For women with PCOS, healthy eating doesn’t need to mean following a restrictive diet or cutting out entire food groups. Below, we look at what a balanced day of eating could include, with practical nutrition tips and meal ideas that focus on protein, fibre-rich carbohydrates, healthy fats and a variety of plant foods.
If you have polycystic ovary syndrome (PCOS), you may have come across conflicting advice about what you should and shouldn’t eat. Cut out carbohydrates. Avoid fruit. Eat more protein. Follow a low-GI diet. With so much information available, knowing what to put on your plate can quickly become confusing.
The good news is that there is no single ‘PCOS diet’. Current international guidelines recognise that there isn’t evidence to support one dietary composition over another for women with PCOS. Instead, the focus should be on a healthy, sustainable way of eating that works for you. (1)
That doesn’t mean nutrition isn’t important. Insulin resistance is a key feature of PCOS for many women, where the body’s cells become less responsive to insulin and the body may compensate by producing more of it. Higher insulin levels can interact with reproductive hormones and contribute to some of the hormonal and metabolic features of PCOS. Lifestyle management, including healthy eating, is therefore considered a core part of PCOS management. (1)
PCOS is also associated with chronic low-grade inflammation and increased oxidative stress, which may contribute to its metabolic and reproductive features. (2) Rather than focusing on individual ‘anti-inflammatory foods’, however, it makes more sense to consider your overall dietary pattern. I like to think about what we can add to the plate: good-quality protein, fibre-rich carbohydrates, healthy fats and a wide variety of colourful plant foods. Together, these create satisfying, nutrient-dense meals while providing fibre, omega-3 fatty acids, antioxidants and polyphenols.
And if you’re preparing for pregnancy, the same approach can help provide a strong nutritional foundation for preconception.
So, what might that actually look like across a normal day?
PCOS (PMOS) Breakfast: Cottage cheese scrambled eggs with avocado, tomatoes, leafy greens and pumpkin seeds
Starting the day with a good source of protein can help make breakfast more satisfying. Eggs are incredibly nutrient-dense, but one egg only provides around 6–7g of protein, so I like to use three and stir some cottage cheese through the eggs for an additional protein boost.
Eggs provide complete protein alongside nutrients including choline and iodine, both of which are particularly relevant if preparing for pregnancy. Cottage cheese contributes additional protein and calcium. Serve the eggs with avocado for fibre and monounsaturated fats, tomatoes and leafy greens for vitamin C, folate and carotenoids and a sprinkle of pumpkin seeds for magnesium, zinc and unsaturated fats. A drizzle of extra virgin olive oil adds further monounsaturated fats and polyphenols.
The result is a colourful, protein-rich breakfast containing a combination of protein, fibre and healthy fats.
Nutrition Tip:
If your usual breakfast is relatively carbohydrate-heavy, think about what you could add to increase the protein, fibre and healthy fat content rather than automatically removing the carbohydrate.
PCOS (PMOS) Lunch: Cajun chicken with roasted sweet potato and colourful salad
Carbohydrates don’t need to be avoided if you have PCOS. Instead, think about the type of carbohydrate you’re choosing and what you’re eating alongside it. For lunch, I’d pair roasted sweet potato with Cajun-spiced chicken breast and a colourful salad of watercress or rocket, red pepper, cucumber and cherry tomatoes, finished with an extra virgin olive oil and lemon dressing.
Chicken provides complete protein as well as B vitamins, including niacin (vitamin B3) and vitamin B6, while sweet potato provides fibre, vitamin C and beta-carotene. Watercress and rocket belong to the cruciferous vegetable family and provide glucosinolates, while the different coloured vegetables contribute an array of carotenoids, polyphenols and vitamin C. Extra virgin olive oil provides monounsaturated fats and polyphenols, while fresh lemon juice contributes vitamin C.
Pairing a fibre-rich carbohydrate such as sweet potato with protein, vegetables and healthy fats creates a balanced meal without unnecessarily restricting carbohydrate.
Nutrition Tip:
Rather than viewing carbohydrate foods in isolation, consider the whole plate. Choose predominantly fibre-rich carbohydrate foods and combine them with protein, vegetables and unsaturated fats.
