By Kym Campbell, BSc. | Updated April 19th, 2023
Carbs are an important part of a PCOS diet because of their impact on insulin sensitivity. Getting the right amount depends on the type of carbs you choose. Low glycemic whole foods are best.
Improving how they consume carbs is partly why so many women start to see results during my free 30-Day PCOS Diet Challenge.
In this article, I tell you everything you need to know about carbs and PCOS.
For worked examples of how to put these ideas into practice download this free 3-Day meal plan.
Link Between Carbs and PCOS
Insulin resistance is one of the underlying drivers of all PCOS symptoms [1-3]. Insulin resistance contributes to menstrual dysfunction, infertility, and trouble managing body weight. Through its impact on androgen levels, insulin resistance promotes acne, hair loss, and unwanted hair. It also impacts mental health.
There are many ways to reverse insulin resistance. The most effective treatment though is to manage your intake of carbohydrate foods.
Unlike fats and protein, carbohydrates in food cause your blood glucose levels to rise. Insulin is then secreted to move this glucose out of the blood and into cells where it can be stored or used. The extent to which blood glucose levels rise determines how much insulin gets secreted. If the carbs you eat have a small impact on blood glucose levels, then your demand for insulin remains low. By eating this way over time, your cells become more sensitive to insulin. This is how you reverse insulin resistance and the PCOS symptoms it drives.
I’ve done it. And I’ve helped a lot of other women do it too through my free 30-Day PCOS Diet Challenge.
Benefits of a Low-Carb Diet
The link between carbs, blood glucose levels, insulin, and PCOS pathology is well established. A low-carb diet exploits this link to deliver several health benefits. Studies show that low-carb diets are best for improving sex hormone balance and reproductive health . Other high-quality PCOS studies have shown that a low-carb diet is better for insulin resistance and metabolic health [5, 6]. These health benefits may be independent of weight loss results .
We see this play out in real life among the many past participants from my 30-Day Challenge.
How Many Carbs Should You Eat?
So, low-carb diets are good for PCOS. But what’s considered low-carb?
Here’s where most diet authorities get things wrong.
They might support a “lower” carb diet compared to USDA recommendations of 45-65% of calories . But they often fail to go low enough to successfully reverse insulin resistance. This is often out of fear that high-fat diets are dangerous because they contain too much saturated fat. Studies have shown that these concerns are unfounded . Even if the low-carb diet is high in saturated fat, it still lowers cardiovascular disease risks.
To meet the definition of “low-carb”, a diet should contain less than 26% percent of calories from carbohydrate foods . This should not be confused with a “very low-carbohydrate”, ketogenic diet. Very low-carb diets generally contain less than 10% of energy from carbohydrates. See my keto diet for PCOS article to better understand the pros and cons of a very low-carb diet.
For people consuming 2,000 calories per pay, a low-carb diet contains between 50 – 130 grams per day of net carbohydrates. Net carbs mean the total carb content, minus the fiber. Fiber doesn’t get counted as a carb because it has minimal caloric value. It just passes straight through you.
Keep in mind too that the weight ranges above refer to the carb content of food, and not the food item itself.
Recommended carb intake
There’s no one-size fits all approach to how many carbs you should eat. But somewhere between 50 – 150 grams per day seems to be the sweet spot for most people.
The biggest factors for where you sit on this spectrum are your insulin sensitivity and your health goals. If your insulin sensitivity is good and you’re happy with your body composition, then 150 grams per day is a good approximate target. If you’re insulin resistant and you want to lose weight, then 50 grams per day may be more appropriate.
Of course, there are many exceptions to this range. Athletes may want to eat 200 grams of carbs per day or more. Others may find they can eat fewer than 50 grams per day without going into ketosis.
Learn more about macros for PCOS here including my recommendations on protein and fat.
When I create macro-balanced PCOS recipes, I generally aim for around 25 grams of net carbs per meal. If you have three meals a day, and eat a piece of fruit, then this will get you around 100 grams of carbs per day. This is what I recommend for my PCOS meal planner subscribers.
You can find approximately 25 grams of carbs in:
- ½ cup of cooked rice or quinoa.
- ¾ – 1 cup of cooked beans or lentils
- A medium-sized sweet potato
- 2 ½ cups of starchy vegetables such as carrots, beetroot, butternut, or acorn squash.
- 1 cup or 1 medium-sized piece of fruit
Best Types of Carbs
Lowering your carb intake isn’t the only way to influence how carbs affect blood glucose and insulin levels. Eating foods that have a relatively low glycemic index (GI) also makes a big difference.
These are almost always whole foods that haven’t been heavily processed. They should be high in fiber because that lowers the GI. And, they should be gluten-free. See my gluten and PCOS article to learn why gluten is bad for PCOS.
Non-starchy vegetables are the best source of carbs for PCOS. That’s because they’re low in carbs and often high(ish) in fiber. They’re also a rich source of all the micronutrients that support good health.
Some of the highest-fiber, low-carb vegetables include:
- Broccoli and cauliflower
- Collard greens
- Romaine lettuce
With these kinds of vegetables, you can eat as much as you like with minimal impact on blood glucose levels.
During my free 30-Day PCOS Diet Challenge, I encourage participants to eat these foods liberally. I also use them in a lot of the recipes in my free 3-Day Meal Plan.
