Food Environments and Diet Quality Among Vendors and Consumers in Five Traditional Urban Markets in Kenya

Abstract

Background/Objectives: Traditional food markets are essential in urban food environments in Kenya and other low- and middle-income countries (LMICs). They provide affordable fresh food, particularly for low-income urban communities, and are vital places of livelihoods and local economic activities. Despite their importance, associations between market-related factors and diet quality for vendors and consumers are underexplored. This study explores these relationships to inform policies aimed at improving diets and nutrition in LMICs. Methods: Survey data were collected from 1042 vendors and 876 consumers in five urban markets in Kenya. The survey assessed market-related factors, consumer purchasing behavior, socioeconomic factors, and dietary outcomes using the Kenya Diet Quality Questionnaire. Linear regression models were employed to evaluate associations between the availability of foods, consumers’ purchase of foods, proximity to the market, reported sickness from food, and diet quality indicators, including the Dietary Diversity Score (DDS), Global Dietary Recommendations (GDRs), NCD-Protect, and NCD-Risk scores. Results: Vendors’ own dietary outcomes were characterized by lower DDS, NCD-Protect, and NCD-Risk scores but higher GDR scores compared to consumers. Significant associations were identified between the purchase of specific food groups (e.g., vegetables, legumes, and nuts) and improved diet quality for consumers. Longer travel times were linked to lower diet quality for both vendors and consumers. Socioeconomic factors, such as gender, age, and education, significantly influenced diet quality. Conclusions: Traditional markets play a pivotal role in urban food environments. Policies that enhance market access and support vendors and consumers, particularly women, young adults, and low-income groups, are essential to improving diets and nutrition outcomes in LMICs.