Evaluating the Impact of Socioeconomic Factors on Dietary Choices and Nutritional Status of Adults in Selected Urban and Rural Communities in Ekiti State

Abstract Introduction Adults in Nigeria face a growing nutrition challenge: while some struggle with undernutrition, others are increasingly affected by overweight and obesity. This “double burden of malnutrition” reflects socioeconomic divides, where income, education, and household conditions shape food choices and health. This study examined how socioeconomic factors influence dietary diversity, nutritional knowledge, and nutritional status among adults in urban and rural communities of Ekiti State. Methods and Analysis A descriptive cross-sectional survey was conducted among 350 adults selected via multistage sampling. Data were collected using structured questionnaires and anthropometric measurements. Dietary diversity was assessed using food group frequency, and nutritional status was determined by BMI. Associations were analyzed using chi-square tests (p < 0.05). Results Significant urban-rural divides were identified: urban respondents were more educated (48.8% tertiary), while rural households were more dependent on farming (35.0%) and low-income (62.0% < 70,000). Dietary patterns differed significantly: urban diets favored legumes (58.4%) and cereals (56.0%), while rural diets predominated in sugar/honey (90.0%) and roots/tubers (71.0%). Nutritional knowledge was higher in urban areas. Nutritional status revealed a dual burden: 20.4% of urban and 22.0% of rural respondents were underweight, while combined overweight/obesity affected 18.4% of urban and 25.0% of rural participants. Conclusion Socioeconomic factors strongly dictate dietary choices and health in Ekiti State. Urban areas show greater diversity but rising obesity risks, while rural areas face persistent undernutrition. These findings highlight the need for tailored, state-specific interventions addressing both food insecurity and emerging diet-related chronic disease risks. What is already known on this topic: Socioeconomic status strongly shapes dietary choices and nutrition in Nigeria, with urban–rural disparities and uneven nutrition knowledge contributing to both undernutrition and rising obesity, yet localized evidence among adults in Ekiti State remains scarce. What this study adds: This study provides the first localized evidence from Ekiti State showing how socioeconomic disparities drive distinct urban–rural dietary patterns, confirm the coexistence of underweight and overweight adults, reveal limits of nutrition knowledge in shaping diets, and highlight the urgent need for tailored interventions that address both rural undernutrition and urban obesity. How this study might affect research, practice or policy: This study shines a light on how everyday realities—income, education, and household size—shape what adults eat in Ekiti State. For research, it fills a gap by focusing on adults rather than children and offers a framework that others can use in different Nigerian states. For practice, it shows that nutrition education alone isn’t enough in cities, where affordability and access matter more, while in rural areas knowledge makes a bigger difference. For policy, it confirms that undernutrition and obesity coexist, urging leaders to move beyond one-size-fits-all national strategies and design state-specific programs that tackle food insecurity in rural areas and rising obesity in urban centers.