Starchy vegetables, legumes, and gluten-free grains are also excellent foods for PCOS. This includes sweet potatoes, beans, lentils, black rice, and quinoa. These are much higher in carbohydrate content though. In this instance, following the serving size guidelines described above is appropriate.
5 Tips for Optimizing Carbs Intake
The whole reason carbs are important for PCOS is because of their impact on blood glucose levels. The reason you want to choose the right ones and eat the right amount is to improve insulin sensitivity over time. This is key for beating PCOS.
But there are many other ways to achieve these goals. Here are five practical tips for optimizing insulin sensitivity.
1. Measure blood glucose levels
Since the aim is to have steady blood glucose levels, why not measure them directly? Using blood glucose monitoring devices helps you optimize your carb intake meal by meal. Using a continuous blood glucose monitor for a few weeks is especially helpful. But a finger-prick meter also provides deep insight. See my PCOS macros blog for optimal blood glucose ranges.
2. Eat carbs with protein and fat
Protein and fat have almost no impact on blood glucose levels. What’s more, eating carbs with protein and fat lowers the glycemic index of the carbs. This is a simple hack for eating more carbs without having a negative impact on blood glucose levels. This is why I recommend people add nut butter or PCOS yogurt when enjoying PCOS fruit.
3. Increase resistant starch content in your carbs
Resistant starch is a type of carbohydrate that functions like soluble fiber. It’s good for your gut and improves blood glucose regulation. Rice, legumes, and starchy vegetables all contain resistant starch. But you can increase these levels by cooking and cooling these foods overnight. This is a great way to enjoy carb-rich foods without negatively impacting blood glucose levels.
4. Take other steps to improve insulin sensitivity
Other diet and lifestyle interventions can further improve insulin sensitivity. For example, not getting enough sleep is a known risk factor for insulin resistance [10-12]. But exercise (of all types) increases insulin sensitivity in women with PCOS [13-15]. This is why sleep and exercise are such important aspects of treating PCOS naturally.
As explained in my article on intermittent fasting for PCOS, the timing of your meals can also affect insulin sensitivity. Research shows good results from restricting when you eat [16-19].
5. Don’t ignore psychological factors
If you’ve tried a low-carb diet before and you saw good results, then that’s a strong sign that it’s good for you. If you found it difficult to maintain, then you need to address why rather than quit the approach.
Being mindful of the psychological impact of dietary changes is often very important. That’s why I include both intuitive eating and emotional wellness modules in my Beat PCOS 10-Week Program. Many participants struggle with disordered eating or trauma from previous diets. These people often find that facing these challenges first is key to their long-term success.
It’s critical to take a long-term approach to a PCOS diet. The changes you make need to be sustainable. Studies show that the longer the duration of a low-carb PCOS diet, the better the results [4, 6].
The Bottom Line
Carbs are important for PCOS because they influence insulin sensitivity. Carbs cause your blood glucose levels to rise promoting the release of insulin. Achieving good insulin regulation is key to managing all aspects of PCOS.
Getting your carb intake right is a matter of consuming the right amounts. You also want to choose high-fiber, low-GI whole foods. These types of carbs result in better blood glucose responses.
There are many ways to further improve insulin sensitivity. Monitoring your blood glucose levels, and preparing your carbs correctly can make a big difference. Exercise, sleep, and intermittent fasting can also be helpful.
To get started on a low-carb diet today, download this free 3-Day Meal Plan. For more help join my next free 30-Day PCOS Diet Challenge here
PCOS and weight lifting – how many carbs should I eat? When exercising intensely, you may want to increase your total caloric intake. It’s not necessary to change your macro levels though.
Should I add more carbs if I’m pregnant or breastfeeding? If you’re eating at the low end of the low-carb range then you may want to increase your carb intake slightly. Be mindful of the impact on blood glucose levels when doing so.
How many carbs should I eat with PCOS and metformin? Taking metformin doesn’t change the recommended carb intake and macros for PCOS. Metformin improves insulin sensitivity. But as explained here, this treatment is generally not recommended for women with PCOS
How much fat, protein, and carbs should I get on low carb to control PCOS? It’s best to get approximately 60% of calories from fat. You should get approximately 20% of your calories from protein, and 20% from carbs. For a person consuming 2,000 calories per day, this means 130 g of fat, 100 g of protein, and 100 g of carbs.
Complex carbs and PCOS. How do these fit into my diet? Complex carbs are the kinds of carbs found in grains, legumes, and vegetables. These are the “good ones”. If you follow the recommendations above, you’ll have this base covered.
PCOS and craving carbs. What should I do? There are two main causes of carb cravings. Quitting sugar abruptly and not having enough carbs. In both cases, the solution is to eat some healthy carbs with fat and/or protein. Don’t cave into processed foods as that will set you back.
PCOS and intermittent fasting – how many carbs to eat? Intermittent fasting shouldn’t change the number of carbs you eat. If you’re following a PCOS diet, then fasting may help enhance your results.
Ready to Take Action?
Combining rigorous science and clinical advice with a pragmatic approach to habit change, Kym is on a mission to show other women how to take back control of their health and fertility. Read more about Kym and her team here.
Quick Disclosure: Some of the links on this page may be affiliate links. This means that when you use them to purchase something, it won't cost you more but I may get paid a commission for referring you. In order to avoid any prejudice, I only recommend products that I personally use or would have recommended anyways.
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