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.

Home cooking has been associated with diet quality, but its relationship with food processing has been poorly explored. We examined the association of home cooking frequency with degree of processing (using the Nova classification) and diet quality (i.e., the Mediterranean Diet Score, MDS; adherence to a pro-vegetarian food pattern; and the dietary inflammation score) in a large sample of Italian women (n = 11,982) from the Moli-sani Study. Participants were asked how often they cooked at home ("never/rarely," "occasionally," "almost every time," and "every time"). Women with the highest (82.6%), compared to the lowest frequency of home cooking reported greater unprocessed/minimally processed foods consumption (β = 0.12; 95%CI 0.02, 0.22), lower UPF intake (β = -0.16; 95%CI -0.26, -0.07), and lower values of the dietary inflammation score (β = -0.13; 95%CI -0.24, -0.03). No difference was observed for the MDS nor adherence to a pro-vegetarian food pattern. Home cooking may be an effective strategy to reduce UPFs and pro-inflammatory food consumption.

Background: Ultra-processed food (UPF) intake may influence outcomes in long-term cancer survivors. This study examined the relationship between postdiagnostic UPF consumption and mortality and assessed whether chronic disease biomarkers explain this association. Methods: We longitudinally analyzed 802 men and women with a previous cancer diagnosis (any site) recruited in the Moli-sani Study (2005–2010). Food intake data were collected at baseline and assessed an average of 8.4 years after diagnosis. UPF was defined according to the Nova classification and calculated as a weight ratio. The Mediterranean diet score (MDS) was used to assess overall diet quality. Inflammatory, metabolic, and cardiovascular biomarkers were analyzed as potential explanatory factors on the basis of change-in-estimate. Results: During a median follow-up of 14.6 years, a total of 281 deaths occurred. Multivariable (including the MDS)-adjusted HRs of higher UPF consumption for all-cause and cancer mortality were 1.48 [95% confidence interval (CI), 1.07–2.03 for highest vs. lowest third] and 1.57 (95% CI, 1–2.47), respectively. Taken together, inflammation markers and resting heart rate levels attenuated the associations of UPF with all-cause mortality by approximately 40%. Conclusion: Higher consumption of UPFs after cancer diagnosis was associated with increased all-cause and cancer mortality rates, irrespective of diet quality. Part of these associations was explained by elevated levels of inflammation markers and resting heart rate. Impact: These findings contribute to the growing body of evidence linking UPFs to adverse health outcomes in cancer survivors. Further research is needed to identify specific mechanisms underlying this relationship and explore potential dietary interventions for improving long-term survival.

Background/Objectives: There is a lack of food frequency questionnaires (FFQs) specifically designed to assess food consumption based on processing levels in younger populations. This study evaluates the validity and the reliability of a 107-item FFQ (NFFQ-Kids) in estimating the intake (g/day) and the weight and energy ratios of Nova groups in Italian children and adolescents aged 2–18 years. Methods: The NFFQ-Kids was administered twice (T0 and T1), with a four-week interval. A total of 73 participants completed the questionnaire at T0, and 53 completed it at T1. Participants were selected from the ICARO Study (December 2023–April 2024), a web-based cohort study in Southern Italy. Questionnaire validity was assessed by comparison with a 3-day food record (two weekdays and one weekend day) collected between the two NFFQ-Kids administrations. Test–retest reliability was evaluated to assess the consistency of the questionnaire over time. Results: A moderate correlation was found between the NFFQ-Kids and the 3-day food record for the energy ratio of ultra-processed foods (UPFs) (r = 0.48; p < 0.001; ICC = 0.46; 95% CI 0.29–0.64) and the weight ratio for both unprocessed or minimally processed foods (r = 0.49; p < 0.001; ICC = 0.50; 95%CI 0.33–0.66) and ultra-processed foods (UPFs) (r = 0.58; p < 0.001; ICC = 0.58; 95%CI 0.42–0.72). Overall, the NFFQ-Kids showed good test–retest reliability across all Nova group intakes, total food, and relative energy and weight ratios of UPFs (r = 0.71, ICC = 0.67; and r = 0.79, ICC = 0.67, respectively), indicating stable measurements over time. Conclusions: The NFFQ-Kids demonstrated acceptable validity and good reliability, proving useful for assessing food intake by processing level in Italian youth.

This file shows associations of group-specific ultra-processed food (UPF) intake (energy ratio) with all-cause and cardiovascular disease (CVD) mortality among cancer survivors in the Moli-sani Study cohort. Footnotes describe the multivariable Cox model covariates and the inclusion of all UPF groups as simultaneous covariates.

This file shows all-cause and cause-specific mortality hazard ratios (HRs) with 95% confidence intervals across levels of ultra-processed food (UPF) consumption among cancer survivors in the Moli-sani Study cohort, using time since cancer diagnosis as the time scale. Footnotes describe the multivariable Cox model covariates.