Objective: The purpose of the present study was to analyse the evolution of the Spanish population's global and regional adherence to the Mediterranean diet (MD) since 1987. Design: A cross-sectional study was conducted analysing food consumption from the Spanish Household Consumption Surveys administered by the Spanish Ministry of Agriculture, Fisheries and Food. Setting: The Mediterranean Adequacy Index (MAI) was applied to measure the adherence to the MD. The significance of the MAI trend was evaluated using a regression model.