Association between folate, vitamin B6 and vitamin B12 intake and depression in the SUN cohort study

Background:  An association between low blood levels of folate, vitamins B₆ and B₁₂ and a higher prevalence of depressive symptoms has been reported in several epidemiological studies. The present study aimed to assess the association between folate, vitamins B₆ and B₁₂ intake and depresion prevalence in the SUN cohort study.
Methods:  The study comprised a cross-sectional analysis of 9670 participants. A validated semi-quantitative food frequency questionnaire was used to ascertain vitamin intake. The association between the baseline intake of folate, vitamins B₆ and B₁₂ categorised in quintiles and the prevalence of depression was assessed. The analyses were repeated after stratifying by smoking habits, alcohol intake, physical activity and personality traits.
Results:  Among women, odds ratios (OR) [95% confidence interval (CI)] for the third to fifth quintile for vitamin B₁₂ intake were 0.58 (0.41–0.84), 0.56 (0.38–0.82) and 0.68 (0.45–1.04), respectively. Among those men with a low level of anxiety and current smokers, a significant positive association between low folate intake and the prevalence of depression was found. The OR (95% CI) for the first quintile of intake was 2.85 (1.49–5.45) and 2.18 (1.08–4.38), respectively, compared to the upper quintiles of intake (Q2–Q5) considered as a group.
Conclusion:  Low folate intake was associated with depression among currently smoking men and men with low anxiety levels. Low intake of vitamin B₁₂ was associated with depression among women. No significant associations were found for vitamin B₆ intake.     

Comparison of nutrient intake between different dietary assessment methods in elderly male volunteers

Aim:  The objective of the study was to compare nutritional intake results obtained from the 4 × 4-day weighed records with those obtained from a food frequency questionnaire, repeated 24-hour recalls, a seven-day food record and a seven-day checklist in elderly men.
Methods:  Seventy-five healthy men aged 55–88 years and living at home in Cambridge, UK, took part in the study. Energy and nutrients had means and standard deviations calculated. Misreporting was based on an evaluation of food intake level, calculated as reported energy intake divided by predicted basal metabolic rate. This was in relation to a plausible physical activity level, calculated as the ratio of energy expenditure divided by predicted basal metabolic rate. Statistical significance was assessed via one-way anova .
Results:  The nutrient density was higher for protein and potassium for the group with low food intake level values in all dietary assessment methods. For some methods, this was also true for calcium, carotene, iron and vitamin C. All methods yielded similar results.
Conclusions:  The present study indicates that selective underreporting exists. Surprisingly, the simplest method, the simplified 24-hour recall, performed as well as more complicated methods.     

Estimated nutrient intake of urban Indigenous participants enrolled in a lifestyle intervention program

Aim:  The present study evaluates the reported nutrient intake of adult urban Aboriginal and Torres Strait Islander people who participated in a medically based lifestyle intervention program.
Methods:  The analysis was based on dietary records from all Indigenous participants (n = 100) enrolled in a 2003–2005 prospective lifestyle intervention study that followed a cohort of overweight (body mass index > 25) participants served by the Townsville Aboriginal and Islanders Health Service, Queensland, Australia. Standardised multiple-pass 24-hour dietary recalls were collected at baseline and 12-month program completion. Changes in pre- and post-program reported intake were evaluated using a paired-sample t -test. The Mann–Whitney test was used to compare baseline intake with an age and gender-matched sample created from 1995 National Nutrition Survey data.
Results:  The cohort was 88% female with a mean age of 44.4 ± 1.3 standard error of the mean. Dietary intake improved between baseline and program completion. At baseline, there was a high prevalence of reported intakes below the Estimated Average Requirement for vitamin A, thiamine, riboflavin, niacin, folate, vitamin C, magnesium, calcium, phosphorus, iron and zinc. Compared with the median Australian intake, the Indigenous intake was significantly higher in protein and cholesterol; however, vitamin A, vitamin C, niacin, potassium, magnesium, iron and fibre were lower.
Conclusions:  The present study found the intake in a cohort of Indigenous people was significantly different than the previously measured Australian nutrient intake. The nutrient patterns observed in the present study may be associated with the excess chronic disease burden experienced by Australian Indigenous populations.     

