Adherence to the Mediterranean diet in urban households across Barcelona is low or moderate, despite its widely recognized benefits for cardiovascular, metabolic, and mental health. This is the conclusion of a new study from the Institute of Environmental Science and Technology of the Universitat Autònoma de Barcelona (ICTA-UAB), which highlights significant social, economic, and district-level inequalities in access to healthy food in cities with more than 100,000 inhabitants. The study notes that structural factors such as income, the gender of the household’s primary breadwinner, and the presence of children under 16 are key determinants.

Conducted within the framework of the Barcelona Food and Health Poverty project (PANIS), the study shows that average adherence to the Mediterranean diet, measured using the adapted MEDLIFE index, stands at 8.12 out of 20, dropping to 7.65 in low-income households with children under 16.

Households headed by women show better adherence than those headed by men, but this effect reverses when children under 16 are present, reflecting an overload of responsibilities that affects diet quality.

The research also underscores the decisive role of social and spatial contexts. The socioeconomic and food environment of each neighborhood strongly shapes consumption habits, and more than 140,000 people live in census tracts with high food vulnerability in the city of Barcelona.

The study provides a detailed analysis of the different components of the Mediterranean diet among urban households in Barcelona. High adherence is observed for snacks, potatoes, and wine; intermediate adherence for red meat, sugary drinks, fiber, fish, sweets, legumes, salt, cereals, and sauté ingredients; and low adherence for fruits, vegetables, olive oil, nuts, white meat, eggs, and low-fat dairy products.

Overall, many households are at risk of not complying with the Mediterranean diet, either due to low consumption of healthy foods such as fruit, vegetables, olive oil, nuts, white meat, eggs, and low-fat dairy, or due to excessive consumption of processed meats.
The presence of children under 16 increases the risk of insufficient consumption of vegetables, fruit, fiber, and olive oil, while households without children under 16 tend to consume excessive amounts of eggs, salt, and red meat. In addition, low-income households consume fewer vegetables, sauté ingredients, and fish, especially when no children are present.
In response to this situation, the report proposes a series of policy recommendations aimed at local administrations, with special attention paid to the Barcelona City Council. Key proposals include:

• • Integrating food policy into economic and social strategies, increasing the minimum wage, regulating rents, and strengthening public housing to reduce the financial burden on vulnerable households.
  • Universalizing and strengthening school canteens, including post-compulsory stages, with healthy menus, nutritional monitoring, and schedules adapted to families.
  • Adopting a gender-sensitive approach in reconciliation and food policies, promoting shared responsibilities and reducing the invisible burden placed on women.
  • Improving food environments in vulnerable neighborhoods through local markets, urban gardens, and regulation of the excessive supply of ultra-processed foods
  • Implementing community food education campaigns, with practical workshops, local counselling, and the strengthening of support networks.
  • Establishing a local neighborhood-level nutritional monitoring system, with data disaggregated by gender and age, to better guide interventions.

These measures aim to strengthen food security in Barcelona through a comprehensive approach that acknowledges the influence of structural, social, and spatial factors on eating habits. To guarantee the right to sufficient, safe, and nutritious food that meets dietary needs and cultural preferences, the report emphasizes the importance of coordinated policies that address socioeconomic, gender, and neighborhood inequalities while fostering community participation, training, and empowerment.

Only through this approach will it be possible to achieve sustainable and equitable improvements in food conditions for the entire population, with particular attention to the most vulnerable groups and by reinforcing the local social fabric.

PANIS Project - Barcelona Food and Health Poverty
Final Report PANIS