This randomized clinical trial will test whether a mobile application with personalized Mediterranean diet-based recommendations can improve health outcomes in women with polycystic ovary syndrome compared with standard lifestyle advice.
Participants will be assigned to either the mobile application group or the standard lifestyle advice group.
The primary outcomes are change in LDL cholesterol and change in body mass index after 3 months.
Secondary outcomes include changes in metabolic and hormonal measures, quality of life, treatment adherence, and ovulatory function assessed through 6 months.
Female participants aged 18 to 45 years.
Diagnosis of polycystic ovary syndrome (PCOS) with an anovulatory phenotype according to the Rotterdam criteria (2003).
Clinical and/or biochemical hyperandrogenism.
Polycystic ovarian morphology on ultrasound, defined as at least 20 follicles measuring 2 to 9 mm in either ovary and/or ovarian volume of at least 10 cm3.
Pregnancy or breastfeeding at the time of enrollment.
Planning pregnancy during the study period.
Type 1 or type 2 diabetes mellitus.
Other endocrine disorders that may affect reproductive or metabolic function, including Cushing syndrome, congenital adrenal hyperplasia, androgen-secreting tumors, hyperprolactinemia, or uncontrolled thyroid disease.
Parallel
Mobile Application-Based Personalized Mediterranean Diet and Lifestyle Intervention
BehavioralThe intervention consists of a mobile application providing personalized Mediterranean diet-based nutrition plans, a food database with nutritional information, automatic calculation of caloric intake and macronutrient composition, monitoring of adherence to the Mediterranean diet, physical activity recommendations (including minimum weekly minutes of moderate aerobic activity and strength training), an activity diary with step tracking, automated feedback and motivational messages, weekly progress reports, push notifications with reminders, and educational materials on PCOS and healthy lifestyle. Participants are instructed to use the application daily for 6 months, to enter food intake and physical activity, and to review personalized feedback. The intervention aims to optimize dietary habits, increase physical activity, improve metabolic parameters, and support restoration of ovulatory function in women with PCOS.
Standard Lifestyle Advice for PCOS
BehavioralStandard care consisting of written lifestyle recommendations for women with polycystic ovary syndrome. This includes printed materials describing the Mediterranean diet (principles, recommended and discouraged foods, example menus), physical activity recommendations, and general educational information on PCOS and the importance of lifestyle changes. Participants will receive a one-time dietitian consultation at baseline to review the recommendations and will be advised to keep a paper diary of nutrition and physical activity throughout the follow-up period. No digital application or additional feedback system will be provided.
Change in LDL cholesterol from baseline to 3 months
Serum low-density lipoprotein (LDL) cholesterol concentration measured in mmol/L after an overnight fast
Change in body mass index (BMI) from baseline to 3 months
Body mass index calculated as weight (kg) divided by height (m²)
Change in fasting insulin and HOMA-IR from baseline to 3 months
Fasting serum insulin (μIU/mL) and insulin resistance assessed by HOMA-IR index, calculated as (fasting glucose × fasting insulin) / 22.5. Changes will be calculated as values at 3 months (Visit 2) minus baseline values (Visit 1)
Change in triglycerides and HDL cholesterol from baseline to 3 months
Fasting serum triglycerides and high-density lipoprotein (HDL) cholesterol measured using standard enzymatic methods. Changes will be calculated as values at 3 months (Visit 2) minus baseline (Visit 1).
Proportion of participants achieving at least 5% weight loss at 3 months
Percentage of participants with a reduction in body weight of ≥5% from baseline to 3 months. Weight is measured in light clothing without shoes. Proportion will be compared between groups using chi-square or Fisher's exact test.
Serum total testosterone, free androgen index (calculated), androstenedione and sex hormone-binding globulin (SHBG) measured by immunochemiluminescence assays. Changes will be calculated as 3 month values minus baseline values.
Serum total testosterone, free androgen index (calculated), androstenedione and sex hormone-binding globulin (SHBG) measured by immunochemiluminescence assays. Changes will be calculated as 3 month values minus baseline values.
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