TY - JOUR T1 - Long-term effects of severe acute malnutrition on lung function in Malawian children: a cohort study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01301-2016 VL - 49 IS - 4 SP - 1601301 AU - Natasha Lelijveld AU - Marko Kerac AU - Andrew Seal AU - Emmanuel Chimwezi AU - Jonathan C. Wells AU - Robert S. Heyderman AU - Moffat J. Nyirenda AU - Janet Stocks AU - Jane Kirkby Y1 - 2017/04/01 UR - http://erj.ersjournals.com/content/49/4/1601301.abstract N2 - Early nutritional insults may increase risk of adult lung disease. We aimed to quantify the impact of severe acute malnutrition (SAM) on spirometric outcomes 7 years post-treatment and explore predictors of impaired lung function.Spirometry and pulse oximetry were assessed in 237 Malawian children (median age: 9.3 years) who had been treated for SAM and compared with sibling and age/sex-matched community controls. Spirometry results were expressed as z-scores based on Global Lung Function Initiative reference data for the African–American population.Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were low in all groups (mean FEV1 z-score: −0.47 for cases, −0.48 for siblings, −0.34 for community controls; mean FVC z-score: −0.32, −0.38, and −0.15 respectively). There were no differences in spirometric or oximetry outcomes between SAM survivors and controls. Leg length was shorter in SAM survivors but inter-group sitting heights were similar. HIV positive status or female sex was associated with poorer FEV1, by 0.55 and 0.31 z-scores, respectively.SAM in early childhood was not associated with subsequent reduced lung function compared to local controls. Preservation of sitting height and compromised leg length suggest “thrifty” or “lung-sparing” growth. Female sex and HIV positive status were identified as potentially high-risk groups.Despite stunting, survivors of acute malnutrition do not have worse lung function than controls http://ow.ly/2nvH308LroU ER -