I recently ate my way through a family vacation to Italy while wearing two proverbial hats: American tourist and nutrition professional. As I sit here clearing my inbox of backlogged nutrition headlines – apparently, I missed the emergence of “The Potato Hack Diet” (a plan that would have us eating nothing but 2 to 5 pounds of plain, unadorned potatoes for up to five days, in case you missed it too) – I realize what a welcome break it was to spend two weeks eating traditional meals in a place with little interest in food fads.
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It’s gotten me thinking a lot about what it means to live in a place with a longstanding, resilient food culture – and the consequences of living somewhere that doesn’t.
A country’s food culture is an encompassing, unifying approach to food production and eating that pervades how most individuals eat, with broadly-accepted norms that are woven into the fabric of everyday life. All countries have one – the U.S. included – but some countries’ food cultures have been around a lot longer than others and have withstood the test of time. Italy is clearly one such country, and certain aspects of its food culture were particularly salient to me on this trip:
Seasonality
Italy’s food culture emphasizes eating in season. The fruit markets I visited were predominated by the plums, peaches, nectarines and pears locally in season; some imported fruits from further afield – like kiwis, bananas and even berries – were wildly expensive and available only in large supermarkets. Restaurant menus were similarly skewed to tomatoes, zucchini, eggplant and artichokes – the seasonal veggies of the moment – with hardly a broccoli floret or winter root vegetable in sight.
True, there was a noticeable lack of variety in veggies compared to what I’m used to seeing in the U.S. – and as such, I mostly failed to secure the few favored veggies that my kids are accustomed to eating. On the other hand, it reminded me that there's great pleasure in eating enough of the fresh, local foods in season that you truly "get your fill," so you can look forward to the novelty of what the next season will offer. After all, how can I miss you, cauliflower, if you never leave?
Sit-Down, Midday Meals
Italian food culture strongly emphasizes sit-down meals over on-the-go eating. There is a time and a place for eating in Italy, and it’s not in your car, while walking around in the street, while sitting at your desk or while recreating. Most restaurants open for lunch from noon until about 3pm, and if, as a tourist, you miss this window for lunch, your food options are mostly limited to the supermarket or the random open-all-day pizzeria.
Local norms enforce this culture of a proper midday lunch in overt and subtle ways. In Italy, many businesses close from 1:30 to 3:00 p.m. to allow employees a proper lunch break. I think of the contrast to how most of my New York patients scarf down a salad at their desk or skip lunch entirely in favor of meetings or other pressing work demands.
I recall a water park we visited, which opened at 10 a.m., but whose food court was only open from noon to 3:00 p.m. And although the place was teeming with people by 10 a.m. on a sweltering 97-degree day, the ice cream and fro-yo cantinas only opened AFTER lunch ended. The capitalist American in me couldn’t believe that the park’s operators would leave those sales on the table. Imagine how much ice cream they could have sold in this heat! But the dietitian in me recognized that these strong, pervasive norms around when it's appropriate to eat what may deserve some of the credit for protecting a society from the excesses of our free-flowing American food culture, in which it’s never not OK to be snacking or treating ourselves.
Grains Are Venerated, Not Vilified
Whatever your personal opinion is about carbs, grains, gluten or the foods that contain them, I dare you to try to convince the average Italian that carbs in general or wheat in particular are the root of all that ails modern humans. This is a culture in which pasta in every conceivable shape and size features prominently in the daily diet – often made from scratch even by quick-service restaurants – though they are served as entrees in portions far smaller than the typical American appetizer. Thick slabs of fresh-baked focaccia bread topped with tomato and fresh veggies alongside appetizing little bites of bruschetta-topped bread are inexpensive options for a light lunch or accompaniment to a pre-dinner drink.
By European Union law, menus must have labeling for wheat and other potential allergens – and “ gluten-free” was certainly a pretty common call-out (and a welcome one for me, as a traveler with celiac disease.) But the labeling is done in such a different spirit than the laundry list of "free from" claims that have come to dominate trendier American eateries, which are essentially marketing claims attempting to establish a “clean” position in relation to the dietary demons du jour.
