ObjectivesRecent data relating to the association between spicy food intake frequency and abdominal obesity are limited, especially in low-income areas. Therefore, the study explored the relationship between spicy food intake frequency and abdominal obesity, and assessed the role of energy intake as a mediator of these associations in a rural Chinese adult population.DesignCross-sectional study.SettingRural Chinese adult population.ParticipantsSubjects from Henan Rural Cohort Study (n=28 773).Primary outcome measuresThe effects of spicy food intake frequency on abdominal obesity were analysed by restricted cubic spline and logistic regression, and the mediation effect was analysed using the bootstrap method.ResultsThe adjusted percentages of abdominal obesity were 47.32%, 51.93%, 50.66% and 50.29% in the spicy food intake subgroups of never, 1–2 day/week, 3–5 day/week and 6–7 day/week, respectively. An inverse U-shaped association was found between spicy food intake frequency and abdominal obesity (p<0.01). Compared with subjects who never consumed spicy food, the adjusted ORs (95% CIs) in the 1–2 day/week, 3–5 day/week and 6–7 day/week subgroups were 1.186 (1.093, 1.287), 1.127 (1.038, 1.224) and 1.104 (1.044, 1.169), respectively. Furthermore, the increased odd of abdominal obesity related to more frequent spicy food intake was mediated by higher fat energy intake; the direct and indirect effects were 1.107 (1.053, 1.164) and 1.007 (1.003, 1.012), respectively.ConclusionsThe data indicated that spicy food intake increased the risk of abdominal obesity, and fat energy intake may be a mediator of this association in rural Chinese populations. Clarifying the mechanisms will facilitate the development of novel preventive and therapeutic approaches for abdominal obesity.Trial registration numberChiCTR-OOC-15006699