Ideally, pregnant teens would receive nutrition counseling during pregnancy, but such services are not always available, especially in private offices. Unfortunately, "adequate nutrition" might be evaluated by weight gain in pregnancy, but multiple authors have suggested that greater attention should be given to studying the effect of food and eating patterns such as the frequency of skipping meals, eating with family, consuming fried food, or drinking sugar-sweetened beverages (Croll et al. ; 2001 ; Kaiser, 2007 ; montgomery, 2003 ) Neumaek-Sztainer et many adolescents engage in unhealthy dieting practices and have erratic eating patterns that include a high intake of fast foods and other foods high in fat and sugar but a low intake of fruits, vegetables, and calcium-rich foods (Croll et al. 2001) Pregnant adolescents are at particular risk for inadequate or excessive weight gain during pregnancy well as an insufficient dietary intake of nutrients that support fetal growth and development (Natkin Nielsen, gittelsohn, ankiker, & o ; dien 2006) in their integrative review of nutrition intervention programs, Notkin Nielsen and colleagues concluded that no studies have rigorously evaluated the independent influence of nutrition education on prenatal dietary behaviors or outcomes, and few studies have targeted dietary attitudes, beheviors. skills, or self-efficacy. Nevertheless, they suggest that appeal to improve nutrition knowledge, support diet quality, and develop program approaches that appeal to pregnant adolescents. It appears likely that effective nutritional education strategies for pregnant adolescents would include