Health crisis : Poor diet costs Kenya close to Sh400 billion

IT is Thursday lunch hour in Westlands, Nairobi. Outside a food kiosk, the air is thick with steam and chatter as construction workers crowd the counter, waiting to be served.

Bernard Otieno (not his real name) and his colleagues are ordering the same meal — ugali, beans and sukuma wiki.

At Sh100 a plate, it is the only food they can afford and still make it home with “something” left for their families.

“There are fruits sold around here, ranging between Sh70 and Sh150, but for me, there are games I can’t engage in, having already spent Sh100 on food. Any amount above that will be eating into other needs in the budget,” Otieno says as he rises too return to work.

Otieno’s lunch break mirrors the bigger national story backed by sobering data from the Food and Agriculture Organization and the World Bank. Nearly 80 per cent of Kenyans cannot afford a balanced diet.

Poor diet not only poses health issues to the population but also has a devastating impact on the country’s economy.

Studies show that malnutrition significantly hinders Kenya's economy by reducing labour productivity, increasing healthcare costs, and impacting education, leading to substantial GDP losses, estimated at nearly Sh400 billion or seven per cent of the Gross Domestic Product.

The latest Cost of Hunger in Africa Kenya Study indicates that this loss stems from impaired cognitive development, higher disease burdens, and repeated school years, trapping families in poverty, with potential economic returns of $22 (Sh2,816) for every $1 (Sh128) invested in nutrition.

Kenya faces a triple burden of undernutrition (stunting, wasting), micronutrient deficiencies, and rising obesity. 

Obesity is a growing concern, with recent data by the Global Nutrition Health showing that over 2.7 million women and 760,000 men are obese, accounting for 10-13 per cent of the total population.

Trends show higher rates in urban areas and among women, impacting millions with rising lifestyle-related health risks.

In 2019, the economic impact of overweight and obesity was estimated to be $742.57 million. This is equivalent to $14 per capita and 0.7 per cent of GDP.

Direct costs and indirect costs made up 18.4 per cent and 81.6 per cent of total costs, respectively. By 2060, economic impacts are predicted to increase to $10.94 billion.

This is equivalent to $107 per capita and 2.1 per cent of GDP, and represents a 15-fold increase in total costs.

Poor diet is among the leading causes of death in Kenya after respiratory-related problems.

Nearly four out of every 10 deaths in Kenya are now caused by non-communicable diseases such as diabetes, heart disease, and cancer  - a growing public health catastrophe fuelled by processed foods laden with sugar, salt, and fat.

The alarming statistics from the Kenya Nutrient Profile Model 2025 report by the Ministry of Health reveal that NCDs account for 39 per cent of all deaths, over 50 per cent of hospital admissions and 55 per cent of hospital deaths in the country.

The findings paint a grim picture of a nation grappling with a dietary crisis, where at least one in four adults aged 18-69 years and four per cent of children under five is either overweight or obese.

The ministry warns that excess consumption of foods high in calories, fats and sugar, combined with inadequate physical activity, is directly associated with increased risk of overweight and obesity.

It identified unhealthy diets - characterised by foods and beverages high in fat, salt and sugar - as one of the major modifiable risk factors for NCDs.

The study underscores how dietary shifts, combined with decreased physical activity levels, have created a perfect storm for the proliferation of lifestyle diseases across all demographic groups.

According to the report, the crisis disproportionately affects women, with 36.9 per cent of Kenyan women aged 18 and above being overweight and 13.4 per cent obese, representing a combined total of over half the adult female population struggling with weight-related health issues.

In sharp contrast, 17.3 per cent of men are overweight and 3.6 per cent are obese.

While a balanced diet promises good dividends to the population, affordability is a key issue, considering that nearly half of Kenya’s population survives on less than Sh130 a day, with the number of people living in extreme poverty rising to seven million since 2015.

A report by Oxfam Kenya dubbed ‘’Kenya’s Inequality Crisis: The Great Economic Divide’’ released late last year indicates that food prices have hit 50 per cent higher than in 2020, leaving ordinary households struggling to make ends meet.

The World Bank estimates that it would cost a minimum of $4.26 (Sh549.5). This is the lowest-cost set of foods available that would meet requirements in dietary guidelines from governments and public health agencies.

It defines a balanced diet as one that provides sufficient calories alongside fruits, vegetables, lean proteins, whole grains, legumes, and fats in the proportions recommended by dietary guidelines is essential for good health.

Eating a balanced diet in Kenya has become an increasingly steep climb for millions of families.  A 2022 survey by KNBS found that many Kenyans spend Sh200-399 daily (Sh6,000-12,000 monthly) on food, with lower earners often in this bracket. 

An analysis by FAO and World Bank data shows that the cheapest possible combination of foods that meets these requirements costs more than many Kenyans earn or can spare after rent, transport, school fees and healthcare.

Several nutrition assessments have also shown that the interplay of economic pressures, rising food prices, food system weaknesses, and shifting consumption patterns has made a healthy diet elusive for most Kenyans.

This has resulted in high medical costs for households, with catastrophic out-of-pocket expenditure exceeding 10 per cent and 25 per cent of monthly income being assessed in a study published by the BMJ Public Health Journal, dubbed 'Catastrophic expenditure associated with childhood hospitalisation for acute illness in Kenya and Uganda.'

