Research

A Taste of Italy

Where All Roads Lead

Think of Italy, and the mind drifts inevitably to food. Tagliatelle con tartufo nero. Zuppa di pesce. Saltimbocca alla Romana. These days, thinking of Italian food means thinking also of nutrition. The so-called Mediterranean diet, with its essentials of olive oil, pasta, tomatoes, and red wine, is championed for heart health and longevity by doctors and nutritionists around the world. What better place than Italy to study the science of food?

women buying cheese from a cheese vendor in Italy

Rome, in particular, is an ideal place for seeing nutrition in various contexts: public health, quality of life, art and culture. Rome the eternal, rich repository of historical achievement, vibrant 21st-century city, is not only home to some of the world's best food, but also the location of a number of world health organizations.

Penn State nutrition professor Claudia Probart has lived in Rome for the past year, working on problems of hunger and international health at the U.N.'s Food and Agriculture Organization. This summer, as director of the International Program in Nutrition, she is leading a contingent of students—mostly nutrition majors—in exploring the markets, gardens, and restaurants of Rome and its surrounding regions. The object: To better grasp both the science of food and food's many-layered role in society and culture.

This July, our roving associate editor, Dave Pacchioli, joins the group to see what he can learn.

Part One: The Diet to End All Diets

British journalists recently interviewed the World's Oldest Man, a retired shepherd from the Italian island of Sardinia who in January turned 112.

"Love your brother and drink a good glass of wine," is Antonio Todde's prescription for long life. Experts point to a mix of good genes—Todde's mother and father lived to 99 and 90, respectively, and a sister is pushing 100—and the Mediterranean diet. Todde still eats pasta, soup, and a bit of lamb or pork daily.

Not every Italian lives to a ripe old age. Nevertheless, Italians (and other southern European peoples) have long enjoyed a higher life expectancy and lower rates of heart disease and cancer than anybody else.

Mediterranean countrysideCourtesy Claudia Probart

The original Mediterranean diet was simple agrarian fare.

"The first studies took place in the 1950s," said Francesco Branca, a research scientist at the Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione. The name roughly translates as the Italian Institute of Nutrition: Italy's leading center for food science. Probart and her students had trekked to the Institute's sprawling, pale-brick campus on Rome's outskirts, via subway then bus, to hear an Italian perspective.

In the '50s, Branca said, "There was an epidemic of cardiovascular disease in the United States, so scientists began to look at the American diet, and compare it to diets in other countries where disease rates were lower." Italy was one of these countries. The first correlation to jump out at these researchers was a link between heart disease and the consumption of saturated fats.

"This link led them to investigate lifestyle and diet in detail," Branca said. A seven-country study conducted in 1960, and the Euratom study of 1965 (undertaken to gauge the possible effects of nuclear fallout on the continent) drew the nutritional outlines of what came to be called the Mediterranean diet.

large group of students posingDavid Pacchioli

Claudia Probart, left, and IPN students visit the Italian Institute of Nutrition. In front of Probart is Institute scientist Laura Rossi.

The basis of this diet was cereals," Branca said. In southern Italy in particular, over 55 percent of daily food was made from grain—pasta and bread. About 20 percent was fresh fruits and vegetables. Only four percent was accounted for by meat, fish, and eggs. Fat made up about 10 percent, most of that added in the form of (monounsaturated) olive oil.

Above all, it was a diet semplice— the simple agrarian fare of a sunny, impoverished region. It was born of necessity, and coupled, of necessity, with lots of physical exercise: plowing and harvesting and tending after sheep. And yes, it included moderate amounts of red wine.

This, in essence, is the diet that was adapted and formalized into a nutritional pyramid by the Oldways Trust in 1994, the one that is increasingly touted as an alternative to strict low-fat diets for protection against disease. Its special virtue, say adherents, is that it tastes good, which means that people are more likely to stick with it. (No argument here.)

Here, Probart's students are studying the mechanisms by which the Mediterranean diet promotes health. In broad terms, some of the linkages are already clear: Scientists can point to the oleic fatty acids in olive oil as protection against high cholesterol, to the antioxidant qualities of lycopenes in fresh tomatoes, to the cancer-fighting fiber in all those carbohydrates. At a closer level, however, there's a lot that remains to investigate.

"We are just now trying to understand the effects of specific compounds," Branca said.

Part Two: Mangiare bene (To eat well)

It's easy to spot the Americans at an Italian ristorante. They're the ones who are rolling their eyes, holding their breath, glancing at their watches. The evening air is magnificent, the sidewalk table is plunked down in the middle of the 16th century, but somehow atmosphere is beside the point. We're done eating, their body language is screaming. What are we doing still sitting here? The waiters seem oblivious. All around, Italians are engaged in spirited after-dinner conversations.

