Data from household food budgetary surveys and regional, population-based, cross-sectional studies show a declining trend in energy intake in the last decades, also applicable to protein, fat and carbohydrate intakes in absolute terms. The pattern suggests a lower fat content in the diet. Protein intake is 200% of the recommended level. Spanish food patterns underwent dramatic changes between the 1960s and the 1980s, including an important increase in fat intake, up to 44% energy intake from fat in the 1980s. The trend changed in the 1990s, and current fat supply provides an average of 37% of energy intake. Main sources of fat in the Spanish diet are added fats for cooking (49% of total fat intake), especially olive oil; meat and meat products (25%); and a lower percentage provided by milk and dairy products. Most saturated fatty acids are supplied by meats (30%) and dairy products (27%). Rapid urbanisation processes and the growing proportion of females in the active workforce have led to important changes in food patterns in the last decades. On the one hand, some changes had a positive impact, such as increasing variety in the diet and access to food; on the other hand, some changes moved the Spanish diet away from the traditional Mediterranean food pattern. Current food patterns evidence high consumption of animal products: meat, fish, milk and dairy products. It seems advisable to increase consumption of plant foods, particularly whole-grain cereals, potatoes and pulses. Intake of fruit and vegetables shows a shift towards a greater consumption of processed foods rather than fresh products, and overall a greater consumption would be recommended.