Abstract There is emerging evidence that the Italian population is switching away from the traditional Mediterranean dietary pattern towards unhealthy eating habits. We derived adults’ dietary patterns (DP) using a principal component analysis (PCA) on food groups intake of a representative sample of the Italian population (INRAN-SCAI 2005-2006), and correlated diet adherence scores with sociodemographic characteristics through multivariable linear regressions. After PCA, “High-fat”, “Western”, “Health-conscious”, “Italian, traditional” and “Junk, out of meal” DPs were retained. Female gender (β = 0.5103; p < 0.001) showed an association with higher adherence scores on the Health conscious pattern. Conversely, being female was associated with lower Z-scores on the High fat (β=-0.1849; p = 0.024), Western (β= -0.0711;p= 0.004) and Italian traditional (β=-0.4799;p<0.001) patterns. Age (β per one year increase=-0.0077;p<0.001) was associated with lower adherence scores in the Western and in the Junk, out of meal (β=-0.0078;p<0.001) pattern. Having either a secondary (β=-0.1301;p=0.016) or tertiary (β=-0.2156;p= 0.001) education level were independently associated with lower dietary Z- scores in the Italian traditional” pattern. Finally, there was wide regional variation, coming from different regions predicted adherence to different DPs. A substantial share of our sample showed unhealthy eating habits, which is consistent with the latest Italian dietary trends. Key messages • Future policies to improve diet quality at the national level should promote food literacy interventions targeting the differences between women and man among different age groups. • This work will provide the basis to investigate the environmental impact of higher pattern adherence scores.