Polycystic ovary syndrome, or PCOS, is an endocrine (hormonal) condition that can cause multiple ovarian cysts, abnormal hair growth, inflammation and other symptoms.

Amanda Stathos, a clinical dietitian at Johns Hopkins’ Sibley Memorial Hospital, says people diagnosed with the disorder can improve their health, starting with nutritious foods.

PCOS: Why Diet Matters

People with polycystic ovary syndrome are more likely to also have obesity, systemic inflammation, metabolic syndrome, insulin resistance or a combination of these chronic conditions. All of them raise the risk of diabetes, cardiovascular disease and other illnesses.

Stathos says that insulin resistance affects 50% to 75% of people with PCOS. She explains, “Insulin is like a key that opens cells and lets glucose in. Glucose is fuel for energy. The body is very good at making insulin, but in people with insulin resistance, the insulin does not convey glucose into the cells properly. The result is glucose building up in the bloodstream and the fat cells, which raises the risk of diabetes.

“Not everyone with polycystic ovary disease has these complications, but for those who do, reaching and maintaining a healthy weight is our first concern,” Stathos says, “and that starts with diet and exercise.”

What’s the best diet for PCOS sufferers? While Stathos approaches each patient as an individual, she points out that the Mediterranean diet is commonly recommended by dietitians, and for good reason. It offers a wide variety of foods from all categories, so it is easy to follow as a lifestyle approach rather than a temporary fix.

Diet for PCOS: What to Avoid

“Research shows that people with PCOS show evidence of all-over inflammation, which is associated with heart disease and other illness. The Mediterranean diet eliminates saturated fats, processed meats and refined sugar, which makes it a powerful tool to address inflammation,” Stathos says.

She notes that other well-balanced plans emphasizing non-starchy vegetables and fruits, lean protein, healthy carbs and low-fat dairy can help people with PCOS get healthier and prevent complications.

Foods to Avoid with PCOS

Stathos emphasizes that individual foods are seldom the culprits behind conditions such as polycystic ovary disease, and likewise, no single food is likely to be a “magic bullet” to restore health.

However, she notes, eating too many foods associated with inflammation can aggravate PCOS symptoms and raise the risk of myriad other diseases that people with PCOS are at risk for developing, such as heart disease.

People with PCOS should avoid these foods that can ramp up inflammation:

• Fried foods (French fries, potato chips, corn chips and fried chicken or fish)
• Saturated fats such as butter or margarine
• Red meat, including hamburgers, roast beef and steaks, processed luncheon meat and hot dogs
• Processed snacks: cakes, cookies, candy and pies
• Prepared cereal high in sugar, including instant oatmeal, granola
• Sugary beverages such as sodas, teas and sports drinks
• Alcoholic beverages
• Refined flour, white bread, rolls, pizza crust and pasta
• White rice

Best Foods for PCOS

“Substituting whole, unprocessed options for inflammatory items can set the stage for better long-term health,” Stathos says. Choices such as these from the Mediterranean diet can help you get to a healthy weight and manage PCOS symptoms with plenty of nutrition and great taste:

• Omega-3 rich fish, such as salmon, baked or broiled
• Olive oil instead of butter or margarine
• Beans and other protein-rich legumes instead of meat
• Non-starchy vegetables such as leafy greens (spinach, kale, escarole, endive, lettuce, etc.), tomatoes, mushrooms, peppers, broccoli, cauliflower, snow peas, celery and fennel
• Whole grains, such as brown rice, barley, sorghum and others. Breads and pastas made with whole grains can help people with PCOS avoid spikes in blood sugar.
• Whole fruit for dessert. The fiber content in whole fruit helps you feel full, helps your digestion and slows down the absorption of its sugars into the bloodstream.

Drink plenty of water and low- or no sugar beverages

Staying hydrated is essential: Drink plenty of water, unsweetened coffee or tea. Instead of soda, try seltzer with a splash of fruit juice.

Fad Diets for PCOS? Not So Fast

Losing weight is essential to controlling insulin resistance but following diet trends may not be the best approach. Any plan based on eliminating whole food groups, such as carbohydrates, is not practical for long-term weight control.

“Eliminating carbs is not something I recommend,” she says. “However, choosing more low-glycemic carbohydrates (those that do not cause a surge in blood sugar) such as fiber-rich whole grains and non-starchy vegetables can be helpful. The goal is to keep blood sugar stable and avoid big dips and spikes. Smaller, more frequent meals can really help, combined with balanced snacks so you’re eating about every four hours.”

Because maintaining consistent blood sugar is important, Stathos says intermittent fasting may not be the best option for people with polycystic ovary syndrome. She points out that some patients may consume too many calories during the times when eating is permitted. Intermittent fasting is a newer approach to weight loss and works for some people, but she says more research is needed to see if it is safe and beneficial for people with PCOS.

PCOS: Take charge

Stathos says together with diet, exercise and other heathy lifestyle habits, such as plenty of sleep and managing stress, can work to control PCOS symptoms, lower your risk of developing chronic disease and improve your life.

“If you are diagnosed with polycystic ovary syndrome, it doesn’t mean that you are destined to have poor health,” Stathos stresses. “There is a lot you can do to take charge, minimize symptoms and keep yourself healthy.”