Spring offers a sense of beginning and purpose for creating and building new opportunities for addressing questions with a fresh perspective. The articles in this issue present a variety of ideas and projects that can impact clinical nutrition practice. New knowledge and applied research methods are used to investigate some important questions and broaden the science of nutrition.

Kohli and Samour have reviewed a controversial area for clinical dietitians, the ketogenic diet for adults. Closely appraising the literature, they concluded that some results were positive but the studies were small and generally of lower quality. The implementation of a ketogenic diet for adults would require more evidence from well-designed clinical trials to forge a path for the future.

Accuracy of resting metabolic rate equations for predicting calorie needs in various populations has been a consistent area of inquiry for clinicians. In this study Miller et al compared 6 prediction equations with measurements of resting metabolic rate in a sample of 38 Hispanic women. Using +/-10% to define accuracy, they found that only one equation was accurate for 82% of the sample. They concluded: "RMR prediction equations had limited applicability for young Hispanic women."

Mulvaney et al administered a survey that was completed by 113 individuals who exercise and have had bariatric surgery. They found an opportunity for increasing education and counseling for this population. Participants requested more information on menu planning and designing their own exercise programs.

Coltman et al examined diet quality for a sample of 99 individuals with type 2 diabetes by applying the Healthy Eating Index 2005. Using 24-hour recalls and a survey, they found higher Healthy Eating Index scores for those older than 60 years, those who were food secure, and those who chose foods from several categories. Their findings indicated that more education is needed to improve diets and meet nutritional guidelines.

Thickened liquids have been used to improve food intakes for adults with dysphagia. Goldberg and Heiss conducted a pilot study to measure taste, texture, and palatability of apple juice thickened with different substances. From the tests, they found taste to be the predominant factor for acceptance of the juice but the texture of starch- versus gum-based agents made a difference to the 15 evaluators. Given the findings, a follow-up study should be done with individuals who have dysphagia.

Kozlova looked at the literature on vitamins C, D, and E and minerals copper, zinc, and selenium that could potentially benefit pediatric patients with burns at higher levels. Some benefits were found, but there were insufficient conclusive studies to recommend specific nutrient levels. In addition, micronutrient deficiencies in this population were difficult to measure, with many factors complicating how to pinpoint increased micronutrient requirements.

The importance of zinc nutriture in plant-based diets should be a focus of inquiry according to Lacey. Plant-based diets have increased in the United States along with the consumption of increased phytates that reduce the bioavailability of zinc. Lacey suggested food preparation techniques that could be applied to lower phytate ingestion and maximize the absorption of zinc.

Chromium supplementation for meeting glucose intolerance and insulin resistance was explored by Boyd and seemed warranted because of societal increases in obesity and diabetes. The evidence for chromium was not clear and convincing. Clinical research should be conducted to determine the role of chromium for managing glucose intolerance and insulin resistance and the potential for toxicity with supplementation.

Gaskins et al have outlined a journey to create a healthy food environment in 1 medical center and its eventual expansion to other facilities in a North Carolina health care system. After a great deal of work and marketing, they were successful in devising a food policy that incorporated healthy criteria and can be used as a standard for program evaluation.

Thank you for all your contributions to the journal. Enjoy a bountiful spring and summer with accurate and accessible food, nutrition, and health information at your fingertips.

-Judith A. Gilbride, PhD, RD, FADA

Editor