INTRODUCTION Tobacco smokers are at high risk of developing severe COVID-19. Lockdown was a chosen strategy to deal with the spread of infectious diseases; nonetheless, it influenced people's eating and smoking behaviors. The main objective of this study is to determine the impact of the COVID-19 lockdown on smoking (waterpipe and cigarette) behavior and its associations with sociodemographic characteristics and body mass index. METHODS The data were derived from a large-scale retrospective cross-sectional study using a validated online international survey from 38 countries (n=37207) conducted between 17 April and 25 June 2020. The Eastern Mediterranean Region (WHO-EMR countries) data related to 10 Arabic countries that participated in this survey have been selected for analysis in this study. A total of 12433 participants were included in the analysis of this study, reporting their smoking behavior and their BMI before and during the COVID-19 lockdown. Descriptive and regression analyses were conducted to examine the association between smoking practices and the participant's country of origin, sociodemographic characteristics, and BMI (kg/m 2 ). RESULTS Overall, the prevalence rate of smoking decreased significantly during the lockdown from 29.8% to 23.5% (p<0.05). The percentage of females who smoke was higher than males among the studied population. The highest smoking prevalence was found in Lebanon (33.2%), and the lowest was in Oman (7.9%). In Egypt, Kuwait, Lebanon, and Saudi Arabia, the data showed a significant difference in the education level of smokers before and during the lockdown (p<0.05). Smokers in Lebanon had lower education levels than those in other countries, where the majority of smokers had a Bachelor's degree. The findings show that the BMI rates in Jordan, Lebanon, Oman, and Saudi Arabia significantly increased during the lockdown (p<0.05). The highest percentages of obesity among smokers before the lockdown were in Oman (33.3%), followed by Bahrain (28.4%) and Qatar (26.4%), whereas, during the lockdown, the percentage of obese smokers was highest in Bahrain (32.1%) followed by Qatar (31.3%) and Oman (25%). According to the logistic regression model, the odds ratio of smoking increased during the pandemic, whereas the odds ratio of TV watching decreased. This finding was statistically significant by age, gender, education level, country of residence, and work status. CONCLUSIONS Although the overall rates of smoking among the studied countries decreased during the lockdown period, we cannot attribute this change in smoking

This narrative review summarizes the main findings of observational studies (case-control and cohort) as well as systematic reviews and meta-analyses on the role of nutrients and dietary patterns on pancreatic cancer (PC) risk and elucidates possible mechanisms for the association between nutrients or specific food components and the risk of PC. A literature search of MEDLINE (PubMed), Google Scholar, ScienceDirect, and Scopus was performed. An extensive search of related articles published in the English language from 1985 to 2022 was carried out. Our search included macro- and micronutrient intake as well as dietary patterns associated with PC. In conclusion, the consumption of a diet high in nutrients such as sugar, fats, and red and processed meats can increase the risk of PC. Conversely, a high dietary intake of fresh fruit and vegetables and their associated nutrients like fiber, antioxidants, and polyphenols may prevent PC. Dietary patterns loaded with red and processed meats were also linked to an increased risk of PC, whereas dietary patterns rich in plant-based foods like vegetables, fruits, whole grains, and legumes were associated with a reduced risk of PC. Dietary fiber, fat-soluble vitamins, water-soluble vitamins, and minerals might also play a protective role against PC.

Objectives: Pancreatic cancer (PC) has been related directly to many risk factors; however, diet is considered one of the most modifiable risk factors. This study is designed to observe the associations between the intake of macromicronutrients and the risk of pancreatic cancer in a Jordanian population. Methods:A case-control study included 100 patients with the incident and histologically confirmed PC and 309 control subjects frequency-matched on age, educational level, occupation, and marital status. Face-to-face interview was used to collect the study's sociodemographic, physical activity, and dietary information. Intakes of macronutrients and micronutrients were assessed by a validated food-frequency questionnaire. Multinomial logistic regression was used to calculate odds ratios and confidence intervals. Results:The patients reported higher consumption of almost all the macromicronutrients and micronutrients as compared with control subjects. The highest tertile of dietary intake of carbohydrates, sugars, fats, saturated fats, monounsaturated fats, trans fats, cholesterol, and vitamin B 3 was positively associated with PC risk (P trend < 0.05). However, dietary intakes of polyunsaturated fats, omega-3, and some vitamins and minerals were not associated (P trend > 0.05) with the risk of PC.Conclusions: Our findings support the positive role of proteins, carbohydrates, sugars, fats, saturated fats, monounsaturated fats, trans fats, and cholesterol on pancreatic carcinogenesis.