What Is the Best Diet for PCOS? Evidence-Based Nutrition Tips from a Registered Dietitian
- MA Nutrition Consulting
- 6 days ago
- 8 min read
Polycystic Ovary Syndrome (PCOS), a hormonal disorder, is one of the most common conditions in women of child-bearing age, affecting around 10% with estimates of up to 70% of women remaining undiagnosed. While it may be a common condition, it’s not fully understood especially when it comes to nutrition for PCOS and lifestyle recommendations
Many times, women diagnosed with PCOS are encouraged to lose weight using diet and exercise without any clear direction of how to to follow a PCOS meal plan or the best diet for PCOS. This can be super overwhelming, so let’s dig a little deeper and look at what the research suggests for eating a healthy and balanced PCOS-friendly diet.
But first… What is PCOS?
Simply put, it’s a female condition of hormonal imbalance. It has impacts on women’s reproductive, metabolic, and psychological health. Not every woman experiences every symptom associated with PCOS, however, they may experience some or all of the following: irregular or loss of menstruation, infertility, pregnancy complications, excess facial and/or body hair, thinning of hair on the scalp, acne, and weight gain (especially around the midsection). For many women, these symptoms can lead to depression, anxiety, and body insecurity. If not well managed, PCOS increases the risk of developing other diseases such as type 2 diabetes, dyslipidemia, metabolic syndrome, cardiovascular disease, and endometrial cancer.
Its symptoms can be attributed to two underlying issues:
High levels of androgens (male sex hormones, ie. testosterone)
High levels of insulin (a hormone that transports glucose, our body’s main source of fuel, into our cells to be used for energy)
How is PCOS diagnosed?
PCOS is diagnosed when at least two of the three following things occur:
Irregular periods or no periods.
High levels of androgens in the blood and/or clinical symptoms to suggest high levels such as excess facial or body hair, scalp hair loss, acne.
Polycystic ovaries confirmed by ultrasound.
It often begins in adolescence, sometimes first noticed as issues with the menstrual cycle, weight gain or severe acne, other times it’s not picked up until women experience difficulties becoming pregnant.
Treatment for PCOS
There’s no cure for PCOS at this time and treatment depends on the symptoms and expressed concerns of each individual. Some medications like metformin and birth control are often prescribed by doctors for off-label use (meaning they’re approved for other conditions but have shown to have benefits for PCOS as well).
The most common advice given to women with PCOS is to lose weight. As a Dietitian, I know how damaging this advice can be for all women, regardless of their health condition. Weight loss can be difficult and there’s a lack of research to support the long-term effectiveness of any one diet. Not to mention the number of negative physical and psychological impacts that diet cycling (on and off dieting) can have on women.
Rather than focusing on weight per se, our approach is to focus on building healthy habits and behaviours that will help women incorporate a style of eating that works best for them while keeping in mind specific nutritional recommendations for PCOS.
What are the specific nutrition recommendations?
There is no one best diet for PCOS, but there are a few key things to consider:
Eat more low glycemic index carbohydrates.
Eat enough protein and more plant-based protein.
Eat more anti-inflammatory foods.
Low Glycemic Index (GI) Carbohydrates
The glycemic index (GI) is a scale that ranks a carbohydrate-containing food (ie. grains, fruits, starchy vegetables, milk, yoghurt) from 0 – 100 based on how much it raises blood sugar levels. Foods that are high GI (70-100) like white bread, sugar, candy, and other sweets are quickly absorbed and digested, resulting in a quick rise in blood sugar. Whereas low GI foods (0-55) are slowly digested and absorbed, resulting in a gradual rise in blood sugar. Following a low GI diet has been shown to be beneficial for women with PCOS.
