Americans love Italian food. Four of the top 20 most successful restaurant chains in the country are Italian (more or less) — Pizza Hut, Domino’s, Olive Garden, and Little Caesars. The international data and analytics group YouGov reports that Italian is our favorite “ethnic” cuisine, beating out Mexican and Chinese, in its analysis of America’s favorite foods from around the world.

But how much of the “Italian” food we eat is really Italian and not Italian-American or just plain made up by chefs or food companies with no Italian background at all? Quite a lot, as it turns out. Most diners probably realize that they won’t find pineapple on pizza in Italy, for instance, but might be surprised that pepperoni is unknown, too. In fact, ordering a pepperoni pizza in Italy will likely get you a pizza topped with peperoni — bell peppers. (There are quite a number of “foreign” foods that are really American.)

Spaghetti and meatballs isn’t found in Italy, either — at least not in anything approximating the way we find it here. Fettuccine Alfredo certainly does exist — it’s a classic of Roman cooking — but it isn’t made with cream, much less peas or ham or other extraneous ingredients.

Click here for 10 Italian dishes you won’t find in Italy

There’s nothing wrong with Italian-American cuisine, of course. It’s popular for a reason: It’s satisfying, comforting, delicious. And there’s nothing wrong with people inventing new dishes based on Italian ideas. But as the quest for authenticity in food becomes ever more popular, it’s good to know where some of our “Italian” favorites actually come from.