The contribution of breakfast to micronutrient adequacy of the Irish diet

A 7-day diet history was completed by 1213 subjects in Ireland between the ages of 8 and 80 years. Subjects were divided into breakfast skippers, cereal eaters or non-cereal eaters.
Ninety-seven per cent of the population ate breakfast. Sixty-eight per cent were breakfast-cereal consumers and of these 62% ate breakfast six to seven times per week. The contribution which breakfast cereal makes to the total daily nutrient intake was calculated for males and females separately, and also for the two age-groups 8–18 years and >18 years. Iron intakes were lower than the RNI for all females but cereal consumers appeared more likely to achieve their RNI than breakfast skippers and non-cereal consumers. Breakfast-cereal consumers had significantly higher intakes of vitamins B, B₁₂, niacin, folate, B₁₂, vitamin D, calcium and iron. For females not consuming a breakfast cereal, mean nutrient intakes of folate and calcium were lower than the RNI. From this study, it appears that breakfast cereal consumption makes a significant contribution to nutrient intake in the Irish diet.     

Folate and Vitamin B12 Status in the Americas

There is growing interest in the potential for folic acid fortification in the Americas and recognition of the high prevalence of low plasma vitamin B₁₂ concentrations reported in various studies. This review summarized available data on plasma vitamin B₁₂ and folate concentrations in the Americas. At least 40% of individuals had deficient or marginal plasma vitamin B₁₂ concentrations in almost all locations and across age groups. Low plasma folate concentrations were less common. It is hypothesized that vitamin B₁₂ deficiency may result from a low intake of animal source foods, while a higher intake of refined flour may result in low plasma folate.     

Folate and Vitamin B12 Recommended Intakes and Status in the United States

This paper presents a synopsis of the Institute of Medicine (IOM) Dietary Reference Intakes (DRIs) for folate and the recommended folic acid intake to reduce the risk of neural tube defects. Estimated intake of folic acid is presented and total folate intake is compared to the DRI. Vitamin B₁₂ DRIs are highlighted in addition to the IOM recommendation for crystalline vitamin B₁₂ intake specifically for individuals ≥57 years of age. Recently reported evidence of vitamin B₁₂ inadequacy in the aging segment of the U.S. population will be addressed.     

Non-starch polysaccharide intake in vegans and the relationship with energy distribution and mineral intakes

Background There is little information available about non-starch polysaccharide (NSP) intake in vegans. This study aimed to estimate the intake of NSP in the habitual vegan diet and to assess the relationship between NSP intake and energy distribution, and intakes of selected minerals.
Method NSP intake, energy distribution and intakes of calcium, magnesium, iron and zinc were estimated, using a 4-day weighed record, in 26 adult vegans (male n  = 11, female n  = 15) consuming their habitual diet.
Results Mean BMI values in males (22.0) and females (21.1) were significantly lower than the average for the UK population. Mean daily NSP intakes in males (27 g) and females (23 g) were higher than the dietary reference value (DRV) population average of 18 g day^–1, although six subjects had intakes below this and two male subjects had intakes below the DRV individual minimum of 12 g day^–1. Cereals were the major contributor to total NSP intakes. Mean contributions to total energy intake in males and females were in-line with the DRV. Mean calcium intakes were below the reference nutrient intake (RNI) while mean intakes of magnesium, iron and zinc were above the RNIs. There were significant positive correlations between NSP intake and calcium, magnesium, iron and zinc.
Conclusion Occasional low NSP intakes and, conversely, high intakes of NSP combined with marginal calcium intakes in some vegans are of concern. Further work is needed to assess food sources and NSP intakes in the current vegan diet.     

Thiamine deficiency is prevalent in a selected group of urban Indonesian elderly people

This cross-sectional study involved 204 elderly individuals (93 males and 111 females). Subjects were randomly recruited using a list on which all 60-75 y-old-people living in seven sub-villages in Jakarta were included. The usual food intake was estimated using semiquantitative food frequency questionnaires. Hemoglobin, plasma retinol, vitamin B-12, red blood cell folate and the percentage stimulation of erythrocyte transketolase (ETK), as an indicator of thiamine status, were analyzed. Median energy intake was below the assessed requirement. More than 75% of the subjects had iron and thiamine intakes of approximately 2/3 of the recommended daily intake, and 20.2% of the study population had folate intake of approximately 2/3 of the recommended daily intake. Intakes of vitamins A and B-12 were adequate. Biochemical assessments demonstrated that 36.6% of the subjects had low thiamine levels (ETK stimulation > 25%). The elderly men tended to have lower thiamine levels than the elderly women. The overall prevalence of anemia was 28.9%, and the elderly women were affected more than the elderly men. Low biochemical status of vitamins A, B-12 and RBC folate was found in 5.4%, 8.8 % and 2.9% of the subjects, respectively. Dietary intakes of thiamine and folate were associated with ETK stimulation and plasma vitamin B-12 concentration (r = 0.176, P = 0.012 and r = 0.77, P = 0.001), respectively. Results of this study suggest that anemia, thiamine and possibly vitamin B-12 deficiency are prevalent in the elderly living in Indonesia. Clearly, micronutrient supplementation may be beneficial for the Indonesian elderly population living in underprivileged areas.     

