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Introduction
In this episode, we examine what nutrition can realistically do in the condition historically known as PCOS, now renamed polyendocrine metabolic ovarian syndrome, or PMOS.
We begin by explaining why the name change matters: the condition is not defined by ovarian cysts, but is better understood as a broader endocrine-metabolic and ovarian syndrome involving insulin resistance, androgen excess, ovulatory dysfunction, metabolic risk, and psychological burden.
We then assess the nutrition evidence, including energy restriction, weight loss, carbohydrate quality, glycaemic index and load, protein intake, fat quality, appetite regulation, fertility outcomes, and phenotype differences. Rather than seeking a single “PCOS diet”, the episode asks which dietary features may plausibly help, how strong the evidence is, and where uncertainty remains.
- [00:22] PCOS to PMOS name change
- [05:13] What can nutrition do?
- [07:14] Diagnosis and heterogeneity
- [13:54] Key nutrition questions
- [17:14] Diet and insulin resistance
- [24:11] Weight loss vs macronutrients
- [32:17] Glycemic index and load
- [37:34] Reproductive outcomes evidence
- [41:13] Appetite regulation in PCOS
- [46:23] Lean PCOS and phenotypes
- [50:46] Practical takeaways and wrap
Episode Resources
- Join the Sigma newsletter for free
- Subscribe to Sigma Nutrition Premium
- Enroll in the next cohort of our Applied Nutrition Literacy course
- Teede et al., 2026 – Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process
About the Host
Danny Lennon is the founder of Sigma Nutrition and host of the popular podcast Sigma Nutrition Radio since 2014. Danny has a master’s degree (MSc.) in Nutritional Sciences from University College Cork, in addition to a BSc. Degree in Biology and Physics.
He is the co-creator of the course Applied Nutrition Literacy with Dr. Alan Flanagan.
And he is currently a member of the Advisory Board of the Sports Nutrition Association, the global regulatory body responsible for the standardisation of best practice in the sports nutrition profession.
Study Notes
Useful Terminology
- Polyendocrine metabolic ovarian syndrome (PMOS): The 2026 consensus name for the condition historically called polycystic ovary syndrome (PCOS). The revised name removes the misleading reference to pathological ovarian cysts and better reflects the syndrome as involving multiple endocrine systems, metabolic features, and ovarian dysfunction.
- PCOS: The older acronym used throughout most of the research literature discussed in these notes.
- Hyperandrogenism: Excess androgen activity, usually assessed clinically through features such as hirsutism, acne, or androgenic alopecia, and biochemically through total testosterone, free testosterone, calculated free androgen index, androstenedione, or DHEAS. Hyperandrogenism is central to many but not all PMOS phenotypes.
- Ovulatory dysfunction: Irregular, infrequent, or absent ovulation, often reflected in irregular menstrual cycles. In PMOS, this can arise through neuroendocrine and ovarian disturbances, including altered gonadotropin signalling, impaired follicular maturation, and androgen excess.
- Polycystic ovarian morphology: An ultrasound or AMH-related diagnostic feature reflecting accumulation of small antral follicles and disrupted folliculogenesis. It should not be casually equated with pathological ovarian cysts.
- HOMA-IR: A fasting surrogate index of insulin resistance calculated from fasting glucose and fasting insulin.
- Glycaemic index and glycaemic load: Glycaemic index ranks carbohydrate-containing foods by their postprandial glucose response compared with a reference food; glycaemic load additionally accounts for the amount of carbohydrate consumed in a serving.
- SHBG: Sex hormone-binding globulin
- Free androgen index (FAI): FAI estimates biologically available androgen exposure using total testosterone and SHBG.
