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<b>Background</b> The Mediterranean Diet (MD) is recognized as heart-healthy, but the economic cost associated with this type of diet has scarcely been studied. The objective of the present study is to explore the cost and adherence of a low-income region population to the MD and its relationship with income. <b>Methods</b> A population-based study was carried out on 2,833 subjects between 25 and 79 years of age, 54% women, selected at random from the municipalities of Vegas Altas, La Siberia and La Serena in the province of Badajoz, Extremadura (Spain). Average monthly cost of each product included in the MD was computed and related to adherence to the MD using the Panagiotakos Index and average disposable income. <b>Results</b> The monthly median cost was 203.6€ (IQR: 154.04-265.37). Food-related expenditure was higher for men (p&lt;0.001), age cohort between 45 and 54 years (p&lt;0.013) and those living in urban areas (p&lt;0.001). A positive correlation between food-related expenditure and the MD adherence was found. Monthly median cost represents 15% of average disposable income, ranging between 11% for the group with low MD adherence and 17% for the group with high MD adherence. <b>Conclusions</b><br> The monthly cost of the MD was positively correlated with the degree of adherence to this dietary pattern. Given that the estimated monthly cost is similar to that of other Spanish regions with a higher income level, the economic effort required to be able to afford the Mediterranean diet is higher. This may represent a barrier to access, which should be analyzed in detail by public decision-makers.

<b>背景</b> 地中海饮食（Mediterranean Diet, MD）被公认为具有心脏健康益处，但针对该饮食模式的相关经济成本的研究却较为匮乏。本研究旨在探究低收入地区人群对地中海饮食的依从性及其饮食成本，并分析二者与收入水平的关联。<b>方法</b> 本研究为以人群为基础的研究，从西班牙埃斯特雷马杜拉自治区巴达霍斯省的Vegas Altas、La Siberia及La Serena市镇中，随机选取25至79岁的2833名受试者，其中女性占比54%。研究人员计算了地中海饮食涵盖各类食品的平均月度成本，并采用帕纳约塔科斯指数（Panagiotakos Index）评估受试者对地中海饮食的依从性，进而将食品成本与依从性及人均可支配收入进行关联分析。<b>结果</b> 受试者的月度食品成本中位数为203.6欧元（四分位距：154.04~265.37）。男性、45~54岁年龄组以及居住于城区的受试者的食品相关支出显著更高（p<0.001、p<0.013、p<0.001）。研究发现食品相关支出与地中海饮食依从性呈显著正相关。月度食品成本中位数占人均可支配收入的15%，其中地中海饮食依从性较低的群体占比为11%，依从性较高的群体占比为17%。<b>结论</b><br> 地中海饮食的月度成本与该膳食模式的依从程度呈正相关。鉴于本次估算的月度成本与其他收入水平更高的西班牙地区相近，坚持地中海饮食所需承担的经济负担显著更高。这或成为饮食准入的障碍，相关问题亟待公共政策制定者展开深入分析。