It is clear that the intake of carbohydrates plays a massive role in the management of PCOS (Polycystic Ovary Syndrome). Since dietary carbohydrates can directly affect blood sugar regulation and insulin resistance, modifying their intake is one of the most effective strategies for women with PCOS.
But do you have to cut out all carbs completely? Or are any types better than others? That’s what I’ll explain in this article giving you my top tips on how to choose and use the best carbohydrate sources for PCOS.
If you’d like to know more about other effective dietary changes for PCOS, make sure to check out my complete guide here: ‘The Best PCOS Diet (Ultimate Guide)’.
What are carbohydrates?
Carbohydrates are one of the three main macronutrients (next to proteins and fats) that we eat in large quantities as a part of our diet. They are made of sugar molecules (saccharides) that can be either simple (monosaccharides, disaccharides) or complex (polysaccharides).
Since glucose (a type of simple sugar) is our body’s preferred source of energy, the primary role of dietary carbohydrates is to provide us with fuel. Essentially, all digestible carbohydrates we eat are broken down into glucose that is either used for energy, stored as glycogen or converted into body fat.
The link between carbs and PCOS
As you can see, carbs are not necessarily bad as they play an important role in the body. However, it’s the amounts and types of carbohydrates we consume that can make a massive difference to our health. If you suffer from PCOS you may already know that insulin resistance is one of the key drivers of this condition.
I’ve explained this in more detail here: ‘PCOS Insulin Resistance Explained & How To Reverse It’
Because carbs are the one macronutrient that affects our blood sugar levels and blood insulin levels the most (unlike fats and proteins), it is perhaps the most important one to control for PCOS and insulin resistance.
This doesn’t mean avoiding all carbohydrates completely, but rather opting for the right types in the right amounts. Here are some important things to consider when choosing your carbohydrate sources for PCOS.
Things to consider:
- Glycemic response
- Nutritional value
- Quality
- Quantity
- Gluten
• Glycemic response
One of the first things to consider when choosing your carbohydrate source for PCOS is how it will impact your blood glucose and insulin levels. Glycemic Index (GI) and Glycemic Load (GL) are two useful tools that can help you estimate how much and how quickly a certain food (containing carbohydrates) will elevate your blood sugars.
In general, you want to opt for foods with a low to moderate GI/GL number to keep your blood glucose levels balanced and prevent any rapid spikes. Most foods in their natural form (unprocessed/minimally processed) will be digested and absorbed into your bloodstream slowly and steadily (low GI) as they’re typically high in other slow-digesting nutrients (such as fiber, water, protein, fat).
Refined carbohydrates (pasta, bread, white rice, white flour), on the other hand, get absorbed into your bloodstream very quickly (high GI) which can result in rapid spikes and dips in glucose levels followed by the overproduction of insulin. This is also one of the reasons why you might experience constant cravings and uncontrollable hunger.
You can learn more about it here: ‘PCOS Cravings: How To Reduce Appetite & Excessive Hunger’
• Nutritional value
Different carbohydrate sources provide a different nutritional value which is another important factor to take into account. By opting for carbohydrate sources high in nutrients (vitamins, minerals, antioxidants, fiber, amino acids) you’re more likely to improve your overall health and manage PCOS.
Overall, highly refined carbohydrates and grains have a very poor nutritional value as they’ve been usually stripped of all the beneficial nutrients during the process. The best way to ensure you’re nourishing your body with nutrient-dense carbohydrate sources is to opt for whole or minimally-processed foods. Try to include a wide range of different foods to diversify your diet and get the most health benefits.
• Quality
As I’ve already mentioned a couple of times, opting for carbohydrates in their natural forms is one of the best ways to go about your diet. Another benefit of this method is that whole foods (unlike most processed foods) don’t come with a long list of added ingredients that might also negatively affect your health.
That being said, the quality of food also depends on how it’s grown and produced. Bear in mind that most regular grains (wheat, maize, rice) are produced in enormous quantities which is why the vast majority of them are genetically modified.
