BackgroundThe nutrition transition continues to affect populations throughout the world. The added impact of market integration and urbanization exacerbates the impact of the nutrition transition upon Indigenous populations worldwide. ObjectivesThis study aims to explore the nutritional concerns of the urban Kichwas community residing in the Andes highlands of Ecuador. Study designThis is a qualitative study. MethodsEight focus groups were conducted with Kichwas men and women in November 2015 in the Imbabura province of the Andes in Ecuador. Data analysisApplied thematic analysis was used to analyze findings regarding nutrition. ResultsThe participants shared concerns regarding increased intake of fast food, poor meal timing, and a shift in the child's food preferences that rejects traditional foods. They attributed these concerns to urbanization resulting from an increase in dual-income households and a loss of cultural identity. ConclusionsSynergistic cultural factors are related to nutritional concerns voiced by the urban Kichwas community. Public health implicationsSyndemic theory is a useful interpretive lens regarding nutritional trends within the Kichwas communities as they relate to the increased risk of chronic disease.