If you have PCOS, you have probably come across a lot of nutrition advice. Eat fewer carbs. Avoid sugar. Lose weight. Follow an anti-inflammatory diet. The list can get overwhelming pretty quickly. The good news is that managing PCOS does not require following a perfect diet or cutting out entire food groups.
In this blog we will go over:
- What insulin resistance has to do with PCOS
- Whether there is a best diet for PCOS and insulin resistance
- Nutrition habits that can help with PCOS and insulin resistance
- Foods you may want to eat less often
- What to know about PCOS supplements
- When to work with a dietitian for PCOS
You may also see PCOS referred to as PMOS, or polyendocrine metabolic ovarian syndrome, in newer resources. PCOS is still a term many people know and use, so we will use PCOS throughout this article.
What Does Insulin Resistance Have to Do With PCOS?
Insulin is a hormone that helps move glucose, or sugar, from your bloodstream into your cells so it can be used for energy. With insulin resistance, your cells do not respond to insulin as effectively. Your body may compensate by producing more insulin to help keep your blood sugar levels within a normal range.
Insulin resistance is common in people with PCOS and may contribute to some of the hormonal and metabolic changes associated with the condition. But there is something important we want to make clear: PCOS is not caused by eating too much sugar, eating a “bad” diet or having a higher body weight.
PCOS can affect people across different body sizes, and insulin resistance can also be present in people who do not have a higher body weight.
Do You Have to Lose Weight to Improve Insulin Resistance With PCOS?
No. You do not have to pursue weight loss to make meaningful changes to your health. Nutrition, physical activity and other lifestyle habits can support metabolic health even when your weight does not change.
For some people, weight management may be part of their personal health goals. For others, it may not be.
Instead of making the number on the scale the only measure of success, nutrition goals can focus on things such as energy levels, eating patterns, blood sugar management, nutrient intake and creating habits that you can actually maintain.
Is There a Best Diet for PCOS and Insulin Resistance?
Despite what you may see online, there is no single PCOS and insulin resistance diet that has been proven to work best for everyone.
You do not automatically need to:
- Follow a ketogenic diet
- Completely cut out carbohydrates
- Stop eating sugar
- Avoid gluten or dairy
- Follow a strict meal plan
A balanced eating pattern can include vegetables and fruit, carbohydrates, protein and fats while still supporting your metabolic health. The best approach will depend on your health needs, food preferences, culture, budget and lifestyle.
Most importantly, the best diet is the diet you can realistically maintain.
Can an Anti-Inflammatory Diet Help PCOS?
You may also hear recommendations to follow an anti-inflammatory diet for PCOS.
There is not one specific “anti-inflammatory diet.” Generally, this term describes an eating pattern that includes plenty of nutrient-rich and minimally processed foods such as vegetables, fruit, whole grains, legumes, nuts, seeds, olive oil and fish.
Many of these foods are also good sources of fibre, healthy fats, vitamins and minerals. Instead of creating another list of foods you are allowed and not allowed to eat, focus on what you can add to the meals you already enjoy.
If you want to learn more about this style of eating, you can also read our guide to anti-inflammatory foods.
6 Nutrition Habits That Can Help With PCOS and Insulin Resistance
There is a lot of PCOS nutrition advice online, but you do not need to change everything you eat at once. Here are a few habits that can be a good place to start.
1. Eat Regularly Throughout the Day
Going for long periods without eating can leave you very hungry later in the day and make it more difficult to put together balanced meals. Eating regular meals and snacks can help you meet your energy and nutrition needs throughout the day.
Some people enjoy three meals each day, while others feel better including snacks. Your eating pattern should work around your appetite, workday, schedule, medications and lifestyle.
2. Pair Carbohydrates With Protein, Fibre and Fat
Carbohydrates often get a bad reputation when talking about PCOS and insulin resistance. You do not need to stop eating them. Carbohydrate-containing foods provide our bodies with energy, and many also provide important nutrients and fibre.
