Nutrition During a Multiple Pregnancy: The Main Considerations

We're going to show you some key points to be aware of in order to optimize nutrition during multiple pregnancies. Don't miss the details.
Nutrition During a Multiple Pregnancy: The Main Considerations
Saúl Sánchez Arias

Written and verified by the nutritionist Saúl Sánchez Arias.

Last update: 25 August, 2022

During a multiple pregnancy, a number of nutritional adjustments must be made to ensure the simultaneous development of the fetuses. In this case, a higher energy intake is needed to meet the demands.

In addition, certain vitamins and minerals may need to be consumed in greater quantities. We’ll tell you everything you need to know to optimally adjust your diet accordingly.

Before we begin, we should mention that multiple pregnancies have increased in recent years. This is partly due to the rise of reproductive therapies, which sometimes result in the development of two fetuses, instead of one. On the other hand, as the age of the woman increases, the probability of experiencing a multiple pregnancy also increases.

Energy needs in a multiple pregnancy

When we talk about a multiple pregnancy, we have to make special emphasis on the increased energy demands during this period. It’s important to compensate for this through diet to ensure the development of the fetuses occur correctly. In fact, it isn’t unreasonable for women to gain between 16 and 20.5 kilos (35 to 45 pounds) during the whole process, depending on their initial weight before pregnancy.

What is clear is that calories must come from good quality fresh food. It’s important to avoid empty calories, present in industrial ultra-processed foods with a high content of simple sugars.

These could increase the risk of developing gestational diabetes, as indicated by research published in the journal Nutrients. Carbohydrates should always be of the complex type.

Regarding low glycemic index carbohydrates, there aren’t usually many problems. These have a significant dose of fiber, which ensures better intestinal health.

This substance is able to reduce the incidence of constipation, also facilitating its approach during pregnancy. A study published in the journal BMJ Clinical Evidence confirms this.

A pregnant woman.
Women with multiple pregnancies have a higher general risk of suffering from pathologies associated with their condition, such as gestational diabetes.

Protein intake in a multiple pregnancy

As far as macronutrients are concerned, a sufficient intake of high quality proteins must be ensured. These are necessary for tissue development and, in many cases, the daily requirements aren’t met.

At least 20% of the total daily energy should come from these elements. However, it must be taken into account that those of animal origin are superior to those of vegetable origin.

There are two reasons for this. Firstly, animal proteins contain all the essential amino acids.

Secondly, we’re talking about nutrients that have a high digestibility score. In fact, there’s a significant portion of vegetable proteins that our bodies don’t use.

In the context of a multiple pregnancy, at least 1 gram of protein per kilogram of body weight per day should be consumed. This will allow the fetuses to grow properly, forming all the organs in an optimal way.

The consumption of fats is vital

Finally, let’s talk about the need to include quality lipids in the diet during a multiple pregnancy. Only trans fats should be avoided, as they have been shown to increase the levels of internal inflammation and the incidence of many chronic and complex pathologies.

It’s important not to consume them in excess. To this end, it’s necessary to limit the consumption of low-quality processed foods or products that have been subjected to very aggressive thermal processes, such as fried foods.

Above all, emphasis should be placed on the intake of omega-3 fatty acids. These are important for brain development and to avoid the genesis of autoimmune problems in later stages, such as allergies.

They can modulate inflammation levels and help maintain homeostasis in the internal environment. They’re found mainly in oily fish.

Fish and garlic.
Pregnant women should prefer small oily fish, which have less risk of concentrating heavy metals.

Changes in nutrition in a multiple pregnancy

There are several key points in nutrition that should be taken into account in the context of a multiple pregnancy. This will allow the fetuses to develop properly.

On the other hand, some micronutrients, such as iron, folic acid, calcium and vitamin C, may require higher intakes. Iron and folic acid are usually supplemented in any pregnancy, but the other two elements aren’t. It’s best to assess each diet on an individual basis.

Finally, it should be noted that it isn’t only our diet that matters during a multiple pregnancy. Other lifestyle habits are decisive and they’ll have a significant impact on the babies’ health. The consumption of toxic substances, such as alcohol and tobacco, should be totally avoided. Likewise, it’s recommended to maintain a certain level of physical activity.

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.

  • Mustad, V. A., Huynh, D., López-Pedrosa, J. M., Campoy, C., & Rueda, R. (2020). The Role of Dietary Carbohydrates in Gestational Diabetes. Nutrients12(2), 385.
  • Tabbers, M. M., & Benninga, M. A. (2015). Constipation in children: fibre and probiotics. BMJ clinical evidence2015, 0303.
  • de Souza, R. J., Mente, A., Maroleanu, A., Cozma, A. I., Ha, V., Kishibe, T., Uleryk, E., Budylowski, P., Schünemann, H., Beyene, J., & Anand, S. S. (2015). Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ (Clinical research ed.)351, h3978.

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