This post was updated on January 18th, 2022

By Kym Campbell, BSc. | Updated January 18th, 2022

Medically Reviewed by Dr. Sarah Lee, M.D & Dr. Jessica A McCoy, Ph.D

If you have polycystic ovary syndrome (PCOS), dietary change is one of the best things you can do to take back control of your health and fertility. What’s more, you can safely follow a PCOS diet as an alternative or as a complementary therapy to any other treatment intervention.

This article outlines how best to implement a PCOS diet and includes this accompanying 3-day meal plan so you can put these ideas into practice.

What Is PCOS?

PCOS is a collection of symptoms that affects approximately 1 in 10 women of child-bearing age. Common signs and symptoms include weight gain, excess stomach fat, irregular periods, infertility, pelvic pain, hirsutism, hair loss, acne, anxiety, and depression.

What Causes PCOS?

PCOS is understood to be caused by a combination of genetic susceptibility and environmental factors, especially those experienced in the womb [1]. It’s been hypothesized that prenatal insults initiate the development of PCOS, but subsequent environmental factors, especially diet and lifestyle, contribute to its manifestation during puberty [2].

How Diet Can Alleviate PCOS Symptoms

The expression of PCOS is largely driven by two diet-related mechanisms; inflammation and poor blood sugar regulation. These two mechanisms independently interfere with healthy hormone regulation leading to the wide range of symptoms seen in PCOS populations.

Studies have shown a clear link between inflammation and the complex manifestation of PCOS [3-5]. Foods that are not well tolerated, or otherwise adversely affect the intestinal lining, elicit an inflammatory response which then worsens PCOS symptoms.

Foods that cause a sharp increase in blood sugar levels are problematic because they require large amounts of insulin to move the sugars out of the blood and into other cells. Chronic exposure to excess insulin levels can lead to insulin resistance. This adversely affects fertility, body composition, skin, hair, and mental health.

Inflammation and poor blood sugar regulation provide a direct path through which PCOS can be managed. By reducing your inflammatory burden, and by improving insulin regulation, women with PCOS have the power to take back control of their health and fertility.

To see what this looks like in real life, see the success stories from my free 30-Day PCOS Diet Challenge.

Foods To Eat

While there’s no one-size-fits-all solution that describes the best diet for PCOS, nutrient-dense whole foods that improve gut health or blood sugar regulation are essential.

Generally speaking, women with PCOS see the best outcomes with a low carb, high fat, moderate protein diet. For weight loss or improved insulin sensitivity, getting 50% or even 60% of calories from whole food sources of fat can help optimize blood sugar regulation. Assuming adequate protein intake, this leaves around 20-30% of energy to be derived from carbohydrate-containing foods with a low glycemic index (GI). Low GI carbohydrate-containing foods tend to be high in dietary fiber, as this slows the rate at which blood sugar levels rise. This is one of the main reasons why most PCOS nutrition experts recommend the consumption of high-fiber foods.

Consuming both probiotic and prebiotic foods is a core pillar for maintaining good gut health. Probiotics include live cultures of “good” gut bacteria, while prebiotic foods provide the nutrients needed for a healthy gut microbiome.

Non-starchy vegetables should visibly form the largest portion of a PCOS-friendly meal. Not only do non-starchy vegetables improve gut health and aid in better blood sugar regulation, but they also provide many micronutrients. Beyond vitamins and minerals, many plant foods contain micronutrients that aren’t readily available elsewhere.

The following are common examples of PCOS-friendly foods to eat. For a more comprehensive list, download my PCOS diet cheat sheet here.

Healthy Fat-Rich Foods

  • Avocado
  • Coconut products
  • Nuts and seeds
  • Olives and olive oil
  • Eggs
  • Oily fish

Healthy Carbohydrate-Rich Foods

  • Black/red/wild rice
  • Peas and beans
  • Root vegetables
  • Sweet potato
  • Quinoa

Healthy Protein-Rich Foods

  • Meat and eggs
  • Fish and seafood

Probiotic Foods

  • Coconut yogurt
  • Natto, tempeh, and miso
  • Kimchi, sauerkraut and other pickled vegetables

Prebiotic-Rich Vegetables

  • Asparagus
  • Artichokes
  • Beetroot
  • Cabbage
  • Fennel bulb
  • Garlic
  • Onion
  • Leek
  • Snow peas

Non-Starchy Vegetables

  • Leafy greens, like Romaine lettuce, spinach, and Swiss chard.
  • Cruciferous vegetables like bok choy, broccoli, Brussels sprouts, cabbage, cauliflower, and kale.
  • Gourd vegetables like cucumber and zucchini.
  • Nightshade vegetables like bell peppers, tomatoes, and eggplant.

Foods To Avoid

Just like the best foods, knowing which foods to avoid with PCOS all comes down to reducing inflammation and improving blood sugar regulation.

