There is a lot of confusing and complicated information on the internet about PCOS diets. That’s why I’ve written this post to answer the most common Polycystic Ovarian Syndrome nutrition questions in plain language.
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1. What is the best diet for PCOS?
I think when most of you ask this question, you’re looking for a one-word answer like Paleo, Atkins, Ketogenic, or ‘counting calories.’ But I’m not going to give you that type of answer. When it comes to PCOS diets, I’m agnostic.
I notice that people tend to cling to trendy nutrition fads like they’ve just joined a cult. They decide the typically-incomplete logic of the new plan is flawless, and are instantly devoted to its tenets. The problem with this strict adherence is that you eventually burn out or become disillusioned when you do not see the promised results — and you quit.
The End of Dieting
Women with Polycystic Ovarian Syndrome need to move away from the diet mentality and start heading toward a lifestyle. You need to gradually start eating in a way that improves your health and never stop doing so.
“Yeah, ok Erika, but what’s healthy for women with PCOS?”
Science has not provided us with the perfect PCOS diet that will solve all of our problems, but we do know a few things for sure. Women living with PCOS become healthier when:
- They eat enough protein to promote muscle growth and repair.
- They meet their vitamin and mineral needs by eating plenty of whole, unrefined ingredients.
- They eat a lower calorie diet when they need to lose weight.
- They reduce their intake of refined, highly palatable junk food.
I know that this does not come close to answering all of your burning PCOS diet questions but keep reading — there’s more!
2. Should I count calories, carbs, protein, or fat?
Nutrition expert Dr. John Berardi describes calorie counting as “outsourcing appetite awareness to the food-label gods.” Constantly tracking your food is no way to live. You should use food journaling as a way to teach yourself about nutrition and portion sizes. Your goal should be to develop healthy eating habits, so you won’t need to track your meals long-term.
I recommend journaling your food periodically so that you can get an objective look at your nutrition. If you are just starting a PCOS diet, journaling your intake for 1-2 weeks can provide valuable insights that will guide your efforts. If you’ve hit a weight loss plateau or are experiencing new symptoms like anovulation or low energy, a detailed nutrition journal might uncover a hidden cause.
3. How many carbs should I eat?
It’s no wonder that carbs are a huge topic of conversation when it comes to PCOS diets. Studies indicate that switching from a diet high in carbohydrates to a moderate or low carbohydrate diet can improve the ovulation, insulin sensitivity, and blood lipid profiles of women who have PCOS.
However, simply limiting the number of carbohydrates you consume each day is not the best strategy for women with PCOS. I think it is far more important that you focus on eating higher quality carbohydrates. Most women get their carbs from food products like commercially made bread, pasta, sweets, chips, and cereals. I believe this is problematic for several reasons.
The problem with highly refined carbohydrates:
- Manufactured food products are low in nutrients and fiber, but high in additives, sugars, and calories. Basically, for every calorie of highly refined food you eat, you are receiving very little actual nutrition.
- These food products tend to be hyper-palatable, which means they are formulated by the manufacturer so that you will find it difficult to stop eating them. And it’s more likely that you will crave them later. So now you are consuming more calories than you need and getting a microscopic amount of nutrients at the same time.
- Refined high-carb food products typically cause your blood sugar to spike. Thus, PCOS symptoms like insulin resistance, fatigue, mood swings, and cravings become aggravated.
Instead of relying on packaged bread and pasta, try eating more whole, minimally processed and carbohydrate-dense foods. They are more nourishing, promote feelings of fullness, and tend to cause a gentle rise in blood sugar. Here is a list of the best carbs for a nutritious PCOS Diet:
- Whole oats
- Brown rice
Most women find that making the shift from refined carbohydrates to whole ones is enough to see positive results. If you think you need to take things a step further, you can aim to get just 40% (or less) of your calories from carbohydrates.
For example, if you consume 1600 calories a day, you want to get 640 calories from carbohydrates or 160 grams of carbs a day. You may find that consuming fewer carbs helps achieve a better result. I suggest starting with 40% and adjust after a 2-week trial, if needed.
4. How much protein should I eat?
Protein is important because it builds lean muscle mass, increases feelings of satiety, and helps to keep your blood sugar stable.
Most women do not eat enough protein. The first step in correcting this problem is to include a protein source with every meal you eat. Poultry, seafood, fish, meat, some protein powders, and eggs are all ideal protein sources. You can also get protein from dairy products and beans. However, these sources also contain carbohydrates so you need to take that into account.
