Ultra-Processed Foods Consumption, Mediterranean Diet Adherence and Sociodemographic Correlates in an Italian Adult...

Background: Although national surveys report increasing ultra-processed foods (UPFs) consumption, updated estimates for Italy are lacking. Given the central role of the Mediterranean Diet (MD), understanding how UPFs contribute to the contemporary Italian diet is essential. This study quantified UPF intake in a convenience sample of Italian adults and examined its main sociodemographic correlates, including MD adherence. Methods: A web-based cross-sectional survey was conducted among Italian adults (≥18 years). Dietary intake was assessed using the validated 94-item NOVA Food Frequency Questionnaire (NFFQ). Associations between sociodemographic factors and NOVA food groups were evaluated using multivariable-adjusted linear regression, expressed as beta coefficients (β) and 95% confidence intervals (95% CI). MD adherence was assessed using the Medi-Lite score. Results: Data from 1629 participants (79.8% women; mean age 42.1 years, range 18-85) recruited between September 2021 and April 2025 were analyzed. Participants resided in Northern (23.4%), Central (40.4%), and Southern Italy (36.2%). UPFs contributed 20.0% (95% CI: 19.5-20.6) of total energy intake, while unprocessed/minimally processed foods, processed culinary ingredients, and processed foods accounted for 39.2%, 9.0%, and 31.8%, respectively. UPF consumption decreased with age (β = -3.34; 95% CI: -5.96 to -0.72 for >64 vs. ≤40 years) and was lower in Central (β = -2.92; 95% CI: -4.31 to -1.53) and Southern Italy (β = -1.51; 95% CI: -3.01 to -0.01) compared to the North. UPF intake showed an inverse linear association with MD adherence. Conclusions: UPFs contribute a modest share of total energy intake among Italian adults, consistent with other Mediterranean populations. Although based on a convenience sample, these findings highlight the relevance of the MD as a dietary model naturally limiting UPF consumption and provide updated evidence on UPF intake and its correlates in Italy.