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Accepted manuscript

Adherence to the Mediterranean diet and colorectal cancer risk: a large case control study in the Moroccan population

Published online by Cambridge University Press:  06 February 2025

Khaoula El Kinany Open the ORCID record for Khaoula El Kinany [Opens in a new window] ,
Zineb Hatime ,
Achraf El Asri ,
Abdelilah Benslimane Open the ORCID record for Abdelilah Benslimane [Opens in a new window] ,
Meimouna Deoula ,
Btissame Zarrouq ,
Pagona Lagiou  and
Karima El Rhazi
Khaoula El Kinany*
Affiliation:
Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco. Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco.
Zineb Hatime
Affiliation:
Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco Email: [email protected]
Achraf El Asri
Affiliation:
Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco. Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco. Email: [email protected]
Abdelilah Benslimane
Affiliation:
Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco. Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco. Email: [email protected]
Meimouna Deoula
Affiliation:
Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco. Email: [email protected]
Btissame Zarrouq
Affiliation:
Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco. Department of Biology and Geology, Teachers Training College (Ecole Normale Superieure), Sidi Mohamed Ben Abdellah University, Fez, Morocco. Email: [email protected]
Pagona Lagiou
Affiliation:
Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Email: [email protected]
Karima El Rhazi*
Affiliation:
Department of Epidemiology and Public Health, Faculty of Medicine and pharmacy of Fez, Sidi Mohamed Ben Abdellah University, Fez, Morocco
*
*Corresponding author: Emails: [email protected], [email protected]
*Corresponding author: Emails: [email protected], [email protected]
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Abstract

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Objective:

The Mediterranean diet (MD) is a dietary pattern associated with several health benefits, including reduction of risk for various cancers. We conducted a study to investigate associations between adherence to the MD and colorectal cancer (CRC) subtype risk among Moroccan adults.

Design:

A matched case-control study.

Setting:

The five major university hospitals in Morocco.

Participants:

A total of 3032 subjects (1516 CRC patients and 1516 controls) matched on age, sex and center, were recruited between September 2009 and February 2017 at five major hospitals in Morocco. Diet was assessed using a validated Food Frequency Questionnaire (FFQ). Adherence to the Mediterranean diet was assessed through a score, ranging from 0 (no adherence) to 10 (maximal adherence) and divided into three categories (low, middle and high). Conditional logistic regression was performed to calculate multivariable odd ratios (OR) and 95% confidence intervals (CI) with low adherence (score 0-3) as referent, adjusting for potential confounding factors.

Results:

Close adherence to the Mediterranean diet (score 6-9) was associated with reduced risk of CRC (ORa = 0.74, 95% CI 0.63-0.86); rectal cancer (ORa = 0.73, 95% CI 0.58- 0.90) and colon cancer (ORa = 0.74, 95% CI 0.60-0.92).

Conclusion:

Our study, conducted in a southern Mediterranean population, adds to the evidence suggesting a protective effect of MD against CRC risk.

Keywords

Mediterranean dietMediterranean diet scorecolorectal cancercase-controlMorocco
Type
Research Paper
Information
Public Health Nutrition , Accepted manuscript , pp. 1 - 21
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Authors 2025