They are also typically treated with heavy pesticides, herbicides and other endocrine-disrupting chemicals that may contribute to hormone imbalances and PCOS. For this reason, I highly recommend looking for non-GMO, wild, organic foods whenever possible to prevent any potential hormone disturbances.
• Quantity
Besides choosing the right high-quality types of carbohydrates, it is equally important to choose the right amounts. That’s because carbs are still carbs and even if you opt for the slow-digesting ones (coming from whole foods), they can still drastically affect your blood sugars when eaten in excess.
While there is no official recommended carb intake for all women with PCOS (individual factors need to be considered), you may want to aim for around 25g of carbohydrates per meal and a total of 50-150g per day to keep your blood sugar levels in check. It’s also best to combine your carbs with dietary proteins and fats to slow down absorption and minimize glucose spikes.
• Gluten
Gluten appears to be a common trigger for many women with PCOS as it may increase inflammation and contribute to poor gut health. I’ve explained it in more detail in my previous article ‘Does Gluten Affect PCOS & How? All You Need To Know‘ where you can find more information.
While there is currently no evidence about the effects of gluten on PCOS specifically, a lot of women with PCOS (me included) seem to benefit from adopting a gluten-free diet. While it is not necessary to eliminate gluten completely or forever, I highly recommend experimenting with a gluten-free diet for a certain period of time (at least 4 weeks) to see how you feel.
Gluten is naturally found in grains including wheat, rye, barley and triticale as well as all products made from these cereals (eg. breads, tortillas, cakes, baked goods, pastries, breakfast foods).
Best carbs for PCOS:
- Non-starchy vegetables
- Starchy vegetables
- Legumes
- Pseudograins
- Fruits
1. Non-starchy vegetables
Non-starchy vegetables are generally considered the best source of carbohydrates for women with PCOS for a number of reasons. Firstly, they are actually very low in carbs but high in fiber (undigestable carbs) which is why they won’t cause rapid spikes in blood sugar levels but rather help slow down the absorption of sugars into your bloodstream.
They are also some of the most nutrient-dense foods in the world as they are packed with a wide range of vitamins, minerals, phytonutrients and antioxidants. Additionally, they tend to be very low in calories but high in volume making them the perfect food for weight loss and weight management.
Since there are so many different types and colors of non-starchy vegetables, they are perfect for creating unique recipes and tasty meals. While they all provide different health benefits and it’s best to opt for a variety, cruciferous vegetables appear to be particularly beneficial for PCOS due to their hormone-balancing properties.
Best non-starchy vegetables:
- Cruciferous vegetables (broccoli, cauliflower, brussel sprouts, bok choy, cabbage, radish)
- Leafy greens (spinach, rocket, kale, romain, collard greens, swiss chard, watercress)
- Allium vegetables (onion, garlic, shallots, chives, leeks)
- Nightshades (tomatoes, bell peppers, eggplant, chili peppers)
- Greens (asparagus, artichoke, cucumber, celery sticks, zucchini)
- Mushrooms (shitake, reishi, white button, chestnut, oyster)
| 100g serving (fresh) | calories (kcal) | carbs (g) | fiber (g) | protein (g) | fat (g) |
|---|---|---|---|---|---|
| Broccoli | 34 | 7 | 2.6 | 2.8 | 0.4 |
| Cauliflower | 25 | 5 | 2 | 1.9 | 0.3 |
| Brussel sprouts | 43 | 9 | 3.8 | 3.4 | 0.3 |
| Spinach | 23 | 3.6 | 2.2 | 2.9 | 0.4 |
| Onion | 40 | 9 | 1.7 | 1.1 | 0.1 |
| Tomatoes | 18 | 3.9 | 1.2 | 0.9 | 0.2 |
| Bell peppers | 20 | 4.6 | 1.7 | 0.9 | 0.2 |
| Eggplant | 25 | 6 | 3 | 1 | 0.2 |
| Cucumber | 15 | 3.6 | 0.5 | 0.7 | 0.1 |
| Zucchini | 17 | 3.1 | 1 | 1.2 | 0.3 |
| Asparagus | 20 | 3.9 | 2.1 | 2.2 | 0.1 |
| Mushrooms | 28 | 5.3 | 2.2 | 2.2 | 0.5 |
Pro tips:
- Eat the rainbow – include different types of veggies (with different colors) in your diet to get a diverse range of nutrients, antioxidants and phytochemicals
- Eat non-starchy veggies first – when applicable, try to eat your non-starchy veggies as the first part of your meal to lower your body’s glycemic response, I highly recommend reading ‘Glucose Revolution’ by Jessie Inchauspe to get more tips on how to flatten your glucose curve
