Food environments in developing economies are rapidly evolving, alongside fast-paced changes in the socioeconomic and demographic characteristics of populations. These changes are evident in Vietnam with the widespread emergence of supermarkets, and restructuring in traditional markets that are poised to have profound effects on household diets and patterns of food acquisition. This paper examines the relationship between province level supermarket density, quantity and quality indices of food groups acquired by households within those provinces, between 2010 and 2014. An original approach on the basis of open access mixed data sets (administrative data on the number of supermarkets at provincial level as a proxy for supermarket density, and household living standard survey) is proposed and implemented. We find that the differential presence of supermarkets across provinces in Vietnam is associated with the diversity and macronutrient quality of food groups acquired by households. In addition, households with higher per capita expenditure, and those that purchase a larger proportion of food (relative to food obtained from own production), acquire a higher diversity of food groups. Additionally, diversity of food acquired is associated with higher fat and lower carbohydrate shares, and this is independent of the presence of supermarkets. We observe a significant interplay between low household financial capabilities (i.e., low per capita expenditure and low proportion of income spent on food), large household size, ethnic minority status, and the existence of limited number of supermarkets in the food environment. All of these factors are associated with a limited diversity of food groups acquired, as well as higher carbohydrate and lower fat shares. Our findings highlight potential intervention opportunities that can “rewire” local food environments to address the challenge of double burden of malnutrition in the country.