, but from left to right it's peppers/camphor, camphor, a weird Chinese herb I'd never heard of called Andrographis paniculata, mint, and finally horseradish/cinnamon/garlic.

OK, so Atomic Fireballs are like a hot pepper in your mouth, great. But now the question is which hot pepper? Jalapeño vs. habanero is a pretty big thing if you're going to talk about this at your next cocktail/candy party.

Luckily, Ferrara is kind enough to let us know that Atomic Fireballs are 3500 on the Scoville scale, a scale that's used for measuring the spiciness of peppers. You pop on over to a chart at Wikipedia and see that they're in a respectable cayenne neighborhood well above Jalapeños but not quite up to bird's eye chili strength.

Does that seem way too high to anyone else? You do not run around crying after you eat a Fireball. Maybe they just mean they use a chili powder with 3500 Scoville units when they put the candy together.

Anyway, now you can tell all your friends that Atomic Fireballs are just hot peppers with cinnamon sticks and sugar inside. If that doesn't make you want to order five pounds of them on Amazon, I'm not sure what will.

## What are the symptoms of gastritis?

Each person’s symptoms may vary. The most common symptoms of gastritis include:

• Stomach upset or pain
• Belching and hiccups
• Belly or abdominal bleeding
• Nausea and vomiting
• Feeling of fullness or burning in your stomach
• Loss of appetite
• Blood in your vomit or stool (a sign that your stomach lining may be bleeding)

The symptoms of gastritis may look like other health problems. Always see your healthcare provider to be sure.

## 3. Some Canned Foods

Canned foods are very convenient since they have a long shelf-life, but it’s important to choose the right kinds of canned foods for your health. Some canned food contains high amounts of sodium and added sugars, which contribute to weight gain, high blood pressure, insulin resistance, type 2 diabetes, and fatty liver disease.

In addition, some canned food items contain a chemical called bisphenol-A (BPA). BPA has been shown to impact hormonal health, but newer research reveals that BPA may also play a role in liver health. A study conducted by researchers at the Division of Pediatric Gastroenterology, Hepatology, and Nutrition at the University of California San Francisco examined the relationship between BPA consumption and nonalcoholic fatty liver disease for adolescents. Results found that BPA intake among adolescents – particularly Hispanic adolescents – is associated with a higher risk of developing fatty liver disease. (3)

To protect your liver, make sure to look for canned foods that are low in sodium and low in sugar. It’s also important to choose brands that produce cans that are free of BPA.

### Healthy Alternatives

As often as possible, go for fresh foods like fruits, vegetables, nuts, seeds, and beans. These fresh foods are filled with micronutrients and macronutrients like vitamin C, vitamin E, healthy fats, fiber, and protein that help you fight against fatty liver disease and reduce the amount of fat in the liver. Examples of fresh plant-based foods that promote liver health include avocados, blueberries, cranberries, oranges, kale, broccoli, brussels sprouts, cauliflower, flaxseeds, chia seeds, walnuts, and pumpkin seeds. Fresh fruits and veggies have the added benefits of fighting against risk factors associated with fatty liver disease, like insulin resistance, type 2 diabetes, high blood pressure, and obesity.

## 2. Caffeine

I know how easy it is to become caffeine dependent. But while this stimulant may make you feel more energy temporarily, it ultimately makes you feel older and more tired.

The problem with caffeine is the very thing we like about it: it’s a stimulant, and if your kidneys are already taxed, long-term caffeine use can increase your risk of renal failure. 2 Even brief caffeine consumption increases your risk of developing kidney stones, especially on an empty stomach. A 2002 study analyzed the immediate effects of drinking caffeine after 14 hours of fasting. The results showed greater calcium excretion in the urine and a higher risk of kidney stone formation. 3

So have caffeine in moderation. Here’s a trick I use for my morning coffee: I brew half regular and half naturally decaf coffee to reduce the amount of caffeine.

## The cool science of hot peppers

Many chili peppers look as fiery as they taste! A single chili pepper can be enough to spice up an entire family&rsquos meal.

Shiny green slices of jalapeño pepper adorn a plate of nachos. Chomping into one of those innocent-looking chilies will make a person’s mouth explode with spicy fireworks. Some people dread and avoid the painful, eye-watering, mouth-searing sensation. Others love the burn.

