Nutritional Care in Cystic Fibrosis Across the Arab World: Regional Heterogeneity, Current Evidence, and Future Directions

Background: cystic fibrosis (CF) is a genetic disease which was previously thought to predominantly affect people of European ancestry but has been increasingly diagnosed in other populations. Although respiratory disease is the principal manifestation, poor nutritional status is a central determinant of pulmonary outcomes and survival. There are gaps in the literature on epidemiology, genetics, clinical manifestations and nutritional outcomes of CF in the Arab world. Methods: in this narrative review, we aim to synthesize and analyze nutrition-relevant data and explore how these relate to epidemiology, diagnostic pathways, genotype-phenotype relationships, and availability and access to care. Results: the published evidence across the region is heterogenous in nature but shows that malnutrition in CF is dominant in reported pediatric cohorts. The overall poor nutritional outcomes of CF in the Arab world reflect the multifactorial effects of disease biology, diagnostics, healthcare capacity, and treatment access, as well as psychosocial and social and structural determinants of health. Conclusions: improving CF-related nutritional status in the region requires early diagnosis of the disease, ideally through newborn screening, proactive intervention, multidisciplinary care, access to therapies including modulator therapy, and the establishment of collaborative registries that capture existing genetic diversity and healthcare disparities while tracking clinical and nutritional outcomes.