The assessment of QOL is a novel approach to assessing dietary intake and quality. Nutrition-related QOL is the physical enjoyment of food along with its social and nurturing aspects and is a separate and distinct concept from other more general aspects of health-related QOL. It is focused on problems associated with food, eating, and nutrition and how these factors affect the patient's overall QOL. Dietary intake, nutritional status, and health-related QOL are related in CKD patients, especially in maintenance dialysis patients. The progression of kidney disease and the dialysis treatments alter patients' physical and functional status. These changes also affect patients' food preferences and intakes, presumably eventually changing their overall QOL and possibly their nutritional status (28,29,31,75-77).
A new tool to measure nutrition-related QOL, the FED tool, has been developed (45). The FED is a subjective and self-administered questionnaire addressing changes of appetite, taste, smell, thirst, GI symptoms, and medications that often occur in illness or other conditions. It can be used with other tools that are used for measuring QOL, such as the Medical Outcome Study Short Form 36 (MOS SF-36) (76) or the Kidney Disease Quality of Life (KDQOL) questionnaire (78), and for measuring dietary intake, such as food records and SFFQs, to develop a fuller picture of what is going on in the patient's eating-related life. Data from the FED tool may be helpful to health care providers in crafting dietary interventions for dialysis patients that maximize QOL, as well as in monitoring changes in nutrition-related QOL. The hope is that, taken together, the use of these tools will be helpful not only in monitoring but in crafting interventions to prevent malnutrition and to improve enjoyment of food and overall QOL. However, additional research needs to be done to establish the validity and reliability of this instrument and its association with health outcomes.
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