Best diet for PCOS: 4 common myths debunked

Key Points

• PCOS or polycystic ovary syndrome is a hormonal issue in females of childbearing age. 
• PCOS symptoms include infertility, excess hair on the face and other parts, fatigue, weight gain, acne, and more.
• Your diet plays a strong role in managing your PCOS. However, there are many myths surrounding the best diet for PCOS.
• The reality is that you do not have to follow highly restrictive diets for PCOS because they are not sustainable in the long run for most people.
• A well-balanced diet rich in nutrients, whole foods, and healthy carbohydrates and fats can help you balance your blood glucose levels.
• Get started on the best PCOS diet for you, right from the start. A Registered Dietitian can tailor a personalized nutrition plan based on your nutritional needs.

Millions of women deal with Polycystic Ovary Syndrome or PCOS every day. 

Although symptoms appear when a woman's period first begins, many discover they have PCOS when they are trying to conceive.

If you have PCOS, you may want to manage your symptoms with the right diet. However, there are conflicting opinions online about what foods are right for PCOS.

So, let's cut through the clutter, bust common myths, and learn about the best diet for PCOS.

What is PCOS?

Before diving into the myths, let's briefly understand PCOS.

Gia Eapen, MD, skilled Obstetrics and Gynecology (OB/GYN) explains, "PCOS occurs when the ovaries produce a higher level of androgens, commonly known as male hormones. Higher androgen levels in females can disrupt the way ovaries work, and cysts may develop."

What are the symptoms of PCOS?

PCOS symptoms vary from person to person but, in general, they include:

• Trouble getting pregnant
• Tiredness
• Weight gain
• Irregular bleeding
• Coarse hair on the face, chest, or other areas
• Acne
• Thinning scalp.

How does diet help PCOS?

PCOS is often related to insulin resistance and system-wide inflammation in the body.

Due to these issues, people with PCOS are at a higher risk for:

• Obesity
• Metabolic syndrome
• Type 2 diabetes
• Heart disease, and more.

A well-balanced diet and exercise can help you balance insulin levels but what does that look like?

According to Dr. Eapen, "My advice is that there is no need to adopt highly restrictive diets for PCOS unless you are following them for religious, cultural, or ethics-related reasons. They may work in the short term but can be hard to sustain in the long term."

She adds, "There's also the risk of triggering disordered eating and anxiety around meals if you think of food as 'good or 'bad'."

So, let's bust some common myths about what to eat if you have PCOS.

Myth 1: Carbs are the enemy

A popular myth about PCOS diets is that you need to quit all carbohydrates. Experts disagree.

The truth

Our body and brain depend on glucose for energy, and carbs are a great fuel source. Misconceptions about carbohydrates persist because of the types of carbs we eat.

The multi-billion dollar food industry perfected the art of selling us highly processed fare rich in sugar, salt, and highly refined carbohydrates.

These 'foods' offer low or zero nutritional value, but produce large insulin spikes, leading to insulin resistance. This can make PCOS symptoms worse.

What carbohydrates to eat for PCOS?

Try and include more of the following in your diet:

• Whole grains: quinoa, brown rice, steel-cut oats, barley, whole-grain bread.
• Fresh fruit: whole fruit like berries, apples, pears, and citrus fruits like oranges and grapefruit.
• Whole, non-starchy vegetables: leafy greens, tomatoes, bell peppers, broccoli, cauliflower, Brussels sprouts, celery, onions, mushrooms, garlic, zucchini, cucumber, radish, eggplant, artichokes, and snow peas.
• Legumes: Kidney beans, garbanzo beans, black beans, green beans, peas, and lentils.

What carbohydrates to avoid for PCOS?

Avoid or eat the following carbohydrates in smaller quantities, less frequently:

• Highly refined grains: white bread, white rice, white pasta, sugary and processed cereals, pastries, and refined flour.
• Foods rich in added sugars: Soda, fruit juices (without fiber), candy, cakes, ice cream, and sweetened yogurt.
• Added sugars: Try sweetening your oats with whole fruit like berries, pomegranates, pears, apples, or other such naturally-occurring sugars with fiber.

Dr. Eapen notes, “The exact amount of carbohydrates needed in your diet depends on your PCOS symptoms and other medical considerations.” 

For example, if you are obese, you may need fewer carbohydrates in your diet compared to non-obese individuals. Similarly, if you have diabetes, you may need different proportions of carbs compared to someone without diabetes.

If you are looking to start a new diet for PCOS, consider working with a Registered Dietitian to get a personalized nutrition plan. 

Fay can help you connect with a Registered Dietitian near you, covered by your insurance.

Myth 2: A low-fat diet is needed for PCOS

In the past, people believed that a low-fat diet was the right way to manage PCOS.

This myth was based on the concept that eating less fat could help you lose weight, which could improve insulin sensitivity.

The truth

You do not need a low-fat diet if you have PCOS.

