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While the effects of supermarket shopping on adult nutrition and health are negative and undesirable (higher rates of overweight/obesity and NCDs), the implications for children are quite different. Focusing on the same households in central Kenya as surveyed by Demmler et al. [21, 22], Debela et al. [24] used panel data from children/adolescents between 2 and 18 years of age. Figure 1 depicts descriptive results showing that stunting and underweight are prevalent in 15 and 7% of all children in the study area, respectively. Furthermore, there is a significantly lower prevalence of stunting in children/adolescents from households that obtain foods from supermarkets (10%) than in children from households that obtain foods solely from traditional sources (21%). Running panel data regression models, Debela et al. [24] confirmed that supermarket shopping has a significantly positive effect on child height, increasing height-for-age Z-scores by 0.34, even after controlling for confounding factors like household expenditures, sanitary aspects, age of the child, and mother’s attributes (body height, education, and age). Supermarket shopping also increases child weight-for-age Z-scores, but the effect is much smaller and no significant effect on child overweight was found [24].

Fig. 2. Comparison of mean FVS (a) and DDS (b) for households shopping and not shopping in supermarkets. FVS based on food item count; DDS based on 12 food groups. Less healthy food items/groups excluded for FVS 2/DDS 2 are fats, oils, sugar, sweets, and spices. *** Difference between households shopping and not shopping in supermarkets significant at the 1% level. Authors’ presentation based on data from Debela et al. [24].

The nutritional improvements in children/adolescents through supermarket shopping seem to be mainly caused by increased dietary diversity [24]. Households that buy food in supermarkets have significantly higher food variety scores (FVS) and dietary diversity scores (DDS) than households that obtain all foods from traditional sources (Fig. 2). One concern could be that supermarket shopping would especially increase the consumption of unhealthy food items, which could drive up FVS and DDS without necessarily increasing dietary quality and micronutrient supply. However, significant differences also remain after excluding the food items/groups that are considered less healthy (Fig. 2). Even though supermarket shoppers consume more processed foods, their diets seem to be more protein and micronutrient rich, especially through higher and more regular consumption of animal-source foods [24]. These additional nutrients are beneficial for child growth, especially in situations where child stunting is still an issue.