Nutrition Diet: What Can People with PCOS Not Have? A Comprehensive Guide

October 8, 2025 •

4 min read

According to research, people with polycystic ovary syndrome (PCOS) often show signs of chronic, low-grade inflammation and insulin resistance, which can be aggravated by diet. Understanding what can people with PCOS not have is crucial for managing symptoms like irregular periods, weight gain, and acne, and for reducing associated health risks.

Quick Summary

A diet for managing PCOS requires limiting or avoiding foods that exacerbate insulin resistance and inflammation, such as refined carbs, sugary drinks, processed foods, and unhealthy fats. Focus on anti-inflammatory, low-glycemic, and whole foods instead.

Key Points

Refined Carbs and Sugar: Avoid white bread, pasta, pastries, sugary drinks, and candy, as they cause insulin spikes that worsen PCOS symptoms.
Processed and Fried Foods: Limit fried foods, processed snacks, and processed meats, which contain inflammatory fats and additives that can aggravate inflammation.
The Dairy Question: For some, dairy may worsen symptoms due to IGF-1, while others can tolerate it. Consider opting for unsweetened plant-based alternatives or moderate consumption of low-fat dairy.
Gluten-Free Isn't a Mandate: A gluten-free diet is only necessary for those with a diagnosed gluten intolerance. Focusing on high-fiber whole grains is more beneficial for most people with PCOS.
Restrict Unhealthy Fats and Excess Red Meat: Cut down on trans fats, margarine, and high intake of red meat to reduce inflammation and improve overall health.
Moderation with Alcohol and Caffeine: Limit alcohol, as it disrupts blood sugar and hormones. Monitor caffeine intake, as it can affect symptoms differently depending on the individual.

The Link Between Diet, Insulin Resistance, and Inflammation in PCOS

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that often involves insulin resistance and chronic low-grade inflammation. Insulin is a hormone that helps cells use glucose for energy. When insulin resistance occurs, cells don't respond to insulin effectively, causing the body to produce even more insulin. This excess insulin can lead to increased androgen (male hormone) production, which worsens PCOS symptoms like irregular periods, acne, and excessive hair growth. Certain foods can significantly worsen both insulin resistance and inflammation, making their limitation or avoidance a key strategy in symptom management.

Foods that Exacerbate Insulin Resistance

High glycemic index foods cause a rapid spike in blood sugar, triggering a large insulin release that further strains a system already struggling with insulin resistance.

Foods to limit or avoid include:

Refined carbohydrates: Products made with white flour, such as white bread, pasta, pastries, and pizza dough, are quickly digested and cause blood sugar to spike.
Sugary foods and drinks: Added sugars in soda, sweetened juices, cakes, cookies, and candy lead to significant insulin spikes and fuel inflammation. Reading labels is critical, as sugar is often hidden in many processed foods.
Certain starchy vegetables: While vegetables are generally healthy, those with a very high glycemic index, such as white potatoes, should be consumed in moderation or paired with protein and fiber to slow glucose absorption.

Foods that Increase Inflammation

Chronic inflammation is a hallmark of PCOS and contributes to its long-term health risks, including heart disease. Certain dietary components can fuel this inflammatory process.

Foods to limit or avoid include:

Fried foods and trans fats: Fried foods like french fries and potato chips, as well as trans fats found in margarine and many processed snacks, increase inflammation.
Processed and red meats: Processed luncheon meats, sausages, hot dogs, and excessive consumption of red meat like hamburgers and steak are linked to higher levels of inflammation.

Should You Avoid Dairy and Gluten?

This is a nuanced topic, and the answer isn't a simple yes or no. For some, reducing or eliminating dairy and gluten may offer benefits, while for others, it's unnecessary.

Dairy:

The theory: Some evidence suggests that dairy, particularly low-fat varieties, may increase insulin-like growth factor (IGF-1), which can contribute to higher androgen levels and worsen PCOS symptoms.
The reality: The link is not conclusive for everyone. Some women with PCOS can tolerate moderate amounts of dairy, especially fermented products like yogurt, which contain probiotics beneficial for gut health. For those with acne triggered by dairy, or who notice other symptom flare-ups, reducing or cutting out dairy may be worth trying. Alternatives like unsweetened plant-based milks are widely available.

Gluten:

The theory: Gluten-containing grains like wheat, rye, and barley can cause inflammation in individuals with celiac disease or non-celiac gluten sensitivity. Since PCOS is associated with inflammation, some hypothesize that removing gluten can help all PCOS patients.
The reality: There is no strong evidence to suggest that all people with PCOS need to go gluten-free. Often, the issue with gluten-containing products is that they are also high in refined carbohydrates. Choosing high-fiber whole grains like brown rice, oats, and quinoa is a better approach for most individuals without a diagnosed gluten issue. For those concerned about gut health, exploring gluten-free alternatives might still be a beneficial experiment.

