A Gram Research analysis of a participatory study with 57 Zambian participants reveals a critical food safety paradox: people choose packaged ultra-processed foods over fresh, nutritious options from informal markets because they perceive packaged foods as safer and cleaner. Poor hygiene conditions in street markets and uncovered food sales near garbage drive this preference, even though fresh foods are more nutritious. Improving market cleanliness and food safety conditions could help people choose healthier diets without increased costs.
A new study from Zambia reveals a surprising problem: people are choosing packaged, ultra-processed foods over fresh, healthy options—not because they taste better, but because they think packaged foods are safer. Researchers talked to 57 people in two Zambian districts and found that while fresh foods from local markets are actually more nutritious, dirty conditions and poor hygiene in these markets make people distrust them. Even traditional fermented milk called mabisi, which is very healthy, gets avoided because it’s often sold in dirty containers. The study shows that fixing hygiene problems in local markets could help people eat better without having to rely on less healthy packaged foods.
Key Statistics
A 2026 participatory study of 57 people in Zambia found that informal food markets, despite being the primary source of fresh and nutritious foods, are widely perceived as unhygienic and unsafe, driving consumers toward less nutritious packaged ultra-processed foods.
According to research reviewed by Gram involving 57 Zambian participants, even mabisi, a traditional fermented milk officially recommended in national dietary guidelines as a healthy food, is often avoided because it is sold in dirty containers, demonstrating how hygiene concerns override nutritional knowledge.
A 2026 Zambian food environment study with 57 participants revealed that urban areas face particular challenges, with street-vended foods sold uncovered near garbage and sewage lines, creating legitimate food safety concerns that push low-income families toward more expensive packaged alternatives.
Research from Zambia involving 57 community members showed that both rural and urban food environments depend heavily on agriculture and informal markets, yet safety perceptions—not availability—are the primary barrier to consuming fresh, nutrient-dense foods.
The Quick Take
- What they studied: Why people in rural and urban areas of Zambia choose certain foods over others, and how clean or dirty food sources affect their choices
- Who participated: 57 people from two different districts in Zambia—Choma and Chipata—living in both cities and rural farming areas
- Key finding: People choose packaged, processed foods because they think they’re safer and cleaner, even though fresh foods from local markets are actually more nutritious. Dirty conditions in markets and poor hygiene make people distrust fresh foods.
- What it means for you: If you live in an area with informal food markets, cleaning up these markets and teaching people about food safety could help everyone eat healthier without having to buy expensive packaged foods. This applies especially to low-income families who depend on local markets.
The Research Details
Researchers used a method called Photovoice, where participants take pictures and share stories about their food environments. This approach lets people explain their own experiences and choices in their own words, rather than researchers just observing from the outside. The study included 57 people from two Zambian districts that were chosen because they have different levels of mabisi (traditional fermented milk) consumption. By comparing these two areas, researchers could see how food environments shape what people eat.
The researchers conducted interviews and focus groups where participants discussed their photos and experiences with food. This method is powerful because it captures real-life perspectives that surveys or questionnaires might miss. The study looked at both urban areas (cities) and rural areas (farming communities) to understand how location affects food choices.
This research approach matters because it shows the real reasons behind people’s food choices, not just what they eat. Understanding why people choose certain foods helps create better solutions. For example, simply telling people to eat fresh foods won’t work if they’re afraid those foods are unsafe. By listening to people’s actual concerns about hygiene and safety, researchers can design interventions that address the real problems.
This study is qualitative research, meaning it focuses on understanding people’s experiences and perspectives rather than measuring large numbers. The sample size of 57 people is appropriate for this type of in-depth research. The study’s strength is that it captures real voices and concerns from the communities being studied. However, because it’s based on interviews and photos rather than measurements, the findings describe patterns and themes rather than precise statistics. The study was published in Health & Place, a peer-reviewed journal focused on how environment affects health.
What the Results Show
The most striking finding is what researchers call a ‘paradox’: informal markets (local food vendors) are actually the best sources of fresh, nutritious foods, but people avoid them because they look dirty and unsafe. In urban areas especially, foods are sold uncovered on the street near garbage and sewage, which makes people worry about contamination. As a result, people choose packaged, ultra-processed foods instead, thinking they’re safer because they come in sealed packages.
Even mabisi, a traditional fermented milk that’s officially recommended in Zambian dietary guidelines as a healthy food, faces this problem. People know it’s nutritious, but they avoid it because it’s often sold in dirty containers. This means that a genuinely healthy traditional food is being replaced by less healthy alternatives simply because of hygiene concerns.
The study found that both rural and urban areas face similar food environment challenges, despite differences in what foods are available. Rural areas depend heavily on farming and gathering wild fruits and vegetables, while urban areas have more access to packaged foods. However, in both places, the informal markets that provide the freshest, most nutritious foods are viewed with suspicion due to cleanliness concerns.