- Preparation – try preparing and eating your veggies in different ways (raw, steamed, roasted, air-fried, sauteed, baked) as different nutrients are more bioavailable in different forms, it also helps to keep your diet enjoyable long-term
- Freezing – buy frozen veggies (or freeze them yourself) since the process of freezing doesn’t cause any major changes in the nutritional content, they’re super practical for last-minute meals and they also tend to be much cheaper
- Batch prep – prepare your veggies (wash, cut, cook, bake) in larger quantities and keep them in the fridge to save a lot of time and effort during the week
- Low-carb alternatives – experiment with veggie-based low-carb alternatives to replace some of the regular refined carbs, some of my favorites are zucchini noodles, broccoli/cauliflower rice, squash spaghetti, cauliflower mash, kohlrabi fries, cauliflower pizza
- Buy organic – choose organic veggies whenever possible to reduce your exposure to harmful pesticides and endocrine-disrupting chemicals, check the list of ‘Dirty Dozen and Clean 15’ to know which types of veggies contain the highest levels
- Shop at farmer’s markets – you can find much cheaper and high-quality veggies in your local farmer’s markets as it’s always seasonal, local, fresh and at the peak of its ripeness
- Combine veggies with fat – make sure to eat your veggies with some source of healthy fat (nuts, seeds, yogurt) to increase the availability of fat-soluble vitamins (A, E, D, K) and antioxidants
Read more: ‘The Best & Worst Cooking Oils For PCOS‘
2. Starchy vegetables
Starchy vegetables are another great carbohydrate source for women with PCOS. While this type of vegetable tends to be much higher in overall carbohydrates and calories (in comparison to non-starchy veggies) they are still a great source of beneficial nutrients and slow-releasing energy.
Orange-colored vegetables (sweet potatoes, squashes, carrots) are particularly great sources of carotenoids (such as beta-carotene – a precursor to vitamin A) which are powerful antioxidants associated with multiple health benefits.
That being said, you may need to pay closer attention to your portion sizes as starchy vegetables can still significantly raise your blood sugars (especially when eaten on their own). A good rule of thumb is to include about 1-2 cups of starchy vegetables per meal as your source of carbohydrates (providing approx. 25g of carbs).
Best starchy vegetables:
- Squashes (butternut, spaghetti, pumpkin, acorn)
- Root vegetables (carrots, beets, sweet potatoes, parsnip, rutabaga, turnips)
- Sweet vegetables (sweetcorn, green peas)
| 100g serving (fresh) | calories (kcal) | carbs (g) | fiber (g) | protein (g) | fat (g) |
|---|---|---|---|---|---|
| Sweet potato | 86 | 20 | 3 | 1.6 | 0.1 |
| Butternut squash | 45 | 12 | 2 | 1 | 0.1 |
| Spaghetti squash | 27 | 6.5 | 1.4 | 0.7 | 0.3 |
| Pumpkin | 26 | 7 | 0.5 | 1 | 0.1 |
| Carrots | 41 | 9.6 | 2.8 | 0.9 | 0.2 |
| Beetroot | 44 | 10 | 2 | 1.7 | 0.2 |
| Sweetcorn | 86 | 19 | 2 | 3.3 | 1.4 |
| Green peas | 81 | 14 | 5 | 5 | 0.4 |
Pro tips:
- Eat the rainbow – include different types of starches (look for dark vibrant colors) in your diet to get a diverse range of nutrients, antioxidants and phytochemicals
- Baking – use starchy veggies for sweet baked recipes as they can be a great alternative for regular fours, some of my favorite flourless recipes are sweet potato brownies, carrot cakes, pumpkin pies or beetroot brownies
- Eat starches last – when applicable, try to eat your starches as the last part of your meal to even lower your body’s glycemic response
- Eat the skin – eat your starches with the skin on whenever possible as the skin contains the highest amounts of nutrients and dietary fiber that helps stabilize your blood sugars
- Batch prep & cool down – prepare your starches in larger quantities and keep them in the fridge to save a lot of time and effort, by cooling them down you’ll also increase their content of resistant starch which is particularly great for the health of your microbiome
- Combine starches with fat – make sure to eat your colorful starches with some source of healthy fat (nuts, seeds, yogurt) to increase the availability of fat-soluble vitamins (A, E, D, K) and antioxidants
3. Legumes
Legumes are not only a good source of complex carbohydrates and dietary fiber, but they also provide a decent amount of plant protein (unlike most carbohydrate sources). This can be extremely valuable for women with PCOS as getting enough dietary protein is one of the key principles of an effective PCOS management strategy.
