الفهرس 
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Abstract
Summary
Malnutrition negatively affects the function of
respiratory muscles, lung elasticity and immune response,
since it increases the risk of pulmonary colonizations and
impacts on the progression of chronic lung diseases so
improving the nutritional status of patients may improve
activity levels and quality of life of these affected
children.
The aim of the study was to assess nutritional status
and nutritional intervention program in children with different
chronic lung diseases and their impact on pulmonary function
& on clinical severity of lung disease.
This case control, clinical interventional study was
done in outpatient Chest Clinic of the Children’s Hospital,
Ain Shams University. The studied groups were:
- 30 Patients with chronic lung diseases (17 patients with
bronchiectasis &13 patients with interstitial lung diseases)
randomly selected from those attending pediatric chest
clinic for follow up. They were 12 males and 18 females,
their ages ranged from 2 years to 16 years old with a
mean of 8.46±4.32, 20 from urban society &10 from
rural society.
Summary
134
- 40 apparently healthy control children. They were
randomly recruited from the outpatient Clinic,
Children’Hospital. Ain Shams University. They were
25males&25 females. Their ages ranged from 5 years to
13 years old with a mean age of8.63±2.50, 26 from urban
society &24 from rural society.
For all studied children, Anthropometry was done
including: Weight, Height, BMI, Triceps Skin Fold thickness
and Mid Upper Arm Circumference. Body composition
analysis was done by BIA.
In this work, nutritional intervention was done as
follow: well-nourished patients were given energy
requirements for same- age healthy children and
adolescents without use of any supplement and
malnourished patients were given 150% of energy
requirements for same- age healthy children and
adolescents by addition of high caloric supplements 1.5
Kcal/ml to well-balanced diet (50% CHO & 20% Protein
& 30% fats) for 3 months. After 3 months, the patients
were reassessed both clinically and through investigations
e.g.(Anthropometry, Body composition analysis by BIA
and Pulmonary function testing by FVC Spirometry).
Summary
135
According to Subjective Global Nutritional
Assessment, 56.67% of studied patients were moderately
malnourished and 23.33% were severely malnourished.
According to Z-score for all anthropometric
measurement, 66.7% of studied patients were underweight
and 50% of patients were stunted growth.
In this study, WAZ, HAZ, BMIZ, z-TSF and z-
MUAC of studied patients were significantly lower than
control groups. There was statistically significant (+ve)
correlation between FVC% and BMI.
There were non statistically significant lower body
composition values (body fat, fat free mass and muscle mass)
of patients compared to controls with P-value >0.05.
In this work, it was found that Nutritional
rehabilitation significantly improved patient
anthropometry, body composition values and respiratory
symptoms.
Nutritional rehabilitation significantly decreased needs for
SABA & school absence.
Patients after nutritional intervention didn’t have a
significant improvement on spirometric PFT(FEV1%, FVC%,
FEV1/FVC and MEF%) (P-value>0.05) .
Summary
136
In this study we stated that by using high energy
nutritional supplement in addition to usual dietary intake,
anthropometry, body composition and respiratory
symptoms were improved in malnourished children with
chronic lung diseases. Also, the needs for excessive rescue
therapy , acute exacerbation and hospital admission were
reduced . This was associated with improvement of school
attendance. the only parameter lagged improvement was
spirometric values