The research revealed that agriculture is central to food security in both districts. Rural participants rely on farming and wild food gathering for survival, while urban participants depend on buying food from markets. In urban areas, the shift toward packaged foods is driven not just by preference but by genuine safety concerns about street-vended foods. Low-income families face a difficult choice: buy affordable fresh foods they worry are unsafe, or buy more expensive packaged foods they perceive as safer.
According to Gram Research analysis, this study adds important context to global research showing that food environments shape eating habits. While previous studies have documented that informal markets provide nutritious foods, this Zambian research highlights a critical barrier: perception of safety. Many developing countries face similar challenges where the healthiest food sources are also the ones with the poorest hygiene conditions. This study suggests that simply improving access to fresh foods isn’t enough—safety and cleanliness must be addressed simultaneously.
This study captures perspectives from 57 people in two districts, so the findings may not apply to all of Zambia or other countries. The research is based on what people said and showed through photos, not on actual measurements of food safety or hygiene. The study doesn’t provide specific statistics on how many people choose packaged foods versus fresh foods, or exact measurements of hygiene problems. Additionally, the study was conducted at one point in time, so it doesn’t show whether these patterns are changing over time.
The Bottom Line
Strong evidence supports improving hygiene and safety conditions in informal food markets as a priority. Communities should invest in better infrastructure for food vendors, including clean water access, covered selling areas, and proper waste management. Education campaigns should help people understand that packaged ultra-processed foods, while appearing safer, often contain less nutrition than fresh foods. For low-income families, the focus should be on making safe, fresh foods both accessible and affordable. These recommendations have high confidence because they address the actual barriers people face.
This research matters most for people living in or near informal food markets in developing countries, particularly in Africa. It’s important for public health officials, city planners, and food vendors who want to improve community nutrition. Low-income families who depend on local markets should care about these findings because they show that market improvements could help them eat better without spending more money. Food safety inspectors and health departments can use these insights to design more effective interventions. This research is less directly relevant to people in areas with well-regulated, clean food markets.
If informal markets improve their hygiene and safety conditions, people could start choosing fresh foods again relatively quickly—likely within weeks to months as trust builds. However, changing deeply held beliefs about food safety takes longer, so education campaigns should run for at least 6-12 months. Actual health improvements from eating more fresh foods would likely become noticeable within 2-3 months of dietary changes.
Frequently Asked Questions
Why do people in Zambia choose packaged foods over fresh foods from markets?
People perceive packaged foods as safer and cleaner because informal markets have poor hygiene conditions—foods are often sold uncovered near garbage and sewage. Although fresh foods are more nutritious, safety concerns drive people toward packaged alternatives, even though these are less healthy.
Is mabisi actually a healthy food in Zambia?
Yes, mabisi is a traditional fermented milk officially recommended in Zambian dietary guidelines as part of a healthy diet. However, a 2026 study found that people often avoid it because it’s sold in dirty containers, making them distrust it despite knowing it’s nutritious.
What would help people eat healthier foods in developing countries with informal markets?
Improving hygiene and safety conditions in informal markets is essential. This includes providing clean water, covered selling areas, and proper waste management. Education about ultra-processed food risks, combined with making fresh foods accessible and affordable, would help low-income families choose healthier options.
How does where you live affect what healthy foods you can buy?
Rural areas depend on farming and wild food gathering, while urban areas have more packaged food access. However, both face the same problem: informal markets provide the freshest, most nutritious foods but are perceived as unsafe due to poor hygiene conditions, forcing people toward less healthy alternatives.
Can improving food markets actually change what people eat?
Research suggests yes. When informal markets improve hygiene and safety conditions, people could start choosing fresh foods again within weeks to months as trust builds. However, changing beliefs about food safety requires sustained education campaigns lasting 6-12 months for lasting behavior change.
Want to Apply This Research?
- Track daily servings of fresh versus packaged foods, noting where each food was purchased. Users can photograph their food sources and rate their confidence in food safety, creating a personal record of how market improvements affect their choices over time.
- Users can set a goal to purchase one additional fresh food item from informal markets per week, starting with foods they trust most. The app can provide tips on identifying clean vendors and proper food handling to reduce safety concerns.
- Over 3 months, track the ratio of fresh to packaged foods consumed, along with user-reported confidence in food safety at different vendors. Monitor whether participation in food safety education correlates with increased fresh food purchases.
This research describes perspectives and experiences from 57 Zambian participants and should not be interpreted as definitive medical or nutritional advice. The findings are based on qualitative research capturing people’s perceptions rather than laboratory measurements of actual food safety. While the study provides valuable insights into food choices and safety concerns, individual decisions about food consumption should consider local food safety regulations, personal health conditions, and guidance from healthcare providers. This research is most relevant to communities in developing countries with informal food markets and may not apply to all regions or populations. Anyone with specific food safety or nutrition concerns should consult local health authorities or qualified healthcare professionals.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.