This issue of TICN has a focus on trends that affect the health and nutrition of older adults. As a long-term proponent of the importance of nutrition and aging, it has been interesting to see a change of approaches to working with this population. The spring issue addresses disabled older adults, the culture change in the dining environment in nursing homes, and assessment of older adults in the community and in health facilities.

Rosenzweig's commentary presents concerns pertinent to individuals with developmental disabilities and considerations for their care as they get older. He includes comments on how dietitians play a key role in improving the health and quality of life of developmentally disabled individuals along with their family and their caregivers. Dietitians who understand the needs and capacities of developmentally disabled individuals will be better equipped to plan for and serve these consumers as they age in place.

Matthews gives her perspective on helping older adults manage the healthcare system and advises dietitians of some of the barriers to affect change. Many resources are available. However, the expansion of nutrition services and an ability to communicate and recognize potential problems are tantamount to providing the best nutrition care for today's older adults.

Robinson and Gallagher highlight the cultural change that is occurring in the dining services of nursing homes across the country. The old rules and routines from the 1960s and 1970s are being transformed by a new concept of person-centered care. They declare: "Culture change is about transforming a facility into a home, a resident into a person, and a schedule into a choice."

The article by Mueller covers much-debated but important concepts for dietitians working with older adults. What are the most useful parameters for assessing nutritional status and what role does inflammation play in chronic diseases associated with aging? He has concluded from the literature that the most useful tools for achieving or maintaining nutritional adequacy are an appraisal of recent weight history and functional capacity.

This descriptive study uses the Mini Nutrition Assessment tool to assess nutritional status in a congregate meal site in Hudson County, New Jersey. The authors compare their findings with a meta-analysis that investigated the same instruments. Differences were found between the groups. However, further study is imperative for using in community settings.

Diet adherence for persons with PKU has been a concern for both patients and healthcare professionals. A new formulation of tetrahydrobiopterin tested in clinical trials has indicated that a subset of PKU patients may respond better and tolerate higher amounts of phenylalanine in the diet. Dr Singh and her coauthors have made recommendations to guide dietetic specialists in the management of these patients.

Gastrich and her colleagues have produced a review of 23 randomized clinical trials that examined the nutritional and pharmacological outcomes of treatments for reducing carotid intima media thickness (CIMT). Significant reductions in CIMT were shown in the large folate trials and the colestipol-niacin and statin trials. A comprehensive table provides some of the specific information on each trial.

Green's case study shows the importance of developing online technology to address practitioners concerns about time and distance constraints in addition to ways for funding certification and continued training. Along with focusing on accurate and current information presented in user-friendly formats, careful planning of the worksite program, its implementation, and participation must be considered at the onset of the online program to ensure its success. A book review by Wardley on Baby Bites is also included in this issue.

Thank you for your support and interest in TICN. Please let us know if you have any comments on these articles or future topics that would improve or change clinical nutrition practice. Please see the erratum on the previous page.

Judith A. Gilbride, PhD, RD, FADA, CDN

Editor