title: The relationship between different diet quality indices and severity of airflow obstruction among COPD patients.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. Smoking is the number one cause of COPD; however, genetic, environmental and dietary factors contribute to the etiology of this disease. In this study, we assessed the association between three diet quality indices -the Healthy Eating Index-2005 (HEI-2005), the Healthy Eating Index-2010 (HEI-2010), and Mediterranean Diet Score (MED)- and the severity of disease in COPD patients.
  
  
  METHODS
  This cross-sectional study was performed at Rasul-e-Akram Hospital in Tehran on 121 COPD patients with the mean age of (SD) of 66.1(10.9) years. A pulmonary specialist diagnosed all participants based on a spirometry test. They were categorized into four groups (1, 2, 3, 4 stages of disease). Three diet quality indices, spirometry test and determination of disease severity were performed for all the participants. ANCOVA and Kruskal-Wallis test were used to assess the relationship between dietary quality indices and severity of the disease. The relationship between HEI-2010, HEI-2005, MED score, their components and lung function was assessed using a multiple linear regression analysis. All analyses were done using SPSS 18.
  
  
  RESULTS
  Reduction of the Healthy Eating Index-2010 and MED score were observed along with the increase in disease severity, but they were not significant. The relationship between the three diet quality indices and lung function showed a significant association between MED score and Forced expiratory volume in one second (FEV1), The Forced Vital Capacity (FVC) (β=2.9, 95% CI (1.1, 4.8), p=0.002), (β=2.8, 95% CI (0.9, 4.8), p=0.007), respectively.
  
  
  CONCLUSIONS
  Mediterranean dietary pattern and obtaining a better score on HEI-2010 diet were associated with a better lung function test.
authors: PhD Candidate in Nutrition, Faculty of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran, yazdanpanah_l@yahoo.com.
authors: Leila
authors: L
authors: Yazdanpanah
authors: Professor, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran, & Department of Clinical Nutrition, Faculty of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. paknahad@hlth.mui.ac.ir.
authors: Zamzam
authors: Z
authors: Paknahad
authors: Professor, Pulmonologist, Hazrat-e-Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. dr_moosavi_pul@yahoo.ca.
authors: Ali Javad
authors: AJ
authors: Moosavi
authors: Professor, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran. mrmaracy @yahoo.co.uk.
authors: Mohammad Reza
authors: MR
authors: Maracy
authors: MD, Pulmonologist, Milad Hospital, Tehran, Iran. masoud_zaker@yahoo.com.
authors: Mohammad Masoud
authors: MM
authors: Zaker
keywords: COPD; Diet Quality Index; Mediterranean Diet; nutrition