Abstract

Introduction: Chili pepper, along with other spices, is an integral part of a traditional Mediterranean diet (MD). Yet there is paucity of epidemiological data on the association between chili pepper intake and mortality risk, with lack of studies from Mediterranean populations. Hypothesis: We assessed the hypothesis of an association between chili pepper consumption and total and cardiovascular (CVD) risk of death in a large sample of the Italian general population, and tested different biological mediators of the association. Methods: Longitudinal analysis on 22,811 men and women aged≥35 years enrolled in the Moli-sani Study cohort, Italy (2005-2010). Chili pepper intake was estimated by the EPIC food frequency questionnaire and categorized as none/rare consumption, up to 2 times/week, 2-4 and > 4 times/week. Multivariable hazard ratios (HR) with 95% confidence intervals (95%CI) were calculated by multivariable Cox regression and competing risk models. Results: Over a median follow up of 8.2 years, a total of 1,236 deaths were ascertained, of which 444 from CVD. Multivariable risk estimates for all-cause and CVD mortality among participants in the regular (>4 times/week) relative to the none-rare intake were, respectively, 0.77 (0.66-0.90) and 0.66 (0.50-0.86). Regular intake also lowered ischemic heart disease (0.55;0.35-0.87) and cerebrovascular death risks (0.39;0.20-0.76). Traditional CVD risk factors (e.g. blood cholesterol, triglycerides) only marginally account for such associations (Table). Conclusions: In a large Mediterranean population, regular consumption of chili pepper is associated with lower risk of total and CVD death independent of adherence to MD. Known biomarkers only marginally accounted for the association of chili pepper intake with total mortality.

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