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EMI-SUS).A avaliação da adesão à dieta foi realizada através de um questionário, elaborado pelos pesquisadores com base nas recomendações da I Diretriz Brasileira de Síndrome Metabólica, sobre a adesão a oito possíveis orientações dietéticas recebidas de profissionais da saúde (em relação à ingestão de "alimentos integrais", "doces", "açúcar", "frutas/verduras/legumes", "sal", "alimentos gordurosos/frituras", "alimentos processados" e "peixes" A questionnaire developed by the researchers based on the recommendations of the I Brazilian Guideline for Metabolic Syndrome was used to evaluate compliance with eight possible dietary guidelines provided by health professionals (intake of "whole foods", "sweets", "sugar", "fruits/vegetables/legumes", "salt", "fatty foods/fried foods", "processed foods" and "fish"). Diet adherence was considered when an individual followed all dietary guidelines (regardless of their number, which ranged from one to eight). The diagnosis of depression was based on the Mini International Neuropsychiatric Interview instrument, used by psychiatrists. Results: A total of 109 elderly patients were included in the study, most of whom were female (67.9%). The mean age was 68.4±6.6 years (61-90 years). Thirty-seven elderly patients (33.9%) were considered adherent to the diet. Lower salt intake was the dietary guidance with greater adherence (89.1%) while the consumption of whole foods exhibited less adherence (59.7%). There was no association of diet adherence with sociodemographic and clinical parameters and with metabolic syndrome components. The frequency of adherence to the recommendation against the consumption of sugar and sweets was significantly lower among individuals with depression (43.9% vs 34.9%; p = 0.001).Conclusions: Diet adherence occurred in one third of elderly patients with metabolic syndrome treated at the primary health care level. There was lower adherence to the recommendation against the consumption of sweets and sugar in individuals diagnosed with depression.KEY WORDS: elderly; metabolic syndrome X; feeding behavior; depression; primary health care.