P645 - STARVING THE VULNERABLE? THE IMPACT OF FASTING ORDERS ON HUNGER PERCEPTIONS OF PATIENTS AT RISK OF MALNUTRITION

P645

STARVING THE VULNERABLE? THE IMPACT OF FASTING ORDERS ON HUNGER PERCEPTIONS OF PATIENTS AT RISK OF MALNUTRITION

T. Braasch^1,2,*, I. Hoffmann^3,4, U. Wesemann⁵, M. Schreiner⁶, M. Ludwig¹, M. Pirlich⁷

¹Internal Medicine, Bundeswehr Hospital Berlin, ²CharitéCentrum13 - Klinik für Gastroenterologie, Infektiologie und Rheumatologie , Charité – Universitätsmedizin Berlin, ³Bundeswehr Medical Care Center, Berlin-Wedding, Berlin, Germany, ⁴Injury Epidemiology and Prevention (IEP) Research Group, Turku University Hospital and University, Turku, Finland, ⁵Bundeswehr Center for Military Mental Health, Berlin, ⁶Internal Medicine, Bundeswehr Hospital Hamburg, Hamburg, ⁷Praxis Kaisereiche, Berlin, Germany

Rationale: Hospitalized patients often fast for diagnostic procedures. We investigated the impact of fasting on hunger perception in patients at risk of malnutrition (ARM) and the potential role of oral nutritional supplements (ONS) in this scenario.

Methods: This post-hoc analysis of a randomized prospective study (July 2021–May 2023) included 210 patients, with 30% (n=64) classified as ARM based on the Nutritional Risk Score 2002 (NRS). The original study compared three preparation protocols before abdominal ultrasound (breakfast, fasting, fat-free liquid ONS). The 15-item Food Craving Questionnaire-State (FCQ-S) assessed cravings (items 1–12) and hunger (items 13–15) on a 5-point Likert scale. Secondary outcomes included the effects of the preparation protocols. Statistical analysis included Welch’s t-test, one-way ANOVA with Tukey’s post-hoc test, and two-way ANCOVA (adjusted for age and sex) with Bonferroni corrections.

Results: ARM patients reported significantly higher FCQ-S Hunger scores compared to non-ARM (NARM) patients (Mdiff = -1.24, p = 0.016), primarily driven by the fasting group (Mdiff = -2.88, p < 0.001). ONS significantly reduced both Craving and Hunger scores in ARM patients, comparable to breakfast (ONS vs. Fasting: Mdiff = -3.83, p < 0.001; Breakfast vs. Fasting: Mdiff = -3.78, p < 0.001). NARM patients receiving ONS had similar Hunger scores to those who fasted. ARM status did not negatively impact abdominal ultrasound assessment.

Image:

Conclusion: ARM patients experienced greater fasting-related hunger, indicating a disproportionate impact of fasting and suggesting a different adaptation to fasting. ONS could alleviate cravings and hunger, similar to the effects of a breakfast in ARM patients.

Disclosure of Interest: None declared