Over the past year, some scientists have expressed concern about the lack of rigor in health and medical research. Nutrition science has not been ignored in these discussions, with investigators wondering about the accuracy and precision in published studies. The ability to adhere to strict protocols, pilot test procedures, and report the strengths and limitations of the methods in their studies strengthens applied research practice. We thank our authors, reviewers, and editors for their efforts in strengthening Topics in Clinical Nutrition and are pleased to present the first issue of 2016.

Marian and Zeigler offer a complex case report about a patient with a venous leg ulcer. Without specific guidelines for venous ulcer treatment, usual medical practice has been to follow the clinical practice guidelines for pressure ulcers. They review the pathophysiology and nutritional implications for venous ulcer care and then follow the malnutrition diagnosis and outcomes of care for a particular patient. Nutritionally, they stress energy, protein, and micronutrient needs for wound healing and the need for more research to compare nutrient requirements for venous versus pressure ulcers.

Berube et al studied the bone health and lifestyle behaviors of premenopausal Hispanic and non-Hispanic white women. Seventy-eight females participated and recorded 7 days of food intake and physical activity logs along with measurements of bone mineral density and selected anthropometric data. No differences were found in the 2 groups. However, to decrease risk, they recommend attention to bone health by monitoring diet patterns, physical activity, and bone mineral density.

Snetselaar et al examined a new approach of participation to integrate group counseling in a worksite health promotion and protection program. They found lower absenteeism in the intervention group (counseling) than that in the control group (newsletter). Several economic and environmental factors hampered active participation throughout the length of the program. Thus, the authors advise careful planning to help volunteers remain actively involved in worksite health programs.

Kuczmarski and her colleagues evaluated the relationship of literacy and diet quality among participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Healthy Aging in Neighborhoods of Diversity across the Life Span encompasses a prospective cohort of socioeconomically diverse urban African Americans and whites. They found an independent and synergistic association of literacy and education with diet quality, emphasizing the need to consider both variables when counseling clients about nutrition.

Nutrition literacy is also a timely issue in an era when patients must take a collaborative role in deciding which drugs, surgical treatments, and medical management seem best for them. Colaizzo-Anas et al compared women with elevated body mass index and their ability in estimating kilocalories in a 900-kcal menu. They found energy estimates to be significantly lower than measured energy expenditure. Meal kilocalorie amounts were underestimated. They concluded that "overweight women have low energy-related nutrition literacy."

Registered dietitians and nutritionists work with clients with disordered eating, usually as part of a team. Trammell et al conducted focus groups with 16 dietitians to determine the needs of registered dietitians and nutritionists who face the challenges of working with this population. Several themes emerged that indicated a need for additional resources, the most promising in this qualitative project was having a mentor to improve their skills and guide their understanding of effective approaches.

Schmalz and Colistra examined obesity stigma in relation to barriers to healthy eating from 67 obese individuals responding to a questionnaire. They found that perceived barriers to healthy eating increased as beliefs about obese people being personally responsible for their weight status increasing. Self-esteem did not improve with healthy eating. To conclude, they stated: "being aware of how weight stigma can negatively affect a person's efforts toward health could benefit the client, and the practitioners alike."

Best of health, sumptuous food, and abundant happiness in the new year to all of our readers and contributors to Topics in Clinical Nutrition!

-Judith A. Gilbride, PhD, RDN, FAND

Editor

-Elizabeth Young, MA, CCP

Managing Editor