The growth and development of vegan children

The results of prospective study on the growth and diets, estimated from 7-day weighed food intake records, of 20 life vegan children (aged 5.8–12.8 years) are presented. The growth and development of the children were normal but they tended to be lighter in weight and exceptionally lean compared with standards. Heights were around the median of the Tanner-Whitehouse standards but were lower than the medians recently proposed by the Department of Health. Energy intakes were similar to those reported in children of the same age in the general population, but dietary fibre intakes were very high which may have influenced the digestible energy. Sugar provided an average 15.6% of the dietary energy and this was supplied mainly by fruit and fruit juice. Mean fat intakes were close to the dietary reference values. Daily intakes of essential nutrients generally met the amounts recommended, with the exceptions of calcium and vitamin B₁₂. Many children received supplementary sources of vitamin B₁₂ and only two children had intakes below the lower recommended nutrient intake. Intakes of saturated fatty acids were low and those of linoleic acid were high. The ratio of linoleic/α-linolenic acid was high. As docosahexaenoic acid is absent from vegan diets, it is suggested that vegans should use oils with a lower ratio of linoleic/α-linolenic acid. Future studies should also consider the influence of a vegan diet on retinal function. None of the children was immunized against whooping cough and 11 had not been immunized against polio: 16 of the children had suffered from whooping cough. Future studies need to take into account factors other than diet when assessing the health of vegans. The results of this study show that children can be successfully reared on a vegan diet providing sufficient care is taken to avoid the known pitfalls of a bulky diet and vitamin B₁₂ deficiency.     

Ten-year trends in vitamin and mineral intake from fortified food in German children and adolescents

OBJECTIVE: We investigated time trends in consumption patterns, and energy and nutrient intakes (protein, fat, carbohydrates, added sugars, vitamins A, E, C, B1, B2 and B6, niacin, folate, calcium and iron) from fortified food in children and adolescents between 1987 and 1996 in Germany. DESIGN: Mixed longitudinal survey (DONALD study) with 3 d weighed dietary records (n=2062 from 594 subjects), one subject per family per year chosen by random. SETTING: Dortmund (Western Germany) district cohort. SUBJECTS: 285 males, 309 females; mean age 6 y (2-13 y). RESULTS: Almost all children and adolescents consumed fortified food irrespective of the year studied. With the exception of vitamin E, significant time trends in the proportions of nutrient intakes from fortification were observed. The fortification of food with vitamins A, C, B1, B2 and B6 and niacin raised the already adequate intakes from non-fortified food (100% to 150% of reference intake values) by 20-50%. The fortification of food with vitamin E and folate raised the low intakes from non-fortified food (about 50% of reference intake values) to about 80% (folate) and 100% (vitamin E) of the references. Fortification of food with calcium and iron was not significant (<10%), but while total intake of calcium was adequate, total intake of iron remained critical. CONCLUSIONS: Since the nutrient intake of the population of children and adolescents studied is adequate with respect to vitamins A, C, B1, B2 and B6, niacin and calcium, fortification seems inefficient, while fortification of food with vitamin E and folate, but not iron, improves an inadequate intake. SPONSORSHIP: The DONALD study is supported by the German Federal Ministry of Health and the North-Rhine-Westphalian Ministry of Science and Research. European Journal of Clinical Nutrition (2000) 54, 81-86     

The contribution of specific dietary patterns to energy and nutrient intakes in 7–8-year-old Scottish schoolchildren. I. Milk drinking