Read more: ‘The Best Protein Sources For PCOS (Food List)‘
Another great benefit of legumes is that they contain resistant starch (a unique type of indigestible fiber) that appears to be largely beneficial for blood sugar management, gut health and the gut microbiome. Apart from other beneficial nutrients (vitamins, minerals, antioxidants), legumes are also rich in lignans, isoflavones and other hormone-balancing compounds that may help improve PCOS.
Read more: ‘Is Soy Good or Bad for PCOS & Why?‘
However, as with any food that predominately consists of carbohydrates, it is still important to keep the portion size in mind. You may want to aim for ¾ – 1 cup of cooked legumes (beans, peas, lentils) per meal to give you 1 serving of carbohydrates (approx. 25g) and prevent any rapid spikes in blood sugar levels.
Bets legumes:
- Beans (soy, edamame, chickpeas, black, broad, fava, navy, black-eyed)
- Peas (green, yellow, split)
- Lentils (red, brown, green)
| 100g serving (cooked) | calories (kcal) | carbs (g) | fiber (g) | protein (g) | fat (g) |
|---|---|---|---|---|---|
| Soybeans | 172 | 8.4 | 6 | 18.2 | 9 |
| Edamame | 121 | 8.9 | 6 | 12 | 5.2 |
| Chickpeas | 139 | 22.5 | 6.4 | 7 | 2.8 |
| Black beans | 140 | 26.1 | 10.5 | 8.2 | 0.6 |
| Red lentils | 150 | 25 | 4 | 12 | 0.5 |
| Navy beans | 140 | 26.1 | 10.5 | 8.2 | 0.6 |
| Fava beans | 62 | 10.1 | 3.6 | 4.8 | 0.5 |
Pro tips:
- Spreads – use legumes to make home-made spreads (such as hummus), dips and sauces to add to your veggies, meals and snacks
- Baking – try using legumes (especially chickpeas and black beans) to make flourless desserts and baked goods (such as brownies, blondies, breads)
- Flour – legumes-based flours (gram, lentil) are also a great alternative you can use in the kitchen, find out more here: ‘The Best Flours for PCOS & How To Use Them‘
- Pasta – swap your regular pasta for some legume-based pasta (red lentil, chickpea, black bean) as they are naturally gluten-free and much higher in protein
- Soaking – make sure you soak your legumes properly prior to cooking to improve their digestibility and reduce their content of anti-nutrients (such as phytic acid and lectins)
- Canned – to save time, keep some canned legumes in the pantry for quick access and an easy addition to your meals
- Sprouting – sprouting legumes is an excellent way of making them more digestible, nutrient-rich and delicious, you can easily do it at home with minimal equipment
4. Pseudograins
In contrast to true grains, pseudograins are typically more nutrient-dense, less processed and lower-GI which makes them another good source of carbohydrates for women with PCOS. Because of their similar features (look-wise and taste-wise), they can be a great alternative for regular grains in your favorite meals (white rice, bread, wheat products).
