Association between numbing-spicy related dietary behavior and hyperuricemia in a Southwestern Chinese population

The consumption of numbing-spicy foods is highly prevalent in southwestern China. However, existing studies examining the relationship between such dietary patterns and disease risk have primarily focused on spicy food intake, with limited attention given to the "numbing" component. This study therefore aimed to systematically investigate the association between both numbing and spicy food intake and hyperuricemia.

All data were derived from the China Multi-Ethnic Cohort (CMEC) study in Rongchang district, Chongqing Municipality, a representative area of southwestern China with high prevalence of numbing-spicy food consumption. Information on numbing and spicy food intake were collected using a standardized questionnaire. The associations between numbing/spicy food consumption and hyperuricemia were evaluated using multivariable logistic regression models and restricted cubic spline analyses. Subgroup analyses were further conducted across diverse demographic and clinical characteristics. To assess potential combined relation, both multiplicative and additive interaction analyses were performed. In addition, mediation and sensitivity analyses were undertaken to assess the robustness of the findings.

A total of 2,265 participants aged 30-60 years were included in the analysis. The mean age was 45.21 years (SD = 7.84), and the overall prevalence of hyperuricemia was 13.20%. After adjustment for potential confounding factors, the combined intake of numbing and spicy foods were positively associated with hyperuricemia, with an odds ratio (OR) of 2.689 (95%CI: 2.045-3.536, P < 0.001). Restricted cubic spline analyses further indicated a nonlinear, positive relationship with hyperuricemia (P _{for overall} < 0.001, P _{for nonlinear} = 0.020). These associations remained robust across subgroup and sensitivity analyses. No significant multiplicative interaction was detected, combined numbing-spicy intake was positively associated with hyperuricemia (OR = 4.703, 95%CI: 1.751-12.902) compared with neither intake in additive interaction. However, formal measures of additive interaction, including the relative excess risk due to interaction, attributable proportion, and synergy index, did not reach statistical significance. In exploratory mediation analyses, the poultry-aquatic dietary pattern statistically explained 6.58% of the association for spicy-only intake and 14.54% of the association for combined numbing and spicy intake. No significant mediation associations were identified for other dietary patterns.

These findings contribute new evidence regarding the link between numbing-spicy food intake and hyperuricemia, extending prior research that has focused primarily on spicy food consumption alone. Accordingly, future investigations into the dietary etiology of hyperuricemia in southwestern China should move beyond treating spicy food intake as an isolated exposure and the joint effects of characteristic numbing-spicy dietary behaviors and their associated culinary context on the prevalence of hyperuricemia should be systematically considered.