PCOS Food List from a PCOS Dietitian (2024)

Figuring out what foods to eat for PCOS can be hard and stressful, especially with all the misinformation out there on the internet. This PCOS food list will clear the clutter and help you create a balanced diet for sustainable lifestyle changes.

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Why is your diet important for PCOS?

Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder of women of child bearing age and the most common cause of infertility. It’s estimated that 1 in 10 women have PCOS, so while it is a very common health condition it can have serious health effects. (1)

Women with PCOS are at increased risk for diabetes, cardiovascular disease, stroke, high blood pressure, high cholesterol, non-alcoholic fatty liver disease, metabolic syndrome and other health conditions.

PCOS is an endocrine condition characterized by high male hormone (androgren) level.. This hormonal imbalance can cause polycystic appearing ovaries, irregular periods, infertility, excess hair growth, acne and hair loss.

Other common symptoms are weight gain, trouble with weight loss, GI issues, fatigue, anxiety/depression and carbohydrate cravings.

From my practice as a registered dietitian nutritionist, serving women with PCOS, I see a lot of clients with disordered eating patterns or eating disorders.

A PCOS-friendly diet is an anti-inflammatory diet, rich in high fiber foods that will improve insulin resistance to manage blood sugar levels, which will decrease androgen levels, reduce inflammation and improve gut health.

A nutrient dense, low GI (glycemic index) diet can play a role in preventing chronic diseases as well as managing symptoms of PCOS.

It’s also important to point out that you don’t need to eliminate any food groups to improve PCOS. You also don’t have to go low carb in order to improve PCOS symptoms or reach a healthy weight for your body.

Creating a sustainable eating plan that you will be able to maintain for the rest of your life is really key.

Diet for PCOS and Insulin resistance

The diet for PCOS and insulin resistance focuses on balancing blood sugars at meals with a combination of protein, fat, and high fiber carbs. Eating a nutrient dense, blood sugar balancing diet is extremely important to improve insulin sensitivity in PCOS.

Most women with PCOS have insulin resistance or higher insulin levels. Research shows 50-70% of women with PCOS have insulin resistance (2).

Insulin is a growth hormone and will promote weight gain when there is too much of it in the bloodstream.

Insulin’s role in the body is to assist blood sugar into the cell so it can be used for energy. I like to explain it as a lock and key system.

Insulin is the key that unlocks the cell door so blood sugar can go inside. Insulin resistance is when the cell doors aren’t opening with the normal amount of insulin “keys”. As a result, more insulin is released by the pancreas to help blood glucose enter the cell.

This extra insulin floating around will promote weight gain, especially in the mid-section. It also makes it very hard to lose weight. The excess insulin will start to affect sex hormone levels as well and cause more inflammation in the body.

More inflammation= more insulin resistance= more weight gain=more insulin resistance.

This continues in a vicious cycle.

The foods you choose and how you combine your macronutrients (carbs, protein, fat) at meals will make a significant improvement in your PCOS symptoms. Learn more about PCOS meal planning.

Research is showing a low glycemic index/glycemic load diet (3), Mediterranean diet (4) and DASH diet (5) are able to help improve insulin resistance in women with PCOS. They are also a lot easier to adhere to long term.

Diet for PCOS and Chronic Inflammation

Chronic inflammation plays a major role in the development and severity of PCOS symptoms. Research shows that women with PCOS have moderately elevated C-Reactive Protein levels (lab indicators of general inflammation) independent of obesity, which indicates chronic low grade inflammation (6).

Angela Grassi RD, in The PCOS Workbook:Your Complete Guide to Physical & Emotional Health says, “The big problem with inflammation is that inflammatory cytokines stimulate the ovaries to produce more androgens, which, in turn, can worsen insulin resistance and lead to more inflammation”.

This PCOS food list includes anti-inflammatory foods to help you reduce inflammation and improve your PCOS symptoms.

Gut health and PCOS

Research shows that the gut microbiome can affect the metabolic and clinical aspects of PCOS (7). So the best diet for PCOS will include foods high in fiber which act as prebiotics and sources of probiotics.

Sustainable

Remember that PCOS is a chronic condition so a diet or eating plan should be sustainable and evidenced based. Trying to follow a super restrictive diet for the rest of your life is difficult, and it’s not necessary according to the current research.

I also want to point out that ALL foods can fit into a PCOS diet. There are no inherent “bad” foods, just foods that you may want to limit and foods you want to increase.

PCOS Food List

Let’s start with what we should be eating more of when we have PCOS. When you concentrate on including these foods there is wiggle room for other favorite foods.

Vegetables for PCOS

Eat more veggies. It’s a simple idea but can be hard to execute. Vegetables provide fiber, vitamins, minerals, and anti-inflammatory properties like phytochemicals and antioxidants. You should include at least 2.5-3 cups of veggies per day to help improve insulin resistance and decrease inflammation.

An easy way to do this is making ½ your plate non-starchy veggies (broccoli, zucchini, salad, green beans, ect) and you can put starchy veggies (sweet potatoes, corn, peas, beans, ect) on a ¼ of plate on the other side.

