Diet Quality, Healthy Dietary Restrictions, and Adherence to the Mediterranean Diet in Food Deserts Among the Elderly in Spain.

Background/objectives: Food deserts are areas characterized by limited access to affordable and healthy food, often due to significant distances from supermarkets-exceeding 1.6 km in urban areas and 16 km in rural settings. These spatial limitations exacerbate health and socioeconomic disparities. This study aimed to assess diet quality and explore the barriers influencing dietary behaviors among individuals aged 60 and older residing in food deserts in Aragón, Spain.

Methods: An exploratory qualitative study using a phenomenological approach was conducted, complemented by descriptive analyses of sociodemographic data and adherence to the Mediterranean diet, assessed through the PREDIMED questionnaire. Data were collected through in-depth interviews and a focus group with residents of food deserts.

Results: Half of the participants showed high adherence to the Mediterranean diet, while the other half had moderate adherence. Despite the lack of access to supermarkets and higher food costs, many participants perceived their diet quality positively. Challenges, such as long distances to stores, limited public transport, and economic constraints, were mitigated through strategies like home gardening, hunting, and traditional cooking, which often reduced reliance on processed foods. However, participants also reported increased alcohol consumption as a means of socializing.

Conclusions: Diet quality in Aragón's food deserts reflects a balance between significant access barriers and community-driven resources. While participants leveraged local strategies to maintain diet quality, systemic issues remain. Public policies should focus on improving transportation, enhancing local food systems, and fostering community-based initiatives to reduce inequalities in food access and promote healthier dietary habits in rural areas.