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Topics in Clinical Nutrition offers an exciting new feature for this issue: case studies. A formal case review is presented on a 5-year-old boy newly diagnosed with phenylketonuria (PKU) and the management dilemmas and outcomes. Two other articles present case studies, one is on cystic fibrosis and the other on wound healing. The PKU case review complements 2 articles that provide insight on genomics and genetics education.
The 'interf ace between genomics and nutrition' by Kozma stresses the need for dietetics professionals to expand their knowledge of genetics and genomics. Most important for today's professionals is to apply the evolving knowledge base into daily practice, as part of family histories and genetic risk for disease. Close monitoring of genomics and genetic discoveries will require new skills and competencies as outlined in Table 1 of Kozma's article. The implications for forecasting and treating multifactorial conditions are enormous and should also include the ethical, legal, and social issues that impact patient care.
Kauwell takes the Human Genome Project and related research further by encouraging the incorporation of genomics into curriculum development of dietetic students. She suggests ways to incorporate genetics into dietetics curriculum and practice. In the future, she comments that, with more knowledge in genetics, we will be able "to target individuals who are most likely to benefit from nutrition intervention." Consumer demand will also drive dietetic practitioners to provide appropriate information and resources on the interaction of genes and the nutrition environment.
The influence of genotype and phenotype on nutritional status in cystic fibrosis is covered by Luder. The gene for cystic fibrosis was identified in 1989 and clinicians are examining its practical application for patients with the disease. An example of using genetic testing to assist with the management of a 12-year-old patient is provided.
Wound healing and implications for nutritional care are reviewed by Fuhrman. She carefully examines the scientific literature on nutrients. She concludes that more research is needed in this area, particularly to identify which nutrients are most beneficial and what levels of nutrients should be given for wound healing. In Part II, she also presents a case study of a female with peptic ulcer disease and cites the importance of early intervention. Nutrition must be integrated into a comprehensive approach of care for effective wound healing and good site care, good medical care, and good nutrition are essential.
The case study provided by pediatric nutritionist Kathy Camp gives readers an example of a monogenic condition that requires nutrition intervention. Diet manipulation remains the key element in treating PKU. She does an excellent job reviewing the case and the decision-making needed to manage a child who was not diagnosed under the newborn screening program.
Byrd-Bredbenner et al did a comparison of the anthropometric measurements in media portrayals of the idealized female body that are directed to men, women, and mixed gender audiences. They indicate concern about the role of the media in shaping the definition or image of beauty as being an ultraslim body shape and what its effect on children and young teenagers may be.
Butcher-Powell et al. collected information via survey on the factors that affect breakfast intake of children. They surveyed 483 children in 15 Pennsylvania school districts and found the most frequently consumed breakfast foods were cereal, milk, and juice. They found that students ate breakfast more often if breakfast was available in school and students indicated that they would consume breakfast more often if it was part of the school schedule.
Greene conducted a pilot project with 31 participants to assess a home-based weight-management program for overweight adults. Fewer than 15% of the participants completed the program and provided follow-up data at 3 months and 6 months. Based on the pilot information and the high attrition rate, the findings suggest a focus on total lifestyle changes rather than simply weight loss in future home-based management programs.
In this issue we also reintroduce the review of selected international journals by Krenkel and a book review by Franklin. It is my pleasure to welcome 2 new members to the Editorial Board: Charles Mueller, PhD, RD, CNSD, CDN, Nutrition Research Manager, General Clinical Research Center, Weill Medical College of Cornell University, New York, NY, and Riva Touger-Decker, PhD, RD, FADA, Associate Professor, School of Health-Related Professions, University of Medicine and Dentistry of New Jersey, Newark, NJ. Their clinical expertise and extensive practice and research experiences will be invaluable to TICN as the journal continues to evolve into a cutting-edge clinical nutrition practice journal.
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