Health and Nutritional Outcomes Among Young Females and Children in Southwest Bangladesh (AQUAFOOD)

Health and Nutritional Outcomes Among Young Females and Children in Southwest Bangladesh: A Cohort Study

This study aims to examine how societal and climate changes influence the nutritional status and fish consumption of young women over a 10 year period in southern Bangladesh, and how these factors affect their children's health. A cohort of 240 adolescents first studied in 2017 will be followed to assess changes in their dietary patterns, nutritional status, climate perceptions and mitigation practices, as well as the nutritional status of their children aged 6 months to 5 years.

The study in 2017 sampled 60 adolescent girls in each of four rural communities, plus a semi-rural community around a fish processing plant, representing in total 5 communities. Of these 60 X 5 = 300 girls, the current study follows up the individuals in the rural communities representing a cohort of 240.

Bangladesh faces high rates of adolescent malnutrition, with many girls married before 18 and suffering from chronic nutrient deficiencies. These issues have long-term impacts on health, productivity, and intergenerational well-being. By linking the fisheries and aquaculture sector, a key to Bangladesh's economy with public health and nutrition, this research aims to guide targeted policies for vulnerable coastal communities.

Study Overview

• Status: Not yet recruiting
• Conditions: Nutritional Status; Markers of Inflammation; Diet Diversity; Micronutrient Status; Omega 3 Fat Status; Climate Adaptation; Climate Change Awareness
• Intervention / Treatment: Other: The follow-up aims to evaluate natural changes occurring from adolescence to young adulthood with respect to the study objectives due to lifestyle and environmental factors, without any intervention.

Detailed Description

Aquatic foods are fundamental to the Bangladeshi diet, providing nearly two-thirds of total animal protein. Despite this, malnutrition remains a severe public health crisis with a complex etiology. Bangladesh faces a double burden of malnutrition, marked by persistently high rates of micronutrient deficiencies affecting roughly half of both pregnant and non-pregnant women alongside rising levels of overweight and obesity. These challenges are further exacerbated by substantial intrahousehold inequities in this patriarchal society. Disempowerment and early marriage disproportionately expose adolescent girls and young women to inadequate nutrient intake and poor health outcomes, perpetuating an intergenerational cycle of malnutrition. Furthermore, chronic undernutrition and stunting continue to affect a large proportion of children under five.

The problem is particularly acute in coastal communities, where climate change impacts such as salinity intrusion and extreme weather compromise food production and dietary diversity. Understanding and improving the dietary and nutritional status of adolescent girls and young women is therefore essential to breaking the cycle of poor health and ensuring long-term population well-being. Building on a 2017 study conducted with a cohort of 240 adolescents, this research aims to provide longitudinal insights into how nutritional status, female autonomy, aquatic food consumption, and dietary practices have influenced the health and well-being of these women and their children nearly after 10 years.

Hypotheses

1. Nutritional status, fish consumption, and female autonomy during adolescence (2017) influence the nutritional status of young women in 2026 and that of their offspring.
2. Fish consumption is positively associated with biological markers (omega-3 fatty acids, vitamin D levels, and stable isotope ratios in hair).

Objectives

1. To assess changes in nutritional status, fish intake, socioeconomic factors, and female autonomy among young women from 2017 to 2026, and examine their associations with the nutritional status of their children (6 months-5 years).
2. To investigate associations between assessed fish consumption and biological markers (omega-3, vitamin D, and stable isotope ratios in hair).

The study will be conducted in four distinct saline gradient agro-ecological zones across the shrimp-prawn farming regions of southwest Bangladesh, specifically in Fakirhat (Bagerhat District), Dumuria and Paikgacha (Khulna District), and Shyamnagor (Satkhira District).

• Study Type: Observational
• Enrollment (Estimated): 240

Contacts and Locations

• Study Contact: Name: Nanna Roos, PhD; Phone Number: +45 3532 0829; Email: nexs@nexs.ku.dk

Study Locations

• Bangladesh
  • Capital Region
    • Dhaka, Capital Region, Bangladesh, 1000
      • International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b)
      • Contact: Gulshan Ara, MSc; Phone Number: +8802982700110; Email: gulshan.ara@icddrb.org

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population is 240 young women who were studied as adolescents in 2017, now young women aged 22-26 years. If they have child aged 6 months to 5 years, the youngest child is included.

