The assessment of Chronic Obstructive Pulmonary Disease (COPD) and its relation to the Mediterranean diet in Moroccan adults - BOLD study

Objective: The protective effect of the Mediterranean diet (MD) is known for several diseases, but the evidence in low- and middle-income countries was still missing. This article assesses the impact of MD and its components on Chronic Obstructive Pulmonary Disease (COPD) among Moroccan adults. Methods: in population-based cross-sectional study, A total of 744 adults with acceptable spirometry according to the GOLD guidelines were randomly selected from a sample frame, of Moroccan adults lived in the areas of the Saïs district-Fez city. Dietary data were collected through a validated food frequency questionnaire. Mediterranean Diet Score (MDS) was used to assess Adherence to the Mediterranean food model, A value of 0 or 1 has been assigned to each of the eight indicated food components according to their beneficial or deleterious effect on health. Results: Although no significant associations were found between COPD and the overall MD. score, associations were found between some of the MD components and COPD when stratifying for overall MDS adherence level (low, middle, high adherence). For the high adherence group, the high consumption of cereals, fruits and nuts were inversely associated with COPD risk with OR = 0.64; 95% CI = 0.26-0.89, and OR= 0.67; 95% CI = 0.44-0.96, respectively. The high consumption of meats and dairy products was positively associated with the risk of COPD, with OR = 1.37; 95% CI = 1.22-2.87, and OR= 1.83; 95% CI = 1.21-2.76, respectively. Conclusion: The results of this study confirmed previous results showing significant associations of COPD risk with some components of MDS. Extensive studies are needed to explore MDS components better and suggest more effective interventions to maintain healthy eating habits and reduce COPD risk.