Can You Follow a Vegan or Vegetarian Diet with PCOS?
Have you seen other PCOS and women’s health dietitians saying they don’t recommend a vegan or vegetarian PCOS diet? Well, I think that’s BS! Not only can you be plant-based or plant-forward, that can be your PCOS super power! In this post I’ll walk you through the dietary concerns surrounding vegan and vegeatarian diets and PCOS and give you tips for following a healthy plant-based diet with PCOS.
Is A Vegetarian Diet Healthy For PCOS?
Another way of asking this question is can you get all the nutrients you need to manage PCOS on a vegetarian diet? Yes, absolutely. The Academy of Nutrition Agrees that you can get all the nutrients you need for PCOS and any other condition on a plant-based diet.
There are some nutrients you’ll need to focus on, but they’re easy to get on a healthy whole-foods based vegetarian or vegan diet.
Is Eating Meat Bad for PCOS?
I rarely need to tell people to eat more meat. Excess red meat and especially processed meats are pro-inflammatory (1). You probably know that PCOS is also pro-inflammatory and that inflammation is one of the causes of many of the vague symptoms of PCOS like fatigue, belly fat and brain fog. So, I’m often trying to get folks to replace some of their red meat with either chicken, fish or a plant-based proteins.
Red & Processed Meat Intake May Increase Insulin Resistance
Higher red meat intake may also increase risk of Type II Diabetes (2), which PCOS also increases. In fact, one study concluded that each serving of red meat replaced with legumes or nuts would decrease risk by 30-40% (3)! So again, I’m usually counseling folks to cut down on meat and eat more vegetarian protein with PCOS.
Note, we don’t see the same negative associations with poultry and PCOS, so go ahead and enjoy chicken if you want to, but it’s by no means necessary.
Soy Improves PCOS Symptoms
On the other hand, whole soy foods like tofu, tempeh and edamame are good for PCOS! It’s another myth within this myth that you should avoid soy for PCOS. The truth is quite the opposite. One study found that replacing 30% of your protein with soy can lower insulin resistance, testosterone and BMI with PCOS (4). Another meta-analyses concluded that soy does indeed lower testosterone (5).
How Does Soy Improve PCOS?
Soy can be either pro-estrogenic or anti-estrogenic depending on the environment it’s in. In a low estrogen environment like PCOS, it gets to its receptor and has estrogen-like effects, but it’s weaker than our own internal estrogen, so it doesn’t cause extreme effects. Flax also has similar effects and can be used if you prefer to avoid soy (6 ).
Whole Grains Are Good for PCOS
Whole grains, which should make up a good portion of a plant-based diet, help lower risk of Type II Diabetes and tend to be helpful in PCOS (7). Yes, these food actually help lower insulin resistance and regulate blood sugar. They also contain a bunch of B vitamins that are great for metabolism and antioxidants like vitamin E.
Plant-Based Diets Improve PCOS Symptoms
Several studies have found that the Mediterranean Diet and the DASH diet can both improve symptoms of PCOS (8,9). While neither of these is fully plant-based, they are both plant-forward and lower in meat that a typical Western diet.
Both diets are rich in beans, nuts, seeds, whole grains and fruits and veggies. The Med diet has more healthy fats from fish, olive oil, nuts and seeds. While the DASH diet is lower in salt and fat, since it’s designed to help with blood pressure and heart disease risk.
Beans Are Beneficial for PCOS
Beans, in particular, seem to be beneficial for PCOS (10). There isn’t much true data on plant-based diets and PCOS, but from these other studies. One study from a few years ago found that “plant-based” diets may lower risk of getting PCOS in the first place (11). I think from the data available it’s safe to conclude that plant-based diets are safe and effective for PCOS.
What to Watch Out for On a Plant-Based Diet with PCOS
Of course, you need to ensure you’re getting certain nutrients on a plant-based diet. You can easily achieve this with a healthy, whole-foods plant-based diet. Check out my post on Top Plant-Based Mistakes to learn more. And here are some top nutrients you’ll want to make sure you get enough of on a plant-based diet for PCOS and how to get them:
1. Protein
Protein is essential for blood sugar balance, muscle maintenance, and hormone regulation. Without enough protein, energy levels and metabolism can suffer.
Best sources: Lentils, chickpeas, tofu, tempeh, edamame, quinoa, hemp seeds, chia seeds, seitan, plant-based protein powders
2. Vitamin B12 (vegan diets)
Since vitamin B12 is primarily found in animal products, plant-based eaters need to be mindful of getting enough. It plays a crucial role in energy production, nerve function, and red blood cell formation.
Best sources: Fortified plant milks, nutritional yeast, fortified cereals, B12 supplements
3. Zinc
Zinc is important for immune function, hormone balance, and ovulation. It also supports insulin sensitivity, which is key for managing PCOS.
Best sources: Pumpkin seeds, hemp seeds, chickpeas, cashews, tofu, whole grains
4. Omega-3 Fatty Acids
Omega-3s help reduce inflammation, support brain health, and promote hormone production. Since plant-based diets lack fish, alternative sources are necessary.
Best sources: Chia seeds, flaxseeds, hemp seeds, walnuts, algae-based omega-3 supplements
5. Iron
Iron is essential for oxygen transport, energy levels, and hormone regulation. Plant-based iron (non-heme iron) is not as easily absorbed as the iron from animal products, but pairing it with vitamin C-rich foods can enhance absorption.
Best sources: Lentils, tofu, chickpeas, quinoa, spinach, pumpkin seeds
6. Iodine
Iodine is crucial for thyroid function, which plays a major role in metabolism and hormone regulation. Plant-based diets can sometimes lack adequate iodine.
Best sources: Seaweed (nori, wakame, kelp), iodized salt, fortified plant milks
7. Choline (vegan diets)
Choline is essential for liver function, brain health, and fertility. Since egg yolks are a primary source, plant-based eaters need alternative options.
Best sources: Tofu, soybeans, quinoa, broccoli, cauliflower, flaxseeds
8. Vitamin D
Vitamin D is vital for immune function, insulin sensitivity, and overall hormone balance. There are very few foods with Vitamin D in them, but mushrooms are one. Still, you will likely need a supplement.
I would argue you have to be careful about these nutrients and more on a Western style, meat-heavy diet. These diets often lack enough fiber, beta-carotene, vitamin C and other nutrients that are important for PCOS.
Conclusions about PCOS Plant Based Diets
All of this is also to acknowledge that some people with PCOS are culturally or religiously plant-based, and they shouldn’t be pressured to change their preferences due to their health condition. I’ve worked with many South Asian women with PCOS who follow a vegetarian or vegan diet, and we’ve had no problem adapting it to improve PCOS symptoms.
If you want a dietitian who will respect your dietary preferences and still help you treat your PCOS, I’m here to help. Book a Free Nutrition Chat to make a plan that works for you.