“A quarter of the world’s population eats chilies every day,” notes Joshua Tewksbury. He is a biologist who spent 10 years studying wild chili peppers. He also happens to enjoy eating hot, spicy food.

Chili peppers do much more than burn people’s mouths. Scientists have discovered many uses for the chemical that gives these veggies their zing. Called capsaicin (Kap-SAY-ih-sin), it’s the main ingredient in pepper spray. Some people use this weapon for self-defense. The spray’s high levels of capsaicin will burn the eyes and throats of attackers — but won’t kill people. In smaller doses, capsaicin can relieve pain, help with weight loss and possibly affect microbes in the gut to keep people healthier. Now how cool is that?

#### A taste for spice

Why would anyone willingly eat something that causes pain? Capsaicin triggers a rush of stress hormones. These will make the skin redden and sweat. It can also make someone feel jittery or energized. Some people enjoy this feeling. But there is another reason why chilies show up on dinner plates the world over. Hot peppers actually make food safer to eat.

A popular Mexican dish, chile rellenos are whole hot chili peppers stuffed with cheese and then fried. Skyler Lewis/Wikimedia Commons (CC-BY-SA 3.0) When food sits out in warm weather, microbes on the food start to multiply. If people eat food with too many of these germs, they risk getting very sick. The cold temperature inside a refrigerator stops most microbes from growing. That’s why most people today rely on refrigerators to keep their food fresh. But long ago, those appliances weren’t available. Chilies were. Their capsaicin and other chemicals, it turns out, can slow or stop microbial growth. (Garlic, onion and many other cooking spices can, too.)

Before refrigerators, people living in most hot parts of the world developed a taste for spicy foods. Examples include hot Indian curries and fiery Mexican tamales. This preference emerged over time. The people who first added hot peppers to their recipes probably had no idea chilies could make their food safer they just liked the stuff. But people who ate the spicy food tended to get sick less often. In time, these people would be more likely to raise healthy families. This led to populations of hot-spice lovers. People who came from cold parts of the world tended to stick with blander recipes. They didn’t need those spices to keep their food safe.

#### Why chilies hurt

The heat of a chili pepper is not actually a taste. That burning feeling comes from the body’s pain response system. Capsaicin inside the pepper activates a protein in people’s cells called TRPV1. This protein’s job is to sense heat. When it does, it alerts the brain. The brain then responds by sending a jolt of pain back to the affected part of the body.

Normally, the body’s pain response helps prevent serious injury. If a person accidentally places fingers on a hot stove, the pain makes him or her yank that hand back quickly. The result: a minor burn, not permanent skin damage.

Hot peppers may as well be candy to birds. They don’t feel the burn. This Sayaca Tanager is chowing down on malagueta peppers, which can be 40 times as hot as jalapeños. Alex Popovkin, Bahia, Brazil/Flickr (CC BY 2.0) Biting into a jalapeño pepper has the same effect on the brain as touching a hot stove. “[Peppers] trick our brain into thinking we are being burned,” says Tewksbury, who now leads the Boulder, Colo., office of Future Earth. (The group promotes research to protect Earth’s resources). Pepper plants likely evolved their fake-out technique to keep certain animals from eating up their fruit, according to Tewksbury’s research.

People, mice and other mammals feel the burn when they eat peppers. Birds do not. Why would peppers develop a way to keep mammals away but attract birds? It ensures the plants’ survival. Mammals have teeth that smash seeds, destroying them. Birds swallow pepper seeds whole. Later, when birds poop, the intact seeds land in a new place. That lets the plant spread.

People managed to outsmart the pepper when they realized that a chili’s pain doesn’t cause any lasting damage. Those with pepper allergies or stomach conditions do need to stay away from chilies. But most people can safely eat hot peppers.

#### Pain fights pain

Capsaicin does not actually damage the body in the same way that a hot stovetop will — at least not in small amounts. In fact, the chemical can be used as a medicine to help relieve pain. It may seem bizarre that what causes pain might also make pain go away. Yet it’s true.

