Healthy Ageing: An Integrative Review of the Social Determinants of Diet and Nutrition in Spain

Spain’s rapidly ageing population presents new challenges for public health, particularly regarding nutrition and healthy ageing. This integrative literature review examines how social determinants—such as income, gender, social isolation, trust in food systems, and lifestyle—affect dietary habits and nutritional outcomes among older adults in Spain. Drawing from 22 peer-reviewed empirical studies published between 2014 and 2024, the review identifies six key factors influencing nutrition: social frailty and isolation, trust in food and interpersonal relationships, lifestyle behaviours, food choices, gender differences, and financial conditions. Findings reveal that social isolation and frailty are strongly linked to poor diet quality, especially among older men. Cultural memory and traditional food practices also shape dietary decisions, often conflicting with medical advice. Although income is frequently cited as a determinant of malnutrition, evidence remains inconclusive. The review highlights a significant gap in qualitative and interdisciplinary research addressing the lived experiences of older adults in Spain. It calls for more nuanced approaches that integrate social science perspectives to inform equitable and culturally sensitive health interventions. Ultimately, understanding the complex interplay of social determinants is essential for promoting healthy ageing and improving nutritional outcomes in this growing demographic.