Energy and nutrient intakes were estimated in 136 7–8-year-old Scottish schoolchildren using the 7-day weighed inventory method. The contribution of liquid milk was assessed by (a) expressing energy and nutrient intake from milk as a percentage of overall intakes; (b) comparing dietary intakes in children with different patterns of milk consumption and (c) investigating the relationships between milk drinking, anthropometry and growth. The average intake of milk in this study was 2.11 l per week and more full-fat than semi-skimmed milk was drunk. Milk contributed around 10% of energy, 13% fat, 30% vitamin A, 36% vitamin B₁₂ and 42% calcium to overall diets. Children with weekly milk intakes of more than 3 l had higher daily intakes of energy and certain micronutrients compared with children with weekly milk intakes of less than 1 l. The overall daily diets of children drinking semi-skimmed milk at home were lower in percentage energy from fat than those of children drinking full-fat milk at home. There was no significant relationship between the type or volume of milk drunk and either anthropometry or growth. It was concluded that (a) intakes of milk in excess of 3 l per week are beneficial in terms of increased micronutrient intakes and (b) the use of semi-skimmed milk may help to decrease intakes of fat in this age group, yet have no adverse effects on anthropometry or growth.     

Institutionalized elderly women have lower food intake than do those living more independently (Dutch Nutrition Surveillance System).

The habitual intake of energy and nutrients (assessed through dietary history) among elderly women (aged 65 and over) living in a nursing home (n = 54), elderly women living in service flats and receiving their dinners from the nursing home kitchen (n = 29), and elderly women living independently (n = 52) was evaluated within the framework of the Dutch Nutrition Surveillance System. Intake of energy and nutrients was lowest among women in the nursing home and highest among those living independently. Almost all differences in absolute intake found were significant, both unadjusted and adjusted for age. In the nursing home the intake of energy and nutrients was lower at higher age. In qualitative terms the differences among the groups of women were less striking. Mean daily intakes of iron, vitamin A, thiamin, vitamin B6 and vitamin C were below the Dutch recommended dietary allowances (RDAs) among the nursing home women. Several interrelationships among nutrient intakes were found, low intake levels clustering somewhat among elderly subjects. Our data indicate that these nutritional risks are due to a lower food intake resulting in a lower intake of energy and nutrients, and owing to differences in food choice resulting in a lower nutrient density. We conclude that it is difficult to design a diet containing all essential nutrients at the RDA level in a nursing home with residents who have a relatively low intake of energy, especially among those at higher age.     

Institutionalized elderly women have lower food intake than do those living more independently (Dutch Nutrition Surveillance System).

The habitual intake of energy and nutrients (assessed through dietary history) among elderly women (aged 65 and over) living in a nursing home (n = 54), elderly women living in service flats and receiving their dinners from the nursing home kitchen (n = 29), and elderly women living independently (n = 52) was evaluated within the framework of the Dutch Nutrition Surveillance System. Intake of energy and nutrients was lowest among women in the nursing home and highest among those living independently. Almost all differences in absolute intake found were significant, both unadjusted and adjusted for age. In the nursing home the intake of energy and nutrients was lower at higher age. In qualitative terms the differences among the groups of women were less striking. Mean daily intakes of iron, vitamin A, thiamin, vitamin B6 and vitamin C were below the Dutch recommended dietary allowances (RDAs) among the nursing home women. Several interrelationships among nutrient intakes were found, low intake levels clustering somewhat among elderly subjects. Our data indicate that these nutritional risks are due to a lower food intake resulting in a lower intake of energy and nutrients, and owing to differences in food choice resulting in a lower nutrient density. We conclude that it is difficult to design a diet containing all essential nutrients at the RDA level in a nursing home with residents who have a relatively low intake of energy, especially among those at higher age.     

Recording the nutrient intake of nursing home residents by food weighing method and measuring the physical activity

The nutrient intake of 47 female nursing home residents, able to eat without help, and of 20 eating-dependent seniors was measured by weighing method. Hand grip strength was examined by a dynamometer. Furthermore the level of physical activity of the seniors able to eat without help was determined by means of a questionnaire. The results showed that the median energy intake of self-feeding elderly women was 1620 kcal (850-4450 kcal). More than one third of the seniors consumed less than 1700 kcal / d. The intake of vitamins and minerals remained below 40-90% of the recommended level. One important cause for the inadequate micronutrient intake was that 30% of the total energy intake is met by foods of a low nutrient density (cakes, cookies, spreadable fats, soups). The eating-dependent seniors were at high risk for protein-calorie malnutrition, consuming an average of 1130 kcal / d and 34 g protein / d. The level of physical activity was very low. Only 34% of the seniors were active for more than 2 hours per week (walking, gymnastics). 30% of the residents were largely inactive although they were able to walk. It is often ignored that immobility is a major risk factor for the development of malnutrition. Firstly inactivity accelerates the loss of muscle mass. This loss of metabolically active tissue decreases the energy requirements thus leading to a loss of appetite and reduced food intake.     