Biting into one of these fresh jalapeños has the same effect on the brain as touching a hot stove. But new data show why the peppery chemicals can help deaden pain from other causes. Kees Zwanenburg /iStockphoto Tibor Rohacs is a medical researcher at New Jersey Medical School in Newark. He recently studied how capsaicin works to deaden pain . Researchers already knew that when capsaicin turns on the TRPV1 protein, it’s like turning on a bright light. Whenever the light is on, the person experiences pain. Rohacs and his colleagues then uncovered a chemical chain reaction that later silences this pain. Essentially, he says, the light “shines so brightly that after a while, the bulb burns out.” Then the TRPV1 protein can’t turn back on again. When this happens, the brain no longer finds out about painful sensations. The team published its findings in the journal Science Signaling in February 2015.

The human body is good at repairing itself, however. Eventually, the pain will fix this pain system and can once again send pain alerts to the brain. However, if the TRPV1 protein is activated often, the pain system may not get a chance to repair itself in time. The person will only feel discomfort or burning at first. Then he or she will experience relief from other types of pain.

For example, people with arthritis (Arth-RY-tis) regularly have pain in their fingers, knees, hips or other joints. Rubbing a cream containing capsaicin onto the painful area may burn or sting at first. After a while, however, the area will become numb.

Rohacs warns that capsaicin creams don’t seem to soak deeply enough into the skin to totally eliminate pain. He says other researchers are currently testing capsaicin patches or injections. These would likely do a better job at halting pain. Unfortunately, these therapies tend to hurt a lot more than a cream — at least in the beginning. Someone who can tough out the initial discomfort, however, could get relief that lasts for weeks, not hours.

#### Sweat it out

Chili peppers also may help people lose weight. However, a person can’t simply eat hot, spicy food and expect to shed pounds. “It’s not a magic remedy,” warns Baskaran Thyagarajan. He works at the University of Wyoming in Laramie. As a pharmacologist, he studies the effects of medicines. His team is now working to create a drug to make the body burn through fat more quickly than usual. A primary ingredient: capsaicin.

In the body, capsaicin triggers a stress reaction known as the fight-or-flight response. It normally occurs when someone (or some animal) senses a threat or danger. The body responds by preparing to either run away or stand and fight. In people, the heart’s beating will speed up, breathing will quicken and the blood will send a boost of energy to the muscles.

The Carolina Reaper currently holds the title as the hottest chili pepper in the world. It is as much as 880 times as hot as a jalapeño — so hot that it can actually leave chemical burns on someone’s skin. Dale Thurber / Wikimedia CC-BY-SA 3.0 To fuel the fight-or-flight response, the body burns through stores of fat. Just as a bonfire chews through wood to produce hot flames, the human body turns fat from food into the energy it needs. Thyagarajan’s team is now working on a capsaicin-based drug aimed at helping obese people — those who have more stored fat than their bodies need — to shed their excess weight.

In a 2015 study, his group showed that mice that ate a high-fat diet containing capsaicin did not gain extra weight. But a group of mice that ate only the high-fat diet became obese. Thyagarajan’s group hopes to start testing its new medication on people soon.

Other researchers have already tried similar therapies. Zhaoping Li is a doctor and nutrition specialist at the University of California in Los Angeles. In 2010, Li and her colleagues gave a pill containing a capsaicin-like chemical to obese volunteers. The chemical was called dihydrocapsiate (Di-HY-drow-KAP-see-ayt). It did help the people lose weight. But the change was slow. In the end, it also was too small to make much of a difference, Li believes. She suspects that using capsaicin would have had a bigger effect. Still, she argues, it would never work as a weight loss remedy. Why not? “When we convert the dose that worked on mice or rats to humans, [people] don’t tolerate it.” It’s too spicy! Even in pill form, she points out, capsaicin gives many people upset stomachs.

But Thyagarajan says his team has come up with a spice-proof way to get capsaicin into the body. A doctor would inject the drug directly into areas with a lot of fatty tissue. Magnets would coat each particle. The doctor would use a magnetic belt or wand to hold the particles in place. This should keep the capsaicin from circulating through the body. Thyagarajan believes that this would help prevent side effects.

