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The Mediterranean Diet for PCOS: 5 Pros & Cons To Consider

Kym Campbell

By Kym Campbell, BSc. | Updated March 18th, 2024

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The Mediterranean diet has a nice emphasis on whole foods and has proven health benefits. But it needs to be fine-tuned for PCOS. Women with PCOS need a lower-carb Mediterranean diet. They should also avoid gluten and dairy, and hold a wider definition of “healthy fats”.

That’s what we do during my free 30-Day PCOS Diet Challenge. The results speak for themselves.

Raynetta Weight Loss PCOS Success Story

Here are the five pros and cons of the Mediterranean diet for PCOS.


Good Emphasis on Whole Foods

Proven Health Benefits


Too High in Carbs

Limited Definition of “Healthy Fat”

Includes Gluten and Dairy

1. Pro: Emphasis on Whole Foods

The best thing about the Mediterranean diet for PCOS is its emphasis on nutrient-dense whole foods. It’s old-fashioned eating created before the dawn of the processed food revolution. Most people would recognize the Mediterranean diet as a common-sense way to eat healthily.

The general guidelines are to:

  • Have 5-10 servings per day of a wide variety of fruits and vegetables.
  • Eat whole grains rather than refined grains as your main source of carbohydrates.
  • Include beans, lentils, and chickpeas as these are high in protein, fiber, and micronutrients.
  • Enjoy nuts and seeds in moderation.
  • Use plenty of healthy fats from olive oil, avocados, and fatty fish.
  • Eat fish and seafood at least twice a week.
  • Limit red meat to less than once a week and choose lean cuts.
  • Choose lean chicken and turkey meat.
  • Eat cheese and low-fat yogurt in moderation.
  • Use plenty of herbs and spices and limit salt.

2. Pro: Proven Health Benefits

The Mediterranean diet is one of the most well-studied diet patterns worldwide. This began in the 1950s when researchers noticed that people living in Greece and Italy had lower rates of heart disease and lived longer.

There’s strong evidence that the Mediterranean diet is good for cardiovascular health. It reduces risk factors such as obesity, hypertension, metabolic syndrome, and dyslipidemia [1, 2]. There’s also evidence that a Mediterranean diet is better for blood glucose control and lowers rates of type 2 diabetes.

These findings are particularly salient to people with PCOS. That’s because PCOS is a metabolic disease [3-5]. Studies show that the better people can follow a Mediterranean diet, the less severe their PCOS symptoms are [6].

3. Con: Too High in Carbs for PCOS

The Mediterranean diet is better for PCOS than the standard American diet. But that doesn’t mean it’s as good as it could be. One of the shortcomings is that it’s too high in carbs.

To be fair, the Mediterranean diet doesn’t have a prescribed macronutrient balance. But it’s typically around 45 – 55% carbs, 30-40% fat, and 15-20% protein. For PCOS women with insulin resistance, this is too many carbs to achieve optimal blood glucose levels. This limits your ability to manage PCOS symptoms by failing to address insulin resistance.

By modifying the macro balance of a Mediterranean diet, you can reverse insulin resistance. This makes a huge difference to your PCOS symptoms as well as your metabolic health. A recent study demonstrated this finding in overweight patients with PCOS. They found that a low-carb Mediterranean diet was better than a low-fat diet [7].

The importance of improving the macronutrient balance of your diet cannot be overstated. You can see the results of this intervention among participants from my free 30-Day PCOS Diet Challenge.

The best macros for PCOS are around 20% carbs, 60% fat, and 20% protein. In my carbs and PCOS article, I explain how best to achieve this balance.

4. Con: Limited on What Counts as a “Healthy Fat”

The Mediterranean diet promotes the consumption of certain high-fat foods. Nuts, seeds, olive oil, and fatty fish are encouraged. It’s fairly indisputable at this point that these are healthy foods.

But the Mediterranean diet is more cautious when it comes to meat. Chicken and eggs are meant to be eaten in moderation. You’re not supposed to eat red meat much at all. The general Mediterranean advice with meat is to always choose lean cuts.

