Long-Term Changes in Chili Pepper Consumption and Inflammatory Biomarkers: A Longitudinal Analysis in the Moli-Sani Study

Chili pepper consumption has been linked to lower cardiovascular disease (CVD) risk, although underlying mechanisms remain unclear. We investigated the association between long-term changes in chili pepper consumption and changes in circulating inflammatory markers. This longitudinal analysis included 573 adults (≥35 years) from the Italian Moli-sani Study with dietary, health, and biological data collected at baseline (2005–2010) and follow-up (2017–2020). The exposure was the 12.7-year change in chili pepper consumption frequency. Outcomes included changes in serum concentrations of C-reactive protein, eight other inflammatory factors (IL-6, IL8, IL-10, TNF-α, IFN-γ, MCP-1, IP-10, and VEGF), and the INFLA-score. Multivariable-adjusted linear regression models accounted for changes in dietary and lifestyle factors. Overall, 41.2%, 20.6%, and 38.2% of participants reduced, increased, or maintained their chili pepper consumption, respectively. A 1-unit increase in the delta of chili pepper consumption was associated with lower serum TNF-α concentrations (β = −0.85; 95% CI: −1.67, −0.03; p = 0.041). No associations were observed with the other inflammatory markers, although most showed downward trends. Among women, increased consumption was associated with different MCP-1 and IP-10 levels. An increase in chili pepper consumption over 12.7 years was associated with lower circulating TNF-α concentrations in this population. Although no consistent associations were observed across the inflammatory markers evaluated, these findings suggest a potential modulation of selected inflammatory pathways by sustained chili pepper consumption and warrant confirmation in larger prospective studies.