Nutritional Status, Dietary Patterns, and the Impact of Structured Lifestyle Education on Knowledge, Attitudes, and Practices Among Urban and Rural Women with Polycystic Ovary Syndrome: A Comparative Interventional Study from Uttar Pradesh, India

Abstract

Background Polycystic Ovary Syndrome (PCOS) is among the most prevalent endocrine disorders in women of reproductive age, with significant metabolic and nutritional implications. Urban-rural disparities in nutritional status and health literacy remain poorly characterised in Uttar Pradesh (U.P.), India. Objectives To assess nutritional status, dietary patterns, and clinical profile of urban and rural PCOS women in U.P., and to evaluate the effectiveness of a structured nutritional education and lifestyle intervention on Knowledge, Attitudes, and Practices (KAP). Methods A comparative pre-post interventional study enrolled 300 women (urban n=150; rural n=150) diagnosed with PCOS. Anthropometric, biochemical, dietary, and KAP assessments were conducted before and after a structured 6-month intervention. Results Fifty percent of participants were overweight or obese (BMI ≥25 kg/m²). Critical micronutrient deficiencies were identified, particularly calcium (<40% RDA), vitamin D (<25% RDA), and dietary fiber (mean 18 g/day vs. recommended 25 g/day). The intervention produced dramatic improvements across all KAP domains (overall total KAP score: 63.85 to 97.36; p<0.001). Rural participants exhibited greater receptivity to the educational programme. Conclusion PCOS women in U.P. — both urban and rural — carry a substantial nutritional burden. Structured nutritional education is a high-impact, scalable intervention for improving health behaviours in this population, particularly in underserved rural communities