Italian open air food standDavid Pacchioli

"Mangiare bene e'un piacere della vita." reads the sign on the cheese man’s shop. "To eat well is one of life's pleasures.""

This was the scene at the small neighborhood restaurant near Piazza Navona that Claudia Probart has adopted as her restaurant in Rome. This was what Probart was talking about. In Italy, she was saying, eating well involves more than just food.

"Take a look around," she said, gesturing. "Here we sit in a piazza—an outdoor living space, really an ideal space for eating. For people." A designed space that acknowledges that eating is more than taking in nutrition, it's an opportunity for enjoyment—and for interaction.

Walk into any of the small stores that exist in every neighborhood—the alimentari where you buy figs and strawberries, the panetteria where you purchase bread—and try to get out again without having a conversation: in Italian, in English, or in something in between. "The shopkeepers want an interaction," Probart said, and it's true. The huge outdoor market at Campo dei Fiori, with all the shouting and hugging and playful haggling, often seems like a gathering of old friends.

In a restaurant, too, interaction is important. Truth be told, the waiters in Rome are sometimes jaded. But in smaller places here, and especially in the lesser cities and towns, a culture of intense hospitality prevails. And when you're done eating, they leave you alone. You have paid for the privilege, this benign neglect says. Stay as long as you like. Why would you want to rush off?

Before or after dinner, Italians of all ages still engage in the passagiata, a leisurely, sociable stroll around the neighborhood—a chance at once to chat, to stretch your legs, and to be seen.

roadside stand selling food in ItalyDavid Pacchioli

More than good food: Shoppers and shop-keepers value the chance to interact.

This relaxedness, this social emphasis, in addition to boosting mood and sanity, may well contribute to the health benefits of the Mediterranean diet. In fact, there's some evidence that the social bonds are more important than the food. A famous study conducted in the 1960s in Roseto, Pennsylvania, a small town populated almost entirely by Italian immigrants, found that in spite of a high prevalence of smoking and a diet that was heavy in fat, the town had a remarkably low incidence of heart disease. This fact was attributed to the closeness of the community and the persistence of communal rituals (which have since died out). "People are nourished by other people," wrote Stewart Wolf, the physician who co-authored the study.

In Rome, Probart has assigned her students to get out and experience the social dimension of eating first-hand. "I asked them to plunge in," she said, "since it's easy to be intimidated. I had them write narrative sketches of their encounters in restaurants and shops, just as the architecture students are drawing sketches of the marketplaces.

"I want them to take notice of the cultural differences, to see that this is a different way of eating. Think about it. What is the American equivalent of buon appetito?"

Part Three: Text and Context

It was drizzling in piazza Bologna when Romolo Martemucci rolled up on his motorbike, and some of the students were still shaking off sleep. The morning clouds made a welcome break in the July heat.

Martemucci, an associate professor of architecture at Penn State, is a native Roman. For the past 12 years he has run Sede di Roma, a small center in the majestic Palazzo Doria Pamphili (near the Pantheon) where all Penn State architecture and landscape architecture students spend at least a semester.

people listening to man talking in plazaDavid Pacchioli

Morning in piazza Bologna: Martemucci lectures in front of Ridolfi's post office.

Over the last six weeks, Martemucci had been giving walking tours to Claudia Probart's nutrition students, tracing a route through 2000 years of Roman architecture. This morning's starting point, from the looks of the surrounding buildings, was going to be the modern era.

"Today's topic is context," Martemucci began. "Background. The thing against which the text is read."

Understanding context, he said, "in architecture and in life in general," is essential to the making of meaning—at least as important as being able to read the text itself. In architecture, in particular, "You measure the effective meaning of a building by first establishing its context."

The problem that faced Romans of the early Renaissance, Martemucci said, as they unearthed the piles of rubble that had once been ancient Rome, was the problem of text without context. What were they to make of all these fragments? How did these pieces fit together? "This is the archeologist's business: to find (or invent) a context that makes sense."

Here in piazza Bologna, the challenge is almost the opposite. This textmdash;a modernist post office, designed by the architect Mario Ridolfi in 1934—exists within multiple contexts at once: that of its immediate vicinity, the buildings that surround it, the piazza it faces; but also that of the city of Rome, and beyond, that of all Italy. "We could even try to understand it in reference to all of Italian culture, back to the Etruscans and Magna Graecia."

pieces of ancient architecture affixed to a wallDavid Pacchioli

Fragments of ancient Rome at the basilica of Sant'Agnese

Set against its immediate context, the building doesn't seem to fit in, the students noticed. It doesn't look much like the dowdy 19th-century fronts that face it. But considered as a part of Rome, it makes more sense. Its sculpted, bow-like shape becomes an echo of a curvilinear, Baroque city, a place where, Martemucci said, "There are very few straight lines. Even the large Roman forms are curves-great vaults and arches."

