Italian-American food reflects a Southern Italian peasant cuisine, mostly from the regions of Siciliy, Campania (Naples), and Calabria, modified with American ingredients, whereas Italian food has remained regional, made with fresh ingredients of the area.Red sauce is the star in Italian-American homes and restaurants.ou sit, order your salad, followed by Italian-American spaghetti and meatballs or linguini Alfredo brought out on large family-style serving plates, and accompanied by a bottle of Chianti perhaps. Now consider scenario number two: You enter the Italian restaurant Trattoria da Luigi in Rome.