Nutrition Literacy and Adherence to the Mediterranean Diet in Women Aged 45–70 Years: A Cross-Sectional Analysis from the Ophelia Study in Florence

Background/Objectives: Nutrition literacy (NL) is an important determinant of healthy dietary behaviors, particularly among population groups at increased cardiovascular risk. This study aimed to describe NL and adherence to the Mediterranean diet (MD), and to describe their association, among women aged 45–70 years living in socioeconomically disadvantaged neighborhoods in Florence (Italy). Methods: A cross-sectional study was conducted within the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI). This study represents the second step of Phase 1 of the Optimising Health Literacy and Access (Ophelia) process. Women were recruited in a primary health care setting using a convenience sample. NL was assessed using the Italian-adapted version of the Nutrition Literacy Assessment Instrument (NLit-IT) and the adherence to the MD using MEDI-LITE. Results: Questionnaires filled in by 143 women were included in the analysis. Most participants (63.6%) had “possibility of poor NL”. Regarding the MD, 60.8% showed moderate and 9.1% low adherence. A positive correlation was observed between total NLit-IT and MEDI-LITE scores (rho = 0.214; p = 0.011). In logistic regression analysis, an increase in the NLit-IT total score was associated with a higher possibility of having a moderate/high adherence to the MD (OR 1.157). Only the subscale “Food Label and Numeracy” of NLit-IT emerged as an independent predictor of moderate/high adherence to the MD (OR 1.416). Conclusions: These preliminary findings suggest a possible association between NL and adherence to the MD. Further longitudinal and interventional studies are needed to confirm these results and inform tailored nutrition education interventions.