These soft forms are the major reference points for Ridolfi's design, Martemucci suggested. But there's more at work. The deceptively plain façade—of pale Travertine brick—and the general lack of adornment reflect the Rationalism of Ridolfi's own era, which, Martemucci said, "attempted to distill architecture away from ornament." The building doesn't mimic the Roman Baroque, in other words; it re-inteprets it. But the awareness of context is what anchors it in place. "Without that anchor it would be floating in isolation."

So what does all this have to do with food? In the case of nutrition and the Mediterranean diet, Probart and Martemucci argue, understanding the text requires understanding the contexts that give it meaning: the culture and the psychology and, yes, the architecture of Italy.

Part Four: A Global Perspective

When Claudia Probart came to Rome a year ago, it was to work at the Food and Agriculture Organization, the U.N.'s lead agency for nutrition, rural development, and food security. In 1996 FAO hosted the World Food Summit, at which representatives from 186 countries pledged to cut world hunger in half by the year 2015.

"I'm interested in developing the use of technology in nutrition education," Probart said. At all levels, she should add: This spring Probart actually chaired a Penn State doctoral dissertation in University Park via two-way audio/video link from Rome. Back home she is director of Project PA, a state-funded program for improving school food-service that is now being disseminated nationwide by satellite teleconferencing.

woman teaching in a classroom with many students sitting at their desks and smilingClaudia Probart

Probart visiting a rural classroom in Zambia

Probart sees communications technology as a crucial tool for fighting hunger. During travels over the last ten years in Costa Rica, Barbados, and war-torn Croatia, she said, she has been impressed by the desperate need for effective, low-cost nutrition education for public-health professionals in developing and transitional areas. "The Web and teleconferencing are excellent tools for doing this," she argued. "Some people say, 'There are no computers in the villages,' but in the capitals there are. And these countries can't afford to send people abroad for face-to-face education in traditional university settings. They need distance education."

As a visiting nutrition expert at FAO, Probart developed lesson plans for Feeding Minds, Fighting Hunger, an educational program on hunger for schoolchildren around the world, including primary, intermediate, and secondary grades. After they are translated into all official FAO languages, these materials will be officially launched on World Food Day in October. (They are already available for downloading from the Web.)

When that project was completed Probart was sent to Zambia, where she served as a consultant and gave computer-education training sessions to teachers and curriculum developers working to introduce nutrition-intervention programs in the Luapula Valley. Introducing these educators to the rich resources available on the Web, she said, "was like opening a new world for them."

woman in front of screen speaking to an audienceCourtesy Claudia Probart

IPN students at the U.N.'s Food and Agriculture Organization

Returning to Rome, Probart began work to finalize her evolving plan to use the city as a base for teaching international nutrition to Penn State students. She met with Romolo Martemucci and saw the facilities at Sede di Roma, and the two explored the possibilities for the collaboration that has taken shape as the International Program in Nutrition. Rome (and Italy) does seem to be a ferment of food-related issues in particular this summer. Airport inspection lines reflect concern for foot-and-mouth disease. Opposition to genetically modified foods, here as elsewhere in Europe, is louder than it is in the United States. The G8 economic summit just concluded in Genoa inspired anti-globalization signs and graffiti even in small mountain villages.

Probart's students have enjoyed a special perspective on all these developments, hearing talks on food security, bioethics, trade and other topics from experts at the FAO and the World Food Program, also headquartered here. "People tend to think of international nutrition as only dealing with hunger and malnutrition in developing countries," Probart said. "But food standards, safety, and technology are global issues.

"My students are as likely to work in a think tank on bioengineering as they are to join the Peace Corps," she said. "I want them to understand the whole spectrum of issues related to the food we eat."

Part Five: The Italian Paradox

Italian food," if such a thing exists, is a federation: a loose collection of regional cuisines, each distinct and independence-minded. The north-south boundary—dividing tomato sauce from bechamel, or olive oil from butter, depending on the authority—is only a rude starting point. Every Italian region has its own traditional cooking. Beyond that, it seems, every hill town and village can brag of at least one specialty.

man speaking to students inside of a cheese factoryClaudia Probart

The real thing: An introduction to Parmigiano Reggiano

The IPN students have picked up some of this local flavor. On a trip to Emilia Romagna, they visited a factory that makes Parmigiano Reggiano cheese, and another that produces prosciutto, the prize ham of Parma. The authenticity of both products, they learned, is tightly enforced by Italian law. Closer to Rome, they toured a cooperative farm that produces sheep-milk cheese, and a winery that supplies the Vatican. "Quality is important to the Italian," one student wrote admiringly.

