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Abstract
Many low income countries are experiencing a “nutrition transition” towards the consumption of more
energy-dense, highly processed foods and beverages that are often high in caloric sweeteners, fat and salt.
Changing lifestyles and urbanisation have coincided with a ‘retail revolution’, a rapid advance of
supermarkets even in remote areas. Among the consequences of the nutrition transition have been
expanding waistlines and surging rates of nutrition-related non-communicable diseases, including diabetes,
heart diseases and certain cancers. Given the still prevailing rates of under-nutrition, affected countries
face a double burden of malnutrition, and individuals that have overcome food poverty risk often remain
health-poor. The effect of supermarkets on consumers’ diets and the nutrition transition remains unclear:
By offering stable and consistent access to a wide range of foods with different dietary qualities,
supermarkets could either discourage or contribute to the consumption of a well-balanced diet. This paper
investigates the effect of supermarkets on consumption patterns using cross-sectional household survey
data collected in Kenya in 2012. In order to establish causality, our sample was designed to be quasiexperimental
in nature, with study sites differing in terms of supermarket access. We employ instrumental
variable techniques to account for potential endogeneity due to selection effects regarding supermarket
purchases. Our findings suggest that supermarket purchases increase the consumption of processed foods
at the expense of unprocessed foods. Supermarkets are associated with higher expenditure shares and
calorie shares of processed foods, and with increased per capita calorie availability. The latter effect is
supported by lower prices per calorie for processed food items. Supermarket purchases have a positive
effect on dietary diversity, but implications for the nutrient adequacy of consumers remain unclear.