From a blood-sugar regulation perspective, this is all about lowering the amount of sugar and readily digested (high GI) carbohydrate-rich foods in your diet. From an inflammation perspective, it’s best to avoid any food that elicits an inflammatory response within the gut. Gluten and dairy are the most common problem foods in this regard, especially within the PCOS population.

While there may not be a clear verdict coming from the scientific literature, there’s certainly strong real-life evidence showing positive outcomes from eliminating dietary gluten. This may be because many women with PCOS suffer from non-celiac gluten sensitivity, a condition that can’t be diagnosed by normal celiac blood tests or even an intestinal biopsy.

When it comes to dairy, it’s not just a matter of lactose intolerance. Many women with PCOS have a sensitivity to the protein’s casein and whey without being aware of it. Like non-celiac gluten sensitivity, an undiagnosed dairy sensitivity can damage the intestinal wall lining, drive inflammation, and worsen the effects of PCOS.

Processed foods, especially those containing industrial “vegetable” oils, and various manufactured food additives are also best avoided. These foods tend to be novel to human biology, thus they’re prone to causing an inflammatory response.

The following are common examples of foods to avoid for women with PCOS. For a more comprehensive list, download my Foods to Avoid list here.

Foods That Are Bad For Blood-Sugar Regulation

  • Anything with a lot of sugar
  • Cereals
  • Cookies, cakes, ice cream
  • Bread and bagels
  • Muffins and pastries
  • Pancakes and waffles
  • Pasta, white rice, white potatoes
  • Chips and pretzels

Foods That Drive Inflammation

  • Any food that’s bad for blood-sugar regulation.
  • Gluten, from wheat, spelt, rye, barley, and other grains.
  • Dairy, including cheeses, yogurt, and protein powders.
  • Industrial seed oils from soybeans, sunflower, canola, and cottonseed, etc.
  • Processed meats such as hot dogs, bacon, sausages, and luncheon meats.

Companion 3-Day PCOS Meal Plan

To help you put a PCOS diet into action, I’ve put together a free 3-Day PCOS Meal Plan which you can download here. The popular recipes included in this meal plan illustrate some of the infinite ways to create PCOS-friendly meals.

For more PCOS recipes, shopping lists, interactive nutritional video lessons, and community support, you can also sign-up for my next free 30-Day PCOS Diet Challenge. This is a live event that has successfully launched hundreds of thousands of women towards better health and fertility. You can see some of their success stories here.

PCOS Diet FAQ

What about fruit? Ideally, fruit should be consumed in moderation, preferably in the presence of healthy fat. 1-2 servings per day are best. When eaten in moderation, the potentially adverse effects of the sugar in fruit are offset by the benefits of fiber, phytonutrients, vitamins, and minerals.

What about soy? The scientific literature is highly conflicted when it comes to soy consumption. For example, a double-blinded, randomized controlled trial on patients with subclinical hypothyroidism found a three-fold increased risk of developing overt hypothyroidism with dietary intake of soy phytoestrogens at levels consistent with a vegetarian diet [6]. When the same researchers repeated a similar experiment several years later though, they found that a high dose of soy phytoestrogens did not significantly alter thyroid function in patients with subclinical hypothyroidism [7]. So, while many studies show that soy intake is associated with improved outcomes in diseases such as obesity, cardiovascular disease, insulin resistance, and immune disorders [8] the clinical significance for women with PCOS remains unclear.

What about alcohol? From a nutritional perspective, alcohol is best avoided. Even rare alcohol consumption has been associated with increased rates of liver disease in women with PCOS [9].

What about coffee and caffeine? While coffee contains bioactive compounds that can be helpful for metabolic health, the acidity can cause digestive discomfort, indigestion, heartburn, and imbalances in the gut microbiome. From a purely nutritional perspective, given that any highly-caffeinated beverage has the potential to disrupt sleep and promote anxiety, minimizing consumption is preferable.

What about sweeteners? When consumed in moderation, the following sweeteners can be appropriately included in a PCOS diet: raw unpasteurized honey (that is never heated), glucose-based sweeteners like brown rice or corn syrup, allulose, xylitol, erythritol, and sugar replacement products containing monk fruit or stevia extract. Most other non-nutritive sweeteners are best avoided.

What about salt? While the risks of too much dietary salt have been talked about for years, studies have also shown that too little salt can lead to increased cardiovascular disease risks. The sweet spot for good health appears to be between 3,000 and 6,000 mg of sodium per day [10]. This is the equivalent of approximately 1.5 to 3 teaspoons.

Should I be restricting calories? No. Despite the popularity of restricting calories for weight loss, this approach is not recommended for women with PCOS. It’s been well documented in the scientific literature that caloric restriction diets are ineffective over the long term [11].