There are many different variations of pseudograins and atypical grains to choose from and they work great for both sweet and savory dishes. Look for wild, less common and unprocessed versions to get the most nutrients and health benefits.
Read more: ‘Which Grain is Best For PCOS?‘
While pseudograins are naturally gluten-free, low in calories and high in fiber, they still contain a significant amount of carbohydrates. That’s why it’s important to treat them as regular grains in terms of portion sizes. Around ½ cup of cooked pseudograins can be your 1 serving of carbs per meal as it provides roughly 25g of carbohydrates.
Best grains:
- Pseudograins (quinoa, buckwheat, wild rice)
- Gluten-free grains (millet, steel-cut oats)
| 100g serving (cooked) | calories (kcal) | carbs (g) | fiber (g) | protein (g) | fat (g) |
|---|---|---|---|---|---|
| Quinoa | 120 | 21.3 | 2.8 | 4.4 | 1.9 |
| Buckwheat | 118 | 21.3 | 2.1 | 4.3 | 1.2 |
| Millet | 119 | 23.7 | 1.3 | 3.5 | 1 |
| Steel-cut oats | 179 | 31 | 4 | 6 | 3 |
| Wild rice | 101 | 21.3 | 1.8 | 4 | 0.3 |
Pro tips:
- Don’t eat grains alone – even low GI grains shouldn’t be eaten on their own if you want to prevent drastic changes in blood glucose levels, make sure to combine them with a good source of protein and healthy fat to slow down digestion
- Opt for whole – always opt for whole minimally processed grains and pseudograins to preserve their nutrients, dietary fiber and low GI
- Eat grains last – when applicable, try to eat your grains as the last part of your meal to even lower your body’s glycemic response
- Buy organic – opt for organic grains whenever possible since most grains tend to be highly contaminated with pesticides, herbicides and other industrial chemicals
- Batch cook & cool down grains – cook your grains in larger quantities and keep them in the fridge to save a lot of time and effort, by cooling them down you’ll also increase their content of resistant starch which is particularly great for the health of your microbiome
- Be creative – don’t be scared to experiment with the new ‘untypical’ grains in the kitchen, you can easily recreate your favorite meals with them (you’re likely to find they taste even better)
5. Fruits
There are many good reasons to include fruits in your diet whether you suffer from PCOS or not. Not only are fruits the nature’s candy that taste sweet and delicious but they are also packed with beneficial nutrients, fiber, phytochemicals and bioactive compounds that can help manage PCOS and improve overall health.
While fruits are particularly rich in carbohydrates and simple sugars (especially fructose), they can still be a good source of carbs in your diet when eaten whole and in moderation. However, it is best to treat fruits as a ‘treat’ rather than the base of your diet as overconsumption can cause rapid spikes in blood sugar levels.
To keep your blood glucose and insulin levels in balance, it is advisable to eat about 1-2 servings of fruit per day (1 serving = 1 cup or 1 medium-sized piece of fruit). You may also want to opt for the low-sugar/high-fiber fruits that have a low GI number and are generally more PCOS-friendly.
I’ve created a whole list of the best fruits for PCOS which you can access here: ‘The Best & Worst Fruits For PCOS (Complete List)‘.
