Food and Health Fact #181

Fact #181: Eat like an Italian

By Matthew Rees

Food and Health Fact #181:

Eat like an Italian

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The summer after graduating from high school, I attended a basketball camp in Salsomaggiore, Italy for five days. It was a fabulous the experience – I was the lone American at the camp, other than the Los Angeles Lakers’ Michael Cooper – with one exception: breakfast.

At home, my morning routine typically included two large bowls of cereal. In Italy, each morning's colazione was limited to a stiff cracker or two (something like this) and a few ounces of coffee (which I didn't drink). Lunch – which featured an endless supply of pasta, naturally – couldn’t come soon enough.

I’ve thought of those meager breakfasts in the context of a striking fact about Italy: it has one of the lowest adult obesity rates of any advanced economy in the world (see chart here and below). There’s even evidence that the child obesity rate declined from 2008-16.

This defies common sense. For starters, the country has a rich culinary tradition, which would seem to create a daily incentive to overeat. And while conventional explanations cite Italians’ tendency to consume the celebrated Mediterranean diet, Mark Schatzker, the author of The End of Craving, points to some eye-popping data related to Italian mangiare trends:

“Since the 1950s olive oil and vegetable consumption are down. Italian men have doubled the amount of meat they eat and more than doubled cheese consumption, while Italian women have tripled the amount of meat they eat and more than quadrupled servings of dessert. Their cheese intake is nearly five times what it used to be.” (My Wall Street Journal review of Schatzker’s fascinating book is here.)

Before trying to explain this, a word on Italy’s obesity data. While all of it shows a relatively low rate, compared to other advanced economies, the numbers vary quite a bit. The most recent data, published a week ago by the IBDO Foundation, show that just 11.1 percent of women and 12.9 percent of men, are obese. But a survey from a few years ago reported that 19 percent of men were obese and 21.7 percent of women, which is in line with World Health Organization data from 2016. (Even this higher obesity rate is only half the level found in the United States.)

So whatever the actual numbers are, how do so many Italians manage to keep the kilos from piling up? One of the keys is the quality of the food they’re consuming. All of those meats, cheeses, desserts, and other highly caloric foods? They’re probably not ultra-processed. A study published last year found that just 17 percent of calories ingested by Italian adults come from ultra-processed foods. (In the United States, the figure is 58 percent.)

Ultra-processed foods are typically larded with a plethora of additives that have little or no nutritional value and offer so little satiation that people tend to consume more. How much more? About 500 calories per day – 20-25 percent of what’s recommended for the average American adult – according to an authoritative NIH study published in 2019.

There are certainly other factors. There’s a lot of anecdotal evidence that portions in Italy tend to be smaller – again, a product of not eating much ultra-processed food. And then there are those tiny breakfasts I experienced at basketball camp.

Italians also seem to eat out less – and restaurants are not of the Italian-American “family style” variety (e.g., Olive Garden and its “Never Ending Pasta Bowl”). Schatzker also introduces intriguing evidence about how Italian food has minimal amounts of thiamine, niacin, and riboflavin, whereas Americans foods fortified with these vitamins could be manipulating us to eat more.

Italy’s public awareness of weight gain may be a factor as well. Despite the country’s relatively low obesity rate, the Chamber of Deputies of the Italian parliament unanimously approved a motion in 2019 declaring obesity a chronic disease and calling on the government to develop a national plan for obesity prevention and treatment, with specific guidelines for the “first 1,000 days of life” of children. It’s a sharp contrast with the United States, where even the federal government’s meager efforts are uncoordinated and ineffective.

The news from Italy isn’t all good. The recent IBDO Foundation report finds that 46 percent of the population is overweight, and there are regional disparities, with Italians in the south weighing more than those in the north.

But there are clearly lessons for the United States – and the rest of the world – to learn from the Italian approach to food. That approach has been summed up by a chef in Bologna, Pino Mastrangelo, who told Schatzker, “It comes down to the difference between feeding and eating. Italians don’t want just to feed themselves, they want to eat. . . . They want an experience.”

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