As cities continue to grow and food deserts proliferate across urban landscapes, it is becoming increasingly difficult to buy affordable, good-quality fresh food. And in East Africa, the rise of supermarket shopping is causing obesity in Kenya to skyrocket.

According to Quartz, obesity in Kenya has been on the rise due to increases in supermarket shopping. As African cities become more densely urbanized, more people have been purchasing processed foods in supermarkets that are low in nutritional value.

A study on nutritional value and supermarket shopping habits coming out of the University of Goettingen and the International Food Policy Research Institute (IFPRI) shows that the body mass index (BMI) of urban Kenyans has been increasing. The study looked at residents’ diet choices and nutritional value and found that shopping at supermarkets increases the chances of being overweight or obese.

The main correlation between increases in BMI and nutritional shift is not an increase in calorie intake per se. The study explains that, because Kenyans are now digesting a lot more dairy, meat, and other foods high in salt and sugars as opposed to fruits and vegetables, their bodies need more energy. And since fruits and vegetables are more difficult to come across in supermarkets, the study singles them out as the main factor leading to rising obesity in Kenya and across Africa.

In 2015, data on obesity in Kenya and across the continent showed that 27 percent of Ghana’s adults were obese, followed closely by adults in the Seychelles at 25.1 percent and Swaziland at 24.3 percent. Togo had the lowest number of obese adults at 6.2 percent. Quartz also states that supermarket sales currently make up 10 percent of Kenya’s GDP and the number may very well rise in the near future.

This stark shift in eating habits as a result of increased supermarket shopping and, accordingly, less access to high-quality, healthy foods is called “nutrition transition.” The rise in the amount of fast food chains that have opened across Africa also contributes to this transition. In 2016, the fast food industry captured 47.8 percent of household income and made up 74.7 of jobs in the same year.

On the other side of the Atlantic, Brazil has also been struggling to address how the consumption of highly processed foods (paywall) can cause obesity in Brazilian adults. The South American nation struggles to provide its residents with healthy and accessible organic food, which encouraged people to band together to start what are called “Community Supported Agriculture.” These initiatives revolve around co-farmers who grow crops and sell them directly to consumers without a supermarket intermediary between the two.

CSA, akin to other alternative farming models in other parts of the world, are usually financed by both the farmers and the consumers and have proven to be successful. Currently, there are 5,000 farmers across Brazil that are now a part of these projects and cater to 15,000 people.