The exact amount you need will vary depending on your activity level, preferences, and body composition. Most experts believe that between .75 grams to 1 gram of protein per pound of body weight is optimal. For example, a 150 pound woman needs 112-150 grams of protein each day.
If you are trying to lose weight, eating more protein might help. A recent study found that PCOS patients on a high-protein nutrition plan (40% of daily calories or more) lost more weight than women who consumed less protein. You can read more about this study at the PCOS Nutrition Center Blog.
5. What about fat? How much should I eat and what types?
You should eat some fat with every meal. In general, it is pretty easy to consume adequate amounts of fat, so you are probably eating enough already.
Women living with PCOS should pay particular attention to what types of fats they are eating. If you have PCOS, you’re at risk of developing heart disease. One of the ways to protect yourself from heart disease is to get your fat from whole foods instead of highly refined sources, like vegetable oil and margarine. Research indicates that eating high amounts of the hydrogenated oils, trans fats, and omega-6 fats found in processed foods puts you at risk for heart disease.
Here are some examples of healthy fat sources for a PCOS diet:
- AvocadosNuts, nut butter, and nut oils
- Coconuts and coconut oil
- Pasture raised meat and eggs
- Fatty fish
- Pasteurized butter
- Olives and olive oil
- Fish oil supplements (especially if you do not eat seafood)
Learn more about why vegetable oils are not so great here.
6. How often should I eat?
Some PCOS diets suggest eating more frequently, and others suggest eating just one or two meals a day. The truth is that the number of meals you eat and the timing of the meals is not that important. As long as you are not eating more calories than you need, it won’t make a huge difference whether you divide the total caloric consumption over three meals or four.
The key is to figure out what makes you feel your best and stick to that schedule. In my experience, eating at erratic intervals does not contribute to overall health. If your mealtimes are all over the place, start by eating three meals a day roughly four hours apart. Make adjustments and add snacks if you need them.
7. Are smoothies and juices good for PCOS?
PCOS diets should not incorporate fruit juice. Even freshly squeezed fruit juice is high in sugar and can cause spikes in blood sugar. If you are craving fresh fruit, eat the whole fruit! It will provide you with blood sugar-stabilizing fiber and you’ll probably consume fewer calories.
If you need a quick meal on the go, you should make your own smoothie. Commercially prepared smoothies tend to contain low-quality ingredients and are high in calories. A healthy meal replacement smoothie will contain the following elements:
- High-quality protein powder
- A serving of veggies
- A serving of fruit
- A healthy fat like avocado, nuts, chia seeds, or nut butter
8. Do I need protein powder?
No, you do not. You need to eat enough protein, but that does not mean you need a powder. I encourage women to meet their nutritional needs through whole foods whenever possible. Whole foods are more satisfying and are sources for a wide variety of other health promoting nutrients.
Protein powders are a good option for vegetarians and women that struggle to get in enough protein every day. Not all protein powders are created equally, though, and I strongly encourage you to be very selective when shopping for any supplement. Look for organic powders that are free of artificial ingredients and choose a brand that gets their product independently tested for quality. The PCOS Diva sells a very high-quality powder.
9. Should I avoid dairy products?
Dairy and PCOS is a difficult subject because we don’t have much research to go on. For example, a study published in the Journal of International Preventative Medicine concluded that “milk intake and prevalence of PCOS may be related in some way.”
That really does not help the average woman trying to manage PCOS!
My opinion is that PCOS women do not necessarily need to eliminate dairy completely but they should limit dairy consumption as much as possible.
Real fast here’s why:
- Dairy naturally contains sex hormones.
- To digest dairy products your pancreas needs to increase its production of insulin.
- Most dairy products are high-glycemic foods (cheese and butter are an exception.)
None of this sounds like it would do PCOS any favors.
I encourage women to think of dairy products as a condiment instead of a food group…
A splash of cream in coffee
A sprinkle of cheese on a taco
A spoon full of greek yogurt on top of fruit
A mound of cheese melted on top of a enchiladas
A cup of greek yogurt for a snack
Cereal and milk for breakfast
10. Will going gluten-free help me lose weight?
It might. When women stop eating commercially prepared bread, pasta, cereals, and snack foods to avoid gluten, they tend to lose weight. I suspect that eliminating these hyper-palatable, high calorie, low nutrient food products is what causes weight loss in most cases. If you simply replace your morning bagel with a gluten free bagel, and your evening plate of Oreos with gluten free cookies, you will not lose weight. In fact, you might gain weight because some gluten free food products contain more calories than their gluten-containing counterparts.