#### Spice it up

Capsaicin may be the most exciting chemical inside a chili pepper, but it isn’t the only reason to spice up your diet. Both hot and sweet peppers also have important vitamins and minerals that the body needs. Li’s team is now studying how chilies and other cooking spices change the bacteria living in the human gut. Outside the body, spices help keep dangerous germs from growing on food. Li suspects that inside the body, they may rout bad germs. They might also help good bacteria thrive. She is investigating both ideas now.

A 2015 study even showed that people with spicy diets tend to live longer. Researchers at the Chinese Academy of Medical Sciences in Beijing tracked half a million adults in China for seven years. Those who ate spicy food six or seven days a week were 14 percent less likely to die during those seven years than were people who ate spices less than once a week. And people who regularly ate fresh chilies, in particular, were less likely to die of cancer or heart disease. This result doesn’t necessarily mean that eating hot chilies prevents disease. It may be that people with healthy overall lifestyles tend to prefer spicier foods.

As scientists continue to uncover the secret powers of chili peppers, people will keep spicing up their soups, stews, stir-fries and other favorite dishes. Next time you see a jalapeño on a plate, take a deep breath, then take a bite.

### Power Words

arthritis A disease that causes painful inflammation in the joints.

bacterium (plural bacteria)A single-celled organism. These dwell nearly everywhere on Earth, from the bottom of the sea to inside animals.

capsaicin The compound in spicy chili peppers that imparts a burning sensation on the tongue or skin.

chili pepper A small vegetable pod often used in cooking to make food hot and spicy.

curry Any dish from the cooking tradition of India that uses a blend of strong spices, including turmeric, cumin and chili powder.

dihydrocapsiate A chemical found in some peppers that is related to capsaicin, but does not cause a burning sensation.

fat A natural oily or greasy substance occurring in animal bodies, especially when deposited as a layer under the skin or around certain organs. Fat’s primary role is as an energy reserve. Fat is also a vital nutrient, though it can be harmful to one’s health if over consumed in excess amounts.

fight-or-flight response The body’s response to a threat, either real or imagined. During the fight-or-flight response, digestion shuts down as the body prepares to deal with the threat (fight) or to run away from it (flight).

gut Colloquial term for an organism’s stomach and/or intestines. It is where food is broken down and absorbed for use by the rest of the body.

hormone (in zoology and medicine) A chemical produced in a gland and then carried in the bloodstream to another part of the body. Hormones control many important body activities, such as growth. Hormones act by triggering or regulating chemical reactions in the body. (in botany) A chemical that serves as a signaling compound that tells cells of a plant when and how to develop, or when to grow old and die.

jalapeño A moderately spicy green chili pepper often used in Mexican cooking.

microbe Short for microorganism. A living thing that is too small to see with the unaided eye, including bacteria, some fungi and many other organisms such as amoebas. Most consist of a single cell.

mineral Crystal-forming substances that make up rock and that are needed by the body to make and feed tissues to maintain health.

nutrition The healthful components (nutrients) in the diet — such as proteins, fats, vitamins and minerals — that the body uses to grow and to fuel its processes.

obesity Extreme overweight. Obesity is associated with a wide range of health problems, including type 2 diabetes and high blood pressure.

pepper spray A weapon used to stop an attacker without causing death or serious injury. The spray irritates a person’s eyes and throat and makes breathing difficult.

pharmacology The study of how chemicals work in the body, often as a way to design new drugs to treat disease. People who work in this field are known as pharmacologists.

proteins Compounds made from one or more long chains of amino acids. Proteins are an essential part of all living organisms. They form the basis of living cells, muscle and tissues they also do the work inside of cells. The hemoglobin in blood and the antibodies that attempt to fight infections are among the better-known, stand-alone proteins.Medicines frequently work by latching onto proteins.

stress (in biology) A factor, such as unusual temperatures, moisture or pollution, that affects the health of a species or ecosystem.

tamale A dish from the cooking tradition of Mexico. It is spicy meat wrapped in cornmeal dough and served in a corn husk.

taste One of the basic ways the body senses its environment, especially our food, using receptors (taste buds) on the tongue (and some other organs).

