What's the Best Diet for PCOS?
Affecting roughly 10 percent of women of reproductive age, polycystic ovary syndrome, or PCOS, is a common health problem characterized by a hormonal imbalance that can wreak havoc on not just your ovaries but your entire body. So, in addition to potentially messing with your menstrual cycle, causing small ovarian cysts, and increasing hair growth (especially on your face), the chronic condition can also lead to, say, weight issues, according to the Office on Women's Health (OASH). Think: weight gain or trouble losing weight. And while there are a number of medications that can help ease PCOS, lifestyle changes — particularly, maintaining a PCOS-friendly diet — are frequently "prescribed" as part of treatment.
So, what constitutes a PCOS diet plan, exactly, and how does it work? Ahead, experts break down everything you need to know about following the best diet for PCOS.
The Connection Between PCOS and Food
While the exact cause of PCOS is unknown, the disease is often associated with other health conditions, such as insulin resistance, according to the U.S. National Library of Medicine. ICYDK, insulin resistance occurs when your body does not respond to insulin — the hormone that controls how the food you eat is changed into energy — efficiently, says Alice Figueroa, M.P.H., R.D.N., C.D.N., a New York-based registered dietitian and founder of Alice in Foodieland. As a result, your pancreas produces excess insulin, thereby increasing your blood sugar levels and, in turn, your risk for developing pre-diabetes, diabetes, and gestational diabetes, she explains. What's more, high levels of insulin can exacerbate PCOS symptoms and, as Minisha Sood, M.D., a New York City-based endocrinologist, previously told Shape, "can also promote weight gain." Point being: Eating habits can make a big difference in managing PCOS symptoms, help patients prevent a worsening condition, and stave off the potential for other diseases. (Related: The Connection Between PCOS and IBS)
There's no one-size-fits-all diet for everyone with PCOS, but patients generally see a reduction in symptoms when they balance blood sugar levels by consuming fewer carbohydrates and including more protein, fiber, and healthy fats into their diet, says Cory Ruth, M.S., R.D.N., a California-based registered dietitian who specializes in women's health. And when you do eat carbs, it's best to choose a complex carb (meaning one that includes fiber, such as brown rice instead of white rice) and pair it with a protein (think: banana with peanut butter, versus just a banana), adds Ruth. Why? Because this will help to slow down the absorption of glucose, preventing large spikes and drops in blood sugar, which can increase the production of androgen (male sex) hormones and cortisol — both of which are known to exacerbate PCOS symptoms, she explains.
Foods to Eat If You Have PCOS
Ideally, half of your plate should be composed of non-starchy vegetables (leafy greens, broccoli, carrots, bell peppers), one-quarter of protein (seafood, chicken, or red meat; if plant-based, tofu, tempeh, beans, or seitan), and one-quarter of starchy vegetables or whole grains (yuca, potatoes, corn, brown rice, quinoa, millet, oats), says Figueroa. She also recommends adding one piece of fruit or 1/2 to 1 cup of fruit to snacks and meals each day to ensure you're getting the recommended daily dose of 1-2 cups of fruit total, she adds. (Related: What Is a Low-FODMAP Diet, Exactly?)
When it comes to veggies, those with PCOS should strive for at least 3 cups per day, according to says Martha McKittrick, R.D.N., C.D.E., a registered dietitian based in New York. This is because they're packed with fiber, vitamins, minerals, and antioxidants, and as such, help to improve three drivers of PCOS: insulin resistance, inflammation, and gut health, says McKittrick. In addition to keeping your digestive running smoothly, consuming adequate fiber is also important because it plays a major role in improving your microbiome, improving insulin resistance, lowering cholesterol and blood sugar, and keeping you full longer — all of which aids in weight management, she explains.
You should also make a point to include anti-inflammatory spices — e.g. turmeric, ginger, garlic, basil, cayenne pepper, rosemary — in your cooking, adds McKittrick, as chronic, low-grade inflammation is a common characteristic of PCOS and, if exacerbated, can make other symptoms worse as well. Also a good idea if you're interested in following a PCOS diet plan? Boosting your intake of omega-3 fatty acids — e.g. salmon, sardines, herring, walnuts — since they can also decrease inflammation and lower triglycerides (the main constituent of bodily fat), she says.
Foods to Avoid If You Have PCOS
It's important to note that all foods can fit into a healthy diet when you're managing PCOS, says Figueroa. So fad diets that ditch food groups, such as gluten or dairy? Probably not your best bet for managing PCOS. "Unnecessarily eliminating whole food groups may lead to stress around meal preparations and make it more difficult to meet nutrient needs," explains Figueroa. "[Doing so can also lead to] difficulty in setting up well-balanced plates and snacks, and feelings of deprivation [that] may trigger binge eating." She also notes that there's no research to support eliminating food groups for PCOS management.