The main reason for this suggestion has to do with insulin levels. As I mentioned above, insulin levels tend to be higher in women with PCOS. Insulin is a hormone that’s released anytime carbohydrate-containing foods are consumed. Its job is to pick up sugar from the bloodstream and transport it into the cells where it can be used as fuel for energy. Similar to diabetes, the issue that we see in women with PCOS is the cells become resistant to insulin. This means the body has a hard time getting sugar into the cells to be used for energy. When this happens, it triggers the release of even more insulin, resulting in hyperinsulinemia or high levels of insulin in the blood. This contributes to many symptoms associated with the condition such as intense cravings, weight gain, and also leads to even more production of androgens (testosterone). Studies have found that eating a low GI diet improved insulin sensitivity which further improved menstrual regularity in women with PCOS.
What are some ways to include more low GI foods?
Swap white bread products for whole wheat.
Swap low-fibre, processed breakfast cereals for high-fibre options like steel-cut oats or bran cereal.
Eat fruits like berries, apples, and oranges.
The important piece to remember here is that we’re not cutting carbs out; we’re merely changing the quality of carbs that you do eat.
Eating Enough Protein
Intense cravings, especially for carbs, is a common experience among women with PCOS and this has to do with the elevated insulin levels. So the key here is to eat in a way that doesn’t cause a large spike in blood sugar (resulting in a similar spike in insulin). In addition to eating low-GI and high fibre foods, eating enough protein throughout the day also helps by slowing digestion (as well as the release of insulin) and managing feelings of hunger between meals.
The type of protein also comes into play here. Plant-based proteins like beans, lentils, chickpeas, as well as some fish sources may be more beneficial than animal proteins (chicken, turkey, red meat) when it comes to ovulatory infertility. Eating more plant-based proteins is a common recommendation these days as we continue to learn about their contribution to overall good health. This doesn’t mean you need to eat a strict vegetarian diet, but try adding in some vegetable protein where you see fit. For example, adding cooked lentils to your bolognese sauce or swapping chicken for tofu in your next stir-fry or power-bowl.
How much protein is enough?
Getting enough protein doesn’t need to be too complicated. You’re likely already eating enough overall, however, sometimes people tend to eat most of their protein within 1 or 2 meals rather than spread evenly throughout the day, which is more ideal. Adding a source of protein at each meal, about a quarter of your plate or the size of your palm for meat, chicken, or fish and incorporating a protein with a carb (ex. hummus and crackers) at snack times is generally enough. Of course, everyone has different needs but eating this way is a safe bet for most people.
Anti-inflammatory Diet
Along with high insulin and androgen levels, PCOS is also characterized by the presence of low-grade inflammation. These three factors (high insulin, androgen, and inflammation levels) cycle off each other creating the underlying physiological processes observed in PCOS. There are some eating patterns that are considered anti-inflammatory, like the DASH (dietary approaches at stopping hypertension) and the Mediterranean Diets. Both of these diets have been heavily researched for their cardiovascular and anti-inflammatory benefits and are well known to be heart-healthy styles of eating. Although there isn’t nearly as much research looking at these diets and PCOS specifically, there are some studies that show they may be helpful. In one study it was found that among the women with PCOS, those who scored lower on a scale measuring adherence to the Mediterranean Diet presented with worse PCOS symptoms (higher testosterone and inflammation levels). Another study showed that women who ate according to the DASH diet ended up with lower levels of androgens as well as other improvements relevant to PCOS. I will say, the studies I’ve read are not perfect and they do not prove that eating this way will lead to resolved symptoms, however, they do provide some direction when it comes to improving menstrual regularity, testosterone levels, and markers of inflammation.
Which foods are considered anti-inflammatory?
It’s not necessary to follow the Mediterranean or DASH diet specifically but it is a good idea to incorporate some of the anti-inflammatory foods that they recommend. This includes foods like fatty fish, nuts, seeds, avocados, and olive oil which are all sources of healthy fats. Fruits like berries and vegetables such as kale or spinach are all sources of antioxidants which help fight inflammation.
Fibre can also be helpful to combat inflammation, so including whole grains and legumes like lentils and chickpeas are also beneficial.
