What foods do you have to avoid with PCOS? As a dietitian specializing in women’s health — specifically PCOS & fertility — I get asked all the time things like “Do I have to avoid pasta with PCOS?” “White rice?” “Potatoes?” “Cheese?”
These questions I get daily make me so sad, because there’s a lot of misinformation out there about PCOS.
A client recently shared with me a list that a prominent PCOS “coach” with no medical experience or nutrition education shared with her followers. The list of foods to avoid was longer than the list of foods to eat and there was no rhyme or reason to it. Avoid canned tuna? WTH? (My view: Tuna is a fantastic, convenient protein source…choose the natural, low-mercury brands whenever possible, and you’re good to go!)
First, you don’t have to avoid ANYTHING if you have PCOS. Not carbs, not gluten, not dairy, not processed foods, heck, not even sugar. To eliminate something means to avoid it entirely. And there is just not any evidence that you need to do that. In fact, avoiding too many foods can be harmful to your diet—and to your mental health. (You already know my take on keto for PCOS).
There are literally zero scientific studies on the effects of gluten on PCOS. Don’t believe me? Check out the PubMed Search page.
What about dairy? Well, there’s one 8-week study in 24 women with PCOS (hint: that’s not a lot) on a low-starch, low-dairy diet. While the diet resulted in weight loss, improved insulin sensitivity and reduced testosterone in women with PCOS, there was no control group in this study…meaning, there is nothing to compare those results to. Was the effect from the starch, the dairy, or simply following a diet at all? Who knows?
And yes, there is plenty of research that a lower-carb diet can help lower blood sugar and improve insulin sensitivity. But there’s no evidence that suggests that you need to cut carbs out entirely.
PCOS is a marathon, not a sprint
PCOS is a life-long condition.
If you cut out all carbs, sugar, etc, you may lose a little weight in the short term, sure. But how long are you going to keep that up? Are you seriously never going to eat a piece of pizza again? A bagel? A piece of birthday cake? Chocolate??? Like for real? I’m sorry, but we can’t be friends anymore.
I want you to close your eyes and picture yourself 20 years from now, enjoying a meal with someone you love. What are you eating? (I see me & Mr. Avocado on the veranda of our beach house, looking out at the ocean and enjoying a delicious & colorful antipasto plate… ) Does what you picture look anything like the diet you’re currently following?
Yeah… for many women, the answer is no.
That’s why I don’t believe in diets. They’re simply not sustainable. And since PCOS is a condition you will have to manage for life, the type of diet you use to manage it should be sustainable over the long term.
Elimination and restriction creates black & white, good vs bad, on-plan vs off-plan thinking around food.
But it’s still your choice.
So, how should you eat for PCOS?
Well, this is different for everyone!
I believe in eating in a way that helps address the underlying root causes of PCOS, but in a way that you can sustain for a lifetime.
Although there’s no one diet that has enough evidence to prescribe it across the board for women with PCOS, here are a few guidelines:
- Eat to balance blood sugar & insulin levels — that means moderate servings of mostly whole-foods–carbs (think quinoa, brown rice, whole wheat pasta), kept to 1/4 of your plate and balanced with protein and lots of fiber to lessen the carbs’ impact on your blood sugar.
- Eat to reduce inflammation — this means loads & loads of fresh fruits & veggies. As in, add some to your plate, and then add even more. These puppies should make up 1/2 of your plate at most meals & snacks. Include Omega-3–rich fish like salmon 2x a week and choose grass-fed meat and pasture-raised eggs over conventional corn/grain-fed meat that’s higher in inflammatory Omega-6s. Choose fresh, healthy oils like olive oil and avocado oil more often than you choose the crap “vegetable” oils they use for frying in restaurants.
- Eat breakfast! This is a big one… you’ve got to get your metabolism cranking for the day, and eating breakfast may be even more important for women with PCOS. Gently consider whether maybe you’re not fueling yourself properly throughout the day and then end up overeating at night.
- Minimize processed/refined/white carbs & ADDED sugars — note that I said minimize and did not say eliminate or avoid! And I’m talking about added sugars only, NOT the sugars naturally found in fruits and vegetables, which should not be limited. Should you eat these “fun” foods multiple times a day? I mean, you could, but that’s probably not in line with your goals. But a small amount of dark chocolate with a meal or a couple of slices of pizza on a Friday are NOT going to make or break you. A healthy diet includes the overall picture of what you’re eating over time. And no beating yourself up for eating these things either—it’s part of a normal, healthy diet. I tell clients I’d rather have you eat a cookie and feel fanfreakintastic about it than eat kale and cry.
Over and over in my work with women with PCOS, I teach them how to incorporate (or re-incorporate) their favorite foods as part of a normal diet. I had one client who hadn’t eaten bread in over 4 years! (I can’t even imagine!) We added a slice of toast to her day as a pre-workout snack, and not only did she enjoy it and feel more free in her dietary choices, she actually had more energy during her workouts, too!
Repeat after me: there is no need to eliminate any food if you have PCOS.
And just for the record — I’ve had many many many many clients with PCOS successfully regain normal menstrual cycles, get pregnant naturally, and lose weight without avoiding a single food — in fact, they were eating MORE food than they had been before working with me.
The Bottom Line
The bottom line is that you’re in this for the long haul.
So, when I get questions about what foods to avoid, or hear about doctors telling women to cut all carbs or not eat bananas, for example, it makes me really sad. And angry! I’d like to challenge those doctors (mostly old, white men, amiright?!) to try going a single week without eating a carb, let alone a lifetime!
My questions for you when it comes to a specific food are:
- How much of it are you eating?
- What are you eating it with?
- How often do you eat it?
- Do you notice any symptoms after eating it?
Click here to download my free 5-Day Meal Plan for PCOS — All recipes are high in protein, high in fiber, low in refined carbs & sugar and full of healthy fats and hormone-balancing foods. (And note that they’re all dairy- and gluten-free — not because that’s what I recommend for PCOS, but so that even people with allergies/intolerances can use the recipes.)
Melissa Groves, RDN, LD
If you’re looking for a different way of managing your PCOS with a plan you can follow for a lifetime, book a free 30-minute nutrition strategy session here.