Does eating more fat make you gain weight? No. In 2010, Hite, Feinman, and colleagues published a critical assessment of the Dietary Guidelines Advisory Committee (DGAC) report [12]. They concluded that this top US nutritional authority ‘failed to provide sufficient evidence to conclude that decreases in dietary saturated fat, salt, and animal protein lead to positive health outcomes.’ Discover 6 reasons for adding saturated fat to your PCOS Diet here.

How is a PCOS diet different from a ketogenic diet? Carbohydrate consumption needs to be restricted to less than 5% of total calories to reach nutritional ketosis. This is significantly lower than the 20 – 30% recommended for a PCOS diet. Because of this wider allowance, a PCOS diet is generally much easier to follow and is better suited to people that have experienced disordered eating in the past. Learn more about the differences between a PCOS diet and a Keto diet here.

Does a vegetarian diet fit in with a PCOS diet? Maybe. Many women report an improvement in health after switching to a vegetarian diet. For women seeking weight loss, or the treatment of insulin resistance, a vegetarian diet can present challenges in obtaining adequate protein, without also consuming too many carbohydrates. The same “clean” diet, with the addition of whole food sources of animal protein, is likely to result in better health outcomes.

How many meals a day is best? Two or three. Some proponents recommend the consumption of many small, regular meals to help manage blood sugar levels. This is not recommended for women with PCOS. Consuming 2-3 main meals that achieve a high degree of satiety is best, both nutritionally and psychologically.

Is snacking okay? Yes. It’s recommended that women with PCOS follow intuitive eating cues and eat when they’re hungry and stop when they’re full, regardless of other considerations. That said, snacking regularly may be an indication that your main meals are inadequate, or that other factors, not related to hunger, need to be addressed.

What about intermittent fasting for PCOS? Intermittent fasting, more correctly known as time-restricted eating, is a proven tool for improving metabolic health [13, 14]. Studies have further shown that for women with PCOS, limiting eating to within eight hours per day may improve body composition, insulin sensitivity, menstruation, chronic inflammation, and androgen regulation [15]. Excluding any potential risks for disordered eating, intermittent fasting is a useful way to further improve a PCOS diet.

Other Evidence-Based Lifestyle Interventions

While diet is one of the best interventions for PCOS, other evidence-based lifestyle changes are well known to further improve health outcomes.

Exercise

The ability of physical exercise to improve insulin sensitivity and body composition in women with PCOS is well documented in the scientific literature [16, 17]. Aerobic exercise is understood to reduce inflammation [18], while resistance training improves the balance of sex hormones in women with PCOS [19]. A meta-analysis of 37 randomized controlled trials showed that exercise can also reduce anxiety and depressive symptoms [20].

Sleep

Poor quality sleep is associated with increased markers of systemic inflammation [21] and is known to affect insulin resistance in women with PCOS [22]. Getting better quality sleep can improve eating behavior [23], including a reduced preference for sugary foods [24].

Stress management

Studies have shown that when subjected to a stressful social situation, women with PCOS suffered greater psychological distress than a non-PCOS control group [25]. Stress is understood to increase inflammation and reduce insulin sensitivity, making it a meaningful risk factor in the development of type 2 diabetes [26] and heart disease [27]. In a first-of-its-kind study, US researchers found more than a two-fold increased risk of infertility in women that had the highest bio-markers of stress compared to those who were more relaxed [28].

Given these risks, engaging in stress-reducing activities, especially sleep and exercise, can add additional value to a PCOS-friendly lifestyle.

The Bottom Line

While living with PCOS presents many challenges, both emotionally and physically, the fact that diet plays such a key role in the expression of symptoms means you can turn the tables on this syndrome.

Whether you’ve just been diagnosed, or you’ve been battling your symptoms for decades, there’s reason to remain optimistic. You can take back control of your health and fertility just by changing the foods you eat.

Ready To Take The Next Step?

Changing your diet is one of the most effective ways to manage PCOS and live programs, like the ones below can help you achieve the best outcomes possible. If you’re ready to take the next step, you can:

  • Join my next free 30-Day PCOS Diet Challenge here. During this live program, as well as receiving weekly meal plans, and nutritional video lessons, you’ll also be part of a motivated and inspiring community of like-minded women.
  • Download my free 3-Day PCOS Diet Meal Plan here. This is perfect for getting started right away before the next 30-Day Challenge begins.
  • Join my monthly PCOS Monthly Meal Planning Service here. With hundreds of PCOS recipes and pre-populated, yet fully customizable meal plans, this service is designed to save you time and provide ongoing support for implementing a PCOS diet correctly.
  • Sign up for my next Beat PCOS 10-Week Program. This live program is run quarterly and provides the most comprehensive support for adapting to a PCOS-friendly lifestyle. As well as diet, nutritional guidance, and the resources available in my monthly meal planning service, participants are supported with PCOS-centric emotional eating interventions, an exercise program, stress management sessions, and much more.

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References

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19Kogure, G.S., et al., Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome. Med Sci Sports Exerc, 2016. 48(4): p. 589-98.

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