This post was updated on June 1st, 2022

By Kym Campbell, BSc. | Updated June 1st, 2022

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

This article describes how best to use a PCOS diet to improve your health and fertility. It also includes this accompanying 3-day meal plan so you can put these ideas into practice.

If you’d like to try a PCOS diet within a supportive online community, then you can also sign up for my next free 30-Day PCOS Diet Challenge.

Dietary change is one of the best things you can do to take back control of polycystic ovary syndrome (PCOS). It’s both an alternative and a complementary therapy to any other treatment intervention.

What Is PCOS?

PCOS is a collection of symptoms that affects roughly 1 in 10 women of child-bearing age. Common signs and symptoms include having difficulty losing weight, excess stomach fat, irregular periods, infertility, pelvic pain, hirsutism, male pattern baldness, acne, anxiety, and depression.

What Causes PCOS?

PCOS is caused by a combination of genetic and environmental factors [1]. It’s been hypothesized that prenatal insults trigger the development of PCOS, but other factors, especially diet and lifestyle, contribute to its manifestation during puberty [2].

How Diet Can Impact PCOS Symptoms

PCOS is driven by two diet-related mechanisms; inflammation and poor blood sugar regulation. These mechanisms cause the hormonal imbalance that drives the wide range of PCOS symptoms [3-5]. Foods that aren’t well-tolerated negatively affect the intestinal lining. This causes an inflammatory response which then makes all PCOS symptoms worse.

Foods that cause a sharp increase in blood sugar levels are also a problem. These readily available carbohydrate-rich foods need large amounts of insulin to restore homeostasis. When your diet frequently causes elevated insulin levels, insulin resistance can develop. This then impacts fertility, body composition, skin, hair, and mental health.

Managing inflammation and blood sugar regulation is key to controlling PCOS long-term.

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 are essential. These foods improve gut health and blood sugar regulation.

Women with PCOS generally see the best outcomes with a low carb, high fat, moderate protein diet. Getting 50% or 60% of calories from whole food sources of fat is a particularly powerful way to drive weight loss and reverse insulin resistance. Assuming adequate protein intake, this leaves room for around 20-30% of energy to come from carbohydrate-containing foods with a low glycemic index (GI). Low GI carbohydrate-containing foods tend to be high in dietary fiber. This is because fiber slows the rate at which blood sugar levels rise. This is one of the main reasons why high-fiber foods are generally considered “good for us”.

Probiotic and prebiotic foods are other key ingredients for maintaining good gut health. Probiotics contain live cultures of “good” gut bacteria. Prebiotic foods, by comparison, provide the nutrients needed for a healthy gut microbiome.

Non-starchy vegetables should form the largest part of a PCOS-friendly meal. Non-starchy vegetables improve gut health and aid in better blood sugar regulation. They also provide many vitamins, minerals, and unique phytonutrients.

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 (for omega-3 fatty acids)

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

Knowing which foods to avoid with PCOS is also a matter of reducing inflammation and improving blood sugar regulation.

Blood-sugar regulation can be improved by reducing intake of sugar and readily digested (high GI) carbohydrate-rich foods. To minimize inflammation, it’s best to avoid any food that causes gut discomfort. Gluten and dairy are the most common problem foods in this regard, especially within the PCOS population.

While evidence-based research is still lacking, many women see significant health improvements after eliminating gluten from their diet. This may be because many women with PCOS suffer from non-celiac gluten sensitivity. This is 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 are also best avoided. These foods often contain industrial “vegetable” oils and various food additives that cause inflammation.

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
  • Foods made from white flour
  • 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.

For more PCOS meal plans, interactive video lessons, and more, you can also sign-up for my next free 30-Day PCOS Diet Challenge. This is a live event that has 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. The adverse effects of sugar in fruit are offset by the benefits of fiber, phytonutrients, vitamins, and minerals.

