title: An example of social activities by registered dietitians: development of recipes for cook-chilled meals to be delivered to kidney disease patients in the conservative treatment and maintenance dialysis stages.
abstract: BACKGROUND
  Many studies have indicated the effectiveness of medical nutrition therapy for kidney diseases in various stages. However, compliance with dietary therapy over a long period is not easy for patients living alone, elderly patients, and disabled patients, and the concern of registered dietitians working at medical facilities has become increased. Our activities started in the form of social services, developing recipes for cook-chilled foods, collaborating with a firm that had been providing a meal-delivery service, for patients with kidney diseases.
  
  
  METHODS
  Our subjects were outpatients with renal failure at the conservative treatment stage, patients at the dialysis stage, and those with diabetic nephropathy. To develop recipes, the nutritional amounts of energy, protein, potassium, phosphorus, salt, and water content in the diet were determined on the basis of the guidelines of the Japanese Society of Nephrology. In 2000, a survey was conducted of 140 regular users of the cook-chilled and delivered foods. The items surveyed were: age, sex, duration of the use of the service, degree of satisfaction with the meals, palatability of menu items, opinions and requests, and reasons for the use of the service.
  
  
  RESULTS
  Between February 1996 and August 2000, recipes for cook-chilled foods for patients with kidney diseases at the conservative-treatment stage, those at the dialysis stage, and those with diabetic nephropathy were gradually developed. As of July 2003, the total number of recipes was 946. Of the 140 users surveyed, we obtained valid responses from 91 (65.0%). Regarding duration of usage of the service (n = 91): it was 1 year or more in 38.6%, 6-12 months in 15.7%, 3-6 months in 22.9%. 1-3 months in 12.3%, and 1 month or less in 10.8%. Regarding degree of satisfaction with the meals (n = 91), it was very good or good in 58%, fair in 30%, and no good in 12% of respondents.
  
  
  CONCLUSIONS
  As the results of the survey indicated, the home-delivered, cook-chilled foods were generally, favorably accepted by users (rate of satisfaction, 58% [very good and good], duration of usage, 54.3% [6 months or longer]), for them to continue their dietary therapy at their homes. It is suggested that the service of delivering cook-chilled meals can be used as one of the choices enabling continued dietary therapy for patients with chronic renal failure who have difficulty in self-management of the diet at home for diverse reasons.
authors.affiliation: Department of Life Sciences, Sagami Women's Junior College, 2-1-1 Bunkyo, Sagamihara, Kanagawa 228-0807, Japan. j-kawakami@star.sagami-wu.ac.jp
authors.forename: Junko
authors.initials: J
authors.lastname: Kawakami
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Midori
authors.initials: M
authors.lastname: Ebata
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Oonaka
authors.forename: Chizuko
authors.initials: C
authors.lastname: Urashima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003296:Cooking; D004032:Diet; D004045:Dietary Services; D005260:Female; D005511:Food Handling; D006437:Hemodialysis, Home; D006801:Humans; D007674:Kidney Diseases / Q000628:therapy*; D008875:Middle Aged; D044623:Nutrition Therapy; D012189:Retrospective Studies; D011795:Surveys and Questionnaires