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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 |