Association of Seafood Consumption and Nutritional Status Among Adolescent Girls (AQUAFOOD)

Association of Seafood Consumption and Nutritional Status Among Adolescent Girls Living in Different Aquatic Ecological Zones in Southwestern Bangladesh

This study examines how seafood consumption, social changes, and climate change affect the nutrition and well-being of adolescent girls in south-western Bangladesh. Many adolescent girls face poor nutrition, early marriage, and limited access to adequate diets. Adolescent girls have high nutritional needs due to growth and potential early motherhood. Seafood, including fish, shrimp, and prawns, provides important nutrients such as omega-3 fatty acids, but little is known about how its consumption relates to nutritional status in this population.

The study will collect new data from adolescent girls in the same area as a 2017 study (IMMANA study), assessing dietary pattern, nutritional status, socioeconomic conditions, and female autonomy. It will also explore how climate change affects household food access and nutrition to provide policies linking food systems and public health.

Study Overview

• Status: Not yet recruiting
• Conditions: Nutritional Status; Climate Change; Micronutrient Status; Omega 3 Fat Status; Fish Consumption; Dietary Pattern; Female Autonomy
• Intervention / Treatment: Other: Assess natural behavior

Detailed Description

Adolescents make up a large share of Bangladesh's population, with 27.7 million aged 10-19 years. Adolescent girls are particularly vulnerable due to high nutritional needs for growth and the risk of early marriage and motherhood. National data show widespread undernutrition: about one-third of girls aged 15-19 are chronically energy deficient, with many experiencing thinness or stunting. Smaller studies suggest similar concerns among younger adolescents, including inadequate intake of both macro- and micronutrients and limited dietary knowledge.

Fish is a key source of essential nutrients in Bangladesh, providing high-quality protein, omega-3 fatty acids (DHA and EPA), and bioavailable micronutrients such as vitamin A, iodine, iron, and zinc. Evidence shows that fish consumption supports cardiovascular health and child development and is associated with improved birth outcomes. Small indigenous fish species are particularly nutrient-dense, and integrated aquaculture systems can further improve dietary diversity. Despite this, the relationship between seafood intake and nutritional status among adolescent girls remains underexplored.

Aquaculture is a rapidly growing sector in Bangladesh, contributing significantly to food systems, livelihoods, and the economy. However, coastal and estuarine regions face environmental challenges such as salinity changes and climate variability, affecting food production and access. Communities in these areas remain vulnerable to poor nutrition despite living in resource-rich environments, and there is limited integration between fisheries and public health policies.

This study will collect new data from adolescent girls in the same area as a 2017 study in two seasons. It will assess dietary intake, nutritional status, socioeconomic conditions, and female autonomy, and explore how climate change influences household food access and nutrition.

Objectives:

1. To assess seafood consumption patterns among adolescent girls.
2. To examine the association between seafood consumption and anthropometric measurements in adolescent girls.
3. To evaluate the relationship between seafood consumption and blood levels of omega 3, vitamin D, ferritin, retinol, vitamin B12, as well as urinary iodine concentration.
4. To assess the quality of life of adolescent girls by measuring selected relevant capabilities.
5. To develop an integrated metric of nutritional well being by linking seafood consumption, nutritional outcomes, quality of life, and farming systems.

• Study Type: Observational
• Enrollment (Estimated): 300

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, PhD; Phone Number: 88 02 2222 77 001-10; Email: gulshan.ara@icddrb.org

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Probability Sample

Study Population

The study will recruit 300 adolescent girls aged 12-16 years from the same study area as the 2017 IMMANA study. This will allow comparison of changes over the past 10 years in dietary patterns, nutritional status, fish consumption, and micronutrient status including blood levels of omega-3 fatty acids.

Description

Inclusion Criteria:

• Adolescent girls aged between 12-16 years
• Residing in the same study area as the 2017 IMMANA study
• Willing to participate and provide informed consent

Exclusion Criteria:

• Any health condition that may affect anthropometric measurements
• Severe illness that may interfere with physical or biochemical assessments

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Cross-sectional assessment of adolescent girls; Adolescent girls' diet, nutritional status, socioeconomic conditions, and female autonomy, and climate change impacts on food access and nutrition will be assessed in two seasons.	Other: Assess natural behavior; No intervention; Other Names: 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	Serum levels of vitamin D (total 25-hydroxyvitamin D), nmol/L	One sampling point between April and August 2026
Micronutrient status	Serum levels of Ferritin (µg/L)	One sampling point between April and August 2026
Micronutrient status	serum levels of retinol (μmol/L)	One sampling point between April and August 2026
Micronutrient status	Serum levels of vitamin B12 (ng/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
Inflammation status	serum levels of C-reactive protein concentration (mg/L)	One sampling point between April and August 2026
Inflammation status	Serum levels of alpha-1-acid glycoprotein (g/L)	One sampling point between April and August 2026
Micronutrient status	Iodine levels in urine will be measured (UNIT)	Between April and August

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Fish consumption pattern over the last seven days	Fish consumption patterns will be assessed using a 7-day food frequency questionnaire. Higher fish consumption is expected to correspond to better omega-3 status among the adolescent girls.	Between April and August 2026
Dietary pattern assessment	Dietary patterns will be assessed using a 7-day food frequency questionnaire. The number of food groups consumed will be calculated. In general consuming ≥5 food groups out of 10 is considered the minimum threshold for the dietary diversity score although this depends on age.	Between April 2026 to August 2026
Female autonomy	Female autonomy will be assessed using a standardized female autonomy questionnaire. Autonomy will be scored based on a total of 32 items covering seven domains. Higher scores indicate greater female autonomy.	Between April 2026 to August 2026

Collaborators and Investigators

• Sponsor: University of Copenhagen
• Collaborators: University of Aberdeen; University of Stirling; Noakhali Science and Technology University; Bangladesh Agricultural University (BAU); The International Centre for Diarrhoeal Disease Research, Bangladesh
• Investigators: Principal Investigator: Gulshan Ara, PhD, International Centre for Diarrhoeal Disease Research, Bangladesh

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 25, 2026
• Primary Completion (Estimated): September 10, 2026
• Study Completion (Estimated): December 15, 2026

Study Registration Dates

• First Submitted: April 16, 2026
• First Submitted That Met QC Criteria: April 21, 2026
• First Posted (Actual): April 29, 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: Nutritional status; Climate change; Adolescent nutrition; Aquaculture; Fish consumption; Female autonomy
• Other Study ID Numbers: PR-25055-AQUAFOOD

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: As per the ethical approval, participant data will not be shared publicly. Anonymised data can be shared by study coordinator 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