That said, it is important to be mindful of the portion sizes you consume of foods that are rich in added sugars, says Figueroa. This includes soft drinks, white sugar, honey, agave, maple syrup, desserts, candy, and fast food. "Ideally, you want to keep consumption of added sugar to less than 6 teaspoons or 25 grams per day," she adds. (This, BTW, is true for all women, according to the guidelines set forth by the American Heart Association.) Those with PCOS should be especially mindful about drinking, too. Alcohol impacts your blood sugar, so if you must imbibe, stick to the U.S. Department of Agriculture's recommended one alcoholic drink per day, says Figueroa.
Sample Weekly PCOS Meal Plan
PCOS Breakfast Ideas
- Avocado on whole-wheat toast topped with an egg or 2 slices of roasted tofu
- 1/2 cup oats with 1 tablespoon chia seeds or flaxseeds, 1 tablespoon nut butter, and 1/2 cup of berries
- Chia seed pudding made with soy or pea milk topped with nut butter and 1/2 cup of fruit (peaches are an excellent choice for balanced blood sugar levels, says Figueroa)
- 3/4 cup plain Greek yogurt with 1/4 cup raspberries, 1 tablespoon hemp hearts or chia seeds, and a pinch of cinnamon
- 2 eggs or 1 cup tofu scrambled with 1 cup baby spinach and 1/4 cup chopped tomatoes with 1/2 avocado on the side (Add a pinch of turmeric for an anti-inflammatory power-up, says Ruth.)
- Smoothie blended from 1 1/4 cup plain unsweetened almond milk, 1 scoop protein powder (be sure to speak with your doctor before adding supplements to your routine, though!) or 1 cup plain unsweetened 2% Greek yogurt, 1 cup frozen riced cauliflower, 1 cup loosely packed baby spinach leaves, 1 tablespoon nut butter, and a pinch of cinnamon
PCOS Lunch Ideas
- Tempeh lettuce "tacos" made with 4 ounces baked tempeh and 2 cups sauteed veggies (such as peppers and mushrooms) wrapped in butter lettuce leaves, served with 1/4 cup refried beans or a handful of organic corn tortilla chips and fresh salsa
- Steak stir-fry bowl made with 2 cups sauteed riced cauliflower, 4 ounces shredded beef or chopped steak, 1/4 avocado, and 1/4 cup cooked brown rice (add cilantro for an antioxidant boost, says Ruth)
- On-the-go lunchbox of 2 hard-boiled eggs, 1 brown rice cake smeared with 1/2 avocado and topped with everything bagel seasoning, 1 cup carrot sticks, 1/2 cup red pepper strips, and 1/2 cup grape tomatoes
PCOS Dinner Ideas
- 4 ounces baked salmon with 1/4 cup cooked quinoa and 2 cups roasted Brussels sprouts or broccoli. For a sauce, Ruth recommends mixing 1/2 teaspoon fresh lemon juice and a pinch of fresh dill with 3 tablespoons plain unsweetened Greek yogurt.
- Edamame salad made with 2 cups mixed greens, 1 cup steamed edamame, 1/2 cup diced cooked sweet potato; drizzle on a light dressing composed of extra-virgin olive oil, balsamic vinegar, and fresh lemon juice; top with 1/4 avocado for some healthy fats and extra fiber
- Pesto chicken pizza made with 1/2 whole-wheat naan bread, 1 tablespoon prepared pesto, 4 ounces chopped or shredded chicken, a sprinkle of Parmesan, and a splash of balsamic vinegar. Partner with a side salad made of 3/4 cup chopped tomatoes, 3/4 cup chopped cucumbers, and 1/4 cup thinly sliced red onions tossed with 1 teaspoon of olive oil, a squeeze of fresh lemon juice, and a pinch of coarse sea salt
PCOS Snack Ideas
- 1 cup fresh veggies (such as 1/2 cup carrot sticks and 1/2 cup grape tomatoes, or 1 cup snap peas) dipped in 1/4 cup hummus
- An apple with 1 tablespoon almond butter
- 1/2 whole-grain pita sliced into triangles with 2 tablespoons guacamole for dipping
- 4 oz plain, full-fat Greek yogurt with 1 tablespoon ground flaxseeds and 1/2 cup berries
- 1 RxBar, any flavor
- 1/4 cup pumpkin seeds with an orange
- 1/2 cucumber sliced into rounds with 2 tablespoons whipped cream cheese and 2 ounces smoked salmon
- 1/2 banana dipped in plain unsweetened yogurt and covered in 1 tablespoon sugar-free chocolate chips, such as those from Lily's
- 2 plain, unsweetened rice cakes, each topped with 1 teaspoon nut butter and sprinkled with cinnamon
- 1 rice cake and 1 teaspoon nut butter paired with 1/2 sliced banana or 1/4 cup blueberries or raspberries
- 1/2 avocado sprinkled with everything bagel seasoning
When choosing healthful snacks for PCOS, McKittrick advises choosing options that are minimally processed and rich in fiber. Ideally, you should always try to pair a carbohydrate with a protein and healthy fat. Finally, "don't feel that your snack has to be healthy every single time," she says. "Everyone deserves a real treat now and then."