Is the Mediterranean Diet Affordable in Türkiye? A Household-Level Cost Analysis

Background/Objectives : Adherence to the Mediterranean Diet (MD) is shaped by its multidimensional nature, encompassing nutritional, cultural, and environmental dimensions. However, systematic reviews indicate a notable decline in MD adherence across Mediterranean countries over the past decade. This study aimed to objectively assess the affordability of the MD under Turkish conditions using nationally representative data for a typical four-person household. Methods : A Turkish Mediterranean Diet Food Basket (MDFB) was developed for a reference household and its affordability evaluated through a four-step analytical framework: (i) construction of the MD food basket, (ii) collection of price data and estimation of average monthly cost, (iii) verification of nutritional adequacy, and (iv) assessment of affordability by comparing the basket cost with household income indicators Results : Based on the regional equivalised median income in the TR62 region (21,331 TRY/month), the monthly cost of the MDFB (TRY 20,930) represented 98% of household income. Using the national median income for couples with children (27,918 TRY/month), this share decreased to 75%. Both estimates substantially exceed the national average share of food expenditure (18.1%). Among the lowest-income households, the MDFB cost corresponded to 214% of income, indicating economic inaccessibility. For middle- and high-income groups, the ratios were 91.9% and 37.3%, respectively. Conclusions : Despite its recognized health benefits, the MD remains economically unattainable for most households in Türkiye, underscoring persistent socioeconomic disparities in diet quality and accessibility.