Author + information
- Received April 30, 2019
- Revision received August 29, 2019
- Accepted September 23, 2019
- Published online December 16, 2019.
- Marialaura Bonaccio, PhDa,∗ (, )@Mbonaccio,
- Augusto Di Castelnuovo, PhDb,
- Simona Costanzo, PhDa,
- Emilia Ruggiero, MSca,
- Amalia De Curtis, BSca,
- Mariarosaria Persichillo, MSca,
- Claudio Tabolacci, PhDc,
- Francesco Facchiano, MD, PhDc,
- Chiara Cerletti, PhDa,
- Maria Benedetta Donati, MD, PhDa,
- Giovanni de Gaetano, MD, PhDa,
- Licia Iacoviello, MD, PhDa,d,
- on behalf of the Moli-sani Study Investigators
- aDepartment of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, Pozzilli, Italy
- bMediterranea Cardiocentro, Napoli, Italy
- cDepartment of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Roma, Italy
- dDepartment of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
- ↵∗Address for correspondence:
Dr. Marialaura Bonaccio, Department of Epidemiology and Prevention, IRCCS Neuromed, Via dell'Elettronica, 86077 Pozzilli (IS), Italy.
Background Chili pepper is a usual part of a traditional Mediterranean diet. Yet epidemiological data on the association between chili pepper intake and mortality risk are scarce, with a lack of studies from Mediterranean populations.
Objectives This study sought to examine the association between chili pepper consumption and risk of death in a large sample of the adult Italian general population, and to account for biological mediators of the association.
Methods Longitudinal analysis was performed on 22,811 men and women enrolled in the Moli-sani Study cohort (2005 to 2010). Chili pepper intake was estimated by the EPIC (European Prospective Investigation Into Cancer) Food Frequency Questionnaire and categorized as none/rare consumption, up to 2 times/week, >2 to ≤4 times/week, and >4 times/week.
Results Over a median follow-up of 8.2 years, a total of 1,236 deaths were ascertained. Multivariable hazard ratios (HRs) for all-cause and cardiovascular disease (CVD) mortality among participants in the regular (>4 times/week) relative to none/rare intake were 0.77 (95% confidence interval [CI]: 0.66 to 0.90) and 0.66 (95% CI: 0.50 to 0.86), respectively. Regular intake was also inversely associated with ischemic heart disease (HR: 0.56; 95% CI: 0.35 to 0.87) and cerebrovascular (HR: 0.39; 95% CI: 0.20 to 0.75) death risks. The association of chili pepper consumption with total mortality appeared to be stronger in hypertension-free individuals (p for interaction = 0.021). Among known biomarkers of CVD, only serum vitamin D marginally accounted for such associations.
Conclusions In a large adult Mediterranean population, regular consumption of chili pepper is associated with a lower risk of total and CVD death independent of CVD risk factors or adherence to a Mediterranean diet. Known biomarkers of CVD risk only marginally mediate the association of chili pepper intake with mortality.
- cardiovascular mortality
- cerebrovascular mortality
- chili pepper
- Mediterranean diet
- risk factors
- total mortality
The enrollment phase of the Moli-sani Study was supported by research grants from Pfizer Foundation (Rome, Italy), the Italian Ministry of University and Research (MIUR, Rome, Italy)–Programma Triennale di Ricerca, Decreto no. 1588, and Instrumentation Laboratory, Milan, Italy. Drs. Bonaccio and Tabolacci were supported by a Fondazione Umberto Veronesi Fellowship. Dr. Costanzo was the recipient of a Fondazione Umberto Veronesi travel grant. The present analyses were partially supported by a grant to Dr. Bonaccio from the Italian Ministry of Health 2013 grant number GR-2013-02356060, a grant to Dr. Iacoviello from the Italian Association for Cancer Research (AIRC) (AIRC “5xMILLE” n. 12237), and a grant to Dr. Iacoviello as a partner of BiomarCaRE (Biomarkers for Cardiovascular Risk Assessment in Europe) by the European Commission Seventh Framework Programme FP7/2007-2013 (HEALTH-F2-2011-278913). The funders had no role in study design; collection, analysis, and interpretation of data; writing of the manuscript; or the decision to submit the article for publication. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 30, 2019.
- Revision received August 29, 2019.
- Accepted September 23, 2019.
- 2019 American College of Cardiology Foundation
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