A cross-sectional study of 350 adults in Ekiti State, Nigeria reveals a striking nutritional paradox: rural communities simultaneously experience high underweight rates (22%) and elevated combined overweight/obesity prevalence (25%), while urban areas show similar dual patterns (20.4% underweight, 18.4% overweight/obese). Urban residents demonstrated greater dietary diversity, favoring legumes and cereals, while rural diets relied heavily on sugar, honey, and root vegetables. This dual burden of malnutrition represents a critical transition phase affecting developing regions worldwide. The findings mirror global patterns where rapid economic development creates complex nutritional landscapes—traditional undernutrition persists alongside emerging diet-related chronic diseases. Rural communities appear particularly vulnerable, experiencing the worst of both worlds: persistent food insecurity alongside increasing access to processed, calorie-dense foods. The higher obesity rates in rural versus urban areas challenge conventional assumptions about urbanization and weight gain. However, this preprint awaits peer review, and the relatively small sample size limits broader generalizability. The research provides valuable baseline data for Nigeria's nutrition transition, suggesting targeted interventions must address both hunger and emerging metabolic health risks simultaneously.