The Right Diet for Twin Pregnancies

The diet for twin pregnancies is no different that of a singleton pregnancy. Consultation with the obstetrician and nutritionist is key.
The Right Diet for Twin Pregnancies

Last update: 12 July, 2023

It’s natural for the gestation stage to have nutritional requirements that respond to the growth of the baby, placenta, uterus, and amniotic fluid. But this doesn’t mean that we should eat for three when it comes to twin pregnancies. This diet is no different from that of a singleton pregnancy, as it follows the same principles, except for some small adjustments.

The twin pregnancy diet will ensure a balanced weight and health of the pregnant woman and the babies. Here, we’ll tell you precisely which nutrients and foods to include. Take note!

Know what to consider in a diet for twin pregnancies

A proper twin pregnancy diet provides the energy, macronutrients, vitamins, and minerals needed for three people. So, the first thing to do is to consult with your obstetrician and nutritionist. In the meantime, we’ll offer you the key principles you need to keep in mind.


According to a group of experts, the caloric recommendations for twin pregnancies range from 3,000 to 4,000 calories, according to the nutritional status. When the body mass index (BMI) or the ratio of weight to height squared before pregnancy is low, 4,000 calories are provided, while with excess weight or obesity, 3,000 calories per day. For a normal BMI, 3500 calories are prescribed.

The National Library of Medicine argues that the physiologic and metabolic adaptations in twin pregnancies respond in a logical manner to the following:

  • A metabolic increase for maternal and infant tissue formation.
  • An increase in the mother’s resting metabolism.
  • An increased heart and respiratory rate.
  • The growth of the babies.

These extra calories will allow a recommended weight gain for twin pregnancies, ranging from 16 to 20.5 kilos. Those who are overweight before gestation should only gain up to 35 pounds. Women who are underweight should gain up to 44.

A pregnant woman looking in the fridge.
In twin pregnancies, the extra calorie intake ranges between 500 and 600 calories per day after the first trimester. However, this doesn’t mean eating for three.


Carbohydrates represent the main source of energy and should provide 40 percent of all daily calories. The Centro de Atención Nutricional Antímano (CANIA) indicates about 350 grams of carbohydrates for pregnant women with a normal BMI. In addition, low glycemic index (GI) carbohydrates are recommended, that is, those of slow absorption. This will help regulate blood sugar.

Therefore, it’s advisable to incorporate more fiber into the diet through whole grains, such as rice, pasta, barley, oatmeal, or whole wheat bread, among others. At the same time, some fruits that have simple carbohydrates are also a source of soluble fiber. Among them are pears, apples, peaches, strawberries, and avocado, among others. To take advantage of the fiber, you should opt for whole fruits or unstrained fruit smoothies.


Protein accounts for 20 percent of all calories in a twin pregnancy diet. That is, about 170 grams per day. These will cover the needs, both in quality and quantity, for the proper growth of the fetal organs and placenta. But what foods should be selected?

It’s advisable to consume lighter proteins, such as chicken, turkey, rabbit, egg whites, skimmed cheeses, and fish. As for vegetable protein, you have legumes, nuts, and seeds. In addition, pseudocereals such as quinoa and amaranth are also considered good sources.


Fats should provide 40 percent of the total caloric requirement. Only 7 to 10 percent of daily calories should come from saturated fat to avoid the elevation of bad or LDL cholesterol and diabetes. Therefore, cholesterol consumption is limited to between 200 and 300 milligrams per day, and the consumption of industrialized fats should be avoided.

Omega-3 consumption is also indicated, such as alpha-linolenic (ALA), docosahexaenoic (DHA), and eicosapentaenoic (EPA), associated with the neurological and visual health of the baby. DHA and EPA are found in oily fish, such as salmon, sardines, permit, and lebranche mullet, among others. Tuna, swordfish, and shark can be contaminated with mercury. Canola and soybean oil provide ALA.

A pregnant woman holding up 2 avocado halves.
The oleic fatty acid in olive oil and avocado is a good source of omega-9. This fat regulates triglycerides and blood sugar.


Vitamin D is essential in pregnancy, as it’s required for proper calcium metabolism. It’s found in fatty fish and some organ meats, although the latter are prohibited due to their high saturated fat content.

According to the journal Clinical Perinatal, folic acid is more deficient in twin pregnancies than in singleton pregnancies. Therefore, it can cause megaloblastic anemia or neural tube defects in the baby. This vitamin predominates in vegetables, green leaves, nuts, seeds, and legumes. Vitamin B12 should be supplemented if the pregnant woman is a vegetarian. If she maintains an omnivorous diet, the best sources are red meat, white meat, eggs, and seafood.


Regarding minerals, iron, calcium, and iodine should be taken into account:

  • Iron: Iron deficiency is common in twin pregnancies, leading to anemia and increasing the likelihood of preterm delivery. Supplementation should begin at 12 weeks, with 30 milligrams of iron. The foods that increase it are lean white and red meats, nuts, and legumes. The latter should be combined with fruits that are sources of vitamin C.
  • Calcium: The demand for calcium is higher than that of simple pregnancy. It requires 1,200 milligrams or 4 servings of dairy products. It’s found in yogurt, cheese, milk, and sesame seeds.
  • Iodine: You should consume a pinch of iodized salt to avoid deficiencies.

Other tips to keep in mind

In this article, we’ll give you general guidelines for a diet, but the indications, specifications, and controls should be supported by your obstetrician and nutritionist.

Water is part of the diet, and it’s best to consume it according to the demands of the mother. Remember that juices, soups, and creams, among others, also count. In addition, if approved by health professionals, aerobic exercise is recommended on a regular basis, between 15 to 30 minutes per session. This will be the ideal complement for your twin pregnancy to reach a happy ending.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • American Dietetic Association. (2008). Nutrition recommendations and interventions for diabetes: a position statement of the American Dietetic Association. Diabetes Care. 31:S61-78.
  • Gyamfi C, Stone J, Eddleman K. (2005). Maternal complications of multifetal pregnancy. Clin Perinatal. 32:431-42.
  • Institute of Medicine. (2009) Weight Gain During Pregnancy: Reexamining the Guidelines. Disponible en:
  • Luke B, Hediger ML, Nugent C, Newman RB, Mauldin JG, Witter FR, O’Sullivan MJ. (2003). Body mass index–specific weight gains associated with optimal birth weights in twin pregnancies. J Reprod Med. 48(4):217-24. PMID: 12746982.
  • Luke B. (2004). Improving multiple pregnancy outcomes with nutritional interventions. Clin Obstet Gynecol. 47(1):146-62. doi: 10.1097/00003081-200403000-00018. PMID: 15024282.
  • National Library of Medicine. Nutrtition during pregnancy: Part I Weiht gain: Part II Nutrient supplements. Disponible en:

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.