PCOS diet: what the 2023 international guideline actually says

Search “PCOS diet” and you’ll find keto, gluten-free, dairy-free, anti-inflammatory and more, each promising to be the one. The biggest review of the evidence, the 2023 international PCOS guideline, comes to a calmer answer. Here’s what it says about food, in plain words.

Is there a best diet for PCOS?

No. The guideline found no evidence that any one type of diet is better than another.

The 2023 guideline was built from 52 systematic reviews by more than 100 experts and people living with PCOS. On diet, its first recommendation is clear. Healthcare professionals and women should consider that there’s no evidence to support any one diet composition over another. That covers weight, metabolic, hormonal, reproductive and mental health outcomes.

That doesn’t mean food doesn’t matter. It means the specific style matters less than whether it’s healthy and whether you can keep it up.

A note on the name: in May 2026, the guideline team renamed the condition polyendocrine metabolic ovarian syndrome (PMOS). You’ll see both names for a while.

So what does the guideline recommend?

Healthy eating that fits your life and that you can keep doing.

The guideline says any diet in line with general healthy-eating guidelines will have health benefits. Within that, it asks clinicians to suggest sustainable healthy eating tailored to your preferences and goals. It also suggests a flexible approach you shape together with your care team, built around foods you actually like.

Should I cut out carbs, gluten or dairy?

Not because of PCOS alone. The guideline warns against overly restrictive or unbalanced diets.

It says avoiding unduly restrictive and nutritionally unbalanced diets is important, as it is for everyone. If you have celiac disease, an allergy or another reason to avoid a food, that’s a separate conversation with your doctor.

Do I have to lose weight?

No. The guideline says a healthy lifestyle has benefits even without weight loss.

It recommends healthy eating and activity for everyone with PCOS, for general health, quality of life and body composition. For some people that includes keeping weight steady or preventing gain. The guideline also recognizes that many women with PCOS face weight stigma in healthcare, and asks clinicians to focus on health behaviors for people of all sizes.

Why do fiber, protein and spread-out carbs come up so often?

Because they’re a simple way to build a healthy pattern, and PCOS raises the risk of type 2 diabetes.

The CDC notes many women with PCOS have insulin resistance, and more than half develop type 2 diabetes by age 40. The guideline itself doesn’t set fiber or protein targets for PCOS. These habits come from general healthy-eating advice, which the guideline points you back to:

• Fiber: the 2020–2025 Dietary Guidelines use 14 g per 1,000 calories, or 25 to 28 g a day for women 19 to 50. Beans, lentils, oats, whole grains, fruit and vegetables lead.
• Protein at every meal: the 2025–2030 Dietary Guidelines suggest it for everyone.
• Carbs across the day: spreading them means no single meal carries most of them.

What about exercise?

The guideline gives the same advice as for everyone, and says any type helps.

For adults 18 to 64, it suggests 150 to 300 minutes of moderate activity a week, or 75 to 150 of vigorous, plus muscle-strengthening on 2 non-consecutive days. It found no one type of exercise better than another. Some activity is better than none.

What about inositol and other supplements?

The guideline says inositol could be considered, but evidence of benefit is limited.

It notes limited harm and limited clinical benefit, and says no specific type or dose can be recommended yet. It also asks women to tell their healthcare team about any supplements. Talk to your doctor before starting one.

How does Imi help?

Imi plans a healthy pattern from food you already like: fiber every day, protein at every meal and carbs spread across your day.

With the PCOS focus on, Imi puts fiber and protein at the top of Home, shows carbs by meal, and plans about 1.0 g of protein per kg a day. A weight trend is there only if it matters to you. Focuses stack, so PCOS and GLP-1 support can run together.

Imi plans and tracks food. It doesn’t diagnose or treat PCOS, and treatment belongs with your doctor. For ideas to start with, see PCOS breakfast ideas, or see what Imi plans.