There is an urgent need to transform global food systems into sustainable models which provide affordable, healthy, and micronutrient rich foods for all. This requires data-driven interventions and policies guided by rigorous food system performance assessments. Life Cycle Assessment (LCA) modelling is increasingly being used to evaluate the combined environmental and nutritional performance of food systems, known as nutritional Life Cycle Assessments (n-LCA). This study utilised novel n-LCA methodology to assess tilapia aquaculture and integrated agriculture-aquaculture systems in Bangladesh. The environmental and nutritional performance of fishponds, rice-fish co-culture, and poultry-fish co-culture was assessed by combining a nutrition metric, the Potential Nutrient Adequacy (PNA) metric, with LCA methods. Micronutrient affordability assessments were also performed to further evaluate the nutritional performance of the farming systems. Although poultry-fish farms were found to have the highest nutritional quality, stand-alone fishponds were found to have better environmental performance overall compared to the rice-fish and poultry-fish farms when nutrition was combined in the LCA. Results show feeds, fertilisers, energy, and chemical inputs have higher environmental impacts compared to other material inputs across all farm types. Results from the affordability assessment identified tilapia and two other fish species (Cirrhinus mrigala and Esomus danricus) as the most affordable sources of essential micronutrients. T hese three fish species have a better environmental footprint compared to the other 17 fish species across the three farming systems. This study provides an important example of how nutritional impact can be combined with Life Cycle Assessments and offers insight into the way nutrition metrics can effect the overall results of environmental performance assessments. Utilising the P otential N utrient Adequacy metric as a nutritional functional unit provides a more transparent approach to food system LCAs, although further development, testing, and validation of n-LCA methodology is needed to refine the process of combining performance assessments. The nutritional quality of tilapia has been undervalued in the literature, but it is shown here that tilapia can provide sustainable, affordable nutrition to populations across Bangladesh.