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At the same time, Mediterranean lifestyles became more sedentary. Cars, remote controls, video games and long days at the office have dramatically cut the amount of time people spend in physical activity. And with women joining the workforce, there's nobody in the kitchen to prepare a home-cooked meal. Paolo Rao, 59, a school janitor who participated in Keys' study, remembers dinners of vegetables and lunches of homemade bread and dried figs. "Now my grandkids just eat fish sticks," he says.
According to the International Association for the Study of Obesity, 36% of Italian children ages 8 and 9 are overweight or obese; it's one of the highest levels in Europe, rivaling the U.S.'s. Greece and Spain are not far behind. Making things worse is the fact that even if Italians wanted to go back to the old ways, it wouldn't be so easy. Italy's new eating habits have altered the country's production chain as small farms have been replaced with industrial operations that cater primarily to supermarkets, where shelf life and appearance are valued over nutritional content. Sound familiar?
Italy's culture has been so transformed that nutritionists have to tread carefully when promoting healthy eating, since it's a whole new thing to some people. Over the past several years, Rome's school system has revolutionized its cafeterias, replacing prepackaged meals with food that is organic, locally grown and cooked on location. But it stopped short of a broad swerve toward a true Mediterranean diet for fear of angry reactions if it stopped offering daily servings of meat. "We'd get accused of scrimping," says Paolo Agostini, a consultant for the program. "To introduce a real Mediterranean diet, you'd need to really push education--not just to the kids but to parents and teachers too."
That would be an investment worth making. The original Mediterranean diet may have been born of economic necessity, but it turns out that it's even healthier than Keys believed it was. Nutritionists continue to uncover the benefits of a menu rich in fiber, olive oil, fruits and vegetables. According to Laura Di Renzo, a nutritionist at Rome's Tor Vergata University, the Mediterranean diet is more effective than a low-fat diet at minimizing heart attacks and strokes and better than a reduced-carbohydrate diet at cutting the risk of diabetes. It also helps combat colon, prostate and breast cancer and aids in the prevention of neurodegenerative diseases like Alzheimer's.
If Italy chooses to fight its way back toward a healthier style of eating, it will have advantages most other countries don't: a culture that venerates food and a generation that remembers the way things were. Italy's current economic woes make it even more important that the country wake up to the wisdom of such Old World dining. "It's not just a health crisis. It's also a financial crisis," says Antonino De Lorenzo, president of the National Institute for the Mediterranean Diet and Nutrigenomics. "Since we have health care that guarantees service for everyone, there will be higher costs."
For Keys, the diet worked well. He died in 2004, two months shy of his 101st birthday. Following his dietary example requires little more than deciding to eat one of the tastiest, freshest and most satisfying menus ever developed. As resolutions go, that's an easy one to keep.