Urbanisation – a double-edged sword for diet quality in Africa

By Hannah Ameye and Vivien Hülsen

Africa is the fastest urbanising region globally. Villages are turning into towns, cities are expanding, and a rising share of people now live somewhere between a small market town and a bustling megacity. This has a direct effect on how people eat.

The conventional wisdom has been that urban households eat better thanks to more diverse diets and less hunger. But the situation is considerably more complicated, and effects depend on who you’re assessing. Our research, based on individual-level data from Malawi, paints a more nuanced picture of how diets shift along the rural-urban gradient.

More food, but not always better food

Our study tracks food consumption and nutrient adequacy for over 2,200 individuals, differentiating between men, women, adolescents and children, across a steep rural-to-urban gradient in Malawi's Central Region. We use satellite nightlight imagery as a continuous measure of urbanisation, allowing our assessment to move beyond a simple rural-urban binary.

First, we find that overall calorie intake rises substantially with urbanisation. This is cause for optimism in a setting with high levels of undernourishment. Further, people in more urban areas consume more animal-sourced foods, legumes, and oils and fats, which translates into better adequacy of carbohydrates, protein, fats, iron, zinc and vitamin B12.

However, it is not just the consumption of healthy and micronutrient-dense foods that increases. In the most urbanised areas, consumption of unhealthy food such as refined grains, deep-fried snacks, sweets, sugar-sweetened beverages and processed foods rises sharply. Simultaneously, intake of whole grains, dark green leafy vegetables, fruits and nuts declines. The result is a diet that is higher in calories and some key nutrients, but whose overall composition does not improve, and for some micronutrients even worsens.

Women, children and adolescents bear the brunt

One of our most novel contributions is the ability to assess how diets change for individuals, which reveals that not all household members are affected in the same way. While men experience increases in a broad range of foods with urbanisation, including some unhealthy foods like sugar-sweetened beverages, women, adolescents and children suffer the sharpest deterioration in relative diet quality.

Adolescents, for instance, show the largest increase in consumption of refined grains and deep-fried foods of any group (see Figure below).

Effects of urbanisation on unhealthy food group consumption (g/day)

Note: The graph shows the regression results of the effects of urbanisation, proxied by nightlight intensity, on the consumption of unhealthy food groups. The bar length indicates the strength of the relationship, with insignificant results at the 10% level highlighted in grey.

Children and adolescents in highly urbanised areas also consume significantly more sweets and juice than their rural counterparts, while eating fewer whole grains, fruits and leafy vegetables that are the foundation of nutritious diets (see Figure below). For both, the strong improvements in macronutrient adequacy with urbanisation are not accompanied by equally strong increases in calcium or vitamin adequacy. One exception is vitamin B12, which is driven by higher animal product consumption.

Effects of urbanisation on healthy food group consumption (g/day)

Note: The graph shows the regression results of the effects of urbanisation, proxied by nightlight intensity, on the consumption of unhealthy food groups. The bar length indicates the strength of the relationship, with insignificant results at the 10 per cent level highlighted in grey.

Women show similar trends with significantly higher consumption of refined grains, starches and fried foods compared to men, whilst improvements in meat consumption and associated nutrients remains lower. The shift away from traditional, nutrient-rich staples towards processed convenience foods appears to hit the young and female members of households hardest.

This matters enormously given Malawi's existing burden of malnutrition. Female overweight and obesity are rising quickly, with obesity among women now exceeding rates of female undernutrition. Urban growth, if unmanaged, risks accelerating this trend while leaving pockets of micronutrient deficiencies untouched.

What drives the change? Income and food environments

We further explore the factors behind these dietary shifts. We find evidence of two key pathways through which urbanisation changes diets: rising household income and changing food environments.

With changing food environments in urban areas, vegetables are often considered inferior food. 
Photo: Vivien Hülsen

Income is the single most important driver. With rising income-generating opportunities in urban areas, purchasing power rises and food spending changes. In settings of high undernutrition, even modest income gains tend to increase food consumption broadly, including both nutritious and less healthy options. Access to a wider variety of foods, and particularly animal-sourced foods, in urban markets also plays a positive role for some micronutrients.

But changing food environments introduce risks as well. Urban markets offer not only greater variety but also a proliferation of cheap, energy-dense processed foods. Preferences shift, too. In Malawi, animal-sourced foods and processed snacks are desirable, while the opposite holds true for vegetables, often considered inferior foods. These attitudes, which intensify with urbanisation, can undermine dietary quality even as incomes rise.

Policy implications: act now, act specifically

Malawi is at a tipping point, similarly to many other sub-Saharan African countries. Urban food environments still contain many nutritious traditional options, with street vendors selling roasted nuts, fresh fruits and traditional dishes. But this window will narrow as globalised fast food and ultra-processed products continue to penetrate lower-income markets.

What is needed is double-duty policies: interventions that simultaneously address undernutrition and prevent the rise of overweight and non-communicable diseases. These cannot be one-size-fits-all. Given the distinct vulnerabilities of women, adolescents and children, policies must be tailored by demographic group.

Practically, this points to several areas of action. Urban planning should prioritise maintaining (and expanding) access to food markets where nutritious foods are available, affordable and safe, including traditional and informal food vendors, while regulating the expansion of cheap, energy-dense processed foods that disproportionately affect women, children and adolescents. Addressing food preferences and the desirability associated with different foods may require more targeted campaigns.

Hannah Ameye is a senior researcher at the Center for Development Research (ZEF) at the University of Bonn, Germany.
Contact: hameye(at)uni-bonn.de

Vivien Hülsen is a postdoctoral researcher in the Department of Agricultural Economics and Rural Development at the University of Göttingen, Germany.
Contact: vivien.huelsen(at)uni-goettingen.de

This article is based on: Hülsen V., Ameye H. & Qaim M. (2026). Urbanization and individual dietary quality: Insights from Malawi. Habitat International 172, 103794.
https://doi.org/10.1016/j.habitatint.2026.103794

Further reading:

Rural 21 Dossier on "Food security and nutrition"

Rural 21, issue 03/2020: Changing times, changing diets

Rural 21, issue 04/2018: Rural-urban linkages