Background: The 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. Objectives: This study aims to explore the nutritional concerns of the urban Kichwas community residing in the Andes highlands of Ecuador. Study design: This is a qualitative study. Methods: Eight focus groups were conducted with Kichwas men and women in November 2015 in the Imbabura province of the Andes in Ecuador. Data analysis: Applied thematic analysis was used to analyze findings regarding nutrition. Results: The 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. Conclusions: Synergistic cultural factors are related to nutritional concerns voiced by the urban Kichwas community. Public health implications: Syndemic theory is a useful interpretive lens regarding nutritional trends within the Kichwas communities as they relate to the increased risk of chronic disease.