Nutrition Knowledge and Dietary Behaviours among Italian University Students: a Literature Review

The transition to university is associated with significant lifestyle changes, often resulting in a decline in students' dietary habits. Even in Italy, where the Mediterranean Diet (MD) is a cultural cornerstone, young adults face challenges in maintaining healthy eating patterns. This review examines the nutrition knowledge of Italian university students in relation to their actual dietary behaviors, with the aim of exploring the gap between theoretical understanding and daily practice. The search process followed PRISMA 2020 guidelines across three main databases: PubMed, Scopus, and Web of Science (covering papers published up to June 2025). After screening the literature, 11 relevant studies—10 cross-sectional and one intervention—were selected for the final analysis. The JBI critical appraisal checklists were used to evaluate the methodological quality of these papers. Based on data from over 5,000 students, the overall adherence to the MD is consistently low. Students frequently scored poorly on standard questionnaires such as PREDIMED and KIDMED, including medical students. The main finding is a clear disconnect between knowing what to eat and actually doing it. While many students understand basic nutrition, practical barriers get in the way. Specifically, living away from parents and lacking basic cooking skills are associated with greater consumption of ultra-processed foods. Italian university students face real-world pressures—such as limited time and budgets—that make it hard to maintain traditional Mediterranean eating patterns. Simply teaching them nutrition facts is not enough to change their behavior. To make a real difference, future university programs should focus on hands-on skills, like budget-friendly cooking classes, rather than just offering more theoretical knowledge. Keywords: University Students; Mediterranean Diet; Nutrition Knowledge; Dietary Behaviour; Italy; Systematic Review.