Why aren't Italians as obese as Americans? It's not really what they eat

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I had the great good fortune to spend the entire month of May in Italy.

And if you've heard the reports of people going there on vacation, eating their way through the country, and miraculously coming home a few pounds lighter, I'm here to tell you it doesn't always work out that way.

Those folks, though, often come home scratching their head about why Italians are so much thinner than Americans. And, when you go to Italy, or even read about going to Italy, it does make you wonder. They eat cookies for breakfast. Lunch and dinner are typically multicourse meals, with a pasta or risotto as a first course and a meat dish as a second. There are sometimes antipasti as well. Even schoolkids often get multicourse meals.

And the foods! Charcuterie! Cheese! Ravioli! Pizza! Focaccia! Gelato! On its face, it doesn't seem like a recipe for avoiding weight gain. Yet, according to the U.N.'s Food and Agriculture Organization, the obesity rate among Italian adults was 17 percent in 2022. In the United States, it was 42 percent.

Why? Why, why, why?

Because I know you come here for hard-nosed empiricism, let's take a look at what we know about the differences in Italian and American diets. But don't expect it to tell us much. Countrywide data is a blunt-force instrument: Many other things vary from country to country, and data is often collected in different ways. Still, let's set the stage. (Unless otherwise noted, the data is from the FAO.)

• Italians eat more fish than Americans do, 64 pounds per person per year to Americans' 49 pounds.

• They drink quite a bit less alcohol overall, according to data from the World Health Organization. To account for differences in the alcoholic content of beer, wine and spirits, the numbers are expressed as pure alcohol: 1.9 gallons worth per year for Italians vs. 2.6 gallons for Americans. But they drink more wine: enough to contain 1.1 gallons of pure alcohol for Italians, 0.4 gallons for us.

• According to the International Pasta Organization (and really, it should know), Italians eat more pasta (51.2 pounds per person per year) than anyone on Earth. At 19.4 pounds, Americans don't hold a candle to them.

• Even though vegetables are a vaunted part of the Mediterranean diet, Italians don't eat more vegetables than Americans do.

• Italians do, however, eat much less meat. Americans eat 67 percent more.

• Italians also eat slightly less added sugar, 71 pounds per person in 2021, compared to 74.3 pounds in the U.S.

• Relatedly, Italians drink less soda. It's hard to find comparable data, but U.S. consumers buy an average of about 37 gallons of soda a year, about three times what Italians drink.

• They certainly don't eat low-carb; Italians get a slightly higher percent of calories from carbohydrates than Americans do (48.5 percent vs. 46.4 percent).

To avoid American-style weight gain, though, Italians don't have to eat differently; they just have to eat less. That's the simple thermodynamic truth. And although eating different foods can certainly contribute to eating less, many other factors come into play.

Two of them, in particular, are on vivid display in Italy. Two really important ones, which could easily account for the weight-gain gap: portion size and snacking.

Many years ago, U.S. de facto nutrition-expert-in-chief Marion Nestle told me that portion size in the U.S. could single-handedly account for all the excess calories Americans consume; when portion sizes double, we eat, on average, about a third more. Italian portions of just about everything are smaller, although it's impossible to say just how much. (When I asked Nestle whether there was any rigorous assessment, she laughed in my face, to the extent you can do that by email.)

Snacking, though, may be an even bigger issue, and it is just as resistant to reliable data. But all the Italians I spoke with, including faculty members at the University of Gastronomic Sciences in northern Italy, agreed. Eating between meals (or after dinner) isn't nearly as common in Italy.

But it's not just about eating between meals. It's about living in a food environment that doesn't facilitate eating between meals.

I spent time in both small towns and large cities in the northern half of Italy, and there wasn't food everywhere. The only foods I saw people eating on the street were gelato (a lot!) and focaccia or pizza (not as much). There weren't places to duck in and get a quick Frappuccino. There were no shops selling giant cinnamon buns, or pretzels, or soda. The pharmacies and hardware stores didn't have a rack of candy and salty snacks at checkout.

The places where there was food had very little that you could just pick up and eat. The outdoor markets (and most cities have one) had stall after stall stocked with vegetables, fruit, cheese, charcuterie, bread and meat (alongside clothing, housewares and leather goods). But there were no funnel cakes. There were no smoothies. There were no corn dogs. People browsed the markets without eating. Go figure.

And now the question changes. Why have the people who created the American food environment - Big Food, but also many smaller producers and franchises - been so much less successful in Italy than other places? Italians eat less processed food than Americans do, but they also eat less of it than almost anyone in Europe.

I'm certainly not going to swan in, spend a month in the country and form a theory about how food is wrapped up in Italian identity. There are people who spend their entire careers studying Italian food culture, which has no simple through-line. Italy, as we know it, didn't even exist until the 19th century, and scholars argue about the origins of some of the foods we think of as iconically Italian (pasta and pizza, for starters). Historian Rachel Laudan, author of “Cuisine and Empire,” told me that it wasn't until about the 1960s that what we think of as Italian food fed most Italians. Before that, meat, cheese and eggs - key ingredients of the Italian menu - were mostly unaffordable for the poor.

However it happened, there's no question that food, and a way of eating it, is central to many Italians' sense of Italianness. And a cuisine that forms part of a national identity is something America, a nation of immigrants, doesn't have. Although I'm a big fan of a patchwork food culture where I can enjoy food from around the world, food here is something we eat, not something we are, so we never had that bulwark against the incursion of cheap, junky food everywhere.

I'm not sure Italians can hold out forever. For the time being, they're maintaining a way of eating that means they eat less; there are about 200 calories fewer per person per day in their food supply than in Americans'. But obesity is on the rise, reports the World Health Organization.

But if you ever wonder why Americans are fat and Italians aren't, spend a month in their shoes. Sure, there are differences in what we eat. But the bigger differences are in where, when, how and how much.

And I gotta say, I like their way better.

Tamar Haspel is an American columnist who "writes on the intersection of food and science". Her column, "Unearthed", has twice been nominated for the James Beard Foundation Award, which she won in 2015.

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