Nutrition in Twin Pregnancy |
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If you are carrying twins you will need to increase the amount of nutrients and calories you eat to meet your own nutritional needs and the high demands of your
growing babies. The requirements for some nutrients increase each trimester
and may not be met by diet alone. Additional iron, folate, calcium, magnesium, and zinc supplementation has been recommended beyond the usual prenatal vitamin
(Table 1).
Table1. Recommendations for Nutritional Supplementation in Twin Pregnancies
First trimester
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Second and third trimesters |
- One multivitamin tablet with iron (30 mg) daily.
If not provided by their diet or multivitamin, supplement additional:
- Calcium 1,500 mg
- Magnesium 400 mg
- Zinc 15 mg
- DHA/EPA 300-500 mg
- Folic acid 1 mg
- Vitamin D 1,000 IU
- Vitamin C 500 - 1,000 mg
- Vitamin E 400 IU
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- Two multivitamin tablets with
iron (30 mg) daily.
If not provided by their diet or multivitamin, supplement
additional:
- Calcium 2,500 mg
- Magnesium 800 mg
- Zinc 30 mg
- DHA/EPA 300-500 mg
- Folic acid 1 mg
- Vitamin D 1,000 IU
- Vitamin C 500 - 1,000 mg
- Vitamin E 400 IU
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20% of the calories in your
diet should come from protein, 40% from carbohydrates, and 40% from fat. You
should eat three main meals with three smaller snacks in between the
main meals.
Eat a wide variety of foods such as almonds , apples, avocado, beans, blue
berries, broccoli, Brussels sprouts, eggs, flaxseed, guava, lentils,
oats, red peppers, spinach, sweet potatoes, tofu, or tomatoes just to name a
few. Try to eat at
least two meals (12 oz total) every week of low-mercury–containing
fish (eg, shrimp, canned light tuna, salmon, pollock, and catfish). Choose
low or no fat dairy products, or try an alternative such as almond milk
.
Recommendations for weight gain
and calorie intake during your twin pregnancy are given below
and are based on your weight before pregnancy. If you started out at a normal
weight before pregnancy and you gain a little more weight than the recommended weight
you should still be O.K. One study found that women with twin pregnancies
and a normal weight before pregnancy, excessive weight gain was associated with
larger birth weights and did not appear to increase the risk of development of
gestational hypertension, pre-eclampsia, or gestational diabetes.
Table 2. Suggested Weight Gain and Calorie Intake by Body Mass Index
(BMI) in Twin Pregnancies
Prepregnancy BMI |
Recommended Weight
Gain |
Daily Calories (kcal) |
Protein (grams) |
Carbohydrate (grams) |
Fat
(grams) |
18.5
or less Underweight |
17 - 25 kg
37 - 54 pounds |
4,000 |
200 |
400 |
178 |
18.5 to 24.9
Normal weight |
17 - 25 kg
37 - 54 pounds |
3.000 - 3500 |
175 |
350 |
156 |
25 to 29.9
Overweight |
14 - 23 kg
31 - 50 pounds |
3250 |
163 |
325 |
144 |
30 or more
Obese |
11 - 19 kg
25 - 42 pounds |
2700 - 3000 |
150 |
300 |
133 |
1 gram protein = 4 Calories, 1 gram carbohydrate
= 4 Calories , 1 gram fat = 9 calories).
See Also
REFERENCE
1.
Goodnight W, et al. Optimal nutrition for improved twin pregnancy
outcome. Obstet Gynecol. 2009 PMID: 20168116
2. Luke B. Improving multiple pregnancy
outcomes with nutritional interventions. Clin Obstet Gynecol 2004;47:146–62.
3. Rasmussen KM ed et al. Weight Gain During Pregnancy: Reexamining the
Guidelines Institute of Medicine; National Research Council 2009. p
252, 254 http://www.nap.edu/catalog/12584.html
4.
Fox NS, et al Excessive weight gain in term twin pregnancies:
examining the 2009 institute of medicine definitions.Obstet Gynecol. 2011 Nov;118(5):1000-4.PMID: 22015867
Reviewed by Mark Curran, M.D. ,F.A.C.O.G |
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