P171 FUNCTIONAL STATUS OF MAGNESIUM IN PATIENTS ON HOME PARENTERAL NUTRITION (HPN) FOR CHRONIC INTESTINAL FAILURE (CIF)

Nutritional Assessment IV References JPEN J Parenter Enteral Nutr 2006;30:309. Clin Nutr 2004;23:758. Am J Clin Nutr 2005;82:49. Disclosure of Interest: I have no conflict of interest.

P169 COMPLEMENTARITY BETWEEN SUBJECTIVE GLOBAL ASSESSMENT (SGA) AND NUTRITIONAL RISK SCREENING (NRS 2002) TO PREDICT CLINICAL OUTCOMES M. Raslan1 , M.C. Gonzalez2 , D.L. Waitzberg1 . 1 Gastroenterology, Lab of Nutrition and Metabolic Surgery Surgical Division University of S˜ ao Paulo School of Medicine, S˜ ao Paulo, 2 Gastroenterology, Surgery, Catholic University of Pelotas, Pelotas, RS, Brazil Rationale: Nutritional Risk Screening (NRS 2002) identifies nutritional risk while Subjective Global Assessment (SGA) assesses nutritional status. The aim of our study was to verify the advantage of the complementarity between SGA and NRS 2002 to predict clinical outcomes Methods: In 705 consecutive hospitalized adult patients, followed until discharge or death, NRS 2002 and SGA were applied until 48 hours of hospital admission. All the patients were followed up by physicians. The agreement among the NRS 2002 and SGA was obtained using the Kappa index, and the logistic regression was applied to identify the tests contribution in relation to clinical outcomes. Results: NRS 2002 identified 27.9% of nutritional risk (NRS+) and SGA evaluated 38.9% of non nourished patients (SGA+) (kappa: 0563, moderate agreement), being 55.6% SGA class B and 43.4% SGA C. Logistic regression model showed that, on admission, patients are likely to develop: (1) very long length of hospital stay (LOS) in 13.1% of the total of the sample (CI 10.23 16.67%) while SGA B increases this probability in 1.94 times (CI 1.19 3.16 times, P = 0.008) and SGA C in 3.77 times (CI 1.97 7.22 times, P < 0.0001); (2) complication occurs in 9% of total patients (CI 6.65 12.1%) and NRS+ increases in 1.92 times the odds (CI 6.65 12.1% times, P = 0.03), SGA B in 1.95 times (CI 1.13 3.37 times, P = 0.02) and SGA C in 2.9 times (CI 1.43 5.81 times, P = 0.003); (3) The happening of severe complication or death or very long LOS occurs in 13.9% of the patients (CI 10.9 17.47%) and SGA B increases the probability in 2.03 times (CI 1.27 3.25 times, P = 0.003) and SGA C in 3.66 times (CI 1.95 6.87 times, P < 0.0001); (4) death alone is1% of the sample while NRS+ increases the chances in 3.90 times (CI 1.16 13.14 times, P = 0.03); (5) Severe complications occurs in 3% of the patients, but NRS+ increases the chances in 2.62 times (CI 1.07 6.42 times, P = 0.04). Conclusion: NRS+ patients should be followed by SGA nutritional assessment in order to identify those at higher risk of morbidity and mortality. Disclosure of Interest: None of the authors have any conflict of interest