In Italy, allergen labels exist for people with food allergies or intolerances to be able to partake safely in the traditional meal. Italian gelaterias offer pre-wrapped gluten-free ice cream cones. And restaurants offer gluten-free pasta – not because of a pervasive belief that gluten-free is somehow healthier or cleaner, but rather because people who have medical trouble with gluten deserve to eat what everyone else in the society is eating.
In addition to pasta offerings, other traditional grain-based foods are widely celebrated on regional menus. We encountered polenta quite a bit, and numerous farro and spelt-based risottos on restaurant menus in places north of Rome as well. To be sure, there were plenty of carb-free meat and seafood dishes available, but they're relatively pricey.
America’s ubiquitously cheap grilled chicken breast is not a thing in Italy, nor is the burger-as-menu-staple. It would be exceedingly difficult and expensive to go a full day in Italy without at least one grain-based meal. So although low-carb staples like cheese and cured meats are essential parts of Italy’s food culture, it’s hard to imagine a keto-type trend gripping the popular imagination there as it has in the U.S. (I checked the health and nutrition shelves of multiple bookshops just to be sure.)
The Take Home
Lest I be accused of viewing Europe through the rose-colored glasses of a recent vacationer, I recognize that Italians are not immune to developing metabolic diseases like obesity and type 2 diabetes. But statistically, they develop these conditions at rates far lower than we Americans do – despite their warm embrace of foods we are increasingly being told to fear.
The obesity rate in Italy is 19.9%, which is far lower than the 36% rate in the U.S. The prevalence of type 2 diabetes among Italian adults is less than half that of American adults – 4.8% versus 10.8%, according to the International Diabetes Foundation’s 2017 data. Unsurprisingly, life expectancy in Italy is at least two years longer than it is in the U.S.
And please don't @ me with anecdotal evidence of your Italian cousin who adopted a fad diet, either. I'm not suggesting that individual Italians can't fall under the sway of global food trends; I certainly did encounter the sporadic turmeric or ginger-celery themed sorbetto among the gelato classics, after all. Rather, I'm suggesting that the culture as a whole is far more resistant to being bullied into throwing away centuries of food tradition based on fleeting pop-culture fueled food fads.
Visit any Italian supermarket and compare their packaged food labels to those you'd find at a Whole Foods Market and you'd see what I mean. While "better-for-you" packaged foods in the U.S. must now contain a laundry list of up to a dozen "free-from" claims, paleo certifications and low-carb designations in order to earn their bona fides with health-oriented consumers, who are being trained to fear everything from soy, grains and gluten to corn, peanuts and dairy. My toilet cleaner literally carries a "gluten free" claim as a case in point.
Similar products on Italian supermarket shelves speak to a very different and more limited set of concerns among consumers. Package "free-from" claims were mostly limited to "senza lattosio" (lactose free, which incidentally is not the same as dairy-free) and either "no grassi idrogenati" or "senza olio di palma" – no hydrogenated oils or no palm oil – all saturated fats. Preservative-free claims ("no conservanti") were also quite easy to spot. Gluten-free claims were actually not widespread on products across the supermarket, but rather limited to a very narrow set of specialty pastas or crackers/cookies, suggesting that it is not a claim with widespread consumer appeal.
And then there’s the matter of health-related quality of life. Born into a society with such a longstanding, traditional food culture, Italians seem far more at peace with their diets than we Americans. Dietary decisions are whole lot less complicated – and certainly less fraught.
Reflecting on the anxiety-driven, fear-based collective eating disorder that has come to represent wellness culture in the U.S., in which celebrities and social media influencers can convince us that legumes are inflammatory and diets made up of 80% fat somehow are not, I’m reminded of the famous quote attributed to Alexander Hamilton: “Those who stand for nothing, fall for anything.”