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Objective: To assess prevailing food patterns among Balearic Islands' adolescents, and socio-economic and lifestyle determinants.Design: Cross-sectional nutritional survey carried out (2007-2008) in the Balearic Islands, a Mediterranean region. Dietary assessment was based on a 145-item semi-quantitative FFQ and two non-consecutive 24 h recalls. Anthropometric measurements and questions related to socio-economic, lifestyle, physical activity and body image were assessed.Setting: Data obtained from a representative sample of all inhabitants living in the Balearic Islands aged 12-17 years.Subjects: A random sample (n 1231) of the adolescent population (12-17 years old) was interviewed.Results: Factor analysis identified two major dietary food patterns: 'Western' and 'Mediterranean'. The 'Western' dietary pattern was higher among boys than girls, associated with spending ≥4 h/d on media screen time, but less prevalent among those adolescents who desired a thinner body and those girls who desired to remain the same weight. The 'Mediterranean' dietary pattern was mainly followed by girls, and also boys who spent < 2 h/d on media screen time and girls with high parental socio-economic status.Conclusions: The present study shows the existence of two major dietary patterns among Balearic Islands' adolescents: 'Western' and 'Mediterranean', but girls are more 'Mediterranean' than boys. This evidence supports that the food pattern of Balearic Islands' adolescents is in a transitional state characterised by the loss of the traditional Mediterranean dietary pattern towards a Western dietary pattern. Low parental socio-economic status, much leisure-time on sedentary behaviours such as media screen time and body image are factors associated with the 'Western' dietary pattern. [ABSTRACT FROM AUTHOR]