This is a mistake for women with PCOS. For a start, eating fatty cuts of meat makes it much easier to achieve the best macros for PCOS. Changing macros improves insulin resistance more than a Mediterranean diet [8].

The health effects of whole food sources of animal fats have also been misrepresented by health authorities. For example, the weight of evidence now shows that saturated fat doesn’t increase heart disease risks [9]. Not all saturated fats are the same as some have positive health effects [10]. Experts argue that US government recommendations to limit saturated fats, ‘lacks scientific rigor’ [11].

From a practical perspective, you only need to look at the success of ketogenic diets in driving weight loss. I don’t support the use of a keto diet for PCOS. But it shows how dietary fat doesn’t make you fat.

There’s other compelling evidence supporting the health benefits of animal fat consumption:

  • Fat consumption has a positive effect on satiety and appetite [12]. This can help with weight loss.
  • CLA fats found in beef and lamb increase insulin sensitivity and reduce body fat [13-16].
  • Red meat, especially from grass-fed animals, is a good source of omega-3 fatty acids. This can be particularly important for people that don’t eat enough oily fish [17].

The take-home here is that not all animal fats are unhealthy. If you can source high-quality, unprocessed meats, eating the fattiest cuts is likely to be good for your PCOS. That’s why I recommend meat in all my PCOS meal plans.

5. Con: It Includes Dairy and Gluten

The best PCOS diet excludes gluten and dairy. At least until you’ve completed an elimination diet like my free 30-Day PCOS Diet Challenge.

Inflammation is one of the underlying drivers of all PCOS symptoms [18-23]. More specially, inflammation caused by gut dysbiosis can account for all the characteristics of a PCOS diagnosis [24-26].

As explained in my article on gluten and PCOS, gluten-containing grains are a problem for many women with PCOS. Even if they’re not yet aware of it. Studies show that gluten can cause “leaky gut” in predisposed people [27]. It even negatively affects intestinal permeability in healthy people [28]. Gluten sensitivity is hard to diagnose. Yet, its predisposing factors are common within PCOS populations.

That’s why a gluten-elimination diet makes good sense before embracing some of the recommended grains in a Mediterranean diet.

A similar argument can be made for dairy. I explain this further in my article on PCOS and dairy.

The Bottom Line

The Mediterranean diet is a good place to start for the treatment of PCOS. But to get the best results, you need to make some PCOS-specific modifications. You want to include all the good parts of this diet, but avoid the bad.

Women with PCOS should eat fewer carbs than what’s “normal” for a Mediterranean diet. The reduction in carbs should be offset by increases in healthy fats. This includes fatty cuts of red meat, especially if they’re sourced from grass-fed animals.

Before embracing gluten and dairy, it’s best to investigate how these ingredients affect your gut health. Follow a gluten-free, dairy-free PCOS-friendly diet for a month or two first.

For help getting started, join my free 30-Day PCOS Diet Challenge.

For examples of a PCOS Mediterranean diet, download this free 3-Day Meal Plan. It includes recipes and a shopping list.

Ready to Take Action?

  • Join my free 30-Day PCOS Diet Challenge here. This is a unique program where you'll receive weekly meal plans, shopping lists, and helpful video lessons. You'll also be part of a motivated and inspiring community of like-minded women.

  • Download my free 3-Day PCOS Diet Meal Plan here. This is perfect for getting started if you aren't ready to commit to 30 days.

  • Join my PCOS Monthly Meal Planning Service here. This service includes hundreds of PCOS recipes within a pre-populated, yet customizable meal plan. It's designed to save you time and help you apply a PCOS diet.

  • Sign up for my Beat PCOS 10-Week Program. This is a comprehensive program that covers diet, PCOS-centric emotional eating, exercise, stress management, and much more. All within a support group environment. The 10-Week Program includes the same recipes and meal plan as my monthly meal planning service.


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