TRPV1 A type of pain receptor on cells that detects signals about painful heat.

vitamin Any of a group of chemicals that are essential for normal growth and nutrition and are required in small quantities in the diet because they cannot be made by the body.

### Citations

T. Hesman Saey. “How hot peppers can soothe pain.” Science News for Students. March 4, 2015.

S. Ornes. “A pepper that burns fat.” Science News for Students. May 19, 2010.

E. Sohn. “Hot pepper, hot spider.” Science News for Students. November 15, 2006.

Picked a pepper? Find out how hot it is using the Scoville scale.

Original Journal Source: N.G. Forouhi. Consumption of hot spicy foods and mortality — is chilli good for your health? BMJ. Vol. 351, August 4, 2015. doi: 10.1136/bmj.h4141.

Original Journal Source: I. Borbiro et al. Activation of TRPV1 channels inhibits mechanosensitive Piezo channel activity by depleting membrane phosphoinositides. Science Signaling. Vol. 8, February 10, 2015, p. ra15. doi: 10.1126/scisignal.2005667.

Original Journal Source: V. Krishnan et al. Dietary capsaicin and exercise: Analysis of a two-pronged approach to counteract obesity. Biophysical Journal. Vol. 108, January 27, 2015, p. 124a. doi: 10.1016/j.bpj.2014.11.693.

Kathryn Hulick is a freelance science writer and the author of Strange But True: 10 of the World's Greatest Mysteries Explained, a book about the science of ghosts, aliens and more. She loves hiking, gardening and robots.

Tomatoes have a variety of well-known health benefits, but are perhaps best known for their cardioprotective effects. According to a February 2017 study in the Atherosclerosis journal, consumption of tomatoes can positively affect blood lipid levels and blood pressure thanks to its lycopene content.

A January 2015 article in the journal Critical Reviews in Food Science and Nutrition reported that tomato consumption is only only helpful in minimizing cardiovascular problems, but can reduce the risk of other health issues like high cholesterol, obesity and cancer. A small January 2017 study in the Asia Pacific Journal of Clinical Nutrition even found that regular consumption of tomato juice could help improve sperm motility in infertile men.

However, like any food, tomatoes have advantages and disadvantages. According to A January 2019 study in the Journal of Nutrition, tomatoes are generally safe to eat. But both regular and excessive consumption of tomatoes have the potential to affect your health. For example, tomatoes are among the leading causes of migraines.

When you eat too many tomatoes, you may experience symptoms of acid reflux. That can affect people who are otherwise perfectly healthy. It is a well-known trigger food for people with existing gastroesophageal reflux disease (GERD). This is likely from the large amount of malic acid and citric acid found in tomatoes.

Too many tomatoes can also trigger other gastrointestinal issues, like irritable bowel syndrome. Consumption of tomatoes has been known to produce side effects like bloating and diarrhea in certain people, which are common symptoms of IBS.

It's also possible to consume too much lycopene, a carotenoid that tomatoes are rich in. If you eat too many tomatoes, it could lead to large amounts of lycopene building up in your bloodstream. Although lycopene isn't bad for you, this can eventually cause a skin discoloration condition called lycopenodermia. Although your skin may turn orange, the condition is reversible and relatively harmless.

It's also possible to develop an intolerance or allergy to tomatoes. The tomato plant has a variety of compounds your body may react to, including b-fructofuranosidase, profilin, superoxide dismutase, pectinesterase, polygalacturonase and the lipid transfer proteins cyclophilin, lyc e-2 and lyc e-3. This essentially means that there's a lot of crossover between the allergenic compounds in tomatoes and other foods or plants you might be allergic to.

## Calories are Calories

While apples are healthy fruits and a great snack, they do contain calories and sugars and should be counted as part of your daily allotment. In other words, they are not "freebies." An average medium apple has between 90 and 95 calories, so if a dieter consumed 10 medium apples in a day, this would amount to more than 900 calories. If you eat other foods besides apples, this caloric allotment for fruit alone is too much, and is likely to tip the scale or inhibit weight loss.

## Diverticular Disease: Greatest Myths and Facts

There’s a lot of misinformation floating around about diverticular disease – namely diverticulosis and diverticulitis.

