Why do we eat the foods that we do? This question is one that is not often considered by individuals as they go about their daily lives, but can have large implications on public health – for, there is a strong, physiological connection between food consumption and one’s health and wellbeing. Accordingly, when reflecting upon the health of a nation it is often important to consider its nutritional status. Ultimately, many determinants can contribute to how and why an individual eats certain foods, as can be seen in Ecuador. In this Latin American country, for instance, historical, socioeconomic, cultural, behavioral, socioeconomic, and environmental factors (among others) can be seen to influence the different diets – and by extension, the nutritional statuses – of different ethnic, regional, and geographic populations. Though common across Ecuador, discrepancies among these groups are particularly noticeable in the highland region, the Sierra. Overall, this paper examines the different forms of malnutrition, their implications on one’s health, and their prevalence across Ecuador. Additionally, it considers how the Ecuadorian diet was shaped, and how different subcuisines lend themselves to varying forms of malnutrition. Specifically, this paper focuses on the Sierra, given that levels of malnutrition are noticeably higher in this region, and that this highland area is home to large rural and indigenous communities who are most significantly impacted by the region’s nutritional conditions.