You want to combine starchy veggies like potatoes or any carbohydrates with protein, some healthy fat and more fiber. This helps with blood sugar balance.

PCOS Food List: Vegetables

• Leafy greens like spinach, chard, arugula, lettuces
• Cruciferous vegetables like broccoli, cauliflower, kale, cabbage, brussel sprouts
• Tomatoes
• Eggplant
• Radishes
• Zucchini and yellow squash
• Winter Squash like pumpkin, spaghetti and butternut squash
• Green beans
• Celery
• Cucumbers
• Bell peppers
• Onions, scallions, garlic
• Root veggies like carrots, potatoes, parsnips
• Beans
• All frozen vegetables without added sauces
• Low sodium canned vegetables, rinsed
• Really any other vegetable!

To learn more about how to make veggies taste good and easily prepare them, check out The PCOS Kitchen Cooking Course.

Fruits for PCOS

Fruit is great for PCOS. Just like vegetables, it’s full of fiber, vitamins, minerals and antioxidants that decrease inflammation.

There are certain fruits like berries and melon that are lower sugar per serving, but in general all fruit is good for PCOS. I recommend 1-3 servings of fruit per day for my PCOS nutrition coaching clients.

PCOS Food List: Fruits

• All berries- strawberries, blueberries, raspberries, blackberries
• Apples
• Oranges
• Peaches
• Plum
• Pears
• Bananas
• Avocado
• Grapes
• Mango
• Pineapple
• Kiwi
• Frozen fruit without added sugar
• Canned fruit in 100% juice
• Dried fruit without added sugar
• Any other fruit!

Make sure to monitor portion size of dried fruits (usually ¼ cup) and check to make sure no sugar was added. Look for frozen fruit without added sugar. When selecting canned fruit, choose varieties canned in 100% fruit juice and not “light” or “heavy” syrup.

Fruit is a healthy carbohydrate for PCOS, but it’s still recommended to consume fruit with a protein and/or fat to help with blood sugar control. It’s even better if the fruit has a skin on the outside as the extra fiber will help slow down digestion and improve blood sugar.

Whole grains for PCOS

Whole grains are a great addition to your diet when you have PCOS because they provide fiber, vitamins, minerals, antioxidants and make meals more enjoyable and satisfying.

A whole grain is defined as having the bran, the germ and the endosperm intact. This means that the grain’s phytochemicals, antioxidants and fiber remain intact. This is different from refined grains like white flour that have the outer layers removed during processing.

Whole grains are low glycemic index due to their higher fiber and protein content. This means that they are digested more slowly so they don’t spike your blood sugar. They also help to keep you fuller longer.

PCOS Food List: Whole Grains

• Amaranth
• Buckwheat
• Bulgur
• Farro
• Freekeh
• Flax seeds
• Kamut
• Millet
• Oats
• Quinoa
• Sorghum
• Spelt
• Wheat Berries

Learn more about whole grains, the health benefits of whole grains and how to identify them at The Whole Grain Council.

Beans and legumes for PCOS

Beans and legumes are a great source of protein and fiber for individuals with PCOS.

Research shows that a pulse-based diet (beans and legumes) may be more effective at improving the cardio-metabolic disease risk factors (like insulin resistance, blood pressure, triglycerides, cholesterol) in women with PCOS than the traditional Therapeutic Lifestyle Change Diet (TLC) (8).

Beans and legumes are also a staple in the Mediterranean and DASH diets as well as many traditional diets around the world.

I recommend my clients consume at least ½ cup of beans or legumes a day.

You can add them to salads, tacos, grain bowls, makes dips, add to sauces and dressings, roast for a crunchy snack and even make into desserts!

PCOS Food List: Beans and legumes

• Chickpeas
• Black beans
• Pinto beans
• Cannellini beans
• Kidney beans
• Lentils- black, brown, green, red
• Dal
• Peas
• Lima beans
• Aduki beans
• Spilt peas
• Whole soy
• Any other bean and legume!

Nuts and seeds for PCOS

Nuts and seeds are nutritional powerhouses for PCOS. They provide healthy mono and polyunsaturated fats which help decrease inflammation in the body. Some nuts and seeds like chia, hemp and walnuts contain omega 3 fatty acids which plays an important role in decreasing inflammation in the body.

They are also great sources of protein, fiber, vitamins, minerals and antioxidants. The addition of nuts and seeds to meals and snacks will help stabilize blood sugar and keep you full and satisfied.

You can easily add nuts, nut butters and seeds to smoothies, salads, sprinkle on stir-frys, blend into dips and soup or add to yogurt.

PCOS Food List: Nuts and seeds

• Hemp seeds
• Chia seeds
• Flaxseeds
• Sesame seeds and tahini paste
• Peanuts
• Almonds
• Walnuts
• Cashews
• Pistachio
• And more!

