Is a specific drinking pattern a consistent feature of the Mediterranean diet in Spain in the XXI century?

•The Mediterranean drinking pattern (MDP) is moderate alcohol intake (wine) with meals.•Life conditions and diet have changed substantially in Spain in the last 50 years.•It is uncertain if the MDP is a habitual feature of the Mediterranean diet (MD) today.•In Spain, in 2008–2010, less than 20% of those who adhered to the MD had a MDP.

Background and aimOver the last 50 years, people in Spain have increasingly been eating their main meal away from home and are shifting from the typical Mediterranean diet (MD). In addition, wine consumption has decreased whereas beer intake has risen. Consequently, it is uncertain if the Mediterranean drinking pattern (MDP; moderate alcohol intake mainly from wine and during meals) is a habitual feature of the MD today.Methods and resultsCross-sectional study conducted from 2008 to 2010 among 8894 individuals representative of the Spanish population aged 18–64 years. Consumption of alcoholic beverages and food was collected with a validated diet history. Accordance with the MD was defined as a score ≥8 on the Mediterranean Diet Adherence Screener (MEDAS) or ≥5 in the Trichopoulou index (after excluding alcohol intake from both indices). Among individuals with MEDAS-based MD accordance, only 17.1% had a MDP. After adjustment for potential confounders, this drinking pattern showed a weak association with higher MD accordance (odds ratio (OR) 1.32; 95% confidence interval (CI) 1.12–1.57). Only 14.7% of those with Trichopoulou-based MD accordance had a MDP; this pattern showed an even weaker association with higher MD accordance (OR 1.17; 95% CI 1.01–1.36). Similar results were obtained when this drinking pattern was redefined to include persons who drank wine with or outside of meals, as well as those who were primarily beer drinkers.ConclusionsThe MDP is not a habitual feature of the MD in the early XXI century in Spain.