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Patients believe they can’t eat nuts or seeds (one of the most common myths). or they’re simply confused about the difference between conditions. Below, colorectal surgeon Michael Valente, DO, dispels the most common myths.

### Myth 1: If you have diverticular disease, you should avoid eating nuts, seeds and popcorn

Fact: This most persistent myth actually contradicts advice doctors give for preventing the condition in the first place. A healthy, high-fiber diet is actually the best medicine against diverticulitis, and seeds and nuts certainly fit the bill.

We used to think that a seed or nut plugged the pocket in the colon, and that’s what caused it to become inflamed or to rupture. But studies have strongly suggested there’s nothing to that idea — or that these foods should be avoided.

### Myth 2: Diverticular disease always requires treatment

Fact: Patients often confuse the related conditions diverticulosis and diverticulitis.

Diverticulosis generally needs no treatment, while diverticulitis is a more serious condition that may require surgery.

Diverticulosis refers to small pockets that protrude through weak muscle layers in the intestinal wall, similar to a bubble in a tire. They’re fairly common — 60% of people have them by age 60. Up to 80% of people have them by age 80.

A colonoscopy usually brings this condition to light, and it’s something that’s just found by chance. Most people don’t even realize they have the pockets. And by themselves, they’re little cause for concern. Diverticulosis is like having freckles: It’s only a problem if those freckles turn into a mole. We only operate on rare cases where the diverticulosis bleeds and doesn’t stop bleeding.

Diverticulitis occurs when one or more of those pockets perforate (make a hole in the colon wall) and an infection occurs. Or when pockets rupture and bacteria that are normally in your stool get outside of the intestines and into the surrounding abdominal area.

When this happens, a variety of complications can arise:

• You may experience pain (especially when you eat or drink) and/or a fever.
• An abscess, or “walled-off” infection, may result from the bacteria in the abdomen.
• A painful infection of the abdominal cavity, or what we call peritonitis, may occur. Peritonitis is potentially fatal. Also, while it’s very uncommon, it does require immediate treatment.

Not everybody who has diverticulitis needs surgery, but they should see a physician (either in primary care or the emergency room) to get a proper diagnosis.

### Myth 3: If you’ve had diverticulosis that developed into diverticulitis in the past, subsequent bouts of diverticulitis are more likely to perforate (and lead to peritonitis)

Fact: Diverticulitis happens in only 10 to 25% of those with diverticulosis. Also the great majority, or 75%, of those cases are the less serious type – requiring simple outpatient treatment, and perhaps antibiotic medication.

Research shows the next bout of diverticulitis is most often going to be similar to your first bout. Usually, if your body could handle diverticulitis the first time, then the next time, it’s going to react just as well.

Lots of patients ask, “How do I prevent myself from getting diverticulitis?” Unfortunately, we don’t know why people get it. We think it’s from high pressure in the bowels and being constipated. We suggest eating a high-fiber, healthy diet and avoiding constipation.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

## Smart Late-Night Choices

Those leftover slices of pizza might call out to you late at night, but save them for the next day. Reach instead for a light, healthy snack that will quash your hunger pains. Some of the best choices include:

• Bananas, which can actually promote sleep because they contain magnesium and potassium, which serve as natural muscle relaxants.
• Broccoli and cauliflower, which supply the all-important “crunch factor” while racking up few carbohydrates.
• Cherries, which contain melatonin, the chemical that helps properly “set” your body's internal clock.
• Eggs, which are a good source of protein that your body should be able to digest quickly.
• Jasmine rice, which your body digests oh-so-slowly while releasing glucose slowly into the bloodstream.
• Kiwi, which a recent Norway study found improved the quality of sleep among insomniacs, probably because of its serotonin content.
• Spaghetti squash, especially if you're craving the taste of pasta but don't want to dish up the carbs.

Mary Wroblewski earned a master's degree with high honors in communications and has worked as a reporter and editor in two Chicago newsrooms. She worked alongside a noted Chicago area nutritionist and holistic healthcare adviser whose groundbreaking work focuses on food allergies and the belief that 1) many people have them but don't know and 2) once you identify them, people can make healthy eating an integral part of their life. Mary writes extensively about healthy eating and healthy living topics.