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.

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).

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.

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.

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.