Instead of simply removing carbohydrates, think about what you can pair with them to create a more balanced meal or snack.
For example:
- Oatmeal with berries and nuts or seeds
- Whole-grain toast with eggs
- An apple with peanut butter
- Yogurt with fruit and seeds
- Rice with vegetables and chicken, tofu or fish
- Whole-grain pasta with vegetables and beans
Adding protein, fibre and fat can make meals more satisfying and can also slow down digestion.
3. Choose Higher-Fibre Carbohydrates More Often
Fibre can help slow digestion and reduce how quickly glucose enters the bloodstream after eating. Higher-fibre foods can also support digestive health and help keep meals more satisfying.
Some easy ways to add more fibre include choosing:
- Oatmeal
- Brown or wild rice
- Quinoa
- Whole-grain bread
- Whole-grain pasta
- Beans
- Lentils
- Chickpeas
- Vegetables
- Fruit
- Nuts and seeds
You may also hear about choosing foods with a lower glycemic index (GI) when looking for a PCOS and insulin resistance diet. The glycemic index describes how quickly a carbohydrate-containing food raises blood sugar.
Choosing higher-fiber and lower-GI carbohydrates can be helpful for some people, but you do not need to look up the GI number of everything you eat.
4. Include Protein With Meals and Snacks
Protein is another important part of building balanced and satisfying meals. There are lots of ways to get protein from both animal and plant-based foods.
Some examples include:
- Fish
- Chicken
- Eggs
- Greek yogurt
- Cottage cheese
- Tofu
- Tempeh
- Beans
- Lentils
- Nuts
- Seeds
You also do not need to eat an extremely high-protein diet or use protein powders just because you have PCOS. The amount that is appropriate for you depends on your individual nutrition needs.
5. Include Unsaturated Fats
Foods containing unsaturated fats can be part of a balanced eating pattern and are also important for heart health.
Try including foods such as:
- Olive oil
- Avocado
- Nuts
- Seeds
- Salmon
- Sardines and other fatty fish
6. Make Changes You Can Actually Maintain
It can be tempting to completely overhaul your diet after receiving a PCOS diagnosis. But you do not need to change everything at once. Smaller changes may be much easier to maintain long-term.
For example, you could:
- Add one vegetable to a dinner you already enjoy
- Choose whole-grain bread more often
- Add beans or lentils to soups, salads or pasta
- Pair fruit with yogurt or nuts for a snack
- Keep frozen vegetables available for busy days
- Add nuts or seeds to your morning oatmeal
- Choose water more often throughout the day
Are There Foods You Need to Avoid With PCOS?
There is no universal list of foods that everyone with PCOS needs to avoid.
Foods such as white bread, pastries, desserts and foods higher in added sugars tend to be lower in fibre and may raise blood sugar more quickly. That does not mean you can never eat them again.
Instead of completely restricting these foods, consider how often you eat them, how much you enjoy them and what else is included in the meal.
For example, having toast does not have to mean replacing it with a completely different breakfast. You could choose a higher-fibre bread more often and pair it with eggs or peanut butter.
This is one of the reasons rigid PCOS food lists can become frustrating. They often focus so much on what to remove that they overlook whether the overall eating pattern is balanced, nutritious and realistic.
What About Supplements for PCOS?
Supplements can sometimes be useful, but what you need will depend on your diet, medications, health history and whether you have any nutrient deficiencies.
For example, your healthcare provider may recommend monitoring certain nutrients depending on your circumstances. People taking metformin may have their vitamin B12 levels monitored over time, while vitamin D or other supplements may be recommended when there is an identified need.
The important thing is that supplements should not automatically replace food or become another long list of products you feel like you need to buy.
If you want to learn more about this specifically, BC Dietitians has a detailed guide to supplements for PCOS and insulin resistance, including commonly discussed supplements and what to consider before taking them.
