When Littenberg says, "it might be there's something else going on," he's referring to what's known as a confounding factor. Chili peppers, after all, are a polarizing food: some people love the heat while others have to get out of the kitchen. It could be, for example, that there's a gene that makes certain people crave chili peppers—and it's that gene, and not the peppers themselves, that provides the health benefit. It could be that when people get seriously ill, they lose their taste for chili peppers and stop eating them, so that anyone close to death in the study data was unlikely to report binging on spicy foods. Or it could be that consuming chili peppers encourages another behavior—like drinking lots of water—that leads to better health overall.