PURPOSE: Wine consumption has been related to a reduced cardiovascular risk. This effect has been attributed partly to the healthier diet of wine drinkers. We compared food habits according to alcoholic beverage preference in a Mediterranean population. DESIGN: A cross-sectional study of a large sample of participants at high risk for cardiovascular disease. SETTING: Primary care centers in a Mediterranean country, Spain. PARTICIPANTS: A total of 1675 men aged 55 to 80 years old and 2150 women aged 60 to 80 years old who had no documented cardiovascular disease but had either diabetes or at least three major cardiovascular risk factors. MEASURES: A food frequency questionnaire, alcoholic beverage consumption, adherence to Mediterranean diet, age, family history of cardiovascular disease, smoking, body mass index, diabetes, dyslipidemia, and educational level were measured. ANALYSIS: We analyzed differences in food consumption according to the type of alcoholic beverage preferentially consumed and adjusted the estimates for age, body mass index, cholesterol level, and total energy intake. RESULTS: We found no substantial differences in adherence to the Mediterranean diet according to the main type of alcoholic beverage consumed, and we found no evidence that Mediterranean wine drinkers at high cardiovascular risk have a healthier diet than other drinkers. However, a better dietary pattern was found among nondrinkers than among drinkers. CONCLUSION: This large, Mediterranean study does not support an association between wine consumption and healthier dietary habits.