According to the survey involving 731 children hospitalised for acute illness, to evaluate direct and indirect costs incurred by caregivers and families, the median (IQR) total cost during hospitalisation per child was $47 (Sh6,016), with higher costs for children with CSM, especially during hospitalisation ($56 (Sh7,168)($26–$99) compared to $36 (Sh4,608) ($20–$65).

During hospitalisation, bed charges followed by food were the main cost drivers. Caregivers reported losing a median of 7 (4–11) days of productive time during a child’s hospitalisation, with a mean loss of income of $10 to $25.6. 

As nutritious foods become more expensive, households shift toward cheaper, calorie-dense staples, mainly refined grains, while cutting back on fruits, vegetables, and protein.

The result is a paradox: people may not feel hungry, yet remain nutrient-deficient.

The World Bank notes that while staples like maize are relatively affordable, nutrient-dense foods such as fruits, vegetables, eggs, and animal proteins drive the cost of healthy diets upward.

The global banker warns that children in households unable to afford healthy diets are more likely to experience stunting, weakened immunity, and poor school performance. These effects often last a lifetime, reducing productivity and increasing healthcare costs later on.

The head of the Division of Nutrition and Dietetics, Veronica Kirogo, says that unhealthy diets remain a concern, with only five adults consuming recommended daily servings of fruits and vegetables, while just 49 per cent of women meet the minimum dietary diversity.

A clinical nutritionist at AAR Hospital,  Dorcas Anyango, says that lack of balanced diets places immense pressure on Kenya’s health system by increasing preventable conditions such as anaemia, recurrent infections, poor maternal and neonatal outcomes, and childhood growth failure. It also accelerates the rise of non-communicable diseases, including diabetes, hypertension, and obesity, which require long-term and costly management.

"Health facilities are increasingly overwhelmed in managing nutrition-related illnesses that could largely be prevented through adequate and balanced diets,'' she told the Star. 

She adds that malnutrition leads to increased illness, disease complications, and healthcare costs at both individual and national levels.

"Poor nutrition reduces physical strength, mental capacity, and work efficiency, resulting in absenteeism and reduced labour output. In children, malnutrition impairs cognitive development, school attendance, and academic performance, limiting future economic potential. This creates an intergenerational cycle of poverty, where poor nutrition reduces productivity and income, further limiting access to nutritious food and healthcare, ultimately slowing national economic growth."

According to Anyango, many individuals may appear healthy but live with chronic fatigue, low immunity, and nutrient deficiencies that silently diminish quality of life and productivity.

"Beyond severe malnutrition, there are many hidden and often overlooked consequences of poor dietary balance. These include weakened immunity, frequent illness, delayed wound healing, poor mental health, reduced memory and concentration, hormonal imbalances, reduced work capacity, and increased pregnancy and childbirth complications."

In terms of general productivity, the International Labour Organisation says that poor diet on the job is costing developing nations, Kenya included, up to 20 per cent in lost productivity, either due to malnutrition that plagues one billion people in developing countries or the excess weight and obesity afflicting an equal number. 

 The World Bank’s 2025 'Cost and Affordability of Healthy Diets' indicators show that while global food prices have stabilised slightly, Sub-Saharan Africa remains the most unaffordable region for nutritious diets because incomes have not kept pace with food costs.

In Kenya, inflation has dropped from 9.2 per cent in 2022 to an average of four per cent in 2025, but consumers are still feeling the pressure to afford basic commodities.

According to the Consumer Federation of Kenya, disposable income has shrunk for many families which have been leaving them barely surviving, a situation that may make a balanced diet seem like a luxury.

“Headline inflation figures may suggest stability, for political optics, but they mask a deeper reality: real incomes have continued to significantly decline. Wages have failed to keep pace with the rising cost of essentials— food, transport, electricity, rent and taxation,” Cofek secretary general Stephen Mutoro told the Star.

“The result is that households have little or nothing left after meeting basic needs. Yet the expenditure side keeps climbing north.”

From a consumer protection perspective, this should concern policymakers, said Mutoro, who noted that when households are forced to cut back on spending, the ripple effects are felt across the entire economy, particularly among informal traders and small enterprises.

“Cofek’s position is that economic success must be measured not only by macro-economic indicators, but by household welfare,” he said.

To ease this pressure on the economy, the Kenyan government has, over the years, rolled out several initiatives, including the nutrient profile model developed last year in efforts to address the rising burden of diet-related non-communicable diseases.

The model sets thresholds for three foods of concern: salt, sugar, and saturated fats, strongly linked to NCDs such as hypertension, diabetes, and cardiovascular diseases.

According to the Principal Secretary, State Department for Public Health and Professional Standards, Mary Muthoni, as part of its strategy to reduce the national burden of NCDs and promote healthier lifestyles among all Kenyans, the ministry is committed to advancing preventive health measures.

"These include introducing regulations to discourage the consumption of unhealthy foods, implementing fiscal policies to reduce the intake of sugar-sweetened beverages, restricting the marketing of unhealthy foods to children, and enforcing front-of-pack nutrition labelling to provide consumers with clear information and warnings about unhealthy food products."

Other interventions include: the school meals programme reaching over 2.6 million learners daily, nutrition-sensitive cash transfers to 48,000 households, and mainstreaming nutrition into education are helping to address the nutrition challenge.