97 P170 NURSING PRACTICES RELATED TO NUTRITIONAL THERAPY IN GREECE M.I.P. Freitas1 , E. Theodosopoulou2 , T. Katostaras3 , P. Galanis3 . 1 Nursing Department, State University of Campinas Unicamp, Campinas, Brazil; 2 Surgery Department, 3 Epidemiology Department, Kapodistrian University of Athens, Athens, Greece Rationale: This study aims to investigate nursing practices involving parenteral and enteral nutrition in Greek hospitals to develop a program to improve nursing practices in Brazil and Greece. Methods: A 53-item questionnaire involving nursing practices during administration of nutritional therapy was developed and sent to 257 nurses of five different hospitals during a three-month period, with 30% of completed questionnaires. Results: PN: 63% of nurses use iodinepovidone to clean and protect against infection; 41% stop infusion when patient goes for examination or other procedures and put glucose 5% infusion (16%) or follow physician’s orders (39%). EN: 60% of nurses use the earlobe to nose to xifoid appendix, adding (13%) or not (47%) other length to the distance of the tube to be inserted. 48% answered they learned how to insert enteral tube in practice, 25% with head nursing and 16% with nursing teacher. 83% related to put the bed in a 35º or 45º. To certificate the feeding tube position 57% said they use air insufflations and auscultation of sounds with stethoscope over epigastria. 89% verifies the gastric residues before administering EN, and 97% said the amount of gastric residual volume should be a factor for cessation of EN. 52% do not aspirate subglottic secretion and 9% saw, any time, one patient became with urine blue after received the blue coloring by mouth. Conclusion: Results suggest that actual practices are based largely on doctor recommendations. Although many nursing practices adopted in Greece are sound, certain problematic practices are still reported. Moreover, nurses are often unaware of internationally recommended procedures and of the implications of locally adopted practices. References A.S.P.E.N. Board of Directors and Task Force. Standards for Specialized Nutrition Support for Adult Residents of Long Term Care Facilities. Nutr Clin Pract. 2006;21:96-104 Disclosure of Interest: None declared.

P171 FUNCTIONAL STATUS OF MAGNESIUM IN PATIENTS ON HOME PARENTERAL NUTRITION (HPN) FOR CHRONIC INTESTINAL FAILURE (CIF) M. Guidetti1 , E. Lanzoni1 , C. Pazzeschi1 , E. Malucelli2 , S. Iotti2 , L. Pironi1 . 1 Chronic Intestinal Failure Center, St. Orsola-Malpighi Hospital, 2 Internal Medicine and Nephrology Diseases, University of Bologna, Bologna, Italy Rationale: The physiological activity of Mg is exerted by its free intracellular form. In patients with CIF, dehydration due to intestinal loss of fluids may cause secondary

98 aldosteronism, which increases renal Mg excretion. The aim of the study was to investigate the relationships between free intracellular Mg (Mg2+), the usual indexes of Mg status, the serum aldosteron concentration and the Mg infused with parenteral nutrition (PN), in patients on HPN for CIF. Methods: Twenty-three metabolically stable adult (18 yrs) outpatients on long-term HPN (>6 months) were enrolled. Exclusion criteria: adrenal gland disease, renal and liver failure, diuretics, HPN or underlying disease complications over the past 4 months. The followings were evaluated: in-vivo free Mg2+ in skeletal muscle by phosphorus magnetic resonance spectroscopy (31P-MRS), serum Mg (S-Mg), 24-hr urinary excretion of Mg (U-Mg), creatinine clearance (CrCl), serum aldosteron, and Mg in the PN bag (PN-Mg). Statistics: Pearson simple regression and multiple regression Results: S-Mg was decreased in 3 pts (14%) and Mg2+ in 7 pts (30%). U-Mg was normal in 12 and increased in 11 pts (48%). Aldosteronism was present in 7 pts (30%). Five pts with reduced Mg2+ had both increased U-Mg and serum aldosteron, whereas only one had decreased S-Mg. Mg2+ was not related to S-Mg, U-Mg and PNMg. A negative trend was observed between Mg2+ and aldosteron (R = 0.39; P = 0.063). U-Mg was positively associated with PN-Mg (R = 0.63; P = 0.001) and aldosteron (R = 0.42; P = 0.045). Multiple regression confirmed both the associations. S-Mg was negatively associated with CrCl (R = 0.62; P = 0.014). Conclusion: In patients on HPN for CIF, Mg functional status is not associated with the usual indexes of Mg status but seems negatively affected by increased urinary losses of Mg due to secondary aldosteronism. Disclosure of Interest: None declared.

