Baseline characteristics of the study sample.

Diet is among the most significant modifiable risk factors for reducing the global burden of chronic diseases. This study aims to investigate the dietary patterns of adults in a large representative sample of the Italian population and to analyze these patterns according to sociodemographic characteristics. Adult participants of the third Italian National Food Consumption Survey were included. A total of 878 food items were classified into 24 pre-defined food groups using the FoodEx2 classification system. Dietary patterns were identified through principal component analysis, and Z-scores were calculated to assess adherence to these patterns. Associations between sociodemographic characteristics, energy intake, and dietary adherence scores were investigated using linear regression models. Based on data from 2,831 subjects (median age 47, IQR 35–60), five principal components (PCs) were retained, explaining 35.63% of the overall variance. PC1 was indicative of a high-fat diet, PC2 suggested a western eating behavior, PC3 represented a health-conscious lifestyle, PC4 can be characterized as an Italian traditional diet, and PC5 represented an unhealthy dietary pattern. According to Z-scores, 42.4% of our study cohort showed high adherence to at least one of the dietary patterns. Less healthy dietary patterns were more prevalent among males and individuals from northern Italian regions. Our results indicate a significant regional variation in terms of dietary pattern, mirroring the general trends of Italian eating habits of the last decades, characterized by a higher tendency towards a more westernized lifestyle. These findings underscore the importance of considering region-specific characteristics when designing future public health interventions and establishing, or updating, national dietary guidelines.膳食是降低全球慢性疾病负担的最关键可干预风险因素之一。本研究旨在针对意大利人群的大型代表性样本中的成年群体开展膳食模式调查，并结合社会人口统计学特征对各类膳食模式进行分析。本次研究纳入了第三次意大利全国食物消费调查的成年参与者。研究采用FoodEx2分类系统（FoodEx2 classification system），将878种食物条目归类为24个预设食物组别。本研究通过主成分分析（principal component analysis）识别膳食模式，并计算Z分数以评估受试者对各类膳食模式的依从程度。采用线性回归模型分析社会人口统计学特征、能量摄入与膳食依从评分之间的关联。基于2831名受试者的数据（年龄中位数为47岁，四分位距为35~60岁），最终保留了5个主成分（principal components, PCs），累计可解释总变异的35.63%。其中主成分1（PC1）提示为高脂膳食模式，主成分2（PC2）对应西式饮食行为，主成分3（PC3）体现为健康导向的生活方式，主成分4（PC4）可被定义为意大利传统膳食模式，主成分5（PC5）则代表不健康膳食模式。根据Z分数结果，本研究队列中有42.4%的受试者对至少一种膳食模式呈现高依从性。不健康的膳食模式在男性以及意大利北部地区的人群中更为普遍。本研究结果显示，膳食模式存在显著的地域差异，这与近几十年来意大利饮食习惯的整体变化趋势相符——即人群愈发倾向于西式生活方式。上述研究结果强调，在未来制定公共卫生干预措施以及修订或出台国家膳食指南时，需充分考虑地域特异性特征。