O066 - HUNGER TRAJECTORY FROM PARENTERAL NUTRITION TO ORAL FEEDING

O066

HUNGER TRAJECTORY FROM PARENTERAL NUTRITION TO ORAL FEEDING

J. Regina Moraes¹, V. Maria Meneguelli¹, L. Honorato David Barrachi², G. Yacoub^1,*, D. Oliveira Toledo¹, F. Antunes Ribeiro ¹, J. Manoel Silva Junior^1,3

¹Einstein Israeli Hospital, ²Albert Einstein Israeli Faculty, ³University of São Paulo, São Paulo, Brazil

Rationale: Subjective hunger during parenteral nutrition is poorly characterized and rarely considered in nutritional decision making. We evaluated longitudinal changes in hunger perception across nutritional phases and assessed whether hunger reflects readiness for transition to oral feeding.

Methods: This prospective observational study included hospitalized adults receiving parenteral nutrition. Hunger was assessed using a 7‑point subjective scale at three time points: exclusive parenteral nutrition, transition phase, and full oral intake (lower scores indicating greater hunger). Repeated measures were analyzed with Friedman and paired Wilcoxon tests. Adjusted longitudinal analysis used ordinal generalized estimating equations accounting for sex, clinical or surgical status, care setting, and vasopressor use.

Results: Ninety patients were evaluated in phase 1, 86 in phase 2, and 57 in phase 3. Mean hunger scores progressively decreased from exclusive parenteral nutrition (4.81 ± 1.58) to transition (4.38 ± 1.74) and full oral intake (3.39 ± 1.46). Among patients with complete data, overall differences across phases were significant (Friedman χ² = 29.38, p < 0.001), with progressive reductions between phases. In adjusted analysis, phase 2 (OR 0.63, 95% CI 0.41–0.97, p = 0.036) and phase 3 (OR 0.18, 95% CI 0.10–0.35, p < 0.001) were independently associated with lower satiety compared with phase 1. The proportion of hungry patients increased from 25.6% to 41.9% and 75.4% across phases.

Conclusion: Subjective hunger increases significantly during the transition from parenteral nutrition to full oral intake and may reflect physiological recovery, representing a simple bedside marker to guide nutritional transition strategies.

Disclosure of Interest: None declared