September 17, 2025
As foods high in sugar, sodium and saturated fat become more readily available, public health concern is increasing around how these foods will affect young people’s diets. This concern is especially notable for those growing up in informal settlements (i.e. slums), such as Kibera, Kenya’s largest slum on the outskirts of Nairobi, where young people may only have access to one or two meals a day and face limited food options.
New research among adolescent girls in Kibera suggests that even though money and lack of variety drive many of the food choices, adolescent girls know about the importance of healthy eating. A complex range of factors influencing their food choices mean that educational messaging alone may not be enough to improve their nutrition.
In the new study, researchers at the UNC Gillings School of Global Public Health worked with CFK Africa (CFK), a leading non-governmental organization in Kenya and long-running UNC partner in global health outreach, to examine the diet quality, level of household hunger and food decision-making among girls aged 15-19 in Kibera. Using surveys, interviews, and focus group discussions with more than 300 girls, the researchers were able to get a clearer picture of how frequently and nutritiously the girls ate and what influenced their food choices.
Jeffrey Okoro
“This work exemplifies the powerful partnership and mutual respect that we share with Gillings,” said Jeffrey Okoro, CEO at CFK. “It was a combination of strengths, pairing Gillings’ expertise in rigorous, community-based research with the deep-rooted trust and contextual knowledge that CFK has established through over two decades of work with the Kibera community.”
Dr. Emily Seiger
“This study was only possible because of the deep trust built between CFK Africa and adolescent girls in Kibera,” said Emily Seiger, PhD, who is the study’s lead author, a Gillings School doctoral alumnus in nutrition and 2022 CFK Africa Peacock Fellow. “That trust enabled girls to speak candidly with local research facilitators—who not only asked detailed, probing questions but also played a central role in interpreting the findings. Their insights revealed the nuanced and multifaceted nature of food decision-making among adolescent girls, improving the limited scientific evidence that currently shapes our understanding of adolescent food choices in urban informal settlements.”
According to findings, the majority of girls ate grains, leafy greens, and sweet tea or coffee, and half ate fried foods like samosas, doughnuts and fries. Those from households experiencing more hunger had slightly better diet scores, because they ate fewer foods that are associated with chronic disease (mostly red meat) than those from households that experienced less hunger.
Girls in the study knew about the importance of eating nutritious food and were involved in preparing meals for their home, but many found that household finances and concerns about food safety led them to skip meals. Those who choose fried foods often did so because they believed they were more safely prepared than fresh foods.
Such findings show that young girls in this region need more support to improve their nutrition beyond being told to make healthier choices. If, for example, girls in the study were asked to stop consuming all deep-fried foods, almost half (47%) would be asked to stop consuming samosas. These foods, while fried, also provide some meat and vegetables that they may not otherwise be able to eat, according to the researchers.
Nathan Ruto
“At the end of the day, we don’t just want to see research findings produced; we want to see tangible benefits for our community,” said Nathan Ruto, CFK’s monitoring, evaluation and theory of change lead and a co-author on the study. “Centering the community throughout the research process helps ensure that findings are grounded in evidence but also actionable and feasible within our context.”
Dr. Stephanie Martin
“I’ve had the privilege of collaborating with CFK Africa since 2018,” said Stephanie Martin, PhD, senior author on the study and associate professor of nutrition at the Gillings School. “CFK Africa’s commitment to participatory development makes it possible to turn research into action. I’m thrilled to continue this partnership. Together, we are using these findings to pilot school-based activities to improve adolescent girls’ diets and well-being in Kibera.”
Researchers in the study include: Emily Seiger, PhD (Gillings School doctoral alumnus in nutrition and 2022 CFK Africa Peacock Fellow); Associate Professor of Nutrition Stephanie Martin, PhD; Jeffrey Okoro, CEO, CFK; Nathan Ruto Kikoech, CFK; Peter Dianga Otieno; Mark Muasa, CFK Africa; Kaburia Frankline Mwenda; Mercy Owuor, CFK Africa; Erick Nandoya, CFK, and several Gillings faculty: Professor of Nutrition and Chair of Anthropology Amanda Thompson, PhD; Assistant Professor of Nutrition Katie Meyer, PhD Distinguished Professor of Nutrition Linda Adair, PhD; Mildred Kaufman Distinguished Professor in Nutrition Alice Ammerman, PhD; Professor of Nutrition Saroja Voruganti, PhD; and Associate Vice Chancellor for Research Penny Gordon-Larsen, PhD.
Read the full study in Maternal & Child Nutrition.
Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.
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