How the Italian people manage to stay slim in the land of pizza and pasta.
By Kathleen Zelman, MPH, RD/LD
WebMD Weight Loss Clinic - Feature
Reviewed by Louise Chang, MD
We've all heard about how the French diet and lifestyle help protect Frenchwomen (and men) from the obesity epidemic that plagues the U.S. But what about the other Mediterranean countries -- like Italy, where obesity is rare despite an abundance of pasta and other delectable dishes? Are there Italian diet secrets we could learn from as well?
Studies show that a Mediterranean-style diet has many health benefits, from reducing the risk of heart disease and cancer, to living a longer life. But something must be getting lost in translation. Many of Americans' favorite Italian foods, like cheese-laden pepperoni pizza and fettuccini Alfredo, are anything but healthy.
On a recent trip to Italy, I decided to see for myself what the Italians' diet secrets were. My trip started in northern Italy, in the Tuscan region, and ended 12 days later further south on the Amalfi coast. My mission was rest, relaxation -- and finding out how the Italians manage to enjoy delectable Mediterranean foods, yet maintain healthy weights.
Italian Diet Secret No. 1: Dine Leisurely
It quickly became clear that the Italians, like other Mediterranean cultures, know how to really enjoy the experience of eating. They relax and socialize while dining for hours, over lunch and/or dinner and coffee. Yet sitting at the table for long periods of time does not appear to lead to excessive eating or drinking.
Before and after dinner, many Italians engage in the passagiata, a leisurely stroll through town. Generations walk together, talking and keeping alive a cherished tradition.
It also became obvious that the typical Italian diet is very different from what you see on an American Italian restaurant menu. Italians enjoy a diet rich in fruits, vegetables, beans, fish, poultry, olive oil, tomatoes, whole grains, dairy, red wine -- and they eat very little red meat.
Typically, Italians start the day with a relatively small breakfast of coffee with milk (rather than cream or half and half) along with cereal or a cornetto, a small biscuit. Lunch varies from family to family and all over the country but typically consists of a "first plate" and "second plate," such as a sandwich and salad, or a small plate of pasta followed by a small piece of fish or chicken and vegetables.
When kids want a midday snack, they usually have yogurt or fruit, not cake, cookies, or candy. Adults often opt for coffee or cappuccino made with milk (not specialty coffees topped with whipped cream).
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Dinner is a larger meal, but is not served too late (to allow time for proper digestion). It's usually pasta with a tomato or vegetable sauce; a small portion of fish or meat; vegetables; and fruit for dessert. Mineral water is the preferred beverage, along with a glass of red wine. All portions tend to be small when compared to our own supersized quantities.
Italian Diet Secret No. 2: Stop When You're Full
Italians are not concerned with calories because they stop eating when they are full, says one Rome physician.
"We eat by our stomachs, not by our heads, and since we dine leisurely, we get the signal that we are full and can just enjoy a coffee and the company," says Stephano Gumina, MD, PhD.
Gumina also describes a very active lifestyle, with lots of walking or bike riding, especially in urban areas of the country. Then there's the Mediterranean-style diet, with plenty of fruits and vegetables, fish a few times a week, lean meats or chicken, whole grains, olive oil, and red wine. All of this helps Italians enjoy long lives, he says.
"Where we differ from Americans: We eat small portions, do not eat after dinner, never in front of the television, computer, or while sitting sedentary reading a book, and no junk food," he says.
In addition, Italians usually satisfy a sweet tooth with fruit instead of higher-calorie desserts. A typical dessert could be fighi e albicocce -- figs and apricots picked from the garden trees. In southern parts of Italy, the enormous and delicate lemons are the basis for desserts such as gelato and lemon ice.
Italian Diet Secret No. 3: Balance Quality and Quantity
On the sunny Amalfi coast up in the village of Ravello, the famous "Mamma" Agata runs a fabulous restaurant overlooking the sea, teaches Italian cooking classes, and plans to publish her first cookbook next year.
She sizes up Italian eating plans quite simply: "We balance the quality and quantity of ingredients -- not too much fat, just enough carbohydrates, lots of fish, chicken, and turkey, and just a little red meat."
"People think Italians eat a lot every day but they are wrong, because while we do eat a big family meal on Sunday, the rest of the week we eat small portions of healthy foods, such as pasta, vegetables, lean meat, fish, and cheese," she says. "But we never drink soda [or eat] chips, junk foods, or mayonnaise."
Olive oil is the preferred oil, used extensively in cooking and on salads. But you won't typically find it on the table for bread dunking as we enjoy in America. Italians enjoy the healthy, monounsaturated fat, but don't overdo it.
"Healthy fats are better than trans or saturated fats, but olive oil is fat, has the same number of calories as other fats, and needs to be eaten in limited quantities," says Gumina.
Italian Diet Secret No. 4: Enjoy Simple, Fresh Food
The Tuscan diet is loaded with beans, which are high in protein and soluble fiber that fill you up for a long time for very few calories. Riboletta soup and pasta e fagioli are two popular hearty dishes that feature beans.
Balsamic vinegar from Modena is another flavorful, yet very low-calorie, product of Italy that is used freely to flavor foods and salads.
Down south, the fresh fish, herbs, artichokes, capers, and gigantic lemons contribute to delicious and healthy cuisine. Pasta is served al dente, with a little olive oil or tomato sauce and vegetables, and always in small portions.
"Our cooking is simple and genuine," says Agata. "We start with fresh ingredients, often from our own gardens. We don't buy precooked foods. [We] eat lots of vegetables, keep it simple, and try to eat like our grandparents."
To make sure the kitchen secrets are passed along from one generation to the next, small children can always be found in the kitchen with their parents -- learning from the masters.
Italian Diet Secret No. 5: Don't 'Diet'
Dieting seems to be a foreign concept to Italians.
"We are not hung up on nutrition labels nor dieting, just eating a healthy, satisfying diet and being active," says Gumina.
Says Agata: "When people go on diets, they get depressed and gain more weight at the end of the diet. So instead, they learn to eat well and only enjoy something sweet on occasion, and this way they are not frustrated."
So the next time you're in the mood for Italian food, serve up a dish inspired by the land of Romeo and Juliet that includes all the health benefits of a Mediterranean diet. Skip fried foods and cream sauces on pasta. Instead, go for a tomato salad, simple vegetable pasta sauce, and use olive oil sparingly. Use herbs, lemon, vinegars, capers, and other intensely flavorful, low-calorie foods for seasoning.
Not only is the Mediterranean way of eating healthy, it's quite pleasurable, says K. Dun Gifford, president and founder of Oldways Preservation and Trust, which developed a Mediterranean diet pyramid in 1993. "Sipping wine, eating fine cheese and succulent seafood is quite luxurious, and an indulgent, lovely eating pattern -- yet it is good for you," he says.
Published July 9, 2007.
SOURCES: Stephano Gumina, MD, PhD, University of Rome. "Mamma" Agata, restaurant and cooking school owner, Ravello, Italy. K. Dun Gifford, president and founder, Oldways Preservation and Trust.
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