Protein for PCOS- Lean meats, fish, poultry and plant-based proteins

Protein is critical for PCOS because it helps with balancing blood sugar and keeping us full and satisfied. Research is showing that for optimal health, plant-based portions should be prioritized.

While you can definitely still consume animal proteins in a healthy diet, incorporating more plant based proteins will provide the opportunity to get more nutrient rich plants to the diet.

Try using red meat or processed meats like bacon and sausage more of a flavor enhancer than a staple on the plate.

PCOS Food List: Lean meats, fish, poultry and plant-based proteins

• Poultry
• Fatty fish and shellfish- specifically cold water fish high in omega-3 fatty acids like salmon, tuna, sardines, herring, cod
• Lean beef- recommend grass fed when possible
• Lean pork
• Unprocessed, whole soy like tofu, edamame, soy milk, fermented soy like tempeh, miso, soy nuts
• Beans and legumes
• Nuts and seeds
• Dairy products like cheese, yogurt, cottage cheese, kefir

Healthy fats for PCOS

Dietary fat plays a critical role in your overall health. It supports metabolism, brain and nervous system, cell signaling, immunity, hormone production and absorption of fat soluble vitamins like Vit A, D and E.

Healthy fats for PCOS that should be consumed daily are monounsaturated and polyunsaturated fats.

It’s important to understand that food provides a mix of different fats with some foods having a higher concentration of a certain type of fat.

Monounsaturated fats like those found in olive oil and polyunsaturated fats like those found in walnuts and fatty fish, may lower LDL cholesterol and reduce the risk of heart disease when used in place of saturated and trans fats.

Women with PCOS have increased risk factors for cardiovascular disease it is critical that the majority of the fats consumed each day be from mono or polyunsaturated foods sources (9).

Omega-3 fatty acids, which are a polyunsaturated fat also play a significant role in reducing inflammation (10, 11). I recommend patients to focus on getting food sources of omega-3 fatty acids daily, if possible.

PCOS Food List: Healthy fats

• Olive oil
• Avocado oil
• Sesame oil
• Peanut oil
• High-oleic varieties of safflower and sunflower oil
• Olives
• Avocados
• Peanuts
• Tree nuts (walnuts, almonds, cashews, hazelnuts, pistachios, pecans)
• Seeds (like pumpkin, chia, ground flaxseed and sesame)
• Fatty fish (salmon, trout, herring, mackerel, sardines)
• Flaxseed oil

Herbs and spices for PCOS

Herbs and spices play a critical role in the PCOS diet.

First, they make food taste delicious so we actually want to eat it. Second, most herbs and spices have anti-inflammatory properties.

Fresh herbs are also nutrient dense and can be thought of as vegetables when cooking.

PCOS Food List: Herbs and spices

• Parsley
• Fresh/dried basil
• Fresh/dried mint
• Fresh cilantro
• Fresh/dried rosemary
• Fresh/dried oregano
• Ginger
• Cinnamon
• Cayenne pepper
• Black pepper
• Paprika
• Turmeric
• Cardamon
• Cumin
• Coriander

Beverages for PCOS

Your beverage choices can also help improve your PCOS symptoms. The best beverage for PCOS will provide additional antioxidants and little to no added sugar.

PCOS Food List: Beverage to include

• Green tea
• Spearmint tea
• Herbal teas
• Water
• Seltzer
• Coffee (in moderation)

PCOS Food List: Beverages to limit or avoid

• Sugary drinks
• Juice
• Fancy coffee house drinks
• Energy drinks
• Excessive amount of alcohol

Foods to avoid for PCOS

This section is last because making dietary changes for a healthy lifestyle should really focus on what to include in your diet, not just what to reduce or eliminate.

PCOS Food List: Foods to avoid for PCOS.

Remember, if you are prioritizing the list of foods above, you will have room to include these foods every now and then.

• High glycemic index foods
• Simple carbohydrates like candy, sugary foods like cookies, ice cream, ect
• Refined carbohydrates like white bread, white rice, low fiber cereals, bagels
• Fast food, especially fried foods like french fries, doughnuts
• Processed meats like bacon, canned sausages, some deli meats
• Highly processed packaged foods like ramen, boxed meals canned pasta or pizza rolls
• Unhealthy fats like saturated fats (any fat solid a room temperature) and trans-fat (usually in commercially fried foods or shelf stable baked goods) which can also increase risk of heart disease
• Restaurant and food truck foods
• Low fiber meals

Final thoughts…

A diet for PCOS should focus on addressing the root causes of PCOS like insulin resistance, chronic inflammation and gut health.

Whole, unprocessed foods that are anti-inflammatory, high in fiber and low glycemic index should be making up a majority of your eating plan.

To create a more sustainable, long term approach to managing your PCOS symptoms and preventing chronic disease, don’t eliminate entire food groups like dairy, fruit or carbs.

Your specific PCOS diet should be tailored to your medical conditions, food preferences, cultural and religious preferences.

Make sure you speak with your healthcare provider or registered dietitian to determine the best foods for you. Learn more about my 1:1 Be Balanced with PCOS Nutrition Coaching Services here.