We need fats because they:

• Make and balance hormones
• Are an important part of all our cells
• Help reduce inflammation
• Balance lipids, and
• Slow down carbohydrate absorption for a more gradual rise in blood sugar after meals (this prevents sudden blood sugar spikes and crashes). As a result, insulin levels remain stable.

What fats to eat for PCOS?

Omega-3 fatty acids are anti-inflammatory and support heart and hormone health.

Here are some healthy fats rich in omega-3 fatty acids to include in your diet:

• Nuts and seeds: Pistachios, almonds, cashews, walnuts, chia seeds, flaxseeds, pumpkin seeds, and sunflower seeds.
• Fatty fish: Salmon, mackerel, trout, and sardines.
• Olive oil: Extra virgin olive oil is a rich antioxidant.
• Fats from dairy: Dairy products and eggs contain healthy fats, but the mantra is 'moderation, moderation, moderation.'

Note: Most of the fatty foods listed above are high in calories, so while they are required for nutrition, the amount you eat matters.

What fats to avoid for PCOS?

It is advisable to limit saturated and trans fats like:

• Fats from processed meats or fatty cuts of meat: Bacon, sausages, pepperoni, etc.
• Cream-based sauces and dressings: Alfredo pasta sauce, blue cheese dressing, ranch dressing, and Thousand Island dressing.
• Coconut oil and palm oil: They are fine in moderation.
• High-fat and processed desserts: Cakes, cookies, and pastries.

Myth 3: You need to quit dairy for PCOS

Some people believe that dairy should be avoided for PCOS. This may be because many dairy products have added hormones. Also, regular milk comes from pregnant cows, so it has natural hormones in it.

While this is true, how does dairy impact PCOS?

The truth

Dairy is not 'bad' for PCOS; dairy products provide calcium, vitamin D, and protein. So, if you choose to eat dairy, you may consider whole milk and full-fat dairy products, in moderation.

What dairy can you eat for PCOS?

More research is needed to understand exactly how dairy and PCOS are related, but on a high level:

• If there is concern about the quality of dairy you consume, you could opt for organic or hormone-free dairy products.
• If you have a dairy allergy, lactose sensitivity, or cannot digest casein, a protein found in milk, going dairy-free may help to lower inflammation in your body.
• If you are not allergic to dairy and do not have an intolerance, avoid low-fat dairy and include small amounts of full-fat dairy in your meals.

Some research shows that low-fat dairy is linked to PCOS. This may be because low-fat dairy stimulates androgen production (male hormones), which may aggravate PCOS.

There is no one diet that's 'best' for PCOS. Working with a Registered Dietitian can help you understand what works best for you. 

Get started today. Fay can connect you to a Registered Dietitian near you, covered by your insurance. 

Myth 4: A keto diet is best for PCOS

The keto diet or ketogenic diet is a low-carbohydrate, high-fat diet that can lead to rapid weight loss and has been shown to lower insulin resistance in obese individuals.

The keto diet includes:

• 70-80% fats
• 5% carbohydrates, and
• The rest is protein.

However, does the keto diet work for PCOS?

The truth

Weight loss is important for PCOS, and if you are obese or have type 2 diabetes, the keto diet can help you lose weight fast. 

This is because keto restricts carbohydrates, so blood glucose levels can be kept low.

Concerns about keto

Although keto has its benefits, some experts have concerns because:

• The keto diet restricts carbohydrates so that the body enters starvation mode, and starts to burn fats through a process called ketosis. However, our bodies are designed to burn glucose for fuel. Avoiding carbohydrates may increase cravings for high-sugar and highly processed carbohydrate foods in some individuals.
• Highly restrictive diets like the keto diet are not easy to sustain over time. A review of over 120 studies and 22,000 adults on different diets (including keto) showed that participants gained most of their weight back in a year.
• Some people on a keto diet may develop ketoacidosis, a serious condition caused when the body does not produce enough insulin. Symptoms include being very thirsty, dry skin and mouth, headache, muscle stiffness, fatigue, nausea, vomiting, and stomach pain.
• Following rigid food rules, like with the keto diet, can lead to a sense of perfectionism, competition, and anxiety around food. This may trigger serious eating disorders or disordered eating in some people.

Final thoughts

• There are many myths surrounding PCOS, including what foods to eat and what to avoid. The right diet is the one that works best for you. 
• You do not have to eliminate entire food groups like carbohydrates, fats, dairy, or grains with gluten unless you have a specific allergy or intolerance causing inflammation.
• You do not need highly restrictive diets like the keto diet if you have PCOS.
• Instead, a diet rich in nutrition-dense foods like whole grains, whole fruits, non-starchy carbohydrates, legumes, healthy fats, and proteins can help you balance your blood sugar levels.
• What also matters is the amount of food you eat and the right combination of foods. For example, eating carbohydrates together with healthy fats and proteins can help lower insulin resistance.

Get the best PCOS diet for you. Fay can connect you to a Registered Dietitian near you, covered by your insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.