Nutrient intake among elderly in southern Peninsular Malaysia

Studies were conducted in selected areas in three states namely Johor (n=117, male=55, female=62), Negeri Sembilan (n=130, male=52, female=78) and Malacca (n=97, male=33, female=64) involving free living elderly (age range from 60 to 93 years old). Respondents were divided into three age cohort groups that is 60 to 69 years, 70 to 79 years and above 80 years old. Assessment of macro and micronutrients were obtained from 24-hour diet recall for three consecutive days. Household measurements were used to estimate the amount of food consumed. Mean energy intake for both sexes were lower than the Malaysian RDA. Mean energy intake were also found to decline with age increment. The percentage of carbohydrate from total calories is higher compared to fat and protein. No respondents were found to consume less than 1/3 RDA for protein. Although no significant difference in nutrient intake was noted among age cohort groups, there was a decline in the intake of protein, fat and carbohydrate. Significantly (p <0.05) lower carbohydrate intake was noted in cohort group above 80 years. As for vitamins and minerals consumption, more than 50% of the elderly population studied consumed less than 2/3 RDA for vitamin A, thiamine, riboflavin, niacin and calcium. Very low intake of nutrient may lead to many health problems. Overall mean energy intake indicate the respondents consume less than the Malaysian RDA for all three age cohort groups. Total mean energy intake were also found to decline with age increment for both sexes. Due to the low energy intake, higher percentage of elderly were found consuming less than 2/3 RDA for thiamine (65%), riboflavin (63%) and niacin (90%). Other nutrients which were also being consumed less than 2/3 RDA by the respondents are vitamin A (67%) and calcium (65%). The intake of calcium which was found to be extremely low (ranged from 277 to 303 mg) could lead to problems like osteoporosis.     

Nutrient intake of Head Start children: home vs. school

OBJECTIVE: To determine mean intake of energy and protein, total fat, saturated fat, percent energy from total and saturated fat, cholesterol, carbohydrate, calcium, iron, zinc, folate, vitamins A, C, E, B-6 and B-12, thiamin, niacin, riboflavin, magnesium, sodium and fiber of preschool Head Start children at school and away from school. DESIGN: Twenty-four-hour food intakes for 358 Head Start children were obtained by observing food intake at school and acquiring intake recalls from parents or guardians specifying food their children consumed for the balance of the day. After determining group estimates of energy and nutrient intake, mean intake was compared to standard nutrient recommendations for the entire 24-hour day, i.e., for the time the children were in school and for the remaining hours away from school ("home" intake). SUBJECTS: The 358 Head Start children attended school either half-day (2- to 3-hour AM and PM sessions) or all-day (5 to 6 hours). STATISTICAL ANALYSES: Differences in nutrient intake among class times were analyzed using one-way analysis of variance (ANOVA) followed by Tukey's multiple comparison test. Differences with a p-value <0.05 (two-tailed) were considered to be statistically significant. Total energy, protein, calcium, iron, zinc, vitamins A, C, E, B6, and B12, thiamin, niacin, riboflavin as well as folate and magnesium were compared to the Recommended Dietary Allowances for the 4- to 6-year-old age group. Other standards that were used for comparisons included the National Cholesterol Education Program (fat, saturated fat and cholesterol), the 1989 National Research Council's Diet and Health Report (carbohydrate and sodium) and the recommendation for fiber proposed by the American Health Foundation. RESULTS: At school, half-day children consumed up to 25% of the daily recommendation for energy and nutrients, while all-day children achieved at least a third of the recommended intakes. When intakes at home and school were combined, all three groups of children (AM, PM and all-day) exceeded dietary recommendations for protein, vitamins and minerals. Energy intake remained below 100% of the recommendation, while intake of total fat, saturated fat and cholesterol exceeded recommendations. APPLICATION: Further research is required to explore energy needs and determine nutritional status and nutrient needs of minority and low-income preschool children. Strategies are required to increase nutrient density, but not fat density, of meals and snacks served to children who attend day care for part of the day. Finally, school meals and nutrition education programs such as Team Nutrition should broaden their base to include healthful eating habits for all school children, including the very youngest children in preschool programs.     

The dietary intake of people with non-insulin-dependent diabetes (NIDDM): how valid is self-reported intake?