Best fruits:
- Berries (blueberries, raspberries, blackberries, strawberries)
- Citruses (orange, lemon, grapefruit)
- Pome fruits (apples, pears)
- Tropical fruits (kiwi, pomegranate, passion fruit)
- Stone fruits (plums, apricots, peaches)
- Fatty fruits (olives, avocado, coconut)
| 100g serving (fresh) | calories (kcal) | carbs (g) | fiber (g) | protein (g) | fat (g) |
|---|---|---|---|---|---|
| Avocado | 160 | 9 | 7 | 2 | 15 |
| Blueberries | 57 | 14.5 | 2.4 | 0.7 | 0.3 |
| Strawberries | 32 | 7.7 | 2 | 0.7 | 0.3 |
| Coconut | 354 | 15 | 9 | 3.3 | 33 |
| Grapefruit | 42 | 11 | 1.6 | 0.8 | 0.1 |
| Orange | 47 | 12 | 2.4 | 0.9 | 0.1 |
| Olives | 115 | 6 | 3.2 | 0.8 | 11 |
| Kiwi | 61 | 15 | 3 | 1.1 | 0.5 |
| Pomegranate | 83 | 19 | 4 | 1.7 | 1.2 |
| Apple | 52 | 14 | 2.4 | 0.3 | 0.2 |
| Plum | 46 | 11 | 1.4 | 0.7 | 0.3 |
| Apricot | 48 | 11 | 2 | 1.4 | 0.4 |
Pro tips:
- Combine fruits with nut butters – fruits in combination with nut butters is one of my favorite thing to eat, not only does it taste delicious but it also helps slow down the absorption of sugar (from the fruit) into the bloodstream and prevent rapid blood glucose spikes
Read more: ‘Best Nuts & Nut Butters For PCOS (Complete List)‘ - Shop at farmer’s markets – you can find much cheaper and high-quality fruit in your local farmer’s markets as it’s always seasonal, local, fresh and at the peak of its ripeness
- Use fruit as a sweetener – try using fruit to sweeten your meals instead of regular sugar and artificial sweeteners, it works great in baking, cooking and raw recipes
Read more: ‘The Best & Worst Sweeteners For PCOS (Complete List)‘ - Eat the rainbow – include different types of fruits (with different colors) in your diet to get a diverse range of antioxidants and phytochemicals
- Combine fruit with fat – make sure to eat your fruit with some source of healthy fat (nuts, seeds, yogurt) to increase the availability of fat-soluble vitamins (A, E, D, K) and antioxidants
- Eat the skin – eat your fruits with the skin on whenever possible as the skin contains the highest amounts of nutrients and dietary fiber that helps stabilize your blood sugars
- Make homemade ice cream – fruit (n)ice cream can also be easily made at home by simply blending frozen fruits (bananas work great) in the food processor until smooth, try adding some extra ingredients (cinnamon, cacao powder, seeds) to create unique flavors
- Buy organic – choose organic fruits whenever possible to reduce your exposure to harmful pesticides and endocrine-disrupting chemicals, check the list of ‘Dirty Dozen and Clean 15’ to know which types of fruits contain the highest levels
- Freezing – buy frozen veggies (or freeze them yourself) since the process of freezing doesn’t cause any major changes in the nutritional content, they’re super practical for last-minute meals and they also tend to be much cheaper
Can I eat carbs if I have PCOS?
In general, women with PCOS can eat carbs as a part of a healthy diet. However, they may benefit from reducing their overall carbohydrate intake and focusing on the consumption of whole unprocessed foods to improve their blood sugar regulation and reduce insulin resistance.
How many carbs a day should PCOS eat?
As a general rule, women with PCOS should eat approximately 50-150g of carbohydrates per day (25g of carbohydrates per meal) to keep their blood glucose and insulin levels balanced. However, the exact amount of carbohydrates may differ between individuals based on their personal circumstances.
Which carbs should I avoid in PCOS?
For women with PCOS, it is generally recommended to avoid highly refined carbohydrates and grains as they may contribute to blood sugar imbalances and insulin resistance. Limiting the intake of gluten-containing carbohydrates may also help reduce inflammation and improve PCOS in some individuals.
Do I have to go low-carb for PCOS?
It is not necessary to go low-carb if you suffer from PCOS, however, reducing the overall intake of carbohydrates appears to be beneficial for most women with this condition. Replacing highly refined carbohydrates with unprocessed complex carb sources may also be an effective strategy to manage PCOS.
Do carbs make PCOS worse?
Carbs, in general, do not make PCOS worse. However, the amount and type of carbohydrates consumed directly affect blood sugar regulation and insulin resistance. For this reason, the consumption of carbohydrates can have a massive impact on the management of PCOS.
Resources:
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