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(OR23-03-26) In-Home Prenatal Nutrition Counseling Improves Diet and Gestational Weight Gain: A Cluster-Randomized Trial in Rural Bangladesh

Monday, July 27, 2026
4:54 PM - 5:06 PM ET
Location: Maryland Ballroom D
Global Nutrition Early Career Scholar Award

    Presenting Author(s)

  • S. M. Tafsir Hasan, MBBS, MS (he/him/his)

    Associate Scientist
    International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
    Dhaka, Dhaka, Bangladesh

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • FA

    Faysal Ahmed

    International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh

  • AN

    Amena Al Nishan

    International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh

  • MK

    Md. Alfazal Khan

    International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh

  • Tahmeed Ahmed, MBBS, PhD

    Executive Director
    International Centre for Diarrhoeal Disease Research
    Dhaka, Dhaka, Bangladesh

Disclosure(s):
S. M. Tafsir Hasan, MBBS, MS: No relevant financial relationship(s) with ineligible companies to disclose.
Tahmeed Ahmed, MBBS, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: To evaluate whether intensive in-home prenatal nutrition counseling improves dietary intake, dietary diversity, and gestational weight gain (GWG) among pregnant women in rural Bangladesh.

Methods: We conducted a community-based, open-label, cluster-randomized controlled trial in rural Matlab, Bangladesh. Twenty community clusters were randomized 1:1 to receive intensive in-home nutrition counseling or standard antenatal care. Pregnant women aged 18–39 years carrying a singleton fetus with BMI 16–24.99 kg/m² were enrolled during the first trimester. Women in the intervention clusters received monthly in-home counseling from 16–36 weeks of gestation, promoting increased energy and protein intake, improved dietary diversity using locally available foods, micronutrient supplementation, and recommended weight gain. Dietary intake was assessed using a validated 7-day quantitative food frequency questionnaire, and dietary diversity using the Minimum Dietary Diversity for Women (MDD-W) indicator at enrollment and 36 weeks. Nutrient intake was estimated using the Bangladesh Food Composition Table. The primary outcome was inadequate GWG rate during the second and third trimesters according to the 2009 Institute of Medicine guidelines. Linear mixed-effects models with random effects for cluster and participant were used to estimate differences in the GWG rate using an intention-to-treat approach.

Results: A total of 147 women in the intervention arm and 138 in the control arm were enrolled. Dietary analyses included 133 intervention and 131 control participants; GWG analyses included 146 and 131, respectively. At 36 weeks, women receiving counseling had higher energy intake (mean difference [MD]: 484.5 kcal/d; 95% CI: 205.6, 763.4) and protein intake (MD: 16.4 g/d; 95% CI: 7.7, 25.2) than controls. The proportion of MDD-W was higher in the intervention group (RR: 1.22; 95% CI: 1.10, 1.35). The rate of GWG during the second and third trimesters was greater among women receiving counseling (MD: 0.05 kg/week; 95% CI: 0.01, 0.08), and the risk of inadequate GWG was lower (RR: 0.66; 95% CI: 0.38, 0.94).

Conclusions: Intensive prenatal nutrition counseling improved dietary intake of energy and protein, dietary diversity, and GWG, and reduced the risk of inadequate GWG among pregnant women in rural Bangladesh.

Funding Sources: icddr,b capacity building fund