Description

Inclusion Criteria:

• Young women aged 22-27 years who previously participated in the 2017 study. See study description.
• If the women has a child age between 6 months to 5 years, the child child is included to be assessed

Exclusion Criteria:

• Participants with serious health conditions that may interfere with study procedures or data collection.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Follow-up of adolescent girls from 2017 to 2026; The cohort of adolescent girls enrolled in 2017 at ages 12-16 will be followed up in 2026 to assess changes in their socioeconomic status, nutritional status, dietary intake, and women empowerment, and to examine how these factors are associated with the nutritional status of their children aged 6 months-5 years.	Other: The follow-up aims to evaluate natural changes occurring from adolescence to young adulthood with respect to the study objectives due to lifestyle and environmental factors, without any intervention.; There is no intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Omega-3 status	Eicosapentaenoic acid (EPA) in whole blood (% of total fatty acid)	One sampling point between April and August 2026
Omega-3 status	Docosahexaenoic acid (DHA) in whole blood (% of total fatty acid)	One sampling point between April and August 2026
Micronutrient status	Vitamin D (total 25-hydroxyvitamin D) concentration in blood, nmol/L	One sampling point between April and August 2026
Micronutrient status	Hemoglobin concentration in blood (g/dL)	One sampling point between April and August 2026
Micronutrient status	Ferritin concentration in blood (µg/L)	One sampling point between April and August 2026
Inflammation status	C-reactive protein concentration in blood (mg/L)	One sampling point between April and August 2026
Inflammation status	Alpha-1-acid glycoprotein concentration in blood (g/L)	One sampling point between April and August 2026

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nutritional status	Height (cm)	One measurement between April and August 2026
Nutritional status	Weight (kg)	One measurement between April and August 2026
Nutritional status	Mid-upper arm circumference (cm)	One measurement between April and August 2026
Nutritional status	Body mass index (kg/m^2)	Between April and August 2026
Hair stable isotopes ratio	Isotope ratios of δ13C and δ15N in hair sample	Between April 2026 to August 2026
Fish consumption	7 days recall, questionnaire	Between April and August 2026

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Climate change perception and mitigation practice	Climate change and mitigation practice, questionnaire	Between April and August 2026
Women empowerment	Women empowerment will be obtained using women empowerment assessment tool, questionnaire.	Between April and August 2026
Dietary pattern, food frequency	Dietary pattern by food groups, questionnaire	Between April 2026 to August 2026
Child omega-3 status	If a woman has a child aged 6-59 months, the child is assessed for EPA concentration in blood (% of total fatty acids).	One timepoint between April and August 2026
Child omega-3 status	If the woman has a child aged 6 months to 5 years, the child is measured for DHA concentration in blood (% of total fatty acid)	One measure between April and August 2026
Micronutrient status, Child	If the woman has a child aged 6 months to 5 years, the child is measured for hemoglobin concentration in blood (g/L)	April-August 2026
Micronutrient status, Child	If the woman has a child aged 6 months to 5 years, ferritin concentration in blood (µg/L), will be measured.	One sampling point between April and August 2026
Micronutrient status, Child	If the woman has a child aged 6 months to 5 years, Vitamin D (total 25-hydroxyvitamin D) concentration in blood, nmol/L will be measured.	One sampling point between April and August 2026
Inflammation status, Child	If the woman has a child aged 6 months to 5 years, the child's C-reactive protein concentration in blood (mg/L) will be measured.	One sampling point between April and August 2026
Inflammation status, Child	If the woman has a child aged 6 months to 5 years, alpha-1-acid glycoprotein concentration in blood (g/L) will be measured.	One sampling point between April and August 2026
Nutritional status, Child	If the woman has a child aged 6-59 months, the child's length/height (cm) is measured.	Between April and August 2026
Nutritional status, Child	If the women has a child aged 6-59 months, the child is measured for weight (kg)	April-August 2026
Nutritional status, Child	If the woman has a child aged 6-59 months, the child is measured for MUAC (cm)	April-August 2026

Collaborators and Investigators

• Sponsor: University of Copenhagen
• Collaborators: University of Aberdeen; University of Stirling; International Center for Diarrheal Disease Research, Bangladesh (icddr,b); Noakhali Science and Technology University; Bangladesh Agricultural University (BAU)

Publications and helpful links

General Publications

• Ara, G., Little, DC, Mamun, AA, De Roos, B., Grieve, E., Khanam, M., ... & Roos, N. (2023). Factors affecting the micronutrient status of adolescent girls living in complex agro-aquatic ecological zones of Bangladesh. Scientific Reports , 13 (1), 6631.
• Grieve, E., Mamun, A. A., De Roos, B., Barman, B. K., Ara, G., Roos, N., ... & Little, D. C. (2023). Adolescent girls in aquaculture ecozones at risk of nutrient deficiency in Bangladesh development and validation of an integrated metric. BMC Public Health, 23(1), 405.

Helpful Links

• Description of the AQUAFOOD project, available on the University of Copenhagen, Department of Nutrition, Exercise and Sports website.

Study record dates

Study Major Dates

• Study Start (Estimated): April 15, 2026
• Primary Completion (Estimated): August 5, 2026
• Study Completion (Estimated): December 10, 2026

Study Registration Dates

• First Submitted: March 27, 2026
• First Submitted That Met QC Criteria: April 16, 2026
• First Posted (Actual): April 21, 2026

Study Record Updates

• Last Update Posted (Actual): May 6, 2026
• Last Update Submitted That Met QC Criteria: April 30, 2026
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Bangladesh; dietary biomarkers; adolescent nutrition; Aquatic foods; fish intake assessment; climate adaptation; intergenerational nutrition
• Other Study ID Numbers: PR-25044

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: According to the ethical approval, individual participant data cannot be shared with external parties and may only be obtained from the study coordinators upon reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No