Like almost all nutrition advice, it essentially comes down to eating a balanced diet; one that is rich in vegetables, fruits, whole grains, fibre, healthy sources of fat and protein, and limiting (but not excluding) foods high in added sugars, saturated and trans fats. It’s important to point out that a number of other factors will also impact inflammation levels like physical activity, sleep, and stress.
Putting it all together.
Although I talked specifically about why eating low-GI carbs, anti-inflammatory foods, and adequate protein are all important for PCOS, the advice itself is not too far off from general healthy eating recommendations. This means a PCOS diagnosis doesn’t necessarily require a diet overhaul or restrictive eating behaviours in any way but understanding how certain foods can impact your body specifically with PCOS can help manage your specific symptoms. So really, the takeaway here is that there is no one best way of eating for PCOS, but rather a number of things you can add to your diet to help manage symptoms depending on your specific case. Because no two women experience PCOS the same, working with a registered dietitian to find an individualized approach to healthy eating and managing symptoms can be extremely helpful.
Whether you’ve recently been diagnosed with PCOS or have been managing it for years, know that you don’t have to navigate it alone. A registered dietitian can help you understand how food impacts your hormones, energy, and overall well-being — without rigid rules or restriction.
Our approach focuses on balanced nutrition, helping you build sustainable habits that support your body and your goals.
To learn more about our nutrition services for PCOS, or to book a free 15-minute discovery call with a registered dietitian, we’d truly love to hear from you. 💛
For more information on PCOS check out the links below:
References:
Azadi-Yazdi M, Karimi-Zarchi M, Salehi- Abargouei A, Fallahzadeh H, Nadjarzadeh A. Effects of Dietary Approach to Stop Hypertension diet on androgens, antioxidant status and body composition in overweight and obese women with polycystic ovary syndrome: a randomised controlled trial. J Hum Nutr Diet. 2016. doi: 10.1111/jhn.12433.
Barrea L, Arnon A, Annunziata G, Muscogiuri G, Laudisio D, Salzano C, Pugliese G, et al. Adherence to the Mediterranean diet, dietary patterns and body composition in women with polycystic ovary syndrome (PCOS). Nutrients. 2019;11: 2278. doi: 10.3390/nu11102278.
Barrea L, Marzullo P, Muscogiuri G, Di Somma C, Scacchi M, Orio F, Aimaretti G et al. Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutr Res Rev. 2018;31(2): 291-301. doi:10.1017/S0954422418000136.
Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Protein intake and ovulatory infertility. Am J Obstet Gynecol. 2008;198(2):210e1-210e7. doi: 10.1016/j.ajog.2007.06.057.
Faghfoori Zeinab, Fazelian Siavash, Shadnoush Mahdi, Goodarzi Reza.Nutritional management in women with polycystic ovary syndrome: A review study.Diabetes and Metabolic Syndrome: Clinical Research and Reviews http://dx.doi.org/10.1016/j.dsx.2017.03.030
Kalgaonkar S, Almario RU, Gurusinghe D, et al. Differential effects of walnuts vs almonds on improving metabolic and endocrine parameters in PCOS. Eur J Clin Nutr. 2011;65, 386–393.
Marsh KA, Steinbeck KS, Atkinson FS, et al. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Am J Clin Nutr. 2010;92, 83–92.
Monash University. (2018).International Evidence Based Guideline for the assessment and management of polycystic ovary syndrome 2018. Retrieved from: https://www.monash.edu/medicine/sphpm/mchri/pcos/guideline
Salama AA, Amine EK, Salem HA, Abd El Fattah NK. Anti-inflammatory dietary combo in overweight and obese women with polycystic ovary syndrome. North Am J Med Sci. 2015;7:310-6. doi: 10.4103/1947-2714.161246
Yang K, Zeng L, Bao T, Ge J. Effectiveness of omega-3 fatty acid for polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biol Endocrin. 2018;16:27. doi: 10.1186/s12958-018-0346-x
Written by: Maggie Assaff, RD
Last Updated: October 15, 2025
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