Insulin resistance affects up to 70% of women with PCOS, regardless of body weight, and it's one of the most common questions I get asked in consultations: "which foods should I avoid?" My honest answer is usually more nuanced than a simple avoid list — but there are some genuinely useful patterns worth understanding.
Why Insulin Resistance Matters in PCOS
When your cells become less responsive to insulin, your body compensates by producing more of it. Higher circulating insulin levels can, in turn, stimulate the ovaries to produce more androgens, which can worsen symptoms like irregular cycles, acne and excess hair growth. Supporting insulin sensitivity through food is one of the most evidence-based nutrition strategies available for PCOS.
Foods That Tend to Spike Blood Sugar Sharply
Rather than eliminating entire food groups, I encourage my clients to notice which foods cause the sharpest blood sugar spikes and pair or moderate them rather than avoid them outright:
- Refined carbohydrates eaten alone — white bread, white rice, and sugary cereals cause a faster rise in blood sugar, particularly on an empty stomach. Pairing them with protein, fibre or healthy fat softens this response considerably.
- Sugary drinks — fruit juice, sugary tea and soft drinks deliver a large amount of fast-absorbing sugar with very little to slow it down. Whole fruit is a better choice, as the fibre slows absorption.
- Highly processed snack foods — these are often low in fibre and protein, meaning less to buffer the blood sugar response.
What to Build Meals Around Instead
Rather than focusing on restriction, I find it more useful — and more sustainable — to focus on what to add. Protein at every meal, plenty of fibre from vegetables, pulses and wholegrains, and healthy fats from sources like olive oil, nuts and oily fish all help slow glucose absorption and improve insulin sensitivity over time. My Mediterranean halloumi and quinoa bowl and spiced roasted chickpeas are both built around this principle — protein and fibre together, rather than refined carbohydrates alone.
A Note on Supplements and Medication
Some clients ask about supplements such as inositol, or medications like metformin, for insulin resistance. These fall outside what I can advise on as a nutritionist — if you're considering either, I'd recommend discussing this with your GP or endocrinologist, who can assess whether they're appropriate for you alongside your dietary changes.
If you'd like a personalised look at how your own eating patterns might be affecting your PCOS symptoms, explore my PCOS nutrition support or book a consultation — we can build a plan that fits your life, not a generic template.