Optional PCOS (PMOS) snack: Live Greek yoghurt with berries, kiwi and ground flaxseed
You don’t need to snack simply because it’s a particular time of day. If your meals are satisfying, you may find you don’t need anything between them. But if you are hungry, a nutrient-dense snack can absolutely form part of a healthy diet for PCOS. One of my favourites is plain, unsweetened live Greek yoghurt topped with berries, kiwi and a tablespoon of ground flaxseed.
Greek yoghurt provides complete protein, calcium and iodine, while choosing a yoghurt containing live cultures also introduces beneficial bacteria into the diet. Berries and kiwi provide fibre, vitamin C and a range of plant compounds, including anthocyanins and other polyphenols. Ground flaxseed adds further fibre, lignans and the plant omega-3 fatty acid alpha-linolenic acid (ALA).
Importantly, fruit doesn’t need to be avoided because you have PCOS. Whole fruit provides fibre alongside vitamins, minerals and phytochemicals. Pairing it with a source of protein and healthy fats also makes for a more satisfying snack.
Nutrition Tip:
Let your appetite guide whether you need a snack. When you do, combining protein with fibre-rich whole foods and healthy fats is a simple way to make it more satisfying.
PCOS (PMOS) Dinner: Za’atar salmon with lemon and herb brown basmati rice and broccoli
Oily fish is a great addition to the diet and salmon provides complete protein alongside the long-chain omega-3 fatty acids EPA and DHA and vitamin D.
For an easy dinner, coat a salmon fillet in za’atar and bake until cooked through. Serve with brown basmati rice tossed with lemon zest, chopped fresh parsley and seasoning, alongside a generous portion of steamed or roasted broccoli. Brown basmati rice provides complex carbohydrate, fibre and B vitamins, while broccoli contributes fibre, folate and vitamin C. As a cruciferous vegetable, broccoli also provides glucosinolates, a group of naturally occurring plant compounds. Herbs and spices aren’t just there for flavour either – they’re another easy way to increase the variety of plant compounds in your diet.
Again, there is no need to remove the rice simply because you have PCOS. Pairing a wholegrain carbohydrate with protein, vegetables and healthy fats creates a balanced, nutrient-dense meal.
Nutrition tip: Aim to include oily fish regularly as part of a varied, balanced diet to provide the long-chain omega-3 fatty acids EPA and DHA.
Diet and Inflammation
PCOS is associated with chronic low-grade inflammation, but this doesn’t mean you need to seek out individual ‘anti-inflammatory superfoods’. Instead, look at your overall dietary pattern. Across this day, extra virgin olive oil, oily fish, berries, vegetables, wholegrains, seeds, herbs and spices provide an array of unsaturated fats, omega-3 fatty acids, fibre, antioxidants and polyphenols.
Dietary patterns rich in minimally processed plant foods and predominantly unsaturated fats, such as a Mediterranean-style diet, may help support metabolic health and are consistent with the healthy eating principles recommended for PCOS. (1,3)
Diet and Gut Health
Gut health is another emerging area of interest in PCOS, with research suggesting differences in the gut microbiome may be associated with the condition, although our understanding of exactly what this means for PCOS management is still developing. (4)
We don’t need a complicated ‘gut health protocol’. Eating a diverse range of plant foods provides different types of fibre and polyphenols that interact with the gut microbiome. Fibre is fermented by gut bacteria to produce metabolites including short-chain fatty acids, while polyphenols and the gut microbiota have a two-way relationship, with microbes metabolising polyphenols and polyphenols potentially influencing microbial composition. (5,6)
Fibre-rich foods also support normal bowel function. The day above contains fibre from vegetables, fruit, wholegrains, avocado, seeds and flaxseed, while kiwi is particularly interesting because clinical research suggests that eating two green kiwi fruit daily can improve bowel movements and gastrointestinal comfort in people with constipation. (7)
And remember to drink
Fibre and Hydration
Increasing fibre goes hand in hand with adequate fluid intake. Keep water available throughout the day and drink regularly according to thirst. Rather than becoming fixated on hitting an arbitrary number of litres, aim for consistent hydration throughout the day, with pale-yellow urine providing a useful practical indicator for most people.
