Scenario 1 - continued

You receive the food record in the mail and use nutrient analysis software to estimate Jeremy’s intake. His energy and protein intake is close to the RDA for age, and his vitamin D and calcium intakes exceed the RDA (but are under the UL). His folic acid intake is less than the RDA (his intake is 120 ug/d and the RDA is 200 ug/d).

You remember that an intake that is less than the RDA does not necessarily indicate a deficiency, but you also remember that long-term anticonvulsant use can lead to a folate deficiency.

You recommend that Jeremy take a small amount of supplemental folic acid, after consulting with Jeremy’s neurologist (who prescribed the medication) and primary care physician. You also recommend that Jeremy’s intake (and the need for a supplement) be re-evaluated in a year.