What is PCOS and How is It Diagnosed?

Polycystic Ovary Syndrome (PCOS) is a common endocrine-metabolic condition affecting up to 13% of reproductive-age women (Teede et al., 2018). It is characterised by irregular periods, excess androgen levels, and insulin resistance, though symptoms can vary widely.

PCOS is diagnosed using the Rotterdam criteria, which require at least two of the following:

Irregular or absent periods (indicating ovulation issues)
Signs of excess androgens (such as acne, excessive hair growth, or hair thinning)
Polycystic ovaries (detected via ultrasound)

Additional symptoms can include weight fluctuations, fatigue, mood changes, and increased risk of insulin resistance.

While PCOS cannot be cured, nutrition and lifestyle modifications can play a key role in improving blood glucose management, gut health, condition and symptom management.

Here are three nutrition strategies that can help PCOS management.

Aim for an anti-inflammatory style of eating

Chronic low-grade inflammation is a common feature of PCOS and is linked to insulin resistance and increased androgen levels (Takahashi et al., 2011). Eating a diet rich in anti-inflammatory foods may help manage symptoms and improve metabolic health.

Principles of an anti-inflammatory style of eating:

Eat a variety of colourful fruits and vegetables
Fruits and vegetables provide fibre, antioxidants, and polyphenols, which help reduce oxidative stress and support gut health. Eating a wide range of colours ensures diverse nutrient intake and enhances overall metabolic function.
Prioritise lean proteins
Including lean protein sources in meals helps stabilise blood sugar, maintain muscle mass, and support metabolic health. Aim for mostly white meats and plant proteins, while having red meat in moderation. Sources include:
- Animal-based proteins: Chicken, turkey, salmon, sardines, lean cuts of red meat
- Plant-based proteins: Tofu, tempeh, legumes (lentils, chickpeas, black beans)
Choose fibre-rich, complex carbohydrates
Fibre helps to slows glucose absorption, improving insulin sensitivity and supporting digestive health. Whole, fibre-rich carbohydrates provide steady energy and help manage cravings. Some examples include:
- Quinoa, brown/ basmati rice, oats, wholegrain breads/ pastas/ wraps, legumes

Prioritise healthy fats
Healthy fats can play a key role in reducing inflammation and supporting hormone production. Sources of beneficial fats include:
- Monounsaturated fats: Olive oil, avocado, nuts
- Polyunsaturated fats (Omega-3s): Flaxseeds, chia seeds, walnuts, fatty fish
Include herbs and spices
Spices contain bioactive compounds that help modulate inflammation and improve insulin function. Sources include turmeric, cinnamon, and ginger.

Choose low-GI carbohydrates for blood sugar control

Up to 70% of women with PCOS experience insulin resistance, meaning their bodies struggle to regulate blood sugar levels efficiently (Dunaif, 2017). This can lead to increased cravings, energy crashes, and weight gain. Choosing low glycaemic index (GI) carbohydrates can help stabilise blood sugar levels and reduce insulin spikes.

The glycaemic index (GI) is a ranking system that measures how quickly carbohydrate-containing foods raise blood sugar levels. Low-GI carbohydrates are digested and absorbed more slowly, leading to a gradual rise in blood sugar rather than a rapid spike. Aiming to incorporate mostly low-GI carbohydrates in your diet, can help support blood sugar levels.

Low-GI Carbohydrates

Wholegrain bread/ pasta, rolled oats, basmati/ brown rice, legumes, most fresh fruits and starchy vegetables.

Balance meals and distribute Carbohydrates Across the Day

Rather than avoiding carbohydrates completely (not necessary), aiming to spread intake evenly across the day as part of balanced meals can help keep blood sugar levels stable.

How to Balance Meals

Aim for each meal to include a serve of protein, complex carbohydrates, fibre and healthy fat.

This combinations helps to reduce the GI index of a meal, promote slow releasing energy and stabilise appetite across the day.

Final Thoughts

PCOS is a complex condition in which nutrition can make a significant difference in reducing symptoms, improving insulin sensitivity, and supporting long-term health.

Key Takeaways

Aiming for an anti-inflammatory style of eating by prioritising omega-3s, colourful fruits/ vegetables and lean proteins can support metabolic health.
Aim for mostly low-GI carbohydrates to support blood sugar control and reduce insulin resistance.
Aim to eat balanced meals with carbohydrates spread evenly throughout the day to maintain steady energy and support blood sugar management.

Since PCOS symptoms vary, working with a dietitian who specialises in PCOS can help create a personalised nutrition plan suited to your needs.

References

Augustin, L. S., Kendall, C. W., Jenkins, D. J., Willett, W. C., Astrup, A., Barclay, A. W., ... & Brand-Miller, J. C. (2015). Glycemic index, glycemic load, and glycemic response: an International Scientific Consensus Summit. Nutrition Research, 35(8), 717-735.
Barclay, A. W., Petocz, P., McMillan-Price, J., Flood, V. M., Prvan, T., Mitchell, P., & Brand-Miller, J. C. (2008). Glycemic index, glycemic load, and chronic disease risk—a meta-analysis of observational studies. The American Journal of Clinical Nutrition, 87(3), 627-637.
Dunaif, A. (2017). Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocrine Reviews, 38(6), 531-549.
Livesey, G., Taylor, R., Livesey, H. F., Liu, S., Reyna-Villasmil, N., Le, K. A., ... & Wolever, T. M. (2019). Dietary glycemic index and load and the risk of type 2 diabetes: assessment of causal relations. Nutrients, 11(6), 1436.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction, 19(1), 41-47.
Takahashi, Y., et al. (2011). Chronic inflammation in PCOS and its metabolic impact. Reproductive Biology and Endocrinology, 9(1), 32.
Teede, H. J., Misso, M. L., Costello, M. F., Dokras, A., Laven, J., Moran, L., ... & Norman, R. J. (2018). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction, 33(9), 1602-1618.
Wolever, T. M., Gibbs, A. L., Mehling, C., Chiasson, J. L., Connelly, P. W., Josse, R. G., & Leiter, L. A. (2006). The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. The American Journal of Clinical Nutrition, 87(1), 114-125.

3 Key Nutrition Tips for Managing PCOS