The Bigger Picture: A Balanced Approach to PCOS (PMOS) Nutrition
There is no perfect way to eat with PCOS, and one meal – or one nutrient – isn’t going to determine your health. Instead, focus on the pattern of your diet over time. Build meals around good-quality protein, include plenty of vegetables and other fibre-rich plant foods, choose predominantly unsaturated fats and don’t be afraid of whole-food sources of carbohydrate.
Eating a wide variety of colourful foods also helps provide the vitamins, minerals, fibre and phytochemicals involved in numerous processes throughout the body. And if you’re trying to conceive, these same principles can help create a nutrient-dense foundation for preconception while providing nutrients that support reproductive health. Most importantly, nutrition for PCOS doesn’t need to be about restriction. Think about what you can add to your plate, rather than everything you think you need to take away.
Frequently Asked Questions
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Is there a specific diet for PCOS (PMOS)?
There is no single ‘PCOS (PMOS) diet’. Current international guidelines recognise that there isn’t evidence to support one dietary composition over another for women with PCOS. Instead, the focus should be on a healthy, sustainable way of eating that works for you.
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Do you need to avoid carbohydrates if you have PCOS (PMOS)?
Carbohydrates don’t need to be avoided if you have PCOS. Instead, consider the type of carbohydrate you choose and what you eat alongside it. Fibre-rich carbohydrate foods can be combined with protein, vegetables and unsaturated fats to create balanced meals.
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Do you need to avoid fruit if you have PCOS (PMOS)?
Fruit doesn’t need to be avoided because you have PCOS. Whole fruit provides fibre alongside vitamins, minerals and phytochemicals. Pairing fruit with a source of protein and healthy fats can also make for a more satisfying snack.
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What should a balanced meal for PCOS (PMOS) include?
A balanced approach can include good-quality protein, fibre-rich carbohydrates, healthy fats and a wide variety of colourful plant foods. Together, these can create satisfying, nutrient-dense meals while providing fibre, omega-3 fatty acids, antioxidants and polyphenols.
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What foods can support gut health as part of a PCOS (PMOS) diet?
Eating a diverse range of plant foods provides different types of fibre and polyphenols that interact with the gut microbiome. The example day includes fibre from vegetables, fruit, wholegrains, avocado, seeds and flaxseed.
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What should you focus on when eating with PCOS (PMOS)?
Rather than focusing on one meal or nutrient, consider the pattern of your diet over time. Build meals around good-quality protein, include plenty of vegetables and other fibre-rich plant foods, choose predominantly unsaturated fats and don’t be afraid of whole-food sources of carbohydrate.
References
1. Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2023;120(4):767–793. doi:10.1016/j.fertnstert.2023.07.025.
2. Rudnicka E, Suchta K, Grymowicz M, Calik-Ksepka A, Smolarczyk K, Duszewska AM, et al. Chronic low grade inflammation in pathogenesis of PCOS. Int J Mol Sci. 2021;22(7):3789. doi:10.3390/ijms22073789.
3. Barrea L, Arnone A, Annunziata G, Muscogiuri G, Laudisio D, Salzano C, et al. Adherence to the Mediterranean diet, dietary patterns and body composition in women with polycystic ovary syndrome (PCOS). Nutrients. 2019;11(10):2278. doi:10.3390/nu11102278.
4. Qi X, Yun C, Sun L, Xia J, Wu Q, Wang Y, et al. Gut microbiota-bile acid-interleukin-22 axis orchestrates polycystic ovary syndrome. Nat Med. 2019;25(8):1225–1233. doi:10.1038/s41591-019-0509-0.
5. Makki K, Deehan EC, Walter J, Bäckhed F. The impact of dietary fiber on gut microbiota in host health and disease. Cell Host Microbe. 2018;23(6):705–715.
6. Cardona F, Andrés-Lacueva C, Tulipani S, Tinahones FJ, Queipo-Ortuño MI. Benefits of polyphenols on gut microbiota and implications in human health. J Nutr Biochem. 2013;24(8):1415–1422.
7. Gearry RB, Fukudo S, Barbara G, Kuhn-Sherlock B, Ansell J, Blatchford P, et al. Consumption of 2 green kiwifruits daily improves constipation and abdominal comfort – results of an international multicenter randomized controlled trial. Am J Gastroenterol. 2023;118(6):1058–1068. doi:10.14309/ajg.0000000000002124.
