Unequal access to food during the nutritional transition: evidence from Mediterranean Spain?

Unequal access to food is one of the main issues in nutritional history, but scarcity of sources has hampered the quantification of this phenomenon. This study uses hospital diets to address this gap. It uses records from between 1852 and 1923 concerning hospital diets in the psychiatric section of the Hospital General de Valencia (Spain), from which it is possible to infer the actual intake of nutrients for six groups of patients and members of staff. The results reveal considerable differences in terms of diet and nutrition. While the most favoured groups (nuns and well-off patients) had by 1852 reduced their relative intake of cereals and increased that of meat, in line with the general trend of the nutritional transition, the poor and orphans were still behind the trend by 1923. Hospital staff were on a high-calorie diet that was adequate for carrying out physically demanding tasks, yet still suffered from a significant deficit in nutrient intake. These inequalities indicate that the nutritional transition was an uneven and non-linear process, with substantial differences according to social group.