Urbanization and individual dietary quality: Insights from Malawi

Urbanization has vast implications for diets in Africa. Existing evidence from household-level data suggests that diet quality changes with the degree of urbanization, but how diets of specific household members are affected remains unclear. We combine geocoded, individual-level food consumption data from Malawi with satellite nightlight imageries to assess diets and nutrient adequacy along a rural-urban gradient for men, women, adolescents, and children. We find that overall food consumption increases with urbanization, leading to higher macronutrient adequacy and lower rates of undernourishment in urban areas. However, in highly urbanized regions, relative diet quality worsens, especially for women, adolescents, and children, due to higher unhealthy food consumption. Furthermore, micronutrient adequacy increase much less than macronutrient adequacy along the rural-urban gradient. The effects of urbanization on diet quality are largely mediated through changes in income and food environments. Our findings call for nutrition-sensitive and subgroup-specific urban planning policies when tackling malnutrition.