Could A Mediterranean-Style Diet Support Metabolic Health In PCOS/PMOS?

What Is A Mediterranean-Style Diet?

The Mediterranean diet is not a strict meal plan or short-term program. It is a flexible way of eating that prioritises:

• Vegetables and fruit
• Legumes such as lentils, chickpeas, and beans
• Whole grains
• Nuts and seeds
• Olive oil as a primary source of fat
• Fish and seafood
• Moderate amounts of dairy
• Smaller amounts of red and processed meat

This pattern naturally provides fibre, healthy fats, antioxidants, and a wide range of nutrients that support blood sugar regulation, cardiovascular health, and healthy inflammatory balance.

Most Women Were Not Closely Following This Eating Pattern

The researchers measured Mediterranean diet adherence using a 14-point questionnaire.

Scores below 7 represented low adherence, scores of 7 to 8 represented acceptable adherence, and scores of 9 or higher represented strict adherence.

The average score was 6.8 out of 14. Overall:

• 55% of the women had low adherence
• 45% had at least acceptable adherence

This highlights an important opportunity. Many women with PCOS/PMOS may benefit from bringing more Mediterranean-style foods into their regular meals.

Greater Adherence Was Linked With Lower BMI And Body Fat

Women who followed the Mediterranean diet more closely tended to have a lower BMI and lower body fat percentage.

The associations were modest, which is expected because body composition is influenced by many factors, including:

• Insulin sensitivity
• Hormones
• Genetics
• Sleep
• Stress
• Physical activity
• Medication use
• Overall food intake

The findings still suggest that a Mediterranean-style eating pattern can form part of a broader approach to supporting body composition and metabolic health.

Greater Adherence Was Connected With Lower Inflammation

Higher Mediterranean diet adherence was also associated with lower levels of C-reactive protein, or CRP.

CRP is a blood marker used to assess inflammation. Low-grade inflammation is commonly linked with PCOS/PMOS and can interact with insulin resistance and other metabolic changes.

Importantly, the association between greater Mediterranean diet adherence and lower CRP remained after the researchers accounted for age and BMI.

This supports the role of a Mediterranean-style diet as one practical way to promote a healthier inflammatory balance.

Body Composition Was Closely Connected With Inflammation

One of the clearest findings was the relationship between inflammation and body composition.

Higher CRP levels were moderately associated with:

• Higher BMI
• Higher body fat percentage

This reflects the close relationship between adipose tissue, inflammation, and metabolic health.

Body fat is biologically active tissue that can release inflammatory signals, particularly when insulin resistance and metabolic dysfunction are present.

This is not about blaming body size. PCOS/PMOS itself can make weight regulation more difficult through insulin resistance, elevated insulin, appetite changes, disrupted sleep, and hormonal imbalances.

Instead, it highlights why metabolic support, rather than weight alone, is such an important focus.

The Study Also Looked At Blood Sugar And Insulin

Researchers examined fasting glucose, insulin, HbA1c, insulin resistance, and glucose levels following an oral glucose tolerance test.

Greater Mediterranean diet adherence was associated with a lower glucose reading one hour after the glucose drink. Some other glucose and insulin markers showed small associations in the opposite direction.

These findings show that blood sugar regulation in PCOS/PMOS is complex and cannot be fully explained by a single dietary score.

The researchers did not have detailed information about:

• Portion sizes
• Total food intake
• Protein intake
• Carbohydrate quality
• Glycaemic load
• Physical activity
• Meal timing

These factors may have influenced the results.

Overall, the study supports the Mediterranean diet as a strong foundation, while also reinforcing the importance of personalising meals for protein, fibre, carbohydrate balance, and individual insulin needs.

Not All Mediterranean-Style Diets Look The Same

The researchers used a short questionnaire to measure how often participants consumed key Mediterranean foods.

However, it did not measure how much of each food was eaten or how meals were balanced.

For example, two people may both receive points for eating fruit, whole grains, or legumes while consuming very different portions and combinations of those foods.

For women with PCOS/PMOS, the quality and structure of meals still matter. Mediterranean-style foods are likely to be most supportive when paired with:

• Adequate protein
• Fibre-rich carbohydrates
• Healthy fats
• Plenty of vegetables
• Balanced portions

PCOS/PMOS Is More Than A Reproductive Condition

The study reinforces that PCOS/PMOS can affect much more than periods, ovulation, acne, or excess hair growth.

It is also commonly linked with:

• Insulin resistance
• Higher insulin levels
• Changes in cholesterol
• Impaired glucose tolerance
• Increased inflammation
• Greater long-term cardiometabolic risk

This is why nutrition strategies for PCOS/PMOS should support the whole body, including hormones, blood sugar, inflammation, and cardiovascular health.

A Dietary Pattern Matters More Than A Single “Superfood”

One of the most useful messages from this research is that metabolic health is supported by the overall pattern of foods eaten consistently.

Mediterranean-style eating naturally encourages:

• Greater plant variety
• More fibre
• Healthy fats from olive oil, nuts, and fish
• More antioxidant-rich foods
• More legumes and whole grains
• Fewer heavily processed foods

Rather than trying to follow the Mediterranean diet perfectly, the goal can simply be to include more of these foods across the week.

Simple Ways To Eat More Mediterranean-Style

Small changes can make this eating pattern feel realistic and sustainable:

• Add an extra vegetable to lunch or dinner
• Use extra virgin olive oil in meals and dressings
• Include lentils, chickpeas, or beans several times per week
• Choose whole grains more often
• Eat fish regularly
• Add nuts or seeds to breakfast and snacks
• Build meals around minimally processed ingredients
• Reduce the frequency of processed meats

For PCOS/PMOS, these foods can be paired with adequate protein and balanced portions of carbohydrates, fats, and fibre.

What This Study Cannot Tell Us

This was a retrospective, cross-sectional study, meaning the researchers looked at existing information from one point in time.

It can show connections between diet and health markers, but it cannot prove that the Mediterranean diet directly caused the outcomes.

The study also did not account for every factor that may influence metabolic health, including:

• Physical activity
• Smoking
• Socioeconomic circumstances
• Detailed dietary intake
• PCOS/PMOS presentation
• Severity of symptoms
• Menstrual patterns
• Fertility status

The participants were also recruited from one specialist clinic in Türkiye, so further research across more diverse groups would help strengthen the findings.

Bringing It All Together

This study adds to the evidence supporting Mediterranean-style eating as a positive nutritional foundation for women with PCOS/PMOS.

Women who followed this pattern more closely tended to have lower BMI, lower body fat, lower inflammation, and higher levels of protective HDL cholesterol.

While blood sugar and insulin regulation remain more individual and complex, the broader principles of this diet are highly relevant to PCOS/PMOS.

More vegetables, legumes, whole grains, fish, olive oil, nuts, seeds, fibre, and minimally processed foods can provide a practical framework for supporting long-term metabolic and hormonal health.