Assessment of Ultra-Processed Food consumption in Rheumatologic Patients: a real-world observation at an outpatient clinic.

Ultra-processed foods (UPFs), according to the NOVA classification system, are industrial formulations, often characterized by high calorie content, considerable amounts of sugars, fats and additives, are increasingly being considered promoters of inflammation and one of the major risk factors for non communicable diseases. However, the impact they have on inflammatory rheumatic diseases, including rheumatic arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA), still remains unclear. An exploratory cross-sectional study was performed at University hospital of Padova between February and June 2025 among rheumatology patients with RA, PsA or axPsA, who completed self-adjusted questionnaires. The content of three preexisting instruments was adapted to create two customized questionnaires: the first was based on the Screening questionnaire for Highly Processed Foods, to measure UPF consumption, while the second combined elements from MedDiet and MedQ-Sus questionnaires to create a single tool to evaluate both adherence to Mediterranean diet and sustainability. Demographic and clinical data had been collected anonymously, and results were evaluated across age, gender and disease. 162 patients were recruited, but after excluding 12 questionnaires due to inadequacy, the final study population consisted of 150 individuals. When analyzing the data, no statistically significant differences were found in the three main variables (age, sex, and pathology), exceptions made for a higher consumption of ultra-processed foods in younger rheumatology patients compared to older ones, and an unexpected more sustainable lifestyle in men rather than women. Overall patients’ percentage of caloric intake from UPFs was higher compared to the Italian national average. A moderate adherence to the Mediterranean Diet was observed. However, this adherence score was mainly determined by a limited intake of foods commonly associated with an unhealthy lifestyle rather than an increased consumption of healthy foods typical of the Mediterranean dietary pattern. The dietary trends identified in patients with inflammatory rheumatic diseases, particularly younger subjects exhibiting high UPFs intake, suggest that nutritional intervention is a promising tool to improve patient outcomes. Integrating nutritional screening and counseling into standard rheumatologic practice is essential to create a more comprehensive and effective management of these conditions.