Alas, however, things are changing. The alimentari and other small shops may be protected by Roman ordinance, but there's a subterranean supermarket at one downtown Metro stop, complete with processed foods and Muzak. Fast-food shops are on the rise. The Mediterranean diet that Americans are starting to embrace is a diet many younger Italians have long since abandoned.

It began in the 1970s, said Francesco Branca of the Nutrition Institute, when Italy's economic boom opened the country to influences from northern Europe and the U.S. "With changes in life-style, advances in food-preservation technology, and increased imports, diet patterns changed drastically." The intake of cereal-based foods fell off, while dietary protein increased and fats almost doubled.

modern supermarket aisleClaudia Probart

Roman supermarket: An idea whose time has come?

This "westernization" hasn't been all bad, Branca said: Italians today get more vitamin A and C and more fresh fruit than their parents did, especially in the north. With improved transportation and the building of greenhouses, he said, per capita tomato consumption since 1960 has actually doubled. But the big increase in energy density in the Italian diet, combined with a dramatic drop-off in physical activity, he said, has led to a rise in obesity. (Even so, he noted, obesity rates here remain lower than those in the U.S.)

What Branca calls "the Italian paradox" is this: Despite the jump in both fat and fatness, there's been no rise in heart disease in Italy. "In fact, there has been a decrease since 1960 in cardiovascular mortality." More consumption of antioxidants and better medical screening, he speculated, may be parts of the answer.

In fact, since the late 1980s, many Italians have turned back to healthier eating, Branca said, as a result of nutritional campaigns and dietary guidelines. "There is a new culture of health," he said. And a renewed interest, too, in protecting the Italian tradition of eating well: The Slow Food movement, conceived by an Italian journalist in 1986 as a bulwark against global hamburger hegemony, now has some 60,000 members worldwide.

Branca, for his part, doesn't want to go back to 1960. "In terms of human health," he said, "it's better to have tomatoes available year round to everyone, than only a few available only sometimes"—even if the quality isn't quite as good.

"In a sense, the future is to find a good combination of tradition and technology."

Part Six: Back to the Future?

It was a hot afternoon on the via del Corso, and the sidewalks were thronged with 21st-century humanity: Map-wielding tourists in cargo shorts pressed against well-dressed Romans, chattering into cell phones as they returned to work. Around the corner, in the cool and quiet of a 16th-century palazzo grafted onto an ancient Roman wall, architecture students from Penn State and the University of Idaho were sharing their visions of the future.

plate of spaghetti with tomato sauceClaudia Probart

Still life with fork: Food is more than nutrients.

The project: Design a comprehensive structure to house the open-air market of San Cosimato in Trastevere, where produce and cheese have been sold since medieval times.

Romolo Martemucci sat front and center, his red laser pen tracing his responses on scale models made of cardboard and balsa wood. The initial talk was of form: "The real power of symmetry is not bilateral, but in the relation of small to big," Martemucci said. And, "You have to find the line that is most compelling."

Underneath the terms of art, however, was a guiding concern for function. The students' first assignment, after all, had been to go out to San Cosimato and just sit there, observing how people actually used this space. The design problem was to make a structure that was both beautiful and functional. The two were inseparable.

Claudia Probart's nutrition students are learning the same lesson. That food is not only about nutrients. That what we eat and the spaces we live in go a long way toward defining us as human beings. That eating—and living—with an eye toward beauty has a definite bearing on our health. In Italy, it's hard to miss the connection. The question, says Probart, is, "What can we learn here that can be taken back home?"

For Martemucci, the answer is: We can learn something about how to live better in the future. For him, this collaboration between nutrition and architecture is part of a larger vision—of Italy as a model for exploring "the way we exist in the world."

two men in t-shirts pointing to a massive world mapClaudia Probart

Can Renaissance ideals help chart a course for the 21st century?

"Italy presents a few key moments when culture attempted an ideal living condition," he had explained earlier. "This place, for instance—the Palazzo Doria Pamphili—is a sort of ideal 16th-century response, an answer to the question, 'If you had all the resources in the world, what could you do with them?'"

He described another ideal place: the Villa La Magia in Tuscany, which he hopes to see opened to Penn State students next year. "It's one of the 14 Medici villas, the only one to remain intact with all its land. It's got spectacular gardens, an ongoing farm operation, produces its own olive oil and wine. This place is one of a kind in the history of architecture."

But Martemucci's interest in these places is not mainly historical. With an eye toward beauty, he contends, they could become "points of departure" for scholars "in every discipline. Not just art and architecture, but the sciences, engineering, agriculture, agronomy." These could be interdisciplinary centers.

"They were ideal responses, in their day, to the question of how humans should be in the world. We can learn from them. We can use them to to explore how best to live in the third millenium."

Last Updated September 23, 2013