P172 PATIENTS WASTE HIGH AMOUNTS OF FOOD PROVIDED BY THE HOSPITAL KITCHEN M.A.E. van Bokhorst-de van der Schueren1 , I.A. Brouwer2 , P.J.M. Weijs1 , J.A.E. Langius1 . 1 dept. of nutrition and dietetics, VU University Medical Center, 2 dept. of health sciences, VU University, Amsterdam, Netherlands Rationale: Prevalence of disease-related malnutrition in hospital inpatients is high; many patients do not meet nutritional requirements. To better understand the reasons for poor nutritional intake, in this study an analysis was made of the composition of hospital meals and amounts consumed and wasted by the patients. Methods: During six days, components of meals delivered from the kitchen to the coronary care departments have been weighed and nutrients calculated. On return from the wards, waste was weighed and nutrients consumed were calculated. To determine percentage of intake and waste, we defined the following cut-off points; ate everything (80 100%), ate more than half (51 85%), ate less than half (16 50%) and ate nothing (0 15%). Results: The 3 main meals (measured from 150 meals of 65 patients) accounted for a mean of 1809±143 kcal and 77±10 g of protein per day. The provided meals met the Dutch guidelines for a healthy diet, except for fruits.

Poster presentations Twenty-eight percent of patients ate everything, 44% ate more than half, 24% less than half and 4% ate nothing of the provided meals. In total, 38% of the food provided by the kitchen was wasted. As a consequence, the main meals supplied on average 1105±594 kcal and 47±27 g of protein to the patients. Pastas with sauce, potatoes, rice, and sauces were food products of which more than 50% was wasted. Patients almost completely consumed cold meats, apple pie, ice cream and soup. Conclusion: The standard meals provided by the hospital kitchen provide adequate amounts of energy and protein. However, the majority of patients does not consume complete meals. Thus, food waste attributes to inadequate intake. Periodical evaluation and adjustment of menus, components and nutrient density of meals may help to increase nutritional intake and to prevent weight loss during admission. Disclosure of Interest: None

P173 DIETARY OMEGA 9 AND OMEGA 3 FAT, BODY COMPOSITION AND LIPID PARAMETERS IN HEALTHY CAUCASIAN MEN AND WOMEN M. Neville1 , J. Geppert1 , Y. Min1 , K. Ghebremeskel1 . 1 Institute of Brain Chemistry and Human Nutrition, London Metropolitan University, London, United Kingdom Rationale: The beneficial effects of dietary omega 9 and omega 3 fats in prevention of cardio-vascular diseases (CVD) have been suggested. The British are known to have high intakes of total and saturated fat with higher prevalence of CVD. Hence, we investigated the association between dietary omega 9 and 3 fat intakes, body composition and lipid parameters in UK Caucasians. Methods: Forty-nine men and 50 women (20 50 yrs) were recruited through an advert within the university. Dietary intake was assessed using a 7-day food diary and dietary analysis software (Foodbase v3.1). Body composition was determined by bioelectrical impedance analysis (Tanita Segmental Body Composition Analyser). Systolic/diastolic blood pressure, pulse rate, fasting serum glucose, triglycerides, total cholesterol, LDL-cholesterol, and HDL-cholesterol were measured. Differences between men and women were tested by two-tailed t-test and relationships between parameters examined by Pearson correlations. Data are expressed as means±S.D. Results: Men consumed higher amounts of omega 9 fat (27 g/day vs 21, p < 0.01), had greater lean body mass (64.6±6.8 kg vs 44.2±2.9, p < 0.001) but less fat mass (15.7±5.6% vs 26.9±6.9, p < 0.001) compared with women. Furthermore, men had elevated levels of glucose (5.3±0.8 mmol/l vs 4.9±0.5, p < 0.001), triglycerides (1.3±0.7 mmol/l vs 1.0±0.4, p < 0.05) and LDLcholesterol (3.0±1.0 mmol/l vs 2.6±0.7, p < 0.05) but lower HDL-cholesterol (1.4±0.3 vs 1.8±0.4, p < 0.001). No gender differences were found in omega 3 fat intake. In men, an inverse correlation was found between dietary omega 9 fat, and total cholesterol (r = 0.315, p < 0.05) and LDL-cholesterol (r = 0.340, p < 0.05). Conclusion: Although most men who participated were highly health conscious and physically active, the lipid