What about soy? The scientific literature is conflicted when it comes to soy consumption. For example, a double-blinded, randomized controlled trial was conducted on patients with subclinical hypothyroidism. At soy consumption levels that are consistent with a vegetarian diet, a three-fold increased risk for developing overt hypothyroidism was observed [6]. When the same researchers repeated a similar experiment several years later though, they found that high soy consumption did not significantly alter thyroid function [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? Pure caffeine, but not caffeinated coffee appears to have an adverse effect on insulin sensitivity [10]. This is consistent with the findings that over the long-term, coffee (and tea) consumption is positively associated with better health outcomes, especially for type II diabetes [11-13], and heart disease [14, 15]. With that said, it’s common for women with PCOS to experience many of the symptoms associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction. For these women, consuming caffeinated beverages (even coffee and tea) is likely to do more harm than good.

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 [16]. 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 [17].

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 [18]. 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. It’s also 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. Getting enough protein without also consuming too many carbohydrates can be difficult though. This is especially important for weight loss or the treatment of insulin resistance. 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 people recommend four of five small, regular meals to help manage blood sugar levels. This is not recommended for women with PCOS. Consuming two or three meals that achieve a high degree of satiety is best, both nutritionally and psychologically.

Is snacking okay? Yes. Women with PCOS should follow intuitive eating cues. This means eating when they’re hungry and stopping when they’re full, regardless of other considerations. That said, snacking regularly may show that your main meals are inadequate. Or, other factors, not related to hunger, may need addressing.

What about intermittent fasting for PCOS? Intermittent fasting, a.k.a time-restricted eating, is a proven tool for improving metabolic health [19-20]. Studies have shown that for women with PCOS, limiting eating to within eight hours per day can improve body composition, insulin sensitivity, menstruation, chronic inflammation, and androgen regulation [21]. Excluding any potential risks for disordered eating, intermittent fasting is a useful way to further improve a PCOS diet.

How is a PCOS diet different from the Mediterranean diet? Like a Mediterranean diet, a PCOS diet is a whole food-based anti-inflammatory diet. There’s a lot of overlap in the recommended foods to eat. A PCOS diet is more inclusive of saturated fats and animal sources of protein. But it’s less inclusive of gluten, dairy, and wine. A PCOS diet is also higher in fat and lower in carbs, than a Mediterranean diet.

How is a PCOS diet different from a DASH diet? Dash stands for Dietary Approaches to Stop Hypertension. This diet was developed in the 1990s with a key focus on reducing saturated fat, sugar, and salt. As a result of more up-to-date science, a PCOS diet does not restrict saturated fat or salt [16, 18].

Other Evidence-Based Lifestyle Interventions

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

Exercise

It’s well known that physical exercise improves insulin sensitivity and body composition in women with PCOS [22, 23]. Aerobic exercise reduces inflammation [24], while resistance training improves sex hormone balance [25]. A meta-analysis of 37 randomized controlled trials showed that exercise can also reduce anxiety and depression [26].

Sleep

Poor quality sleep is associated with increased markers of systemic inflammation [27]. It’s also known to affect insulin resistance in women with PCOS [28]. Better quality sleep can improve food choices [29], and reduce the desire for sugary foods [30].

Stress management

Studies have shown that when subjected to a stressful social situation, women with PCOS suffer greater psychological distress than non-PCOS controls [31]. Stress increases inflammation and reduces insulin sensitivity. This makes it a meaningful risk factor in the development of type 2 diabetes [32] and heart disease [33]. 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 stress compared to those who were more relaxed [34].

Given these findings, reducing stress is likely to further add value to a PCOS-friendly lifestyle.

The Bottom Line

Living with PCOS presents many challenges, both emotional and physical. But since diet plays such a key role in the expression of symptoms, you can turn the tables on this syndrome. This is true whether you’re trying to get to lose weight, get pregnant, or just want to feel better.

If you’ve recently 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 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. 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. This is a live program where you’ll receive weekly meal plans and helpful 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 before the next 30-Day Challenge begins.
  • Join my PCOS Monthly Meal Planning Service here. This service includes hundreds of PCOS recipes within a pre-populated, yet customizable meal plan. It’s designed to save you time and help you apply a PCOS diet.
  • Sign up for my next Beat PCOS 10-Week Program. This is a comprehensive live program that runs quarterly. Topics covered include diet, PCOS-centric emotional eating, exercise, stress management, and more. The 10-Week Program includes the same recipes and meal plan as my monthly meal planning service.
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    References

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