Background: In diabetes care, an accurate assessment of dietary intake is essential for clinical management. This study assessed the validity of dietary records from people with NIDDM by comparing reported energy and protein intakes with estimated total energy expenditure (TEE) and urinary nitrogen excretion.
Method: To assess energy and nutrient intake 185 patients kept dietary records for two 3-day periods. Basal metabolic rate (BMR^est) was estimated to calculate reported energy intake/BMR^est. Appropriate age and sex-specific physical activity levels (PAL=TEE/BMR) from published doubly-labelled water studies of TEE, were used to calculate a cut-off PAL for energy intake/BMR^est, below which intakes were statistically unlikely to be valid. A subgroup (46 patients) collected a complete 24-h urine sample to compare nitrogen excretion with protein intake.
Results: The mean value of energy intake/BMR^est (1.14±0.3) was markedly below the calculated cut-off point (1.58±0.06) suggesting widespread underreporting. Protein intake (82.5±21.3) was also lower than estimated protein losses (92.5±19.4). Obese and female NIDDS were more likely to underreport and their intakes were closer to the diabetes dietary recommendations. Conclusion: This study found that people with NIDDM were likely to underreport their food intake.     

Estimating food intakes in Australia: validation of the Commonwealth Scientific and Industrial Research Organisation (CSIRO) food frequency questionnaire against weighed dietary intakes

Background:  There is a dearth of knowledge about the foods that Australian adults eat and a need for a flexible, easy-to-use tool that can estimate usual dietary intakes. The present study was to validate a commonly used Australian Commonwealth Scientific and Industrial Research Organisation (CSIRO) food-frequency questionnaire (C-FFQ) against two 4-day weighed food records (WFR), as the reference method.
Methods:  The C-FFQ, as the test item, was administrated before the WFR. Two 4-day WFR were administrated 4 weeks apart. Under-reporting was established using specific cut-off limits and estimated basal metabolic rate. Seventy-four women, aged 31–60 years, were enrolled from a free-living community setting.
Results:  After exclusion for under-reporting, the final sample comprised 62 individuals. Correlations between protein intake from the WFR and urinary urea were significant. Overall agreement between FFQ and WFR was shown by 'levels of agreement' (LOA) and least products regressions. There was presence of fixed and proportional bias for almost half the nutrients, including energy, protein, fat and carbohydrates. For most of the nutrients that did not present bias, the LOA were 50–200%. Agreement was demonstrated for percentage dietary energy protein and fat; carbohydrate; and absolute amounts of thiamine, riboflavin, magnesium and iron. However, relative intake agreement was fair to moderate, with approximately 70% of (selected) nutrients exact or within ±1 quintile difference.
Conclusion:  The C-FFQ is reasonable at measuring percentage energy from macronutrients and some micronutrients, and comprises a valuable tool for ranking intakes by quintiles; however, it is poor at measuring many absolute nutrient intakes relative to WFR.     

Pregnant adolescent and adult women have similarly low intakes of selected nutrients

OBJECTIVE: To examine the dietary intake of pregnant adolescents during the second and third trimester of pregnancy, and to compare their nutrient intake with that of pregnant adults. DESIGN: Two 7-day food records (14 days) from subjects participating in a larger randomized clinical calcium trial: the first at 19 to 21 weeks and the second between 29 and 31 weeks gestation. Intake of energy and selected nutrients were calculated and compared with dietary standards. SUBJECTS/SETTING: Fifty-nine pregnant adolescents and 97 pregnant adults recruited from prenatal clinics at a metropolitan university hospital. STATISTICAL ANALYSES: Two sample t tests, equality of variances, and repeated measures (analysis of variance). RESULTS: There was no difference in mean nutrient intakes between the second and third trimesters. Using two 7-day food records, we found mean intakes for energy, iron, zinc, calcium, magnesium, folate, and vitamins D and E to be below recommended standards in both groups. Other nutrients examined met or exceeded reference values. Total daily intakes for energy and 11 nutrients were significantly higher in the adolescent compared to the adult diets (P < .05). These differences were not evident when nutrient values were corrected for energy, indicating that increased energy intake in the teen-aged population was contributed by nutrient-dense foods. APPLICATIONS: This study indicates the need for continued dietary monitoring of pregnant adolescents and pregnant adults, including nutrition guidance that stresses food sources of calcium, magnesium, zinc, iron, fiber, folate, and vitamins D and E, the nutrients found deficient in their diets.