Respiratory Medicine 145 (2018) 237–238

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Respiratory Medicine
journal homepage: www.elsevier.com/locate/rmed

Correspondence

Comment on Favorable association of polyphenol-rich diets with lung function: Cross-sectional findings from the Moli- T

sani study

A R T I C LE I N FO

Keywords:
Methodological issues
Cross-sectional study
Prediction
Univariate logistic regression

Secondly, generally, to identify the most important factors affecting

Dear Editor-in-Chief,
outcome, the first, univariate logistic regression analysis should be
performed for each variable, then in this analysis any variable with a
We studied the paper entitled ‘Comment on Favorable association of
significant level of less than 0.2, it is selected as a candidate for the
polyphenol-rich diets with lung function: Cross-sectional findings from
multivariate analysis. While in this study variables with a significant
the Moli-sani study’ written by Pounis Get al. [1], which was published
level of less than 0.05 are included in the multivariate analysis [6].
in Respiratory medicine journal in March 2018. The aim of the study
Therefore, it is essential to interpret the results of this study in light
was to evaluate evaluating the association of polyphenol consumption
of the above explanation.
with lung function in a novel holistic approach. The results of this study
in both genders, in age, height, and energy intake adjusted models, the
Conflicts of interest
majority of classes of polyphenols (mg/day) showed a positive asso-
ciation with FEV1, FVC, FEV1% predicted, and FVC% predicted (β-
None.
coef > 0, P < 0.05). Associations remained significant after adjust-
ment for confounding factors in most cases (β-coef > 0, P < 0.05). The
Funding
PAC score was associated in both genders with an increase in pul-
monary function parameters (β-coef > 0, P < 0.05). The inclusion of
No funding was received.
white blood cell (WBC) counts in the multivariate model reduced the
association in men but not in women. Finally, this study concludes a
Authors' contributions
higher overall polyphenol content of human diet was associated with
better pulmonary function in a general population. The association
All authors had active participation in preparation of manuscript.
might be partially mediated by WBC in men [1]. However, although
this research was valuable and the results are interesting, there are
References
some methodological issues which should be referred to them:
Firstly, given that in a cross-sectional study exposure and outcome
[1] G. Pounis, A. Arcari, S. Costanzo, A. Di Castelnuovo, M. Bonaccio, M. Persichillo,
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https://doi.org/10.1016/j.rmed.2018.03.022
Received 11 March 2018; Accepted 19 March 2018
Available online 20 March 2018
0954-6111/ © 2018 Elsevier Ltd. All rights reserved.
Correspondence Respiratory Medicine 145 (2018) 237–238

(2017) 23. Kamyar Mansori∗

[5] S.J. Kamper, M.J. Hancock, C.G. Maher, Optimal designs for prediction studies of School of Public Health, Dezful University of Medical Sciences, Dezful, Iran
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[6] Z. Bursac, C.H. Gauss, D.K. Williams, D.W. Hosmer, Purposeful selection of variables Department of Epidemiology, School of Public Health, Iran University of
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E-mail address: kamyarmansori@yahoo.com
Fatemeh Khosravi Shadmani
Department of Epidemiology, School of Public Health, Shahid Beheshti
University of Medical Sciences, Tehran, Iran

∗
Corresponding author. Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.

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