PCOS Nutrition Is About More Than Food
Physical activity, sleep, stress management, medications and regular medical care may all be part of your treatment plan. That does not mean you need to create the perfect morning routine, exercise every day and cook every meal from scratch.
Choose the areas that are realistic for you and work on them gradually.
Small changes that fit into your actual life are usually much easier to maintain than trying to follow a completely new routine all at once.
When Should You Work With a Dietitian for PCOS?
There is no shortage of PCOS nutrition advice online. The hard part is often figuring out which advice actually applies to you and how to implement them in your life.
You may want to work with a dietitian if:
- You feel overwhelmed by conflicting PCOS diet information
- You are not sure how to eat for insulin resistance
- You have been cutting out carbohydrates or other foods and are unsure if it is necessary
- You want to improve the balance of your meals without following a restrictive diet
- You take metformin and have questions about your nutrition
- You are managing prediabetes or another health concern alongside PCOS
- You have fertility or pregnancy-related nutrition goals
- You want recommendations that work with your culture, family meals and lifestyle
A Registered Dietitian can look at what you are already eating and help determine where changes could actually make a difference. The goal does not have to be creating a completely new diet. Sometimes it is simply making your current meals work better for your needs.
Find a Dietitian Who Supports PCOS in Ontario
Ontario Dietitians help connect you with Registered Dietitians who work in different areas of nutrition, including PCOS, insulin resistance, hormonal health and metabolic health.
Caroline Klemens
Caroline Klemens works with metabolic health concerns including insulin resistance, prediabetes and metabolic syndrome and also provides nutrition support for PCOS. Her approach focuses on research-backed behaviour change while helping clients move away from restrictive dieting.
Nutrition Well - Annie Tsang
Annie Tsang is a Registered Dietitian specializing in fertility, perinatal nutrition, hormonal health, and PCOS. She provides practical, evidence-based guidance tailored to your health, fertility goals, and readiness for change. Annie supports clients across Ontario virtually and offers services in English, Cantonese, and Mandarin.
Get Personalized PCOS Nutrition Advice
Managing PCOS and insulin resistance does not mean finding the perfect diet.
You can start with simple habits like eating regularly, adding more fibre, balancing carbohydrates with protein and including more nutrient-rich foods that you already enjoy.The best nutrition approach is one that supports your health and works in your actual life.
If you are tired of sorting through conflicting PCOS nutrition advice on your own, find an Ontario Dietitian who can help you create an approach that fits your health needs, lifestyle, culture and goals.
Frequently Asked Questions About PCOS Nutrition
There is no single diet that has been shown to be best for everyone with PCOS.
A balanced eating pattern that includes enough fibre, protein, carbohydrates and healthy fats can support overall health and insulin resistance. The right approach should also be personalized to your nutrition needs, preferences and goals.
No. You do not have to remove carbohydrates from your diet because you have PCOS. Choosing higher-fibre carbohydrates more often and pairing carbohydrates with protein, fibre and fats can help create more balanced meals.
No. Eating sugar does not cause PCOS.
Some foods higher in added sugars can raise blood sugar more quickly, so considering how often you eat them and what you pair them with can be helpful for managing insulin resistance. But that is very different from saying sugar caused your PCOS.
Yes. Nutrition, physical activity and other lifestyle habits can support metabolic health even when weight does not change. Weight loss does not need to be the only measure of whether your nutrition changes are helping.
Lower-GI carbohydrate foods can be one helpful part of managing blood sugar, but you do not need to base your entire diet around glycemic index numbers. Choosing more whole grains, beans, lentils, vegetables, fruit and other higher-fibre foods is a simpler way to start.
Not necessarily.
Supplement needs depend on your diet, medications, health history and whether you have any nutrient deficiencies. Before starting supplements because they are marketed for PCOS, speak with your dietitian, doctor or another qualified healthcare provider about whether they are actually appropriate for you.
You can also read BC Dietitians’ guide to supplements for PCOS and insulin resistance for more information on that specific topic.
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