PREDICTION OF LUNG-FUNCTION IN THE INADEQUATELY NOURISHED

Background-In animal models, nutritional deficiency leads to profound qualitative changes in the lung beyond an effect on organ size. Althou gh lung growth is non-isotropic, predictive values for spirometric lun g function in children are corrected for height alone. Prediction of l ung function should consider isotropic growth and nutritional status c oncurrently. Aim-To establish whether nutritional status influences lu ng function following the exclusion of the effect of isotropic growth. Methods-Nutritional status (weight, body mass index, mid-upper arm ci rcumference, and subscapular and triceps skinfold thicknesses) was ass essed, and lung function (forced vital capacity (FVC), forced expirato ry volume in one second (FEV1), and peak expiratory flow rate (PEFR)) was measured in 391 healthy school age children with normal respirator y history and examination in a rural setting in West Bengal, India. Re sults-Lung function normalised for sitting height and stature correlat ed significantly with indices of nutrition in both sexes. Adding weigh t as an independent variable to sitting height, new reference predicti on equations for FEV1, FVC, and PEFR were calculated. Conclusions-Nutr itional differences influence qualitative aspects of lung development in childhood beyond simple isotropic lung growth. Prediction of lung f unction must take account of these differences if change as a result o f disease is to be accurately measured. The identification and correct ion of relevant dietary deficiencies might help to improve lung functi on in children.