The Impact of Alcohol and Caffeine

Alcohol: Excessive alcohol consumption can disrupt blood sugar control, potentially causing both spikes and dangerous drops, which is particularly problematic for those with insulin resistance. It can also interfere with sleep and hormone balance. Opting for low-sugar alcoholic beverages in moderation or choosing non-alcoholic alternatives is advisable.
Caffeine: The effect of caffeine on PCOS symptoms can vary. For some, it can worsen anxiety or affect blood sugar levels, while others tolerate it well. Monitoring your personal response is key. Green tea is often recommended as a healthier alternative due to its antioxidant properties.

Comparison of Foods for PCOS


Food Group	Limit or Avoid	Healthy Alternatives	Reason
Grains	Refined carbs (white bread, pasta), sugary cereals, instant oatmeal	Whole grains (brown rice, quinoa, steel-cut oats, whole wheat)	Refined carbs spike insulin; whole grains stabilize blood sugar due to fiber.
Fats	Fried foods, trans fats, margarine, saturated fats from processed meat	Healthy fats (avocado, olive oil, nuts, seeds, fatty fish like salmon)	Unhealthy fats increase inflammation; healthy fats have anti-inflammatory effects.
Protein	Processed meats (hot dogs, sausages), excessive red meat	Lean protein (fish, poultry, beans, lentils, eggs, tofu)	Processed and red meats can increase inflammation; lean proteins are anti-inflammatory.
Dairy	Full-fat dairy (ice cream, processed cheese), sugary yogurts	Low-fat Greek yogurt, unsweetened plant-based milk alternatives	Some find dairy exacerbates symptoms; alternatives or low-sugar options may be better.
Beverages	Sugary drinks (soda, fruit juice, energy drinks), excessive alcohol	Water, herbal tea, green tea, seltzer with a splash of fruit juice	High sugar content causes insulin spikes; water and tea are hydrating and low-sugar.
Snacks	Packaged snacks, candy, cookies, cakes	Nuts, berries, seeds, high-fiber fruits	Processed snacks contain refined carbs and sugar; whole-food snacks are nutrient-dense.

Conclusion

While a single diet doesn't fit all individuals with PCOS, focusing on a nutritional strategy that targets insulin resistance and chronic inflammation is highly effective. For people with PCOS, what they can not have includes a heavy reliance on refined carbohydrates, sugary beverages, processed foods, and unhealthy fats. However, navigating individual sensitivities to dairy and gluten is best done with a personalized approach, often in consultation with a healthcare professional. Shifting your dietary focus towards whole, unprocessed foods like vegetables, lean proteins, healthy fats, and high-fiber whole grains is the most impactful step toward managing symptoms and improving long-term health. This informed approach allows you to take charge of your well-being. Visit Johns Hopkins Medicine for more detailed information on a PCOS diet.

Frequently Asked Questions

People with PCOS should limit sugar because many have insulin resistance. High sugar intake causes rapid blood sugar spikes, triggering the release of excess insulin, which can lead to higher androgen levels and worsen PCOS symptoms.

Excessive consumption of red and processed meats is not recommended for PCOS because they can contain unhealthy saturated fats and promote inflammation. Opting for leaner protein sources like fish, chicken, or plant-based alternatives is a healthier choice.

Going dairy-free is not a universal requirement for everyone with PCOS. The decision depends on individual tolerance and symptoms. Some studies suggest dairy might increase IGF-1, but the link isn't conclusive. You can test your personal tolerance or try unsweetened dairy alternatives.

Gluten is only a problem for people with PCOS who also have celiac disease or a gluten sensitivity. For others, the main issue is that many high-gluten products, like white bread and pastries, are also high in refined carbohydrates. Focusing on whole grains instead is often sufficient.

People with PCOS should avoid refined carbohydrates, which include white bread, refined pasta, sugary cereals, and pastries. These foods can spike insulin and blood sugar levels. Choosing high-fiber, low-glycemic carbs like brown rice, quinoa, and whole grains is a better option.

Alcohol can disrupt blood sugar control, interfere with sleep, and negatively impact hormone balance, all of which can worsen PCOS symptoms. Limiting or avoiding alcohol, especially sugary cocktails, is generally recommended.

Yes, fried foods and trans fats found in many processed snacks should be limited because they are pro-inflammatory. Since PCOS is associated with chronic inflammation, avoiding these unhealthy fats can help manage symptoms and reduce long-term health risks.