Obviously, if you have Celiac disease or a gluten intolerance, you should cut out gluten. There’s lots of talk about a possible correlation between PCOS, gluten intolerance, and Celiac, but there is no clear-cut proof. You will not find any medical studies on gluten and Polycystic Ovarian Syndrome. Having a healthy gut will improve your overall health, though. If you suspect you are intolerant of any foods, you should follow an allergy elimination diet to uncover food sensitivities.
The takeaway here is that you should get most of your carbohydrates from whole, plant-based sources. Most of these foods also happen to be gluten-free. If you decide to go gluten-free, remember that gluten-free breads, noodles and snacks are not necessarily part of a healthy PCOS diet.
11. Should I eat soy?
To be honest, I don’t see much of an upside to eating soy. It bestows very little in the way of health benefits, and it’s not particularly delicious. Like dairy, soy is not an essential part of a healthy diet so you can easily leave it off your menu and avoid any risk (no matter how small).
When it comes to PCOS diets, the concern surrounding soy has to do with phytoestrogens. The phytoestrogens found in soy are similar to estradiol, a form of estrogen. These compounds have some estrogen-stimulating and estrogen-inhibiting effects. It is possible that the phytoestrogens in soy could imbalance our hormones more than they already are — yikes! However, you would need to consume a lot of soy to affect your hormonal balance.
If you choose to eat soy, I recommend that you limit yourself to a serving each day and avoid highly processed forms like soy burgers. To learn more about soy, check out this article by nutrition smarty-pants Ryan Andrews.
12. Should I drink caffeine?
The truth is, I don’t think we know much at all about caffeine. For every study that says one thing, another study will contradict it.
If you drink caffeine, be reasonable about it. Limit yourself to one or two cups of tea or coffee a day. Do not drink caffeine after noon because it might disrupt your sleep. Sleep is incredibly important to your health — a cappuccino is not! And whatever you do, don’t even look at an energy drink. Not only do they contain an obscene amount of caffeine, they’re also loaded with sugars or artificial junk your body does not need.
13. Should I drink alcohol?
First, set aside any buzz-worthy headlines about the health benefits of beer, red wine or any other adult beverage. For every upside to drinking, there is a downside. The health benefits are just not compelling enough to make a case for regular alcohol consumption.
Alcoholic beverages contain a lot of calories and not a lot of nutrition. For this reason alone, I recommend limiting yourself to just a few drinks a week, especially if you are trying to lose weight. We all know that alcohol lowers your inhibitions, and for some women, those lower inhibitions will trigger poor nutritional choices. Do you find that your beer always comes with nachos? Is your glass of wine followed by a huge plate of lasagna? If you answered yes, then alcohol might be sabotaging your efforts to lose weight.
If you enjoy the occasional drink, I do not think that you must give that up to be healthy. You can follow these rules to keep your PCOS diet on track while savoring a nice Pinot.
- Limit yourself to one or two beverages a day.
- Do not order specialty cocktails or blended drinks. Most are high in calories and sugar. Instead, choose a light beer, red wine, or a hard alcohol with soda water and lime.
- Have a healthy, balanced meal before drinking. If you are eating dinner out, do not order a drink until after your food has arrived. This way, your buzz will not influence what you choose to order.
- Metformin and alcohol do not mix. If you drink and take metformin, talk to your doctor about the dangers associated with this interaction.
Keep in mind – women who have PCOS are at risk for nonalcoholic fatty liver disease (NAFLD). If you were diagnosed with NAFLD, you should talk to your doctor about whether or not you should consume alcohol.
14. Should I cut out all sugar?
No, you do not need to cut out all sugar. That’s an oversimplified solution to a complex problem.
First, let’s talk about the difference between added sugar and naturally occurring sugars. Added sugars are put into products by human hands – like honey in your green tea or the 9.33 teaspoons of sugar found in a can of Coke. Naturally occurring sugars are in whole foods that also contain water, fiber, vitamins and nutrients. You don’t need to actively avoid naturally occurring sugar! For example, don’t decide to stop eating carrots because they have more sugar than other veggies. No one has ever become obese by eating too many carrots.
I think any good PCOS diet will limit added sugars. There is a correlation between being overweight and having a diet high in added sugars. The American Heart Association recommends women limit themselves to 100 calories of added sugar per day (that’s 25 grams or 6 teaspoons). The average person consumes around 19 teaspoons of added sugar a day. So there’s a good chance you too are eating too much added sugar.
4 Ways To Avoid Added Sugars:
- Pass on sweetened beverages like soda, juices, teas, and specialty coffee drinks.
- Say “no, thank you” to packaged snack foods. Nearly every manufactured food product under the sun has added sugars, even savory foods like chips.
- Make your own condiments. Manufactured salad dressings, sauces, nut butters, and sandwich spreads often contain added sugars.
- Make your desserts from scratch. If you are going to indulge in a treat, make it from scratch so you can control how much sugar is added to the batch.
Try keeping your daily consumption of added sugars very, very low. This way, when you go out for a birthday dinner, you can enjoy a small slice of cake completely guilt free. When your overall diet is very low in added sugar, a rare splurge will not do much damage.
If you are struggling with sugar cravings, read my article on The Cakewalk System to learn how I kicked sugar cravings to the curb. Looking for more tips on how to cut out sugar? Check out this handy article by a holistic nutritionist.
15. What foods absolutely do not belong in a PCOS diet at all?
Hmm, I can’t think of any. A healthy diet is not really about cutting out certain foods. Eating a healthy PCOS diet is about filling your plate with plenty of delicious, satisfying and nutritious foods – so many that there is not much room left in your life for the junk!
The idea that you can never ever have certain foods again is not a productive or healthy way of thinking about nutrition. Strictly eliminating a certain food often causes people to fetishize it. Fantasizing about, craving, and coveting foods are dangerous behaviors. Indulging in a slice of pizza every month is not nearly as destructive as binging or yo-yo dieting because you can’t tolerate the strict diet you’ve put yourself on.
16. Is Intermittent Fasting good for PCOS?
Intermittent fasting (IF) is a dietary strategy where you simply do not eat for a set period of time (between 12 hours and 36 hours .) I think it became a hot topic in the PCOS world because IF can improve insulin resistance in some people.
Keep in mind that, IF only works if you eat healthfully during the time when you are not fasting. It is not a magic bullet.
The female reproductive system is very sensitive to fluctuations in food intake. For that reason, I think women with PCOS need to be very cautious when it comes to Intermittent Fasting. If you want to use it to help you lose weight, I’d recommend a 12 to 14-hour fast starting after dinner and until breakfast the next morning.
17. Is Keto good for PCOS?
It probably depends on the individual woman.
The Ketogenic Diet was a medical diet developed to treat epilepsy. Some PCOS women have reported that the Ketogenic diet has worked very well for them.
I have some serious concerns when it comes to keto and PCOS. My primary concern is a lack of research. I’ve only been able to find one medical study that has investigated keto as a treatment of PCOS.
Keto is a very restrictive diet, and to do it properly; you need to strictly adhere to the protocol. Frequently going in and out of ketosis could cause more harm than good.
Keto diets tend to be low in antioxidants, which help reduce systemic inflammation- a known issue for women living with PCOS.
Keto is very high in fat (70-90%), and I wonder how that will influence cholesterol levels for women with PCOS.
It is not advised for pregnant, or breastfeeding mothers again because of a lack of research.
Despite these concerns, I would not rule out keto for every woman with PCOS. If you are considering a Ketogenic diet, you should seek the advice of a medical professional.
18. I know I need to change the way I eat. Where do I start?
Begin with the basic building blocks of a nutritious PCOS diet and master them. Most people fail to lose weight because they never turn the basic principles of healthy eating into daily habits. This infographic is what I call my PCOS Plate. It is a simple concept, but it works. If you can make eating this PCOS plate a lifelong habit, you will not need to buy another PCOS diet book ever again.
The PCOS Plate is simple, but it is not easy. It will take time, consistency and practice to make the PCOS Plate your habit. Remember to be patient and kind to yourself as you take this step by step, one day at a time. Sign up hereto get my PCOS Plate plus PCOS diet meal ideas sent to your inbox.
Complex diets are very appealing and they can deliver impressive results in the short term. But eventually, most people fall off the wagon and all their hard work fades away.
I am begging you to try something different. Slowly start making your meals look more like the PCOS Plate. Take it one small change at a time and once 90% of all your meals look like this, message me and tell me how you feel!